The Indonesian Biomedical Journal

8-14

Authors: Diah Ayu Aguspa Dita, Nurul Paramita, Ria Kodariah, Neng Tine Kartinah

BACKGROUND: Exposure to environmental enrichment has a positive effect on brain function, including improved cognition. Environmental enrichment has many aspects, including social interactions, object stimulations, and physical activities. Exercise and environmental enrichment can be considered to improve cognitive function with different underlying mechanisms. This study aims to compare the effects of environmental enrichment and aerobic exercise at both synaptic and whole-organism levels using synapyophysin as a measure of synaptic physiology and spatial memory as a measure of cognitive function. METHODS: A six-week in vivo experimental study on 15, 6-month old male Wistar rats randomly divided into three groups (n=5): aerobic group (A), enriched environment group (EE), and enriched with an aerobic or combined group (EEA). All rats were tested four times in the Water-E maze (WEM) task at weeks 0, 2, 4, and 6 of the study. We used immunohistochemistry to determine the synaptophysin expression in hippocampal CA1 region. RESULTS: Based on synaptophysin immunostaining, there were higher optical density scores for synaptophysin in hippocampal CA1 region following EEA, but there were no statistically significant differences between groups (ANOVA test, p>0.05). The spatial memory test showed there were significantly reduced travel time and total errors from the 2nd and 4th weeks in the EEA group, respectively (p<0.05). CONCLUSION: The combination of enriched environment and aerobic exercise seems to rapidly improve spatial memory and enhances the presynaptic protein, synaptophysin in hippocampal CA1 region.

19-26

Authors: Stefani Candra Firmanti, Rina Triasih, Tri Wibawa, Sofia Mubarika Haryana

BACKGROUND: The diagnosis of tuberculosis (TB) in children is challenging by the absence of a practical gold standard. Interferon (IFN)-ginducible protein 10 (IP-10) is a chemokine that may serve as the leading candidate marker in child TB diagnosis. The aim of this study is to assess the diagnostic value of IP-10 in the diagnosis of TB in children. METHODS: We recruited eligible symptomatic and asymptomatic children aged <15 years actively by contact investigation and passively from inpatient and outpatient clinics in two hospitals, in Yogyakarta, Indonesia. We conducted clinical examination and chest X-ray in all eligible children. Sputum smear and the rapid molecular TB test were performed in children with TB symptoms. All participants underwent blood sampling for IFN-g Release Assay and IP-10 test. RESULTS: A total of 79 children were recruited to this study. Twelve children were with TB disease, 16 with latent TB infection (LTBI), 40 were TB-exposed only and 11 were non-TB. Children with evidence of TB infection either with TB disease or LTBI had higher levels of antigen-stimulated IP-10 compared to non-infected children, both TB exposed only and non-TB (p=0.000). A cut-off 408.74 pg/mL for antigen-stimulated IP-10 showed high diagnostic accuracy for diagnosis of TB infection (AUC: 0.97, 95% CI: 0.92-1.00, sensitivity: 92.3%, and specificity: 91.9%). However, the stimulated levels of IP-10 between children with TB disease and LTBI were not significantly different (p=0.268). CONCLUSION: IP-10 performed well to diagnose TB infection in children. However, it cannot be used to differentiate TB infection from TB disease.

34-9

Authors: Ade Dharmawan, Anis Karuniawati, Pratiwi Pudjilestari Sudarmono, Delly Chipta Lestari, Cleopas Martin Rumende

BACKGROUND: Community-acquired pneumonia (CAP) is the most common infectious with serious rate of morbidity and mortality. Recent conventional method only described 30-50% of CAP etiology. Sputum specimen quality assessment is important to obtain an accessible CAP-causing pathogens identification. METHODS: This was a prospective descriptive study involving 100 specimens from CAP-diagnosed subjects in Budhi Asih Regional General Hospital inpatient care. We assessed three gram-staining criteria for specimen quality determination, and continued by bacterial identification. RESULTS: All specimens were qualified according to criteria II, while only 94 and 96 specimens were qualified according to criteria I and III, respectively. Sixty-five specimens could be identified by culture and pneumoCLART polymerase chain reaction (PCR) examination, and the 35 specimens remained unknown. Ten out of those 35 specimens were positive after analyzed by Acid-fast Bacilli (AFB) test. The pathogens we identified including Klebsiella pneumoniae (29.6%), Acinetobacter baumanii (10.2%), Enterobacter cloacae (4.6%), Pseudomonas aeruginosa (4.6%), Staphyloccocus aureus (4.6%), Moraxella catarrhalis (3.7%), Enterobacter aerogenes (2.8%), Escherichia coli (2.8%), Streptococcus pneumoniae (1.9%), Mycoplasma pneumoniae (1.9%) and Citrobacter koseri (0.9%). CONCLUSION: There were no significant differences among the three criteria for sputum specimen quality assessment, based on culture and pneumoCLART examination. We suggest that criteria II could be used to avoid many specimen rejections while good quality specimens still attained for accessible bacteria identification.

