Correlation between alkaline phosphatase, g-glutamyl transpeptidase, and bilirubin with interleukin-1b level in dogs with obstructive jaundice

Surgical management in obstructive jaundice still contributes to significant morbidity and mortality. One of complications following surgery in obstructive jaundice is sepsis. This complication is caused by the toxic effects of bilirubin and bile salts, endotoxins, bacterial translocation, modulation of the immune-inflammatory cascade, decreased cellular immunity and/or nutritional status. Many studies have shown the elevated inflammatory response indicator, interleukin-1 (IL-1b), in patients with obstructive jaundice. However, only a few report described the association between the indicators of obstructive jaundice (alkaline phosphatase [ALP], g-glutamyl transpeptidase [GGT], and bilirubin)and the indicator of inflammatory response (interleukin-1b [IL-1b]). This study aimed to investigate the association between the indicator of obstructive jaundice (ALP, GGT, and bilirubin) and the level of interleukin-1b (IL-1b) in dogs as the animal model. We performed ligation on distal common bile ducts (CBD) to produce a model of obstructive jaundice. Every three days within a month, the blood samples from ten dogs were extracted to determine the ALP, GGT, direct and total bilirubin, and IL-1b levels. We found a significant correlation between the ALP and GGT with IL-1b level with p-value of 0.036 (r=0.626) and 0.003 (r=0.826). However, there was no association between the increased directbilirubin with the IL-1b level (p=0.068; r=0.537). Moreover, the increased level of ALP and GGT had a strong correlation with the increased level of direct bilirubin with p-value of 0.004 (r=0.810) and p=0.011 (r=0.746). In conclusion, the increased level of GGT was the strongest indicator for inflammatory response in dogs with obstructive jaundice. Furthermore, the increased levels of GGT and ALP might imply the development of obstructive jaundice in dogs

RP-HPLC Method Validation for Purity Assay of α-Mangostin Isolate

The quality of natural products regarding the purity of their active compounds, such as α-mangostin isolate from mangosteen pericarp, may vary depending on cultivation, harvest season, and isolation process. Thus, extensive isolation procedures are involved in obtaining a certain level of purity of the active compounds. Studies on the yield of α-mangostin isolate and its effectiveness as an active compound in health care have been reported. The quality parameter of the isolate as the intended active compound can be indicated by its purity level. Measuring the purity of the active compound is proposed to define the grade α-mangostin isolate as a starting material or even reference standard. The higher the purity level of α-mangostin isolate, the greater its potential as a reference standard candidate. Therefore, a selective analytical method is required to measure the purity level accurately. For this reason, a rapid analytical method to ensure α-mangostin isolate was developed and validated to confirm its purity. Separation condition semployed an X-Terra® C18 column 5 μm, 4.6 x 150 mm under an isocratic system with a mobile phase composition of MeCN:water (85:15) at a flowrate of 0.5 mL/ min and a detector wavelength of 243 nm were selected. Acceptable validation parameters of linearity in the range of 2.6 –52 μg/mL with r2 = 0,9994, Vx0 = 2.64%; accuracy 96.38 – 100.99%; precision 1.36%; and LOD/LOQ = 4.6 μg/mL/ 13.7μg/mL were achieved. The validated method was successfully applied to the purity assay α-mangostinisolate with a run time of less than 9 minutes

CORRELATION OF KNOWLEDGE OF COMORBID FACTORS AS A RISK FACTOR OF COVID-19 SEVERITY WITH BEHAVIOR RELATED TO COVID-19 PREVENTION IN MEMBERS OF CHRONIC DISEASE MANAGEMENT PROGRAM IN BANGKALAN

Background: Knowledge about COVID-19 is very important for everyone during this pandemic. This is related to efforts to break the chain of the spread of the Covid- 19 virus. Moreover, many deaths caused by this virus are experienced by many people with comorbidities.Research Objectives: This research study was conducted to know the relationship between knowledge of comorbid factors as the main risk factor for the severity of COVID-19 and behavior related to COVID-19 prevention among members of the Chronic Disease Management Program (PROLANIS) in Bangkalan Regency. Research Methods: This study uses quantitative methods. This type of research is observational with a cross-sectional. This sampling used a simple random sampling technique. And the data analysis used in this research is the Spearman correlation test. Research Results: From the results of the analysis, it is known that there is a relationship between knowledge about comorbid factors as the main risk factor for the severity of COVID-19 with behavior related to preventing COVID-19 among members of the Chronic Disease Management (PROLANIS) program in Bangkalan Regency, as evidenced by a p-value of 0.000 <0, 05. The correlation coefficient value of 0.619 is included in the strong category.Conclusion: meaning that there is a strong relationship between knowledge about comorbid factors as the main risk factor for the severity of COVID-19 and behaviors related to preventing COVID- 19 among members of the Chronic Disease Management (PROLANIS) program in Bangkalan Regency

