Effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke

@#Introduction: Cigarette smoke exposure can cause inflammation, inducing the release of acute phase cytokines, such as IL-6, that will then trigger the recruitment of neutrophils, which are mostly phagocytic cells. Zinc and probiotics are known to have beneficial effects against inflammation. This study was conducted to investigate the effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke. Methods: In a randomised, experimental study with post-test control group design, thirty 2 to 3-month-old male Wistar rats, each weighing 180-220 g, were divided into five groups: control group without treatment (C); exposed to cigarette smoke [C (-)]; exposed to cigarette smoke and received zinc (Z); exposed to cigarette smoke and received probiotics (P); and exposed to cigarette smoke and received a combination of zinc and probiotics (ZP). Results: Mean tissue neutrophil levels in Z, P, and ZP groups were 43.43±2.01, 34.67±1.32,and 29.77±5.05 cells, respectively. There were significant differences between supplementation intake and tissue neutrophil levels in each group compared to C (-) group (p<0.05). Meanwhile, only IL-6 level in the ZP group (6.02 pg/mL) decreased significantly compared to C (-) group (10.61 pg/mL). Conclusion: These results suggest that a combination of zinc and probiotics have an anti-inflammatory effect as measured by IL-6 and neutrophil levels.

Tobacco Use among School-Age Adolescents in Indonesia: Findings from the 2015 Indonesia Global School-Based Student Health Survey / 가정의학회지

Background@#Although Indonesia has a considerable proportion of adolescent smokers, nationally representative studies of its determinants remain limited. The 2015 Indonesian Global School-Based Student Health Survey (GSHS) was conducted with school-age adolescents and provided information about smoking behavior. This study aimed to examine the prevalence, determinants, and correlates of tobacco use among adolescents in Indonesia using the GSHS survey. @*Methods@#A secondary data analysis of a cross-sectional study was conducted using data from the 2015 Indonesian GSHS. Multivariate logistic regression was used to assess the determinants and correlates of tobacco use. @*Results@#Our analysis showed that 9.1% of school-age adolescents had used tobacco products in the past 30 days. Most were 13–15 years (61.7%) and had attempted to stop smoking (92.4%). After adjusting for covariates, significant risk factors associated with tobacco smoking were older age groups (prevalence odds ratio [POR], 3.01–9.40; 95% confidence interval [CI], 1.71–23.1), male (POR, 13.7; 95% CI, 8.71–21.5), psychological distress (POR, 1.41; 95% CI, 1.05–1.90), smoking exposure (POR, 1.98–2.15; 95% CI, 1.35–3.42), and when both parents smoked (POR, 2.96; 95% CI, 1.78–4.94). In addition, tobacco use was associated with other risky behaviors, including sex with multiple partners, using drugs, drinking alcohol, and being involved in physical fights. @*Conclusion@#Tobacco use is high among Indonesian adolescents. This prevalence highlights the need for a more stringent tobacco control policy and tailored cessation programs for adolescents by considering important modifiable determinants of tobacco use among adolescents, including risky smoking-related behaviors.

Phenol compound content and antibacterial activity of gaharu leaf extract products (Aquilaria malaccensis)

Gaharu leaf extract produces yield extraction, phenol compound, and antibacterial activity in diverse quantities. The purpose of this research was to investigate the influence of the extraction method and type of solvent on the extractability of the polyphenol component and the antibacterial activity of gaharu leaves. Extraction was done through maceration and Soxhlet methods by using solvents of hexane, ethyl acetate, and ethanol. The extraction result showed that the highest yield value of 18.4% was found on the treatment of a combination of ethanol solvent and Soxhlet method. The total content of phenol and tannin of gaharu leaf extract was in the range of 11.2 to 18.62mg. mL-1 and 12.82 to 13.41%, respectively. Antibacterial activity of gaharu leaf extract on the Gram-positive test of Staphylococcus aureus was higher than that of the Gram-negative test of Escherichia coli having a value of zone of inhibition in the range of 5.33 to 6.33 mm and 4.00 to 5.00 mm, respectively.

