The Role of Stem Cell Therapies in the Treatment of Neurodegenerative Diseases.

Cellular replacement therapy and genetic transfer in injured brains provide new pathways for treating human neurological illnesses. Current progress in the field focuses on the production of neurons and glial cells from many types of stem cells, such as embryonic, induced pluripotent, mesenchymal, and neural stem cells. This has led to a significant increase in research on brain transplantation treatments. Extended neurodegeneration results in the progressive decline of certain neuronal subtypes or whole neuronal cells. An analysis of the progress made in induced pluripotent and mesenchymal stem cells reveals their significant promise in disease modeling, regeneration, and medication screening. The requirement for stem cells in neurodegenerative disease studies has been crucial in recent years. Stem cells provide the potential for replacing impaired neurons, comprehending disease needs modeling, and creating efficient treatments, but they have many challenges in culturing and acceptability to the host immune cells. The need to use their potential in discovering novel therapies for diseases such as Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis leads to promising therapy. This review examines the function of stem cells in the pathogenesis and treatment of Huntington's disease, Parkinson's disease, Alzheimer's disease, and multiple sclerosis. This review further examines hurdles such as immunological reactions and delivery systems intending to overcome these problems. This article offers a detailed viewpoint on the use of stem cell-based nanotherapies as revolutionary treatments for various neurological illnesses.

The Relationship Between Decrease in Vision Aquity and Gadget Use During Online Lectures and COVID-19 Pandemic in Students of the Faculty of Medicine, Universitas Sumatera Utara.

Background: The use of gadgets for a long duration causes problems related to discomfort and causes various other eye complaints. Online lectures cause students to be more intense in using gadgets to support their learning. Therefore, it is necessary to conduct research on the relationship between decreased visual acuity and the use of gadgets during online lectures during the Covid-19 pandemic. Objective: Knowing the relationship between decreased visual acuity and the use of gadgets during online in Covid-19 pandemic for students of the Faculty of Medicine, Universitas Sumatera Utara class of 2019 and 2020. Methods: This research is an analytic research with cross sectional design. The sampling technique used in this study was stratified random sampling, in which 100 respondents were selected using simple random sampling. Results: There are 100 respondents, 81 of them used gadgets for more than 4 hours in one day, 67 of them used gadgets with a viewing distance of 30 cm to 40 cm, and 91 of them had normal visual acuity. Conclusion: There is no significant relationship between a decrease in visual acuity and the duration or distance of seeing in the use of gadgets as evidenced by the p-values of 0.653 and 0.095 respectively.

Association between type of congenital heart disease with child growth and development status: A cross-sectional study in Medan, Indonesia.

Congenital heart disease (CHD) is a congenital disorder primarily affecting newborns and children. Children with CHD have a greater risk of experiencing growth delays or disorders compared to healthy children. CHD also affects various aspects of a child's development. The aim of this study was to determine the association of CHD types (cyanotic and acyanotic) with the growth and development status of children. A cross-sectional study was conducted among CHD patients at a national reference hospital in Sumatra, H. Adam Malik General Hospital in Medan, Indonesia. The children's growth status was assessed using the WHO growth chart, and the developmental condition was evaluated through the Denver Developmental Screening Test-II. Chi-squared test and Fisher's exact test were used to assess the association between the type of CHD with growth and development status in children. Using a consecutive sampling method, a total of 53 individuals were included in this study. Almost half of CHD patients (48.1%) were within the age group of 0-2 years and more than half (61.1%) were girls. Acyanotic CHD (74.1%) was more prevalent than cyanotic CHD (25.9%), with ventricular septum defect (VSD) as the most common diagnosis. A total of 37% of children with CHD suffered from malnutrition, whereas the remaining 62.9% had good nutrition. The Denver Developmental Screening Test-II indicated that 81.4% of the children were normal, whereas 18.5% had developmental disorders. Our data suggested a significant association between cyanotic CHD and poor growth status in children based on weight-for-age, weight-for-length, and body mass index (BMI)-for-age. However, there was no association between the type of CHD and developmental status in children. This study highlights that the type of CHD is significantly associated with the growth status of children, but not with their developmental status.

