Bioactivity, phytochemistry studies and subacute in vivo toxicity of ethanolic leaf extract of white mulberry (Morus alba linn.) in female mice

ETHNOPHARMACOLOGICAL RELEVANCE

Traditional uses of Morus alba L. leaf extracts (MLE) have been reported for treating hyperglycaemia and diabetes. Phytochemical compounds in the leaves demonstrated the ability to enhance insulin sensitivity and β-cell secretory function, suggesting their potential value in reducing blood glucose and treating diabetes. However, the phytochemical constituents and safety of the herbal medicines need to be verified in each experimental field from different growing areas. Studies on the phytochemistry and toxicity of Morus alba leaves in Southeast Asia, especially in Brunei, have never been investigated.

AIM OF THE STUDY

This study aimed to investigate the bioactivity and phytochemistry of Morus alba ethanolic leaf extract from Brunei Darussalam and its subacute toxic effects in the Institute of Cancer Research (ICR) female mice.

MATERIALS AND METHODS

The phenolic yield and antioxidant of the extract were analysed. Meanwhile, liquid chromatography-mass spectrometry and high-performance liquid chromatography were utilised to determine the phenolic compound of the MLE. In the subacute toxicity study, twenty-five female mice were randomly divided into five groups: the control group, which received oral gavage of 5% dimethyl sulfoxide solvent (DMSO), and the MLE treatment group, which received the extract at a dose of 125, 250, 500 and 1000 mg/kg. Physiology, haematology, biochemistry, and histology were evaluated during the study.

RESULTS

Morus alba leaf depicted total phenolic 10.93 mg gallic acid equivalents (GAE)/g dry weight (DW), flavonoid 256.67 mg quercetin equivalents (QE)/g DW, and antioxidant bioactivity content of 602.03 IC50 μg/mL and 13.21 mg Fe2+/g DW. Twenty compounds in the Morus alba ethanolic leaf extract were identified, with chlorogenic acid (305.60 mg/100 g DW) as the primary compound. As for subacute toxicity in this study, neither mortality nor haematological changes were observed. On the other hand, administration of 500 and 1000 mg/kg MLE resulted in mild hepatocellular injury, as indicated by a significant (p < 0.05) increase in liver enzyme activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The histopathological score showed mild hepatocellular necrosis in administering 250, 500, and 1000 mg/kg of MLE. The parameters of renal injury were within normal limits, with the increase in eosinophilic cytoplasm observed in the histological scoring at 1000 mg/kg of MLE.

CONCLUSIONS

Morus alba leaf extract showed abundant polyphenols. In a study on subacute toxicity, MLE caused mild hepatotoxicity in mice. The toxic effect of the extract may be due to kaempferol and chlorogenic acid compounds. The 125 mg/kg MLE dose was safe with no adverse effects.

COVID-19 Pandemic is Associated With Increased Prevalence of GERD and Decreased GERD-related Quality of Life: Analysis From 9800 Participants in the Indonesian GERD-Q Study

INTRODUCTION

The prevalence of gastroesophageal reflux disease (GERD) is expected to increase during the pandemic due to unexpected, sudden lifestyle changes such as decreased physical activity and worsening mental conditions. Here, we aim to explore the difference in the prevalence of GERD and GERD-related quality of life (QoL) in Indonesia during the COVID-19 pandemic compared with before the COVID-19 pandemic.

METHODS

Retrospective analysis of the Indonesian GERD Questionnaire study, a cross-sectional study utilizing an online form of the GERD Questionnaire, was done to compare the prevalence of GERD between March 2, 2018 to March 1, 2020 (prepandemic group) and March 2, 2020 to March 1, 2022 (pandemic group). The prevalence odds ratios between the 2 groups were calculated using χ 2 .

RESULTS

A total of 9800 participants were included in the analysis; 1807 and 7993 were allocated to the pandemic and prepandemic groups, respectively. The prevalence of GERD in the pandemic and prepandemic groups were 67.9% and 61.8%, respectively (prevalence odds ratio: 1.31; 95% CI: 1.17-1.46).

CONCLUSION

During the COVID-19 pandemic, the prevalence of GERD, heartburn, and those who reported impaired GERD-related quality of life increased. Regurgitation was the most common symptom reported by participants.

Hematological, biochemical, and histopathological evaluation of the Morus alba L. leaf extract from Brunei Darussalam: Acute toxicity study in ICR mice

Background

Studies have reported that the phytochemical content of Mulberry (Morus alba Linn.) is influenced by the area where it grows. On the other hand, the study of the bioactivity and toxicity of mulberry leaves from Brunei Darussalam still needs to be completed. In particular, the investigation regarding the safe dose for Mulberry's application from Brunei Darussalam has yet to be studied. Hence, toxicity information must be considered even though the community has used it for generations.

