Coal plays a crucial role in Indonesia's foreign exchange and East Kalimantan's revenue sharing, yet its environmental impacts, including soil acidification, raises concerns. Reclamation measures involve revegetation with pioneer plants such as Macaranga sp., known for their medicinal properties. However, the pharmacological properties of these plants are influenced by secondary metabolites, which depend on soil parameters such as pH and nutrient levels. The aim of this study was to evaluate the acute toxicity, secondary metabolites, and antioxidant activities of Macaranga tanarius leaf extracts from post-coal mining area (MTPCMA) and non-mining area (MTNMA) alongside soil parameters. Acute toxicity of M. tanarius leaf extracts and soils were assessed using the brine shrimp lethality test (BSLT). Phytochemical screening was done using thin-layer chromatography (TLC), determining total phenolic (TPC) and flavonoid content (TFC). The DPPH radical scavenging assay was used to assess the antioxidant activity. A comparative analysis between MTPCMA and MTNMA was conducted using Student t-test. The data showed no significant difference in toxicity between MTPCMA and MTNMA leaf extracts (LC50 of 100-1000 µg/mL) (p=0.062), and soils from both areas were non-toxic (LC50 of >1000 µg/mL). Although heavy metal concentrations were higher in PCMA than in NMA soil (p<0.001), secondary metabolite compounds and TFC in both extracts were not significantly different (p=0.076). Both extracts contained flavonoids and polyphenols with antioxidant activity and terpenoids without antioxidant activities. The DPPH radical scavenging test suggested insignificant antioxidant activity between MTPCMA and MTNMA extracts (p=0.237). In conclusion, non-toxic soils in post-mining land and insignificant differences between MTPCMA and MTNMA extracts suggest good soil nutrient availability, highlighting the success of land recovery after 10 years of revegetation with M. tanarius.
Clinical manifestations of neonatal sepsis are often unspecified. Therefore, sepsis biomarkers could be used to support diagnosis while waiting for blood culture results, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). The aim of this study was to evaluate the role of NLR and PLR as diagnostic markers in neonatal sepsis. A cross-sectional study was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, from April to October 2019. This study included neonates aged less than 28 days, diagnosed with suspected sepsis, and had no previous history of antibiotics administration. Patients underwent clinical assessment, laboratory examination, and blood culture. Patients were grouped into sepsis and non-sepsis based on the blood culture results. The median hematological examination and the range of NLR and PLR in both the sepsis and non-sepsis groups were subjected to analysis using the Mann-Whitney U test to assess differences. NLR and PLR optimal cut-off values were determined using a receiver operator curve (ROC) with a confidence interval of 95%. A total of 137 neonates were enrolled, of which 49 were classified as sepsis and 89 as non-sepsis based on blood culture results. The optimal cutoff values for NLR and PLR were 2.75 and 11.73. Using those cutoff values, NLR and PLR could predict neonatal sepsis with sensitivities of 52.1% and 47.9%, specificities of 50.6% and 47.2%, area under the curve (AUC) of 0.46 and 0.47, with p=0.525 and p=0.662, respectively. Further investigation is warranted to refine the NLR and PLR utility and enhance diagnostic accuracy in clinical practices.
