Background: Cervical incompetence is primarily a clinical diagnosis, which is characterized by recurrent painless dilation of cervix and spontaneous second trimester loss and preterm delivery. Despite recent advances, the indications and efficacy of cervical cerclage have been remained controversial. This study was performed with the aim of evaluating the risk factors of preterm birth among women who underwent cervical cerclage and establishing a scoring system to predict preterm labor in this group of women.

Material and Methods: This retrospective cohort study was performed on 95 women who had undergone cervical cerclage from January 2016 to January 2018 in Maternity Teaching Hospital of Sulaimaniyah, Iraq. A total of 66 women who delivered after 34 weeks were used as control group, compared to 29 cases who delivered before 34 weeks.

Results: According to the findings of the present study, there was a significant association between the preterm birth before the 34 weeks of pregnancy and the risk factors of pathological vaginal discharge, cervical length less than 25 mm prior to cerclage placement, and passive smoking. The positive predictive value was calculated using the prediction model was %99 with a risk score of 3, 47.6% with risk score 2 and 28.2 % with risk score 1.

Conclusion: The prediction model can be used as a tool to identify patients at a higher risk for PTD <34 weeks and to recognize those that could benefit from cerclage and deliver after 34 weeks. It could also be a useful tool for identifying those high risk women with cerclage who require increased surveillance.

Purpose: The work was aimed at comparative studying of the functional and physical state of the patients with rectal prolapse after surgical treatment with various surgical techniques and at identifying the most optimal procedure technique.

Patients and methods: The authors observed 49 patients (32 women, or 65.3 %) aged 22 — 83 years (the median age of women was 46.1 ± 1.3 years old, of men — 48.7 ± 1.4 years old) with the rectal prolapse of varying severity. The Delorme’s procedure was indicated for 28 patients (57.1 %). Perianal proctosigmoidectomy (the Altemeier’s surgery) was performed in 12 patients (24.5 %). In the young patients, preference was given to the Ripstein’s abdominal surgery (nine patients; 18.4 %). To objectively assess the physical state of the anal sphincter apparatus, traditional sphincterometry was performed using S4402 sphincterometer with a nonperfusing sensor (Pro Medika GmbH, Germany), and the functional state of the sphincter complex was subjectively assessed using the Wexner’s score scale.

Results: The best results were obtained after the Delorme’s procedure (p<0.05), while the worse results were obtained in the young patients after the Ripstein’s surgery (p<0.05).

Conclusion: The obtained results may be used for assessing the functional and physical state of the anal sphincter complex in the surgical treatment of the patients with the rectal prolapse syndrome, especially in those with ASFs of varying severity.

Background: Aging and estrogen deficiency in menopause women increase susceptibility to liver diseases. In postmenopausal women, the change of ERα expressions and oxidative stress is related to liver diseases' pathogenesis. Phytoestrogens have been shown to protect and repair the liver organ due to estrogen deficiency. Purple Sweet Potatoes contain anthocyanins, a subgroup of flavonoids that have been shown to have antioxidant and phytoestrogen activity. This study aims to evaluate the phytoestrogen and antioxidant activities of purple sweet potato in a liver animal model of menopause through Superoxide Dismutase (SOD) and ERα expressions.

Method: A true experimental study by randomized post-test-only control group design was conducted among 28 female Wistar rats-aged 10-12 weeks with a bodyweight of 180-220 gram, which underwent bilateral ovariectomies. These animals were divided into 4 groups, with 7 rats in each group. On day 7, Group T0, as control was given aquadest, ethanol extract of purple sweet potato was assigned to Group T1, T2, and T3 with doses 1, 2, and 4 mL/day, respectively, during 30 days. The SOD and ERα mRNA expressions were evaluated by qRT-PCR with specific primers. Data were analyzed using SPSS version 20 for Windows.

Results: The mRNA expressions of ERα were not significantly different among groups (p>0.05), while SOD expressions were significantly different among groups (p<0.05). The expression of SOD in Group T1 (504.39±231.4 pg/μL), T2 (2,147.92±417.1 pg/μL), and T3 (405.30±224.1 pg/μL) showed a significantly higher than Group T0 (15.34±15.27) (p<0.05)

Conclusion: Oxidative stress could be prevented by purple sweet potato in the liver through the SOD mRNA expression but not ERα.

