PSIDIUM GUAJAVA L. EXTRACT INCREASES PLATELET COUNT THROUGH ENHANCEMENT OF STEM CELL FACTOR EXPRESSION IN THROMBOCYTOPENIC MICE MODEL

Objective: The purpose of this study was to determine the mechanism through which guava extract increases platelet count.Methods: Twenty male Swiss webster mice were divided into 4 group. Group I received 2.8 mg/20 g body weight of quinine and 1 ml of distilled water. Group II received 2.8 mg/20 grBW of quinine and 0.785 mg/20 grBW of guava extract. Group III received 1 ml distilled water and 0.785 mg/20 grBW of guava extract and Group IV only received 1 ml distilled water. After 14 days** treatment, platelet count was measured using Raas-Ecker method. SCF and TPO mRNA expressions in mice liver were assessed using qRT-PCR.Results: The data showed that quinine administration reduced platelet count significantly (P<0.05). Psidium guajava L. extraction significantly enhanced platelet count in mice that were treated with quinine compared with quinine group (p<0.05). The mechanism was analysed further and our RT PCR data showed that stem cell factor mRNA expression significant increased (p<0.05) in quinine plus guava extract group compared to quinine group.Conclusion: It indicated guava extract role in increasing megakaryopoiesis which resulted in an increase of platelet count.Â

The Effect of Systemic Methotrexate and Cyclosporine Combination Therapy inPsoriasis Vulgaris Patients in Bandung, Indonesia

Background: Methotrexate (MTX) and cyclosporine have been used as effective systemic mono-therapy for psoriasis. Several factors are considered to switch monotherapy to combination therapy because monotherapy is no longer effective and has higher side effects. Hence,clinicians have avoided systemic therapy combinations due to its toxicity. However, some studies showed that this combination therapy could be usedeffectively for psoriasis patients. Purpose: This study aimed to analyze the efficacy and adverse effects of systemic MTX and cyclosporine combination therapy in Indonesian psoriasis vulgaris patients. Methods: The retrospective study assessed the effectiveness of 3 monthsmono-therapyand combination therapy of systemic MTX and cyclosporine in psoriasisvulgaris patients from 2016–2017 in Dermatology Clinic, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia. Result: Psoriasis area and severity index (PASI) score 90 were achieved in the group MTX (50%) and cyclosporine group (50%), while none in the combination group.However, eight patients (50%) in group MTX and cyclosporine reached the primary endpoint of PASI 50. One patient in cyclosporine group had adverse effects on kidney profiles. Nonetheless, other patients had no biochemical changes. But, there was no significant difference in the change of PASI between each group (p=0.102). Conclusion: We propose that combination therapy of MTX and cyclosporine is relatively safe and efficacious in treating Indonesian psoriasis vulgaris patients. This combination treatment isas effective as MTX or cyclosporinemono-therapy

The Development of Germicidal Air Purifier by Employing Ultraviolet System in Controlling Airborne Bacteria