The Components of Height and Blood Pressure in Javanese Children

@#Introduction: Understanding the correlation between body height components and blood pressure in children can encourage proper investment in population-based primary prevention programs and gives benefits in terms of public health and economic well-being. This study aimed to investigate the prevalence of stunting and relationship between height, sitting height, leg length, and systolic and diastolic blood pressure (SBP and DBP) in Javanese children in Yogyakarta, Indonesia. Methods: This study used a cross sectional method which was conducted on 492 Javanese children aged 6-12 years old (237 boys and 255 girls). All children underwent anthropometric, SBP, and DBP measurements using standard procedures. Height-for-age based on WHO chart was used to define stunting, while leg length was based on the relative subischial leg-length. Statistical analysis was conducted using independent sample t-test and Pearson’s correlation test with a significance of p<0.05. Results: It was found that around 22.3% of children were stunted with two thirds of girls. Height components were positively correlated with SBP in boys (r=0.19–0.32, p<0.05) and girls (r:0.22–0.37, p<0.05) as well as DBP in boys (r:0.18–0.24, p<0.05) and girls (r:0.22–0.33, p<0.05). The highest correlations were found between siting height and SBP in boys and girls (r:0.32 and r:0.37, respectively). Conclusion: In this study, the incidence of stunting in girls was higher than boys. A positive correlation was found between the components of height and blood pressure. The component of sitting height was better than leg length for predicting blood pressure in Javanese children aged 6-12 years.

Delivering a modified continuous objective structured clinical examination for ophthalmology residents through a hybrid online method / 한국의학교육

Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.

Growth Patterns of Indonesian Infants with Cow's Milk Allergy and Fed with Soy-Based Infant Formula / 대한소아소화기영양학회지

Purpose@#The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. @*Methods@#A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptombased clinical scores. @*Results@#Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. @*Conclusion@#These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Growth Patterns of Indonesian Infants with Cow's Milk Allergy and Fed with Soy-Based Infant Formula / 대한소아소화기영양학회지

Purpose@#The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. @*Methods@#A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptombased clinical scores. @*Results@#Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. @*Conclusion@#These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Construct Validity Of Indonesian Language Version Of Childhood Autism Rating Scale™ Second Edition

@#Combination of The Childhood Autism Rating Scale™ Second Edition - Standard Clinical Tool (CARS2-ST) with criteria for autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is thought to improve diagnostic process. To meet diagnostic needs, localized, Indonesian-translated version of CARS2-ST is developed. Therefore, assessment of construct validity of the Indonesian-language translated CARS2-ST must be performed. A cross-sectional study was conducted in Child Development Center in Surabaya, Indonesia from August to December 2019. Diagnosis of ASD then performed by using CARS2-ST and DSM-5 criteria. To assess construct validity, principal components analysis and Kaiser-varimax rotation was performed for CARS2-ST in order to determine factors. DSM-5 criteria for ASD was used to compare scale.There were 201 children aged 2 - 6 years old with reported speech and behavior problems. Sixty-six children were diagnosed for ASD. Factor analysis using Kaiser-varimax rotation indicates a significant two factors: social communication and interaction factor and restrictive stereotyped behaviors and sensory factor sensitivites. The factors satisfyingly reflects the criteria for ASD in DSM-5.Construct validity of Indonesian-translated version of CARS2-ST is confirmed, as shown by its correspondence with DSM-5 criteria for diagnosing . This study supports the continued relevance of the Indonesian CARS2-ST in ASD assessment.

Role of micronize purified flavonoid fraction and ethanol Graptophyllum pictum extract on experimental anal ulcer healing. Study on Wistar rat / Papel da fração flavonoica purificada micronizada e do extrato etanólico de Graptophyllum Pictum em experimento de cicatrização de úlcera anal. Estudo com ratos Wistar

ABSTRACT Aim of the study To evaluate the role of micronized purified flavanoid fraction and ethanol Graptophyllum pictum extract in the treatment of anal ulcer. Method Twenty-eight Wistar rats were randomly allocated into four groups. Groups 2, 3 and 4 the anus were induced with croton oil, but was not induced on group 1. Groups 1 and 2 were treated with normal saline, while groups 3 and 4 were treated with micronized purified flavanoid fraction, and ethanol G. pictum extract, respectively. On 9th days blood sample were taken from the retro-orbital region, and Wistar was killed by cervical dislocation under ether anesthesia. The anal canal was resected up 2 cm from anal opening, weighted, photographically taken to measure the percentage of residual ulcer, and then prepared for microscopic examination. Elisa methods were done for superoxide dismutase and malondialdedhyde. The total leukocyte in the anal specimen was counted under 400 magnification power. superoxide dismutase, anal coefficient, and total leukocyte for statistical analysis were using ANOVA and LSD, while malondialdedhyde and percentage of ulcers were using Kruskal-Wallis and Mann-Whitney. Result Treatment with ethanol G. pictum extract dose of 100 mg/kg BW significantly reduces the percentage of anal ulcer, the edema, leukocyte infiltration, and malondialdedhyde, and increase the superoxide dismutase in comparison without treatment. Treatment with micronized purified flavanoid fraction did not reduce the leukocyte, anal coefficient, and percentage of anal ulcer, only increase malondialdedhyde and decrease superoxide dismutase significantly.

