Changes in thyroid function in prostate cancer patients receiving docetaxel chemotherapy at Haji Adam Malik Hospital, Indonesia.

Background: Prostate cancer treatment is determined based on several factors, namely tumor grading, staging, co-morbidity, patient preferences, life expectancy at diagnosis. Today, taxanes are commonly prescribed to treat several types of cancer and have been shown to have antitumor effects in many cancers. This research has never been done in prostate cancer patients but similar studies have been done before in breast cancer patients. Materials and methods: The research design was observational analytic where this type of research was a prospective cohort where data was collected to record prostate cancer patients who received docetaxel chemotherapy which were then examined for thyroid function in cancer patients at the Adam Malik Hospital, Medan, Indonesia. Result: In this study, data were collected regarding the thyroid function of the study sample in the form of free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels before chemotherapy with the docetaxel regimen. The mean of fT4 in all research subjects was 1.05 with a standard deviation of 0.26. The mean TSH in all study subjects was 1.52 with a standard deviation of 1.21. Thyroid function was examined after 3 cycles of docetaxel chemotherapy. The mean of fT4 in all research subjects was 0.91 with a standard deviation of 0.23. The mean TSH in all study subjects was 1.69 with a standard deviation of 1.09. Conclusion: There are traces of the use of docetaxel chemotherapy in prostate cancer patients on decreased thyroid function at the Adam Malik Hospital in the form of decreased fT4 levels and increased TSH.

Plasma Concentrations of Adiponectin in Patients with Coronary Artery Disease and Coronary Slow Flow.

BACKGROUND: Adiponectin, an adipocyte-secreted hormone involved in energy homeostasis, has broad anti-inflammatory, antioxidant, and endothelium- and myocardial-protective effects, together with a potentially positive regulatory function in coronary microcirculation. Although the physiological role of adiponectin has not yet been fully elucidated, it may well be involved in the regulation of many of the inflammatory processes or lipid metabolisms that contribute to atherosclerosis. In this study we investigate the plasma concentration of adiponectin in patients with coronary artery disease (CAD), those with coronary slow flow (CSF) and in healthy subjects. METHODS: this study was conducted according to a cross-sectional design involving 30 CAD, 30 CSF, and 30 healthy subjects. These subjects were sourced from the Dr. Zainoel Abidin Center Hospital, Banda Aceh, Indonesia, between December 2017 and February 2018. The plasma concentration of adiponectin was measured using enzyme-linked immunosorbent assay (ELISA) according to the manufacturer's specifications. RESULTS: there were statistically significant differences at p<0.001 between the CAD, CSF, and healthy-subject groups in terms of age, sex, systolic blood pressure, total cholesterol, triglycerides, and creatinine. Mean plasma concentrations of adiponectin in patients with CAD were significantly lower than in patients with CSF and in healthy subjects (CAD: 3.40 (0.87) µg/ml; CSF: 4.58 (2.32) µg/ml; healthy subjects: 5.65 (4.87) µg/ml; P<0.001). CONCLUSION: the findings suggest that low plasma adiponectin concentration is associated with atherosclerosis. Plasma concentrations of adiponectin may be related to the pathophysiology role of cardiovascular disease in both CAD and CSF patients.

Chemical Composition and Neuroprotective Properties of Indonesian Stingless Bee (Geniotrigona thoracica) Propolis Extract in an In-Vivo Model of Intracerebral Hemorrhage (ICH).

