Organophosphate Resistance in Aedes aegypti: Study from Dengue Hemorrhagic Fever Endemic Subdistrict in Riau, Indonesia.

Background: Dengue hemorrhagic fever (DHF) is a significant health problem. The high number of cases requires preventions, including controlling the dengue vector, Aedes aegypti mosquito. One of the control methods is the use of insecticides containing organophosphate. This study aims to detect organophosphate resistance in Aedes aegypti from DHF endemic subdistrict, Riau, Indonesia by a sensitivity test of temephos and 5% malathion and measuring the activity of non-specific alpha and beta esterase enzymes. Methods: This observational study determined Aedes aegypti resistance from larvae to adult in one DHF endemic subdistrict in Riau, Indonesia. The bioassay was used for temephos sensitivity of Aedes aegypti larvae. The LC99 value was analyzed using probit and compared with the diagnostic value from WHO. The WHO susceptibility test was conducted to determine 5% malathion resistance from adult mosquitoes. The mortality of less than 90% was declared as resistant. Measurement of alpha and beta esterase levels used Lee's microplate assay technique based on visual identification and absorbance value (AV). Results: The results showed that Aedes aegypti were resistant to temephos. It also showed that adult mosquitoes were resistant to 5% malathion. Based on the alpha esterase activity test, it was found that most of the mosquitoes showed very sensitive meanwhile, based on the beta esterase activity test, most of the mosquitoes were moderate resistance. Conclusion: This study suggests that Aedes aegypti population from DHF endemic subdistrict in Riau, Indonesia are indicated to develop resistance to organophosphate.

Efficacy of vitamin D supplementation on the severity of atopic dermatitis in children: A systematic review and meta-analysis.

Background: Atopic Dermatitis (AD) is a common dermatosis in children, that includes skin architecture defects, immune dysregulation, and changes of skin flora. Several new drugs have been found to reduce the severity of AD. Vitamin D is one of the new therapies that is still controversial. The purpose of this research is to conclude the efficacy of vitamin D on atopic dermatitis severity in children aged 0-18 years old. Methods: A systematic search was conducted on the PubMed, Cochrane, ProQuest, Google Scholar, Clinical Trial website, and university repositories including studies published from January 2010 through October 2020. We compared populations, intervention, study design, and outcomes. Statistical analysis was done with Review Manager 5.4.1. Results: Eight articles met eligibility and inclusion criteria, four articles provided complete data and were analysed. Not all studies demonstrated the efficacy of vitamin D but a meta-analysis of four studies of vitamin D supplementation vs placebo found a mean difference of -0.93 (95%CI -1.76, to -0.11, p<0.001) of patient outcome, but statistically, there was no difference in cure rate (risk ratio 1.46 (95%CI 0.72, to 2.97, p=0.008) in vitamin D supplementation groups compared to placebo groups. Conclusions: Vitamin D supplementation in paediatric atopic dermatitis patients could offer improvement of disease severity but the recommended dose and duration of administration cannot be concluded yet.

A comparison study of the 0.1% tretinoin cream versus fractional microneedle radiofrequency combination with fractional CO2 laser for the treatment of striae alba in Indonesian patients.

Striae distensae (SD) are linear scar tissue in the dermis that arises from stretching the skin. There are two types of SD, striae rubrae and striae albae (SA) which is marked with a line hypopigmentation that cause a psychological problem, especially in the high skin type. The standard therapy is a 0.1% tretinoin cream, but it takes a long time to reach the collagen so it needs invasive measures to reach these targets. This study was comparing 0.1% tretinoin cream with combination therapy of fractional microneedle radiofrequency (FMR) and fractional CO2 laser for SA. The number of subjects in this study was 11 patients each group with Fitzpatrick skin types IV or V. Biopsy was taken before and after therapy. The clinical changes in SA lesions in this study were represented by measurements of the length and width. The percentage of collagen area is the amount of collagen fibers with Masson's trichrome staining. The clinical changes of lesion in the combination therapy decreased. The percentage change in collagen area in the combination therapy group had a higher increase. The side effect experienced by all combination group subjects was postinflammatory hyperpigmentation, two subjects in 0.1% tretinoin cream group experienced irritation.