RESUMO Objetivo do estudo Avaliar o papel da Fração Flavonoica Purificada Micronizada e do Extrato Etanólico de Graptophyllum pictum no tratamento de úlcera anal. Método Vinte e oito ratos Wistar foram randomicamente alocados em quatro grupos. Nos grupos 2, 3 e 4, indução com óleo de cróton foi realizada no ânus, excetuando-se o Grupo 1. Os grupos 1 e 2 foram tratados com solução salina normal, enquanto os grupos 3 e 4 foram tratados com fração flavonoica purificada micronizada e extrato etanólico de Graptophyllum pictum, respectivamente. No nono dia, amostras de sangue foram colhidas da região retroorbital, e o rato Wistar sofreu eutanásia por deslocamento cervical sob anestesia com éter. O canal anal foi ressecado até 2 cm da abertura anal, ponderado e fotografado para medir a porcentagem de úlcera residual e, em seguida, preparado para exame microscópico. Os métodos superoxide dismutase e malondialdedhyde do ensaio Elisa foram realizados. A contagem total de leucócitos foi realizada na amostra anal com ampliação de 400 vezes. ANOVA e LSD foram utilizados para a análise estatística de superoxide dismutase, coeficiente anal e número total de leucócitos, enquanto os testes de Kruskal-Wallis e Mann-Whitney foram utilizados para a análise de malondialdedhyde e porcentagem de úlceras. Resultado O tratamento com o extrato etanólico de Graptophyllum pictum (100 mg/kg de peso corporal) reduz de modo significativo a porcentagem de úlceras anais, o edema, a infiltração de leucócitos e o malondialdedhyde e aumenta a superoxide dismutase, comparado ao não tratamento. O tratamento com a fração flavonoica purificada micronizada não reduziu os leucócitos, o coeficiente anal e a porcentagem de úlceras anais, apenas aumentou o malondialdedhyde e diminuiu significativamente a superoxide dismutase.

Effectiveness of Flaxseed Oil on Peripheral Nerve Regeneration Following Crush Injury of Sciatic Nerve in Rat: Behavioural Analysis and an Electron Microscopic Study

@#Introduction: Peripheral nerve injuries (PNI) are a disabling injury as it often results in motor and sensory deficit with cognitive impairment. Flaxseed oil provides a good source of omega-3 fatty acid and it is believed to be able to protect the damaged nerve cell for successful nerve recovery. This study aimed to investigate a potential neuro-regeneration properties of flaxseed oil in treating the PNI. Methods: A total of 65 rats were separated into 4 groups: Group 1: Normal group (n=5), Group 2: Negative group (n=20), Group 3: Experimental group (n=20) and Group 4: Positive control (n=20), all the group were further divided into 4 groups (post-operative 7, 14, 21, 28 days, n=5 for each days). The functional restoration was assessed by walking track analysis (Sciatic Functional Index analysis-SFI) and toe spreading reflex (grading score). Electron microscope studies were performed on sciatic nerve to evaluate the regenerative process through morphologic and morphometric changes. Results: Oral administration of flaxseed oil (experimental group) at 1000 mg/kg body weight/day showed better recovery compared to negative control value. However, there was no significant difference in SFI and toe spreading reflex between positive (mecobalamin) and experimental group (flaxseed oil). Morphological and morphometrical findings indicated increases in the myelin thickness and myelin sheath layer after administration of flaxseed oil. Conclusion: The flaxseed oil supplementation could enhance the neurorestorative capacities of injured sciatic nerve.