Butterfly pea flower (Clitoria ternatea) may serve as an alternative anti-dandruff treatment; however, its effects on Malassezia spp. remain unexplored. The aim of this study was to explore the effects of C. ternatea as an herbal-based anti-dandruff treatment on Malassezia spp. DNA expression, plakoglobin levels, IL-8 levels, sebum levels, dandruff severity scores, adverse effects, and patient satisfaction. An experimental study with a pretest-posttest control design was conducted at the Outpatient Clinic of Dermatology and Venereology, Arifin Achmad Hospital, Pekanbaru, Indonesia, from November 2023 to January 2024. The flower of C. ternatea was used to formulate the shampoo. The study involved 70 female patients aged 18-25 with dandruff, who were divided into two groups: (a) experimental group using 20% C. ternatea shampoo and (b) control group using 2% ketoconazole shampoo. The present study found that 2% ketoconazole shampoo significantly reduced Malassezia spp. DNA expression compared to 20% C. ternatea shampooo (Clitoria ternatea: ΔCq=1.76±3.18; ketoconazole: ΔCq=3.77±2.90; p=0.008). No significant difference was observed in plakoglobin levels (C. ternatea: ΔCq=1.98±3.63; ketoconazole: ΔCq=2.50±2.36; p=0.427) or IL-8 levels (C. ternatea: ΔCq=3.46±4.00; ketoconazole: ΔCq=4.16 ± 3.62; p=0.459). C. ternatea significantly reduced sebum levels more than ketoconazole (C. ternatea: 1.16±0.98%; ketoconazole: 0.22±0.38%; p<0.001). Dandruff scores and patient satisfaction were similar for both shampoos (p=0.115 and p=0.336, respectively). Adverse effects were more common in the 2% ketoconazole shampoo group, affecting 21.2% of the patients. In conclusion, 2% ketoconazole shampoo is more effective in reducing Malassezia spp. DNA expression, while 20% C. ternatea shampoo offers better sebum control. Both shampoos are similarly effective in ameliorating dandruff severity and are well-tolerated, with fewer adverse effects reported for C. ternatea.
Recent studies highlighted the role of platelet-rich plasma (PRP) in progenitor cell homing, migration, and nerve cell regeneration while also inhibiting fibrosis and apoptosis in cavernous nerve injury (CNI). The aim of this study was to investigate the effect of PRP administration on axon and collagen regeneration in CNI. A true experimental study using a post-test-only control group design was conducted. Twenty-five male Wistar rats (Rattus norvegicus), weighing 200-300 grams, were divided into five groups: two control groups (sham procedure and negative control), and three experimental groups receiving local PRP, intraperitoneal PRP, and a combination of local and intraperitoneal PRP. The cavernous nerve was injured with a hemostasis clamp for one minute before 200 µL of 200 PRP was injected locally, intraperitoneally, or both, depending on the group. After four weeks, the rats were euthanized, tissue segments (2 mm) from each cavernous nerve and mid-penis were collected and analyzed for collagen density, axon diameter, and number of myelinated axons. Our study found that collagen growth was slower in CNI group without PRP (sham procedure) compared to all PRP groups (local, intraperitoneal, and combination). The intraperitoneal PRP group had the highest collagen density at 5.62 µm; however, no significant difference was observed in collagen density among all groups (p=0.056). Similar axon diameter was found across the groups, with no statistically significant difference observed (p=0.856). In the number of myelinated axons, a significant difference was found among all groups with significantly more axons in local PRP and combined local and intraperitoneal PRP groups compared to others (p=0.026). In conclusion, PRP administration improved the number of myelinated axons in CNI, suggesting PRP role in CNI regeneration and the potential for an innovative approach to treating erectile dysfunction associated with CNI.
Tuberculosis remains a significant global health issue, with spinal tuberculosis being a severe form of extrapulmonary tuberculosis. Despite the high morbidity associated with spinal tuberculosis, effective and rapid diagnostic methods are limited. The aim of this study was to evaluate the diagnostic accuracy of the GeneXpert compared to other microbiological methods in diagnosing spinal tuberculosis. A systematic review and meta-analysis were conducted following the PRISMA guidelines. Six databases (PubMed, Scopus, EBSCO, EMBASE, ScienceDirect, and Cochrane Central) were searched for relevant studies as of August 31, 2023. Studies were selected based on predefined inclusion criteria, focusing on patients diagnosed with spinal tuberculosis and comparing GeneXpert to microbiological culture, acid-fast bacilli (AFB) staining, and polymerase chain reaction (PCR). Two authors independently performed data extraction and quality assessment, and the meta-analysis was conducted using Meta-DiSc 2.0. Fourteen studies comprising retrospective cohort, prospective cohort, and cross-sectional designs were included. GeneXpert demonstrated a pooled sensitivity of 92% (85-96%) and specificity of 71% (51-86%) compared to culture. AFB smear had the highest specificity at 80% (70- 88%) but the lowest sensitivity at 27% (20-35%). The PCR had sensitivity and specificity of 83% (67-92%) and 58% (31-81%), respectively. Substantial heterogeneity was noted across the studies. This study highlighted that GeneXpert had high sensitivity and moderate specificity in diagnosing spinal tuberculosis, making it an alternative to conventional methods. However, further validation through larger, interventional studies is necessary to standardize its use in clinical practice.
