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A gastric ulcer arises due to an imbalance between the stomach's aggressive and defensive factors, one of which can be induced by ketorolac. The gastric mucosa serves as a protective layer against gastric damage. Probiotics may enhance mucosal secretion, reinforcing their barrier function. This study evaluated the effect of Lactiplantibacillus plantarum IS-10506 on repairing gastric mucosal injury expressed by Mucin 5AC (MUC5AC) induction from ketorolac in rodent model. In the experiment, 48 male Wistar rats were randomly assigned and segregated into four groups: the control group (K1), the group with ketorolac administration (K2), the group given L. plantarum IS-10506 after ketorolac administration (K3), and the group given L. plantarum IS-10506 before and after ketorolac administration (K4). Gastric tissue was examined for cells producing MUC5AC via immunohistochemistry. MUC5AC differences between groups were compared using Kruskal-Wallis and Mann-Whitney U tests. Significant differences were observed between each group on Days 5, 7, and 10 of necropsy (p=0.043; p=0.030; p=0.022). The ketorolac group (K2) consistently exhibited the lowest values during all examination days. Group K4 manifested a higher expression of MUC5AC relative to group K3. However, group K3 demonstrated a significantly increased from Day 1 to 10 of necropsy (p=0.030). Administering probiotic L. plantarum IS-10506 prior to ketorolac proved beneficial by significantly accelerate (p=0.030) the MUC5AC expression cells and gene expression. [ABSTRACT FROM AUTHOR]

Introduction: Caspase-3 is a crucial mediator of the extrinsic apoptosis pathway. The role of caspase-3 for extrinsic apoptosis signalling is still a challenge and should be exploited in childhood ALL. This study aimed to compare the caspase-3 expression in the patient's bone marrow before and after the induction phase of chemotherapy in childhood ALL. It will also to correlate the mean difference in caspase-3 expression between ALL standard-risk and ALL high-risk patients. Methods: Seventeen newly diagnosed ALL subjects were enrolled in this study. Caspase-3 expression in bone marrow was assessed using flow cytometry and monoclonal antibodies. A T-test and a paired T-test were used to compare between groups. The correlation coefficient between ALL groups was evaluated using Spearman's test and linear regression with a significant p-value of 0.05. Results: The caspase-3 expression is higher after induction therapy. However, it showed an insignificant difference (16.56+12.91% vs 27.71+12.33%; p = 0.08, p > 0.05). The mean difference of caspase-3 in ALL high-risk groups was significantly higher than in ALL standard-risk groups with a positive correlation (p = 0.007, r = 0.756). Conclusion: The caspase-3 expression after induction phase chemotherapy was increased in all standard-risk and high-risk patients; other lymphoblast apoptosis markers need to be confirmed alongside caspase-3. [ABSTRACT FROM AUTHOR]

Introduction: L-asparaginase chemotherapy often causes hepatotoxicity and affects complete remission in pediatric acute lymphoblastic leukemia (ALL). This study aims to investigate the risk factors that affect the incidence of hepatotoxicity caused by L-asparaginase chemotherapy in ALL children. Methods: An observational study with prospective sampling was conducted at Dr. Soetomo Hospital, Surabaya. The inclusion criteria included ALL children aged 1-18 years, undergoing ALL Induction phase chemotherapy based on the 2018 Indonesian Children's ALL protocol as evidenced by bone marrow aspiration, receiving L-asparaginase chemotherapy, and obtaining written consent from parents or guardians. Each child had 3 ml of blood drawn from a peripheral vein to assess their complete blood count, alanine transaminase (ALT) levels, and albumin level. Results: Thirty-two children with ALL were collected. Two of them were excluded due to allergic reaction and enable to continue the L-asparaginase chemotherapy. Thirty of them were eligible participants. Approximately 53.3% of ALL children aged ≤ seven years. Fourteen (47%) children with ALL were included in the standard-risk group and 16 (53%) of them included high-risk group. There were significant differences in ALT levels between the four stages of observation (p=<0.001). Twenty-two ALL children had hepatotoxicity (73.3%), while 8 had non-hepatotoxicity (26.7%). Two risk factors had a significant influence on the occurrence of hepatotoxicity due to L-asparaginase chemotherapy including age and hypoalbuminemia (p=0.045, p=0.028). Conclusion: Age and hypoalbuminemia were the risk factors that might affect the incidents of hepatotoxicity. Clinical monitoring before and after treatment needs to be done to prevent poor outcomes. [ABSTRACT FROM AUTHOR]