Awareness, Knowledge & Attitude on Urinary Tract Infection among Government Secondary School Students in Shah Alam, Malaysia

@#Introduction: A cross-sectional study was conducted to provide preliminary insight of Awareness, Knowledge and Attitude (AKA) assessment on urinary tract infection (UTI) among adolescents which includes the general level of AKA and correlation between the domains as well as the relationship between Total AKA and the sociodemographic factors. Methods: A modified and adapted questionnaire was developed, consisting of socio-demographic questions and AKA domains employing descriptive statistics, linear regression and multiple regression analysis via SPSS Version 23.0. Results: In general, AKA level was reported as moderate (0.5 ± 0.11). Among the three domains, Knowledge (0.70 ± 0.12) risen with the most astounding mean, took after Awareness (0.36 ± 0.22) and Attitude (0.65 ± 0.11). A positive but weak correlation was found between the domains; Awareness and Knowledge is significant at p = 0.034, r = 0.157; R2 = 0.02 and similarly, a weak correlation was also found between Knowledge and Attitude which is significant at p = 0.000, r = 0.411; R2 = 0.17. After covariates adjustment, female gender was found to have the strongest relationship with Total AKA. Conclusion: The general level of Total AKA on UTI is moderate. The AKA domains in this study was found to be positively correlated and female was found to be the best predictor for a better Total AKA on UTI. Thus, these findings provide important information to formulate an effective education intervention to improve the AKA on UTI among adolescents.

Relationships Between Awareness, Knowledge, Attitudes And Coping Mechanisms In Epilepsy

Objective: The relationships between awareness, knowledge and attitudes (AKA) and coping mechanisms among people with epilepsy (PWE) have not been well-explored particularly in Asia. This study aimed to: identify preferred coping strategies, correlate between AKA and coping mechanisms and compare coping strategies of PWE with different AKA levels. Methods: A cross-sectional sample of epilepsy out-patients was recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu. The participants completed the Malay AKA Epilepsy and the Malay Brief COPE instruments. The data was analysed using non-parametric statistics. Results: Sixty out of 72 patients (response rate = 83.3%) consented participation (median age = 27.5 years; male = 53.3%; unmarried = 63.3%; Malay = 90.0%; SPM education = 54.2%; unemployed = 35.0%; rural residents = 70.0%). Religion was the most preferred coping strategy (93.3%), followed by Emotional Support (86.7%) and Instrumental Support (81.7%). Awareness was negatively correlated with Instrumental Support (rs = -0.268; p<0.05) while Knowledge was positively linked to Humour (rs = +0.267; p<0.05). Positive associations between Attitudes versus Active Coping and Positive Reframing were also detected (rs = +0.284 to +0.331; p<0.05). Patients with good AKA levels coped significantly better through Self Distraction, Positive Reframing and Humour (p<0.01). Conclusion: AKA levels seemed to influence the type of coping strategies adopted by PWE in dealing with their illness suggesting that, efforts in improving AKA level should be combined with appropriate coping strategies to provide better health outcomes in epilepsy management.

Anxiety and Depression Symptoms And Health-related Quality of Life Status Among Patients With Cancer In Terengganu, Malaysia

Objective: This study was aimed to determine the prevalence of anxiety and depressive symptoms , to examine their association with health-related quality of life (HRQoL) profiles and to determine the predictors on overall HRQoL. Methods: This was a cross-sectional study conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. The Malay Hospital Anxiety and Depression Scale (HADS) and McGill Quality of Life Questionnaire (MMQoL) were administered to a sample of 150 cancer patients (mean age = 50.4 years). Chi-square test, correlation and multiple regression were utilised for data analysis. Results: The prevalence for mild anxiety and depressive symptoms was 30.7% and 23.3% respectively. The HADS-A correlated strongest with Total MMQoL Score (r = - 0.578) and Psychological Well-Being (r = -0.526). Only HADS-A (beta = - 0.486), and HADS-D (beta = -0.173) were significant in predicting overall health-related quality of life. Conclusion: Findings in our study indicated that the prevalence of anxiety and depressive symptoms in Terengganu cancer patients are moderate. If anxiety and depression are identified and treated, health-related quality of life among oncology patients appropriately could significantly be improved.

Asthma symptoms improvement in moderate persistent asthma patients with gastroesophageal reflux disease (GERD): the role of proton-pump inhibitor.

This study aimed to evaluate effect of proton pump inhibitor (esomeprazole) on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR) in moderate persistent asthma with gastroesofageal refluks disease (GERD). This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group) for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male) completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05). Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05). Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD.