The role of gut microbiota in health and diseases

ABSTRACTABSTRACTMicrobiota contributes a crucial part in the human hosts' health and actively provides to the emergence of various diseases. The optimal composition of healthy intestinal microbiota varies from person to person. The more various and abundant of the microbiota, the greater their resistance to outside hazards. Colonization of the microbiota in the human body starts after delivery and develops continuously from infant to adult. The largest microbial colony is constructed in the lower part of the adult human digestive tract. The composition of the human intestinal microbiota alters promptly during the beginning of life and is steady. It has been described the close relationship among dysbiosis of the intestinal microbiota with intestinal and non-intestinal diseases. Nevertheless, it is uncertain whether dysbiosis is the culprit of the disease or only as a result of the disease. Human microbiota's role must be investigated more deeply so that later it can be developed for the prevention, diagnosis of disease, and more effective treatment strategies in the future. In this minireview, we will describe the development of the gut microbiota, its interaction with our bodily systems and defense, the multiple causes of dysbiosis, and its impact on several metabolic in inflammatory diseases in humans. With this insight, it is hoped that we can be more cautious about using antibiotics, avoid things that lead to dysbiosis, and handle diseases more holistically, putting the balance of the microbiota into account. Keywords:  human, microbiota, gastrointestinal tract, dysbiosis, health and diseaseCorresponding author: [email protected]

Profil Pasien Urtikaria

Latar Belakang: Sebanyak 15-20% manusia pernah mengalami episode urtikaria satu kali selama hidupnya. Urtikaria adalah erupsi pada kulit, berwarna merah, berbatas tegas, dan memutih bila ditekan. Prevalensi urtikaria di dunia berkisar antara 0,3%-11,3% tergantung besar populasi yang diteliti. Tujuan: Mengevaluasi profil dan gambaran umum pasien baru urtikaria. Metode: Penelitian ini dilakukan di Instalasi Rawat Jalan Ilmu Kesehatan Kulit dan Kelamin dan Ilmu Penyakit Dalam RSUD Dr. Soetomo Surabaya periode 2015-2017. Metode yang digunakan adalah deskriptif retrospektif dengan mengevaluasi rekam medis pasien berupa umur, jenis kelamin, klasifikasi International Classification of Diseases (ICD) urtikaria, durasi urtikaria, dan pengobatan. Hasil: Didapatkan 463 pasien urtikaria. Pasien didominasi oleh rentang umur antara 12-25 tahun. Diagnosis terbanyak adalah urtikaria alergi sebanyak 36% pada tahun 2015, 34% tahun 2016, dan meningkat menjadi 40% pada tahun 2017. Pengobatan yang paling sering dilakukan adalah golongan obat antihistamin H1 generasi kedua. Kombinasi antihistamin H1 dan H2 juga masih banyak digunakan untuk terapi urtikaria. Simpulan: Pasien urtikaria di RSUD Dr. Soetomo tidak mengalami banyak perubahan bila dibandingkan dengan data profil urtikaria yang dilakukan tahun sebelumnya. Pengobatan urtikaria yang dilakukan kurang sesuai dengan guideline urtikaria terbaru tahun 2014

Contact Dermatitis in Tertiary Hospital: A 2-year Retrospective Study

Background: Contact dermatitis (CD) is a skin inflammatory caused by allergen or irritant that generates public health impact. CD is classified into two types, based on its etiological perspective, namely allergic contact dermatitis (ACD) due to a hypersensitivity type IV reaction and irritant contact dermatitis (ICD), which is a non-immunological reaction. Purpose: To determine the profile of CD patients at Dermatology and Venereology Outpatients Unit of Dr. Soetomo General Academic Hospital Surabaya in January 2018 – December 2019. Methods: A retrospective study by observation and recording data. The results of the data recap were then processed using Microsoft Excel to obtain conclusions.  Result: The results obtained were ACD (61.9%) and ICD (38.1%), aged 26-45 years (32.7%), female (79.3%). The most frequent occupation was housewives (25.3%), followed by private employees (24.5%). The most suspected causative substance was cosmetic (47.7%). The most common skin disease history was food allergy (11%), followed by drug allergy (2.8%), and atopic dermatitis (2.3%). The most frequent manifestation was acute (69.8%), with the most clinical presentation was erythematous macules (35%). Most therapies were given in combination (73.6%), with antihistamines (61%) and topical corticosteroids (49.2%) were the most prescription drug. Conclusion: ACD was more common than ICD, mostly in a female, dominated in the 26-45 years old. Housewife was the most occupational. Cosmetic was the most suspected causative substance. Food allergy was the most skin disease history. Acute was the most frequent manifestation. Erythematous macules were the most clinical presentation. Antihistamine and corticosteroid are the most common drug in combination therapy

