Laura Wihanto

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the global problem of respiratory disease from 2019 to 2024. One of the earliest variations in the SARS-CoV-2 S protein was the S D614G mutation. SARS-CoV-2 has several important variants, namely, Alpha, Beta, Gamma, Delta, and Omicron. Omicron is the variant that has caused severe health problems, some resulting in death, in the elderly. Omicron has further differentiated to some wellknown variants, such as, BA.1, BA.2, BA.2.75, BA.5, BQ.1.1, and XBB.1. According to Japanese Government data, the number of citizens aged 65 years old and above reached 28.9% in 2021. From our previous experiment, antibodies of the elderly that have received four doses of mRNA vaccine still could not optimally neutralize Omicron BQ.1.1 and XBB.1. We aimed to analyze the plaque size of SARS-CoV-2 variants that caused severe COVID-19 in the elderly. SARS-CoV-2 variants were seeded in Vero E6-TMPRSS2 cell culture to create plaques. The resulting plaques were analyzed with ImageJ application to select solitary plaques and to determine plaque sizes. The size of BA.1 plaque was indifferent to BA.2 plaque. The plaque area comparison result was as follows, BA.1/BA.2in vitro experiment inferred that there is increase in fusogenicity of BQ.1.1 and XBB.1, when compared with BA.1 and BA.2.

Preclinical studies for discovering and developing a drug for a disease involve utilizing animals as experimental subjects. The search for an effective and efficient murine model of dengue virus (DENV) infection is ongoing to support further scientific updates. This study aimed to explore the suitability of Wistar rats as a murine model for DENV infection. Twenty-four Wistar rats (male sex, 2-3 months old, 200-300 grams weight) were randomly divided into four groups (n=6 per group): control group (no infection), SC-Group (DENV-2 s.c.), IV-Group (DENV-2 i.v.), and ADE-Group (DENV-3 i.p. twice and DENV-2 i.v. once). Inactive 0.2 mL of 10 ¹¹ FFU/mL DENV-3 were injected on days -14 and -5. Active 0.2 mL of 5 x 10 ⁸ FFU/mL DENV-2 were injected on day 0. Rectal temperature was measured on day 0 until 6. NS1 antigen tests were carried out from the viral medium on days -14, -5, and 0 and from the blood serum samples on day 4. Hematological parameters (leukocytes, hemoglobin, hematocrits, and platelets) were analyzed on days 0, 4, and 6. Biochemical parameters (albumin, ALT, and AST) were analyzed on day 6. SC-Group showed significant increases in the temperature from day 0 to day 1 ( p =0.028). IV-Group showed significant increases in the temperature from day 0 to day 1 ( p =0.007), day 2 ( p =0.002), and day 3 ( p =0.006). There were significant temperature increases on day 1 ( p =0.047), day 2 ( p =0.009), and day 3 ( p =0.001) compared to the control group. ADE-Group had a mortality rate of 33.3%, lusterless and ruffled hair coat, and several hemorrhagic manifestations. ADE-Group also showed significant increases in the temperature from day 0 to day 2 ( p =0.043) and day 3 ( p =0.038). There were significant temperature increases on day 1 ( p =0.048), day 2 ( p =0.002), day 3 ( p =0.000), and day 4 ( p =0.004) compared to the control group. Leukocytes in the ADE-Group showed significant decreases from day 0 to day 6 ( p =0.021). ALT ( p =0.033) and AST ( p =0.011) of the ADE-Group also showed significant increases compared to the control group. DENV infection through an induction method adapted from the antibody-dependent enhancement mechanism shows the most severe clinical manifestations and laboratory findings compared to other induction methods in Wistar rats.

Cryptococcal meningitis is a rare disease caused by Cryptococcus neoformans or Cryptococcus gatii as the fungal pathogen in humans. The disease is highly prevalence in people living with human immunodeficiency virus (HIV) and is the major cause of mortality in an immunocompromised individual. This life-threatening disease does not often occur with specific signs and symptoms. We reported a case of an early adulthood HIV-infected patient with a mild headache and low-grade fever. There were no altered mental status or other significant specific manifestations. Blood examination, chest radiograph, and computed tomography scan revealed no significant results. C. neoformans were isolated from a culture of the cerebrospinal fluid specimen as the conventional gold standard examination for cryptococcal meningitis. A positive result was confirmed in the India ink staining preparation. The patient was treated with fluconazole monotherapy for the induction and consolidation phase and showed a positive disease progression during observations.

Purpose: The incidence and mortality rates of arterial ischemic stroke (AIS) among pediatric patients have been frequently reported. While pediatric stroke can have multiple severe effects, its risk factors have not been methodically examined. This systematic review and meta-analysis were completed to summarize the existing evidence regarding risk factors for AIS in pediatric patients.Methods: To gather relevant articles published in the past 15 years, searches were conducted of PubMed and Scopus. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using Review Manager 5.4.Results: From the initial screening of 507 articles, five articles comprising a total of 1,423 participants were selected for qualitative analysis. Two of these additionally underwent quantitative analysis. Among the total participants, 1,108 children with AIS (77.9%) had arteriopathy as the underlying disease. Types of arteriopathy included moyamoya disease (24.28%), arterial dissection (23.29%), focal cerebral arteriopathy (16.16%), and vasculitis (14.71%). The meta-analysis revealed that being between 6 and 9 years of age (OR, 2.19; 95% CI, 1.76 to 2.73; P<0.00001) and having sickle cell disease (OR, 3.46; 95% CI, 2.38 to 5.05; P<0.00001) were associated with arteriopathy in pediatric AIS.Conclusion: Arteriopathy is the most common risk factor for AIS in pediatric patients, and in turn, an age of 6 to 9 years and sickle cell disease are risk factors for arteriopathy within this demographic.