Anti Inflammatory Action of Allium Sativum Ethanol Extract to Prevent Lung Damage in Smoker Rat Model.

Background: Smoking is the leading cause of death in worldwide and is known as one of the risk factors in the development and pathogenesis of several diseases and most are respiratory and cardiovascular diseases. Secondhand smoke (SHS) exposure is associated with negative health consequences including respiratory tract infection, asthma, and cancer. One of the pathogenesis that has known to cause these diseases is inflammation. Garlic (Allium sativum) is a medicinal herb that contains Allicin and other active constituents that are known to have anti-inflammatory ability by suppressing the expression and production of proinflammatory cytokines that will cause inflammation. Objective: The aim of this study is; to analyze the anti-inflammatory action of Allium sativum ethanol extract to prevent lung damage in the smoker rat model. Methods: This is a case-control study with five groups of rats each group contains of three rats. The five groups were negative control (KN), 10 days (10d) smoker (K1), 20 days (20d) smoker (K2), 20d smoker treated with Allium sativum for 10 days (K3) and 20d smoker treated with Allium sativum for 20 days (K4). After 20 days all animals were sacrificed and histological preparation of lung organs was observed under a microscope with 100 dan 400 times magnification and then captured by photomicrograph for analyzed. Results: There were improvements in lung structure both in group K3 and K4 . there was a decrease of leucocytes and inflammatory cells infiltration that covered almost all alveolar surface to 10-20% surface area and the dilated alveoli decrease from more than 50% to less than 30% area. The bronchus was clean in both two groups compared to the groups that were not treated with Allium sativum. Conclusion: This study shows that Allium sativum ethanol extract has the ability to prevent lung damage in the smoker rat model.

Effect of Garlic Ethanol Extract Administration on Gluthatione Levels to Prevent Oxidative Stress in Smoker Rat Model.

Background: Sickle Garlic (Allium sativum L.) is known as a spice native to western Asia has a strong antioxidant effect and revealed it functions as an antioxidant by increasing ROS-capture activity, cellular antioxidants, SOD, CAT, and GSH levels in cells. Cigarette smoke is very dangerous because it can cause serious illness and death. Cigarette smoke is a major source of exogenous ROS because its particles are high in free radicals. Smoking is also related to a decrease in the body's natural antioxidant levels. Glutathione (GSH) synthesis and expression were found to increase initially and then decrease after being exposed to cigarette smoke. Objective: The aim of this study is; to analyze effect of garlic ethanol extract administration on gluthatione levels to prevent oxidative stress in smoker rat model. Methods: This was a case-control study with a control group design, with 15 healthy rats (Rattus norvegicus, sp.) divided into three groups, KN untreated animals (control), K1 animals exposed to cigarette smoke for 40 days (smoker), and K2 animals exposed to cigarette smoke for 40 days and treated with Allium sativum 0.1 g per day for 40 days (smoker and Allium sativum L.). After 40 days of treatment, all animals, including the control, were sacrificed with 30 mg/IP ketamine injections, and the blood plasma were taken for examination. Results: there were significant difference in glutathione levels between the treatment groups (K2) with the control group (KN) and the smokers group (K1) (p <0.05). Conclusion: garlic ethanol extract administration can increase gluthatione levels and prevent oxidative stress in smoker rat model.

Effectiveness of nifedipine, labetalol, and hydralazine as emergency antihypertension in severe preeclampsia: a randomized control trial.

