The Effect of Superoxide Dismutase on Inhibition of Acute Kidney Injury Induced by Sepsis Based on Kidney Tissue Histology and Murine Sepsis Score.

Sepsis is one of the leading causes contributing to the incidence of acute kidney injury (AKI). Oxidative stress can be used as the main approach against sepsis-induced AKI. One of the primary antioxidants that plays a role in warding off oxidative stress is superoxide dismutase (SOD). This research aimed to observe the effect of antioxidant SOD in inhibiting sepsis in AKI based on kidney tissue histopathology. The research method was an experimental laboratory with a post-test-only control group design. Twenty-five adult male rats aged 12-16 weeks, weighing between 200 and 250 g, were randomly divided into five groups: Group I, as a positive control, where rats were injected with lipopolysaccharides (LPS); Group II, as a negative control; Group III, as treatment 1, where rats were injected with LPS and administered orally with SOD (Glisodin®) 250 IU daily; Group IV, as treatment 2, where rats were injected with LPS and administered orally with SOD (Glisodin®) 500 IU daily; and Group V, as treatment 2, where rats were injected with LPS and administered orally with SOD (Glisodin®) 1000 IU daily. Rats were administered with SOD (Glisodin®) by oral gavage with a flexible feeding tube for 16 weeks, given once daily in the morning, and then injected with LPS of 10 mg/kg body weight. Glisodin SOD had a significant effect on murine sepsis score (MSS). MSS influenced the tubular injury score linearly. We conclude that the optimal dose of SOD at 1000 IU for inhibiting sepsis-induced AKI incidence is compared to SOD at a dose of 250 and 500 IU. The antioxidant effect of SOD can prevent sepsis-induced AKI with oxidative stress events.

The association of depression with child abuse among Indonesian adolescents.

BACKGROUND: Depression is one of the most prevalent mental health problems among adolescents. Mental health problems might be the result of child abuse considering that their prevalences are increasing simultaneously in Indonesia. The aim of this study was to determine the association between depression and a history of abuse among adolescents. METHODS: An analytic cross-sectional study was conducted on 786 junior high school students from Bandung City, West Java, Indonesia. Subjects were selected using two-stage cluster sampling. The Children's Depression Inventory (CDI) and the ISPCAN Child Abuse Screening Tool (ICAST) questionnaires were applied to assess depression and a history of abuse, respectively. Depression was diagnosed by a psychiatrist after a positive score on the CDI. The data were analysed using chi-square tests and multiple regression. RESULTS: A history of child abuse was associated with depression in adolescents. All dimensions of child abuse had a significant association with depression. Psychological violence had the highest risk factor for the occurrence of depression (PR = 6.51), followed by exposure to violence and physical violence. Sexual violence was not a common dimension of child abuse among students. Psychological violence had the strongest association with depression, and victims were three times more likely to develop depression (POR = 3.302, p = 0.004). CONCLUSION: Psychological violence was proven to be a strong risk factor for developing depression symptoms among adolescent students. While each victimization domain remained a significant predictor of depression, the experience of multiple domains during a child's life-course may predict mental health risk. Early detection and interventions to prevent abuse and its consequences are critical.

Factors influencing mother's participation in Posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia.

BACKGROUND: Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu. METHODS: This research used a cross-sectional design with sample of mothers who had children under five. They were chosen by multistage random sampling. Sample size was determined by the WHO formula. Face-to-face interviews were carried out using a questionnaire. The questionnaire consisted of items about socio-demographic characteristics, satisfaction with Posyandu services, attitude towards Posyandu benefits, and intention to attend Posyandu. The collected data were analyzed by using EZR (version 1.21). Fisher's exact test was performed to examine the associations between the socio-demographic factors, attitude, satisfaction, and intention covariates with participation. Logistic regression was used to describe the strength of the relationship between the predictor variables and participation. RESULTS: There were no significant differences in age, marital status, education level, occupation, family size, and distance to Posyandu between low participation group except for the monthly household income. Among the socio-demographic factors, only monthly household income had a significant association with the frequency of mothers' participation. Satisfaction, attitude, and intention were associated with participation. The logistic regression showed that monitoring the nutritional status of children under five was the main reason that mothers participated in Posyandu. Mothers who were satisfied with the Posyandu services were more likely to attend than those who were dissatisfied. Respondents with intention to participate in Posyandu every month were more likely to attend than those who did not intend to attend every month. Households with low income were more likely to participate in Posyandu than households with high income. CONCLUSION: Household income, mothers' satisfaction with Posyandu services, attitude towards Posyandu benefits and intention to attend Posyandu affect the participation frequency of the mother. In addition, monitoring the nutritional status of children under five was the main reason respondents attend Posyandu. Improving the quality of Posyandu services and providing qualified resources are needed to promote mothers' participation.