Musculoskeletal pain is one of the common symptoms of menopause syndrome throughout the world. Estradiol is the most potent and abundant derivative of estrogen and is associated with musculoskeletal pain, stiffness, and depressed mood during the menopausal transition. C-telopeptide is a molecule released during osteoclastic bone resorption and degradation of type I collagen, which is reported to have higher levels in individuals with musculoskeletal pain. An observational analytical study with a cross-sectional design was used in this research. Estradiol and C-telopeptide levels were measured in this study using enzyme-linked immunosorbent assay (ELISA). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire (NMQ) and the Menopause Quality of Life Questionnaire (MENQOL). Musculoskeletal pain was determined if the participant answered "yes" on questions number 12, 14 and 25 on the MENQOL. Data analysis was performed using the independent Student t-test for normally distributed data and the Mann-Whitney test for non-normally distributed data. A correlation test was performed using the Pearson correlation test for normally distributed data and the Spearman correlation test for non-normally distributed data. The results showed a non-significant relationship between estradiol and C-telopeptide levels with musculoskeletal pain assessed using the NMQ or MENQOL questionnaires. The correlation test also showed no correlation between estradiol and C-telopeptide levels in women with and without musculoskeletal pain.
Lantana camara Linn contains a diverse array of metabolites that exhibit therapeutic potential. The aim of this study was to evaluate the potential of L. camara leaves, which were collected at the Ie-Seu'um geothermal area in Aceh, Indonesia, as an anti-inflammatory through network pharmacology and in vitro analysis. The ethanolic extract derived from L. camara underwent identification utilizing gas chromatography-mass spectrometry (GC-MS) to verify chemical constituents for drug-likeness properties. The evaluation of anti-inflammatory activity included network pharmacology and a series of in vitro investigations using two methods: protein inhibition and albumin denaturation assays. The findings revealed that the extract contained a domination of terpenoids and fatty acids class, which met the evaluation criteria of drug-likeness. Network pharmacology analysis identified the top five key proteins (peroxisome proliferator-activated receptor gamma, prostaglandin G/H synthase 2, epidermal growth factor receptor, hypoxia-inducible factor 1-alpha, and tyrosine protein kinase-Janus kinase 2) involved in inflammation-related protein-protein interactions. Gene ontology enrichment highlighted the predominance of inflammatory responses in biological processes (BP), cytoplasm in cellular components (CC), and oxidoreductase activity in molecular functions (MF). In vitro analysis showed that the extract inhibited protein activity and protein denaturation with inhibitory concentration (IC50) values of 202.27 and 223.85 ppm, respectively. Additionally, the extract had antioxidant activity with DPPH- and ABTS-scavenging IC50 values of 140 ppm and 163 ppm, respectively. Toxicological assessment by brine shrimp lethality assay (BSLA), yielding a lethal concentration (LC50) value of 574 ppm (essentially non-toxic) and its prediction via ProTox 3.0 that indicated non-active in hepatotoxicity, carcinogenicity, immunotoxicity, mutagenicity, and cytotoxicity. These results suggested that L. camara holds noteworthy effectiveness as a potential candidate for complementary medicine in the realm of inflammatory agents, warranting further investigation in clinical settings.
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