Background: Preeclampsia is a highly prevalent disease among pregnant women. In the event of hypertensive emergency, nifedipine, labetalol, and hydralazine are assigned as first-line therapies in preeclampsia. Further studies are needed to compare the effectiveness of these drugs to find the most cost-effective drug with minimal side effects. This study aimed to compare the effectiveness of these drugs in lowering blood pressure during hypertensive emergencies in severe preeclampsia. Methods: 60 pregnant women with severe preeclampsia were recruited in this multiple centre double-blind randomized clinical trial from May 2021 to April 2022 in Indonesia. The patients were divided equally into three groups and treated with three doses of nifedipine, labetalol, and hydralazine, respectively within one hour with 20 minutes interval. The effectiveness was measured based on systolic and diastolic blood pressures, and mean arterial pressure (MAP). The observation was carried out until five hours post-third dose administration.   Results: The blood pressure was reduced significantly after the administration of the first to the third dose of each antihypertensive (p<0.05). A single dose administration, four, one, and three patients had 20% MAP reduction in nifedipine, labetalol, and hydralazine group. Three, seven, and one patient had a failure of reaching 20% MAP reduction even after receiving the third dose. The effectiveness of the drugs to achieve 20% reduction of MAP could be ranked as follows: nifedipine>labetalol>hydralazine (57.49%, 42.13%, and 40.87%, respectively) for single dose and hydralazine>nifedipine>labetalol (111.3%, 85.12%, and 90.04%, respectively) for triple dose. Conclusions: Nifedipine is the most effective drug to reduce the blood pressure when single dose administration is used, but requires more doses to further reduce the blood pressure. Hydralazine is the most effective when the drug administration is maxed up to three doses within 60 minutes with 20 minutes interval. Thai Clinical Trials Registry (TCTR): TCTR20221014007 (14/10/2022).

Prevalence Oncogenic Human Papillomavirus in Cervical Cancer Patients in Riau Province Indonesia.

Background: Cervical cancer is the fourth most deadly cancer in the world, and it is caused by infection of high-risk subtypes of Human PapillomaVirus (HPV) in most cases. The aims of this study were to determine the prevalence oncogenic HPV in cervical cancer patients in Riau Province Indonesia and to determine the clinical manifestation of HPV in cervical cancer patients in Riau Province Indonesia. Methods: This research was a descriptive study conducted at Arifin Achmad General Hospital Riau from February to August 2018 which aimed to analyze HPV genotype prevalence oncogenic of cervical cancer patients. Results: This study showed out 86 of 110 women (78.1%) were found HPV positive, and the most common genotype of HPV was HPV 16 (38.2%). The average age of cervical cancer patient was 50 years old, and the average number of parities was 4 times. The majority of participants were married at the age before 20 years (77.3%) and had low educational background (64.5%). Vaginal bleeding happened in more than half of the participant as major clinical manifestation (72.7%), followed by fluor albus (72.7%), pelvic pain (60.2%) and fatigue (65.9%). Conclusion: The most common HPV genotype in Riau Province was HPV type 16 and the most common clinical symptoms of cervical cancer patient were vaginal bleeding, fluor albus, pelvic pain and fatigue.

Detecting Human Papillomavirus Type 16 in Cervical Cancer Patients with Molecular Variation of Gene L1 in Riau Province Indonesia.

BACKGROUND: Cervical cancer is the second most deadly cancer in the world after breast cancer. The cancer is caused by infection of high risk Human Papillomavirus (HPV) type 16. It is often found in cervical cancer of which the genome structure is composed of L1 proteins. The L1 protein makes up the viral capsid that has an important role in causing the cervical epithelium. Several studies have found the differences in HPV nucleotides variants that lead to changes in amino acids that disrupt the structure, the natural function of the virus itself, and ultimately lead to changes in biological functions including host immunological recognition. Variation of the L1 gene also affects the effectiveness of existing vaccines. METHODS: This research was a descriptive study conducted at the laboratory of microbiology, the Faculty of Medicine, Universitas Riau, Pekanbaru from February to August 2018. The study was aimed at looking at the molecular variations of the L1 HPV type 16 gene and examining phylogenic kinship. RESULTS: The SNPs (Single Nucleotide Polymorphism) which occurred in 26 sample isolates are the substitution of C/G (6240), A/G (6432), T/G (6686), C/T (6824). These variations also cause changes in amino acids, insertion of ATC nucleotide bases (6902), and deletions of GAT bases (6954). CONCLUSION: There are  molecular variations of the L1 HPV type 16 gene which can cause different host immune responses. Phylogenic kinship of HPV type 16 isolate in Riau is similar to  Asian-American isolate.

