BACKGROUND Global nations have enforced strict health protocols because of the COVID-19’s high transmission, infectivity, and mortality. As shown by increased online learning and video conferencing, the employment and education sectors are shifting to home-based activities. Video conferencing as a communication medium has subtly led to zoom fatigue. This study aimed to analyze the risk factors of zoom fatigue for early prevention and treatment. METHODS This cross-sectional study was conducted on 335 Indonesian university students selected by purposive sampling in July 2021. Data were collected using a demographic questionnaire including online courses duration during the COVID-19 pandemic; Pittsburgh sleep quality index; depression, anxiety and stress scale-21; and zoom & exhaustion fatigue (ZEF) scale through Google Form (Google LLC, USA) distributed via social media and student forums. Association and correlation tests were used, and the model was developed using linear regression. RESULTS The respondents were aged 21.3 (1.8) years with 12.8 (5.1) months of online courses during the COVID-19 pandemic and a ZEF scale of 2.8 (0.9). Students with higher ZEF had irregular physical exercise, poorer sleep quality, longer video conferencing sessions, longer months of courses during the COVID-19 pandemic, and higher mental illness (i.e., stress, anxiety, and depression). Smoking negatively correlated with fatigue (r = −0.12). The model for ZEF showed good predictability for zoom fatigue (p<0.001, R2 = 0.57). CONCLUSIONS Daily exposure to video conferencing in educational settings throughout the pandemic has drastically increased zoom fatigue. The stakeholders must act immediately to minimize the risks while providing maximum benefits.

<p>Pelvic organ prolapse is a condition of descent or herniation of woman’s pelvic organs through the birth canal or onto birth canal space. As someone gets older, the incidence of pelvic organ prolapse increases, due to weakening of ligaments and muscles as suspensor for the pelvic organs. Prolapse may or may not show symptoms. Symptoms that occur are associated due to pressure of the pelvic area, difficulty urinating and defecation. The staging of pelvic organ prolapse utilized the Baden-Walker System and Pelvic Organ Prolapse Quantification (POP-Q). Management for pelvic organ prolapse can be done conservatively and operatively, and the decision of which approach should be taken based on the patient’s condition and choice.</p>

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(English) Objective: To report a rare case of thanatophoric skeletal dysplasia type 2 that we diagnosed during prenatal period; and to provide further review of dilemmas in diagnostic methods and management, based on appropriate literatures and guidelines available.     Methods: Case report Case: A 33-year old primigravida women was diagnosed with pre-term pregnancy (24th weeks of gestation) and intra-uterine singleton live fetus with thanatophoric skeletal dysplasia type 2 via ultrasonography. Pregnancy termination via elected caesarean section at 26th weeks of gestation was performed per the patient request after considering the fetus’s lethality. A female neonate was born weighing 980 grams with frontal bossing (Head Circumference: 26 cm), lower set of ears, hypertelorism, bilateral exopthalmos, short neck, rhizomelic short extremities, and narrow thorax (Thorax Circumference: 17 cm). The newborn was immediately transferred to NICU for post-natal management and observation. The newborn is in stable condition for the first several hours; nevertheless, significant destabilization occurred afterwards and the newborn deceased approximately 10 hours after birth due to cardiorespiratory failure. No further invasive resuscitative efforts and post-mortem examinations were performed on the parent’s request. Conclusion: Thanatophoric dysplasia is primarily diagnosed using ultrasonography, which has a high detection rate for both diagnosis and prognostications. Even though, There has been a dilemma in performing molecular diagnostic testing, prediction of recurrence risk in future pregnancies can be assessed with its use. Although still remains a challenge in ethical and medicolegal grounds; proper management requires holistic considerations of maternal, fetal, and perinatal aspects. Keywords: Thanatophoric, Skeletal Dysplasia, FGFR3 mutation Abstrak (Indonesia) Tujuan: Melaporkan suatu kasus langka displasia skeletal tanatoforik tipe 2 yang kami diagnosa dalam periode perinatal; serta memberikan ulasan lanjut mengenai dilema dalam metode diagnostik dan manajemen, berdasarkan literatur dan pedoman ilmiah yang tersedia. Metode: Laporan Kasus Kasus: Seorang perempuan primigravida berusia 33 tahun di diagnosa dengan kehamilan pre-term (24 minggu gestasi), janin tunggal hidup intrauterin dengan displasia skeletal tanatoforik tipe 2 via ultrasonografi. Terminasi kehamilan dengan Sectio Caesarea dilakukan atas permintaan pasien setelah mempertimbangkan letalitas janin. Lahir bayi perempuan berat 980 gram, dengan ‘frontal bossing’ (lingkar kepala: 26 cm), kedua telinga rendah, hipertelorisme, eksoftalmos bilateral, leher pendek, ektremitas pendek rizomelik, dan rongga dada kecil (lingkar dada: 17 cm). Bayi segera dipindahkan ke NICU untuk manajemen paska-natal dan observasi. Kondisi bayi stabil selama beberapa jam pertama; namun, ketidakstabilan yang signifikan terjadi setelah itu dan bayi dinyatakan meninggal 10 jam paska kelahiran dikarenakan kegagalan kardiorespirasi. Bayi tidak dilakukan tindakan resusitasi invasif dan pemeriksaan paska kematian atas permintaan pasien. Kesimpulan: Displasia tanatoforik dapat di diagnosa secara primer menggunakan pemeriksaan ultrasonografi (US) dengan tingkat deteksi diagnosis dan prognosis yang tinggi. Meskipun pemeriksaan diagnostik molekular  masih menjadi dilema, pemeriksaan ini dapat memprediksi resiko rekurensi pada kehamilan selanjutnya. Walaupun masih merupakan suatu tantangan dalam segi etika dan medikolegal; manajemen ideal perlu mempertimbangkan secara holistik seluruh aspek yang mencakup: ibu, janin, dan paska kelahiran. Kata Kunci: Tatanoforik, Displasia Skeletal, Mutasi FGFR3 Correspondence: Gezta Nasafir Hermawan, Faculty of Medicine, Sam Ratulangi University. Email: gezta.hermawan@gmail.com

<p><em>Cervical cancer is one of the most prevalent cancer in the world and caused by Human Papilloma Virus (HPV). The pathogenesis of cancer as whole (50%) is caused by gene mutation. HPV stimulates carcinogenesis on cervix epitel cells by HPV-Encoded viral oncoproteins, E6 and E7, which will inhibit tumor suppressor gene activation, such as p53 gene. HPV-encoded E6 oncoprotein  is able to directly attached on p53 causing degeneration via E6-AP-mediated ubiquitination pathway. Moreover, overexpression on YY1 gene has significant role on the progression of HPV on cervical cancer. YY1 inhibits p53 activation dan inhibits apoptosis on cells infected by HPV. Overexpression of YY1 induces reduction of endogenous p53, which will inhibit p53 function as tumor suppressor gene.</em></p><p><strong><em>Keywords: cervical cancer, HPV, P53, YY1</em></strong></p>