Introduction:The incidence of placenta accreta spectrum (PAS) has increased, but the optimal management and the optimal way to achieve vascular control are still controversial. This study aims to compare maternal outcomes between different methods of vascular control in surgical PAS management. Material and methods: A retrospective cohort study on consecutive cases diagnosed with PAS between 2013 and 2020 in single tertiary hospital. The final diagnosis of PAS was made following preoperative ultrasound and confirmation during surgery. Management of PAS using cesarean hysterectomy with internal iliac artery ligation (IIAL) was compared with two types of vascular control in uterine conservativeresective surgery (IIAL vs identification-ligation of the upper vesical, upper vaginal, and uterine arteries).Results: Over an 8-year period, 234 pregnant women were diagnosed with PAS meeting the inclusion criteria. Uterine conservative-resective surgery (200 cases) was associated with lower mean blood loss compared with cesarean hysterectomy with IIAL (34 cases) in all PAS cases (1379 ± 769 mL vs 3168 ± 1916 mL; p < 0.001). In subanalysis of the two uterine conservative-resective surgery subgroups, the group with identification-ligation of the upper vesical, upper vaginal, and uterine arteries had a significantly lower blood loss compared with uterine conservative-resective surgery with IIAL (1307 ± 743 mL vs 1701 ± 813 mL; p = 0.005). Women in the hysterectomy with IIAL group had more massive transfusion (35.3% vs 2.5%; p < 0.001; odds ratio[OR] 21.3, 95% confidence interval [CI] 6.9-66), major blood loss (>1500 mL) (70.6% vs 34%, p < 0.001; OR 4.7; 95% CI 2.1-10.3), catastrophic blood loss (>2500 mL)

Background: Maternal with to COVID-19 is a new maternal emergency issue leading to maternal morbidity and mortality. In Indonesia, the number of cases of maternal mortality with COVID-19 began to increase. This study aims to determine the characteristic of maternal deaths due to COVID-19 in a tertiary care center in Indonesia.Method: This observational-retrospective study descriptively analyzed 15 maternal deaths due to COVID-19 admitted to the Department of Obstetrics and Gynaecology at the tertiary care teaching hospital from March to December 2020. We included suspect, probable, and confirmed COVID-19 in the samples. Therefore, the total sampling was recorded and analyzed descriptively by Microsoft Excel.Results: There are fifteen maternal deaths from 429 maternal cases with COVID-19 in our hospital. The majority ages were in the age group 19-35 years (73.33%); body mass index (BMI) 25-29.9 (33.33%); five days average length of stay; one comorbidity (53.33%); and multiple comorbidities (20.00%). The case fatality rate (CFR) of maternal death due to COVID-19 is 3.49% were profiled out this study. The most cause of death was acute respiratory distress syndrome (ARDS) (53.33%).Conclusions: Most common characteristics of the object of this study were the age between 19-35 years, comorbidity, obesity, upper respiratory tract symptoms, elevated D-dimer, and the complication of ARDS, which are the risk factors of the deaths.

Research that examines the effect of cooperative learning teams games tournament types on student learning outcomes has been done a lot, but the results of these studies have not received further study to be summarized and tested again the effectiveness of the effect of the learning model used. This study aims to analyze the effect of the use of a team games tournament type cooperative learning model with spinning wheel media-based local wisdom on the learning outcomes of elementary school students. The method used in this research is meta-analysis. The collection of data through online searches using the Google Scholar platform as many as 15 articles were collected with the details of 10 articles representing the learning models of team’s games tournaments and spinning wheel media while the remaining 5 articles are educational articles based on local wisdom. All articles are then analyzed with differences and similarities in data and then reprocessed using SPSS Version 25 using paired sample t-test and showing the Sig. (2-tailed), i.e. (0, 019) <α (0.05). So, H0 is rejected and it can be concluded that there is a significant difference from before and after the use of the learning model that assisted team’s tournament games wheel media in science subjects.

This study aims to determine the effect of size of local government and wealth of local government on the level of disclosure of Local Government Finance Report. The sample in this study amounted to 140 District/ City of Local Government Finance Report in Central Java during the years 2015-2018, purposive sample method using path analysis. The analysis technique used is determine the estimation of panel data regression models, classic assumption test, multiple linear regression, t-test, f-test and test the coefficient of determination, with using E-views 10. The results showed that the variable of size of the local government have no effect on the level of disclosure of Local Government Finance Report, while the wealth of local government have effect level of disclosure of Local Government Finance Report.

Background: Endometrial cancer is the second most common type of gynecologic malignancy. Studies on factors of lymphatic metastases are few. This study aimed to determine the clinical and pathological characteristics that can predict lymph node metastases. Purpose: To determine the correlation of clinicopathological characteristics with LNM (Lymph Node Metastases) in Endometrial Cancer (EC). Methods: This study used observational analysis and a cross-sectional methodology to examine medical records of endometrial cancer patients who underwent lymphadenectomy sampling surgery in 2018-2020. The risk factors are determined using multivariate analysis. Results: The stage IB and IIIC1 patients accounted for the most (17.27%) of the 63 research participants. Only one patient (1.1%) is in stage IIIB. The rests are stage IA and IIIA, each including eight patients (8.13%), and stage II, which has twelve people (12.19% ). There were 17 patients with endometrial cancer who had lymph node metastases (27% ). The incidence of LNM is 23.2% in endometrioid types, while the incidence of metastases is 57.1% in non-endometrioid kinds. The incidence of LNM in EC was not linked with the patient's age (p=0.628), BMI (p=0.190), parity (p=0.194), or menopausal status (p=0.970). The study found no correlation between LNM and histological kinds (p=0.078), histopathological degrees (p=0.514), or myometrium invasion (p=0.134) in EC. The risk factors most linked with LNM in EC are LVSI (+) (OR = 0.10; IK 95% 0.19–0.56; p = 0.009) and cervical invasion (OR = 0.07; IK95 percent 0.008–0.64; p = 0.019) according to the results of multivariate analysis. Conclusion: Cervical invasion and LVSI (+) are the risk factors most associated with the incidence of LNM.