45-50

Authors: Dina Evalina Gultom, Muhammad Ali, Ayodhia Pitaloka Pasaribu, Syahril Pasaribu

BACKGROUND: Soil-transmitted helminth (STH) infection is endemic in Indonesia. Singledose albendazole is routinely used to control STH infections. Some studies found that repeated-dose of albendazole showed better efficacy. There is no study in Indonesia to compare single-dose and repeated-dose albendazole for against STH infections. METHODS: A randomized, open clinical trial was conducted in July-September 2018 among primary school children. Stool samples were collected before treatment and on day 7, 14, 21, and 28 after treatment then stained using the Kato-Katz method. Group I received three consecutive days, group II received two consecutive days, and Group III received single-dose of albendazole. Cure rate (CR) and egg reduction rate (ERR) were compared using Chi-square tests, and eggs per gram (EPG) was compared using the Kruskal Wallis test (p<0.05). RESULTS: One hundred ninety-five subjects enrolled and divided into 65 subjects in each group. The CR and ERR of trichuriasis after three consecutive days (79.5% and 97.4%) and two consecutive days regimen (70.3% and 91.9%) were higher than single-dose regimen (32.2% and 74.6%) with p<0.001, but not for ascariasis or hookworm infection. The highest efficacy was found in three consecutive days regimen group. Trichuris trichiura EPG was significantly different among the three groups on day 7, 14, 21, and 28 after treatment (p<0.001). CONCLUSION: Three and two consecutive days albendazole have better efficacy than single-dose of albendazole for trichuriasis, but not for ascariasis or hookworm infection. Two consecutive days albendazole is better choice for treating trichuriasis with more adherence and less side effect than three consecutive days regimen.

57-61

Authors: Parawansah Parawansah, I Putu Sudayasa, Andi Noor Kholidha Syarifin, Amirudin Eso, Nuralifah Nuralifah, Wa Ode Siti Rahayu Fathanah, Ferry Sandra

BACKGROUND: Chronic hyperglycemia causes an increase of free radical production and in longterm, the hyperglycemia increases oxidative stress. Among medicinal plants, Momordica charantia L. fruit has been known to overcome hyperglycemia. However, role of M. charantia L. fruit on oxidative stress is not well understood. Therefore, current study was conducted to investigate the effect of M. charantia L. fruit extract on malondialdehyde (MDA) level and hepatic damage in hyperglicemic rat model. METHODS: Twenty five white rats (Rattus novergicus) were induced with Streptozotocin (STZ) and treated with/without glibenclamide, sodium carboxymethyl cellulose (Na-CMC), or M. charantia L. fruit ethanol/ethyl acetate/ n-hexane fraction. After the treatment, rat’s livers were collected and separated for histopathological examination and MDA analysis. RESULTS: The MDA level average of rats before the STZ induction was 1.37 μg/mL. MDA level average was markedly increased (23.85 μg/mL) in rats induced with STZ and treated with Na-CMC merely. The MDA level average of STZ-induced glibenclamide-treated rats was 3.12 μg/mL. Meanwhile, the MDA level averages of STZ-induced M. charantia L. fruit ethanol, ethyl acetate and n-hexane fractions-treated rats were 14.95, 8.98 and 5.37 μg/mL, respectively. The histopathology results of this study showed that adipocytes, dilated sinusoids and central vein thickening were mostly observed in STZ-induced Na-CMC-treated rats. Meanwhile, the STZ-induced ethanol/ethyl acetate/n-hexane fraction-treated rats did not exhibitthose expressions. CONCLUSION: M. charantia L. fruit fractions inhibit the MDA level average in liver tissue and regenerate hepatic damage of STZ-induced rats, especially the n-hexane fraction which could be a potential hepatic antioxidant and regenerative agent.

69-77

Authors: Rahmad Mulyadi, Mochammad Hatta, Andi Asadul Islam, Bachtiar Murtala, Jumraini Tammase, Reninda Ananda Aman, Eka Susanto

BACKGROUND: The conventional magnetic resonance imaging (cMRI) and apparent diffusion coefficient (ADC) may have a role in predicting tumor grade for gliomas and may in turn assist in identifying tumor biopsy sites. In this study, we aimed to determine the added value of a joint approach of diffusion-weighted imaging (DWI) and cMRI to determine of low grade and high-grade glioma, compare to cMRI alone. METHODS: Data were collected from 56 glioma patients, who underwent examinations and received treatment at Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia, from the period of 2015–2018. Inclusion criteria was patients who underwent cMRI with a DWIADC sequence and patient that were diagnosed with glioma according to the histopathological results. Pathology reports of the imaging results were reviewed independently. A receiver operator curve (ROC) analysis assessed the predictive potential of cMRI and ADC values for low-grade and high-grade gliomas. RESULTS: Fifty-six subjects met the inclusion criteria. The combination of MRI and ADC values increased sensitivity (to 90%) and negative predictive value (to 92.9%), and also improved the negative likelihood ratio (to 0.14). However, the combination of MRI and ADC values had the highest area under the curve (78.6%) and sensitivity (78.6%), which was similar to the separated examination. CONCLUSION: The combination of ADC value and conventional MRI increases sensitivity in differentiating low-grade and high-grade glioma compared to separated examination.