Sago enterprise / Hanani Omar... [et al.]

SAGO ENTERPRISE is a business that focuses on producing products based from the sago palm (Metroxylon sp.). Our products are sago flour and Tebalui and had certificated from Sabah Forestry Department. All of these products are high demand especially in northern Sabah because it is highly used on a tourism sector. Unfortunately, the producers of sago products is very limited suppliers and about only 3 suppliers around Sabah. For the reason, we produce sago products to local people and small holders. According to the Sabah's history (early 1940), sago has saving many of people around Kuala Penyu and Beaufort on Japanese colonization. At that moment, the local people don't have any source of food especially rice because all of food sources has been taken by Japanese soldiers. Nowadays, the sago palm became as a commercial plant that can give better profit for those who involve with these plant. This is because only several areas in our country get benefit from it. As we know, sago is also has a potential to be a substitute product for substituting the starch flour

Kadar Malondialdehid Sebagai Biomarker Stress Oksidatif Sebelum dan Sesudah Kemoterapi Fase Induksi pada Pasien Anak dengan Leukemia Limfoblastik Akut

Latar belakang. Leukemia merupakan keganasan yang sering terjadi pada anak dan kemoterapi merupakan terapi kuratif penting pada pasien leukemia limfablastik akut. Penggunaan kemoterapi pada awal diagnosis dapat memicu terbentuknya radikal bebas yang mengganggu homeostasis sel. Malondialdehid merupakan produk sekunder dari peroksida lipid yang dihasilkan oleh reaksi radikal bebas lemak tak jenuh dalam membran sel dan dapat digunakan sebagai penanda stress oksidatif. Protokol kemoterapi sebelumnya tidak konsisten. Protokol kemoterapi di Indonesia saat ini menggunakan protokol LLA 2018 yang berbeda dari protokol sebelumnya. Tujuan. Penelitian ini bertujuan mengetahui perbedaan kadar malondialdehid sebelum dan sesudah kemoterapi fase induksi pada anak dengan limfoblastik leukemia akut. Metode. Penelitian ini merupakan penelitian kohort prospektif dengan subjek penelitian anak berusia >1 bulan hingga 18 tahun dengan LLA yang mendapat pengobatan di Rumah Sakit Umum Pusat Prof. dr. IGN Gde Ngoerah dari bulan Juli 2021 hingga September 2022. Uji Wilcoxon digunakan untuk menilai perbedaan kadar malondialdehid sebelum dan sesudah kemoterapi fase induksi. Tingkat signifikansi ditentukan dengan nilai p <0,05. Hasil. Terdapat 30 subjek dalam penelitian ini. Median kadar malondialdehid serum sebelum kemoterapi fase induksi adalah 77,63 (20,45-578,66) dan menurun menjadi 66,63 (22,6-357,3) setelah kemoterapi fase induksi, tetapi tidak signifikan secara statistik (p=0,60). Pada kelompok sesudah kemoterapi fase induksi, terdapat peningkatan status gizi baik pada 22 subjek (73,4%), sedangkan sebelum kemoterapi hanya terdapat 15 subjek (50%), tetapi tidak signifikan secara statistik (p=0,464). Kesimpulan. Kadar malondialdehid menurun setelah kemoterapi fase induksi, terutama pada pasien dengan status gizi baik, meskipun tidak bermakna secara statistik

Characteristics, mortality and outcomes at transition for adolescents with perinatal HIV infection in Asia

Objectives: The aim of this study was to describe characteristics of perinatally HIV-infected adolescents (PHIVAs), factors associated with mortality, and outcomes at transition. Design: Ongoing observational database collating clinical data on HIV-infected children and adolescents in Asia. Methods: Data from 2001 to 2016 relating to adolescents (10-19 years) with perinatal HIV infection were analysed to describe characteristics at adolescent entry and transition and combination antiretroviral therapy (cART) regimens across adolescence. A competing risk regression analysis was used to determine characteristics at adolescent entry associated with mortality. Outcomes at transition were compared on the basis of age at cART initiation. Results: Of 3448 PHIVA, 644 had reached transition. Median age at HIV diagnosis was 5.5 years, cART initiation 7.2 years and transition 17.9 years. At adolescent entry, 35.0% hadCD4+ cell count less than 500 cells/ml and 51.1% had experience da WHO stage III/IV clinical event. At transition, 38.9% had CD4+ cell count less than 500copies/ml, and 53.4% had experienced a WHO stage III/IV clinical event. Mortality ratewas 0.71 per 100 person-years, with HIV RNA >1000copies/ml, CD4+ cell count less than 500cells/ml, height-for-ageorweight-for-agez-score less than - 2, historyofa WHO stage III/IV clinical event or hospitalization and at least second cART associated with mortality. For transitioning PHIVA, those who commenced cART age less than 5 years had better virologic and immunologic outcomes, though were more likely to be on at least second cART. Conclusion: Delayed HIV diagnosis and cART initiation resulted in considerable morbidity and poor immune status by adolescent entry. Durable first-line cART regimens to optimize disease control are key to minimizing mortality. Early cART initiation provides the best virologic and immunologic outcomes at transition

Global temporal changes in the proportion of children with advanced disease at the start of combination antiretroviral therapy in an era of changing criteria for treatment initiation

Introduction: The CD4 cell count and percent at initiation of combination antiretroviral therapy (cART) are measures of advanced HIV disease and thus are important indicators of programme performance for children living with HIV. In particular, World Health Organization (WHO) 2017 guidelines on advanced HIV disease noted that &gt;80% of children aged &lt;5&nbsp;years started cART with WHO Stage 3 or 4 disease or severe immune suppression. We compared temporal trends in CD4 measures at cART start in children from low-, middle- and high-income countries, and examined the effect of WHO treatment initiation guidelines on reducing the proportion of children initiating cART with advanced disease. Methods: We included children aged &lt;16&nbsp;years from the International Epidemiology Databases to Evaluate acquired immunodeficiency syndrome (AIDS) (IeDEA) Collaboration (Caribbean, Central and South America, Asia-Pacific, and West, Central, East and Southern Africa), the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE), the North American Pediatric HIV/AIDS Cohort Study (PHACS) and International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) 219C study. Severe immunodeficiency was defined using WHO guidelines. We used generalized weighted additive mixed effect models to analyse temporal trends in CD4 measurements and piecewise regression to examine the impact of 2006 and 2010 WHO cART initiation guidelines. Results: We included 52,153 children from fourteen low-, eight lower middle-, five upper middle- and five high-income countries. From 2004 to 2013, the estimated percentage of children starting cART with severe immunodeficiency declined from 70% to 42% (low-income), 67% to 64% (lower middle-income) and 61% to 43% (upper middle-income countries). In high-income countries, severe immunodeficiency at cART initiation declined from 45% (1996) to 14% (2012). There were annual decreases in the percentage of children with severe immunodeficiency at cART initiation after the WHO guidelines revisions in 2006 (low-, lower middle- and upper middle-income countries) and 2010 (all countries). Conclusions: By 2013, less than half of children initiating cART had severe immunodeficiency worldwide. WHO treatment initiation guidelines have contributed to reducing the proportion of children and adolescents starting cART with advanced disease. However, considerable global inequity remains, in 2013, &gt;40% of children in low- and middle-income countries started cART with severe immunodeficiency compared to &lt;20% in high-income countries