TWO-PORT LAPAROSCOPIC APPENDECTOMY IS MORE BENEFECIAL THAN OPEN APPENDECTOMY IN EARLY ACUTE APPENDICITIS

Open appendectomy has already commonly been performed to treat acute appendicitis, but the relatively more painful and longer incision scar becomes a cosmetical problem. Two port laparoscopic appendectomy can be performed safely, less painful and leaving only two small incision scars. The aim of the study was to evaluate the benefit of two-port laparoscopic appendectomy and that of with open appendectomy in the case of early acute appendicitis. An observational study was conducted from 2012 to 2014; to compare the operating time, post operative pain and wound infection in early acute appendicitis, performed with two-port laparoscopic appendectomy and with open appendectomy. The statistical analysis in this study uses t-test. There were 114 patients (73 men and 41 women) divided into two groups based on the choice made by the patients themselves. The number of samples performed with two-port laparoscopic appendectomy was 64 and that with open appendectomy was 46. Four patients were excluded from this study. In analysis using t-test, we found that the two-port laparoscopic appendectomy was more beneficial than open appendectomy. There was a significant difference between the two groups, the length of operation time was 37.22 minute in two-port laparoscopic appendectomy and 43.83 minute in open appendectomy (p=0.00), VAS pain score was 1.58 in two-port laparoscopic appendectomy and 2.30 in open appendectomy (p=0.00) and no post operative wound infection in both two groups. The conclusion is two-port laparoscopic appendectomy technique is faster and less painful and the same risk of wound infection than open appendectomy in early acute appendicitis

The effects of duration of mesenteric artery ligation to the ratio of TNF-α/IL-10 in a rat model of acute mesenteric ischemia (AMI)

The mortality rate of acute mesenteric ischemia (AMI) is high due to the delay in diagnosis.Determination of potent biomarker for early AMI is the key in reducing the mortality. As aproinflammatory cytokine, the level of TNF-α might be affected during the ischemia andreperfusion, with the prediction duration of 60-120 min. High TNF-α level may stimulatethe upregulation of IL-10 as an inhibitor of TNF-α. This provides a new opportunity forearly diagnosis of AMI by measuring the ratio between those two cytokines. The purposeof this study was to investigate the effect of duration of the mesenteric artery to theratio of TNF-α/IL-10 in a AMI rat model. This was an experimental study using Wistarrat. We performed mesenteric artery in 28 male rats to produce an AMI model, withligation duration of 0, 30, 60, 90, 120, 150, and 180 minutes. At the end of ligation,blood samples were taken for measurement of TNF-α and IL-10 level using ELISA. For themicroscopic examination of tissue necrosis, intestinal organ samples were taken and madeinto paraffin blocks and stained using Haematoxylin-Eosin. TNF-α increased in minute 120compared to other treatment groups (p<0.05). IL-10 increased in minute 180 comparedto control group (p<0.05). Microscopic examination showed that the duration of ligationaffects the structure and morphology of intestinal mucosa characterized by discolorationof organs along with increasing the ligation duration. Ligation of the superior mesentericartery was found to be significantly increased the TNF-α level and to be compensated byincreasing IL-10. It is assumed that when the IL-10 level, that has protective effect as aninhibitor, higher than TNF-α level as a proinflammatory cytokine on duration 150 minutes,it means no more inflammatory or cells is dead. Therefore TNF-α/IL-10 ratio can be usedas a biomarker candidate of prognosic factor management of AMI

Unusual Skin Metastasis from Gastric Cancer: A Case Report

Background: Skin metastasis from gastric cancer are relatively rare, but they have important clinical significance because they usually indicate a worse prognosis. Skin metastasis from gastric cancer may spread through lymphatic ducts, blood vessels in the ligamentum teres, contiguous extension, or embryologic remnants of the umbilicus. Purpose: To report an unusual skin metastasis from gastric cancer that clinically resembles as a benign lesion of skin papules. Case: A rare metastasis from gastric cancer origin in a 61-year-old male in the abdominal skin. Gastric cancer metastasis in an unusual site such as the abdominal skin often resembles as dermatitis, especially in the early course of metastatic spreading, which looked like common papules on the skin. Discussion: In the beginning, the skin papules were not suspected to be a metastatic process because there was no palpable or no tenderness in the subcutan or fascia underneath. The appearance resembled common dermatitis. However, as papules rapidly spread to the surrounding skin, the malignancy was then suspected. The incisional biopsy from the papules was performed and showed that it was metastatic diffuse-type gastric adenocarcinoma. Conclusion:  The skin metastasis was different from general nodules, but rather as skin papules of general dermatitis in initial appearance. The surgeon and dermatologist should be alert if they find any benign appearance of a skin lesion on the abdominal wall in a patient with a history of gastric cancer surgery