Aim

This study investigated Morus alba ethanolic leaf extract (MAE) to observe the acute toxicity in mice.

Methods

In particular, this study utilized 12 female Institute of Cancer Research mice, 8 weeks old, divided into 2 groups: the control group and the MAE group (2,000 mg/kg single dose). Physiology, hematology, biochemistry, and histology were analyzed during the study.

Results

The examination result indicated no mortality and behavioral changes throughout the testing period. However, the mice developed mild anemia and leukopenia, followed by decreased numbers of neutrophils, lymphocytes, and monocytes. In addition, the mice developed a mild hepatocellular injury, indicated by significant (p < 0.05) elevations of both alanine aminotransferase (ALT) and aspartate transaminase (AST). The histopathological findings of the liver were also consistent with the increment of ALT and AST, indicating mild hepatocellular necrosis through the eosinophilic cytoplasm and pyknosis (p > 0.05).

Conclusion

It was evident that a single oral administration of MAE was not lethal for mice (LD50, which was higher than 2,000 mg/kg). However, the administration of high doses of MAE must be carefully considered.

Protective potential of fish oil supplementation against insulin resistance and pancreatic islet damage in STZ-induced Wistar rats

Background

Fish oil, which is regarded as the primary source of omega-3 fatty acids, has been long studied for its potential as an antidiabetic therapy. However, its protective ability against insulin resistance and pancreatic islet alteration remains unclear and controversial.

Aim

To investigate the beneficial effects of fish oil consumption on the progression of insulin resistance and pancreatic islet dysfunction in a rat model of diabetes.

Methods

Diabetic rats model (n = 30) were divided into five groups and received; 1) NS injection + NS oral (normal control); 2) NS injection + 3 g/kg fish oil (fish oil control); 3) streptozotocin (STZ) injection + NS oral [diabetes control (DC)]; 4) STZ injection + 1 g/kg fish oil (DFO1); and 5) STZ injection + 3 g/kg fish oil (DFO3). Fasting blood insulin was analyzed by commercial rat insulin enzyme-linked immunosorbent assay; meanwhile, the determination of insulin sensitivity was calculated by homeostatic model assessment of insulin resistance (HOMA-IR) and homeostatic model assessment of beta-cell function. A histological study was conducted on pancreas tissue using H and E staining.

Results

Fish oil supplementation reduced hyperglycemia and ameliorated HOMA-IR in STZ-induced animal models indicating that fish oil supplementation improved insulin sensitivity. Furthermore, animals treated with fish oil at a dose of 3 g/kg (DFO3) showed an enhancement in pancreatic islets, which was displayed by less abnormal structures than DC animals. This could imply that the administration of fish oil, especially rich in bioactive omega-3 fatty acids effectively inhibits insulin resistance and restore islet of Langerhans alteration in rats injected with STZ.

Conclusion

Thus, the current study suggested that fish oil supplementation could support the treatment of diabetes but should not be considered as an alternative therapy.

Relationship between the attitudes of biology education students towards statistics with knowledge of data analysis

Students' knowledge of data analysis determines the quality of the research they report but they tend to perceive courses on statistics or data analysis as challenging and unappealing. The present study aimed to investigate the correlation between biology education students' attitudes toward statistics and their proficiency in determining various data analytical techniques. This study involved biology education students from the Universitas Muhammadiyah Malang who had completed a course in statistics, research methods, and data analysis. The Survey of Attitudes Toward Statistics (SATS) and the Statistics Assessment of Graduate Students (SAGS) were used sequentially as instruments for collecting data on student attitudes toward statistics and data analysis competencies. The results revealed that while most students had positive attitudes toward statistics, they perceived the subject as challenging to learn. Additionally, the students demonstrated low levels of competency in data analysis. The aspects of cognitive competence and difficulty from SATS correlate significantly with their SAGS score. These results suggest that there is a need for a revision of the biology education curriculum to better equip students with the skills and knowledge to increase their data analysis competencies.

Workshop Manajemen Bandwidth Jaringan Komputer RT/RW pada Mitra Knowledge Connecting Community Kota Bekasi