Background: One of the typical responses to the protection of the body is inflammation. Extensive and severe inflammation can result in tissue damage. Earthworms have been used empirically for years to treat diseases that are based on inflammatory events. This study evaluates the anti-inflammatory properties of red earthworm (Lumbricus rubellus) ethanolic extract from organic farmland in Bali, Indonesia.

Methods: An experimental study by post-test only control group design was conducted among 30 adult male Wistar rats, divided into 6 groups. Each group was given 0.5% NaCMC (negative control), Diclofenac sodium 9 mg/kgBW (positive control), Red earthworm ethanolic extracts of 50 mg/kgBW (P1) and 100 mg/kgBW (P2) at 1 hour before carrageenan injection. In addition, the ethanolic extracts of Red earthworms, respectively 50 mg/kgBW (P3) and 100 mg/kgBW (P4), which had been given once a day, during 1 week before and at the eighth day 1 hour before carrageenan injection. The measurements of edema were performed 4 hours after the administration of the test material. Data were analyzed using SPSS version 20 for Windows.

Results: The median score of Rats Hind Paw Edema was 0.3 (0.2-0.4) ml in negative control, 0.1 (0.0-0.2) ml in positive control, 0.2 (0.1-0.2) ml in P1, 0.2 (0.1-0.3) ml in P2, 0.2 (0.1-0.2) ml in P3, and 0.1 (0.1-0.2) ml in P4 groups. There was a significant differences between the NaCMC group (negative control) with the Diclofenac sodium group (positive control), P1, P3, and P4 groups (p<0.05), but not with P2 group (p>0.05).

Conclusion:  We conclude that red earthworm (Lumbricus rubellus) ethanolic extract from Bali's organic farmland exhibits an anti-inflammatory effect.

Introduction: Psoriasis vulgaris is still a major problem in the field of dermatology. Until recently, the exact cause of psoriasis is still being debated. In recent years research has been carried out on vitamin D and its role in the immune system, especially in psoriasis. Vitamin D cannot be separated from the role of VDR. The study aims to evaluate correlation between VDR plasma levels and the severity of psoriasis vulgaris.

Method: Study design using a cross-sectional design to determine the correlation of vitamin D levels in plasma with the severity of psoriasis vulgaris calculated using the Psoriasis Area and Severity Index (PASI) score.

Result: This study included 47 study participants who had psoriasis vulgaris, consisting of 30 (63.8%) men and 17 (36.2%) women with a mean age of 44.66 years. The mean PASI score was 6.904, while the mean plasma VDR level was 30.328 ng/ml. Spearman correlation shows a strong negative correlation (r = - 0.979; p <0.001) between plasma VDR levels and PASI scores in psoriasis vulgaris patients.

Conclusion: Vitamin D plays a role in regulating the growth and differentiation of keratinocytes and influences dendritic cells and T lymphocytes' immune function so that low vitamin D levels have essential implications in the pathogenesis of psoriasis vulgaris. In performing its function, vitamin D must bind to VDR and form a complex. In this study, it was found that there was a strong negative correlation between plasma VDR levels and PASI scores, so it can be concluded that low plasma VDR levels correlate with high degrees of psoriasis vulgaris severity and vice versa.

Background: Vitiligo is an acquired depigmented skin disease that occurs due to the death of melanocytes. There are various presumed theories about the cause of melanocyte death in vitiligo; one of them is oxidative stress theory. Lipid peroxidation is the primary manifestation of oxidative stress, producing malondialdehyde (MDA) as its end product. Malondialdehyde is a stable marker to assess the occurrence of oxidative stress. This study aims to prove the differences in serum MDA levels in the active vitiligo, stable vitiligo, and normal control groups.

Method: This research is an analytical cross-sectional study involving 64 vitiligo patients with active and stable lesions and 20 normal controls. The study was conducted at Sanglah General Hospital Denpasar in February - November 2019. Serum MDA levels were measured to assess oxidative stress. The measurement of MDA levels was carried out by a spectrophotometer instrument using Competitive-ELISA method.

Results: In this study, there were significant differences in MDA levels between active, stable vitiligo patients, and control group (p=0.000) with active vitiligo type have the highest MDA mean, followed by stable type and control group respectively.

Conclusion: Increased serum MDA levels are an indicator of oxidative stress in vitiligo, which leads to melanocyte death and manifests as increased vitiligo disease activity. The results of this study support the role of oxidative stress in vitiligo pathogenesis and the use of oxidative stress indicators like serum MDA levels as biomarker in evaluating vitiligo disease activity.

