The body mass index profiles in chronic pulmonary aspergillosis: trend and variability in post tuberculosis patients

Tuberculosis (TB) is the main risk factor for chronic pulmonary aspergillosis, especially in patients with residual cavitary lesions after completion of TB therapy. The body mass index (BMI) is one of the established markers in predicting the mortality of CPA. However, the data regarding BMI profiles of CPA patients in Indonesia is still limited. We evaluated the BMI profiles of CPA patients among post-TB patients. Patients diagnosed as CPA based on clinical, radiology and the Aspergillus IgG test. 50 patients were included with a mean age of 35 years; 13 patients met the criteria of CPA. The overall median of BMI in these patients was 21. The median BMI in the CPA group was 19,3. The lowest (19,8) median BMI value was observed in the positive Aspergillus IgG group (11,5 – 30 mg/L) with a minimum BMI of 14,7 and a maximum BMI of 29,2. The differences in median BMI across CPA and non CPA groups and Aspergillus IgG level were not statistically significant. However, there is a trend that lower BMI were distributed among patients with positive Aspergillus IgG. More than one third of CPA patients in this study were classified as underweight. Future study is necessary to better  depict the BMI profiles in larger scale of populations of CPA in Indonesia in order to achieve better diagnosis and management of CPA

Density of Dermatophagoides spp. and Its Relationship with House-dust Mite Specific Serum IgE in Persistent Asthma

Background: Asthma is a chronic inflammation of the bronchial tree that emerges as a response to exogenous factors, such as allergens, irritants, and infections. Some asthmatic patients had been reported having symptoms of asthma due to house-dust mites (HDM) allergen exposure. It is associated with immune responses which were increased in the form of specific Immunoglobulin E (IgE) production against HDM allergens. This case-control study aimed to determine the HDM profiles in persistent asthmatic patients, including density of mites, as well as its relationship with specific IgE anti-HDM serum levels.Materials and Methods: A total of 13 patients with persistent asthma and 12 control patients had their specific anti-HDM IgE levels examined using Immulite 2000 xpi. The house dust samples were taken and analyzed with the Fain method.Results: The results have shown that 69% of patients in the persistent asthma group and 25% of normal patients were positive for IgE anti-HDM. Dermatophagoides pteronyssinus is a predominant species with a total of 120 mites (83.9%) of 143 mites. Correlation analysis indicated a positive relationship between IgE anti-HDM levels within the serums of patients and the density of mites in the dust obtained from bedroom spaces (Spearmen Rho, R=0.35, p=0.04).Conclusion: Positive IgE anti-HDM patients in the persistent asthma group were higher (69%) than those in the clinically normal group (25%). The density of mites were dominated by D. Pteronyssinus. The bedroom-dust mites density revealed a positive correlation with serum IgE anti-HDM levels in persistent asthma patients.Keywords: asthma, density, Dermatophagoides spp.,Ig

Biological Activity of Der p 1 and Der f 1 in Allergic Asthma and Their Contribution in Inflammation and the Role of Anti-inflammation in Allergic Asthma

Asthma is a disease marked by chronic inflammation of the airways, with indications including wheezing, shortness of breath, and/or cough. As reported by GINA, the global prevalence of asthma is 1-18%. One type of asthma is Allergic asthma which is triggered by allergens, like Der p 1 and Der f 1 which upregulate type II immune response to secret IL-4 and IL-13 to upregulate IgE secretion. IgE binds to FcεRI in mast cells to release mediators that cause hypercontraction, this condition leads to asthma. Meanwhile, anti-inflammatory IL-10 manages IgE production by reducing inflammatory cytokine production and changing isotype switching. IgE Production is a crucial step. Therefore, it is essential to explore the cellular and molecular factors that trigger the regulated isotype-switching IgE and its suppressed mechanism, so this review will explore the biological activity of Der p 1 and Der f I and their contribution to inflammation and the role of anti-inflammation in allergic asthma especially isotype switching IgE We used PRISMA approaches, and tools (RSCB PDB, Uniprot, and SMART). The result appeared Der p 1, and Der f 1 activity have impacts on IL-4, IL-13, IL-10, and IgE secretion