Jaringan komputer merupakan sebuah system yang tersetruktur untuk menghubungkan sebuah perangkat ke perangkat lainnya untuk dapat saling berkomunikasi tidak hanya sekedar untuk menghubungkan antar perangkat satu dengan perangkat lainnya pada jaringan komputer perlu dilakukannya manajemen untuk mengatur lalu lintas data agar tidak saling bertabrakan satu sama lain dan tidak berat sebelah agar semua orang data mengakses sebuah data tanpa perlu antri dan saling rebut bandwith untuk itu pada kegiatan pengabdian masyarakat sebelumnya bekerja sama dengan mitra Knowledge Connecting Community Indonesia Cerdas sudah dilakukan pembekalan dan workshop dalam merancang jaringan konfigurasi RT/RW Net dengan bahan evaluasi selama satu tahun ditemukan adanya permasalahan bahwa dalam mengakses internet user mengalamai ketidak seimbangan akses bilamana salah satu user sedang menggunakan aplikasi streaming makan beberapa user tidak dapat mengakses website karena kehabisan bandwidth oleh sebab itu Dosen Universitas Nusamandiri berserta mahasiswa aktif Kembali mengadakan kegiatan Workshop berdasarkan hasil evaluasi selama satu tahun dengan menejemen bandwidth pada sebuah jaringan komputer dengan menggunakan Mikrotik board agar semua akses bandwidth terbagi rata antar user sehingga dengan adanya kelanjutan dari kegiatan ini para peserta tidak hanya dapat membuat sebuah topologi jaringan komputer akan tetapi juga dapat memanajemen jaringan komputer khusunya pada studi kasus ini adalah pembagian bandwidth agar dapat menghasilkan jaringan yang merata kepada semua user.

Clinical Importance of Sarcopenia And How It Impacts Orthopaedic-Trauma Patients and The Surgical Outcomes

Highlights: Sarcopenia can cause deleterious effects on patients. The Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP) provide the most widely used criteria to diagnose sarcopenia. Knowledge of sarcopenia should be a trigger for clinicians and surgeons to evaluate the treatment plan and anticipate the implications experienced by the patients.   Abstract: Sarcopenia is a condition of low muscle strength, mass, and low physical performance that is affected by age (primary sarcopenia) and one or combination of systemic diseases, physical inactivity, and insufficient intake of energy (secondary sarcopenia). This condition affects one in ten healthy adults aged ≥60 years. There are two widely used criteria to diagnose sarcopenia, the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP). These working groups created algorithms to facilitate the diagnosis. Establishing the diagnosis is crucial because it has deleterious impacts on patients, such as increasing risks of mortality, morbidity, falls, complications during and after surgery, disability, prolonged hospitalization, and fractures. Sarcopenia is considered an independent mortality risk. It is paramount for physicians to assess this condition before treating the patients because it can predict the risk and plan better treatment options to achieve better outcomes. Early assessment is crucial, even for surgeons. Sarcopenia also negatively impacts patients who had surgery. Up to 44% patients who underwent orthopedic trauma surgery had sarcopenia. The high percentage was affected by the increased risk of falls and fractures. On that account, this condition needs to be treated. The main treatments for this condition are exercise dan adequate nutrition intake. The recommended exercise as a first-line treatment is resistance or strength training. Overall, knowledge on sarcopenia can prepare clinicians and surgeons in anticipating the implications of sarcopenia.

Gender-based and grade-level mapping of student genetic literacy in the midst of the covid-19 pandemic

The Covid-19 pandemic has resulted in the face-to-face teaching and learning process being shifted to distance learning which has the potential to affect student literacy levels. This quantitative study aims to determine the effect of gender and grade level on the genetic literacy of high school students in Malang. This survey research used a statement instrument as many as 17 items involving 97 students. Data collection was carried out from November to December 2021. The sampling technique used was cluster random sampling. The research data was tested using a Two-Way ANOVA analysis. The results showed that gender did not have a significant effect on genetic literacy, while class level has significant effect. Furthermore, gender and class level did not have a significant interaction. Further research that examines the effect of other variables on genetic literacy needs to be done.

Effects of Amnion Lyophilization Sterile Radiation against the Number of Osteoblasts and Osteocytes in Nonunion Fractures: An Experimental Research Study

Background: This study used an experimental posttest-only control group design that involved white rats of the Sprague Dawley strain. Methods: The samples used were 8-week-old rats, weighing 250–350 grams of the male sex. The study was conducted on five groups of rats with a total of seven rats per group. Results: The mean value of osteocytes in the control group was 00.00 ± 00.00 and in the ALSR group it was 87.14 ± 44.85. The mean value of osteoblasts in the control group was 50.06 ± 5.76 and in the ALSR group it was 283.63 ± 22.86. This study showed that there were differences in the number of osteocytes and osteoblasts in the two groups. Conclusion: The study reported that the ALSR group had significantly different numbers of osteoblasts and osteocytes than the control group.