Purpose: Upper gastrointestinal bleeding is the major medical emergency case in the field of gastroenterology. The complications of UGI bleeding are recurrent bleeding and death. Identifying risk factors for the complications is expected to prevent or reduce recurrent bleeding complications and deaths from UGI bleeding. This study aims to know the risk of UGI bleeding complications in patients with a high level of C reactive protein (CRP).

Patients and methods: A prospective observational analytic study was performed, including all UGI bleeding patients (variceal and nonvariceal). CRP level was used to determine the high-risk cohort. High-risk cohort if the CRP level 5 mg/L and above, and low risk if CRP level less than 5 mg/L. The outcome of the study was the incidence of complication, both rebleeding and death during follow up for six weeks. 

Results: Based on the characteristic data of the sample, the high-risk group appears to have a slightly older age, higher leucocyte count, lower hemoglobin levels, and higher serum creatinine than the low-risk group. The incidence rate of complication in the high-risk group was 85.3% while in the low-risk group was 37.5%, and the relative risk (RR) was 2.27 (95% CI: 1.43-3.67). There were significant differences in the incidence of complications between the group, X²: 16; p <0.001. The RR for rebleeding in the high-risk to low-risk cohort was 2.68 (95% CI: 1.31-5.47); this difference is statistically significant (X²:9.3; p=0.02). The RR for death complication was 1.70 (95% CI: 0.63-4.53), and the difference is not statistically significant (X²: 1.2; p=0.28).

Conclusion: In this study, we found the CRP level ≥ 5 mg/L as a significant risk factor for rebleeding complications but not mortality in a patient with UGI bleeding.

Background: The denture usage should be accompanied by good denture cleansing to prevent denture damage and oral disease due to bacterial on the denture. Research on purple leaves (Graptophyllum pictum) showed that purple leaves have anti-bacterial and antimicrobial activity. So it is essential to study the effectiveness of purple leaves as denture cleanser towards the growth of S. mutans on flexible denture plates.

Objective: The objective of the study was to compare the effectiveness of purple leaf extract at different concentrations: 1.25%; 2.5%; 10% and 40%, fittident^Ò and aquadest towards S. mutans growth on flexible denture plates.

Methods: This study was in vitro study that used S. mutans from local isolates of the microbiological laboratory faculty of medicine, Universitas Udayana. The isolates were incubated for 24 hours with temperature 37^oC on 18 plates (10x10x2mm). The concentration of purple leaf extract was 1.25%; 2.5%; 10% and 40%. The effectiveness of purple leaf extract, fittident^Ò and aquadest towards the growth of S. mutans can be evaluated from the number of S. mutans colonies on flexible denture base plate (CFU/ml). Data were analyzed using the One Way Anova test with 95% confidence level (α = 0,05%). LSD (Least Significant Different) was tested to determine the significance of differences in the treatment group. 

Result: The lowest mean of colonies' growth was found in 10% concentration (21.0000). There was significant difference in colony count between the extract concentration groups (p=0.000). LSD-multi comparisons test on the Post Hoc analysis showed a significant difference between the extract concentrations of 1.25% to 10% (p=0.037), and the 2.5% extract to 10% (p=0.012) and 40% (p=0.027). Graptophylum pictum extract showed with highest flavonoid content (4340,30 mg/100 QE wb).

Conclusion: All extract concentrations are effective in suppressing bacterial growth. The optimum concentration to the growth of S. mutans was the extract with 10% concentration but did not differ significantly with the 40% concentration extract.  

Introduction: high accountability of employees, the organization can be helped to achieve the goals. In general, this research is to investigate the relationship between accountability and job satisfaction in nurses in an educational hospital affiliated to Yazd University of Medical Sciences

Method: This study was a descriptive study of correlation type that has been conducted a cross-sectional study in 2017. We involved 190 nurses from selected educational hospitals affiliated to the Yazd University of Medical Sciences in the city of Yazd that have been chosen by stratified random sampling method. The data collection tool was Costa and M Care Accountability Questionnaire concerning 12 items, and Kendall and Smith Job Satisfaction Questionnaire were 37 items. Likert's 5 scales were used to determine the score of accountability and job satisfaction. The data was analyzed by descriptive-analytical statistical tests and Pearson correlation coefficient, a significance level of 0.05, and in the SPSS software version 20.

