Problem: Soluble immune checkpoint molecules constitute the emerging novel mediators in immune regulation. Their role in the pathogenesis of endometriosis has not been fully addressed. In this study, we aimed to investigate the relationship between the clinical manifestation of endometriosis-associated infertility and the level of four soluble immune checkpoints: sCTLA4, sHLA-G, sPD-1, and sPD-L1. Method of study: The soluble immune checkpoint concentrations in serum and peritoneal fluid from 88 patients who underwent laparoscopy were evaluated by the enzyme-linked immunosorbent assay (ELISA). Clinical and hematological parameters were documented and analyzed. Results: Endometriosis cases were evident to have significantly higher levels of serum sPD-L1 and all four molecules in peritoneal fluid compared to non-endometriosis control. Contrary, no significant differences were found in the concentration of serum sCTLA-4, sHLA-G and, sPD-1 between endometriosis and control group. There were significant positive correlations between serum and peritoneal fluid concentrations of sCTLA-4, sPD-L1, and sHLA-G. Serum sPD-L1 could discriminate endometriosis-related infertility to other pathological control. At a cutoff of 14,61 pg/ mL, serum sPD-L1 had a sensitivity of 77% and specificity of 83%. Moreover, sPD-L1 level showed positive correlations with pelvic adhesion score and myeloid cell count. Conclusion: The elevated level of sPD-L1 in serum and immune checkpoint molecules in the peritoneal fluid could represent the hallmark of immune regulation in endometriosis. Serum sPD-L1 could serve as a potential noninvasive endometriosis biomarker. Also, the immune compartment related to the local immune checkpoint molecules may be implicated in biological mechanisms underlying endometriosisrelated infertility.

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Objective To evaluate IL-1β, IL-6, IL-8, and IL-12p70 levels in serum and peritoneal fluid in women related to infertility and pelvic pain. Methods Eighty-seven women were diagnosed with endometriosis or cases related to infertility. IL-1β, IL-6, IL-8, and IL-12p70 levels in serum and peritoneal fluid were determined by ELISA. Pain assessment was evaluated by the Visual Analog Scale (VAS) score. Results Serum IL-6 and IL-12p70 levels increased in women with endometriosis compared to the control group. Serum and peritoneal IL-8 and IL-12p70 levels correlated with VAS scores in infertile women. A positive correlation was also found between peritoneal IL-1β and IL-6 with VAS score. A significant difference in peritoneal IL-1β levels was associated with menstrual pelvic pain, while peritoneal IL-8 levels were related to dyspareunia, menstrual, and post-menstrual pelvic pain in infertile women. Conclusion An association of IL-8 and IL-12p70 levels were related to pain in endometriosis, as well as a relationship between cytokine expression and VAS score. Further studies should be addressed to investigate the precise mechanism of cytokine-related pain in endometriosis.

background: Implant as long-acting reversible contraception (LARC) is ideal for Indonesian women. Two-rod implant (2x75mg levonorgestrel) is the most common implant used in Indonesia. Another alternative method is a one-rod implant (1x150mg levonorgestrel). objective: This study evaluated the effectiveness, changes in body weight (BW), and menstrual cycle between the one-rod and two-rod implant acceptors. method: This study was an RCT design with phase II clinical trials; 179 subjects were recruited. Subjects were met with inclusion and exclusion criteria and divided into one-rod and two-rod groups. The variables were evaluated within 12 months. result: This study involved 70 subjects in the one-rod implant group and 66 subjects in the two-rod implant group. At 12 months, there were no differences between the effectiveness of the two types of contraception, and pregnancy was reported in 1.26% vs 1.31%. The concentration of levonorgestrel in the one-rod group was 0.31 ng/dL as the median (IQR: 0.33 ng/dL) and 0.34 ng/dL as the median (IQR: 0.33 ng/dL) in the two-rod group (p=0.438). The BW in the two-rod group increased significantly in month six (p=0.035) and twelve (p=0.017) but not in the one-rod group. Menstrual cycle changes occurred in 51.4% of subjects and 57.6% of subjects in the one- and two-rod groups (p=0.584), respectively. conclusion: At 12 months, one-rod and two-rod implants had similar effectiveness and concentration of levonorgestrel. Significant weight gain happened in the two-rod group, and the weight gain increased in months six and twelve. Menstrual cycle changes have occurred in both.

Introduction: Earlier menopause has been associated with increased risk of cardiovascular disease, osteoporosis, shorter life expectancy and even cognitive decline. There are many factors that cause differences in the age of menopause in women, one of these environmental factors is a history of night shift work as a consequence of a job. It is not yet known whether female medical workers, with a history of night shifts, get earlier menopause.Methods: This case control study was conducted among 57 female night workers of the Dr. Soetomo General Academic Hospital. Data collection was conducted from December 2019 - March 2020. The study sample was postmenopausal health workers (nurse and midwife) and administrators. The instrument used in this study was a list of interview questions. The data was processed using SPSS software release 23.Results: The results show that from 45 children diagnosed with ALL, 53% are of the age ≤ 5 years old, with 58% males and 42% females. 13% of the patients are in the high risk group and 87% are in the standard risk group. Nutritional statuses of patients are 2% of them obese experienced remission after induction phase therapy, 56% normal with 80% of them experienced remission. 40% underweight with 89% of them experienced remission and 11% not experienced remission, 2% malnutrition and experienced remission. There is no correlation between the nutritional status of children with acute lymphoblastic leukemia with the outcome of induction phase (p = 0.798).Conclusion: In conclusion, there is no correlation between nutritional status and remission outcome of patients with ALL in the induction phase of therapy. However, high percentage of underweight patients shows nutrition needs special attention to improve therapy outcomes.