Stroke is the world's second-leading cause of death. Current treatments for cerebral edema following intracerebral hemorrhage (ICH) mainly involve hyperosmolar fluids, but this approach is often inadequate. Propolis, known for its various beneficial properties, especially antioxidant and anti-inflammatory properties, could potentially act as an adjunctive therapy and help alleviate stroke-associated injuries. The chemical composition of Geniotrigona thoracica propolis extract was analyzed by GC-MS after derivatization for its total phenolic and total flavonoid content. The total phenolic content and total flavonoid content of the propolis extract were 1037.31 ± 24.10 µg GAE/mL and 374.02 ± 3.36 µg QE/mL, respectively. By GC-MS analysis, its major constituents were found to be triterpenoids (22.4% of TIC). Minor compounds, such as phenolic lipids (6.7% of TIC, GC-MS) and diterpenic acids (2.3% of TIC, GC-MS), were also found. Ninety-six Sprague Dawley rats were divided into six groups; namely, the control group, the ICH group, and four ICH groups that received the following therapies: mannitol, propolis extract (daily oral propolis administration after the ICH induction), propolis-M (propolis and mannitol), and propolis-B+A (daily oral propolis administration 7 days prior to and 72 h after the ICH induction). Neurocognitive functions of the rats were analyzed using the rotarod challenge and Morris water maze. In addition, the expression of NF-κB, SUR1-TRPM4, MMP-9, and Aquaporin-4 was analyzed using immunohistochemical methods. A TUNEL assay was used to assess the percentage of apoptotic cells. Mannitol significantly improved cognitive-motor functions in the ICH group, evidenced by improved rotarod and Morris water maze completion times, and lowered SUR-1 and Aquaporin-4 levels. It also significantly decreased cerebral edema by day 3. Similarly, propolis treatments (propolis-A and propolis-B+A) showed comparable improvements in these tests and reduced edema. Moreover, combining propolis with mannitol (propolis-M) further enhanced these effects, particularly in reducing edema and the Virchow-Robin space. These findings highlight the potential of propolis from the Indonesian stingless bee, Geniotrigona thoracica, from the Central Tapanuli region as a neuroprotective, adjunctive therapy.

Salat dhuha effect on oxidative stress in elderly women: A randomized controlled trial.

Background: The aging process and a chronic sedentary lifestyle in the elderly as a result of physical restrictions during the COVID-19 pandemic, induces oxidative stress through oxygen supply and antioxidant activity imbalance which in turn induce degenerative diseases. Salat dhuha as a prayer and mind-body medicine which is practiced by the Muslim community can hopefully be a solution to decrease oxidative stress in the elderly. Objective: To evaluate the acute physiological effects of salat dhuha on Glutathione Peroxidase activity (GPx) as an antioxidant and Malondialdehyde (MDA) as an oxidant in healthy elderly Muslim women population who have done salat dhuha regularly. Method: A randomized controlled study was done on elderly women (aged 60-74 years old) who are treated in the North Sumatra Government's Nursing Home in Binjai and who routinely do 2 rakaat of salat dhuha every day. Several physical, clinical, and blood examinations were done pre and post-intervention. 101 elderly Muslim women in the nursing home were selected, 26 met the study criteria and were included in the study. The volunteers were randomized into 2 groups using lottery papers, the "2-rakaat salat dhuha group" (n = 13) and the "8-rakaat salat dhuha group" (n = 13). All volunteers did salat dhuha for at least 5 days per week for 6 weeks. Result: 24 elderly women completed the study, and one volunteer from each group dropped out. The characteristics of participants from both groups were homogenous. Results of the t-independent analysis showed that MDA concentrations in both groups in the pre and post-test were not significantly different (p > 0,05). Mann Whitney analysis showed that GPx on both groups in the pre and post-test were not significantly different (p > 0,05). Paired sample t-test analysis on the MDA concentrations pre and post-test in the 8-rakaat group showed a significant difference in MDA levels (p < 0,05). The 8-rakaat salat dhuha group showed that GPx activity increases as much as 8,9% and MDA levels decrease as much as 48,35 % after 6 weeks. Conclusion: Salat dhuha promotes redox homeostasis and has the potential to prevent oxidative stress in elderly women.

The Effect of the Intra-Arterial Heparin Flushing (IAHF) Procedure on Hearing Threshold in Sensorineural Hearing Loss Patients.