Results: there was no significant relationship between accountability and job satisfaction except one of job satisfaction (nature of work) (p=0.009). Also, a significant association was observed between three demographic variables of the age group (31-35) years (p=0.047) and work experience between (11-15) years (p=0.03) and the gender of women (p = 0.005) and two variables of accountability and satisfaction.

Conclusion: According to the results, it is better to pay more attention to work nature to implement responsibilities more efficiently and increase job satisfaction.

Background: Atopic dermatitis is a chronic inflammatory skin condition that significantly impacts patients' quality of life. A disturbed sleep pattern, frequent potent topical and sometimes systemic corticosteroid use, and diet restriction, all of which could affect child's growth.

Objective: This study determined height and weight impairment in children with atopic dermatitis.

Patients and Methods: A cross-sectional study took children with atopic dermatitis ≤18 years, which was conducted in the "Erbil Dermatology Teaching Center." The patients' data included sociodemographic information, family history, drug history, and present complaints. The severity of the disease evaluated using SCORAD score. The weight was recorded using a medical electronic weighing machine, and standing height was recorded using a stadiometer.  

Results: Among 100 children with atopic dermatitis, their mean of age was 6.84±1.8 years.  Males and Females frequencies were 54 and 46, respectively. The family history of atopic dermatitis was positive in 73%. Generally disturbed sleep pattern was dominant, and almost all severe AD patients had disturbed sleep (87.5%). The severity of AD was classified by SCORAD score to mild (23%), moderate (69%), and severe (8%). Patients having their growth percentile for weight and height for age below 3^rd percentile were 10% and 3%, respectively. Patients' weight and height for age below 25^th percentile were 15% and 9%, respectively.

Conclusions: Atopic dermatitis can affect the height and weight of the children inversely. The study sample's most dominant character was sleep pattern disturbances, which can affect both weight and height.

Background: Acne vulgaris (AV) is a chronic inflammation of the pilosebaceous unit with clinical polymorphic lesion consist of non-inflammatory (open and closed comedones) and inflammatory lesions (papules, pustules, and nodules) with varying degree of inflammation and depth. Earlier studies showed that other bacteria might also found and played a role in acne pathogenesis besides Cutibacterium acnes (C. acnes).

Patients and Methods:  This descriptive observational study used cross-sectional method. Samples were collected from 40 subjects with AV. We took the samples from non-inflammatory (closed comedones) and inflammatory lesions (pustule) in each subject, followed by Gram staining, aerobic and anaerobic bacterial culture, and bacterial identification. This research has been approved by the Ethical Committee, Faculty of Medicine, University of Sumatera Utara.

Results: There were 12 bacterial species that were identified from 80 samples. We identified Cutibacterium acnes (21,2%) in anaerobic culture. While in aerobic culture, we identified Staphylococcus epidermidis (47,5%), Staphylococcus hominis (17,5%), Staphylococcus aureus (8,7%), Staphylococcus haemolyticus (8,7%), Leuconostoc mesentroides (6,2%), Micrococcus luteus (3,7%), Kocuria varians (2,5%), Staphylococcus vitulinus (1,2%), Staphylococcus cohnii (1,2%), Staphylococcus arlettae (1,2%) and Dermacoccus nishinomyaensis (1,2%).

Background: Striae has been reported as a skin problem often experienced by a woman and becomes an aesthetic problem. This skin problem can occur at any age, including adolescents, even though it is more common in younger women. Some conditions increase the risk of striae, such as weight, pregnancy, puberty, and hormonal drugs. Women with higher body mass index (BMI) tend to have more striae. With a limited study on striae, it is quite interesting to evaluate the high incidence of striae in the population.

Patients and Methods:  This was a cross-sectional study using a total sampling method. The study was conducted after approval from the Ethics Committee Faculty of Medicine, Universitas Sumatera Utara. Samples are 155 female students aged 18-25 years old from the Medical Faculty of Universitas Sumatera Utara. All samples were physically examined to diagnose the striae, and the BMI was calculated.  All the collected data were analyzed statistically with ETA statistical tests to see the relationship between BMI and striae. P-value <0.05 considered statistically significant.

Results: The dominant age of the subject is 19 years old (62.5%), followed by 20 years old (30.3%), 21 years old (3.8%), and 18 and 23 years old (0.6%). Out of 155 subjects, there are 117 have striae (75.5%). None of the striae subjects is underweight, normal weight was 113, 3 obese and one overweight. The 38 subjects without striae are in normal BMI. An analysis using ETA proved that BMI is not significantly associated with striae (p>0.05).