Profil Pasien Urtikaria

Latar Belakang: Sebanyak 15-20% manusia pernah mengalami episode urtikaria satu kali selama hidupnya. Urtikaria adalah erupsi pada kulit, berwarna merah, berbatas tegas, dan memutih bila ditekan. Prevalensi urtikaria di dunia berkisar antara 0,3%-11,3% tergantung besar populasi yang diteliti. Tujuan: Mengevaluasi profil dan gambaran umum pasien baru urtikaria. Metode: Penelitian ini dilakukan di Instalasi Rawat Jalan Ilmu Kesehatan Kulit dan Kelamin dan Ilmu Penyakit Dalam RSUD Dr. Soetomo Surabaya periode 2015-2017. Metode yang digunakan adalah deskriptif retrospektif dengan mengevaluasi rekam medis pasien berupa umur, jenis kelamin, klasifikasi International Classification of Diseases (ICD) urtikaria, durasi urtikaria, dan pengobatan. Hasil: Didapatkan 463 pasien urtikaria. Pasien didominasi oleh rentang umur antara 12-25 tahun. Diagnosis terbanyak adalah urtikaria alergi sebanyak 36% pada tahun 2015, 34% tahun 2016, dan meningkat menjadi 40% pada tahun 2017. Pengobatan yang paling sering dilakukan adalah golongan obat antihistamin H1 generasi kedua. Kombinasi antihistamin H1 dan H2 juga masih banyak digunakan untuk terapi urtikaria. Simpulan: Pasien urtikaria di RSUD Dr. Soetomo tidak mengalami banyak perubahan bila dibandingkan dengan data profil urtikaria yang dilakukan tahun sebelumnya. Pengobatan urtikaria yang dilakukan kurang sesuai dengan guideline urtikaria terbaru tahun 2014

Exclusive Breastfeeding Duration and Allergic Asthma Severity in Children

Introduction: Asthma is a disease marked by bronchial hyperresponsivity. It is commonly seen in children and often affects their quality of life. Many factors affect asthma, including breastfeeding. Bioactive and immunological components of maternal milk have a protective effect on allergic asthma. However, some studies denied this, stating that it had no significant association to asthma. This study aimed to analyze the correlation between breastfeeding duration and the severity of allergic asthma described by the frequency of asthma attacks, sleep disorder, and activity limitation. Methods: This analytic observational study used a cross sectional approach. The subjects were pediatric outpatients aged 1 – 5 years old with allergic asthma at Pediatric Clinic of Dr. Soetomo General Hospital Surabaya and Private Pediatric Clinic from September 2019 to July 2020. Subjects were assessed based on the history of exclusive breastfeeding duration, frequency of asthma attacks, sleep disorder, and activity limitation through an interview using questionnaire. Results: Through the data obtained from 62 respondents, duration of exclusive breastfeeding showed no significant relation to the frequency of asthma attack (rs = -0.227, p = 0.076), sleep disorder (rs = -0.214, p = 0.095), and activity limitation (rs = -0.055, p = 0.672). Conclusion: There was no correlation between the duration of exclusive breastfeeding and the frequency of asthma attack, sleep disorder, and activity limitation

Factors Related to Knowledge, Perception, and Practices Towards COVID-19 Among Patients with Autoimmune Diseases: A Multicenter Online Survey

Background: autoimmune patients can be more susceptible to infection. Proper knowledge, perception, and practices towards COVID-19 are essential for these patients during pandemic. This study aimed to know their knowledge, perception, and practices regarding COVID-19. Methods: cross sectional study using online survey was conducted from April to May 2020. Patients with autoimmune disease were asked about demographic characteristics, diagnosis, history of treatment, knowledge, perception, and practice regarding COVID-19. Results: there were 685 respondents. Most of them were female and had systemic lupus erythematosus with median age of 37 years old. Almost all respondents had good knowledge regarding transmission of COVID-19 and did proper prevention practices. Adequacy of information and steroid or mycophenolate mofetil/mycophenolic acid (MMF/MPA) use were related to perception of the effect of pandemic to their own health. Visiting private clinic and receiving hydroxychloroquine/chloroquine sulfate or sulfasalazine were related to perception that autoimmune conditions would make them more prone to COVID-19. Work from home was related to perception that when contracting COVID-19, the symptoms would be more severe. Living in Sumatra region and getting hydroxychloroquine/chloroquine sulfate or MMF/MPA were related to perception that autoimmune medications could reduce risk of getting COVID-19. Adequate information, university education, private clinic visit, and hydroxychloroquine/chloroquine sulfate use were related to perception that COVID-19 pandemic would cause difficulties in getting medications. Conclusion: almost all respondents had good knowledge and practices regarding COVID-19. Adequacy of information, autoimmune treatment, work from home, educational background, area of living, and health care facilities contributed to perception regarding COVID-19 pandemic

