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Introduction: This case report aims to describe the diagnostic strategy and optimal management of pregnancy with Myasthenia Gravis and Myasthenic Crisis.Case Description: A 27-years-old pregnant female with Myasthenia Gravis complicated by Myasthenic Crisis was hospitalized six times during her pregnancy. Two initial hospitalizations due to acute exacerbation treated with plasmapheresis, and two other hospitalizations complicated with myasthenic crisis treated with massive Therapeutic Plasma Exchange in the Intensive Care Unit. Managing myasthenia gravis in pregnancy, from early pregnancy until delivery, is challenging. Furthermore, the myasthenic crisis in pregnancy is a rare case that requires airway and ventilation support and treatment with plasmapheresis.Conclusion: Myasthenic crisis in pregnancy is a rare condition. Therefore, a guideline about the prenatal, antenatal, delivery plan, exacerbation, and myasthenic crisis management in pregnancy and pregnancy planning women are urgently needed.

Background: The aging process can increase the incidence of neurodegenerative diseases such as dementia. Dementia is characterized by a gradual loss of cognitive performance for locomotor activity in exploring new environments. Research on dementia in mice was carried out by administering d-galactose to induce mitochondrial dysfunction, oxidative stress, inflammation and apoptosis of neurons.Objective: The purpose of this study was to determine differences in locomotor activity in rats induced by oral d-galactose and intraperitoneal injection.Methods: An experimental study with a posttest control group design. The subjects were male Wistar rats aged 12-14 weeks with weighing 200-300gram obtained from the Animal Laboratory of the Pharmacology Unit of the Faculty of Medicine, Udayana University. The study was conducted for 8 weeks, from June to August 2019. A total of 20 rats induced d-galactose dose of 100 mg/kg/day orally and intraperitoneal injection. The use of animals was carried out after obtaining ethical clearance from the ethical committee of the Faculty of Medicine, Udayana University. Y maze test is conducted for 5 minutes at the end of week 8.Results: There was a decrease in locomotor activity in both groups. The average locomotor activity in the oral group was 6.5+0.268, and the injection group was 5.5+0.341. Bivariate analysis with unpaired t-test showed significant differences in locomotor activity between groups given oral d-galactose compared to the intraperitoneal injection group with p=0.034 (Conclusion: Alzheimer's dementia induced d-galactose mice to have a different locomotor activity after administration by oral or intraperitoneal injection of d-galactose. This study supports the results of previous studies that the administration of d-galactose can cause impaired locomotor activity.

Background: Rat is frequently used as a model for ischemic stroke, because it has strains with homogeny gene, and ethically has been widely accepted. Model for ischemic stroke on animal testing are global and focal ischemic. Mechanical or pharmacological approach may be used to stop the blood flow of brain artery. The purposes of making ischemic stroke model on animal testing are to study how risk factors cause brain cells damage, thus can be used as consideration for preventing ischemic stroke, and to study pathophysiological aspects and therapeutic plan (rechanalization, neuroprotection, and neurorestoration). The blood flow in brain artery may be stopped by intraluminal filament, photochemical, tromboemboli and endotelin injection, electro coagulation on brain blood vein. Methods: In this study, method to stimulate ischemic stroke on Wistar rat was done through conventional method, which is by binding (ligation) common carotid artery, external carotid artery, and internal carotid artery on proximal middle cerebral artery. Twenty five Wistar rats were used in this experiment. This experiment was conducted in Institute of Bioscience, Brawijaya University, Malang. Results: From 25 Wistar rats that subjected to the artery binding method, 2 rats (8%) showed neurological deficit level 1, one rat (4%) with level 2, 17 rats (68%) with level 3, and 5 rats (20%) with no symptom of neurological deficit. Conclusion: This simple method successfully stimulate ischemic stroke on 80% of treated rats, suggested that this method can be considered as one of methods for stimulating ischemic stroke on Wistar rat for animal testing.