The various infection routes of Toxoplasma gondii that are close to daily life strongly support the incidence of toxoplasmosis. The emergence of drug-resistant Toxoplasma gondii strains raises future concerns. Moringa leaf ethanol extract has been shown to have several anti-pathogen activities, which could have an anti-Toxoplasma effect. This research was conducted to analyze the anti-Toxoplasma effect of moringa leaf ethanol extract against tachyzoites replication in Toxoplasma gondii and the correlation between extract doses with the number of tachyzoites. Mice were divided into five groups. The negative control group (Group I) received CMC-Na solution. The positive control group (Group II) received spiramycin 100 mg/kg BW. The treatment groups received moringa leaf ethanol extract 250 mg/kg BW (group III), 500 mg/kg BW (group IV), and 1000 mg/kg BW (group V), respectively. Mice were injected with 1 x 10⁵ tachyzoites/0.1 mL/mice intraperitoneally on the first day. Moringa leaf ethanol extract and spiramycin were given orally once daily for three days. The number of tachyzoites in the intraperitoneal fluid was calculated on the fifth day. The results have shown that there were significantly lower differences (P < 0.05) in group IV (P = 0.021) and group V (P = 0.022) compared to group I. There was also a significant negative correlation between the extract doses and the number of tachyzoites (P = 0.000; r = -0.781). Moringa oleifera leaf ethanol extract has an anti-Toxoplasma effect by inhibiting the tachyzoite replication at 500 mg/kg BW and 1000 mg/kg BW.

Introduction. The 2018 Riskesdas data shows that the prevalence of diabetes mellitus is increasing each year. Strobilanthes crispus leaves are known for lowering blood glucose levels. This study aimed to determine the difference in the effectiveness of S. crispus leaves ethanolic extract on fasting blood glucose (FBG) and post-oral glucose tolerance test (OGTT). Methods. True experimental study using post-test only control group design and Rattus norvegicus as experimental animals. Rattus norvegicus were selected by random sampling which were then divided into 4 groups (K, P1, P2, P3), each group consisted of 5 animals. The animals were subsequently induced with diabetes mellitus via a single injection of 160 mg/kgBW/IP alloxan. Group K was given 0.5% NaCMC solution at a dose of 1 ml/200 g BW/day/oral/day. Group P1, P2, and P3 received extract at a dose of 100, 400, 600 mg/kg BW/oral/day for 21 days using oral gavage. Statistical analysis was performed using ANOVA, Tukey, Brown-Forsythe, and Kruskal-Wallis tests. Results. Mean FBG level in group K, P1, P2, P3 were 338.40 mg/dL, 270.80 mg/dL, 200.00 mg/dL, and 138.60 mg/dL, respectively. Mean value of 60 minutes OGTT blood glucose level in group K, P1, P2, P3 were 355.60 mg/dL, 289.00 mg/dL, 188.00 mg/dL, and 164.40 mg/dL, respectively. Meanwhile, mean value of 120 minutes OGTT blood glucose level in group K, P1, P2, P3 were 346.60 mg/dL, 236.20 mg/dL, 175.40 mg/dL, and 117.20 mg/dL, respectively. The hypothesis test results showed a significant difference in 120 minutes OGTT blood glucose level (p= 0.031). Conclusion. The use of ethanol extract from S. crispus leaves is more beneficial in reducing blood glucose levels in 120 minutes OGTT compared to FBG level and 60 minutes OGTT level, with the highest reduction observed in the group given a dose of 600 mg/kgBW/oral/day compared to control.

A liver injury could impair the integration of the body’s organ system, which may cause complications that can lead to death. The dried red jujube fruit extract has the potential to protect the liver from toxic substances through its antioxidant properties. To determine and analyze the hepatoprotective effect of dried red jujube fruit extract on aminotransferase levels against acetaminophen-induced acute hepatotoxicity. Male Wistar rats were divided into five groups. The negative control group (G1) received carboxymethylcellulose sodium (CMC-Na) 1%. The positive control group (G2) received acetaminophen. The treatment group G3 received dried red jujube fruit extract 70 mg/kg BW + acetaminophen, G4 received dried red jujube fruit extract 140 mg/kg BW + acetaminophen, and G5 received dried red jujube fruit extract 280 mg/kg BW + acetaminophen. Dried red jujube fruit extract was given for 10 consecutive days. Acetaminophen (3 g/kg BW) was given on the ninth day. Blood samples were collected, and aminotransferase levels were measured on the 11th day. Kruskal-Wallis comparison test showed significant differences (p < 0.01) between all groups on alanine aminotransferase (ALT; p = 0.003) and aspartate aminotransferase (AST; p = 0.001) levels. Mann-Whitney post hoc test showed significant differences (p < 0.01) between G2:G3, G2:G4, and G2:G5 groups on ALT and AST levels. Pearson correlation test showed a significant negative correlation (p < 0.01; r = -1) between all given doses of dried red jujube fruit extract on ALT (p = 0.000; r = -0.778) and AST (p = 0.000; r = -0.774) levels. The dried red jujube fruit extract has a hepatoprotective effect on aminotransferase levels against acetaminophen-induced acute hepatotoxicity at 70 mg/kg BW, 140 mg/kg BW, and 280 mg/kg BW (the most effective dose), and there was a negative correlation between all doses and the aminotransferase levels.