THE CORRELATION OF PREECLAMPSIA IN PREGNANCY WITH THE INCIDENCE OF ASPHYXIA NEONATORUM AT THE MANGUSADA BADUNG REGIONAL HOSPITAL IN BALI FROM JANUARY 2017 – DECEMBER 2020

Introduction: Preeclampsia is included as one of hypertension in pregnancy, with the prevalence still quite high now. This condition increases maternal and perinatal mortality and morbidity. Preeclampsia causes decreased oxygen supply from mother to fetus due to systemic vasoconstriction. So, it can cause the fetus to be born in a state of asphyxia (neonatal asphyxia).Purpose: To determine the correlation between preeclampsia in pregnancy and the incidence of asphyxia neonatorum at the Mangusada Badung Regional Hospital in Bali from January 2017 – December 2020.Method: The research used an analytic observational study with a case-control design. The sampling technique used in this research is probability sampling with simple random sampling. Sample selected from members of the population based on the inclusion and exclusion criteria that have been set. The total sample used was 268 newborns, divided into 2, the case group and the control group. The statistical test used is Spearman's rho.Result: From 134 sample cases, 65 samples were from mothers with preeclampsia diagnosed, and 69 samples were from mothers without preeclampsia diagnosed. Of the 134 control samples, 31 samples were from mothers with preeclampsia diagnosed, and 103 samples were from mothers without preeclampsia diagnosed. The results of the test using Spearman's rho p = 0.000 and the results of the analysis Odds Ratio OR = 3.13.Conclusion: There is a significant correlation between preeclampsia with the incidence of neonatal asphyxia at the Mangusada Badung Regional Hospital from 1 January 2017 – 31 December 2020

PERBEDAAN KERUSAKAN KULIT PERIILEOSTOMA ANTARA PENGGUNAAN KANTONG ILEOSTOMA DENGAN SKIN BARRIER TEMPURUNG KELAPA DAN PLASTIK, MELALUI ANALISIS ELA-1, IgG, IL-4, CD-8, MMP-8 DAN SKOR DRAIZE

Kasus penyakit saluran cerna yang memerlukan pembedahan ileostomi semakin meningkat dan bahkan digunakan sebagai pengganti kolostomi, karena dalam beberapa hat justru ileostomi lebih menguntungkan daripada kolostomi. Walaupun angka kejadian kerusakan kulit periileostoma lebih besar pada ileostomi daripada kolostomi, namun apabila perawatannya sempurna maka kerusakan kulit tersebut dapat dicegah, sehingga ileostomi lebih merupakan pilihan bagi ahli bedah maupun penderita. Keuntungan ileostomi dibandingkan dengan kolostomi adalah kebersihan Iebih terjaga, tidak berbau feses, ekskreta masih cair sehingga kemungkinan terjadi impaksi feses pada stoma lebih kecil, dan apabila dilakukan pembedahan lagi untuk menutup ileostomi, maka prosedurnya lebih mudah. Beberapa penderita yang kurang mampu, menggunakan tempurung kelapa yang hanya ditelungkupkan saja pada kulit peristoma dan ditahan dengan sabuk untuk menampung ekskreta, ternyata tidak terjadi kerusakan kulit yang nyata walaupun telah dipakai dalam jangka waktu lama. Pengalaman pribadi peneliti menggunakan skin barrier tempurung kelapa pada kantong ileostoma, ternyata kerusakan kulit yang timbul hanya minimal. Berdasarkan hal tersebut peneliti berpendapat bahwa tempurung kelapa dapat dipakai sebagai skin barrier, sehingga beberapa penderita ileostoma dianjurkan untuk rnemakai kantong ileostoma yang menggunakan skin barrier tempurung kelapa. Temyata pada pengamatan klinis, penderita yang menggunakan kantong ileostoma dengan skin barrier tempurung kelapa memberikan reaksi kerusakan kulit yang minimal bila dibandingkan dengan penderita yang menggunakan kantong ileostoma dengan skin barrier plastik. Penurunan reaksi iritasi kulit pada pengguna kantong ileostoma yang dibuat dari tempurung kelapa, sampai saat ini belum jelas. Berdasarkan hal tersebut peneliti melakukan uji pada dua kelompok penderita yaitu kelompok penderita yang menggunakan kantong ileostoma dengan skin barrier tempurung kelapa sebanyak 7 kasus dan penderita yang menggunakan kantong ileostoma dengan skin barrier plastik 7 kasus. Lima belas hari setelah penggunaan kantong ileostoma, diukur beberapa variabel yaitu Elastase pankreas-1, sel plasma penghasil IgG, limfosit penghasil IL-4, limfosit CD-8, netrofil penghasil MMP-8 dan derajat kerusakan kulit periileostoma. Selanjutnya dilakukan uji statistik dengan MANOVA, t-test dan uji korelasi. Hasil yang diperoleh : Elastase pankreas-1, sel plasma penghasil IgG, netrofil penghasil MMP-8 dan derajat kerusakan kulit periileostoma menunjukkan suatu perbedaan yang bermakna (p&lt;0.05), yaitu pada pengguna kantong ileostoma dengan skin barrier tempurung kelapa, menimbulkan kerusakan kulit lebih kecil daripada pengguna kantong ileostoma dengan skin barrier plastik. Sedangkan limfosit penghasil IL-4 dan limfosit CD-8 pada kedua kelompok tersebut tidak menunjukkan suatu perbedaan yang bermakna (p&gt;0.05). Pada uji korelasi, ternyata IgG meinpunyai peranan yang paling besar (r =0.756) pada proses kerusakan kulit periileostoma penderita yang menggunakan kantong ileostoma dengan skin barrier plastik. Kesimpulan penelitian ini adalah penggunaan kantong ileostorna tempurung kelapa dapat mengurangi derajat kerusakan kulit periileostoma melalui peranan IgG yang berlanjut ke reaksi komplek imun. Kebocoran enzim elastase pankreas- I (ELA-1) dan MMP-8 berbeda pada kedua kelompok, sedangkan peranan IL-4 dan CD-8 belum jelas. Mengacu dari basil penelitian ini, maka perlu dikembangkan pemanfaatan limbah tempurung kelapa sebagai skin barrier pada kantong ileostonra, karena harga yang murah, bahan mudah diperoleh dan menimbulkan efek samping yang minimal

