Melasma is a hyperpigmentation arising due to the buildup of melanin in the epidermis, dermis, or both. Melasma can appear on the users of hormonal contraceptives such as the pill or injection combination and tend to appear on face areas so that it can be influencing the life's quality. The appearance of melasma on the user of injection and pill combination is affected by the presence of estrogen and progesterone hormones which is contained in contraception and it will cause kind of accumulation in the body. Estrogen and progesterone hormones are interrelated in affecting cells pigmentation, as one of melanocyte's receptor. The difference of hormonal substances can give different influence to the genesis of melasma. This research aims to know the correlation between melasma occurrence with the use of injection combination of hormonal contraceptives and pills combination in Dwi Astutik Maternity Home, Petungsewu Village in Dau District of Malang Regency. The research design was used the case-control sampling technique using a purposive sampling technique. The number of respondents as many as 34 people, on each group (case and control). Data analysis using the Chi-Square Test and obtained the value of α = 0.015 (significant) and the odds ratio of 3.378. The conclusion of this study is there is a correlation between injection and pill combination and the genesis of melasma. the use of injection combination 3.378 times is riskier to emerge melasma than the use of pill combination. ABSTRAKPeningkatan penggunaan kontrasepsi hormonal di Indonesia berhubungan dengan beberapa keuntungan yang diberikan, seperti efektif, murah, dan terjangkau berbagai kalangannamun terdapat salah satu efek samping yang dianggap merugikan bagi penggunanya, yaitu melasma. Melasma adalah hiperpigmentasi yang ditimbulkan akibat adanya penumpukan melanin pada

The etiology of preeclampsia consists of 2 stages, first, abnormal placentation which can increase ROS, and the inflammatory response then progresses to angiogenic imbalance. Pravastatin has a pleiotropic effect that can act as an antioxidant, anti-inflammatory, and anti-apoptotic, which is expected to be a vasodilator for angiogenic balance and reduce proinflammatory cytokines. This study aimed to examine the effect of pravastatin on the expression of angiogenic factors (sFlt-1 and VEGF) and inflammatory response (TNF-α and IL-10) in the placenta of preeclamptic rat models. This study is an experimental study, only post- test with a control group design using the placenta of preeclamptic rat models (L-NAME induced) and given pravastatin in 3 doses, namely 2 mg, 4 mg, and 8 mg.

Background: Postpartum blues is one type of psychological distress. It can happen when a mother fails in taking in phase. It is a normal peripartum occurrence after delivery. Postpartum blues is usually characterized by several clinical symptoms such as irritability, anxiety, fluctuating mood, etc. Early identification can help in proper treatment. Objective: To identify postpartum blues condition and understand the referral system for maternal problems. Methods: This is a qualitative study with a case report method on postpartum mother which assessed with Edinburgh Postnatal Depression Scale (EPDS) and followed up with maternity needs. Results: Evaluation of maternity need by nursing and midwifery concepts bring a significant average decrease in the value of postpartum blues. In the first screening, the score is 11, and now the score showed <9. Conclusion: Early detection and appropriate intervention by healthcare providers to collaborate on mitigating these interrelated risk factors would be more effective in reducing rates of postpartum blues. Keywords: psychiatric syndrome, postpartum blues, depression, EPDS.

Introduction: Preeclampsia has two stages: improper placental and maternal circulation. Abnormal trophoblast invasion causes uteroplacental ischemia and hypoxia. Ischemia in the placenta produces endothelial cell dysfunction, which is defined by a change in endothelial cell activity to a reduced ability to vasodilate (decreased eNOS) and prothrombotic conditions (decreased PECAM-1). Reduced maternal eNOS activity and PECAM-1 can cause preeclampsia. Pravastatin is the statin class's most hydrophilic medication, and it limits placental transfer. Pravastatin can reduce endothelial dysfunction by targeting pleiotropic effects in pregnancy. The aim was to show the effects of pravastatin on the eNOS and PECAM-1 expression in the placenta of preeclampsia rat model. Materials and Methods: This is a true experimental study with only a post-test and a control group design. The sample was biological material in the form of placental tissue from a pravastatin-treated preeclampsia rat model (using L-NAME exposure). This research was divided into five groups, each with five samples. The parameters studied were eNOS and PECAM-1 expression. Results: The Shapiro-Wilk test result was significant (p>0.05). Annova tests on eNOS (p=0.000) and PECAM-1 expression (p=0.000) confirmed the hypothesis. The Tukey test showed significant differences in eNOS (sig. 0.001) and PECAM-1 (sig. 0.000) expression between normal and preeclampsia rats. Positive controls and treatment groups P1, P2, and P3 all showed significant changes in eNOS and PECAM-1 expression. Pravastatin dose considerably increased eNOS (p=0.015; r=0.536) and PECAM-1 (p=0.000; r=0.734) expression.. Conclusion: Pravastatin has been shown to increase eNOS and PECAM-1 expression in the placenta of preeclampsia rat model.