Assessing the Effectiveness of an E-Coaching Intervention in Improving Family Support for Individuals with Mental Disorders: A Quasi-Experimental Approach.

Background: The increasing number of mental disorders (MDs) requires government, social, and family attention. The purpose of this study was to determine the effectiveness of an e-coaching empowerment application in improving families' abilities to care for individuals with mental disorders (MDs). Methods: A quasi-experimental design was used for this study. Totaling 122 individuals selected through purposive sampling from families with (MDs) in six selected community health centers that divided into two groups, intervention and regular mental healthcare. The data collected were analyzed using multiple linear regression. The independent variable was the provision of intervention using the e-coaching application with GROW (Goal, Reality, Option, Will) model, while the dependent variables were the family's ability to recognize problems, make decisions, take care of people with MDs, modify the environment, and utilize health facilities. Further, multivariate tests were used to evaluate the effect of e-coaching empowerment on families' ability to care for MDs. Results: The results demonstrated a significant impact of e-coaching on the family's ability to care for individuals with MDs (p<0.01). Education also partially affected the family's ability to care for individuals with MDs (p<0.01). Additionally, age, gender, occupation, relationship with the individual MDs, and duration of care simultaneously did not significantly affect the family's ability to care for individuals with MDs (p<0.01). However, educationally background was significantly affect family ability in taking care for MD patients. Overall, e-coaching significantly improved the family's ability to recognize problems, make decisions, care for patients with MDs, modify the environment, and utilize health facilities. Recommendations: The e-coaching empowerment application for families can assist healthcare workers in enhancing the family's ability to provide assistance for individuals with MDs at home. This application can improve mental health services in the broader location accessible via the internet and can be developed for other health fields. The application can be expanded into a simple game so that families can view their scores for their proficiency in each session to make it more entertaining.

Potential role of ACE2-related microRNAs in COVID-19-associated nephropathy.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease (COVID-19), potentially have severe kidney adverse effects. This organ expressed angiotensin-converting enzyme 2 (ACE2), the transmembrane protein which facilitate the entering of the virus into the cell. Therefore, early detection of the kidney manifestations of COVID-19 is crucial. Previous studies showed ACE2 role in various indications of this disease, especially in kidney effects. The MicroRNAs (miRNAs) in this organ affected ACE2 expression. Therefore, this review aims at summarizing the literature of a novel miRNA-based therapy and its potential applications in COVID-19-associated nephropathy. Furthermore, previous studies were analyzed for the kidney manifestations of COVID-19 and the miRNAs role that were published on the online databases, namely MEDLINE (PubMed) and Scopus. Several miRNAs, particularly miR-18 (which was upregulated in nephropathy), played a crucial role in ACE2 expression. Therefore, the antimiR-18 roles were summarized in various primate models that aided in developing the therapy for ACE2 related diseases.

Correlation between CD4 count and glomerular filtration rate or urine protein:creatinine ratio in human immunodeficiency virus-infected children.

BACKGROUND: Studies on kidney complications in human immunodeficiency virus (HIV)-infected children are lacking. CD4 T lymphocytes are an important immune functions regulator and used as a basis for initiating antiretroviral therapy (ART) and monitoring disease progression. This study aims to determine the correlation between CD4 and estimated glomerular filtration rate (eGFR) or urine protein:creatinine ratio (uPCR) as markers of kidney complications. METHODS: This cross sectional study was conducted on HIV-infected children aged 5 to 18 years who visited the Teratai HIV Clinic at Hasan Sadikin Hospital for monthly monitoring in June 2019. CD4 count, eGFR based on the Schwartz formula, and uPCR were obtained. Correlation analysis was performed with the Pearson test. RESULTS: Subjects were 42 HIV-infected children, consisting of 23 males (54.8%) and 19 females (45.2%). Most children (65.0%) were in an advanced clinical stage and had been diagnosed with HIV for an average of 8 ± 3 years. All subjects had received ART, and six received tenofovir. Compliance to medications were good, and most subjects (79.0%) had normal nutritional status and CD4 count. All subjects had eGFR > 90 mL/min/1.73 m2, of which 21 (50.0%) were above normal value. Proteinuria was found in 12 patients (28.6%), and it was not significantly associated with clinical stages of HIV infection. CD4 count was correlated positively with eGFR (r = 0.473, P = 0.001) and negatively with uPCR (r = -0.284, P = 0.034). CONCLUSION: The degree of immunodeficiency appears to correlate with severity of renal injury. Screening at diagnosis and periodic monitoring of kidney functions are crucial in all childhood HIV patients.

Complicated Urinary Tract Tuberculosis in a 13-Year-Old Adolescent with Chronic Kidney Disease and Antituberculous Drug-Induced Hepatotoxicity.