Penerapan Strategi Digital Marketing Model AIDA dalam Pemberdayaan Masyarakat Kelompok Usaha Bersama (KUBE) Cakrawala, Rawalumbu, Kota Bekasi

Pandemi COVID-19 membawa dampak yang besar bagi para pelaku usaha, khususnya industri rumah tangga. Para pelaku usaha harus merubah cara pemasaran produk mereka agar bisa tetap bertahan. Kelompok Usaha Bersama (KUBE) Cakrawala adalah salah satu pelaku usaha berbasis industri rumah tangga yang mencoba untuk mengalihkan strategi pemasaran produknya secara online melalui sosial media. Namun, upaya tersebut belum berjalan dengan optimal karena kurangnya pengetahuan mereka tentang cara memaksimalkan pemasaran produk melalui sosial media dan strategi digital marketing. Tujuan dari pengabdian ini adalah untuk memberikan solusi terkait permasalahan yang dihadapi oleh KUBE Cakrawala dengan cara mengadakan pelatihan digital marketing agar upaya pemasaran produk mereka kian maksimal. Metode yang digunakan pada kegiatan pengabdian terdiri dari dua tahap, yaitu pertemuan secara online dengan para anggota KUBE Cakrawala untuk memberikan materi tentang digital marketing dan pertemuan secara tatap muka untuk mempraktekkan materi yang telah dipelajari. Hasilnya dalam beberapa pekan, para anggota KUBE Cakrawala mampu memiliki pengetahuan tentang strategi digital marketing, mengembangkan kemampuan mereka dalam membuat konten promosi produk yang menarik, dan memperluas jangkauan pemasaran produk.

Indonesia medical students' knowledge, attitudes, and practices toward COVID-19

Implementing health protocols and preventive measures are the only effective ways to suppress COVID-19 transmission before vaccines and antiviral drugs are developed. The implementation of health protocols and preventive measures are influenced by one's knowledge, attitudes, and practices (KAP) toward this pandemic. Medical students as candidates for healthcare workers and role models for the community should have a good KAP. This study intends 1) to explore the KAP of medical students in Indonesia toward COVID-19 and 2) to assess which demographic factors have a significant effect on their KAP scores. An online questionnaire consisting of 18 items of knowledge, six items of attitudes, and 12 items of practices were used as instruments in this study. After being distributed for two weeks in June 2020, 525 respondents whose data were worth analyzing were obtained. The respondents consisted of male and female students, from diploma to bachelor degree, and came from all four types of higher education institutions in Indonesia. The results, 48% of respondents had good knowledge, 81% had good attitudes, and 43.5% had good practices toward COVID-19. The location of students' residence has no significant effect on their KAP score. Gender has a significant effect on knowledge and practice scores. Age, institution type, and institution status have a significant effect on their three KAP domains. The KAP survey results can be used as a reflection of the importance of the curriculum that prepares medical students for the pandemic. Medical students are also expected to be able to actively participate in educating people around them on how to minimize the transmission of COVID-19 during the pandemic.

Epidemiology, treatment, and recurrence of odontogenic and non-odontogenic cysts in South Sulawesi, Indonesia: A 6-year retrospective study

Background

Diagnosis of jaw cysts is challenging in general dental practice, and most cases are incidentally discovered through routine dental radiography. The aim of this study was to examine the epidemiology and treatment of odontogenic and non-odontogenic cysts to better understand the status of these lesions in populations in South Sulawesi, Indonesia.

Material and Methods

This retrospective study was conducted on patients treated at four different hospitals in Makassar between January 2011 and June 2017. Patients diagnosed as having odontogenic or non-odontogenic cysts were included in the study. Information on variables such as sex, age, histopathological, and anatomical distributions was collected. Statistical analyses were performed using an independent T-test and the Pearson chi-square test (p< 0.05).

Results

A total of 173 samples were collected, of which only 60 were histopathologically analyzed. The patients’ mean age was 30.3 years. The cysts occurred more frequently in women and in the anterior maxilla, followed by the posterior mandible. The radicular cyst was the most prevalent type, followed by the dentigerous cyst. Most cysts were treated with enucleation. Of the patients, 72.8% were followed up, of whom 3.2% had a recurrence and only 19.1% had complaints of clinical symptoms.

Conclusions

Our findings indicate that odontogenic and non-odontogenic cysts widely vary in terms of incidence, with some exhibiting a predilection for specific ages and sites and specific sex. Knowledge of these factors could be useful for both clinicians and pathologists in the diagnosis and choice of the appropriate treatment plan.

Key words:Cyst, epidemiology, odontogenic, non-odontogenic, treatment.

Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Urine as a Potential Non-Invasive Method for Determine Kidney Damage in Predialysis Patients

NGAL expression in acute kidney failure is well known. It is approved that NGAL expression occurs earlier than the level of BUN and creatinine in acute kidney failure. NGAL is not only expressed in the blood but also in the urine, where urine collection has many advantages over blood collection. This study aims to observed the expression of NGAL in predialysis patients and to determine the correlation between NGAL serum and NGAL urine of patients. The sample was taken from healthy persons as control and predialysis patients. The examination of BUN, creatinine, and urinalysis were done to approve the diagnose in predialysis patients. While NGAL in serum and urine were analyzed using the Enzyme-Linked Immunoabsorbent Assay (ELISA). The results showed that the concentration of NGAL in serum was higher in the predialysis patients compared to the healthy subjects (p<0.05). There was a strong positive correlation between the NGAL in the serum and the NGAL in the urine (r= 0.98 and p<0.000). It is concluded that the non-invasive examination of NGAL in urine can be choose rather than using serum NGAL. However, it must be noted that NGAL could be used for chronic renal failure in predialysis patients as long as other biomarkers have been proven.

