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Background and Aim: There is an increasing rate of antibiotic resistance in Neisseria gonorrhoeae (N. gonorrhoeae). Several obstacles affect the culture and susceptibility testing of N. gonorrhoeae. This study was aimed to determine the antimicrobial susceptibility pattern and molecular characteristics in multidrug-resistant (MDR) N. gonorrhoeae in Jakarta, Indonesia. Materials and Methods: Forty-one endocervical specimens were streaked onto the chocolate agar and then gently rolled onto a glass object. The suspected colonies were identified by Gram staining, oxidase testing, and biochemical identification using VITEK® 2 NH cards. The antimicrobial susceptibility testing was performed using the disk diffusion or E-test method. Molecular detection of N. gonorrhoeae was carried out using the SYBR green real-time PCR targeting the opa gene. The multiplex real-time PCR with high-resolution melting (HRM) was also conducted to analyze the gene mutations in penA and 23S rRNA. DNA sequencing was used to confirm penA and 23S rRNA mutations. Results: SYBR green real-time PCR against the opa gene on direct specimens detected N. gonorrhoeae with higher positivity rate (49%) compared to the culture (34%). Susceptibility testing detected 11.1% N. gonorrhoeae resistant to cefixime, whereas resistance to azithromycin and ceftriaxone was 0%. The resistance of N. gonorrhoeae to levofloxacin and kanamycin was 33.3% and 88.9%, respectively. All isolates were resistant to penicillin, tetracycline and ciprofloxacin. There were no mutations in the penA genes Ala501, Gly545Ser, 23S rRNA A2059G and C2611T. Conclusion: Cefixime resistance was found in our samples. This resistence was not correlated with penA gene mutations. All isolates were still susceptiblle to azithromycin, which was in line with its molecular characteristics. The SYBR green real-time PCR targeting the opa gene successfully detected the DNA extracted from endocervical swabs as N. gonorrhoeae. [ABSTRACT FROM AUTHOR]

Psoriatic lesions on the scalp, face, intertriginous, genitals, palms/soles, and nails are often delay diagnosed, hard-to-treat, and cause disability. Metabolic syndrome (MetS) is one of the most frequent and significant comorbidities in psoriasis. Many studies have discovered a link between psoriasis and MetS, but none have specifically assessed the hard-to-treat psoriasis in Indonesian population. This is a multicenter study involving four dermatology referral hospitals to investigate the association between psoriasis severity that has hard-to-treat lesions with the prevalence of MetS in Jakarta, Indonesia. Data was collected from April to October 2022. The severity of 84 hard-to-treat psoriasis patients was measured by Psoriasis Area Severity Index (PASI) scores. The participants divided into PASI score >10 (severe) and ≤ 10 (mild-moderate) groups. MetS was identified based on the modified National Cholesterol Education Program Adult Treatment Panel III. MetS was found in 64.3% of patients. Patients with a PASI score>10 had a significantly higher risk of metabolic syndrome compared to those with a score ≤ 10 (78.6% vs 50%, OR 3.667; 95% CI 1.413–9.514; p = 0.006). The prevalence of hypertension (p = 0.028), low levels of high-density lipoprotein (HDL) cholesterol (p = 0.01), mean fasting blood sugar (p = 0.018), and triglyceride levels (p = 0.044) between the two groups differed significantly. This study found most frequent components of MetS were abdominal obesity, decreased levels of HDL cholesterol, hypertension, hyperglycemia, and hypertriglyceridemia respectively. Individuals with severe hard-to-treat psoriasis had a 3.67 times more likely to have MetS rather than the mild-moderate group. [ABSTRACT FROM AUTHOR]

Monkeypox is a viral zoonotic disease. It has evolved into human-to-human transmission with similar characteristics to smallpox. In contrast with the previous endemic outbreak, this 2022 multinational outbreak found numerous data of different skin lesions, predilections and populations. Furthermore, recent findings regarding monkeypox revealed the possibility of sexual transmission. As a basis for future monkeypox diagnosis guidelines, providing comprehensive data on the symptoms, predilections, age at presentation, previous history of sexual activities, comorbidities, range of incubation period from the time of sexual activity until the symptoms occured, as criteria for diagnosis of sexual transmitted disease. We performed a comprehensive search on a topic that assesses the outbreak of monkeypox disease in 2022 regarding the route of transmission from inception up until September 2022. There were 1310 patients from 10 studies who had monkeypox disease in 2022. Patients were mostly found in European countries, with averaging in their 30s, and were 99.54% male. Vesiculopustular lesions and ulcers with central umbilication appeared prior to prodromal signs were characteristic. Approximately 90% were transmitted during sexual intercourse and in homosexual group (MSM/Men who have sex with men), and 5-10% between bisexuals. Approximately 40.84% cases also had HIV as a comorbid disease and 15.42% have concurrent or history of sexually transmitted infection (STI) including syphilis, gonorrhea, chlamydia, herpes simplex, mixed, and other STIs. Homosexual and bisexual populations are the most high risk populations in the 2022 outbreak of monkeypox disease. The epidemiology, clinical manifestation, and type of skin lesion were different from the previous outbreak. The findings in this review may supplement information to further establish clinical guidelines on the new presentation of monkeypox disease. Further largescale studies are necessary to further describe and verify the data with higher levels of evidence. [ABSTRACT FROM AUTHOR]

Background Great scientific interest has grown around the role of vitamin D in many chronic diseases, due to its reported immunomodulatory effects and its association with several autoimmune and allergic diseases, including chronic urticaria (CU). Previous studies have shown low serum 25-hydroxyvitamin D [25(OH)D] or calcidiol levels in CU patients, with clinical improvements after vitamin D supplementation. However, data on the correlation between levels of vitamin D in the serum and CU disease activity are still limited, especially in low-middle income tropical countries like Indonesia. Objective We proposed to investigate the correlation between serum calcidiol levels and clinical disease activity in patients with CU. Methods We performed an analytic-descriptive cross-sectional study. Disease activity in CU patients, measured using the Urticaria Activity Score 7 (UAS 7) questionnaire, and serum calcidiol levels were assessed in 30 patients aged 18-59 years with CU. Results Mean UAS7 score was 14.6, median duration of illness was 12 months, and the median serum calcidiol level was 12.1 ng/mL. Most subjects (80%) were vitamin D deficient. We found no statistically significant correlations between serum calcidiol and CU disease activity (r=0.151; p=0.425). However, in subjects with severe vitamin D deficiency, a significant negative correlation was found (r=-0.916; p=0.001). Significant moderate correlation was also found between CU disease activity and illness duration (r=0.391; p=0.033). Conclusion We found no correlations between serum calcidiol levels and CU activity, however there was a tendency of increased CU disease activity in vitamin D deficient patients. [ABSTRACT FROM AUTHOR]