Children with transfusion-dependent thalassemia experience stressful conditions related to chronic anemia, repeated blood transfusions, and iron chelation adherence. They are vulnerable to emotional and behavioral problems and psychosocial disturbances. An observational evaluation of psychosocial issues in children with TDTs aged 4–18 using Strengths and Difficulties Questionnaires (SDQ). Psychosocial part in children with TDTs often experiences difficulties in childhood under 10 years old, compared to adolescents (11–18 years) for emotional symptoms and conduct problems. Boys and girls had similar psychosocial problems regarding emotional symptoms, conduct problems, hyperactivity-inatttention, peer relationship problems, and prosocial behavior. In a quarter of cases, they had emotional symptoms, conduct, and hyperactivity-inattention issues, especially in younger children. Interestingly, younger children have more problems than adolescence in peer relations even though they are still under strict parental supervision. Difficulties in emotion, conduct, and hyperactivity would affect their relationship life. Children may try to be accepted by their social environment (prosocial) even though they realize that there are problems in their emotional life and peer relationships. Regular screening of the psychosocial aspects should be followed by counseling because regular transfusion and iron chelation are necessary for long-term management. [ABSTRACT FROM AUTHOR]

Background: Transfusion-dependent thalassemia (TDT) necessitates regular transfusions, resulting in complications such as iron overload, hemolytic anemia, and the emergence of alloantibodies/autoantibodies. This situation poses challenges in obtaining compatible transfusions. Excessive iron and chronic hemolysis impact the elevation of Interleukin-6 (IL-6), initiating an inflammatory process that triggers hepcidin formation and influences antibody development. This study aims to analyze disparities in IL-6 and hepcidin levels and establish the correlation between IL-6 and hepcidin in TDT patients with and without alloimmunization/autoimmunization. Methods: Forty whole blood samples were collected from TDT patients with and without alloimmunization/autoimmunization, centrifuged, and the serum extracted, then stored in a refrigerator at -80°C. IL-6 and hepcidin levels were assessed using the ELISA method. The Mann-Whitney U test was employed to evaluate differences in hepcidin and IL-6 levels between the two groups. In contrast, the Spearman Correlation test was utilized to analyze the correlation between hepcidin and IL-6 levels. Results: IL-6 levels in the TDT group with alloimmunization/autoimmunization (3.64 pg/mL) were significantly higher compared to the TDT group without alloimmunization/autoimmunization (1.41 pg/mL; p < 0.05). Hepcidin levels in the TDT group with alloimmunization/autoimmunization (2,950.6 pg/mL) were significantly higher compared to the TDT group without alloimmunization/autoimmunization (1,599.6 pg/mL; p < 0.05). The Spearman correlation test revealed a significant positive correlation between hepcidin and IL-6 levels in TDT patients with alloimmunization/autoimmunization (r = 0.764; p = 0.000). Additionally, a significant positive correlation was observed between hepcidin and IL-6 levels in TDT patients without alloimmunization/autoimmunization (r = 0.559; p = 0.010). Conclusion: IL-6 and hepcidin levels were elevated in TDT patients with alloimmunization/autoimmunization compared to those without. Interleukin-6 and hepcidin exhibited a positive correlation in both transfusion-dependent thalassemia groups. [ABSTRACT FROM AUTHOR]

Thalassemia is a hereditary form of anemia that affects the synthesis of hemoglobin. The management of therapy in patients with β-thalassemia major which patients should receive continuous blood transfusions and increased iron absorption from the digestive tract causes excess iron in the body. This will lead to an increase of free iron level that triggers Radical Oxygen Species (ROS). Increased level of ROS can initiate lipid peroxidation which used as an indicator of oxidative stress in cells and tissues and produce reactive carbonyl, mainly malondialdehyde (MDA). Thus, MDA measurement is widely used as an indicator of lipid peroxidation. On the other hand, the risk of oxidative damage can be reduced by antioxidant, one of them is Vitamin E that is a fat-soluble vitamin with high potential antioxidant. The objective of this study was to analyze the effect of the dl-α-tocopherol (Vitamin E) administration on decrease of MDA serum level on pediatric patients with β-thalassemia major. This was a longitudinal observational study design for one group without comparison was conducted to examine the use of vitamin E to decreased MDA serum level on children patients with β-thalassemia major. The inclusion criteria were patients who rely on blood transfusions, patients who received only one type of iron chelating agents during the study period, the clinical condition is stable, agrees, and has completed the informed consent. In the course of the study of 21 patients there were variations in patient compliance in taking vitamin E tablet dosage 200 IU once-daily for one month: only 11 out of 21 patients consumed 30 tablets of vitamin E 200 IU (total dose of 6000 IU) in the 1-month study, and only data from those 11 samples will be analysed further. MDA serum level was measured pre- and post-administration of vitamin E and patient's characteristics of subjects was obtained for additional information. Pre-administration of vitamin E, serum level of MDA was 1239.4 ± 502.55 ng/mL with a range of 216.95 to 2297.3 ng/mL, whereas in the group post administration of vitamin E, MDA serum level was 786.49 ± 704.88 ng/mL with a range of 6.5380 to 1958.6 ng/mL. In conclusion, there was no significant difference in MDA serum level in the group pre- and post-administration of vitamin E (p = 0.15). [ABSTRACT FROM AUTHOR]