The difficulty index of biology topics in Indonesian Senior High School: Biology undergraduate students’ perspectives

Biology is a subject that contains of many difficult concepts to study. This study aimed to identify Biology topics taught in Senior High School (SHS) which were considered as difficult materials by undergraduate students. The data were gathered by means of a web-based survey from 198 Biology students of 25 universities and 51 Biology education students of nine universities in Indonesia. The biology students graduated from SHSs in 97 regions/municipality, while the biology education students were graduated from 34 regions/municipality. The data were analyzed using two formulas: 1) Biology Difficulty Index (BDI) to determine the difficulty index of Biology subject, and 2) Topic Difficulty Index (TDI) to examine the difficulty index of each Biology topics. The results showed that the highest value of TDI was Genetics. There was no significant difference of BDI between Biology students and Biology education students. The lower of the students’ BDI, the higher the level of their interest in Biology subject. The primary cause of difficulty encountered by the students in studying various topics of Biology was the complicated characteristics of the materials. The findings of this study can be followed up by designing diagnostic tests and instructional designs in biology topics which consider students’ difficulty.

How Universities Entrust Digital Literacy to Improve Student Learning Outcomes During the COVID-19 Disruption

Since the policy of sending students home to study as a result of responding to the dangers of the pandemic, universities around the world have increasingly trusted distance learning solutions. The solution was to rely on digital literacy to continue and improve student learning outcomes during the COVID-19 disruption. For this reason, the researchers have proven it through analytical efforts and in-depth studies in several international publications. In short, the researchers examined each piece of evidence with a phenomenological approach to get answers to research questions that are among other things, involve a data coding system, critical evaluation, and drawing of valid and reliable final results. The data discussion concludes that world universities believe that digital technology that was increasingly trending can become a learning innovation even though the world will continue to hit global education. Hence, the researchers hope that these findings should support other studies in the future. Keywords: Digital Literacy, Learning Outcomes, Entrust Digital Literacy

Larvicidal toxicity and parasporal inclusion of native Bacillus thuringiensis BK5.2 against Aedes aegypti

OBJECTIVES

Native Bacillus thuringiensis BK5.2, isolated from soil of Baluran National Park, East Java, Indonesia, has been shown to be toxic against Aedes aegypti larvae. This study aims to determine the strength and the speed of the toxicity of B. thuringiensis BK5.2 against A. aegypti larvae in lethal concentration (LC) and lethal time (LT), as well as detection of toxin structure and parasporal inclusion.

METHODS

LC values were determined by the mortality of A. aegypti third instar larvae after 24 and 48 h exposure to five various concentrations of B. thuringiensis BK5.2, while LT values were determined based on the mortality of A. aegypti third instar larvae due to exposure to LC₉₀ concentration at 0; 0.5; 1; 2; 4; 8; 10; 20; 24; and 48 h. Larvicidal toxicity was determined based on value of LC₅₀ and LC₉₀ (CFU/mL), as well as LT₅₀ and LT₉₀ (hours) analysed ​​with Probit analysis. Parasporal inclusion was detected using transmission electron microscope (TEM) and scanning electron microscope (SEM).

RESULTS

Based on bioassay, LC₅₀ and LC₉₀ values ​​were 11.6 × 10⁶ and 22.7 × 10⁶ CFU/mL, respectively, at 24 h exposure, as well as 8.3 × 10⁶ and 15.4 × 10⁶ CFU/mL, respectively, at 48 h exposure, while the value of LT₅₀ and LT₉₀ were 19.0 and 26.6 h, respectively. Morphological observation of the dead larvae showed there was damage on abdomen and thorax region. Detection by TEM and SEM showed there was cuboidal parasporal inclusion.

CONCLUSIONS

Native B. thuringiensis BK5.2 has high toxicity against A. aegypti larvae and detected flatcuboidal toxin in parasporal inclusion.

Polyphosphate (PolyP) for alveolar cleft repair: study protocol for a pilot randomized controlled trial

Objective

Bone grafting is an important surgical procedure to restore missing bone in patients with alveolar cleft lip/palate, aiming to stabilize either sides of the maxillary segments by inducing new bone formation, and in bilateral cleft cases also to stabilize the pre-maxilla. Polyphosphate (PolyP), a physiological polymer composed of orthophosphate units linked together with high-energy phosphate bonds, is a naturally existing compound in platelets which, when complexed with calcium as Ca-polyP microparticles (Ca-polyP MPs), was proven to have osteoinductive properties in preclinical studies.