Diagnosis dan Penatalaksanaan Ventilator-Associated Pneumonia

Abstrak Ventilator-associated pneumonia (VAP) atau pneumonia terkait penggunaan ventilator masih menjadi masalahdalam penatalaksanaan pasien pengguna ventilasi mekanis. Kejadian VAP dihubungkan dengan meningkatnyamorbiditas, lama rawat di rumah sakit atau ICU serta biaya yang harus dikeluarkan pasien. Etiologi VAP sangatbervariasi, hal itu berdasarkan atas populasi pasien, lama rawat di rumah sakit serta terapi antimikrobasebelumnya. Identifikasi segera pasien terinfeksi dan pemilihan antimikroba yang tepat berperan penting dalampenatalaksanaan. Pemilihan terapi antimikroba awal hendaknya didasarkan atas flora paling dominan yangbertanggungjawab terhadap terjadinya VAP pada tiap pusat perawatan, jenis ruang rawat, data laboratoriumpemeriksaan langsung bahan klinis paru, aktivitas antimikroba serta karakteristik farmakokinetiknya. Kata kunci : ventilator-associated pneumonia, diagnosis, penatalaksanaan, pemilihan antimikroba Abstract Ventilator-associated pneumonia (VAP) continues to complicate the management of patients receiving mechanical ventilation (MV). The VAP is associated with excess morbidity, increasing intensive care unit (ICU)/hospital stay and patient costs. The etiologic agents widely differ depend on the population of patients, duration of hospital stay and prior antimicrobial therapy. Rapid identification of the infected patients and accurate selection of the antimicrobial agents represent important clinical goals. Selection of the initial antimicrobial therapy should be based on the predominant flora responsible for VAP at each institution and clinical setting. Furthemore, the information provided by direct examination of pulmonary secretions. Finally, it should also be based on the antimicrobial agents activities and their pharmacokinetic characteristics. Keywords: ventilator-associated pneumonia, diagnosis, management, antimicrobial therapy&nbsp

The Review of Histoplasmosis Endemicity and Current Status in Asia

Histoplasmosis is a common disease among immunocompromised patients and a notable endemic disease among immunocompetent patients. Disseminated histoplasmosis in acquired immunodeficiency syndrome (AIDS) patients is mostly lethal. We conducted a literature review of histoplasmosis and histoplasmin skin test in Asia. There were around 1692 cases of histoplasmosis reported from Asian countries. India (623 cases), China (611 cases) and Thailand (234 cases) are detected as endemic areas of histoplasmosis although the complete mapping of this disease is still missing in some Asian countries. However, definite diagnosis is difficult since the symptoms frequently mimicking tuberculosis (TB), tissue samples are rarely obtained, and lacked of serology tests in Asian countries

Kriptokokosis Meningeal: Epidemiologi Berbasis Molekular, Manifestasi Klinis dan Luarannya

Abstrak Cryptococcus sp. sebagai penyebab kriptokokosis meningeal telah banyak diteliti di dunia, tetapi epidemiologi molekular, manifestasi klinis, penegakan diagnostik dan luaran klinisnya belum dibahas secara komprehensif. Tujuh nama baru Cryptococcus sp. telah diusulkan dan berdasarkan hal itu penyebarannya bervariasi di beberapa negara. Cryptococcus. gattii masih lebih terbatas area penyebarannya dibandingkan C. neoformans. Keragaman genotipe dapat diperoleh baik dalam satu negara maupun pada satu pasien kriptokokosis meningeal. Manifestasi klinis yang mucul berbeda-beda, namun utamanya adalah sakit kepala, demam dan penurunan kesadaran. Prosedur diagnosis dapat dipilih mulai dari pemeriksaan konvensional hingga uji berbasis molekular dan protein. Luaran klinis dipengaruhi oleh beberapa faktor, diantaranya beban jamur, penyakit dasar, status imun pasien, diagnosis dini, serta ketersediaan obat. Kata Kunci: Cryptococcus, kriptokokosis, spesies, aspek klinik. Abstract Cryptococcus sp. as the cause of meningeal cryptococcosis had been widely studied around the world. But its molecular epidemiology with clinical manifestations, diagnostic procedures and clinical outcomes have not been comprehensively discussed. Seven new names for Cryptococcus sp. have been proposed and the distribution varies in several countries. However, C. gattii is still more restricted in area than C. neoformans. Genotype diversity was obtained in both one country and in one patient meningeal cryptococcosis. The clinical manifestations that appear are different, however the main ones are headache, fever and decreased consciousness. Diagnosis procedures could be carried out from conventional to molecular and protein-based. Clinical outcomes are influenced by several factors, including fungal load, underlying disease, patient’s immune status and early doagnosis as well as the availability of drugs.Key words: Cryptococcus, molecular epidemiology, clinical aspects &nbsp

