Methylenetetrahydrofolate Reductase (MTHFR) C677T gene polymorphism is associated with decreased MTHFR enzyme activity that leads to hyperhomocysteinemia and hypertension. The MTHFR C677T polymorphism is also associated with lower affinity and faster unbinding of flavin adenine dinucleotide, a riboflavin-derived cofactor for MTHFR enzyme. Natuna is a district which once reported has the highest prevalence of hypertension in Indonesia, based on a national basic health research. Therefore, this study aims to investigate the association between MTHFR C677T polymorphism and riboflavin intake with hypertension in the Natuna district population. An analytic cross-sectional population study was conducted in the region. Data of demographic, physical examination, and food recall, as well as MTHFR genotyping from blood samples of study subjects were collected. The subjects were 268 adults, among which 128 (45.9%) had hypertension, 49 (17.5%) had mutant allele of MTHFR genotype (CT or TT), and 158 (56.4%) had low daily riboflavin intake. There was association between MTHFR C677T polymorphism and hypertension [OR 3.387 (1.724 – 6.654), p = 0.001]. Post-hoc analysis showed that group of mutant MTHFR C677T genotype with low riboflavin intake showed strong association with hypertension [OR 19.320 (4.498–82.980), p<0.01]. Meanwhile, group with mutant MTHFR C677T genotype and normal riboflavin intake did not show a significant association with hypertension. As a conclusion, there was association between interaction of riboflavin intake and MTHFR C677T polymorphism with hypertension. This suggests possibility of riboflavin supplementation in population with high prevalence of hypertension especially those with MTHFR C677T gene polymorphism

Pelvic congestion syndrome (PCS) is a clinical syndrome supported by specific findings, such as ovarian vein's dilatation, that cause pelvic vein congestion. Although many theories are explaining the pathophysiologies of this condition, the underlying cause remains unknown. The clinical manifestations of PCS are various including chronic pelvic pain (CPP), voiding disturbances, or ureteral obstruction. Imaging modality, such as ultrasonography, computed tomography (CT scan), magnetic resonance imaging (MRI), and venography, are needed to confirm and exclude the differential diagnosis. Currently, American venous forum guidelines recommended endovascular therapy which is percutaneous embolization as the first option therapy of PCS. Here, we reported a 35-year-old woman with PCS who underwent successful percutaneous embolization therapy.

The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) that first appeared in Wuhan, China. COVID-19 was found to have significant connection with the cardiovascular system by causing complications such as myocarditis and arrhythmias. Furthermore, medications for COVID-19 have been shown to induce cardiovascular side effects. The emergence of COVID-19 spreading also raised questions on the need for modification of life support algorithms to protect vulnerable healthcare workers.