Aim

To evaluate the feasibility, safety, and osteoinductivity of Ca-polyP MPs as a bone-inducing graft material in humans.

Methods

This prospective non-blinded first-in-man clinical pilot study shall consist of 8 alveolar cleft patients of 13 years or older to evaluate the feasibility and safety of Ca-PolyP MPs as a bone-inducing graft material. Patients will receive Ca-polyP graft material only or Ca-polyP in combination with biphasic calcium phosphate (BCP) as a bone substitute carrier. During the trial, the participants will be investigated closely for safety parameters using radiographic imaging, regular blood tests, and physical examinations. After 6 months, a hollow drill will be used to prepare the implantation site to obtain a biopsy. The radiographic imaging will be used for clinical evaluation; the biopsy will be processed for histological/histomorphometric evaluation of bone formation.

Discussion

This is the first-in-man study evaluating the safety and feasibility of the polyP as well as the potential regenerative capacity of polyP using an alveolar cleft model.

Trial registration

Indonesian Trial Registry INA-EW74C1N. Registered on 12 June 2020

REPRODUCTIVE CYCLE OF FEMALE JAVAN LANGUR (TRACHYPITHECUS AURATUS) BASED ON ESTROGEN AND LUTEINIZING HORMONE LEVELS

Currently, the information about Javan langurs female reproductive cycle in both cycle length and hormonal patterns is still widely unknown. Meanwhile, this information can be used as a guide in determining the fertile period of Javan langurs to conduct mating with higher pregnancy rate. The purpose of this study was to determine the reproductive cycle of adult female Javan langurs based on estrogen and luteinizing hormone (LH) levels. The experimental animals was originated from Coban Talun forest in Batu, which was undergoing a rehabilitation program. Feces samples of two female Javan langurs were taken for 40 days. Examination of estrogen and LH hormone levels in the feces was carried out by the enzyme-linked immunosorbent assay (ELISA) method and then analyzed descriptively. The results showed that fluctuations in the graphs of the hormones estrogen and LH appeared on days 8 to 16 and days 30 to 40 which showed the existence of two reproductive cycles. Whereas younger langur showed a pattern of hormonal fluctuations that are less regular, making identification of the reproductive cycle difficult. Based from the results, we concluded that the reproductive cycle of female Javan langur was estimated about 24 days with a hormonal pattern consisting of the follicular phase, the ovulation period and the luteal phase.

Anti-diabetic medication burden amongst older persons with diabetes and associated quality of life

BACKGROUND

Older persons with diabetes are the major demographic of diabetic patients followed up in primary health clinics. Despite their increasing age and morbidities, they are still being managed strictly towards good sugar control in order to achieve the ideal HbA1c level without taking their quality of life into consideration. This study aimed to determine the prevalence in the use of antidiabetic drugs among older persons with diabetes and its association with their quality of life.

METHODOLOGY

A cross-sectional study was conducted among 269 older persons with diabetes in all government health clinics in Kuantan using Diabetes Quality of Life questionnaire. SPSS version 23 was used for the statistical analysis.

RESULTS

Majority of the respondents were females (61%), Malays (84.8%), pensioners (54.3%) with education up to primary school (52%) and are staying with family members (93.7%). Most of the patients were on two antidiabetic agents (48%) followed by a single antidiabetic agent (32%). Despite the risk of hypoglycaemia, 0.4% of them are on glibenclamide. The use of insulin is still common among 21% of them that are on intermediate-acting insulin, 15.6% on premixed insulin and 7.8% on short-acting insulin. Those taking a higher number of antidiabetic agents were found to be associated with poorer quality of life (p=0.001) compared to those taking one or two antidiabetic medications. Those on insulin also have significantly poorer quality of life score (p=0.012).

CONCLUSION

Despite aiming for controlled diabetes, older persons suffer poor quality of life with further intensification of their antidiabetic medications according to the guidelines. This includes the complexity of insulin usage and polypharmacy, which contribute to the low quality of life score.

Survey data of COVID-19-related knowledge, attitude, and practices among indonesian undergraduate students

The dataset presented in this paper is an examination of COVID-19-related knowledge, attitude, and practice among Indonesian undergraduate students. The data were collected during first month of college or university closure due to COVID-19 through a survey distributed via an online questionnaire, assessing sociodemographic information (6 items), knowledge (18 items), attitude (6 item), and practice (12 items), from 27^th April and 2^nd May 2020, gathering a total of 6,249 responses. A combination of purposive and snowball techniques helped to select the respondents via Whatsapp from more than ten universities in Indonesia. The survey data were analyzed using descriptive and inferential statistics. The data will assist in preventing and curbing the spread of COVID-19 in the university and can assist with planning for educational interventions for students’ awareness.