Traditional antidiabetic plants from Indonesia

Background: Indonesia with its widely varied geographical features is rich with knowledge and practice in the utilization of plants for maintaining health and treating diseases, including for diabetes mellitus. This review summarizes the result of ethnopharmacological studies mentioning the application of plants to treat diabetes mellitus conducted in Indonesia. Methods: The online literature search using Google Scholar (https://scholar.google.com/) was carried out to collect data on the use of plants for traditional treatment of diabetes mellitus from ethnobotanical studies in Indonesia published in 2014-2018. Results: The traditional medicinal plants listed in this article are compiled from 67 studies conducted in 18 provinces and 37 defined ethnicities. There are 132 species of antidiabetic plants from 53 families reported. The most popular plants with multiple uses in different places include Orthosiphon aristatus (Blume) Miq., Persea americana Mill., and Syzygium polyanthum (Wight) Walp. Leaves, decoction, and oral were found to be the most frequently used plant parts, preparation method, and administration route of those antidiabetic plants, respectively. Conclusions: Indonesia has a large number of traditional antidiabetic plants that are potentially developed further into standardized herbal medicines to enable their uses in formal healthcare systems. Keywords: Ethnopharmacology, Indonesia, medicinal plants, antidiabetic activities, antidiabetic compounds

Gonial Angle Characteristics of Class III Malocclusion in Javanese Ethnic

Objective: To describe the gonial angle characteristics in class III skeletal malocclusion in Javanese ethnic. Material and Methods: Pretreatment lateral cephalometric radiographs of 43 Javanese ethnic patients were measured: upper (Go1) and lower gonial angle (Go2), anterior (AFH) and posterior face height ratio (PFH), maxilla-mandibular length difference, mandibular plane angle (FMA), Y axis, ramus position, ANB angle, posterior cranial base/ramus height and mandibular body length/anterior cranial base. The relation between Go1, Go2 and other variables were analysed using correlation and regression analysis. Results: The total gonial angle is within normal range, but Go1 is below normal and Go2 is above normal. There is no difference between male and female gonial angle measurements (p=0.939 and p=0.861, respectively). Ramus position is positively correlated to Go1 (p=0.003), while AFH (p=0.000), maxilla-mandibular length difference (p=0.000), FMA (p=0.000), Y axis (p=0.000), and posterior cranial base/ramus height (p=0.018) are positively correlated to Go2. PFH is negatively correlated to Go2 (p=0.018). Conclusion: The upper gonial angle is influenced by the position of mandibular ramus, while the lower gonial angle is affected by the posterior and anterior lower facial height and mandibular size and rotation. Javanese with class III malocclusion tends to have hypodivergent facial type, with more posteriorly located mandibular ramus and excess mandibular length