Search

Objective: Traumatic brain injury (TBI) is a leading cause of disability and death worldwide, with an estimated 64-74 million cases annually. The current gold standard for diagnosis is a computed tomography (CT) scan, which has limitations such as access, cost, and radiation risk. Therefore, a simple, accessible, and safe diagnostic modality is needed, one of which is biomarker examination. This study aims to establish the relationship between blood levels of the biomarker ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) and the severity of TBI based on the Glasgow Coma Scale (GCS) and Rotterdam CT score. Material and Methods: This observational analytic study with a cross-sectional design involved 41 samples aged 18-50 years who presented to the Emergency Department of Dr. Soetomo General Hospital, Surabaya, within 3-24 hours of the incident. UCH-L1 levels were measured from blood samples using the ELISA method, and the data on UCH-L1, GCS, and Rotterdam CT scores were analyzed with SPSS 29. Results: The mean UCH-L1 level was 0.522 ± 0.592, with a cutoff value of > 0.2057, indicating moderate to severe TBI if UCH-L1 levels exceeded 0.2057. Spearman's test and correlation coefficient analysis showed a strong relationship between UCH-L1 levels and Rotterdam CT score (p < 0.05), as well as between UCH-L1 levels and TBI severity based on GCS (p < 0.05). The cutoff value for Rotterdam CT score was > 2, indicating moderate to severe TBI if the score exceeded 2. Conclusion: Serum UCH-L1 levels are significantly associated with the severity of TBI based on GCS and Rotterdam CT score. [ABSTRACT FROM AUTHOR]

Introduction: Head injuries contribute significantly to morbidity and mortality globally, and there is need of effective treatment. This study focuses on evaluating NGF (Nerve Growth Factor) expression in a rat model of traumatic brain injury, exploring the potential therapeutic effects of Kaempferia galanga L. extract. Methods: Male Wistar rats were used in the experiment, and traumatic brain injury was induced using Marmarou's weight drop model. Four groups of rats were studied: a negative control group, a group with traumatic brain injury without Kaempferia galanga L. extract, and two groups with traumatic brain injury treated with different doses of Kaempferia galanga L. extract. Rats were divided further based on the time of decapitation, either 24 or 48 hours post-injury. NGF expression was assessed using immunohistochemistry. Results: The study confirmed NGF expression variations among groups, with stronger expression observed 48 hours post-injury in rats receiving 1200 mg/kgbb of Kaempferia galanga L. extract. This suggests a potential impact of the extract on NGF expression, likely attributed to its anti-inflammatory and antioxidant properties. Discussion: Kaempferia galanga L. extract has known antiinflammatory and antioxidant effects, which may contribute to increased NGF expression observed in this study. Conclusion: This study sheds light on the potential benefits of Kaempferia galanga L. extract in promoting NGF expression and improving outcomes in traumatic brain injury, emphasizing the need for further investigation to translate these findings into clinical practice. [ABSTRACT FROM AUTHOR]

Background: Recurrent cardiovascular disease (CVD) incidence puts patients at higher risk for mortality and morbidity. One of the CVD symptoms is acute coronary syndrome (ACS). Many genetic polymorphisms are CVD risk factors. This study's purpose was to investigate the correlation between recurrent ACS incidence and apolipoprotein E (ApoE) gene polymorphism. Method: Case-control design was used in this study. About 90 patients who visited the cardiology and internal medicine clinics at UNAIR Hospital in Surabaya, Indonesia, served as the study's subjects. There were 30 patients with recurrent ACS, 30 patients with a single ACS, and 30 patients with no history of cardiovascular disease. Afterward, using the polymerase chain reaction-restriction fragment length method, the ApoE gene polymorphism examination was carried out. The Tropical Disease Center UNAIR Laboratory conducted all laboratory testing. Results: In the recurrent ACS group, ApoE polymorphism genotype patterns were 5 subjects for ε2ε2 (16.67%), 23 subjects for ε3ε3 (76.66%), and 2 subjects for ε4ε4 (6.67%). Meanwhile, in the single ACS group, ApoE polymorphism genotype patterns were 6 subjects for ε2ε2 (20%), 22 subjects for ε3ε3 (73.4%), 1 subject for ε4ε4 (3.33%), and 1 subject for ε2ε3 (3.33%). And, in the non-ACS group, ApoE polymorphism genotype patterns were4 subjects for ε2ε2 (13.34%), 25 subjects for ε3ε3 (83.33%), and1 subject for ε4ε4 (3.33%). There was no correlation of ApoE gene polymorphism with recurrent ACS incidence by Chi-square analysis (p > 0.05). Conclusion: ApoE gene polymorphism cannot significantly affect recurrent ACS incidence. [ABSTRACT FROM AUTHOR]

Background: Aquaporin (AQP) is a family of integral membrane proteins that function as water channels. AQP facilitates the transport of water across the plasma cell membrane. AQP lining the periventricular wall in the presence of edema may impair the function of the AQP to prevent or facilitate proper movement of water. Result: We analyze the effect of hydrocephalus and CSF drainage on the expression levels of aquaporin 4 (AQP4) end feet astrocytes in a hydrocephalus mice model. The test was carried out using a mice model of hydrocephalus induced with kaolin, then CSF drainage was performed on the 7th and 14th day, and compared the levels of AQP4 expression in each group. Data showed an increase in AQP4 excretion levels in astrocyte end feet along with the duration of hydrocephalus (p = 0.001) in comparison between hydrocephalus mice on the 7th, 14th, and 21st days. AQP4 before and after CSF drainage, comparison of the hydrocephalus group on day 21 with the group of mice undergoing CSF drainage (p<0.05). The results showed that the CSF drainage treatment was proven to reduce the level of AQP4. Conclusion: This is the first study to describe immunohistochemical distribution of AQP4 after drainage hydrocephalus model in mice end feet astrocyte. The AQP4 expression and distribution in after drainage hydrocephalus model was comparable 14th and 21st day of hydrocephalus but 7 days after drainage. Larger studies are needed to substantiate the influence of breed and ageing on AQP4 expression after drainage of hydrocephalus model. [ABSTRACT FROM AUTHOR]

Background: Pulmonary arterial hypertension (PAH) in congenital heart disease (CHD) mechanism includes vasoconstriction and vascular remodeling. In Indonesia, sildenafil as a vasodilator is the only standard treatment for PAH. Research on pomegranate extract showed its potential as an anti-inflammatory and anti-proliferative agent that could work synergically with sildenafil in reducing pulmonary arterial pressure (PAP) Objective: To investigate the effect of pomegranate supplementation in the clinical manifestation of PAH in children with acyanotic CHD. Methods: This study was a randomized controlled clinical trial that compared the clinical manifestation of PAH in children with acyanotic CHD who received standard therapy for PAH and pomegranate extract supplementation with the placebo group. Observations were carried out over three months, and pre-and post-test evaluations were conducted to assess changes in PAP, functional classification of PAH, body weight, systolic blood pressure, heart rate, respiratory rate, and oxygen saturation in both groups. Statistical analysis was undertaken using the Wilcoxon, Mann-Whitney, and Spearman correlation tests. Results: There was no significant difference in PAP reduction between the pomegranate and placebo groups (p = .44) and no significant difference in the functional classification of PAH in the placebo and pomegranate groups (p = .55). There was a considerable reduction in the respiratory rate in the pomegranate group (p = .017). Respiratory rate was positively correlated with the functional classification of PAH (p = .011). Conclusion: There was a significant reduction in the respiratory rate in the pomegranate group that correlated with the functional classification of PAH. [ABSTRACT FROM AUTHOR]