The nosocomial infection could be acquired through airborne disease in the hospital. However, only a particular health center in Indonesia carried out a complete, cautious prevention procedure by utilizing air purifiers due to cost problems. Thus, to minimize the number of nosocomial infections related to bacterial air pollutants, excellent tools with low cost are required to address this problem. We developed an ultraviolet light system within the air purifier at a low cost and the best way to eradicate pathogenic microorganisms in the healthcare center. The study was conducted at the Faculty of Medicine, Universitas Padjadjaran, Bandung in 2009–2010. The room prototype was built from a transparent glass material with two holes at the upper corner as an inlet and outlet pipeline canal. In the middle of the pipeline circulation, a vacuum pump, ultraviolet system, and a cooler were installed so the air will initially flow through those devices before being re-circulated into the room through the pipeline's inlet hole. A fan was set on the room floor, and several ten-centimeter apart, Petri dishes containing microbial growth medium were placed. The microbial colonies from the room with and without the installed ultraviolet system in the air purifier were then compared for analysis. The result showed that an air purifier equipped with an ultraviolet system killed microorganisms 73% more effective than the air purifier without an ultraviolet system (p<0.05). In conclusion, employing an ultraviolet system within the air purifier might be effectively killed microorganisms and ultimately reduce nosocomial infection.   PENGEMBANGAN AIR PURIFIER RUANGAN DENGAN PEMANFAATAN SINAR ULTRAVIOLET UNTUK MEMBUNUH MIKROB BAWAAN UDARA Infeksi nosokomial dapat ditularkan melalui penyakit yang ditularkan melalui udara di rumah sakit. Namun, hanya rumah sakit atau pelayanan kesehatan tertentu di Indonesia yang melakukan prosedur pencegahan infeksi nosokomial secara optimal dengan memanfaatkan air purifier karena kendala biaya. Oleh sebab itu, untuk meminimalkan jumlah infeksi nosokomial yang terkait dengan bakteri pencemar udara diperlukan pengembangan air purifier yang baik dengan biaya yang murah. Kami telah mengembangkan sistem pembersih udara yang terintegrasi sinar ultraviolet dengan biaya rendah untuk mengurangi mikroorganisme patogen di ruang pelayanan kesehatan. Penelitian dilaksanakan di Fakultas Kedokteran, Universitas Padjadjaran, Bandung pada tahun 2009–2010. Prototipe ruangan dibuat dari bahan kaca transparan dengan dua lubang di sudut atas sebagai ruang instalasi pipa saluran masuk dan keluar. Pada bagian tengah sirkulasi pipa dipasang pompa vakum, sistem ultraviolet, dan pendingin sehingga udara akan mengalir melewati alat-alat tersebut sebelum disirkulasikan kembali ke dalam ruangan melalui lubang masuk pipa. Sebuah kipas dipasang pada prototipe ruangan dan setiap jarak sepuluh sentimeter ditempatkan cawan Petri yang berisi media pertumbuhan mikrob. Koloni mikrob dari ruangan model dengan dan tanpa sistem ultraviolet yang terpasang di air purifier, kemudian dibandingkan untuk dianalisis. Hasil penelitian menunjukkan bahwa air purifier yang dilengkapi sistem ultraviolet membunuh mikroorganisme 73% lebih efektif daripada air purifier tanpa sistem ultraviolet (p<0,05). Simpulan, penggunaan sistem ultraviolet dalam air purifier efektif membunuh mikroorganisme dan pada akhirnya dapat mengurangi infeksi nosokomial

PSIDIUM GUAJAVA L. EXTRACT INCREASES PLATELET COUNT THROUGH ENHANCEMENT OF STEM CELL FACTOR EXPRESSION IN THROMBOCYTOPENIC MICE MODEL

Objective: The purpose of this study was to determine the mechanism through which guava extract increases platelet count.Methods: Twenty male Swiss webster mice were divided into 4 group. Group I received 2.8 mg/20 g body weight of quinine and 1 ml of distilled water. Group II received 2.8 mg/20 grBW of quinine and 0.785 mg/20 grBW of guava extract. Group III received 1 ml distilled water and 0.785 mg/20 grBW of guava extract and Group IV only received 1 ml distilled water. After 14 days** treatment, platelet count was measured using Raas-Ecker method. SCF and TPO mRNA expressions in mice liver were assessed using qRT-PCR.Results: The data showed that quinine administration reduced platelet count significantly (P&lt;0.05). Psidium guajava L. extraction significantly enhanced platelet count in mice that were treated with quinine compared with quinine group (p&lt;0.05). The mechanism was analysed further and our RT PCR data showed that stem cell factor mRNA expression significant increased (p&lt;0.05) in quinine plus guava extract group compared to quinine group.Conclusion: It indicated guava extract role in increasing megakaryopoiesis which resulted in an increase of platelet count.Â

Increased expression of interleukin-17A in the lesional skin indicates increase of serum antibody anti-phenolic glycolipid-I in leprosy patients