Background: Sensorineural hearing loss (SNHL) is a frequent problem in Indonesia but its treatment is still limited. This type of hearing loss is related to oxidative stress and decreased vascularization, which can damage the hair cell. The intra-arterial heparin flushing (IAHF) is a procedure that can recover circulation and its agent, namely heparin, also has antioxidant activity. Therefore, the IAHF procedure has the potential to improve hearing function and can be considered an alternative therapy for SNHL. Objective: The study evaluates the effect of the IAHF on hearing improvement based on the difference in hearing threshold values before and after the procedure. Methods: This experimental study used a Pretest-Posttest One-Group Only design. A total of 17 patients with sensorineural hearing loss who met inclusion and exclusion criteria were subjected to pure tone audiometry tests before and 4 hours after the IAHF procedure. The mean difference in hearing threshold was analyzed using paired Students t-test for normally distributed data and Wilcoxon for non-normally distributed data. Results: There was a decrease in the means of hearing threshold in the right and left ear 4 hours after the IAHF procedure. However, based on the paired Students t-test, there was not a significant difference in hearing threshold before and after the procedure (p-value > 0.05). Conclusion: There was hearing threshold improvement 4 hours after the IAHF procedure. This study showed that the IAHF procedure can have a therapeutic effect on sensorineural hearing loss patients.

Doxycycline as a Potential MMP-1 Inhibitor for the Treatment of Spondylitis Tuberculosis: A Study in Rabbit Model.

Background: Tuberculosis (TB) of the spine is a highly disruptive disease, especially in underdeveloped and developing countries. This condition requires standard TB treatment for 9-18 months, which increases patient risk of drug-resistant TB. Consequently, this raises the concern of adopting additional therapies to shorten the treatment duration, improve the efficacy of anti-TB drugs, and further decrease damage in the affected tissues and organs. Matrix metalloproteinase- (MMP-) 1 is a key regulator of the destruction of the extracellular matrix and associated proteins and is a new potential target for TB treatment research. In the present study, we investigated the effects of doxycycline as an MMP-1 inhibitor in patients with spondylitis TB. Methods: Seventy-two New Zealand white rabbits with spondylitis TB were divided into 12 different groups based on incubation period (2, 4, 6, and 8 weeks) and doxycycline administration (without, 1 mg/kg body weight (BW), and 5 mg/kg BW). We observed the course of infection through the blood concentration changes and immunohistochemical examination of MMP-1, in addition to BTA staining, culture, polymerase chain reaction (PCR), and histopathological examination. Results: Treatment with once daily 5 mg/kg BW doxycycline significantly improved the blood MMP-1 level (p < 0.05) compared with the placebo and 1 mg/kg BW doxycycline. A significantly reduced ongoing infection and a higher healing rate were demonstrated in rabbits with a higher doxycycline dose through BTA staining, culture, PCR, and histopathology. Various degrees of vertebral endplates, vertebral body, and intervertebral disc destruction were observed in 32 rabbits with positive histopathological findings, in addition to positive inflammatory cell infiltration, characterized by numerous lymphocytes, macrophages, and epithelial cells, as well as abundant granulation tissue and necrotic substances proximal to the inoculated vertebral area. Bone and intervertebral disc destructions were more apparent in the untreated rabbits. Conclusion: Our study demonstrated the potential of doxycycline as an adjunctive treatment in spondylitis TB. However, limitations remain regarding the differences in the pathogenesis and virulence of Mycobacterium tuberculosis between rabbit and human systems, sample size, and the dose-dependent effect of doxycycline. Further studies are needed to address these issues.

The effect of honey on post-tonsillectomy pain relief: a randomized clinical trial.

OBJECTIVE: The study aimed to evaluate the effects of honey on the incidence of post-operative pain in patients undergoing tonsillectomy. METHODS: This study is a double-blind and randomized controlled trial design. Twenty-four adult male patients underwent tonsillectomy surgery and were randomized assigned into three groups consist of honey group, placebo group, and control group. All subjects were given standard analgesia and antibiotics, also honey for the honey group and placebo for the placebo group, and only standard post-operative regimens for the control group. This study used silk-cotton tree or kapok tree honey (Ceiba pentandra). Honey was used by gargling every six hours for ten days. Likewise, the same method was applied in the placebo group. Pain scale was assessed for ten days using the Visual Analogue Scale questionnaire, and the frequency of analgesic drugs was recorded on days 1, 2, 4, 7, and 10. RESULT: Honey group showed significantly higher pain reduction when compared to placebo and control groups, with a significant reduction in the pain scale on day 1, 2, 4, 7 and 10 (p = 0.034; p = 0.003; p < 0.001; p = 0.001; p = 0.001) gradually; Significant differences were also observed in analgesic use, especially on day 2, 4 and 7 (p = 0.028; p = 0.001; p = 0.003). CONCLUSIONS: Administration of Kapok tree honey (C. pentandra) after tonsillectomy might reduce post-operative pain and reduce the need for analgesia. Therefore, honey can be considered a complementary medicine and can be administered routinely as adjunctive therapy for post-operative patients.

