Ilhamjaya Patellongi

Chronic hepatitis B in pregnant women: is hepatitis B surface antigen quantification useful for viral load prediction?

BACKGROUND New cases of hepatitis B virus (HBV) infection continue to occur worldwide. Most of these are due to mother-to-child transmission (MTCT), with maternal viraemia as the most important contributing factor. The hepatitis B surface antigen (HBsAg) level, which correlates positively with viral load, has been used for treatment monitoring in chronic hepatitis B. This study evaluated the usefulness of quantitative HBsAg for viral load prediction in HBsAg-positive pregnant women. METHODS A total of 943 pregnant women in Makassar, Indonesia, were screened for HBsAg. Sixty-four women were HBsAg-positive and investigated. HBsAg level and hepatitis B e antigen (HBeAg)/hepatitis B e antibody (anti-HBe) status were determined serologically. Viral load was measured by real-time PCR. HBV DNA was sequenced and analysed for identification of genotype and basal core promoter (BCP)/precore (PC) mutations. RESULTS Of 64 subjects, 12 (18.8%) were HBeAg-positive and 52 (81.3%) were HBeAg-negative. HBsAg and HBV DNA levels were significantly higher in the HBeAg-positive group (p<0.001). HBsAg and HBV DNA levels were positively correlated in the HBeAg-positive group (r = 0.659; p=0.02), but not in the HBeAg-negative group (r=0.194; p=0.168). Low HBsAg levels (<3.0 log10 IU/ml) corresponded with HBV DNA levels<6.0 log10 IU/ml (r=0.404; p=0.001), a recognized threshold for MTCT. Genotype C was more prevalent than genotype B, but not associated with HBsAg level, viral load, or HBeAg status. Two-thirds of HBeAg-negative subjects with high HBV DNA levels harboured BCP (A1762T/G1764A) and/or PC (G1896A) variants. CONCLUSIONS HBsAg levels provide a good viral load predictor in HBeAg-positive but not HBeAg-negative pregnant women. The HBeAg-negative group had a frequent occurrence of BCP/PC variants, which may have contributed to the lack of correlation observed. Samples with a low HBsAg level, which is associated with a low risk of MTCT, do not require HBV DNA measurement.

Impact of interleukin-6 and interleukin-10 serum level and its mRNA expression level on polytrauma patients

Purpose Host response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patients outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 (IL-6) and interleukin-10 (IL-10). Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients. Methods This prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score (ISS) ≥ 16]. Plasma levels and mRNA expression of IL-6 and IL-10 were measured for 5 days after trauma. Clinical evaluation was conducted to observe whether patients endured multiple organ dysfunction syndrome (MODS) and death. MODS evaluation was performed using sequential organ failure assessment (SOFA). Trauma load which in this study is represented with ISS, plasma level, expression of cytokine genes and patients outcome were examined with correlation test and statistical analysis. Results The elevated IL-6/IL-10 ratio indicated increased activity of systemic inflammation response, especially pro-inflammation response which bears higher probability of progressing to MODS and death. The decline of IL-6/IL-10 ratio with heavy trauma load (ISS > 30) showed that compensatory anti-inflammation response syndrome (CARS) state was more dominant than systemic inflammatory response syndrome (SIRS), indicating that malfunction and failure of immune system eventually lead to MODS and deaths. The statistical significance in plasma level of cytokines was found in the outcome group which was defined as bearing a low trauma load but mortality. Conclusion The pattern of cytokine levels in inflammation response has great impact on the outcome of polytrauma patients. Further study at the genetic level is needed to investigate inflammation process which may influence patients outcome.

Characteristics and the average 30-day and 6-month clinical outcomes of patients hospitalised with coronary artery disease in a poor South-East Asian setting: the first cohort from Makassar Cardiac Center, Indonesia

Objective To provide a detailed description of characteristics at hospital admission and clinical outcomes at 30-day and 6-month follow-up in patients hospitalised with coronary artery disease (CAD) in a poor South-East Asian setting. Design Prospective observational cohort study. Setting From February 2013 to December 2014, in Makassar Cardiac Center, Indonesia. Participants 477 patients with CAD (acute coronary syndrome and stable CAD). Outcome measures All-cause mortality and major adverse cardiovascular events (MACE). Results Out of 477 patients with CAD, the proportion of young age (<60 years) was 53.9% and 72.7% were male. At admission, 44.2% of patients were diagnosed with ST-segment elevation myocardial infarction (STEMI), 38.6% with diagnosis or signs of heart failure and 75.1% had previous hypertension. Out of 211 patients with STEMI, only 4.7% had been treated with primary percutaneous coronary intervention (PCI) and 6.2% received thrombolysis. The time lapse from symptom onset to hospital admission was 26.8 (IQR 10.0–48.0) hours, and 19.1% of all patients had undergone either PCI or coronary artery bypass graft. The survival rate at 6 months was 78.9%. The rates of all-cause mortality at 30 days and 6 months were 13.4% and 7.3%, respectively; the rate of composite MACE at 30 days was 26.2% and 18.0% at 6 months. Conclusions Patients with CAD from a poor South-East Asian setting present themselves with predominantly unstable conditions of premature CAD. These patients show relatively severe illness, have significant time delay from symptom onset to admission or intervention, and most do not receive the guidelines-recommended treatment. Awareness of symptoms, prompt initial management of acute CVD, well-established infrastructures and resources both in primary and secondary hospital for CVD should be improved to reduce the high rates of 30-day and 6-month mortality and adverse outcomes in this population.