Conclusion: There is no significant relationship between BMI and striae.

Introduction. This study aimed to review the clinical characteristics and outcomes of COVID-19 patients presented with in-hospital hyperglycemia or pre-existing type 2 diabetes (T2DM).

Methods. This is a retrospective study conducted in Fatmawati General Hospital, Indonesia, from March 18th-Apr 30th, 2020. We reviewed medical records of 27 COVID-19 patients presented with either in-hospital hyperglycemia (11, 12.2%) or pre-existing T2DM (16, 17.8%) from a total of 90 confirmed COVID-19 cases admitted in our hospital.

Results. Critical conditions occurred in 50% of T2DM and 54.55% of the in-hospital hyperglycemia group. Mortality was documented in 68.75% of T2DM and 81.82% of in-hospital hyperglycemia group. Hypoglycemia, diabetic ketoacidosis, lactic acidosis and ketosis were found in 12.5%, 25%, 18.75%, and 25% of individuals with T2DM, respectively, resulting in a high mortality rate. Meanwhile, diabetes-related complications were rare among the in-hospital hyperglycemia group. However, respiratory failure (45.45% vs. 6.25%) and septic shock (27.27% vs. 6.25%) were more frequent than in the T2DM group.

Conclusion. In this preliminary study, a high mortality rate was documented among COVID-19 patients with preexisting T2DM and in-hospital hyperglycemia. In T2DM subjects, diabetes related-complications contributed to a higher mortality rate, while in-hospital hyperglycemia group, respiratory failure and septic shock were more frequent.

Introduction. There is a need for continual evaluation of the effective use of plant-based medicine as combination therapies as more therapeutic potentials are being associated with phytomedicine. The changes in the lipid and cardiac profile of adult Wistar rats following the co-administration of Cisplatin and methanolic extract of Portulaca oleracea (MEPO) were investigated.

Methods. Twenty-four (24) rats with an average weight of 154 kg were randomly divided into six (6) groups (A-F). Group A was given no treatment and served as the normal control group. Group B received only a cisplatin injection and served as the cisplatin control group. Group C and D were given 400mg/kg and 800 mg/kg MEPO six hours after cisplatin injection. Group E and F were administered 400mg/kg and 800 mg/kg MEPO 6 hours before cisplatin injection. All cisplatin injections were single-dose intraperitoneal injection (2 ml/kg) and MEPO administration lasted for 7 days. Animals were euthanized under diethyl ether anesthesia at the end of the experiment and blood collected for serum lipid profile investigations. Some cardiac and lipid parameters were estimated from standard formulae.

Results. There was a significant increase in the serum levels of TG and TC (p=0.01 and p < 0.001) and some estimated parameters – LDL, VLDL, CRR, HDL-LDL and TG-HDL (p<0.001, p=0.049, p<0.001, p<0.001 and p=0.001 respectively) while HTR was significantly decreased (p<0.001) due to cisplatin treatment. HDL and AI levels were unchanged by cisplatin treatment. MEPO significantly reversed (p<0.05) the cisplatin-induced changes in the serum lipid parameters (TG and TC) and estimated parameters (VLDL, CRR and TG-HDL) across all MEPO-treated groups.

Purpose: Isocitrate dehydrogenase 1 (IDH1) mutation plays an important role in the carcinogenesis of gliomas. The most recent WHO classification of central nervous system tumors has added molecular genetic in addition to the histological features of the tumor, including status of IDH mutation in glial tumors. The purpose of this study was to determine the prevalence of IDH1 mutations in Balinese glioma patients and its association with clinicopathological features.

Patients and methods: This study was conducted from 30 glioma patients at Sanglah General Hospital during January 2018 until June 2019. DNA extractions were carried out from the FFPE of tumor tissue, followed by amplification of codon 132 in exon 4 of the IDH1 gene by allele specific PCR. Relationship between IDH1 mutation status and clinicopathological features was tested with X² with 0.05 significance.

