HISTOLOGICAL EFFECT OPTIMIZATION COMBINATION OF BACILLUS SPHAERICUS 2362 AND BACILLUS THURINGIENSIS SUBSP. ISRAELENSIS IN MIDGUT OF CULEX QUINQUEFASCIATUS RESISTANCE

ABSTRACTObjective: The objective of the study was to analyze pore‑forming at Culex quinquefasciatus resistant larvae midgut and analyze optimization ratioafter treatment using combination Bacillus thuringiensis var. israelensis (Bti) and Bacillus sphaericus (Bs) 2362.Methods: This research was an experimental study. C. quinquefasciatus larvae were divided into 10 groups. The Group I until VII had treatment bythe various concentration of combination Bti and Bs 2362, treatment Group VIII as a positive control, Group IX as a negative control, and Group X asa single Bs 2362. All of the treatment groups were examined for the histological effect of C. quinquefasciatus larvae midgut by hematoxylin eosin. Thelowest lethal concentration 50% (LCResults: The lowest LC5050) was a standard optimization ratio of combination Bti and Bs 2362. LC50 was analyzed by probit. was 2.274 part a million (ppm) at Group I was the optimization ratio. Various combination treatments Group I until VII wereshown pores at C. quinquefasciatus larvae midgut after treatment by a combination of Bti and Bs 2362.Conclusion: Combination of Bti and Bs 2362 was shown pores at C. quinquefasciatus larvae midgut, and optimization ratio was shown in Group I.Keywords: Bacillus thuringiensis var. israelensis, Bacillus sphaericus 2362, Culex quinquefasciatus midgut

Experiences of people with HIV/AIDS (PLWHA) at the critical condition due to AIDS

Background: PLWHA who suffered critical condition and being treated in intensive care the majority (84%) due to Pneumocystis carinii pneumonia, 47% experienced respiratory failure, sepsis, 12% and 11% neurologic disease. The death rate PLHIV patients treated in intensive reaches 83%. Of all patients passing through a critical phase, 27% survived for 1 year, 18% survive the second year, 13% survived 3 years and 11% last more than four years. They have the experience that need to be explored in a comprehensive manner to provide support to people living with HIV else.Methods: This research was conducted through qualitative research with phenomenological approach that focuses on the depth of the process through in-depth interviews on 10 participants. Participants in this study were HIV-positive people who visit the Polyclinic Teratai Hasan Sadikin Hospital in Bandung. Recruitment of participants was done by purposive sampling with criteria for inclusion namely 1) PLHIV been treated in hospital with critical conditions, 2) Ability to communicate with tray, 3) People who say they remember past experiences related to the care in critical condition.Results: The data were analysed to identify themes about the experiences of people living with HIV during critical condition. The results found six themes namely: 1) experiencing emotional response, 2) striving to overcome the feelings and the impact of illness, 3) closer to God, 4) undergoing their destiny as People Living with HIV/AIDS (PLWHA), 5) received support and prayers of people around, and 6) has a hope of a cure.Conclusions: PLWHA treated in a critical condition experience threat of death from opportunistic infections and had the psychological burden of disease due to the stigma of HIV/AIDS. This makes them slumped physically and psychologically, thus they felt helpless. The recommendation from the results of this research is that communities, families and health workers should provide a support system to people living with HIV in order to increase life expectancy due to a collapsed condition and hopelessness