The Cancer Mycobiome: A Highlight to Lung Cancer

Microbiota is a collection of microorganisms such as bacteria, fungi, viruses, and archaea, with bacteria being the most numerous in the human body. Meanwhile, the mycobiome consists of commensal fungi, which are a small part of the microbiota. Examples found in the human body, from the skin to the internal organs, play a role in the immune response, homeostasis, metabolism, and disease. The composition of mycobiome varies over time, and the human intestine is the most studied organ due to the diversity of microbiota. Furthermore, lung cancer is the leading cause of death in oncology patients worldwide. Various studies suggest that mycobiomes play a role in cancer associated with dysbiosis. Chronic inflammation, biofilm formation, and carcinogen products are parts of cancer pathogenesis. Metagenome analysis has provided information about the diversity of microbiota, specifically mycobiome in the human body. The common method for gene sequencing in the metagenome is next-generation sequencing (NGS). Analysis through metagenomes in chronic diseases such as cancer shows that mycobiomes play a role in the process of cancer formation. However, the causal relationship between mycobiomes and cancer remains unknown

The Potential of Herbal Combinations as Adjunctive Therapy for Standard Care of COVID-19 Patients: A Lesson Learned from Indonesia

The pandemic of novel coronavirus disease (COVID-19) has become a global disaster that occurred between the end of 2019 and 2023. It caused immeasurable damage to almost all aspects of human life. The disease has opened a lot of new perspectives on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) origins and pathogenesis, the nature of the virus, the potential for new treatments, and new policies to overcome this pandemic. This review aims to know the potential of plants that are beneficial to combat the diseases, including immunomodulators in the management of COVID-19. Studies reporting COVID-19 with the keywords SARS-CoV-2, COVID-19, pathogenesis, clinical manifestations, medicinal plants, and their benefits were included. We also discussed the molecular pathways of the bioactive compound that may interact with the pathogenesis of COVID-19. Clinical management for COVID-19 is still being refined from time to time because many aspects are not yet fully understood and need further studies. Therefore, effective, non-invasive, and affordable treatment must be sought immediately to meet this very urgent need. The commotion situation of the COVID-19 pandemic has encouraged various efforts to develop new drugs, including alternative therapies from potential medicinal plants. The pharmacotherapeutic activity of Indonesia-based medicinal plants for COVID-19 has evolved, including Phyllanthus niruri, Andrographis paniculata, Anacardium occidentale, Zingiber officinale, and Glycyrrhiza glabra. The potential benefits of that combination of herbal medicinal plants also need to be explored for better contribution in managing COVID-19, particularly in Indonesia

Rodent is Potential Reservoir of Zoonoses Fungi in Jakarta, Indonesia

Some potentially human pathogenic fungi are known to be zoonoses. Rodent is one of potential reservoir of fungi. To date, little is known about the role of rodent in transmitting fungal disease in Indonesia. Therefore, purpose of this study was to find evidence of potential fungal zoonoses in rodent. We caught two house rats, one rat was from the house of patient suffering from talaromycosis and the other one was from a healthy person house. These rats internal organs (lung, liver, and spleen) were inoculated onto sabouraud dextrose agar (SDA) and SDA with additional of chloramphenicol. Fungi grown in the medium were analyzed using polymerase chain reaction (PCR) of internal transcribed spacer (ITS) continued by sequence-based approach. In addition PCR was also conducted using primers developed from beta tubulin gene. Amplified regions were sequenced and compared to database that contains reference sequences.We found three fungal species. Talaromyces atroroseus was isolated from the rat that caught from the house of patient with talaromycosis, while Purpureocillium lilacinum and Penicillium citrinum were isolated from the other rat caught in the house of healthy individual. Although naturally could be found in the environment, these species had been reported to cause fatal systemic mycosis in human. In conclusion Talaromyces atroroseus, Purpureocillium lilacinum and P. citrinum could be found in rat. This result indicates that rat could be a reservoir for these fung