Techniques Closed Suction Influence on Oxygen Saturation In Patients Using Mechanical Ventilation In Intensive Care Unit Room

@#Introduction: The problem in patients who are intubated with endotracheal tube is the occurrence of accumulation of secretions. One of the actions to reduce the secretion is closed suction. This research monitors the patient's oxygensaturation and also reveals the effect of closed suction on oxygen and AaDO2 saturation (alveolar-arterial oxygen difference) in patients who were mechanically ventilated in the Intensive Care Unit (ICU) of Dr. Kariadi Hospital. The design of this study uses pre experiment. Methods: The research process has been carried out on April 2, 2019 until May 26, 2019 in the Intensive Care Unit with a total sampling technique, on 15 respondents. Result: The results of the study showed that there was effect of closed suction technique on the value of oxygen saturation in patients with mechanical ventilation (p-value = 0.010). Conclusion: Closed suction can lead to decrease of air volume in the lungs up to 1200 ml. So hyperoxygenation must be done before closed suction as it can reduces the incidence of hypoxemia by 49%. Before closing the suction, it is recommended to do hyperoxygenation.

Effectiveness of Rebound Therapy along with Conventional Physiotherapy for Muscle Tone Management in Children with Cerebral Palsy

Background: According to world health organization globally 15% of populations are disabled and in Bangladesh 10% are disabled and among them, 42% child has a disability related to CP. The study purpose was to explore the effectiveness of rebound therapy along with conventional physiotherapy for muscle tone management in children with Cerebral palsy (CP). Methodology: Study used Randomized control trial (RCT) at CRP pediatric department at Dhaka Bangladesh. Results: Statistical analysis was done by using Mann Whitney “U” test. Where in experimental group, mean difference of muscle tone at the following of quadriceps femoris (Right), quadriceps femoris (Left), Hamstrings (Right), Hamstrings (Left), Gastrocnemius (Right), Gastrocnemius (Left), Biceps brachi (Right), Biceps brachi (Left), Wrist flexors (Right) and Wrist flexors (Left) was 1, 1, 1.5, 1.4, 1.9, 1.9, 0.5, 0.7, 0.3 and 0.5 more than control group. Pre-test and post-test score ensure rebound therapy more significant for the management of lower limbs muscle tone than upper limbs. Significant improvement wasn’t found (p>0.05). So improvement was not statistically significant. According to mean difference study has found greater improvement in the experimental group by applying rebound therapy to CP child. Conclusion: This true experimental study concludes that rebound therapy with conventional physiotherapy is more effective than only conventional physiotherapy.

Diversity and functional characterization of antifungal-producing Streptomyces-like microbes isolated from the rhizosphere of cajuput plants (Melaleuca leucodendron L.)

Aims@#The study was undertaken to evaluate the diversity of actinomycetes from the rhizosphere of the cajuput plant (Melaleuca leucodendron L.) using ARDRA, and to examine their in vitro antifungal potency against selected fungi. @*Methodology and results@#A total of 78 Streptomyces-like microbes were isolated from the limestone rhizosphere of cajuput plants and cultured in SN agar medium. The ability to inhibit fungal growth was observed using a dual culture assay. The diversity of the isolates was examined by morphological and genotype profiling using ARDRA (Amplified 16S ribosomal DNA restriction analysis), following which they were assigned to eight groups. Seventeen (21.8%) strains showed the ability to produce the antifungal compound as evidenced by their antagonism in vitro against the tested fungi, namely Saccharomyces cerevisiae BY 47420, Candida albicans CGMCC 2538, Aspergillus flavus NRLL 3357, and Fusarium oxysporum KFCC 11363P in the dual culture assay. One isolate, GMR22, which showed potent antagonism against unicellular and filamentous fungi, displayed 97% 16S rRNA sequence similarity to Streptomyces vayuensis. @*Conclusion, significance and impact of study@#This study demonstrated that a diversity of Streptomyces-like antifungal producing microbes were present in the rhizosphere of cajuput plants in the Wanagama Forests of Indonesia. This rhizosphere represents a potential new source of actinomycetes that produce biologically active compounds. One selected strain (GMR22) has the potential to be developed as a commercial biofungicide.

The Prevalence of CYP2B6 Gene Polymorphisms in Malaria-endemic Population of Timor in East Nusa Tenggara Indonesia

OBJECTIVES: The CYP2B6 is one of the most polymorphic CYP genes in humans that has the potential to modify the pharmacological and toxicological responses to clinically important drugs such as antimalarial artemisinin and its derivatives. The aim of the study was to determine the frequency of CYP2B6 polymorphisms in Timor malaria endemic area, East Nusa Tenggara, Indonesia where Artemisin-based Combination Therapy (ACT) has been used to treat uncomplicated malaria. METHODS: A total of 109 healthy subjects were participated in this study. CYP2B6*4, *6 and *9 polymorphisms were analyzed using PCR-RFLP to confirm the SNPs prevalence of 516G>T and 785A>G in exon 4 and 5. RESULTS: There were 96 subjects included in the analysis. In the exon 4 of CYP2B6 516G>T, the frequency of the T mutation was 37.5% (39/96), and the wildtype 27.1% (26/96). In the exon 5, CYP2B6 785A>G mutant was detected in 29.2% (28/96) of individuals, and the wildtype allele in 35.4% (34/96). The frequency of CYP2B6*9 (516G>T), CYP2B6*4 (785A>G) and CYP2B6*6 (516G>T and 785A>G) were 40.6%, 29.2% and 22.9%, respectively. The prevalence of these CYP2B6 gene polymorphisms in Timorian ethnic were higher than that in Malay, Han Chinese, Indian, and Egyptian populations. CONCLUSION: The prevalence of these CYP2B6 516G>T and 785A>G polymorphisms in Timorian ethnic is higher than that in other populations. These polymorphisms may affect the metabolism of artemisinin and its derivatives.

