Lusi Oka Wardhani

BACKGROUND: Diabetes mellitus induces oxidative stress, inflammation, and endothelial dysfunction, accelerating atherosclerosis development marked by elevated high-sensitivity C-reactive protein (hs-CRP) and interleukin-12 (IL-12). Diabetes often causes significant vascular changes, which can be represented by carotid tunica intima thickening and elevated renin level. Metformin, which remains as the standard therapy, has limited vascular effects. Vitamin D and magnesium exhibit vasoprotective and anti-inflammatory properties; however, their combined effects on diabetic vascular injury remain unclear. This study evaluated the effects of vitamin D and magnesium combination on serum hs-CRP, IL-12, renin, and carotid tunica intima thickness in diabetic rats.METHODS: Wistar rats were diabetic-induced by 45 mg/kg streptozotocin and 110 mg/kg nicotinamide. Following the induction, the rats were subsequently assigned to receive no treatment, metformin, or a combination of vitamin D and magnesium. Healthy rats were also included as control. Blood sample was collected after 21 days of treatment. Serum hs-CRP, IL-12, and renin were measured using enzyme-linked immunosorbent assay (ELISA), while the carotid tunica intima thickness was assessed by Doppler ultrasound.RESULTS: Diabetic rats showed significant increases hs-CRP, IL-12, renin level, and intima thickness (p<0.001) compared to control. Both metformin and combination of Vitamin D and magnesium reduced these parameters, with combination of Vitamin D and magnesium showing the greatest improvement. Carotid intima thickness in the combination of Vitamin D and magnesium group was comparable to normal controls, indicating marked vascular protection.CONCLUSION: Vitamin D and magnesium combination provided superior glycemic, anti-inflammatory, and vascular protective effects compared to metformin alone. This adjunctive strategy might have potential in preventing vascular complications in diabetes.KEYWORDS: diabetes mellitus, oxidative stress, endothelial dysfunction, hs-CRP, IL-12, atherosclerosis

BACKGROUND: Dyslipidemia derives from disturbances in lipid metabolism as an interaction between genetic and environmental factors, characterized by increased levels of cholesterol, triglycerides, low-density lipoprotein (LDL) and decreased levels of high-density lipoprotein (HDL). Continuous dyslipidemia will increase the risk of atherosclerosis. In dyslipidemia, macrophages release inflammatory cytokines such as interleukin (IL)-1, IL-6, IL-12, IL-15, IL-18, and then induce T-cell infiltration formed atherosclerotic plaques. Beet (Beta vulgaris L.) which contains active compounds and antioxidant, such as flavonoids and betacyanin, has the ability to reduce dyslipidemia. This study evaluated effect of beetroot juice and beetroot extract on dyslipidemic rat models by evaluating the level of HDL, LDL and IL-6.METHODS: Fourty-two male Sprague Dawley rats were divided into seven groups. Rats were fed either with standard food or high fat diet (HFD) for 28 days, then different interventions using either single combination of simvastatin, beetroot juice, or beetroot extract were given alongside the standard food or HFD diet for another 28 days. LDL and HDL were measured pre- and post-intervention, while IL-6 was measured only post-treatment.RESULTS: Daily administration of a single beetroot juice or beetroot extract or in combination with simvastatin reduced LDL significantly compared to pre-intervention. The interventions also increased HDL significantly and lower IL-6 concentrations compared to group that received no intervention.CONCLUSION: Administration of beetroot juice and beetroot extract can lower LDL, increase HDL, and decrease IL-6 either alone or in combination treatment with simvastatin, it is indicated beetroot have a potential benefit for prevention and therapeutic in dyslipidemia.KEYWORDS: beetroot juice, beetroot extract, LDL, HDL, IL-6