Comparison of Gambier Extract (Uncaria Gambier Robx) and Angiotensin Receptor Blocker on Proteinuria Reduction and Antioxidants - Enhancement in Nephrotic Rat Models.

Background: Proteinuria is a significant clinical manifestation that causes edema in several diseases, including Nephrotic Syndrome (NS). Untreated proteinuria is strongly linked to the progression of kidney failure. One of the adjuvant therapies could be used to reduce proteinuria such as Angiotensin Receptor Blocker (ARB) including Losartan®. Gambier is a traditional medicinal plant widely known for its antioxidant effects. Catechin, a compound contained in Gambier Extract (GE), has been used to reduce microalbuminuria in diabetics. However, its application in NS has not been widely studied. Objective: This study compared the effects of GE and ARB in reducing proteinuria and increasing antioxidant activity levels, as well as reported histopathological findings in the nephrotic Wistar rat model. Methods: An experimental design study with a control group and a posttest was conducted. The experimental animals were divided into four groups: the control group (K1), the group with puromycin aminonucleoside (PAN) injection (K2), the group with PAN injection + GE (K3), and the group with PAN injection + Losartan® (K4). The standard GE used was Sarie Uncariae® by Toyo Brothers, PT while the ARB (Losartan®) was obtained from Novell, PT. Protein urine, the activity level of total superoxide dismutase (T-SOD), and malondialdehyde (MDA) were assessed using the colorimetric method. Renal histopathology was assessed based on Rollerman's criteria. Results: Gambier extract significantly reduced proteinuria, as depicted by a decrease in protein/volume urine (p = 0.009), increased antioxidant activity, as illustrated by an elevation in T-SOD activity levels (p = 0.007), and tended to decrease MDA levels compared to Losartan®. Based on histopathological findings, GE tended to reduce the percentage of kidney damage in rats induced by puromycin. Conclusion: Gambier extract has been shown a higher antioxidant effect by increasing T-SOD activity levels, reducing proteinuria and also exhibiting a tendency to diminish kidney damage.

The Effect of Thiamine, Ascorbic Acid, and the Combination of Them on the Levels of Matrix Metalloproteinase-9 (MMP-9) and Tissue Inhibitor of Matrix Metalloproteinase-1 (TIMP-1) in Sepsis Patients.

Background: Sepsis is a global health problem. Therapeutic agents continue to develop for the management of sepsis. Ascorbic acid and thiamine are currently potential agents intensively studied for their benefits in sepsis. Methods: This study was a randomized controlled trial (RCT) with a pretest-posttest control group design. Randomization was using a computer. The research was conducted at Haji Adam Malik General Hospital Medan and Grand Medistra Hospital. Blood tests were at the Integrated Laboratory of the Faculty of Medicine, University of North Sumatra. The research was for 14 months. The number of patients in this study was 86 septic patients divided into four groups (NaCl, thiamine, ascorbic acid, and combination). The parameters measured were the enzyme MMP-9 and the enzyme TIMP-1. Results: The number of subjects who met the inclusion criteria was 147 patients. Fifty-three patients passed away during the monitoring period, and eight blood samples were damaged. The final data analyzed consisted of 86 subjects. Of the 86 septic patients obtained Based on initial MMP-9 values, MMP-9 levels increased in the 0.9% NaCl group (25.6%), while MMP-9 levels decreased after intervention in the thiamine, ascorbic acid, and combination groups but a significant decrease in MMP-9 was found in the ascorbic acid group (17.2%; p = 0.04) and the combination group (17.9%; p = 0.026). For TIMP-1 levels, a decreasing trend was only in the ascorbic acid (5.1%) and combination (5.9%) but not significant (p > 0.05). The highest MMP-9/TIMP-1 ratio was in septic patients receiving thiamine with a significant linear correlation (p < 0.05) between levels of MMP-9 and the MMP-9/TIMP-1 ratio with a moderate correlation level and significant negative correlation (p < 0.05) between TIMP-1 and the MMP-9/TIMP-1 with a moderate level of correlation. Conclusion: Administration of thiamine alone gives better advantages than ascorbic acid alone and their combination.