In Vitro Antifungal Activity of (1)-N-2-Methoxybenzyl-1,10-phenanthrolinium Bromide against Candida albicans and Its Effects on Membrane Integrity

Metal-based drugs, such as 1,10-phenanthroline, have demonstrated anticancer, antifungal and antiplasmodium activities. One of the 1,10-phenanthroline derivatives compounds (1)-N-2-methoxybenzyl-1,10-phenanthrolinium bromide (FEN), which has been demonstrated an inhibitory effect on the growth of Candida spp. This study aimed to explore the in vitro antifungal activity of FEN and its effect on the membrane integrity of Candida albicans. The minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of FEN against planktonic C. albicans cells were determined using the broth microdilution method according to the Clinical and Laboratory Standards Institute guidelines. Cell membrane integrity was determined with the propidium iodide assay using a flow cytometer and were visualized using scanning electron microscopy (SEM). Planktonic cells growth of C. albicans were inhibited by FEN, with an MIC of 0.39–1.56 µg/mL and a MFC that ranged from 3.125 to 100 µg/mL. When C. albicans was exposed to FEN, the uptake of propidium iodide was increased, which indicated that membrane disruption is the probable mode of action of this compound. There was cells surface changes of C. albicans when observed under SEM.

Stage specificity of pasak bumi root (Eurycoma longifolia Jack) isolate on Plasmodium falciparum cycles

In previous study, in vitro antiplasmodial activity fractions isolated from methanol extract of E. longifolia, Jack. have been evaluated. Among 5 isolates evaluated from the study, isolate 4 showed high in vitro antiplasmodial activity. However, which stage specificity of the isolates on P. falciparum cycles has not been evaluated. This study was intended to evaluate the stage specificity of the isolate on P. falciparum cycles. The study was conducted by observing the percentage of each stages of P. falciparum microscopically after 8, 16, 24, 32, 40, 48, 56, 64, and 72 hours incubation periods with 3 various concentration of isolate 4 compared with control. The result showed that isolate 4 of E. longifolia root methanol soluble fractions most potent at trophozoites stages of P. falciparum.

In vitro and in vivo antiplasmodial activity and cytotoxicity of extracts of Phyllanthus niruri L. herbs traditionally used to treat malaria in Indonesia.

In endemic areas where malaria is prevalent, medicinal plants are often used to treat malaria. This study was conducted to evaluate the in vitro and in vivo antiplasmodial activity and cytotoxicity of extracts of meniran (Phyllanthus niruri L.) herb traditionally used to treat malaria in Indonesia. Three extracts viz aqueous, methanolic and chloroformic extracts were obtained by maceration of the herbs. A radioactive method was used to evaluate the in vitro antiplasmodial activity of the extracts on chloroquine-resistant (FCR-3) and chloroquine-sensitive (D-10) strains of Plasmodium falciparum. In vitro antiplasmodial activity was expressed by the concentration inhibiting 50% of parasite growth (IC50). Cytotoxicity was estimated on Hela cells and the Cytotoxicity Index (CI = IC50 on HeLa cells/IC50 on FCR-3 strain) was calculated to evaluate the safety of tested extracts. A standard 4-day test on P berghei infected mice was used to evaluate the in vivo antiplasmodial activity of the extracts showing strong in vitro antiplasmodial activity, for both the methanolic and aqueous extracts. The in vivo antiplasmodial activity was expressed by the dose inhibiting 50% of parasite growth (ED50). The IC50 values obtained for these extracts against P. falciparum ranged from 2.3 to 202.4 microg/ml. The methanolic extract was the most active in vitro extract with an IC50 that ranged from 2.3 to 3.9 microg/ml and a CI that ranged from 41.3 to 57.5. This was also the most in vivo active extract with an ED50 of 9.1 mg/kg/d. Further study will be conducted to isolate and purify active compounds presented in the methanolic extract.

In vitro antiplasmodial activity and cytotoxicity of newly synthesized N-alkyl and N-benzyl-1,10-phenanthroline derivatives.

A previous study showed that the 1,10-phenanthroline skeleton was active in vitro against chloroquine-resistant and sensitive strains of Plasmodium falciparum. Based on this skeleton, 8 derivatives of N-alkyl and N-benzyl-1,10-phenanthrolines have been synthesized. This study was conducted to evaluate the in vitro antiplasmodial activity and cytotoxicity of these compounds. The in vitro antiplasmodial activity was tested on two strains of P. falciparum, FCR-3 chloroquine-resistant and D10 chloroquine-sensitive strains, while their cytotoxicity was tested on the Vero cell line. The parasite and cell growth were estimated by hypoxantine-[2,8-3H] uptake after 24- and 72-hour incubation with each compound tested. The control parasite or cell free from any compounds was referred to as having 100% growth. For this radioactive method, the IC50 value showing concentration inhibiting 50% of the parasite growth was determined by probit analysis. The results showed that the highest antiplasmodial activity was observed with (1)-N-benzyl-1,10-phenanthrolinium iodide with the IC50 0.18-0.45 microM, and the IC50 of the compound on Vero cells ranged from 2,582.30 to 7,057.71 microM. The cytotoxic/ antiplasmodial ratio indicates that this compound has high selectivity (10,993 +/- 330.79-38,965 +/- 6,888.27).