Kadar Asam Urat Suku Serawai dan Suku Jawa di Kabupaten Kepahiang

Peran asam urat dalam meningkatkan penyakit ginjal dan kardiovaskuler dalam beberapa tahun terakhir ini sering menjadi perdebatan para ahli. Penyakit kardiovaskuler dan infark miokard dilaporkan dipengaruhioleh tingginya asam urat dalam darah dalam beberapa penelitian besar. Jenis penelitian menggunakan rancangan cross sectional study. Tujuan penelitian ini melihat perbedaan kadar asam urat antara suku Jawa dengan suku Serawai. Penarikan sampel menggunakan purposive sampling dengan 104 orang berusia 40-65 tahun. Data primer berupa data subjek termasuk umur, jenis kelamin, pendapatan, pendidikan, pekerjaan, kadar asam urat. Untuk menganalisis perbedaan dan kadar asam urat darah pada kedua suku dengan menggunakan uji t tidak berpasangan. Suku Serawai 55,8% mempunyai kadar asam urat tinggi dan Suku Jawa yang mempunyai kadar asam urat tinggi sebanyak 40,4%. Dari analisis uji beda kadar asam urat antara Suku Serawai dengan Suku Jawa diperoleh p=0,031 (p<0,005), terdapat perbedaan kadar asam urat antara Suku Jawa dengan Suku Serawai

Alternatif Cara Deteksi Kandungan Iodium Pada Garam Beriodium Di Pasar

Mengingat tingginya biaya yang diperlukan dalam menganalisa kandungan iodium pada garam secara laboratorium, serta pentingnya partisipasi masyarakat dalam penanggulangan masalah gangguan akibat kekurangan iodium, maka diperlukan teknologi sederhana untuk mendeteksi iodium pada garam iodium yang diperjualbelikan di pasar. Untuk itu telah dilakukan penelitian mengenai beberapa cara mendeteksi iodium pada garam menggunakan sumber karbohidrat dan sumber zat pereduksi, seperti Dioscorea Hispida Dennst (gadung), Manihot utilissima (singkong), atau Rubber seed (biji karet). Berdasarkan jenis dan jumlah campuran yang digunakan ada 6 formula yang diuji pada penelitian pendahuluan yaitu formula ICo, IICo, IC1, IIC1, ISo, dan IISo. Pada penelitian lanjutan, formula yang terpilih diuji menggunakan garam iodium yang dibeli dari pasar di Kodya Bogor. Hasil penelitian menunjukkan bahwa formula IICo dan IIC1 menggunakan perasan singkong atau gadung, serta formula IISo menggunakan parutan biji karet, dapat digunakan sebagai alat untuk mendeteksi kadar iodium pada garam beriodium. Formula IICo terdiri dari 4 ml perasan gadung atau singkong, dicampur dengan 45 g garam beriodium dan 8 ml asam cuka 25 persen. Formula IIC1 sama seperti formula IICo, tapi menggunakan gadung yang telah disimpan tiga minggu, dan singkong yang telah disimpan dua minggu. Formula IISo terdiri dari 7 gr parutan biji karet, ditambah dengan 45 g garam iodium dan 16 ml asam sitrat. Hasil penelitian lanjutan menunjukkan hanya 11.1 persen garam beriodium di Kodya Bogor mempunyai kandungan diatas 30 ppm, dan 88.9 persen dibawah 30 ppm. Garam beriodium yang mempunyai kandungan di atas 30 ppm akan menunjukkan warna biru atau ungu, dan yang mempunyai kandungan dibawah 30 ppm akan menunjukkan warna cokelat, warna biru yang tidak stabil atau tidak menunjukkan Perubahan warna

Penilaian Kromium Serum Darah pada Penyandang Diabetes Mellitus Tipe 2 dan Non Diabetes

Diabetes mellitus tipe 2 merupakan salah satu masalah kesehatan dunia. Berdasarkan survei Riskesdas 2013, prevalensi dari diabetes melitus tipe 2 di Indonesia pada usia 15 tahun atau lebih adalah 6.9%. Prevalensiyang tinggi dapat dipicu oleh diet yang kurang sehat dan rendahnya aktivitas fisik. Kromium dalam hal ini sebagai mineral mikro yang memiliki peran dalam menjaga homeostasis glukosa darah diduga memiliki fungsi dalam meningkatkan respon insulin. Penelitan ini bertujuan mengetahui hubungan antara aktivitas fisik, tingkat kecukupan energi dan zat gizi, dengan kadar glukosa darah puasa dan HbA1c. Desain penelitian ini adalah survei potong lintang dengan subjek penyandang diabetes tipe 2 sebanyak 42 orang dan subjek normal sebanyak 49 orang. Kriteria inklusi adalah pria atau wanita normal atau penyandang diabetes usia 50-65 tahun, sudah menopause untuk wanita minimal 1 tahun, dan bersedia mengikuti penelitian dengan menandatangani informed concent. Hasil penelitian menunjukkan bahwa Cr serum darah pada penyandang diabetes lebih rendah dibandingkan pada subjek normal. Terdapat hubungan yang signifikan antara HbA1c dengan IMT, lingkar pinggang, aktivitas fisik, Cr serum darah, dan tingkat kecukupan serat. Tingkat kecukupan Cr berpengaruh signifikan terhadap HbA1c. Tingkat Cr serum HbA1C (r = -0.466, p<0.01). kesimpulan dari penelitian ini adalah rendahnya tingkat Cr serum darah diduga menjadi salah satu penyebab berkembangnya diabetes mellitus tipe 2

