Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey / 예방의학회지

Objectives@#The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age. @*Methods@#A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia. @*Results@#The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms. @*Conclusions@#The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.

Development and validation of the maternal blues scale through bonding attachments in predicting postpartum blues

@#Background: Postpartum blues in Indonesia has a high prevalence at 37% to 67%. Postpartum blues syndrome has been described as varying changes in the affective domain, such as feelings, behavior, or thoughts, that can be influenced by the roles and tasks of women, along with their social, cultural, and economic support. Instruments that measure maternal blues through bonding attachment behavior have never before been developed in Indonesia. Objective: This study aimed to develop a maternal blues scale through bonding attachments to predict postpartum blues. Method: The research design consisted of three stages: 1) phenomenology design and focus group discussion; 2) development and construction of the maternal blues scale, and 3) a cross-sectional study to measure validation of the scales. Respondents were postpartum mothers in the first week after birth. The sample comprised 501 participants. Sampling was done by consecutive sampling at the Public Health Center (PUSKESMAS) in the South Jakarta area. Data analysis used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), correlation, and a diagnostic testing . Results: Item analysis produced 32 items consisting of 24 items regarding the mother’s role and duties as internal factors and eight factors involving social, cultural, and economic support as external factors. Both factors were valid and reliable in predicting postpartum blues with indicators (t loading factors ≥ 1.96, standardized loading factor (SLF) ≥.50, internal factors: construct reliability (CR) ≥ .70 and extraction variants (VE) ≥ .50 and external factors: CR ≥ .74 to .83 VE ≥ .50 to .63). The relationship with Kennerley’s maternity blues as a gold standard was significant. Internal factors had a score of 53, with a sensitivity of 60.2%. The external factors score was 19, with a sensitivity of 77.3%. Conclusion: The new scale for postpartum blues prediction developed displayed internal consistency and validity of each indicator (internal and external factors) that was good (CR ≥ .70; VE ≥ .50). This scale provides a feasible tool to predict postpartum blues.

Inhibition Effect of Garlic (Allium sativum) Extract on Streptococcus sanguinis Biofilm Formation Involving Bacterial Motility Mechanism

@#Introduction: Streptococcus sanguinis is a primary colonizer in oral biofilm formation, often implicated in infective endocarditis. Methods to control oral biofilm formation are yet to be developed. Garlic (Allium sativum) has shown antimicrobial activities against many pathogen species. We sought to observe the potential of garlic extract to inhibit bacterial adherence to hydroxyapatite (HA) discs as a model of the tooth surface. Methods: Susceptibility of S. sanguinis ATCC 10556 to garlic extract was examined by minimum inhibitory concentration (MIC) test using broth microdilution method. For bacterial adherence assay, saliva-coated HA discs were incubated with various concentrations of extract then stimulated with S. sanguinis ATCC 10556 suspension. Adherent bacteria were stained with 0.1% crystal violet and measured at 595 nm using a microplate reader. A qualitative method to test bacterial motility was performed using Motility Indole Ornithine (MIO) medium. Results: The result of minimum inhibitory concentration test showed that MIC value for garlic ethanolic extract was at a concentration of 625 μg/ml. Moreover, garlic extract inhibited bacterial adherence to HA discs starting at concentration of 62.5 μg/ml. The inhibition of bacterial motility can be observed, indicated as limited the diffused growth of bacteria closer to the inoculating line. Observation using SEM confirmed these results. Conclusion: This present study suggest that garlic extract has the ability to inhibit S. sanguinis adherence to HA discs involving inhibition of bacterial motility, with the optimal concentration being 500 µg/ml.

Viability and DNA Damage of Buccal Mucosa Cells in Patients Exposed to Panoramic X-ray

ABSTRACT@#Panoramic X-ray is well known to cause DNA damage and induces cellular death. The aim of the present study was to evaluate the cytotoxicity of radiation exposure from panoramic radiography on human buccal mucosa cells by assessing the cell viability using the simple-trypan blue exclusion test. The genotoxicity effect was evaluated by assessing comet assay score. This research included a total of 20 healthy patients who had panoramic radiography for a routine dental examination. Buccal mucosa cells were collected from all participants before X-ray exposure and at 30 min or 24 h after exposure in Groups 1 and 2, respectively, and subjected to a comet assay and trypan blue exclusion test to assess cell viability and DNA damage. Cell viability was calculated as the ratio of live (translucent) to total counted cells. Comet assay output images were analysed using OpenComet software and a visual score by measuring the percentages of tail DNA and summing the visual score, respectively. A statistically significant (p < 0.05) reduce in cell viability was observed at 30 min after exposure, furthermore there is no more reduction after 24 h. Both comet assay measurements showed a significant (p < 0.05) increase in the percentage of tail DNA and visual score at 30 min after exposure, then tend to decrease after 24 h of exposure, although it was not significant (p > 0.05). The results showed that panoramic radiography interfered cell viability and induced DNA damage in buccal mucosa cells within 30 min after exposure, but these effects were ceased after 24 h.

Combination of Blue Laser Exposure with UV-LED to Improve Antimicrobial Effects on Staphylococcus aureus Biofilm

@#Introduction: Staphylococcus aureus biofilm is a major mediator of infection. The light based therapy is still not adequate to eradicate biofilm caused by Extracellular Polymeric Substances (EPS). The Ultra Violet (UV) irradiation has high energy and sufficient to penetrate a tissue. This study aims to investigate the effect of combination of UV LED irradiation and blue laser on the biofilm. Methods: The pure culture of Staphylococcus aureus ATCC 25923 approximated 108 CFU/mL or 1.0 McFarland Standard was used for this study. The biofilm sample was placed onto micro plate for 48 hours. The treatment group was divided into 3 groups, which were blue laser group, UV LED group and UV-Blue laser group. Results: The results showed that the highest biofilm reduction (80.57 ± 0.77) % was treated by blue laser irradiation for 4 minutes and UV irradiation for 20 s. Conclusion: Thus, the combination UV LED and Blue laser is the best choice to eradicate more biofilm.

Empowering the Implementation of Patient Handover with Increasing Nurse Knowledge and Attitude at X General Hospital Indonesia

@#Introduction: In several studies it was described that ineffective communication during patient handover between the hospital departments or during shift-to-shift transfer result in discontinuity of care, inappropriate treatment, and potential risks of injury for patients. The patient handover is a professional responsibility and accountability related to nursing care. SBAR (Situation - Background - Assessment – Recommendation) method as part of the international patient safety goals(IPSGs) was developed to improve communication breakdown. Knowledge and attitude are essential factors associated with the implementation of patient handover, yet limited research was done on this. The purpose of this study was to examine the relationship between nurse knowledge and attitude toward a patient handover. Methods: A cross-sectional approach was applied in this study. A total of 61 nurses consisting of the head nurse, and team leaders participated in sampling technique done by simple random sampling method from the hospital database. Data collection used a structured questionnaire with a good result of validity and reliability. Univariate and bivariate test were used for data analyzing with Statistical Package for the Social Science (SPSS) Version 18. Results: There is a relationship between nurses' knowledge and attitude toward patient handover with OR 5.280 (1.063-26.227); OR 5.333 (1.351-21.062), respectively and statistically significant (p<0.000). Conclusion: Handover is a dynamic process and impacts directly on patient care. Increasing nurse knowledge and attitude are essential to enhance the implementation of patient handover. Training, seminar and intensive practice are strongly needed to build the culture of patient safety.

Major depressive disorder patients on antidepressant treatments display higher number of regulatory T cells

@#Introduction: Regulatory T cell (Treg) is a subtype of T lymphocyte that plays a crucial role in establishing immunologic self-tolerance and maintaining immune homeostasis. In this study, we set out to investigate the percentage and absolute count of Tregs in major depressive disorder (MDD) patients and their correlation with disease severity. Materials & Methods: This is a case-control study consisting of 47 MDD patients and 47 healthy controls. MDD patients were treated with antidepressant drugs according to their physician’s choice. The severity of MDD was assessed using Beck Depression Inventory (BDI) and Montgomery-Asberg Depression Rating Scale (MADRS) at the time of recruitment. Healthy controls completed the Depression Anxiety Scoring System (DASS21) questionnaire to ensure they were in good mental health without history of MDD. The percentage and absolute count of CD4+ CD25+ Tregs and CD4+ CD25+ FOXP3+ Tregs were identified by multiparameter flow cytometry. Results: The percentage and absolute count of CD4+ CD25+ Treg cells were significantly higher in MDD patients than in healthy controls (P<0.001, in both cases). Likewise, the percentage and absolute count of CD4+ CD25+ FOXP3+ Treg cells were also significantly higher in MDD patients compared to healthy controls (P=0.003 and P=0.002, respectively). However, there was no significant correlation between the percentage and absolute count of CD4+ CD25+ Treg and CD4+ CD25+ FOXP3+ Treg cells with BDI or MADRS score. Conclusions: Our results suggest that antidepressant treatments contributed to an upregulation of Tregs in MDD patients.