Results: The age range of patients is 14-81 years with an average age of 43.4 years (SD±17.9 years). Most patients with astrocytic tumors (25/30; 83.3%), others were oligodendroglial tumor (2/30; 6.7%) and oligoastrocytic tumor (3/30; 10%). Most patients were found with grade IV glioblastoma (18/30; 60%).  Genotyping analysis showed IDH1 mutations in the majority of glioma patients (90%). Most cases (92.6%) of mutant IDH1 showed heterozygous mutations (GA genotype) while the rest showed homozygous mutations (AA genotype). There were no significant relationship between IDH1 status and age (p=0.09), sex (p=0.63) and histologic type (0.14), but there was significant relationship between IDH1 mutation status and tumor grade (p=0.01). All of IDH1 mutation were found in diffuse glioma (grade II and III gliomas and grade IV glioblastoma).

Conclusion: Most of diffuse glioma (grade II-IV glioma) patients in Bali had IDH1 mutation and IDH1 mutation status has significant relationship with tumor grade. Further research about genetic abnormalities in order to improve therapeutic efficacy against IDH-mutated gliomas is needed.

Background: Stigma is one of many problems that hinders leprosy prevention efforts. Perceived stigma refers to the perceptions and subjective awareness of leprosy patients what the community thinks or do to themselves which can reduce quality of life (QOL). This study aimed to analyze the correlation between perceived stigma and QOL of leprosy patients

Methods: This study involved 30 leprosy patients and the baseline data were collected through interview. We assessed perceived stigma and QOL respectively by using Explanatory Model Interview Catalogue (EMIC) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Pearson correlation test is used to analyze the collected data.

Results: There was a significant correlation between perceived stigma and QOL (p=0,011; r= -0,459). The majority of research subjects were aged between 19-40 years old with male sex predominance, senior high school education, income below the city minimum wage and married status. Most of them had negative perceived stigma. Covering illness from others and discussing their illness closest people were the dominant factors affecting perceived stigma. They had ordinary QOL subjectively, not satisfied to health condition, physical domain was the most affected by Leprosy and had a good QOL.

Conclusion: There was a significant correlation between perceived stigma and QOL.

Background: Bullous keratopathy is one of the leading causes of vision loss following cataract surgery. Several factors have been elucidated regarding the influence of bulosa keratopathy post cataract surgery. This study aims to evaluate pre-, intra-, and postoperative predisposition factors for bullous keratopathy following cataract surgery.

Methods: A retrospective descriptive study was done using data extracted from medical records. Patients diagnosed with bullous keratopathy after cataract surgery who underwent further examination procedures for at least 3 months were included. Patients with a history of glaucoma, Fuch's dystrophy, or other intraocular procedures were excluded. Data were analyzed by SPSS version 20 for Windows.

Results: Fourteen cases were included in this study. Most cases were female (78.57%) aged ≥60 years old (64.29%). There were postoperative changes in visual acuity and corneal status in most patients without any change in intraocular pressure. The majority of patients underwent manual small incision cataract surgery with posterior chamber intraocular lens implantation. Intraoperative complications were vitreous prolapse and Descemet membrane stripping, while postoperative complications were uveitis and lens adhesion.

Conclusion: Bullous keratopathy after cataract surgery was more common in elderly females. There were notable changes in visual acuity and corneal status postoperatively. Further large-scale analytic study is warranted to confirm the predictive factors and causality.

Background: Acute limb ischemic is a disease that threatens the viability of the leg with the threat of amputation to death. Fast and accurate diagnosis is essential in the management of this disease, one of the most commonly performed surgical therapies in Indonesia is thromboembolectomy using a Fogarty catheter. Thromboembolectomy with this method is very effective but gives a variety of complications, one the complication is the occurrence of intima hyperplasia which affects the lumen restenosis of the blood vessels. The aim of this study is to determine whether the administration of oral L-Arginine as a supplement for 4 weeks after endothelial trauma with a Fogarty embolectomy balloon catheter can prevent the incidence of intimal hyperplasia of the iliac artery of the New Zealand Rabbit (Cuniculus oryctolagus).

Methods: Experimental study with 16 experimental animals of Oryctolagus cuniculus rabbits subjected to endothelial trauma with Fogarty catheters and divided into 2 groups. The control group was not given L-Arginine and the experimental group was given post-treatment oral L-Arginine for 4 weeks, then the intima-media ratio was compared with histopathological examination.

Results: There was a significant difference in the ratio of intima-media thickness between the control group (without L-Arginine administration) 5.13 ± 4.12 and the experimental group (with L-Arginine administration) 1.18 ± 0.59 (p=0.03 ). Significant differences were also found in the intima thickness of the control group 302.22 ± 217.42 and the experimental group 118.21 ± 32.59 (p=0.048). Meanwhile, for the thickness of the tunica media and the intima-media complex, there were no significant differences observed.