A superhydrophilic bilayer structure of a nylon 6 nanofiber/cellulose membrane and its characterization as potential water filtration media

A bilayer structure of a nylon 6 nanofibrous membrane on a cellulose membrane has been successfully developed for water filter application. The nylon 6 nanofibrous membrane was deposited on the cellulose membrane via the electrospinning technique. The bilayer membrane properties, including mechanical strength, wettability, porosity, and microfiltration performance (flux and rejection), were thoroughly investigated. The membrane properties were studied using nylon 6 nanofibrous membranes having various fiber diameters and membrane thicknesses, which were obtained by adjusting the solution concentration and spinning time. The measurement of solution parameters, i.e., viscosity, conductivity, and surface tension, showed a strong relationship between the solution concentration and these parameters, which later changed the fabricated fiber sizes. The FTIR spectra depicted complete solvent evaporation after the electrospinning process. Smaller nanofiber diameters could improve the mechanical strength of the membranes. The porosity test showed a strong relationship between the nanofiber diameter and the pore size and pore distribution of the membranes. The water contact angle measurement showed the significant influence of the cellulose membrane on increasing the hydrophilicity of the bilayer structure, which then improved the membrane flux. The particle rejection test, using PSL sizes of 308 and 450 nm, showed high rejection (above 98%) for all sample thickness variations. Overall, the bilayer structure of the nylon 6 nanofibers/cellulose membranes showed excellent and promising performance as water filter media.

The SEM image of (a) cellulose membrane and (b) the bilayer structure of a nylon 6 nanofibrous membrane on a cellulose membrane as water filter media.

Critical thinking, metacognitive skills, and cognitive learning outcomes: a correlation study in genetic studies

Understanding the concept of genetics needs to be balanced with high-level thinking skills and excellent metacognitive skills. However, efforts to measure the correlation between these two factors are still carried out partially. This study aims to determine the correlation between critical thinking, metacognitive skills, and cognitive learning outcomes in genetic studies. This study is correlational that measures the relationship between variables students’ critical thinking skills (X1), metacognitive skills (X2), and students’ cognitive learning outcomes (Y). As much as 118 students who took the genetic course were involved as the population as well as research subjects. Data collection instruments in this study consisted of tests of critical thinking skills and metacognitive skills tests as well as students' cognitive assessment sheets. The results showed that the achievement of student cognitive learning outcomes was influenced by 94% of the dependent variables examined in this study, while other variables influenced the remaining 6%. The conclusion of this study recommends that the regression models and coefficients used in this regression can be used to predict cognitive learning outcomes.

The utilization of a commercial gloss spray in stabilization of incinerated dental structures

PURPOSE

Incinerated human remains may require dental comparison to establish identity. The remains are often fragile and minor forces can damage teeth and facial bones, disrupting anatomical relationships, and impairing the ability to compare with antemortem records. This study evaluated the ability of a commercially available gloss spray to stabilize teeth in incinerated remains.

METHODS

Lower anterior teeth of scavenged sheep mandibles were incinerated in a furnace at a temperature of 500 °C for 35 min. Before a series of vibration tests, the left side of each sample was treated with the spray, with the right side acting as a control.

RESULTS

Significant retention of dental data was achieved utilizing the spray in comparison to the non-stabilized sides.

CONCLUSION

This study showed that a commercial clear gloss spray did not affect the ability to document or perform radiographic assessment of restorations, and statistically improved the stability and anatomical relationships of incinerated dental remains in scavenged sheep mandibles. Commercial products, such as the one tested in this study, are readily available and could be deployed at a mass disaster situation. However, the spray should not be used if there is any suspicion that accelerants might be involved at the scene.

The effectiveness of endoscopic retrograde cholangiopancreatography in the management of patients with jaundice at Cipto Mangunkusumo Hospital, Jakarta

AIM

to evaluate endoscopic retrograde cholangiopancreatography (ERCP) benefits in treating patients with clinical appearance of yellowish discoloration.

METHODS

a descriptive retrospective cross-sectional study was performed on 122 patients at Cipto Mangunkusumo Hospital from January 2008 to December 2010. The main complained was yellowish discoloration of the skin. ERCPs were performed as appropriate, and then the distribution of disease entity, results of procedure and complications were noted.

RESULTS

subjects of this study consist of 63 males (52%) and 59 females (48%), 7 patients have undergone ERCP 2 times. Data showed 63 cases (51%) were indicated by stone and 52 cases (43%) by tumor/mass and 7 cases by infection (6%). Ten out of 122 cases (7%) showed normal results. Difficult canulation was encountered in 23 cases (18%) as access to the CBD could not be obtained. From 53 cases with stone, the extraction was successful in 43 (81%) including while 12 procedures with high grade of difficult ERCP left stone remnants (23%), and the remaining 10 procedures entailed stones retention (19%). Radioopaque stones found in 2 cases (4%) and radioluscent in 51 cases (96%). Stent placement was done in CBD (30 cases, 83%), pancreatic duct (4 cases, 11%), and extraneous CBD (2 cases, 5%). Complications found 3 cases (2%) migration stent outside CBD in 2 cases, 1 case with crand radioluscentin 51 acked basket.

