DEPRESSION AMONG HIGH SCHOOL STUDENTS: UNDETECTED, UNDERDIAGNOSED

Background. Depression is a condition that can not be taken lightly, in any age.  It is one of the most significant risk factor for suicide, especially in adolescents.  More over, depression can also interfere one’s social and educational life.  Hence, recognizing it and treating it becomes pivotal, let alone in teenagers like high school students who are also at risk for suffering from depression.  This study wished to identify the incidence of depression among high school students in Palembang, Indonesia.Method. This is an observational descriptive study towards 47 high school students in Palembang, Indonesia.  Students who were eligible for the study were asked for informed concent before they participated in the study.  They were then asked to fill in the Self Rating Questionnaire (SRQ) in order to screen depression among them.Result.  Almost half of the high school students are having depression (42.55%).  Most of them are females (51.35%) and are from the tenth grade, meaning they are the new students (57.14%).Conclusion. Depression is quite prevalent among adolescents, hence it needs special attention on how to prevent depression in teenagers

The Condition of Mycobacterium Tuberculosis Lineages and Resistances in Indonesia

Background: Tuberculosis is a disease caused by Mycobacterium tuberculosis. Indonesia ranks second worldwide in TB incidence in the country. Content: The spread of the disease is happening across Indonesia. Each area of Indonesia had different types of lineage M. tuberculosis and TB incidence number. Drug resistance is threatening to society and it needs full attention and immediate medication to control the disease. Therefore, this paper is composed of reviews from 10 journals that reported drug resistance TB in several different locations in Indonesia using different methods available. Conclusion: The number of TB cases and their lineages differ in each area in Indonesia, one of which is due to the availability of diagnostic tools and level of self-awareness in each area. There are reported findings of drug resistance TB in Indonesia that are concerning. Currently, many TB treatments are under development to produce the best therapy to treat the disease

The First Look in Autism Spectrum Disorder (ASD) Geographical Distribution in National Reference Hospital, South Sumatera Region, Indonesia

Background. Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized with disorders in cognitive, behaviour, and social interaction. It is estimated to affect 1:160 children worlwide. Despite its increasing trend, the exact cause of it is yet to be known. Objective. This study wished to identify the geographical distribution of ASD cases in Dr. Mohammad Hoesin Hospital as one of the national reference hospitals in Indonesia for South Sumatera region. Methods. Medical records of the patients who are diagnosed with ASD during 2014-2018 was observed in order to identify the patients’ residential area. Results. There were 107 patients who were clinically diagnosed of having ASD during 2014-2018 in Dr Mohammad Hoesin Hospital, Palembang.  Based on its residential area, ASD cases were mostly found in Palembang as the capital city of South Sumatera Province. Conclusion. ASD is found in small and big cities across the South Sumatera province, implying its common occurrence.  The varied prevalence could be signifying the role of different related risk factors identified in the area

Inhibition of Receptor for Advanced Glycation End Products as New Promising Strategy Treatment in Diabetic Retinopathy

BACKGROUND: Extensive intracellular and extracellular formation of advanced glycation end-products (AGEs) is considered a causative factor for vascular injury triggered by hyperglycemia in diabetes. The hyperglycemia will cause accumulation of AGEs, damage to pericytes, nerve growth factor (NGF), glial acid fibrillary protein (GFAP) and increase in vascular endothelial growth factor (VEGF). AIM: This study aimed to assess the efficacy of RAGE inhibition in suppressing the development and progression of diabetic retinopathy through modulation of the inflammatory pathway involving NGF, GFAP, and VEGF. METHODS: The design was in vivo experimental study. Thirty white rats were induced with Alloxan monohydrate. Rats were divided into 5 groups, normal, negative control, groups with an anti-RAGE dose of 1 μg/uL, the dose of 10 μg/uL and 100 μg/uL. After 4 weeks of treatment, HbA1c, NGF, and GFAP levels were measured using ELISA. Quantification of VEGF expression was done using the ImageJ® application. Data was expressed with mean ± SD. Independent T-test with ANOVA and Tukey's post hoc was done. RESULTS: RAGE inhibitors yielded a significant decrease in blood glucose and HbA1c levels. VEGF and RAGE expression were reduced in anti-RAGE groups in various doses. Inhibition of RAGE reduced the damage of retinal pericytes, by reducing GFAP and increasing NGF, and reduced the formation of new blood vessels, by decreasing VEGF expression, in diabetic retinopathy. CONCLUSION: Inhibition of receptor for advanced glycation end-products (RAGE) was effective in suppressing the development and progression of diabetic retinopathy

Birth Anthropometry Characteristics of Hypospadias Patients in Palembang, Indonesia

ABSTRACT. Background. Hypospadias is one of the most common urogenital anomaly in males. The etiology is poorly understood, but is believed to be multifactorial where Intra Uterine Growth Restriction (IUGR) is one of the suspected risk factors, leading to low birth weight and low birth length in affected patients. Objective. This study aims to identify the birth anthropometry characteristics of hypospadias patients who visited RSUP. Dr. Mohammad Hoesin Palembang. Materials and Methods. This was an observational descriptive study with cross sectional design. This study included hypospadias patients with detailed birth characteristics in RSUP Dr. Mohammad Hoesin Palembang during the period of 2012-2015. Results. Out of 106 hypospadias patients, only 19 (17.92%) of them presented with detailed birth characteristics. There were 12 (63,2%) patients with low birth weight and 7 (36,8%) patients with normal birth weight. There were 10 (52,6%) patients with low birth length and 9 (47,4%) patients with normal birth length. The mean birth weight is 2442 grams and the mean birth length is 46,9 centimeters. Conclusion. The majority of hypospadias patients in this study showed a low birth weight and low birth length, signalling an accordance to the existing theory.   Keywords: Hypospadias, birth anthropometry, characteristic

A Hospital-Based Study: Interventions for Patients with Disorders of Sex Development (DSD) in National Reference Hospital, South Sumatera Region, Indonesia

ABSTRACT Background. Disorders of Sex Development (DSD) is a term used to describe a congenital condition where sex chromosomes, gonads, and or anatomy of a person are atypical.  It is estimated to affect 1:4,500 people worlwide with varied clinical findings, hence the integrated and diverse interventions. Objective. This study wished to observe the many interventions DSD patients received in Dr. Mohammad Hoesin Hospital as one of the national reference hospitals in Indonesia for South Sumatera region. Methods. Medical records of 173 patients with clinical findings in accordance with DSD spectrum during 2013-2017 was observed in order to identify both surgical and medical interventions applied. Results. Sixty two patients were diagnosed of having hypospadias (35.84%), making it the most common clinical finding among DSD patients in this hospital.  Surgical intervention was the most favored intervention, with 155 patients (89.6%) underwent various surgeries, ranging from urethroplasty to vaginoplasty and many more.  Five patients(2.9%) were treated with either hydrocortisone and florinef, or both.  One patient diagnosed with Congenital Adrenal Hyperplasia (CAH) had both surgical and medical intervention. Conclusion. DSD gives a wide phenotypic spectrum, making its management both challenging and complicated.  Surgical, medical, and or a combination of both are the indispensable interventions when dealing with DSD patients.  Study focusing on psychological intervention for DSD patients is further needed.   Keyword: Disorders of Sex Development, DSD, surgical, medical, intervention

HOW CLOSELY IS PROTEIN CARBONYL (PCO) LEVEL CORRELATED WITH SEPSIS-RELATED ORGAN FUNCTION ASSESSMENT (SOFA) SCORE?

Objective: Sepsis remains an unsolved problem in hospitals since its mortality rate is not significantly reduced despite considerable therapy efforts. The most used prognostic tool is the Sepsis-related Organ Function (SOFA) score, which requires several clinical and laboratory examinations; our recent studies also showed that the protein carbonyl level (PCO) has prognostic value in predicting sepsis mortality. Methods: This prospective study was designed to assess the correlation between PCO values and the SOFA score following ethical approval. Adult patients aged>18 y who met the Sepsis-3 definition were included. Exclusion criteria were patients not admitted to the intensive care unit. Dropout criteria included mortality within the 1h bundle protocol. Baseline demographic data and blood collection were measured for all subjects. Subjects were treated with the 1h bundle protocol and observed for 28 d. Results: Fifty-nine subjects were included, with no significant differences in age, sex, diagnosis, microbiology or Charlson’s Comorbidity score between survivors and non-survivors. The SOFA score was higher in non-survivors (10.90±3.38 vs 8.11±3.07; p=0.003), as was the PCO value (24.5 [14.67-81] vs 18 [15-21.33]; p<0.001). However, the correlation between PCO and SOFA score is very weak (r=0.101; p=0.45). Conclusion: Both the PCO level and SOFA scores were higher in non-survivor septic patients. However, they have a very weak correlation and cannot be used interchangeably

Antidepressant Effect of Cinnamon (Cinnamomum burmannii) Bark Extract in Chronic Stress-Induced Rats