Conclusion: Administration of L-Arginine orally after endothelial trauma with Fogarty catheter in rabbit iliac artery significantly reduces the degree of intima hyperplasia.

Background: Decreased health due to the aging process is characterized by a decrease in the function and work of the body's organs which triggers the risk of disability and frailty, especially in postmenopausal women prone to sarcopenia which can worsen the condition of the elderly. The aim of the study is to determine the relationship between body mass index, handgrip, and cognitive status on frailty status in elderly women at some elderly integrated health services (posyandu lansia), Semarang City, Indonesia.

Methods: This study used a cross sectional design with a consecutive sampling method of 70 subjects. Subjects measured vital signs, weight and height. Subjects were then assessed for handgrip strength, cognitive status and frailty status. Univariate and bivariate data analysis used SPSS 25.0 with the Spearman correlation test.

Results: A total of 70 elderly women followed this study with an average age of 65.96 years. As many as 67.1% of elderly women have hypertension. There are 70% of all elderly women with pre-frail status and 4.3% with frail status. There is no significant relationship between body mass index and frailty status (p=0.328). There is no significant relationship between handgrip and frailty status (p=0.476). There is no significant relationship between cognitive status and frailty status (p=0.664).

Background: The Malaysian Breastfeeding Peer Counselor Association (MBfPCA) is a pioneer non-governmental organization (NGO) of trained breastfeeding peer counselors in Malaysia. We explored the effect of peer counseling support on breastfeeding outcomes among postnatal mothers who delivered at a national tertiary teaching hospital and their satisfaction with the peer counseling services.

Method: A total of 210 postpartum mothers were recruited in a single-blinded, randomized, controlled trial. Block randomization was used to allocate the participants into the intervention (I) group (n=105), who received telephone-based peer counseling support at 72 hours, 2 weeks, 1, 2, 4 and 6 months postpartum; and the control (C) group (n=105), who received routine breastfeeding advice. The infant feeding practices information was obtained at 2, 4 and 6 months postpartum from both groups. Data on maternal satisfaction with peer counseling services was acquired from the intervention group participants 6 months postpartum.

Results: Ninety-four mothers were lost to follow up, leaving 116 (I=60, C=56) for analysis. The number of participants who practiced exclusive breastfeeding was higher in the intervention group at all intervals, with significant difference seen at 6 months postpartum (p = 0.035). Significant differences were also seen in the prevalence of breastfeeding between the groups at 4 and 6 months postpartum (p = 0.017 and p = 0.010). All participants who practiced exclusive breastfeeding found that peer counselors helped them reach their breastfeeding goals (p =0.001) and would recommend peer counseling services to others (p = 0.037).

Conclusion: Peer counselor support in Malaysia increased the duration and exclusivity of breastfeeding and was well accepted among postnatal mothers.

Background:  Negative psychological responses related to HIV seropositivity status disclosure are prevalent and often remain unattended. We proposed a comprehensive care delivery method with biopsychosocial approach (comprehensive care, support, and treatment [C-CST]) along with an instrument (KET-U-T phenomenon) to assess its efficacy.

Methods:  A total of 200 individuals HIV positive were consecutively enrolled in this study and equally distributed into pre- and post-C-CST groups. All participants were structurally interviewed to assess HIV-related information level, family support, and KET-U-T phenomenon (K=disappointment, E=emotion/anger, T=denial, U=effort, T=acceptance).  Appropriate statistical analyses were done to determine the effect of C-CST on the KET-U-T phenomenon.

Results: Post test counselling for 100 individuals pre-C- CST, demonstrated HIV-related information level (68%) and family support (78%) inadequacy, with respective proportion of KET-U-T phenomenon components of; K: 43.0%, E: 12%, T: 30%, U: 100%, T: 15%. Significant improvement post C-CST observed in reduction of HIV-related information level (26%) and family support (38%) inadequacy, with respective proportion of KET-U-T phenomenon components of; K: 18%, E: 2%, T: 5%, U: 100%, T: 75% (p=0.000).

Conclusions: Comprehensive care, support, and treatment yielded significant improvement in negative psychological adaptation and seropositive status acceptance in PLWH as observed with the KET-U-T phenomenon.