An ethanol extract of Senduduk fruit (Melastoma malabathricum L) inhibits the expression of vascular endothelial growth factor and tumour necrosis factor alpha in HeLa cells.

Aim Senduduk fruit (Melastoma malabathricum L) is native to Indomalaya and is believed to possess anticancer activity. This study investigated antiangiogenic and anti-inflammation effects of an ethanolic extract of Senduduk fruit (EESF) on HeLa cells. Methods Cytotoxicity was assayed in HeLa cell cultures exposed to a concentration series of 500-7.8 µg/mL of EESF. IC50 was determined with a methylthiazol-tetrazolium (MTT) cell viability assay. Antiangiogenic and anti-inflammation activity was evaluated by an immunocytochemical assay of vascular endothelial growth factor (VEGF) and tumour necrosis factor alpha (TNF-α) expression in HeLa cells cultured with 1× or 2× IC50 or as a control without EESF. Results IC50 of the EESF was 956 µg/mL. The intensity of VEGF staining indicated moderate expression in HeLa cells in response to IC50, weak expression in response to 2×IC50, and strong expression in the absence of the EESF. While the intensity of TNF-α staining indicated moderate expression in HeLa cells in response to IC50 and to the absence of EESF, and weak expression in response to 2× IC50. Conclusion Senduduk fruit extract inhibited VEGF and TNF-α expression in HeLa cells in a concentration-dependent manner.

Analysis of two single-nucleotide polymorphisms (rs2241766 and rs1501299) of the adiponectin gene in patients with coronary artery disease and coronary slow flow.

Aim To investigate the association of two single-nucleotide polymorphisms (SNPs) of the adiponectin gene (+45 T>G [rs2241766] and +276 G>T [rs1501299]) in patients with coronary artery disease (CAD), coronary slow flow (CSF) and in healthy subjects. Methods The study investigated 90 patients: 30 patients with coronary artery disease (the CAD group), 30 with only coronary slow flow (the CSF group) and 30 healthy patients. Genotyping was carried out for two of these SNPs in the adiponectin gene using the TaqMan polymerase chain reaction (PCR) method. Results There were no significant differences in the frequencies of polymorphism +45T>G (rs2241766) genotype (p=0.464) and the allele (p=0.362). There were also no significant differences between the +276 G>T (rs1501299) genotype and the allele (p=0.624 and p=0.281, respectively). Conclusion Our study indicated that in patients with CAD, CSF, and in healthy subjects, the SNP +276G>T and +45T>G alleles of the adiponectin gene were not associated.

The effect of snakehead fish extract supplementation to first-line eradication regimen on macrophage migration inhibitory factor (MIF) expression in rats induced by Helicobacter pylori infection.

OBJECTIVE: This work was organized to assess macrophage migration inhibitory factor (MIF) expression in snakehead fish extract supplementation to first-line eradication regimen in rats induced by Helicobacter pylori infection. MATERIALS AND METHODS: A total of 28 manly rats were haphazardly isolated equally into four groups. Group-1 was the control negative, and groups-2-4 were H. pylori-infected groups. Group-2 was the control positive. Groups-3 and 4 were treated with first-line eradication regimen and first-line eradication regimen supplemented with snakehead fish extract, respectively. Immunoreactive scores (IRS) of MIF expression and eradication testing procedure were carried out. The comparison and difference between groups were analyzed by Kruskal-Wallis and post hoc Mann-Whitney U-test. A value of p < 0.05 was considered to be a limit of significance. RESULTS: The average IRS of MIF expression in group-2 was the highest among other groups (p < 0.05). Group-4 (supplemented by snakehead fish extract) had a lower median value IRS of MIF expression compared to group-3 [1.0 (0.0-2.0) vs. 3.5 (2.0-6.0), p = 0.004]. CONCLUSION: MIF expression was higher in rats induced by H. pylori infection. Snakehead fish extract supplementation to first-line eradication regimen significantly reduces more MIF expression compared to a single administration of first-line eradication regimen in rats induced by H. pylori infection.