Image quality assessment of pre-processed and post-processed digital panoramic radiographs in paediatric patients with mixed dentition

PURPOSE: To determine the impact of an image processing technique on diagnostic accuracy of digital panoramic radiographs for the assessment of anatomical structures in paediatric patients with mixed dentition. MATERIALS AND METHODS: The study consisted of 50 digital panoramic radiographs of children aged from 6 to 12 years, which were later on processed using a dedicated image processing method. A modified clinical image quality evaluation chart was used to evaluate the diagnostic accuracy of anatomical structures in maxillary and mandibular anterior and maxillary premolar region of processed images. RESULTS: A statistically significant difference was observed between pre and post-processed evaluation of anatomical structures (P 0.05). The Inter-observer and intra-observer reliability of both pre and post processed images were excellent (>0.82) for anterior region and good (>0.63) for premolar region. CONCLUSION: The application of image processing technique in digital panoramic radiography can be considered a reliable method for improving the quality of anatomical structures in paediatric patients with mixed dentition.

Serum Vascular Endothelial Growth Factor (VEGF) as a Biomarker for Disease Activity in Lupus Nephritis

Background: Previous studies have shown that serum VEGF levels were elevated in patients with active systemic lupus erythematosus (SLE), especially in those with lupus nephritis (LN). In this case control study, we aimed to compare serum levels of VEGF in SLE patients between LN, non-LN and healthy participants to determine the association between serum VEGF levels and the activity and histological classes of lupus nephritis. Methods: Blood samples were obtained from 92 SLE patients (46 LN and 46 non-LN) and 26 controls. Data were collected from medical records. Serum VEGF assays were performed by specific, enzyme-linked immunosorbent assay kits (ELISA). Laboratory investigations included urinalysis, urine protein–creatinine ratio, serum creatinine, albumin and VEGF levels. Blood pressure, renal biopsy result and treatment were recorded. LN activity was evaluated using the renal subscale of the British Isles Lupus Assessment Group (rBILAG, 2004). The rBILAG measures blood pressure (diastolic and systolic), urine protein, serum creatinine, calculated glomerular filtration rate (GFR), presence of active urinary sediments and histological evidence of active nephritis. Results: Serum VEGF was elevated in SLE patients with LN compared with the non-LN group and healthy controls. The levels found were significantly higher in the sera of patients with active nephritis compared to those with quiescent nephritis (P = 0.024). The study did not find a statistically significant relationship between serum VEGF levels and histological classes of LN. Conclusion: There was no significant difference of serum VEGF level between LN and non-LN SLE groups and between the non-LN group and healthy controls. However, there were increased levels of serum VEGF in the LN group, especially in patients with active nephritis as compared to quiescent nephritis group. This reflects the role of VEGF in the pathogenesis of lupus nephritis, however the clinical potential of this biomarker needs further study.

Association Between IL-31 Serum Levels And Other Predisposing Factors With Allergic Diseases In HRPZ II and HUSM, Kelantan, Malaysia

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzyme-linked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.

Immunomodulatory Effect of Water Extract of Stachytarpheta jamaicensis (L.) Vahl.

Stachytarpheta jamaicensis (L)Vahl traditionally is used to treat several diseases, such as urinary tract infections, rheumatic, and pharyngitis. The objective of this study was to test immunomodulatory effect of water extract of S. jamaicensis (L.) Vahl. herbs. Immunomodulatory assay of water extract of S. jamaicensis herbs have been examined in male Balb/c mice using carbon clearance assay. The doses of the extract were 62.5, 125, and 250 mg/kg bw. Parameter of immunomodulatory effect was phagocytic indexes after seven days administration of the extract. The result showed thatwater extract of S. jamaicensis at doses of 62.5 and 250 mg/kg bw had lower phagocytic index compared to Zymosan A, but higher phagocytic indexes compared to Methylprednisolone. The water extract of S. jamaicensismay be considered as an immunosuppresant agent.

Comparative Evaluation of Antioxidant Properties of Methanolic Extract of Red and Green Custard Apple Fruits.