Introduction: Meningioma is a common brain tumor with an incidence of more than 30% of all primary brain tumors in adults. The incidence of meningiomas increases with increasing age, women suffer more from meningiomas with a ratio of 3:1. Meningiomas are known to have steroid receptors in the form of progesterone (88%), estrogen (40%), and androgen (40%). Therefore, the use of hormonal therapy is suspected to affect the incidence and histopathological degree of meningioma. One of the widely used hormonal therapy is medroxyprogesterone acetate (MPA). However, there is not enough literature to explain the relationship between MPA and the incidence of meningioma. Objective: To identify the relationship between the duration of the use of Medroxyprogesterone acetate (MPA) hormonal contraceptives and the histopathological degree of meningioma. Methods: This study is an analytic observational with a retrospective design of meningiomas patients based on the duration of use of MPAtype hormonal contraception who performed surgery at Dr. Soetomo General Academic Hospital during the period January 2015 to December 2019. We determined the inclusion criteria for meningioma patients: a history of using MPA hormonal contraceptives or 3-month injectable contraceptives; and the control group: meningioma patients without a history of hormonal contraception. Results: There were 452 cases of meningioma and 101 patients met the inclusion criteria. Based on the results of statistical analysis, it was found that there was no difference relationship between the grade of meningioma and meningioma patients either using MPA or without using MPA. There was no difference in duration of use between the group using MPA <10 years or more than 10 years with the non-hormonal control group on meningioma grading (p = 0.772). There was also no difference relationship between the group that did not use hormonal contraception and the MPA group on the age of the patient (p = 0.217), both using contraception for <10 years and more than 10 years. Conclusion: There was no relationship found between histopathological degree of meningioma with the patients who use MPA contraceptives, both duration of use <10 years and =10 years compared with meningioma patients who do not use MPA contraception. [ABSTRACT FROM AUTHOR]

Background: Pulmonary arterial hypertension (PAH) is one of the complications due to acyanotic congenital heart disease. New treatment approach using natural ingredients from plants has been demonstrated in vitro to prevent and improve vascular remodeling in PAH. Objective: This study aimed to analyze the effect of pomegranate extract on N-terminal pro brain natriuretic peptide (NT pro BNP) and asymmetric dimethylarginine (ADMA) levels in children with PAH in acyanotic CHD. Method: This study is a double-blind, quasi-experimental text with pre-test, post-test, and control group approach to children aged one month to 10 years old in Outpatient Department of Pediatric Cardiology Department/Pediatrics Department RSUD Dr. Soetomo in the period of February-October 2022, alongside met the inclusion criteria. Data were analyzed using Wilcoxon and Mann-Whitney test with 95% CI. Result: The study cohort included 15 subjects in the placebo group and 15 subjects in pomegranate extract group. The study was predominantly female (53,3%) with a mean age of each group, i.e., placebo group was 49 months, and pomegranate extract group was 58 months. The mean level of NT pro-BNP in the pomegranate extract group was 29.31 ± 33.55 ng/L (p= 0.008) and its mean ADMA level was 5619 ± 6166 ng/L (p= 0.173). As for the difference of NT pro-BNP and ADMA level changes after the intervention did not show a significant difference (p-0,330; p=0,885, respectively). Conclusion: No significant effect towards NT pro-BNP and ADMA levels found with giving pomegranate extract to children with PAH due to acyanotic CHD. [ABSTRACT FROM AUTHOR]

Introduction: Traumatic brain injury (TBI) is still a major health problem in the world. It might cause long-term disability that affect socio-economic life and become nation health burden. Post-traumatic cerebral edema might develop and commit to an unfavorable prognosis. Aquaporin 4 (AQP4) is water channel protein and a key regulator of water metabolism in the brain. Although the mechanism of AQP4 in the regulation of post-traumatic brain edema remains controversial, AQP4-lacking mice show better survival and decreased brain edema. Thus, novel strategies that suppress AQP4 become a potential field. We hypothesized that Kaempferia galanga L. may suppress brain expression of AQP4 following TBI and possibly limit the development of cerebral edema due to its neuroinflammation properties. Method: We conducted TBI to experimental rats, then given Kaempferia galanga L. extract at a dose of 600 mg/kg BW and 1200 mg/kg BW. Evaluation intensity of AQP4 expression by immunohistochemistry was performed 24 and 48 hours later to see its therapeutic effect. Results: Administration of Kaempferia galanga L. extract at a dose of 1200 mg/kg BW showed weak expression of AQP4 in all samples, both 24 and 48 hours following traumatic brain injury treatment. Conclusions: Intensity of AQP4 expression in rats' brain was lower at 24 and 48 hours after TBI in rats receiving Kaempferia galanga L. extract with dose 1200 mg/kg BW compared to the other groups. Our result indicates that Kaempferia galanga L. might affect the expression of brain AQP4 in a dose-dependent manner. [ABSTRACT FROM AUTHOR]