The effect of Channa striata extract and standard eradication regimen on asymmetric dimethylarginine in Helicobacter pylori gastritis rat model.

BACKGROUND AND AIM: The presence of gastric mucosa or submucosa inflammation due to Helicobacter pylori leads to histological changes. Gastric injury, pro-inflammatory factors, and oxidative stress in H. pylori infection produce asymmetric dimethylarginine (ADMA), which are a competitive inhibitor of nitric oxide synthase. Investigations were carried out aimed at finding new drugs derived from natural products for the treatment of H. pylori. Channa striata is known to have in vitro anti-inflammatory and antimicrobial properties. This study aimed to investigate the effect of C. striata extract and a standard eradication regimen on ADMA levels and histological changes in the H. pylori gastritis rat model. MATERIALS AND METHODS: Thirty-five male rats were randomly and equally divided into five groups. Group-1 was the negative control group and Groups-2 to 5 were H. pylori-infected groups. Groups-3 to 5 were administered C. striata extract, a standard eradication regimen, and a combination of standard eradication regimen and C. striata extract, respectively. Histological examination and serum ADMA levels were analyzed. The difference between groups was analyzed using the Kruskal-Wallis and one-way analysis of variance tests. The significance was p<0.05. RESULTS: Serum ADMA levels and severity of gastritis were higher in infected groups compared to the negative control group (p<0.05). The severity of gastritis and mean ADMA levels in the group that received a single administration of the C. striata extract was higher than the others (p<0.05). Serum ADMA levels and severity of gastritis were significantly reduced in the group that received a combination of standard eradication regimen and C. striata extract (p<0.05). CONCLUSION: Single administration of C. striata extract worsens the severity of gastritis and increased serum ADMA levels in the H. pylori gastritis rat model. The administration of a combination of standard eradication regimen and C. striata extract reduces serum ADMA levels and significantly improves the severity of H. pylori gastritis rat model.

Poguntano effect on cell viability in cholesteatoma keratinocyte of chronic suppurative otitis media.

Aim Chronic Suppurative Otitis Media (CSOM) with or without cholesteatoma is a global major problem and it is becoming a burden especially in developing countries. Studies have found that ethanol extracts of Puguntano leaves obtained by the percolation and socletation methods have phytochemical contents that provide anti-inflammatory effect. The aim of this study was to investigate the effects of ethanol extract and Puguntano on the viability of cholesteatoma keratinocytes. Methods This in vitro experimental study included 8 groups of the cholesteatoma keratinocyte culture: not given puguntano leaf ethanol extract, three positive control groups given different concentrations of dexamethasone, and four groups that were given different concentrations of ethanol extract of leaf Puguntano. Results A statistically significant decrease in procalcitonin level (p<0.001) and an amount of bacterial colonies (p<0.001) in four groups were found. Conclusion This study showed that Puguntano leaf extract has the same effect as dexamethasone in terms of suppressing cell viability and has lower side effects compared to dexamethasone as other herbal medicines. Thus, the ethanol extract of Puguntano leaves can be used as an alternative for the prevention of cholesteatoma.

A therapeutic effect of Nigella sativa extract on female Wistar rats vulvovaginal candidiasis model.

Aim Vulvovaginal candidiasis (VVC) is a disease mostly caused by Candida albicans and affects the quality of life of women especially in the form of chronic recurrent vulvovaginal candidiasis(RVVC). Nigella sativa is known to have several effects such as antimicrobial, anti-inflammatory, immune stimulation and anticancer properties. The aim of this study was to evaluate the effect of Nigella sativa on vulvovaginal candidiasis. Methods This study is a true experimental design, we used 28 Wistar strain rats divided into 4 groups, all groups were conditioned in a pseudoestrus state. Candida albicans was inoculated into the rats' vagina for 3 consecutive days. All groups were observed every 24 hours, 48 hours and 72 hours to evaluate the number of Candida albicans colonies, IgG and IgM anti Candida. Results After administration of intervention, there was a significant difference in the amount of fungal colonization after the treatment in each group (p<0.001). There was no significant difference in the effectiveness of Nigella sativa and fluconazole in supressing Candida albicans colonies after 72 hours (p=0.101). The administration of Nigella sativa showed a significant difference in the increase in IgM levels compared to the others group (p<0.001), while the IgG level did not show a significant difference (p=0.423). Conclusion Nigella sativa provides a therapeutic effect by decreasing the number of fungal colonies and increasing IgM levels.