Annona squamosa (custard apple) or also called Sugar Apple. It is native to the tropical Americas and West Indies, but the exact origin is unknown. It is now the most widely cultivated of all the species of Annona, being grown for its fruit throughout the tropics and warmer subtropics, such as Indonesia, Thailand, and Taiwan; it was introduced to southern Asia before 1590. There are two varieties of custard apple which were available in the local Malaysian market. In the present study we aimed to carry out comparative antioxidant activity of methanolic extract of both custard apple fruits by using 2,2-diphenyl-1-picryl-hydrazyl (DPPH) method. The results showed that the methanolic extract of red custard apple showed better antioxidant activity than methanolic extract of green custard apple. However, the standard ascorbic acid showed better antioxidant activity than both the extracts. In conclusion, the red custard apple is good candidate for further investigation.

Cortisol dynamics and endothelin-1/nitric oxide ratio are associated with clinical vasospasme.

Background: Cortisol dynamics in serum might be related to clinical vasospasm, also known as delayed ischemic neurological deficits (DIND). Two vasoactive substances that play a role in pathophysiology of DIND are endothelin-1 (ET1) and nitric oxide (NO), both are proved associated with cortisol. This study aimed to know how cortisol plays a role on ET1/NO ratio and its relationship to DIND. Methods: This was a prospective cohort study for the first 14 days after aneurysmal subarachnoid hemorrhage (SAH). Patients with inclusion criteria will be enrolled for blood test before surgery, and post-operative day 2, 4, 7, and 10 (between 8:00-9:00 AM). The blood tests were performed for cortisol, ACTH, CBG, NO, and ET1. Free cortisol is calculated with Coolens equation. Logistic regression was used to see the interaction model and its scale. Bivariate analysis (corelation) was used to see the relationship between total cortisol, free cortisol, NO, ET1, and clinical vasospasm (DIND). Results: Forty-four patients were enrolled into this study (20 males; 24 females). Mean age was 52.02 ± 11.23 years. There were 29 patients (66%) within DIND group and 15 patients non-DIND as the control group. The mean of cortisol level shown was significantly higher in DIND group (35.99 ± 14.24) μg/dL compared to non-DIND group (19.57 ± 6.19) μg/dL, p < 0.001. The mean of free cortisol level was significantly higher in DIND group (2.06 ± 1.094) μg/dL compared to non-DIND group (0.838 ± 0.365 μg/dL; p < 0.001). The scatter plot graph showed that correlation of cortisol with ET1/NO ratio started increasing on day 4 and became stronger on day 10. Conclusion: Cortisol is associated with DIND following aneurysmal SAH, probably through its role in keeping the balance between ET1 and NO level.

Comparison of fetal bovine serum and platelet-rich plasma on human lipoaspirate-derived mesenchymal stem cell proliferation.

Background: Lipoaspirate-derived stem cells (LSCs) are very promising for regenerative medicine, e.g. to treat acute myocard infarction. Fetal bovine serum (FBS) is commonly used to propagate the LSCs. However, for its clinical application, FBS contains xeno-proteins that are potential to elicit immune rejection in patients. Platelet rich plasma (PRP) is one of the candidates to replace FBS. This study was aimed to compare the proliferation of LSCs cultured in 5% PRP, 10% PRP, and FBS containing medium (MesenCult®). Methods: LSCs were cultured in 5% PRP/DMEM, 10% PRP/DMEM, and MesenCult®. After the primary culture reached its confluency, cells were harvested using TrypLE Select and seeded (around 20,000 viable cells) in new vessels in the same media. Passages were done until passage-5, with six replications. Population doubling time (PDT) of the three groups were analyzed using Kruskal Wallis test. Results: LSCs showed different proliferation rates when cultured in 5% PRP/DMEM, 10% PRP/DMEM, and MesenCult®. PDT of the three experimental groups in passage 1-5 were significanly different (p < 0.05), with the lowest rank was cultured in medium of 10% PRP/DMEM. Conclusion: The results suggest that 10% PRP/DMEM can be used as an alternative to replace FBS in LSC culture.

A comparative study of computed radiography-based mammography using digital phosphor storage plate and full field digital mammography.

Background: Two digital mammography systems, based on different physical concepts, have been introduced in the last few years namely the full-field digital mammography (FFDM) system and computed radiography-based mammography using digital storage phosphor plate (DSPM). Aims: The objective of this study was to compare the image quality for DSPM and FFDM using a grading scale based on previously published articles. Materials and Methods: This comparative diagnostic study was done for 5-month duration at the Breast Clinic. The system used was the Lorad Selenia FFDM system and the Mammomat 3000 Nova DSPM system. The craniocaudal and mediolateral oblique projections were done on both breast on 58 asymptomatic women using both DSPM and FFDM. The mammograms were evaluated for eight criteria of image quality: Tissue coverage, compression, exposure, contrast, resolution, noise, artifact, and sharpness by two independent radiologists. Statistical Analysis: Wilcoxon Signed Rank Test and Weighted Kappa. Results: FFDM was rated significantly better (P < 0.05) for five aspects: Tissue coverage, compression, contrast, exposure, and resolution and equal to DSPM for sharpness, noise, and artifact. Conclusion: FFDM was superior in five aspects and equal to DSPM for three aspects of image quality.