Urinary tract tuberculosis (TB) is a rare extrapulmonary manifestation of TB in children. The disease is potentially underdiagnosed because it clinically resembles other urinary tract infections. A 13-year-old adolescent girl presented with pain, difficulty in micturition, and gross hematuria for almost two years before admission, and she had left flank pain since one year ago and significant loss of body weight during the illness. The close TB contact was her grandmother who was on TB treatment. Acid-fast bacilli yielded positive result, Mantoux test was positive (17 mm), urine GeneXpert MTB/Rif was positive; tuberculoma was identified on kidney histopathology, and a diuretic renogram revealed an uncorrected glomerular filtration rate (GFR) of the right and left kidney to be 32.5 mL/min/1.73 m2 and 5 mL/min/1.73 m2, respectively. During the treatment, oral anti-TB drug-induced hepatotoxicity (ADIH) occurred to the patient. This problem was solved with management according to the British Thoracic Society (BTS) guidelines. Screening TB in children is very important for a better outcome. If children complain of some complicated urinary tract infection, TB should be suspected. Optimaly treating children with urinary tract TB exagerrated with ADIH and CKD is very challenging.

Pneumococcal carriage, density, and co-colonization dynamics: A longitudinal study in Indonesian infants.

OBJECTIVES: Nasopharyngeal carriage of Streptococcus pneumoniae underpins disease development and transmission. This study was performed to examine pneumococcal carriage dynamics, including density and multiple serotype carriage, in Indonesian infants during the first year of life. METHODS: Two hundred healthy infants were enrolled at 2 months of age. Eight nasopharyngeal swabs were collected from enrolment until 12 months of age. Pneumococci were detected using quantitative PCR and serotyped by microarray. Regression models assessed factors influencing pneumococcal carriage and density. RESULTS: Eighty-five percent of infants carried pneumococci at least once during the study. The median age at first acquisition was 129 days (interquartile range 41-216 days). The median duration of carriage was longer for the first pneumococcal acquisition compared with subsequent acquisitions (151 days vs. 95 days, p<0.0001). Of the 166 infants who carried pneumococci during the study, the majority (63.9%) carried a single pneumococcal serotype at a time. Pneumococcal carriage density was higher when upper respiratory tract infection symptoms were present, lower during antibiotic usage, decreased with age, and tended to decrease over time during a carriage episode. CONCLUSIONS: The majority of Indonesian infants carry pneumococcus at least once during the first year of life. Pneumococcal carriage is a dynamic process, with pneumococcal density varying during a carriage episode.

Critical pertussis in a young infant requiring mechanical ventilation.

Pertussis may likely be misdiagnosed in its initial or catarrhal phase as a common respiratory infection. The earlier diagnosis of pertussis really depends on the capability of the medical professional especially in the first line public health services. The lack of awareness in diagnosis of severe pertussis as one of the causes of severe respiratory problems may likely misdiagnose pertussis as respiratory failure or even septic shock. In fact, pertussis may manifest as a critical pertussis which can be fatal due to the respiratory failure that require pediatric intensive care unit using mechanical ventilation. We reported a confirmed pertussis case of a 7-weeks-old female infant referred to our tertiary hospital with gasping leading to respiratory failure and septic shock requiring mechanical ventilation, aggressive fluid therapy, and antibiotics. Pertussis was diagnosed late during the course of illness when the patient was hospitalized. Improvement was noted after administering macrolide which gave a good response. Bordetella pertussis isolation from Bordet-Gengou media culture yielded positive result.

Association of complex lipids containing gangliosides with cognitive development of 6-month-old infants.

BACKGROUND: Human breastmilk contains gangliosides which may play an important role in infant neurodevelopment. AIM: A pilot study was conducted to assess the impact of infant formula supplemented with gangliosides from complex milk lipid on cognitive functions of normal healthy infants. STUDY DESIGN: The study was a double-blind, randomized, controlled, parallel group clinical trial in which infants received the treatment or control product from 2 to 8 weeks of age until 24 weeks of age. The control group (n=30) received standard infant formula and the treatment group (n=29) received the same formula supplemented with complex milk lipid to increase the ganglioside content to approximately 11 to 12 µg/ml. A reference group (n=32) consisted of normal healthy exclusively breast-fed infants. OUTCOME MEASURES: Cognitive development using the Griffith Scales and serum gangliosides was measured before (2-8 weeks of age) and after intervention (24 weeks of age). RESULTS: Ganglioside supplementation using complex milk lipids significantly increased ganglioside serum levels (control group vs treatment group, P=0.002) and resulted in increased scores for Hand and Eye coordination IQ (P<0.006), Performance IQ (P<0.001) and General IQ (P=0.041). Cognitive development scores and serum ganglioside levels for the treatment group did not differ from the reference group. CONCLUSIONS: Supplementation of infant formula with complex milk lipid to enhance ganglioside content appears to have beneficial effects on cognitive development in healthy infants aged 0-6 months, which may be related to increased serum ganglioside levels.