Validity and Reliability of an Instrument for Assessing Self-Care Behaviours in Diabetes Mellitus Type 2 Patients in Binjai City, Indonesia.

BACKGROUND: Self-care behaviour becomes very important for diabetic patients; good self-care behaviour will prevent complications and improving the quality of life. AIM: The aim of this study was to provide a preliminary assessment of the validity and reliability of a new measure of self-care behaviour of Diabetes Mellitus Type 2. METHODS: The research was a cross-sectional study. The study population was T2DM patients from Primary Health Centers (PHC) in Binjai City, Indonesia. Sample determination using a single simple formula for the hypothesis of one population with calculation is 115 patients; sampling was done by convenience sampling with inclusion and exclusion criteria. Research questionnaire Self-care behaviour of T2DM patients was forming by knowledge, attitudes, communication, family support, financing, motivation, and self-efficacy. Each of the predictors forms self-care behaviour and finally, the instrument consists of 28 questions. The data analysis techniques were Confirmatory Factor Analysis (CFA) tests with Structural Equation Models (SEM) with AMOS aids. RESULTS: Based on the results of the confirmatory analysis proved that the instrument is valid and reliable, the measure the self-care behaviour of T2DM. CONCLUSION: The new instrument for assessing self-care behaviour of T2DM patients is valid and reliable, besides being able to assess self-care behaviour, they can also know the components that make up self-care.

Curcumin's Effect on COX-2 and IL-10 Serum in Preeclampsia's Patient Undergo Sectio Caesarea with Spinal Anesthesia.

BACKGROUND: Curcumin is a major component in curcuminoid which acts as an anti-inflammatory agent. Curcumin affects several biological markers that are thought to play a role in the pathogenesis of preeclampsia such as IL-10 and COX-2, resulting in an improvement in pregnant women with preeclampsia. AIM: To see the effect of perioperative curcumin administration on IL-10 and COX-2 in preeclamptic patients undergoing caesarean section under spinal anaesthesia. METHODS: This study was a double-blind, randomised clinical trial conducted at Pirngadi Hospital, USU Hospital and Sundari General Hospital Medan as a hospital network of Faculty of Medicine, North Sumatra University. Group 1 received a drug containing curcumin (as a treatment), and another group received a placebo (as a control). RESULTS: There were no significant differences in the median values of COX-2 and IL-10 before and after treatment and also the p-values were greater than 0.05 in both groups (control and treatment). CONCLUSION: There is no significant difference between the use of curcumin on serum COX-2 and IL-10 levels.

The Effectivity of Ethanolic Extract from Papaya Leaves (Carica papaya L.) as an Alternative Larvacide to Aedes spp.

BACKGROUND: Dengue haemorrhagic fever (DHF) is a disease found in most tropical and subtropical regions of the world, including Indonesia. One of the problems of vector control programs is insecticides resistance to Aedes spp. AIM: The objective of this study is to determine the effectiveness of an alternative larvacide using papaya leaves (Carica papaya L). METHODS: To obtain an ethanolic extract of C. papaya leaf (EECP), the dried of C. papaya leaf was macerated with ethanol 70%. Phytochemical compounds were screened qualitatively. Twenty-five larvae were entered into each cup that had been mixed with five concentrations of EECP i.e., EECPI (100-), EECPII (150-), EECPIII (200-), EECPIV (250), EECPV (300 ppm), 1% of Temephos (T), and water (A). Alkaloid carpain, saponin, flavonoid, tannin, glycosides and triterpenoid/steroid were traced in EECP. The mortality of larvae at 180, 360, 1440 and 2880 minutes were observed. The lethal concentration (LC50) and lethal time (LT50) were measured. Probit analysis was used to determine the concentration of killing larvae. RESULTS: The mortality of larvae was found at 360 minutes only in EECPV. Then after 1440 minutes, all extracts shown the increasing of larvae mortality. LC50 and LT50 values were 215,96 ppm and 2,369 minutes of each. CONCLUSION: EECP has larvicidal activity to Aedes spp.