Incidence of SARS-CoV-2 infection in hospital workers before and after vaccination programme in East Java, Indonesia-A retrospective cohort study

BACKGROUND: The incidence of the Coronavirus Disease 2019 (COVID-19) among healthcare workers (HCWs) is widespread. It is important to understand COVID-19 characteristics among HCWs before and after vaccination. We evaluated the incidence of COVID-19 among HCWs in East Java, Indonesia comparing the characteristics of the disease between the pre- vs post-vaccination periods. METHODS: A retrospective observational study was conducted among HCWs in two major hospitals in East Java, Indonesia, between April 01, 2020, and Oct 31, 2021. All HCWs were offered vaccination with inactivated viral vaccine (CoronaVac) from Jan 15, 2021. Therefore, we divided the time of the study into the pre-vaccination period (between April 01, 2020, and Jan 14, 2021) and post-vaccination period (between Jan 15 and Oct 31, 2021). We then compared the pattern of COVID-19 infections, and hospitalisations between these periods. FINDINGS: A total of 434 (15.1%) and 649 (22.6%) SARS-CoV-2 infections were reported among study participants (n=2,878) during the pre-vaccination and post-vaccination periods, respectively. The vaccine effectiveness was 73.3% during the first 3-4 months after vaccination but this decreased to 17.6% at 6-7 months after vaccination, which coincided with the emergence of the delta variant. The overall hospitalisation rate was reduced from 23.5% in the pre-vaccination period to 14.3% in the post-vaccination period. Hypertension appeared to be the strongest risk factor affecting hospitalisation in the pre-vaccination period. However, the risk due to hypertension was reduced in the post-vaccination period. INTERPRETATION: The risk to contract COVID-19 remains high among HCWs in East Java, Indonesia. Vaccination is important to reduce infection and hospitalisation. It is essentially important to evaluate the characteristics of COVID-19 infection, hospitalisation, the impact of co-morbidities and vaccine effectiveness in order to improve the measures applied in protecting HCWs during the pandemic. FUNDING: Mandate Research Grant No:1043/UN3.15/PT/2021, Universitas Airlangga, Indonesi

Hypertension is associated with antibody response and breakthrough infection in health care workers following vaccination with inactivated SARS-CoV-2

Several types of vaccines have been developed to prevent the coronavirus disease 2019 (COVID-19). It is important to understand whether demographic and clinical variables affect the effectiveness of various types of vaccines. This study analysed the association between demographic/clinical factors, antibody response and vaccine effectiveness in healthcare workers vaccinated with inactivated virus. We enrolled 101 healthcare workers who received two doses of inactivated viral vaccine (CoronaVac). Blood samples were analysed at 1, 3, and 5 months after the second dose of vaccination. Data regarding demographic characteristics, medical histories, and clinical parameters were collected by interview and medical examination. In a separate retrospective study, we analysed the incidence of vaccine breakthrough infection on 2714 healthcare workers who received two doses of inactivated viral vaccine. Medical histories and demographic data were collected using a structured self-reported questionnaire. We found that antibody titres markedly increased at 1 month after vaccination but gradually decreased at 3–5 months post-vaccination. We observed a significant association between age (≥40 years) and antibody level, whereas sex and body mass index (BMI) exhibited no effect on antibody titres. Amongst clinical variables analysed, high blood pressure and history of hypertension were significantly correlated with lower antibody titres. Consistently, we found a significant association in the retrospective study between hypertension and the incidence of breakthrough infection. In conclusion, our results showed that hypertension is associated with lower antibody titres and breakthrough infection following COVID-19 vaccination. Thus, blood pressure control might be important to improve the efficacy of inactivated virus vaccine