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

Progress and potential roles blood biomarkers of ischemic stroke in clinical setting

Stroke is one of the leading causes of death and disability which involving a complex pathophysiology with multiple mechanisms. Rapid treatment is necessary to terminate the disease progression, hence minimizing CNS damage and subsequent disability. Stroke diagnostic process composed of history taking, neurological examination and supplemented with neuroimaging. Imaging modalities such as CT-scan or MRI are essential in establishing a definitive diagnosis of ischemic stroke. However, the high cost and limited number made them inaccessible for those who have low or middle income which will delay the diagnosis and treatment. On the other hand, blood biomarker has potential in either diagnostic or prognostic aspect of ischaemic stroke management. It has a promising potential to aid diagnosis, determine the subtype of stroke, predicting the outcome or early neurological deterioration, and recurrence. It also could potentially help to assess the risk of hemorrhagic transformation, treatment selection, as well as to detect salvageable ischemic penumbra. Although it could not replace neuroimaging, blood-based biomarker assessment had lower cost and faster result. However, despite its promising potential, none of the blood biomarkers is currently used in clinical practice. Therefore, further studies are needed to develop biomarkers or panels of biomarkers with better sensitivity and specificity. This review provides a highlight and summary of blood biomarkers based on their potential application in a clinical setting.</p

Risk factors of soil-transmitted helminth infection among elementary school students

Background Helminth infection remains a health problem, especially in school-aged children. Mass eradication programs with a single dose of anti-helminthic drugs were employed by the local government in some endemic areas in Bali. However, the effectiveness of the programs has not been well evaluated. Objective To investigate prevalence and possible risk factors of helminth infection, including nutritional status, in elementary school students from endemic areas who participated in mass eradication programs. Methods This cross-sectional study involved 126 students from Elementary School No. 3 Gegelang, Karangasem, Bali, a location that had recently undergone a mass eradication program. Diagnoses were based on direct smear examination of fecal specimens. Information on suspected risk factors and nutritional status were collected by questionnaire and anthropometric measurement, respectively. Statistical analyses included Chi-square and odds ratio, using SPSS v21 software. Results The prevalence of helminth infection was 31.7% with etiologies of Trichuris trichuria (75%), Ascaris lumbricoides (17.5%), or both infections (7.5%). Habits of not using footwear [OR=4.88; 95%CI 1.15 to 20.65], not keeping nails trimmed [OR=3.33; 95%CI 1.07 to 10.37], and absence of a proper toilet [OR=4.31; 95%CI 1.93 to 9.64] were found to be significant risk factors for helminth infection. However, we found no significant association between helminth infection and nutritional status, although a considerable number of students had less than normal reference values, in terms of weight, height, and BMI for age. Conclusion The prevalence of helminth infection continues to be high, with personal hygiene and sanitation as significant risk factors. History of mass eradication programs did not confer an effective protection against helminth infection