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"Intrauterine insemination and ovulation induction is effective first-line treatment for infertility in many straightforward cases and is preferred by many clinicians because they are less invasive than in-vitro fertilization and its variants. This is a comprehensive account of how to set up and run a successful IUI program. The book addresses the practical aspects of treatments that will produce optimum results in terms of pregnancy outcome and safety, as well as the pharmacological and physiological reasons for their use. Chapters on how to prevent complications of ovulation induction such as multiple births and ovarian hyperstimulation syndrome are included, as well as how to diagnose infertility in both sexes. Laboratory procedures for sperm preparation are described in detail. Worldwide resources for obtaining donor sperm and legal issues that surround the management of patients are included. This manual is of interest to reproductive medicine specialists, general practitioners and general obstetrician gynecologists."

"Latar Belakang: Penggunaan klomifen sitrat sebagai obat induksi kehamilan masih memiliki angka keberhasilan kehamilan yang rendah. Letrozol merupakan agen penghambat aromatase yang dianggap memiliki efektivitas lebih baik dibanding klomifen sitrat, namun efektivitasnya masih dilaporkan bervariasi. Penelitian ini bertujuan untuk mengetahui perbedaan pemberian klomifen sitrat dan letrozol terhadap ketebalan endometrium, morfologi endometrium dan jumlah folikel dominan pada perempuan yang dilakukan induksi ovulasi atau stimulasi ovarium. Metode: Penelitian ini merupakan penelitian retrospektif dengan menggunakan medis pasien yang dilakukan induksi ovulasi atau stimulasi ovarium pada Januari 2011 - Mei 2015. Didapatkan 143 wanita siklus anovulasi yang terbagi dalam empat kelompok: klomifen sitrat 50 mg, klomifen sitrat 100 mg, letrozol 2,5 mg dan letrozol 5 mg. Agen pemicu ovulasi pada subjek dimulai pada hari ke-2 selama berlangsung selama lima hari. Data ketebalan endometrium, morfologi endometrium dan jumlah folikel dominan didapat pada status dari data pemeriksaan ultrosonografi transvaginal di hari ke-12 siklus haid. Hasil: Dari semua subjek, didapatkan 45 subjek (31,5%) mendapat klomifen sitrat 50 mg, 29 subjek (20,3%) dengan klomifen sitrat 100 mg, 23 subjek (16,1%) dengan letrozol 2,5 mg, dan 46 subjek (32,2%) dengan letrozol 5 mg. Subjek dengan letrozol memiliki endometrium yang lebih tebal dibandingkan dengan klomifen sitrat (p<0,05). Didapatkan pulan subjek dengan letrozol memiliki lebih banyak proporsi subjek dengan morfologi endometrium trilaminer. Tidak dijumpai perbedaan ketebalan endometrium pada subjek dengan perbedaan dosis pada masing-masing obat. Selain itu, tidak ditemukan perbedaan jumlah folikel dominan pada keempat kelompok. Kesimpulan: Penggunaan letrozol menghasilkan endometrium yang lebih tebal dan endometrium trilaminer dibandingkan klomifen sitrat. Tidak dijumpai perbedaan jumlah folikel dominan pada kedua kelompok.

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Background: The use of clomiphene citrate as an induction agent still has dissappointing results regarding its pregnancy rate. Letrozole is an aromatase inhibitor that is perceived to has better efficacy compared to clomiphene citrate, however, the reporting results were still varied. This study aimed to know the efficacy of clomiphene citrate and letrozol for ovulation induction in anovulation women.

Method: This was a retrospective study using medical recors of women undergone ovulation induction from January 2011-May 2015. A number of 143 anovulation women were divided into clomiphene citrate 50 mg, clomiphene citrate 100 mg, letrozol 2,5 mg and letrozol 5mg. Every group of ovulation induction agent recieved the agent daily on 3rd until 7th day menstrual cycle. On 12th menstrual cycle the transvaginal ultrasound was performed to measure endometrial thickness and dominant follicle number.

Results: From all subjects, 45 subjects (31,5%) were in 50 mg clomiphene citrate groups, 29 subjects (20,3%) in 100 mg clomiphene citrate group, 23 subjects (16,1%) in 2,5 mg letrozole group, and 46 subjects (32,2%) in 5 mg letrozole group. Subjects receiving letrozol had thicker endometrium compared to clomiphene citrate (p<0,05). Different doses did not associated with different endometrial thickness between subjects receiving either letrozole or clomiphene citrate. In addition, subjects receiving letrozole had higher proportion of having trilaminar endometrium morphology. We did not observe a difference in total number of dominant follicle between groups.

Conclusion: The usage of letrozol resulted in thicker endometrium and proportion of subjects with trilaminar endometrium. Yet, there is no difference in number of dominant follicle between groups. "

"Kualitas perpindahan gigi sangatlah penting untuk meningkatkan usia pakai sistem transmisi tersebut dengan cara mengurangi wear-and-tear pada komponen- komponen transmisi. Lebih lanjut, kemudahan pengoperasian yang dicapai dengan pengotomatisan tahapan perpindahan roda gigi sangat penting pada situasi yang sulit, sebagai contoh adalah perpindahan roda gigi kendaraan alat berat pada jalanan menanjak. Pada sistem transmisi manual, perpindahan roda gigi dilakukan dengan cara melepaskan kopling, menyambungkan roda gigi netral, perpindahan ke roda gigi yang baru, dan menyambungkan kopling kembali. Dengan menggunakan kontrol mesin terintegrasi, yang pada kendaraan listrik umumnya berupa motor induksi, sistem transmisi manual dapat diotomatiskan dan meniadakan kopling serta synchronizer, dinamakan sistem clutchless Automated Manual Transmission (AMT). Dengan mengestimasi nilai torsi pada sistem transmisi lalu mengendalikannya ke nol, fungsi kopling untuk memutuskan aliran daya dapat digantikan. Objektif tersebut dapat dicapai dengan kontrol vektor. Lebih lanjut, sistem transmisi manual yang diotomatiskan memiliki efisiensi yang lebih tinggi serta harga yang relatif lebih murah dibandingkan sistem transmisi otomatis lainnya.

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The quality of gearshift is very important to increase the lifetime of transmission system by reducing wear-and-tear on the transmission components. Furthermore, the ease of operation achieved by automating the gear shifting stages is very important in difficult situations, for example the gear shifting of heavy equipment vehicles on uphill roads. In a manual transmission system, gearshift is performed by disengaging the clutch, connecting to a neutral gear, shifting to a new gear, and reconnecting the clutch. By using an integrated engine control, which in an electric vehicle is generally an induction motor, a manual transmission system can be automated and negate the clutch and synchronizer, named clutchless automated manual transmission system. By estimating the torque value in the transmission system and then controlling it to zero, the function of the clutch to disconnect the power flow can be replaced. This objective can be achieved using vector control. Furthermore, automated manual transmission systems have higher efficiency and relatively lower prices compared to other automatic transmission systems."