Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection that causes novel Coronavirus Disease 2019 (COVID-19) has become a major health problem worldwide and been declared a pandemic since March 2020 by WHO. One special population that poses a challenge is pregnant women with COVID-19. There have not been many studies related to COVID-19 in pregnancy. In this study, we present five serial cases of Remdesivir treatment for COVID-19 in pregnant women with moderate to severe symptoms. Case Illustration: We briefly describe five serial cases being treated with Remdesivir therapy during hospitalization. Four cases were delivered by cesarean section, and one was delivered vaginally in gestation week 37. All cases showed a shortened duration of hospitalization, rapid improvement in clinical symptoms, and no adverse events were observed in mothers, fetuses, and neonates. Discussion: Remdesivir, an inhibitor RNA Polymerase, has been used in COVID-19 treatment and is known to shorten recovery time in nonpregnant women. Some studies have shown no adverse effects on Remdesivir for pregnant women. Based on randomized control trial (RCT) during the Ebola epidemic, Remdesivir was safe to use for pregnant women. All cases showed reduced hospitalization time and better clinical outcomes without maternal, fetal, or neonatal adverse events. Conclusion: Remdesivir protocol for pregnant women with moderate to severe symptoms of COVID-19 has resulted in better clinical improvement with a shorter recovery period and no adverse effects during the hospitalization period. Further studies and RCT are warranted to evaluate the biosafety and effects of Remdesivir in pregnant women.

Background: Multi-drug-resistant Tuberculosis (MDR-TB) remains a public health problem in developing countries such as Indonesia. The extensive parenchymal damage due to MDR-TB could manifest as an irreversible destroyed lung, leading to respiratory and also cardiovascular complication. Its occurrence in pregnancy is uncommon but is highly associated with higher mortality and morbidity for both maternal and fetal. Case Report: We report a case of 24 year old primigravida in National Respiratory Center Hospital, diagnosed with an unilateral destroyed lung due to MDR-TB in pregnancy at 32 weeks of gestational age. On initial presentation, she reported fatigue, nausea, night sweats, chronic dyspnoe and was found to have complete left destroyed lung. Her disease was managed during pregnancy using long-term oxygen therapy despite persistent desaturation. Conlusion: Aside from frequent monitoring, prolonged oxygen therapy might benefit the chronic hypoxia condition in gestational destroyed lung due to previous MDR-TB infection, for preventing maternal-fetal mortality and morbidities, such as respiratory failure and IUGR. Tuberkulosis MDR rekuren dengan Kerusakan paru unilateral dalam kehamilan : Sebuah laporan kasus Abstrak Latar Belakang: Tuberkulosis Multi-drug-resistant (TB-MDR) tetap menjadi masalah kesehatan pada negara berkembang, seperti Indonesia. Kerusakan parenkin luas yang diakibatkan oleh infeksi TB-MDR dapat bermanifestasi sebagai kerusakan paru ireversibel, dengan komplikasi respiratorik dan kardiovaskular. Kejadian kerusakan paru akibat TB-MDR dalam kehamilan jarang terjadi, namun berdampak pada peningkatan mortalitas dan morbiditas pada janin dan ibu. Laporan Kasus: Studi ini melaporkan kasus perempuan primigravida 24 tahun didiagnosa dengan kerusakan paru unilateral akibat infeksi TB-MDR pada kehamilan 32 minggu di RS Pusat Paru Nasional. Pada pemeriksaan awal, didapatkan pasien mengeluhkan kelelahan kronik, nausea, keringat malam, sesak kronik dan didapatkan memiliki kerusakan paru kiri komplit. Keadaan pasien dalam kehamilan ditatalaksana dengan terapi oksigen jangka panjang untuk mengatasi desaturasi persisten Kesimpulan: Di samping pengawasan ketat, terapi oksigen jangka panjang dapat menjadi tatalaksana utama untuk kondisi hipoksia kronik pada kerusakan paru dalam kehamilan akibat infeksi lama TB-MDR untuk mencegah morbiditas dan mortalitas ibu dan janin, seperti gagal napas dan pertumbuhan janin terhambat (PJT).

Catamenial pneumothorax is a rare primary spontaneous pneumothorax associated with the menstrual phase and is the most common manifestation of thoracic endometriosis syndrome. We report a case of a 32‐year‐old woman with a history of endometriosis who presented to the emergency ward with a chief complaint of dyspnea and right‐sided chest pain, and a chest X‐ray showed a right pneumothorax. Initial management was by placing a chest tube to expand the right lung. The patient underwent a video‐assisted thoracoscopy and talc pleurodesis, during which we found multiple perforations in the tendinous part of the diaphragm. A partial resection of the tendinous part of the diaphragm was done. Our review indicated that primary spontaneous pneumothorax in women should be suspected as catamenial pneumothorax due to thoracic endometriosis. The gold standard procedure for diagnosis and treatment is surgery. Hormonal therapy is an effective choice to prevent and reduce post‐operative recurrence.

The association between insulin resistance (IR) and ovarian neoplasm is little known. The present study attempted to investigate the difference in clinicopathological characteristics, metabolic parameters, and IR prevalence between benign and malignant ovarian neoplasms. The cross-sectional study involved 52 non-diabetic women with benign (n=27) and malignant (n=25) diagnoses in a tertiary hospital in Indonesia. Fasting insulin level (FIL), homeostatic model assessment of IR and β-cell dysfunction (HOMA-IR and HOMA-β), fasting IR index (FIRI), and quantitative insulin sensitivity check index (QUICKI) were used as surrogate markers to evaluate IR. Parametric and nonparametric statistical tests were employed to analyze the different parameters between the two groups. Pearson or Spearman's rank test assessed the correlation between markers and clinical variables. Results revealed that patients with benign neoplasms were younger than those with malignant neoplasms (38.63 vs. 47.40 years; P=0.003) and had a higher median body mass index (BMI) than their counterparts (22.98 vs. 18.61 kg/m 2 ; P=0.014). Different characteristics between benign and malignant neoplasm cases were found in menopausal status, ovary side affected, systolic blood pressure, and BMI classes. Endometrial cysts and mucinous carcinoma were the most often diagnosed benign and malignant neoplasms. Malignant neoplasms had a lower median HOMA-β score than benign neoplasms (49.33 vs. 75.79; P=0.011), indicating more severe β-cell dysfunction. No significant difference was observed in the prevalence of IR between benign and malignant ovarian neoplasms for the following values of each marker: FIL (25.9% vs. 12.0%), HOMA-IR (37.0% vs. 28.0%), FIRI (51.9% vs. 48.0%) and QUICKI (81.5% vs. 92.0%). The indicators of FIL, HOMA-IR, HOMA-β, FIRI, and QUICKI correlated with each other and confirmed the reliability of these surrogate markers for measuring IR status in ovarian neoplasms. In brief, benign ovarian neoplasms tended to have more IR when compared with malignant ovarian neoplasms. However, this difference was not statistically significant.