The Levels of Vitamin D, Metalloproteinase-9 and Tissue Inhibitor Metalloproteinase-1 in COPD Patients, Healthy Smokers and Non-Smokers of Indonesian Citizens.

BACKGROUND: Exposure to cigarette smoke may stimulate the inflammatory response and activate polymorphonuclear leukocytes, thus resulting in secretion of cellular proteases. Vitamin D has the potential to modulate the inflammatory response to harmful particles in patients with Chronic Obstructive Pulmonary Disease (COPD). AIM: This study aimed to determine the levels of vitamin D, MMP-9, and TIMP-1 in COPD subjects, healthy smokers and nonsmokers of Indonesian citizens. METHODS: Seventy-eight male subjects took part in this study. They comprised three groups, i.e. COPD (n = 26), healthy smokers (n = 25) and healthy non-smokers (n = 27). Serum 25(OHD) levels, MMP-9, and TIMP-1 concentrations measured by electrochemiluminescence binding assay (ECLIA) and enzyme-linked immunosorbent assay (ELISA). RESULTS: The levels of vitamin D in COPD (21.96 ± 6.62ng/mL) and healthy smokers (27.87 ± 7.08 ng/mL) were significantly (p < 0.001) lower compared to that in healthy non-smokers (31.71 ± 9.24 ng/mL). On contrary, the levels of MMP-9 in COPD (11.98 ± 41.54 ng/mL) was significantly (p = 0.003) higher compared to that in healthy smokers (2.23 ± 3.39 ng/mL) and healthy non-smokers (0.89 ± 1.12 ng/mL). Whereas the levels of TIMP-1 in healthy smokers (24.64 ± 57.77 ng/mL) was significantly (p < 0.001) lower compared to that in COPD (58.40 ± 77.53 ng/mL) and healthy non-smokers (46,54 ± 71,48 ng/mL). CONCLUSION: The present study showed the lowest level of vitamin D, the highest level of MMP-9 and TIMP-1 in the COPD subjects.

Correlations between Insulin Receptor Substrate-1 with Phosphoinositide 3-Kinase and P38 Mitogen-Activated Protein Kinase Levels after Treatment of Diabetic Rats with Puguntano (Curanga Fel-Terrae [Merr.]) Leaf Extract.

BACKGROUND: Defects in post-receptor insulin signalling are the major cause of insulin resistance in type 2 diabetes mellitus (T2DM). AIM: This study aimed to investigate the correlations between insulin receptor substrate (IRS)-1 with phosphoinositide 3-kinase (PI3K) and p38 mitogen-activated protein kinase (MAPK) levels after puguntano (Curanga fel-terrae [Merr.]) leaf extract treatment in a rat model of T2DM. METHODS: A combination of high-fat diet-feeding (HFD) and multiple low dose intraperitoneal injections of streptozotocin was used to induced T2DM in 48 Wistar rats, which were then randomly divided into control and treatment groups (n = 24 per group). Puguntano leaf extract was administered to the treatment group once daily (200 mg/kg.bw) for 10 days. IRS-1, PI3K and p38 MAPK levels were measured in skeletal muscle using sandwich ELISAs in control group after becoming T2DM and in the treatment group after 10 days of puguntano treatment. Data were analysed using the Wilcoxon test and Spearman's correlation. RESULTS: IRS-1, PI3K and p38 MAPK levels were significantly higher in the treatment group than in the control group. There were also significant positive correlations between IRS-1 with PI3K and p38 MAPK levels (r = 0.375, p = 0.035; r = 0.552, p = 0.003; respectively) after the treatment. CONCLUSION: This study demonstrated significant positive correlations between IRS-1 with PI3K and p38 MAPK levels after puguntano leaf extract treatment of T2DM rats.