Anti-Inflammatory Potential of Takokak (Solanum Torvum) Ethanol Extract in Rats Exposed to 7,12-Dimethylbenz[A]Anthracene (Dmba)

Background: Takokak fruit (Solanum torvum) is a type of eggplant containing solasodin, solamargin, solasonin and other phytochemicals components with anti-inflammatory and anti-cancer properties. The purpose of this study was to examine the effects of takokak ethanol extract on TNF-α, IL6, and SOD levels.Methods: Experimental factorial study design, with the effect of takokak extract concentration factor (0, 400 and 800 mg/kgBW), takokak extract administration time factor including preventive (weeks 1-7) and curative (weeks 6-12) administration, and necropsy factor (necropsy in weeks 12 and 16). The data obtained included rats body weight, TNF-α, IL-6 and SOD levels.Results: The result showed that the interaction between takokak concentration and handling has significant effect on the increase of TNF-α levels (p=0.003) and the decrease of IL-6 levels (p=0.000). Interaction between takokak concentration, handling and necropsy has significant effect on the increase of SOD levels (p=0.010).Conclusion: Takokak ethanol extract has significant effect on the increase of TNF-α, and SOD levels, and the decrease of IL-6 levels

Inhibition of G-protein signalling in cardiac dysfunction of intellectual developmental disorder with cardiac arrhythmia (IDDCA) syndrome.

BACKGROUND: Pathogenic variants of GNB5 encoding the β5 subunit of the guanine nucleotide-binding protein cause IDDCA syndrome, an autosomal recessive neurodevelopmental disorder associated with cognitive disability and cardiac arrhythmia, particularly severe bradycardia. METHODS: We used echocardiography and telemetric ECG recordings to investigate consequences of Gnb5 loss in mouse. RESULTS: We delineated a key role of Gnb5 in heart sinus conduction and showed that Gnb5-inhibitory signalling is essential for parasympathetic control of heart rate (HR) and maintenance of the sympathovagal balance. Gnb5-/- mice were smaller and had a smaller heart than Gnb5+/+ and Gnb5+/- , but exhibited better cardiac function. Lower autonomic nervous system modulation through diminished parasympathetic control and greater sympathetic regulation resulted in a higher baseline HR in Gnb5-/- mice. In contrast, Gnb5-/- mice exhibited profound bradycardia on treatment with carbachol, while sympathetic modulation of the cardiac stimulation was not altered. Concordantly, transcriptome study pinpointed altered expression of genes involved in cardiac muscle contractility in atria and ventricles of knocked-out mice. Homozygous Gnb5 loss resulted in significantly higher frequencies of sinus arrhythmias. Moreover, we described 13 affected individuals, increasing the IDDCA cohort to 44 patients. CONCLUSIONS: Our data demonstrate that loss of negative regulation of the inhibitory G-protein signalling causes HR perturbations in Gnb5-/- mice, an effect mainly driven by impaired parasympathetic activity. We anticipate that unravelling the mechanism of Gnb5 signalling in the autonomic control of the heart will pave the way for future drug screening

Influence of Stefan blowing on nanofluid flow submerged in microorganisms with leading edge accretion or ablation

The unsteady forced convective boundary layer flow of viscous incompressible fluid containing both nanoparticles and gyrotactic microorganisms, from a flat surface with leading edge accretion (or ablation), is investigated theoretically. Utilizing appropriate similarity transformations for the velocity, temperature, nanoparticle volume fraction and motile microorganism density, the governing conservation equations are rendered into a system of coupled, nonlinear, similarity ordinary differential equations. These equations, subjected to imposed boundary conditions, are solved numerically using the Runge-Kutta-Fehlberg fourth-fifth order numerical method in the MAPLE symbolic software. Good agreement between our computations and previous solutions is achieved. The effect of selected parameters on flow velocity, temperature, nano-particle volume fraction (concentration) and motile microorganism density function is investigated. Furthermore, tabular solutions are included for skin friction, wall heat transfer rate, nano-particle mass transfer rate and microorganism transfer rate. Applications of the study arise in advanced micro-flow devices to assess nanoparticle toxicity

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Common, low-frequency, rare, and ultra-rare coding variants contribute to COVID-19 severity

The combined impact of common and rare exonic variants in COVID-19 host genetics is currently insufficiently understood. Here, common and rare variants from whole-exome sequencing data of about 4000 SARS-CoV-2-positive individuals were used to define an interpretable machine-learning model for predicting COVID-19 severity. First, variants were converted into separate sets of Boolean features, depending on the absence or the presence of variants in each gene. An ensemble of LASSO logistic regression models was used to identify the most informative Boolean features with respect to the genetic bases of severity. The Boolean features selected by these logistic models were combined into an Integrated PolyGenic Score that offers a synthetic and interpretable index for describing the contribution of host genetics in COVID-19 severity, as demonstrated through testing in several independent cohorts. Selected features belong to ultra-rare, rare, low-frequency, and common variants, including those in linkage disequilibrium with known GWAS loci. Noteworthily, around one quarter of the selected genes are sex-specific. Pathway analysis of the selected genes associated with COVID-19 severity reflected the multi-organ nature of the disease. The proposed model might provide useful information for developing diagnostics and therapeutics, while also being able to guide bedside disease management. © 2021, The Author(s)

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication