EFEKTIVITAS EKSTRAK KULIT MANGGIS (Garcinia mangostana) TERHADAP JUMLAH SEL NK DAN KADAR IFN-γ PADA PENDERITA HIV DENGAN TERAPI ANTIRETROVIRAL

Background: Mangosteen peel contains a xanthone as strong antioxidant, which is useful as a prooxidant balancer (reduxing radicals, oxidizing radicals, carbondentered, UV light, metal, etc) that can be found in human environment. The activity of xathone can be found from the number of NK cell that will increase the production of IFN-γ cytokine. Methods: The human experimental research has been done by Randomized Control Group Pretest-Post Test Design, 20 patients sample for each group. Group 1: The HIV patients with ARV therapy were given mangosteen peel extract, 2: The HIV patients with ARV therapy were given placebo capsule. The treatment was done for 30 days, then NK cells number and IFN-γ level examination was done in pre – post treatment. The result was tested to find out the normality of data distribution by Saphiro Wilks test. If the data distribution is normal, the data analysis was continued by Paired Sample T Test to determine the difference between the pre test nad post test treatment. If the data distribution is abnormal, data analysis was continued by Wilcoxon Smith test. And Spearman’s Rho test was used to determine the correlation between the number of NK cells and IFN-γ level. Whereas the Mann Whitney test was used to determine the difference between the group 1 and group 2. Results: There are no significant differences between NK cell number (p:0.911) and IFN-γ level (p:0.588) to HIV patients with ARV therapy in the pre and post test examination after having been given mangosteen (Garcinia mangostana) peel extract. There are no significant correlations between NK cell number and IFN-γ level in each group (p: 0.074). Conclusions: There are no effects of giving mangosteen (Garcinia mangostana) peel extract on the number of NK cell and level of IFN-γ to HIV patients by antiretroviral therapy. Key Word: Mangosteen (Garcinia mangostana) Peel Extract, NK Cell Number, INF-γ Cytokin

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding: Bill & Melinda Gates Foundation