ObjectiveIndonesia has overcome several barriers to the growth of kidney transplantation within the past decade. Currently, the procedure is increasingly performed in several centers across the country. However there are limited publications on kidney transplantation from Indonesia, especially from centers outside Jakarta. This study aims to give a brief overview on transplantation performed, discuss current efforts and progresses of transplantation in Indonesia and chiefly Semarang.MethodsRetrospective analysis of 20 transplant cases in Semarang during 2014–2018 was performed. Information from other transplant centers was acquired through formal correspondences with 11 central teaching hospitals in Jakarta, Surabaya, Yogyakarta, Malang, Bali, Solo, Palembang, Aceh, Medan, Bandung, and Padang.ResultsThere were 629 recorded kidney transplantations performed in 12 centers, and we report on 245 cases with viable data. The average age of kidney recipients were younger (35.4 years old) compared to the donors (41.3 years old). Approximately half of the kidneys were obtained from related donors (49.0%) and there was only one case of cadaveric donor. The three leading etiologies of end-stage renal disease were hypertension (37.4%), diabetes mellitus (26.1%), and autoimmune disease (11.3%). There is only one center that has performed more than 100 kidney transplants in Indonesia.ConclusionIndonesia has successfully overcome several major hurdles that had previously hindered the growth of transplantation. Further improvement should concentrate on the development of integrated organ transplant infrastructure, decentralization of transplant professionals, establishment of National kidney transplant database and changing the Nation's paradigm on cadaveric organ donor through public education.

Background & Objective: Infertility is a health problem that affects 72.4 million couples worldwide. Infertility can occur as a result of an unhealthy lifestyle, such as a smoking habit. Cigarettes contain nicotine, a toxic compound that can trigger oxidative stress and eventually decrease fertility. Temulawak is a medicinal plant that is rich in antioxidants and anti-inflammatory properties. It has been used as a traditional remedy and is believed to improve fertility. We aim to study the effect of temulawak extract on the morphology, motility, and sperm counts of nicotineinduced mice. Materials & Methods:A total of 20 mice were divided into four groups (n = 5): control normal (K0); nicotine-induced (K1); and nicotine-induced treated with two different concentrations of temulawak extract, 4 mg/20 g body weight (P1) and 8 mg/20 g body weight (P2). The mice were given nicotine and temulawak for 28 days and then killed by neck dislocation. Both testes and vas deferens were collected for sperm analysis.Results: Mice treated with nicotine (K1) showed lower sperm counts (p=0.012) and motility (p<0.001) compared to mice in the control normal (K0) but had no difference in morphology. Treatment with temulawak (4 mg/20 g body weight) on nicotineinduced mice (P1) significantly increased sperm motility (p< 0.001). A double dose of temulawak extract (P2) resulted in significantly higher motility and sperm counts than in group K1. Conclusion:Temulawak treatment (8 mg/20 g body weight) on nicotine-induced mice can significantly improve motility and sperm counts.

BACKGROUND: Obstructive uropathy and hydronephrosis are common complications of cervical cancer. In order to provide an alternative route due to ureteral obstruction, urinary diversion was performed. Urinary diversion procedures are a therapeutic option for obstructive uropathy but their effectiveness is remain unclear. There is limited data that support urinary diversion as a treatment of ureteral obstruction to improve overall survival and progression-free survival. AIM:  To determine the effectiveness of urinary diversion in the treatment of obstructive uropathy in cervical cancer patients. METHOD: This study is a cross sectional involved cervical cancer patients with symptoms of obstructive uropathy. Data were obtained from medical records and limited to patients admitted from May, 2020 to May, 2021. Primary outcome was urea level, creatinine level, stage of hydronephrosis and overall survival rate of patients. RESULT: A total of 100 patients were included in the study. In both groups, the mean age of study subjects was 52-53 years with stage IIIB being the most widely reported. There was an improvement in post creatinine in the urinary diversion group. There was a significant difference in post creatinine levels between the non-urine diversion and urinary diversion groups (p=0.039).The 12-month survival rate, in the non-urinary diversion group had a value of 86% while the urinary diversion group had a value of 94%. CONCLUSION: This study shows that urinary diversion procedure is effective in increasing the renal function and increasing the 12-month survival of cervical cancer patients with obstructive uropathy.