Gallbladder edema in Dengue hemorrhagic fever and its association with haematocrit levels and type of infections.

AIM: To determine gallbladder edema with type of Dengue infection and hematocrit level. METHODS: A retrospective study was performed on 225 cases of DHF admitted from January to December 1997 to determine the association between the type of Dengue infection, hemoconcentration and the presence or absence of gallbladder edema. Primary or secondary types of Dengue infection consider to determine the severity and degree of plasma leakage in dengue hemorrhagic fever. The Chi square and Spearman 's tests were performed to establish association between variables. RESULTS: out of 225 cases of DHE 129 cases were found with the following dengue serology test results: 92 IgM positive and 37 negative. Abdominal ultrasound was performed in 57 cases, revealing gallbladder edema in 17 cases and none in 40 cases. The 57 cases were classified as primary dengue cases (positive IgMA), secondary dengue(positive IgM and IgG), or seronegative (negative IgM). Primary dengue was found in 5 cases with gallbladder edema and 15 cases without (25%). In the secondary dengue group,10 cases were found with gallbladder edema and 8 cases without (55.5%), while in the non-Dengue group, there were 2 cases with gallbladder edema and 17 cases without (10.5%). There was association between the development of gallbladder edema and the type of dengue infection(p=0.010). Gallbladder edema was more common in secondary Dengue (55%). There was a tendency for gallbladder edema in patients with higher increases in hematocrit. CONCLUSION: It conclude that gallbladder edema is more common in cases of secondary dengue and that there is a tendency for gallbladder edema with higher increase of hematocrit.

The correlation between coagulation test and albumin with antithrombin III in Dengue hemorrhagic fever.

AIM: To analyse the correlation between coagulation tests (PT APTT fibrinogen, D-dimer) and albumin with AT-II in DHF as well to find the formula to calculate AT-III with the parameter of coagulation tests and albumin. METHODS: A descriptive-correlative cross sectional study was conducted to 49 patients with DHF consisted of DHF I(17), DHF (19), DHF III (6) and DHF IV (7). The diagnosis of DHF is based on WHO criteria 1997. The laboratory examinations were coagulation tests (PT, APT, fibrinogen and D-dimer), antithrombin III and albumin, performed when the fever subside and the platelets reached the lowest count(4(th) - 6(th) day). RESULTS: A significant correlation was found between PT and AT-III (r= -0.631; p=0.000), between D-dimer and AT-III (r= -0.337; p=0.021) and between albumin and AT-III (r= 0.291; p-0.045). In multiple linier regression analysis(backward), AT-III can be calculated with the formula, accuracy 68.3%. CONCLUSIONS: PT and D-dimer were correlated negatively with AT-III, however albumin was correlated positively with AT-III. PT, D-dimer and AT-III were correlated with the grading severity of the DHF. In this study, AT-III can be calculated with the formula, accuracy 68.3%.

The correlation between thrombopoietin and platelet count in adult dengue viral infection patients.

AIM: To investigate alteration in humoral regulation during the course of dengue viral infection. METHODS: A prospective analytic study had been conducted involving 40 subjects with dengue viral infection. Subjects were recruited according to consecutive non-probability sampling. Subjects were categorized according to days of illness, platelet counts and serum thrombopoietin (TPO) levels. The plasma TPO levels examinations were done once daily until the platelet counts reached more than 100,000/mm(3). RESULTS: Statistical analysis showed the mean serum TPO levels were increased during thrombocytopenia phase of the disease, and differ significantly from the convalescent phase (mean value 428 pg/ml vs 220.1 pg/ml, p= 0.00). There was also a statistically significant inverse correlation between serum TPO levels and platelet counts (p= 0.00). CONCLUSION: TPO levels were significantly increased in adult patients with dengue infection in which platelets in circulation were markedly reduced, and the TPO levels were inversely related to the platelet counts.