Background: High-fat diets habit can lead to metabolic disorders, such as dyslipidemia which a significant contributor for cardiovascular diseases. Dyslipidemia occurs as a result of metabolically interrelated abnormalities of plasma lipids and lipoproteins, including low level of high-density lipoprotein cholesterol, and increasing of low density lipoprotein cholesterol, total cholesterol, and triglyceride. In order to enhance anti-lipid treatment, nutritional therapy containing bioactive compounds are investigated extensively, including those found in beetroot which shown potential in preventing and treating metabolic disorders.Objective: This study evaluated the effect of beetroot extract and beetroot juice on cholesterol and triglyceride levels as a dyslipidemia treatment, in comparison to simvastatin. Ethanol extract can attract flavonoids and betalain, but the extraction process can degrade fiber. Meanwhile, juice still contains quite a lot of fiber.Materials and Methods: Male Sprague Dawley rats were divided into seven groups and fed different diets for 56 days. The groups were: normal control (K0), negative control-HFD (KN), positive control-HFD + simvastatin (KP), single-dose treatment with BE (P1) or BJ (P2), and combination treatment with BE or BJ + simvastatin (P3 and P4), each intervention was given for 28 days. After blood drawn, cholesterol total and triglyceride serum were examined and analyzed.Results: Administration of beetroot extract and juice in single dose or combination with simvastatin gave a significant decrease in cholesterol and triglyceride levels compared to before the intervention. The average reduction levels of cholesterol in P1, P2, P3, and P4 were 54.81, 56.31, 94.19 and 69.11 respectively. Whereas the average decreasing level of triglyceride were 43.28, 30.78, 54.28 and 46.37 in P1, P2, P3 and P4 groups. Combination treatment with simvastatin gave more reduction level compared with single dose beetroot extract or beetroot juice. The most effective reduction was in the beet extract combination with simvastatin group were -94.19±4.08 mg/dL (cholesterol) and -54.28±6.93 mg/dL (triglyceride).Conclusion: Both beetroot extract and juice, as single or combined with simvastatin, were able to decrease cholesterol and triglyceride levels, these indicated their potential for prevention and therapeutic in dyslipidemia. Further research is needed to investigate its mechanisms and establish optimal dosages for human consumption.

Narra J is a multidisciplinary journal and it is published three times (April, August, December) a year. The objective is to promote articles on infection, public health, global health, tropical infection, one health and diseases in tropics. Narra J publishes original research work across all disciplines of medicine and allied sciences, related to infection, public health, global health, tropical infection, one health and diseases in tropics. The journal publishes Original articles, Short Report, Review articles, and Letters to the Editor. All articles published in Narra J are peer-reviewed and published online for immediate access and citation.

Hepatitis B Virus (HBV) infection causes inflammation of the liver, which has a high prevalence in both Indonesia and the world. Serum HBV deoxyribonucleic acid (DNA) is important in determining the initiation therapy for Chronic Hepatitis B (CHB) patients. However, it has several limitations. Precore protein 22 kilodalton (p22cr) is synthesized from the HBV gene in hepatocytes, representing covalently closed circle (ccc) DNA. This study aimed to analyze the diagnostic performance of p22cr levels on HBV DNA in CHB patients. An observational analytic study with a cross-sectional approach was conducted on 83 CHB patients who were examined at the Clinical Pathology Laboratory of Dr. Moewardi General Academic Hospital in December 2020. Blood plasma samples were taken for HBV DNA and p22cr examination by using Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA), respectively. The cut-off level of p22cr was determined by the Receiver Operating Curve (ROC) with the widest area Under the Curve (AUC). Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), and accuracy were calculated for the diagnostic performance of p22cr. The cut-off point of p22cr on HBV DNA > 20,000 IU/mL was 7.440 ng/mL with AUC 0.693 (p=0.003). The diagnostic performance of p22cr levels on HBV DNA obtained 44.44% sensitivity, 82.98% specificity, 66.67% PPV, 66.10% NPV, 2.61 PLR, 0.67 NLR, and 66.27% accuracy. P22cr level has a good specificity so it can be an alternative examination of HBV DNA in making decisions on therapy in patients with chronic hepatitis B. Further research needs to be done using HBcrAg and excluding elderly patients.

Viral-based disease is very closely related to the climate change. For years, dengue infection was reported to be related to rainy season. Any climate change supposedly induces the change on the pattern of dengue infection. Since March 2020, the Covid-19 is started to report in Indonesia. The toll was relatively low in the beginning but gradually increased in the following months. In the same period of rainy season, as it is annually reported, the dengue fever is also increasing. The possible coincidence of covid-19 and dengue infection is therefore an interesting issue. We review 19 cases of which the Dengue fever serological test as well as Covid RT-PCR test were simultaneously performed based on the symptoms and signs found on the patient. Of those cases, coincidence was found on 4 cases. Even relatively low, the 4 cases were significant issue for public health management and the possible correlation with climate change. The emerging covid infection interfered with the dengue case infection along with the climate change. Those issues should be taken into consideration seriously for the health policies.

The tumor microenvironment (TME) formation involving host cells and cancer cells through cell adhesion molecules (CAMs) is essential for the multiple steps of cancer metastasis and growth. Sphingomye...

Background/Aim: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer, frequently infected with Merkel cell polyomavirus (MCPyV). H3K27me3 acts as a repressive histone modification that epigenetically controls gene transcription. The aim of this study was to examine H3K27me3 expression in MCC. Materials and Methods: H3K27me3 expression levels were immunohistochemically analyzed in 20 MCPyV-positive MCCs, 15 MCPyV-negative MCCs with squamous cell carcinoma (SCC) (combined MCCs), and six MCPyV-negative pure MCCs. Results: Reduced H3K27me3 expression was variously observed in MCCs. H3K27me3 H-score was significantly lower in MCPyV-negative MCCs than in MCPyV-positive MCCs (p=0.002). H3K27me3 expression was significantly lower in MCPyV-negative combined MCC component than in MCPyV-positive MCCs (p<0.001), MCPyV-negative pure MCCs (p=0.036), or pure MCC histology (p<0.001). Kaplan–Meier analysis showed no association of H3K27me3 with outcome. Conclusion: Differential reduction in H3K27me3 expression was observed based on MCPyV status and morphological type. These results implicate H3K27me3-mediated epigenetic changes in tumorigenesis of MCC, especially in MCPyV-negative MCC combined with SCC.

Background Recent rapid advances in molecular biology have led the discovery of disease-specific novel fusion genes in a variety of soft tissue tumors. In this study, we attempted to detect these fusion genes using formalin-fixed paraffin-embedded (FFPE) tumor tissues and investigated their clinical utility and factors that affect the results of examination.Methods Reverse transcription polymerase chain reaction for the detection of tumor-specific fusion genes was performed using 41 FFPE tumor samples obtained from 37 patients representing nine histological types of soft tissue tumors that were diagnosed from 2006 to 2017 in our laboratory.Results Fusion genes in 19 (51.3%) out of 37 cases were detected successfully. Relatively high detection rates were observed in synovial sarcomas (100%, 4/4) and alveolar rhabdomyosarcomas (75%, 3/4). The detection rates of fusion genes were inversely correlated with the storage period of FFPE blocks. Decalcification by Plank-Rychlo solution significantly affected detection rates of the internal control gene (P = 0.0038). In contrast, there was no significant difference in detection rates between primary and metastatic lesion, or biopsy and resection material, or presence and absence of treatment history.Conclusion In certain histological types, detection of disease-specific fusion genes of soft tissue tumors using FFPE tissues showed high sensitivity and thus had diagnostic utility. However, due to the diversity of fusion patterns and the low-quality of nucleic acid, the detection rate as a whole was sluggish and required further improvement. For factors affecting the detection results, our results suggested that it was impossible to detect fusion genes by decalcified FFPE tissues, but it may be not necessary to consider factors such as the type of specimen (biopsy or resection) and treatment history of the patients when selecting the FFPE tissues.