Althea Medical Journal
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Difference of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in Patients with Non-Hodgkin and Hodgkin Lymphoma
Full text linkBackground: Malignancy and inflammation are strongly connected. The inflammatory processes play a significant part in the development of lymphoma. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) can be used as potential biomarkers of inflammation in lymphoma. This study aimed to discover the differences between NLR, MLR, and PLR in patients diagnosed with non-Hodgkin lymphoma (NHL), and Hodgkin lymphoma (HL). Methods: This study employed a retrospective design using data from the lymphoma registry at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from 2020 to 2023. Sampling was carried out consecutively. Hematological data of patients with NHL and HL before chemotherapy were collected. The variance between the two groups was examined utilizing the Mann-Whitney U test.Results: In total, 122 data of patients were included, consisting of 75% NHL patients and 25% HL patients with a median age of 54 years (IQR 43–62). The overall NLR, MLR, and PLR tended to be lower in nHL than in HL patients although the differences were not statistically significant; with NLR 2.7 (0.7 – 12.2) vs. 3.2 (1.1 – 10.8) p=0.287, MLR 0.36 (0.04 – 1.86) vs. 0.46 (0.09 – 1.78) p=0.150, and PLR was 160.6 (20.2 – 1533.3) vs. 211.2 (50.6–1156.3) p=0.189, for NHL and HL, respectively.Conclusion: The lower values of NLR, MLR, and PLR in NHL indicate lower systemic inflammatory status in NHL than HL patients. Further studies are needed to evaluate dynamic changes of these biomarkers during treatment
Blood Pressure Reduction in Patients with Hypertension Through Soursop Leaf Tea Consumption
Full text linkBackground: Controlling hypertension through pharmacological treatment is effective but can potentially lead to long-term side effects. Thus, more patients with hypertension have turned to herbal plants for treatment. The objective of this study was to examine the effectiveness of soursop leaf tea in reducing blood pressure in patients with hypertension.Methods: This study employed a quasi-experimental approach with a non-randomized pretest-posttest control group design, involving 30 participants in the intervention group and 30 participants in the control group. Data was analyzed using the Wilcoxon test to assess the disparity in mean blood pressure levels before and after consumption of soursop leaf tea. The Mann-Whitney test was used to examine the distinction in mean blood pressure between the intervention group and the control group.Results: In the intervention and control groups, most respondents were aged 56–65 years (60% and 66.7%), male (70% and 56.7%) and had suffered from hypertension for more than 5 years (70% and 56.7%). There was a significant difference in systolic blood pressure (p<0.001) and diastolic blood pressure (p<0.001) before and after the administration of soursop leaf tea. The mean systolic and diastolic blood pressure in the intervention group decreased significantly compared to the control group (p<0.001).Conclusions: Consumption of soursop leaf tea can reduce systolic and diastolic blood pressure, suggesting that this local herb has a potential effect on individuals diagnosed with hypertension
Development and Optimization of SARS-CoV-2-Specific Primers for Accurate Diagnosis: A Case Study in West Sumatra - Indonesia
Full text linkBackground: In 2022, new cases of Covid-19 emerged, including the Omicron variant which is classified as a variant of concern (VOC). West Sumatra is one of the top ten provinces with the highest number of cases in Indonesia. This study aimed to design specific primers and optimize the PCR method that can be used for accurate detection, specifically for SARS-CoV-2 circulating in West Sumatra.Methods: This study used an in silico approach, using whole genome sequencing (WGS) data available at the global initiative on sharing avian influenza data (GISAID), and employing the Geneious Prime application which confirmed samples collected from Padang, West Sumatra, and from Jakarta, Bogor, Depok, Tangerang, Bekasi (Jabodetabek) serving as comparative sample tests. Technology development was supported by bioinformatics testing, laboratory testing, and validation methods, involving gene mining, sequence alignment, and primer design. Laboratory tests and validation included viral genomes extraction and cDNA synthesis, polymerase chain reaction (PCR) testing, and results analysis. Results: Three sets of optimal primer candidates amplified the coveted target gene was discovered, specifically, the S gene of the receptor binding domain (RBD) region.Conclusions: The primers designed through a consensus between the complete genome of the SARS-CoV-2 isolate Wuhan-Hu-1 and the WGS of the Omicron variant in Padang, West Sumatra, have successfully detected the SARS-CoV-2 virus variant in the region. The most effective temperature optimization results were achieved by testing three primer products on samples from Padang and Jabodetabek. It has significance as a valuable diagnostic tool in the primer form
Distribution of Hypertension Cases Based on Primary Health Care 2017–2021 in Malang, Indonesia: Spatial Analysis