Association between multimeric adiponectin and free leptin index with atherogenic dyslipidemia in non-diabetic obese men.

Background: To analyze the role of various adiponectin and free leptin index on the occurrence of atherogenic dislipidemia in non-diabetic central obese men. Methods: This is a cross-sectional study on 120 non-diabetic central obese men that was done in Jakarta. The measured indicators were total adiponectin, high molecular weight adiponectin (HMW adiponectin), medium molecular weight adiponectin (MMW adiponectin), low molecular weight adiponectin (LMW adiponectin), leptin, soluble leptin receptor, triglycerides, high-density lipoprotein cholesterol (HDL cholesterol), low density lipoprotein cholesterol (LDL cholesterol) and apolipoprotein B (Apo B). Atherogenic dyslipidemia was characterized by reduced level of HDL cholesterol, and high levels of triglyceride and small dense LDL (sdLDL). Ratio of LDL cholesterol and Apo B were calculated to get sdLDL. Free Leptin Index (FLI) was the ratio between total leptin and soluble leptin receptor (sOB-R), and median values were used as cut off to defi ne high and low values of each parameter. Cross tabulation were done on categorical data. Relationships between multimeric adiponectin and free leptin index with atherogenic lipids were analyzed by using Spearman analysis. Further, the interaction of all indicators with the occurence of atherogenic dyslipidemia was analyzed using binary logistic regression. Results: A negative correlation of HMW adiponectin with atherogenic dyslipidemia (p < 0.05), whereas there were no correlation between MMW adiponectin and LMW adiponectin with atherogenic dyslipidemia (p > 0.05). Free Leptin Index was associated positively with atherogenic dyslipidemia (p < 0.05). Odds Ratio (OR) of HMW adiponectin for the occurrence of atherogenic dyslipidemia was 3.62 (p < 0.05), where as OR of FLI with atherogenic dyslipidemia was 4.57 (p < 0.05). Conclusion: HMW Adiponectin and FLI might contribute to atherogenic dyslipidemia in central obese non-diabetic males.

Angiopoietin like protein 3 (Angptl3), fatty acid binding protein 4 (FABP4) and homeostasis model assessment of insulin resistance (HOMA-IR) among Indonesian obese non diabetic males.

Aim To reveal the correlation between Angptl3, FABP4 and HOMA-IR among Indonesian obese non diabetic males. Methods This is a cross sectional study with 133 obese non diabetic males volunteers (characterized by waist circumference > 90 cm; fasting blood glucose < 126 mg/dL; and no diabetic specific symptoms) age between 30-60 years which was done in Jakarta, Indonesia. We measured biochemical markers such as Angptl3, FABP4, FFA, fasting insulin and fasting glucose. We also measured weight, height, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Correlation between each marker was measured using Pearson and Spearman’s analysis. Results Pearson and Spearman’s correlation analysis showed significant positive correlation between Angptl3 and FABP4 (r = 0.319; P = 0.000), Angptl3 and FFA (r = 0.171; r = 0.049), FABP4 and HOMA-IR (r = 0.202; P = 0.019), FFA and FABP4 (r = 0.506; P = 0.000), WC and HOMA-IR (r = 0.323; P = 0.000), WC and FABP4 (r = 0.387; P = 0.000), Body Mass Index (BMI) and HOMA-IR (r = 0.270; P = 0.002), BMI and FABP4 (r = 0.362; P = 0.000). Conclusion This study showed positive significant correlations between Angptl3-FABP4, Angptl3-FFA, FFA-FABP4 and FABP4-HOMA-IR. We suggest that Angptl3 can activate lipolysis in adipose tissue (through its correlation with FABP4), and Angptl3 concentration is related to insulin resistance risk among Indonesian obese non diabetic males.

The Relationship Between Retinol/Retinol Binding Protein 4 ratio, resistin and inflammation in non diabetic obese Indonesian men.