Introduction: Malaria is still one of the major health problems, specifically due to drug resistance in Plasmodium, which encourages extensive research to find effective alternatives. One of the new antimalarial compounds is chalcone-derivative compound (E)-1-(4-aminophenyl)-3-(2,3-dimethoxy phenyl)prop-2-en-1-one. However, its potency is still needed to be evaluated. Therefore, this study aimed to determine the efficacy and identify the pharmacological mechanism of this chalcone-derivative. 

Methods: An experiment using post-test only with control group design was conducted from May 2016 to July 2017 in the laboratory of Parasitology and Clinical Pathology Faculty of Medicine, Universitas Gadjah Mada. Swiss mice were used and infected with Plasmodium before being divided into nine groups with different concentrations of (E)-1-(4-aminophenyl)-3-(2,3-dimethoxy phenyl)prop-2-en-1-one. Histological examination was conducted to count the number of Kupffer cells and the proportion of Kupffer cells that had phagocytosed the Plasmodium.

Results: Both doxycycline and (E)-1-(4-aminophenyl)-3-(2,3-dimethoxy phenyl)prop-2-en-1-one  decreased the parasitemia in the tested mice with higher efficacy was observed in the doxycycline group. Likewise, both compounds also increase the number of  Kupffer cells which become phagocytes of erythrocytes containing Plasmodium was higher in the treatment group than in the control group (p 0.000 <0.05). Substance (E)-1-(4-aminophenyl)-3-(2,3-dimethoxy phenyl) prop-2-en-1-one may act as an antimalarial by phagocytes of erythrocytes containing Plasmodium.

Conclusion In conclusion, the (E)-1-(4-aminophenyl)-3-(2,3-dimethoxy phenyl)prop-2-en-1-one exhibited potent antimalarial activity via the phagocytic activity of Kupffer cells. This compound may be developed into a new antimalarial drug.

Introduction: Myrmecodia pendans, or traditionally known as ant nest fruit, is one of popular traditional medicines in Indonesia with a wide range of effects such as antidiabetic, anticancer, and free-radical scavenging agents. Despite of the extensive research, reports regarding its toxicity are scarce. Gentamicin is also one of popular and widely used anti-biotic but it is associated with a wide range of toxicity, especially if administered at high dose. Therefore, this study aimed to evaluate the effect of Myrmecodia pendans extract in the mice what received toxic dose of gentamicin.

Method: 24 male white rats were used and randomly divided into 4 groups: P0 (negative control), P1 (100 mg/kgBW intraperitoneal gentamicin), P2 (gentamicyn + 250 mg/kgBW myrmercodia extract), P3 (250 mg/kgBW myrmercodia extract which administered for 7 days and followed by gentamicin). The treatment was given for 10 days and all mice were sacrificed at the end of the study. The stomach was taken from each mouse and examined pathologically using Hematoxylin-Eosin (HE) staining.

Results: The necrosis was found in all groups that received gentamicin (P1-P3) with P2 had the most severe necrosis. Hemorrhage was only found in group that received Myrmecodia extract (P2 and P3) and, again, P2 had higher score of hemorrhage compared to P3.

Conclusion: The administration of Myrmecodia extract at 250 mg/kgBW together with toxic dose of gentamicin exacerbate the gastric tissue damage in Wistar rats.

Introduction: Diabetes and its complications are the leading causes of premature death worldwide. Diabetes causes complications such as hypertension and an increased risk of cardiovascular diseases. Endothelial dysfunction is the primary pathophysiology that underlies complications of diabetes mellitus. EDHF (Endothelial-Derived Hyperpolarizing Factor) is a relaxing factor that targets current therapy in vascular dysfunction and insulin resistance in obesity and diabetes mellitus. Yoga training is a physical activity that has been shown to play a role in decrease blood pressure, but to our knowledge, there are no studies that prove the effectiveness of yoga in increasing EDHF levels. Therefore, this study aimed to determine the efficacy of yoga to decrease blood pressure and increase EDHF levels in type II diabetes mellitus patients with hypertension.

Methods: This research was a randomized control trial that involved 39 hypertensive diabetic respondents and was conducted in Denpasar, Bali, Indonesia. Yoga exercise was carried out two times a week for eight weeks, with a duration of 60 minutes per session. EDHF levels were examined using the ELISA technique.

Results: There was a significant difference in systolic, diastolic and EDHF levels after the intervention between the yoga and control groups and large effect size.

Conclusion: In conclusion, yoga training effectively reduced blood pressure and prevented endothelial dysfunction by increasing the blood vessel relaxing factor, namely EDHF.