Full text linkBackground: Malang Regency is one of the cities in East Java, Indonesia that has a high trend of hypertension cases. The study aimed to describe the distribution of hypertension cases at the primary health care level in Malang Regency, Indonesia using spatial analysis.Methods: This was a descriptive analysis study using secondary data obtained from the Health Profile of Malang Regency from 2017 to 2021. The total sampling method was used. Data on hypertension cases from 16 primary health cares was collected. Quantum geographic information system (QGIS) was used to visualize the distribution of cases. Data was presented in the tables and a map with different coloring based on the high-low categories of hypertension cases in a region.Results: There was a tendency for an increase in hypertension cases every year in 3 of 16 primary health care. Primary Health Cares with an increased prevalence of cases during 2017–2021 were Arjowinangun (7.65% to 24.24%), Mojolangu (17.20% to 31.57%), and Kendalsari (8.84% to 27.29%). However, cases decreased from 2017 to 2018, and experienced a very high increase from 2018 to 2019.Conclusion: The distribution of hypertension cases in Malang Regency from 2017 to 2021 tends to fluctuate from year to year. An education program for the community about a healthy lifestyle and the importance of conducting regular health checks is needed to decrease hypertension cases
Turmeric and Mangosteen Extract Modulate Autophagy Gene Expression in High-Fat Diet-Induced Rats
Full text linkBackground: High-fat diet (HFD) increases the risk of obesity, metabolic syndrome, coronary artery disease, and chronic kidney disease, resulting in lipotoxicity. Turmeric and mangosteen are two ingredients mostly used in Indonesian food, and are known for their antihyperlipidemic and antioxidant effects. The aim of this study was to explore the effect of turmeric and mangosteen on autophagy gene expression in HFD-induced kidneys in rats model.Methods: The study was an experimental study, including 25 male Wistar rats aged 8 weeks, divided into 5 groups with a completely randomized design; group with a standard diet as negative control group, the group with a high-fat diet as a positive control group, and the HFD groups with turmeric or mangosteen or fenofibrate. The study was conducted in Maranatha Biomedical Research Laboratory from January to November 2022. Autophagy gene expression (LC3, p62) was measured along with the histopathological scoring to observe necrosis, inflammation, and fat degeneration state. Data was analyzed using One Way ANOVA or Kruskal Wallis and post hoc Least Significant Difference or Mann Whitney.Results: There were significant differences in inflammation in groups treated with mangosteen (p=0.007); in fat degeneration in groups treated with mangosteen and fenofibrate (p=0.007). Furthermore, the LC3 gene expression was increased in all HFD groups as well as the p62 gene expression in group treated with turmeric (p=0.020) and fenofibrate (p=0.005).Conclusions: Mangosteen decreases inflammation and fat degeneration scoring, while turmeric increases autophagy in the kidney of HFD induced Wistar rats
Maternal Risk Factors among Pregnant Women with Miscarriage
Full text linkBackground: Approximately, 4.1% of maternal deaths in Indonesia occur due to miscarriage. Miscarriage might be caused by various factors such as fetal, maternal, and external factors. Monitoring and early detection of maternal factors might prevent miscarriage. This study aimed to analyze the influence of maternal factors on the incidence of miscarriage. Methods: This was an analytic observational study with a case-control design conducted in Banjar District, South Kalimantan in August–September 2022. Data was collected from the medical records of pregnant women who experienced miscarriage (n=60) and pregnant women who did not (n=120). Data was analyzed using the chi square test and logistic regression. The level of maternal risk factors for the incidence of miscarriage was determined from the odds ratio (OR) value at a 95% confidence interval.Results: The results revealed that parity (p=0.000; OR=2.2), nutritional status (p=0.000; OR=77.1), level of education (p=0.001; OR=3.5), and employment status (p=0.000; OR=8.1) had a significant effect on the incidence of miscarriage.Conclusion: Maternal factors such as parity, nutritional status, education level, and employment status influence on the incidence of miscarriage, therefore, it is essential to educate pregnant women on various factors related to miscarriage
Expression Levels of Intestinal Toll-Like Receptors 2 and 4 in Acute Inflammation Caused by Intestinal Candidiasis: An Experimental Study in Wistar Rats
Full text linkBackground: Candida albicans grows in the gastrointestinal tract as a normal microflora that may cause intestinal candidiasis, characterized by formation of biofilm and inflammation. Candida is recognized by toll-like receptors (TLRs). This study aimed to explore the relationship between intestinal TLR 2 and TLR 4 expression levels in candidiasis at each phase of inflammation.Methods: An experimental study was performed using a simple randomized sampling on 30 male Wistar rats divided into a control and a treatment group. Each group was inoculated with Candida albicans. Dysbiosis conditions were designed in the treatment group using multiple antibiotics and on day 5 the rats were injected with subcutaneous cortisone acetate. The groups were terminated in five different times (days 7, 14, 21, 28 and 35). On the termination day, intestinal tissue was isolated and the TLR 2 and TLR 4 expression were analyzed by immunohistochemistry. The data were analyzed by parametric test with SPSS (p<0.05) and completed by post-hoc test Least Significance Difference (LSD) to compare pairs of groups.Results: The expression of TLR 2 and TLR 4 between control and treatment groups showed significant differences (p=0.005). In the treatment group, there was a gradual increase in the TLR2 and TLR 4 expressions. Positive expression of TLR appeared more in the submucosal or basal area than apical surface. The treatment group showed the highest expression of both TLR2 (82.37%) and TLR4 (87.40%) on termination day 35.Conclusions: Inflammation caused by intestinal candidiasis can result in increased expression of intestinal TLR2 and 4 contributing to an increased risk of biofilm formation
Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia
Full text linkBackground: Necrotizing fasciitis (NF) is a serious infection that can rapidly kill tissue and potentially lead to multiple organ failure. Early diagnosis and treatment are essential for survival. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score may aid in early detection of NF. Although initially promising, studies on the effectiveness of LRINEC have shown mixed results. This study aimed to investigate the accuracy of LRINEC in predicting NF.Methods: This was an observational prospective cohort study, including patients with NF as well as skin and soft tissue infection (SSTI) who were treated at a tertiary referral hospital in Bandung, Indonesia in 2022. The LRINEC scores was calculated to measure sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The accuracy of LRINEC scores was specified in the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results: Of the total 70 patients, 33 were diagnosed with NF and 37 with SSTI. The LRINEC score with ≥6 points cut-off showed a sensitivity of 90.9% (95%CI; 75.67–98.08%), specificity of 75.60% (95%CI; 58.80–88.23%), PPV of 76.9% (95%CI; 60.67–88.87%), and NPV 90.30% (95%CI; 74.25–97.96%). The area under the ROC (AUROC) curve for the accuracy of the LRINEC scores was 0.895 (95%CI; 0.821–0.969).Conclusions: The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is an accurate predictor and feasible early diagnostic indicator in NF. However, clinical judgment remains a crucial factor in diagnosing NF
Subchronic Oral Exposure to Chlorpyrifos Decreases Butyrylcholinesterase in Wistar Rat
Full text linkBackground: Indonesia as an agricultural country has more than 33 million workers in the agriculture. Pesticides have an important role in agriculture because they function as powerful plant pest exterminators. However, its use is considered to cause various toxic effects, one of which is on the nervous system. This study aimed to evaluate the impact of pesticide exposure on cognitive impairment by assessing the butyrylcholinesterase biomarker in the blood of rats as experimental animals.Methods: This was a true experimental study conducted during September–November 2022 at the Pharmacology and Biochemistry Laboratory, Faculty of Medicine, University of Jember with a post-test only approach using Wistar rats which were divided into 1 control group and 4 treatment groups treated with chlorpyrifos 5 mg/kg orally. Serum butyrylcholinesterase enzyme levels were measured using the kinetic photometric method and then analyzed with a regression test in IBM SPSS® Statistics software.Results: The average value of butyrylcholinesterase was 920.23±145.27 (Control group); 904.48±91.6 (7 days after chlorpyrifos administration); 889.81±95.2 (14 days after chlorpyrifos administration); 457.84±69.5 (28 days after chlorpyrifos administration); 575.82±194.25 (56 days after chlorpyrifos administration). The results of the One-Way ANOVA test showed significant differences between groups as indicated by a significance test of 0.024 (p <0.05).Conclusions: There is a relationship between the duration of exposure to chlorpyrifos and butyrylcholinesterase levels in Wistar rats. This fact shows that the longer an organism is exposed to low doses of chlorpyrifos pesticides, the higher the level of neurological system toxicity that occurs in that organism
Clinical Symptoms and Treatment Outcomes of COVID-19 Patients with Stroke
Full text linkBackground: COVID-19 patients who come to the emergency room often suffer from stroke. This study aimed to examine clinical symptoms and treatment outcomes of COVID-19 patients with stroke.Methods: This study was a retrospective study using secondary data from medical records of COVID-19 patients with stroke, hospitalized at the Universitas Kristen Indonesia Hospital, Jakarta, Indonesia for the period 2020–2022. Patients with PCR test positive for COVID-19 who had clinical symptoms of stroke, confirmed by CT scan showing brain ischemic or hemorrhage were included. Data on gender, age, Glasgow coma scale (GCS), subtype of stroke, severity of COVID-19, and outcome were recorded and analyzed using paired t-test and the Spearman correlation.Results: Of the 49 patients included, 91.8% were over 45 years old and suffered from severe COVID-19. Men were slightly more (51.1%) than women and 93.9% of patients suffered from ischemic stroke. The GCS scores of 46.9% of patients decreased significantly during hospitalization (p=0.02). Most of patients (65.3%) had used non-rebreathing mask (NRM), 10.2% ventilators, and others used nasal cannulas. As many as 46.9% of patients died, 44.9% recovered with neurological deficits, and only 8.2% recovered completely. Interestingly, oxygen delivery devices were significantly correlated with outcome (p=0.00). Patients receiving the antiviral favipiravir had better outcomes compared with those taking remdesivir (p=0.021).Conclusion: The mortality rate for stroke patients with severe COVID-19 is high, and the outcome of patients using NRM or ventilator is worse than patients using nasal cannulas. The antiviral Favipiravir has better outcomes for stroke patients with severe COVID-19