Etiology of Allergic Contact Dermatitis based on Patch Test

Background: Allergic contact dermatitis is a type of contact dermatitis, whose  prevalence tends to increase every year. Patch test is an important diagnostic test to confirm the disease. The result of patch test can help doctors to perform appropriate treatment.  The aim of the study was to identify  the most frequent allergen causing allergic contact dermatitis based on patch test results. Methods: This was a descriptive retrospective study among patients who underwent patch test at the Dermatology and Venereology Clinic in Dr.Hasan Sadikin General Hospital Bandung, Indonesia from August 1st, 2014 to August 31st, 2015. The patch test result was obtained from the patient’s medical record and recapitulation data. The patient’s medical record would be collected based on inclusion and exclusion criteria. This study also collected demographic data of the patients, including age, sex, and occupation.The collected data were presented using tables. Results: Out of 45 patient’s medical records, 19 patients were male (42.2%) and 26 patients were female (57.8%). Nickel sulphate was the most frequent allergen with 17 sensitization. Thirteen out of 17 patients who were sensitized by nickel sulphate were females. A great majority of the patients were in the age group of 15–44 years. Most of the patients were students (42.2%). Allergic contact dermatitis (64.4%) was the main clinical diagnosis among the patients. Conclusions: The most frequent allergen causes allergic contact dermatitis is nickel sulphate

Keberhasilan Terapi Kombinasi Menggunakan Metotreksat Injeksi dan Siklosporin pada Psoriasis Pustulosa Generalisata

Psoriasis pustulosa generalisata (PPG) adalah bentuk khusus dari psoriasis yang bersifat akut dan berat. Etiologi yang belum diketahui secara pasti menyebabkan pengobatan PPG masih menjadi suatu tantangan. Terapi kombinasi dapat diberikan pada PPG yang berat maupun yang tidak memberikan respons terhadap terapi sistemik tunggal, selain itu terapi kombinasi juga dapat meningkatkan efektivitas dari obat tunggal. Dilaporkan satu kasus PPG pada seorang wanita yang diterapi dengan menggunakan kombinasi metotreksat (MTX)  injeksi dan siklosporin. Dari anamnesis dan pemeriksaan fisis didapatkan pustula berkelompok pada dasar makula eritem yang bergabung membentuk lake of pus, disertai gejala sistemik demam dan leukositosis. Keluhan tersebut sudah berulang sejak 13 tahun yang lalu. Pasien diberikan terapi kombinasi injeksi MTX dan siklosporin. Pustula pada pasien menghilang setelah tujuh hari pemberian obat. Terapi kombinasi dengan MTX injeksi dan siklosporin ini baru pertama kali dilakukan 19 Mei–26 Mei 2017 di Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dan memberikan hasil yang baik. [MKB. 2017;49(3):208–12]Kata kunci: Metotreksat, metotreksat injeksi, psoriasis pustulosa generalisata, siklosporin Succesful Treatment of Generalized Pustular Psoriasis with a Combination of Methotrexate Injection and CyclosporineGeneralized pustular psoriasis (GPP) is a special form of acute and severe psoriasis. The definite etiology of GPP remains a challenge. Combination therapy may be given to severe GPP or GPP that does not respond to a single systemic therapy sincecombination therapy may also improve the effectiveness of a monotherapy drug. A GPP case was reported in a woman treated with a combination of methotrexate (MTX) and cyclosporine. From anamnesis and physical examination it was revealed that there were clustered  pustules on the base of erythematous macules that form a lake of pus accompanied by systemic symptoms of fever and leukocytosis. This was a recurrent complaint since 13 years ago. Patients were given combination therapy of MTX injection and cyclosporine. Pustules disappeared after seven days of drug administration. This case was the first combination therapy with MTX injection and cyclosporine used during the period of 19 May to 26 May 2017 at the Department of Dermatology and Venereology Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, resulting in good results. [MKB. 2017;49(3):208–12]Key words: Cyclosporine, generalized pustular psoriasis, methotrexate, methotrexate injectio

Non-contact Electric Field Exposure Provides Potential Cancer Therapy through p53-Independent Proliferation Arrest and Intrinsic Pathway Apoptosis Induction in MG-63 Cell Lines