The Effect of Hypoxia Inducible Factor -1 Alpha and Vascular Endothelial Growth Factor Level in Type 2 Diabetes Microvascular Complications and Development.

Background: Angiogenesis in diabetic patients is often caused by hyperglycemia induced by hypoxia. Objective: The aim of this study was to analyze the serum level of Hypoxia Inducible Factor -1α (HIF-1α) and Vascular Endothelial Growth Factor (VEGF) between March until Desember 2020. Methods: This is a cross-sectional analytic methods, 135 patients with Type 2 Diabetes 48 samples with Microvascular complication and 87 samples with non-microvascular complication were recruited from the various primary health care centers in Medan city and surrounding areas in North Sumatera. VEGF levels and HIF-1α tested were done with ELISA methods in the laboratory of Medical Faculty, Universitas Sumatera Utara. Statistical analysis was performed using the IBM SPSS Statistics version 24. The significance level was set up to 0.005. Results: The median HIF-1 levels in patients with microvascular complications were lower than those without microvascular complications, with a range of HIF-1α values in non-complicated samples (0.02-13.96) ng/ml and a range of HIF-1α values in vascular complications (0.52- 8.87) mg/dL. There was a significant difference in HIF-1α levels in patients with Type-2 DM with complications compared to those without complications (p<0.05). Median VEGF levels were higher in complicated Type-2 DM. There was no difference in VEGF levels in patients with Type-2 DM with complications compared to those without complications (p > 0.005). Conclusion: HIF-1α and VEGF levels showed the development in vascularity. With the higher level of HIF-1α, an increase in VEGF levels were found, indicating the angiogenesis is occurring. Although complications have not yet occurred, it is predicted that high VEGF values will cause vascular complications in the future.

Glucose Lowering Effect of Basil Leaves in Diabetic Rats.

BACKGROUND: The incidence of diabetes and its complications has risen since the last decades, and it has been predicted that the prevalence of diabetes will be double in the coming year. Chronic hyperglycemia marked as elevated advanced glycation end products plays an important role in complications of diabetes. Basil leaves (Ocimum basilicum) originating from India and commonly found in Southeast Asia, is widely used empirically to decrease the blood sugar in diabetic patients. AIM: The purpose of the study was to investigate the effect of extract ethanol of Basil leaves in diabetic rats. METHODS: This is an experimental study; Streptozotocin was used to induce type 2 diabetic rats. Thirty Wistar male rats were divided into six groups (normal group, group treated with metformin 45 mg/kg body weight, group treated with Basil leaves 100 mg/kg body weight, 200 mg/kg body weight, 400 mg/kg body weight, control diabetic group). The blood glucose level was measured before induction and after treatment at week 1 and 4. Advanced glycation end products were measured in all groups at week 4. RESULTS: Extract ethanol of basil leaves 100, 200, 400 mg/body weight all showed significant lowering blood glucose level (p < 0.001) compared to diabetic group without treatment, but did not show superior to metformin group (p = 0.17), advanced glycation end products did not show statistical significance between group with normal rats and group of diabetic rats treated with basil leaves 100 mg/kg, 200 mg/kg, 400 mg/kg (p = 0.12, p = 0.33, p = 0.26). CONCLUSION: Extract ethanol of basil leaves showed good results in lowering blood glucose and advanced glycation end products in diabetic rats.

The Effect of Diabetes Self-Management Education on Hba1c Level and Fasting Blood Sugar in Type 2 Diabetes Mellitus Patients in Primary Health Care in Binjai City of North Sumatera, Indonesia.