Background: Leprosy is a chronic granulomatous infection and is one of the neglected diseases caused by Mycobacterium leprae. ENL is a complex syndrome, that caused inflammation of the skin, nerves, and other organs due to an inflammatory immune response to Mycobacterium leprae antigens. Acute ENL was defined as the first episode of ENL with a duration of less than 24 weeks. Chronic ENL was defined as ENL that persisted for more than 24 weeks. These types of ENL can have different risk factors and require different therapeutic interventions. Purpose: The onset of ENL is acute, but may progress to a chronic or recurrent phase and require long-term therapy. Early detection of leprosy is very important, because the infection is curable and prompt treatment can reduce nerve damage and associated stigma. Chronic ENL patients require prolonged high doses of corticosteroids to control inflammation in ENL and cause severe complications and side effects associated with morbidity and mortality. Methods: This retrospective study was conducted using a non-probability sampling technique consecutively using a casecontrol formula in leprosy patients with ENL in the Leprosy Division of the Outpatient Dermatology and Venereology Unit RSUD Dr. Soetomo Surabaya for the period 2015 - 2020, using secondary data in the form of medical record data. Result: The results of this study obtained leprosy patients with ENL as many as 234 patients, 56 patients with acute ENL and 89 patients with chronic ENL. 45 patients with acute ENL and 45 patients with chronic ENL were obtained from the case-control minimal sample size formula. Conclusion: The results of the bivariate analysis test showed that there was a relationship between risk factors for coinfection and steroid therapy with the type of ENL. The presence of coinfection and steroid therapy showed that patients tend to be chronic ENL, conversely, in the absence of coinfection and without steroid therapy, patients tend to be acute ENL. The multivariate logistic regression analysis test showed a significant association between risk factors for ENL onset before MDT and the presence of coinfection with chronic ENL, whereas ENL onset after MDT and absence of coinfection were associated with acute ENL. [ABSTRACT FROM AUTHOR]

Introduction: Candidal vaginitis is an inflammatory disease that caused mainly by Candida albicans. Yeast transitions to filamentous hyphae considered the most important virulence factor. Neutrophils are the first line of defense of the immune system, but in patients with Candidal vaginitis the recruitment of neutrophils into the vaginal lumen is positively correlated with symptoms of the disease. This is supported by the release of proinflammatory cytokines such as TNF-α. Standard treatment is considered less effective in relieving symptoms, so other alternative/adjunctive treatments are needed. Golden sea cucumber (Stichopus hermanni) extract has been widely studied, especially for anti-fungal and anti-inflammatory. This study aims to analyze the mechanism of decreasing number of hyphae and neutrophils, and proinflammatory cytokine TNF-α in BALB/c mice inoculated intravaginally with C. albicans after administration of golden sea cucumber extract (S. hermanni). Methods: Experimental research uses a post-test only control group design. The experimental unit consisted of 36 BALB/c mice that were inoculated intravaginally with C. albicans and divided into 4 groups, group that did not receive treatment (K-), group that received standard treatment fluconazole (K+), group that received treatment with golden sea cucumber extract (S. hermanni) (P1) and group that received standard treatment with fluconazole plus extract of golden sea cucumber (S. hermanni) (P2). The hyphae and neutrophils number were seen microscopically on vaginal mucosal tissue. Cytokine levels of TNF-α were seen from the ELISA blood samples. Results: Results showed from the vaginal mucosal tissue of mice, there was significant difference in the number of hyphae (p = 0.001) between groups and no significant difference in the number of neutrophils (p = 0.070) between groups. From the blood serum of mice, there were significant differences in TNF-α levels (p=0.001) between groups. From the path analysis obtained a significant relationship from the number of hyphae to the number of neutrophils (p = 0.034) and the number of neutrophils to TNF-α levels (p = 0.021). The strength of the pathway from number of hyphae to number of neutrophils (β= 0.354) and number of neutrophils to TNF-α levels (β= 0.382) with positive interactions all. Conclusion: In summary, the administration of S. hermanni extract was able to reduce the number of hyphae, neutrophils and TNF-α levels through the hyphae, neutrophil and TNF-α pathway. [ABSTRACT FROM AUTHOR]