Osteosarcoma is a highly malignant primary tumor on bone that mainly attacks children and young adolescents. Until now, osteosarcoma therapy still combines some high costs and invasive therapy modalities that may give side effects, such as pain and nausea. Our previous studies suggested that non-contact electric field has anti-proliferative effect on breast cancer cells, in vitro and in vivo. In this study, we were interested studying alternating current electric field effects on osteosarcoma cells progression as well as its potential cytotoxic effects. MG-63 human osteosarcoma cells were cultured and treated with 200 kHz for 6 days. Several genes of interest including p53, p21, MDM2, caspase-3, caspase-8, and caspase-9 were analyzed using real-time qPCR method. Apoptotic index was measured using flow-cytometry assay. Apoptosis was observed through p53-independent p21 pathway (p = 0.011). Cells undergoing apoptosis through internal pathways were shown by the increase of caspase-3 (p = 0.015) and caspase-9 (p = 0.001) levels, but not caspase-8 (p = 0.080). This treatment has successfully reduced the number of living osteosarcoma cells by 14.7% (p = 0.000) and increased cell death up to 4.26% (p = 0.055). Apoptotic index was markedly increased to 16% (p = 0.001). 200 kHz non-contact electric field exposure can disrupt osteosarcoma progression through disruption of normal cell cycle via p53-independent p21 pathway and induction of apoptosis

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

Kadar Interleukin-18 pada Kultur Limfosit Penderita Dermatitis Atopik yang Distimulasi Staphylococcal Enterotoxin B (SEB)

Staphylococcus aureus (S. aureus) has an important role in the pathogenesis of atopic dermatitis (AD). S. aureus acts as a triggering factor for AD and also causes chronic inflammation. These roles of S. aureus are related to various proteins such as Staphylococcal enterotoxin B (SEB) as a potent toxin. Interleukin-18 (IL-18) is an important regulator of cytokine production of Th-1, which is interferon-γ (IFN-γ). The aim of this study was to reveal the levels of IL-18 in cultured lymphocytes from AD patients exposed by SEB. This study was conducted on 20 people with DA (7 men and 13 women) and 20 healthy volunteers (9 men and 11 women) in dr. Hasan Sadikin General Hospital. The in vitro experimental study on cultured lympocytes exposed with SEB was performed at the Integrated Research and Testing Laboratory of Gadjah Mada University. The average levels of IL-18 in cultured lymphocytes before and after being exposed to SEB increased both in AD group and control group. After the statistical tests was performed on the ratio of the average levels of IL-18 before and after being exposed to SEB between AD and control groups, it was shown that the levels of IL-18 AD group was significantly higher than the control group (p <0.05). Therefore, it can be concluded that the levels of IL-18 increased higher in AD group exposed by SEB

AKTIVITAS DEPIGMENTASI FRAKSI N-HEKSANA BUAH MALAKA (PHYLLANTHUS EMBLICA) PADA SEL MELANOSIT MOUSE MELANOMA B16

AbstractInhibitor of melanin synthesis can be used as depigmenting agent to treat skin hyperpigmentation. Herbal depigmenting agents are increasingly utilized due to their character in inhibiting melanin synthesis without causing melanocyte toxicity. This study was aimed to examine depigmenting activity of n-hexane fraction of Phyllanthus emblica fruit by measuring its melanin synthesisinhibition on melanocyte mouse melanoma B16 cell line. Melanin synthesis inhibition was measured spectrophotometrically by counting the melanin and the activity of tyrosinase. The cytotoxicity of n-hexane fraction on melanocytes was measured by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. This study was conducted on November-December2009 at Department of Biochemistry and Diabetes Research Centre, Chonbuk National University Medical School, South Korea. The result of this study indicated that melanin count and tyrosinase activity decreased in a dose-dependent manner of n-hexane fraction of P. emblica fruit (IC50 31.68 and 77.92 μg/ml, respectively). The viable cells decreased with increasing concentration ofthe n-hexane fraction of P. emblica fruit (LD50 87.39 μg/ml).Key words: n-hexane fraction, Phyllanthus emblica, depigmenting agen