AIM: The study aimed to evaluate the effect of short-term diabetes self-management education (DSME) on Hba1and Fasting Blood Sugar in type 2 diabetes mellitus patients attending the Primary Health Care (PHC) in Binjai city of North Sumatera, Indonesia. SUBJECTS AND METHODS: A quasi-experimental (pretest-posttest) study was conducted in 4 PHCs, involving 80 patients with type 2 diabetes mellitus. The patients in received a 3-months intervention, including an 8 week education on self- management of diabetes mellitus and subsequent 4 weeks of practice of the self- management guidelines.The patients received standard advice on diet management. RESULTS: There was a significant reduction in Hba1c levels. The statistical analysis using t-test found that there was a significant difference of Hba1c value between pre and post education among type 2 diabetes mellitus patients (p < 0.005). CONCLUSIONS: Diabetes self-management education in PHC of Binjai city can reduce the Hba1c level in type 2 diabetes mellitus patients.

Association between Haemoglobin A1c and Uric Acid Levels among Patients with Diabetes Mellitus Type 2 at a Primary Health Care Clinic in North Sumatera, Indonesia.

BACKGROUND: Haemoglobin A1c (Hba1c) levels and uric acid levels may be associated. AIM: This study aimed to determine Hba1c, and uric acid levels are associated among patients with diabetes mellitus type 2 who attend a primary health care clinic in North Sumatera, Indonesia. METHODS: We conducted a cross-sectional study among patients was conducted on 70 type 2 Diabetes Mellitus patients who attended Primary Health Care in Binjai. Patients with age > 40 years old attend a primary health care clinic in Binjai city, North Sumatera with diabetes mellitus type 2. In each subject demographics, age, sex, body mass index, blood pressure, post health history, fasting blood sugar, Hba1c and uric acid levels were checked and recorded. A student's t-test was used to determine if there was an association between Hba1 and uric acid levels. A total of 70 were included in this study. RESULTS: The mean age of study subjects was 58.33. The mean Hba1c level was 8.743, and standard deviation (SD) was 1.80. The mean of uric acid was 6.31, and standard deviation (SD) was 1.58. The statistical analysis using T-test found that there was no significant association between Hba1c and uric acid levels among study subjects (p > 0.05). CONCLUSION: We found no significant association between Hba1c and uric acid levels among the study subjects.

CD4 and Its Relevance to Advanced Glycation End Products in Tuberculosis Patients with Co-morbidity Diabetes.

BACKGROUND: Tuberculosis (TB) is one of the most common infectious diseases found in developing countries. One of the risk factors for TB is diabetes, a chronic metabolic disorder characterised by hyperglycemia. The altered in glucose metabolism will cause dysfunction of phagocyte and antibacterial that furthermore impaired activation of natural killer cells, dendritic cells. These together will alter the balance of T-cell immunity. Under hyperglycemic conditions, AGEs (advanced glycation end products) was increasingly formed and was believed to play a role in cell dysfunctions and diabetic complications. The CD4 deficiency will alter the immunity status in diabetes and TB with co-morbidity diabetes. AIM: This aim of this study was to evaluate CD4, and it's relevant to Advanced Glycation End Products (AGEs) in TB with co-morbidity diabetes. METHODS: This is a case-control study with a total of 80 patients (40 diabetes and 40 TB with co-morbidity diabetes were recruited from Murni Teguh memorial Hospital Medan after ethical approval from Health Research Ethical Committee. The CD4, AGEs, Blood glucose and HbA1C were measured. RESULTS: There was no statistical difference of CD4, HbA1C and blood glucose within diabetes and TB with co-morbidity diabetes but BMI (p = 0.009) and AGEs (p = 0.001) did. The CD4 below 500 were seen in 15% diabetes and 25% in TB with co-morbidity diabetes but did not show statistical significance difference (p = 0.07). No correlation was found between CD4 and AGEs in TB with co-morbidity diabetes (p = 0.44). CONCLUSION: The CD4 was not correlated significantly with AGEs.