Allogeneic islet cells implant on poly-l-lactide matrix to reduce hyperglycaemia in streptozotocin-induced diabetic rat

OBJECTIVE To demonstrate the effects of allogeneic islet cell matrix implants for glycaemic control in rats with induced diabetes. METHOD Sprague-Dawley rats were used as allogeneic donors of islet cells. Cells were seeded on three-dimensional proprietary poly-(l-lactide) matrices. Animals were rendered diabetic and a week later a matrix seeded with islet cells (IMI group) or a control matrix (placebo group) was implanted in the small bowel mesentery. Blood glucose levels were measured weekly for 12 weeks. After sacrifice, implant sections were Gomori stained for beta-cells and immuno-stained for insulin 3, 4, 5, and 6 months post implantation. RESULTS 82% of seeded islet cells attached to the matrices. In the IMI group blood glucose levels were significantly reduced after implantation compared with before implantation across several time points. In the IMI group beta-cells and insulin-positive cells were identified at the implant site. CONCLUSION The islet cell matrix implant reduced the blood glucose levels although complete normo-glycaemia was not established. The islet cell matrix implant may serve as an additional option for islet cell transplantation using 3D scaffold platforms for better survival and function of the islet cells.

Effect of Doxycycline in Autologous Serum to Improvement Clinical Manifestation of Acne Vulgaris

Acne vulgaris (AV) is an inflammatory disease of skin on the follicle polisebasea frequent and considered dermatological problems the most common worldwide. This study investigates the relationship topical therapy using autologous serum containing doxycycline in women with moderate to severe acne vulgaris. Research conducted in Makassar, South Sulawesi, as many as 13 samples that met the inclusion criteria. Clinical examination in patients with moderate acne vulgaris to severe and based on clinical manifestations, level of sebum measured before, and levels of estradiol. All patients given the autologous serum after being given doxycycline 200 mg single dose oral which will be applied every night. Furthermore monitored on day to 14 and day to 28. The data were processed using paired Wilcoxon test. Results improvement in clinical manifestations and levels of sebum on days 14 and 28 compared to day 1 was significantly (p <0.05). There were improvements in clinical manifestations and decrease sebum levels in patients with moderate to severe AV after application of autologous serum containing doxycycline.

Identification of Methicillin-Resistant Staphylococcus Epidermidis (MRSE) in Mild, Moderate and Severe Acne Patients

Acne cases caused by Staphylococcus epidermidis bacteria have been reported previously. This study identified methicillin resistant Staphylococcus epidermidis (MRSE) directly from pus speciment from acne patients at various degree of severity. There were 61% positive samples detected by Polymerase Chain Reaction (PCR) for MRSE using target gene mecA for PCR amplification of acne samples. Significant correlation between the severity of acne and its causative agent (MRSE) was not found.

The Relationship Between Serum Level of Interleukin-10 and State of the Disease with Atopic Dermatitis and Helminth in Children

Background: IL-10 is an antiinflammatory cytokine. During infection it inhibits the activity of Th1 cells, NK cells, and macrophages. Regulatory cytokine interleukin-10 (IL-10) has been proposed as a key molecule involved in the attenuation of helminth infection and chronic inflammation, such as atopic dermatitis. The maintenance of the asymptomatic state is now recognized as reflecting an immunoregulatory environment, which may be promoted by parasites, and involves multiple levels of host regulatory cells and cytokines; currently, there is much interest in whether helminth-associated immune regulation may ameliorate allergy and autoimmunity. The objective of this study was to measure the IL-10 level in healthy person, atopic dermatitis, helminth infection and healthy persons. Methods: Levels of IL-10 was measured by ELISA technique. Kato-Katz method is used to determine the number of eggs of helminth. Results: Our study showed that those aged > 5 years old and helminth infection without atopic dermatitis had higher levels of IL-10 (3.05 ± 2.44) which was significantly higher (p 5 years old in others group. Also, no correlation between egg count of helminth and level of IL-10 in serum. Conclusion: The serum of IL-10 was significantly higher in children > 5 years with helminth infection without atopic dermatitis than children with atopic dermatitis.

Hair’s Zinc Level on Androgenic Alopecia

Androgenic alopecia is characterized by progressive loss of hair from the scalp. This research aimed to determine the hair and blood zinc levels in men with androgenic alopecia. The research was conducted in the Departement of Dermatovenereology of Dr. Wahidin Sudirohusodo Hospital, Makassar and the Center for Health Laboratory, Makassar, using the observational research method. The samples comprised 21 males with androgenic alopecia and 11 control samples without androgenic alopecia. The hair and blood of the samples were analyzed using the atomic absorption spectrophotometer receipts. The results showed that there was significant difference (p <0.05) between the levels of androgenic alopecia hair zinc and control. On blood zinc levels found no significant differences between androgenic alopecia and control. Hair zinc levels had a significant relationship with the degree of Hamilton, where the lower the levels of zinc in the hair androgenic alopecia, the greater the degree of Hamilton. However, things are different, between blood zinc levels in hair zinc levels and degrees of Hamilton that there is no significant difference. In this study also found between age and degree of Hamilton, where the increasing age, the greater the degree of Hamilton.