Background: In lepromatous type of leprosy, the serum titer of the antibody against phenolic glycolipid (PGL)-I-a-specific antigen in leprosy that is produced by B cell is high. Whereas, the interleukin (IL)-17A expressed by T-helper 17 cells could induce B-cell differentiation. The role of IL-17A in leprosy is still unknown. Hence, this study aimed to assess a correlation between IL-17A expression in the lesional skin and anti-PGL-I immunoglobulin (Ig) M serum levels in leprosy patients. Methods: This study was performed in Leprosy Clinic, Dr. Hasan Sadikin Hospital Bandung, Indonesia, using a cross-sectional analytical study. A punch biopsy obtained from 49 leprosy patients was included through consecutive sampling for measurement of IL-17A expression in the skin by immunohistochemistry scoring (histoscore). Furthermore, the anti-PGL-I IgM level in serum is evaluated by enzyme-linked immunosorbent assay. Results: The IL-17A expressions in the skin biopsies of tuberculoid (TT), borderline tuberculoid (BT), mid-borderline (BB), borderline lepromatous (BL), and lepromatous leprosy (LL) patients using histoscore were 1.00, 2.31, 4.63, 5.06, and 10.14, respectively, and they showed significant differences (P = 0.0001). The titer of anti-PGL-I IgM levels was 89 pg/ml, 555 pg/ml, 1.244 pg/ml, 1.920 pg/ml, and 23.591 pg/ml in TT, BT, BB, BL, and LL patients, respectively, and they showed significant differences (P = 0.005). The results of Rank–Spearman correlation analysis between IL-17A expression in the skin and anti-PGL-I IgM serum levels were as follows: r = 0.767 and P = 0.0001. Conclusion: These results suggested that the increase of IL-17A expression in the lesional skin indicates the increase of anti-PGL-I IgM serum levels in leprosy

Clinical pilot study: Clarithromycin efficacy in multibacillary leprosy therapy

Background: Rifampicin is one of the important components in the multidrug therapy (MDT)-World Health Organization regimen for leprosy. Clarithromycin is one of the alternative therapies of rifampicin. Methods: This clinical pilot study was to compare the efficacy of 2,000 mg clarithromycin to 600 mg rifampicin in combination with dapsone and clofazimine for 3 months in multibacillary (MB) leprosy patients. They were divided into an MDT-MB regimen group that consists of rifampicin-dapsone-clofazimine and clarithromycin-dapsone-clofazimine (CDC) regimen group, each group consisted of seven patients. Results: The morphological index (MI) was reduced insignificantly after 3 months therapy in MDT-MB group (P = 0.248). While in the CDC group, the MI decrement showed a significant result (P = 0.004). The comparison of MI reduction in MDT-MB and CDC groups showed an insignificant difference (P = 0.130). Skin discoloration was occurred in both groups, whereas mild-nausea was presented in the CDC group, in addition, red-colored urine was developed in the MDT-MB group. Conclusion: We concluded that 2,000 mg clarithromycin is as effective as 600 mg rifampicin in combination with dapsone and clofazimine regimen in MB leprosy patients. Hence, clarithromycin can be considered as an alternative therapy for leprosy patients who resistance and/or allergy to rifampicin

BIG1 is required for the survival of deep layer neurons, neuronal polarity, and the formation of axonal tracts between the thalamus and neocortex in developing brain

<div><p>BIG1, an activator protein of the small GTPase, Arf, and encoded by the <i>Arfgef1</i> gene, is one of candidate genes for epileptic encephalopathy. To know the involvement of BIG1 in epileptic encephalopathy, we analyzed BIG1-deficient mice and found that BIG1 regulates neurite outgrowth and brain development <i>in vitro</i> and <i>in vivo</i>. The loss of BIG1 decreased the size of the neocortex and hippocampus. In BIG1-deficient mice, the neuronal progenitor cells (NPCs) and the interneurons were unaffected. However, Tbr1⁺ and Ctip2⁺ deep layer (DL) neurons showed spatial-temporal dependent apoptosis. This apoptosis gradually progressed from the piriform cortex (PIR), peaked in the neocortex, and then progressed into the hippocampus from embryonic day 13.5 (E13.5) to E17.5. The upper layer (UL) and DL order in the neocortex was maintained in BIG1-deficient mice, but the excitatory neurons tended to accumulate before their destination layers. Further pulse-chase migration assay showed that the migration defect was non-cell autonomous and secondary to the progression of apoptosis into the BIG1-deficient neocortex after E15.5. In BIG1-deficient mice, we observed an ectopic projection of corticothalamic axons from the primary somatosensory cortex (S1) into the dorsal lateral geniculate nucleus (dLGN). The thalamocortical axons were unable to cross the diencephalon–telencephalon boundary (DTB). <i>In vitro</i>, BIG1-deficient neurons showed a delay in neuronal polarization. BIG1-deficient neurons were also hypersensitive to low dose glutamate (5 μM), and died via apoptosis. This study showed the role of BIG1 in the survival of DL neurons in developing embryonic brain and in the generation of neuronal polarity.</p></div