BACKGROUND: Depression is a psychiatric disorder that has become a serious health problem in the past decade. This disorder is characterized by prolonged dysphoric mood, and in more severe condition would result in decreased self-care and even life-threatening action. Serotonin is believed to play a role in the regulation of mood elation in depressive disorders. Decreased levels of serotonin in the hippocampus will cause an increased dopamine in mesolimbic dopamine neuronal cells. An effective and commonly used drug is the selective serotonin reuptake inhibitor, namely, fluoxetine. However, this agent has so many side effects, one of them is erectile dysfunction. In order to find the better treatment, exploration and discovery of therapeutic modalities need to pursued using natural materials. AIM: This study aimed to explore and evaluate antidepressant effects of cinnamon (Cinnamomum burmannii) extract (CE). METHODS: A total of 30 male Wistar rats were obtained from Eureka Research Laboratory (Palembang, Indonesia). Cinnamon simplisia was obtained from the Institute for Research and Testing of Traditional Medicine, Tawangmangu, Central Java, Indonesia. Rats were induced using chronic mild stress (CMS). CMS was a form of stress induction performed on experimental animals continuously, for 4 weeks. Forced swimming test (FST) was a test conducted to assess mobility in animal model. After induction for 4 weeks, rats were randomly divided into six groups which each contained five rats: Normal control group, CMS group (negative control), CMS + fluoxetin (Fluox 1: mg/kg), CMS + CE 25 mg/kg, the CMS + CE 50 mg/kg, and the CMS + CE 100 mg/kg. Treatment with fluoxetine or CE was given for 14 days intragastrically using gastric sonde. After treatment and FST, organ evacuation was performed and followed by immunohistochemistry and enzyme-linked immunosorbent examination. RESULTS: This study showed that CE with dose of 25 mg/kg BW to dose 100 mg/k BW could reduce the duration of immobility when compared to the CMS group. Clinically, CE possessed the potential to reduce the duration of immobility and potentially reduce symptoms of depression. Histologically, CE showed the potential to improve serotonin levels in the hippocampus with increasing doses. Tumor necrosis factor (TNF)-alpha expression in the hippocampus as a marker of inflammation had increased in the CMS group. CE was able to reduce the expression of TNF-alpha compared to the CMS group. CONCLUSION: CE possessed antidepressant efficacy by inhibiting the inflammatory process in the hippocampus so it was able to optimally increase serotonin levels in the hippocampus

PHYSICAL COMORBIDITIES IN CHILDREN WITH AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorders (ASD) is a neurodevelopmental disorder characterized by two core symptoms; impairments in social communication and restricted or repetitive behavior. ASD is a broad group of conditions where patients have a variety of abilities and needs. Their ASD related-physical and psychological comorbidities also affect their mortality risk. This study wished to investigate physical comorbidities associated with ASD in the national reference hospital in Indonesia. This is a descriptive study with a cross-sectional approach on children with ASD who visited RSUP Dr. Mohammad Hoesin, Palembang, during 2014-2018. Data were obtained from the medical records and telephone interviews with the parents. Of all the 60 participants included in the study, most are male (n=52;86,7%). The most prevalent ASD-related physical comorbidities were gastrointestinal disorders (n=27;45%), followed by nervous system disorders (n=35;58,3%), and immune system disorders (n=11;18,3%). Despite the small sample size, the prevalence of ASD-related physical comorbidities in children with ASD is profoundly high, implying the need to do early detection from both parents and health professionals to prevent morbidity and complications that may occur. Children with autism can benefit from various therapies start in early childhood and continue throughout their lives to improve their development, and quality of life

Antidepresant effects of Cinnamon (Cinnamomum burmannii) extract in depressed induced rats using 3-minutes Tail Suspension method

Abstract Background. The increasing prevalence of depression gives rise to challenges in not only elucidating its diverse causes, but also in finding an effective treatment. One of the factors linked to depression is the imbalance of serotonin, norepinephrine, and dopamine neurotransmitters.  Cinnamon (Cinnamomum burmannii) as one of the world’s wellknown cooking ingredients is believed to be able to regulate the neurotransmitters imbalance with the help of terpenoids and flavonoid polyphenols as one of its content. Objective. This study aims to determine the effectiveness of cinnamon extract as an antidepressant in depressed induced animal model. Methods. An experimental in vivo with pre-post control group design was conducted in twenty five Wistar strain white rats that were divided into 5 treatment groups that received fluoxetine as positive control, aquades, and different dose of cinnamon extracts (50 mg/kgBW, 100 mg/kgBW, and 200 mg/kgBW).  Depression induction method used was 3-minute Tail Suspension Test, done for 14 days. The antidepressant effectiveness test was carried out by calculating the immobility time duration with Forced Swimming Test method and was further analyzed using one-way ANOVA test. Results. One-way ANOVA test results showed that there were differences in the mean duration of immobility time between treatment groups after being given cinnamon extract (p value = 0,000). Groups that were given 100 mg/kgBW cinnamon extract and 200 mg /kgBW showed a p value>0.05 when compared with positive control group receiving Fluoxetine although displayed a similar reduced immobility time. Conclusion. Cinnamon (Cinnamomum burmannii) extract showed a promising potential as an effective antidepressant tested in animal model.     Keywords: cinnamon, extract, depression, immobility time, ra