Tamarillo Consumption Associated with Increased Acetylcholinesterase Activity and Improved Oxidative Stress Markers in Farmers Exposed to Daily Pesticide-related Activities in Baturiti, Bali, Indonesia

BACKGROUND: The behavior of pesticide use that does not meet the standards will increase the risk of pesticide intoxication among farmers. The main content of pesticides, namely, organophosphates and carbamate, has been widely known to be the main culprit of the negative side effect through inhibition of the acetylcholinesterase (AChE) enzyme. However, this effect theoretically could be reduced by exogenous antioxidants properties provided in tamarillo fruit. AIM: This study aims to determine the effect of tamarillo consumption on the AChE activity and biomarkers of oxidative stress among farmers who exposed daily pesticide-related activity. METHODS: A randomized, open-label clinical trial was conducted among 40 farmers in the Baturiti, Tabanan Regency, Bali, Indonesia, during March–August 2018. The respondents were randomly divided into two groups: (1) Groups of farmers without tamarillo juice supplementation (control), and groups of farmers who were given pure tamarillotamarillo juice 250 ml/day every day for 2 weeks (intervention). Measurement of AChE, malondialdehyde (MDA), and superoxide dismutase (SOD) levels was carried out at the beginning and the end of the study. Data were analyzed using SPSS version 17 for windows. RESULTS: Bioactive compound assessment found several antioxidant properties such as flavonoid, tocopherol, polyphenol, β-carotene, ascorbic acid, citric acid, and anthocyanin. The study participants were dominated by male and the distribution of gender between control and intervention groups was comparable (p > 0.05). There were also no significant differences in age, height, weight, body mass index, land area, duration of being farmers, spraying frequency, and smoking history (p > 0.05). However, bivariate analysis between control and intervention groups found a statistically significant difference in SOD (MD: 23.31 ± 15.89 nmol/l; 95% CI: 14.13–32.49; p < 0.0001), MDA (MD: 81.82 ± 62.45 nmol/l; 95% CI: 45.76–117.88; p < 0.0001), and AChE (MD: 341.61 ± 206.44 nmol/min/ml; p < 0.0001) levels. CONCLUSION: Tamarillo consumption associated with increased AChE activity and improved oxidative stress through increased SOD and decreased MDA levels among farmers

Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Stage Determination in Breast Cancer

BACKGROUND: Breast cancer tends to respond differently to treatments, which are usually determined by clinicopathological characteristics. Several studies evaluated the role of the peripheral blood test as diagnostic and prognostic markers in several types of solid cancer and neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR) are two of them which already tested. However, the evidence in breast cancer is still lacking. AIM: Therefore, the study aimed to investigate the value of NLR and PLR as biomarkers concerning breast cancer stage. METHODS: A retrospective study was conducted using breast cancer patients’ medical records from 2014 to 2019 at Sanglah General Hospital. The histopathological records and complete blood counts of the patients were collected and analyzed risk analysis model, receiver operator characteristics analysis, and correlation of NLR and PLR with cancer staging analysis used correlation test. RESULT: One hundred five patients data were used in this study, with 35 subjects had early-stage breast cancer while 70 subjects had an advanced stage. Breast cancer staging with NLR and PLR showed significant associations (p < 0.001). Both NLR and PLR had area under the curve >0.7 (p < 0.001). The cutoff, sensitivity, and specificity values of NLR and PLR were 2.504 (71%; 70%) and 157.1 (73%; 70%). Advanced stage of breast cancer was mostly found in high NLR and PLR value with (OR: 4.231; CI = 1.791-9.995, p < 0.001) and (OR: 3.949; 95% CI = 1.679–9.287; p < 0.001). CONCLUSION: From this preliminary study, pretreatment NLR and PLR values might determine the breast cancer stage. Further research is needed to evaluate the association between grade and patient survival

The Stromal Cell-derived Factor-1/CXCL12 3’A-gene Polymorphism is Related to the Increased Risk of Coronary Artery Disease: A Systematic Review and Meta-analysis

BACKGROUND: Single-nucleotide polymorphism in the stromal cell-derived factor-1 (SDF-1)/CXCL12 gene had been associated with an increased risk of coronary artery disease (CAD). However, several published studies have shown inconsistent results. AIM: A meta-analysis was assessed to evaluate the association between SDF-1 3’A-gene polymorphism and CAD in the literature. METHODS: A systematic review was conducted in accordance with PRISMA guidelines and adhering to the Cochrane Handbook for Systematic Reviews. The literature search strategy was carried out on April 3, 2019, from PubMed, EBSCO, Google Scholar, and DOAJ during 2013–2018 period using various keywords related to SDF-1, CXCL12, polymorphism, and CAD. Original data from the group, case-control study, English full-text, and DNA polymorphism assessment using polymerase chain reaction were enrolled. Gene polymorphism in A-base nucleotide among patients with CAD and healthy subjects were evaluated. All data were analyzed using Review Manager 5.3 (Cochrane, Denmark) for meta-analysis. RESULTS: Five eligible studies extracted for data analysis (2013–2018) based on the assessment of 2-independent reviewers. Several studies have been excluded due to irrelevant criteria evaluated. A significant result was found between SDF-1 3’A gene polymorphism with the increased risk of CAD in the overall effect evaluation using a fixed-effects model (odds ratio [OR]: 2.02; 95% confidence interval 1.54-2.65; I2: 34%; p<0.001) on the forest plot. CONCLUSION: Our meta-analysis suggests that gene polymorphism in A-base nucleotide of SDF-1/CXCL-12 was associated with the susceptibility of CAD. However, a bigger-scale and well-design of case-control study should be conducted to clarify these conclusions

Factors associated with visit-to-visit variability of blood pressure in hypertensive patients at a Primary Health Care Service, Tabanan, Bali, Indonesia

Background: An increasing number of valid and well-designed trials have demonstrated a positive correlation between visit-to-visit variability (VVV) in systolic blood pressure (SBP) and increased risk of stroke and coronary heart disease among hypertensive patients. Methods: A cross-sectional study was conducted that involved 74 patients who visited the outpatient clinic at the Tabanan III Primary Health Care Service during April to May 2017. Blood pressure was retrospectively obtained from medical records. VVV was classified as low or high on the basis of the standard deviation of SBP. Antihypertensive medication adherence was expressed as the percentage of days covered, and sodium intake was measured with 24-hour food recall. Bivariate analysis was performed, followed by multivariate analysis for significant variables. Results: Among the participants, 67.6% were female, with a mean (standard deviation [SD]) age of 62.70 (10.00) years. Blood pressure was measured 4.82±0.78 times during the period, and the mean (SD) SBP was 139.65 (10.57) mm Hg. Nonadherence and sodium intake were significantly higher in the high-VVV group than in the low-VVV group (nonadherence 13.5% vs. 37.8%, P=0.033; sodium intake 1278.44±43.02 mg vs. 1495.85±45.26 mg, P=0.038). After adjustment for other covariates, the differences remained significant only for nonadherence (model I exp β=3.89 [95.0% confidence interval 1.23–12.34, P<0.05], model II exp β=3.9 [95.0% confidence interval 1.12–14.15, P<0.05]). The area under the curve was 0.636 (P<0.05), with sensitivity of 67.6% and specificity of 51.4%. Conclusion: Nonadherence to antihypertensive medication was significantly associated with higher VVV of SBP. Further study is needed to assess whether improving adherence could reduce VVV and improve cardiovascular outcomes