Aim To verify the correlation between Retinol/RBP4 Ratio, and resistin with inflammation (represented by hsCRP) in non-diabetic obese Indonesian men Methods This was a cross sectional study using 125 subjects. Measured parameters were retinol, RBP4, resistin, and hsCRP. Correlation between retinol, RBP4, resistin, hsCRP and Retinol/RBP4 Ratio was calculated. Cut off point of hsCRP were classiied as follows: <1 mg/l for low risk of inflammation, 1-3 mg/l for moderate risk, and 3-10 mg/l for high risk (according to CVD risk). The Retinol/RBP4 ratio was dichotomized into high (>0.9) and low ratio (≤0.9). The cross tabulation test was performed to predict the inflammation trends described by Retinol/RBP4 Ratio and resistin. Results Retinol was found strongly correlated with RBP4 and resistin (r=0.53; p<0.01). A positive but not significant correlation was found between resistin and Retinol/RBP4 Ratio with hsCRP. In high ratio group, 17.6% subjects were found with low risk inflammation, 26.4% with moderate risk, and 20.8% with high risk, in low ratio group, 8% subjects were low risk inflammation, 20% moderate risk, and 7.2% high risk. Combination between ratio and resistin showed that in “high ratio and low resistin” group, 12% subjects have low risk of inflammation and 8% have high risk. Meanwhile in “low ratio and high resistin” group, 3.2% subjects were found having low risk and 13.6% high risk of inflammation. Conclusions Combination between Retinol/RBP4 Ratio and resistin showed better description about the inflammation risk in non-diabetic obese subjects compare to the ratio itself.

Negative impact of imflammation and insulin resistance on the biogenesis of HDL-c in Indonesian men with metabolic syndrome.

Aim To find out the relationship between inflammation and insulin resistance with impaired HDL biogenesis that cause low HDL-c concentration Methods Using a cross-sectional design, this study involved 163 adult men, aged 25-60 years old with metabolic syndrome (IDF criteria, 2005), without liver and kidney dysfunction. This study was undertaken in Jakarta in the year 2007-2009. Measured indicators were serum apolipoprotein A-1 (apoA-1), prebeta-1 HDL, cholesteryl ester transfer protein (CETP), HDL cholesterol (HDL-c), body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and triglyceride. The apoA-1/HDL-c ratios were taken as indicator of HDL maturation, whereas CETP/HDL-c and CETP/TG ratios were indicated HDL catabolism. high-sensitivity CRP (hsCRP) and HOMA-IR were taken as indicator of inflammation and insulin resistance, respectively. Data were analyzed by using univariate, bivariate, and multivariate analysis. Results Positive correlations were found between hsCRP and CETP (rs= 0.200, p= 0.042), and CETP/HDL-c ratios (rs= 0.188, p= 0.013). HOMA-IR positively correlated with apoA-1/HDL-c ratios (rs= 0.190, p= 0.016) and negatively correlated with the CETP/TG ratios (rs= -0.162, p= 0.04). Results of general linear model analysis showed that serum hsCRP concentration had the highest contribution to CETP/HDL-c ratios, apoA-1, dan CETP (p= 0.009; 0.016; 0.054, respectively). Conclusions Inflammation and insulin resistance related to dysfunction of HDL biogenesis in men with metabolic syndrome. The inflammation correlated with increased HDL catabolism, whereas the insulin resistance correlated with decreased HDL maturation and increased HDL catabolism. These may lead to low HDL-c concentration. Inflammation had higher contribution to HDL biogenesis factors than insulin resistance.

A randomized study camparing oral versus injection triamcinolone in carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy found in clinical practice. Corticosteroids are effective in treating CTS. The purpose of this study was to evaluate the effi cacy of oral versus local injection of triamcinolone in relieving symptoms and improving neurophysiological parameters in CTS. This is a randomized controlled trial performed at Hasan Sadikin Hospital, Bandung. Inclusion criteria were idiopathic CTS patients without thenar atrophy and no contraindications to corticosteroids. Subjects were divided into oral or injection groups. The oral group was given 16 mg triamcinolone daily for 2 weeks followed by 8 mg daily for the next 2 weeks and local placebo injection. The injection group was given 15 mg local injection triamcinolone and oral placebo. The outcome was assessed using Global Symptom Score and nerve conduction studies. Fifty subjects were randomized to oral or injection group. The injection group show signifi cant improvement at 2 and 4 weeks while the oral group showed signifi cant improvement only at 2 weeks. Comparing both groups, improvement in neurophysiological parameters were signifi cantly greater in the injection group. In conclusion, local injection triamcinolone show better neurophysiologic outcome and effi cacy in relieving symptoms compared to oral triamcinolone in CTS.