CONCLUSION

ERCP procedure is really helpful in assisting clinicians to diagnose and manage therapeutic measures, especially in pancreaticobilliar tract disorder, while performing stone extraction and stent placement.

The value of fecal tumor M2 pyruvate kinase as a diagnostic tool for colorectal cancer screening

AIM

to evaluate the performance of fecal tumor M2 pyruvate kinase (M2PK) as a diagnostic biomarker for colorectal cancer (CRC) screening in high-risk or symptomatic populations.

METHODS

consecutive patients (N=328) who were referred for elective colonoscopy were prospectively enrolled. One walnut-sized stool sample was collected from each patient for analysis of tumor M2PK content using an ELISA kit. No dietary restrictions were applied. The clinical pathologists who conducted the M2PK analyses were blinded to the patients' confirmed diagnoses. Levels of fecal tumor M2PK were compared with histopathological results from colorectal biopsies.

RESULTS

of the 328 patients who underwent colonoscopy examinations, 197 (60.1%) were men and 131 (39.9%) were women. Based on histopathological examination, 83 (25.3%) patients had normal bowel histology, 42 (12.8%) patients had CRC, 67 (20.4%) patients had adenoma, 19 (5.8%) patients had inflammatory bowel disease, three (0.9%) patients had amoebic colitis, and 114 (34.8%) patients had infective colitis. The cutoff level for tumor M2PK concentration was defined as 4.00 U/mL. The sensitivity, specificity, positive predictive value, and negative predictive value of the M2PK test were 71.4%, 71.0%, 73.5%, and 94.4%, respectively. There was a significant association between CRC and fecal tumor M2PK level (P<0.001). The M2PK test detected 16 tumors among 67 (23.9%) cases of adenoma, eight tumors among 19 (42.1%) cases of inflammatory bowel disease, 35 tumors among 114 (30.7%) cases of infective colitis, and two tumors among three (66.7%) cases of amoebic colitis.

CONCLUSION

the fecal tumor M2PK test has good sensitivity and specificity for CRC detection, especially in high-risk or symptomatic populations.

Molecular profile of colorectal cancer in Indonesia: is there another pathway?

Colorectal cancer is an emerging public health problem in Indonesia and currently ranks among the three highest cancers. Lack of a colonoscopy screening and lifestyle changes might contribute to it. In the last few decades, there is an increasing interest towards the contribution of genetic-environment interaction in colorectal carcinogenesis. Some studies have indicated that CRC might develop through several different pathways; the three major routes are chromosomal instability (CIN), microsatellite instability (MSI), and inflammatory pathways. An earlier study on clinical epidemiology of CRC in Indonesia showed that the majority of patients were diagnosed between 45 and 50 years old, with a mean age around 47 years old. Further studies showed that most young Indonesian cases of CRC do not have hereditary characteristics; however, the CRC did not follow the conventional pathways of sporadic CRC (the CIN) pathway. Rather, it is a mixed of MSI and inflammatory pathways. Immunohistochemical studies showed that the proportion of patients with negative mismatch repair proteins was 43.5% for MSH2 and 83.5% for MLH1. Along the sporadic colorectal carcinogenesis pathway, there was a specific role of cyclooxygenase-2 (COX-2) enzyme during the polyp formation. COX-2 expression was reported in about 80% CRC cases worldwide. However, our study found only 49% of COX-2 expression among the CRC patients. Interestingly, an inflammatory marker, the nucleus factor κB (NF-κB), was expressed in about 73.5% cases, in line with a previous study. More recently, KRAS has been used as a potential tumor marker to select treatment and its expression was reported to be as high as 30%-40% worldwide. However, we found that KRAS gene expression was only 16.3%. Our findings support that CRC patients in Indonesian might follow a distinct pathway, a hypothesis that deserves further exploration.

Hypertensive retinopathy and sensorineural hearing loss

OBJECTIVE

To determine the correlation between hypertensive retinopathy (which is the end-organ damage of the vessels due to chronic hypertension) with sensorineural hearing loss.

METHODS

Pure tone hearing threshold of 56 hypertensive patients were compared with 56 normal age and sex matched control. Comparisons of pure tone hearing threshold are made among different group (grade) of hypertensive retinopathy patients and control (non-hypertensive patients).

RESULTS

The mean hearing thresholds were higher (worse) in all the frequencies on both sides in the hypertensive study group compared with normal subjects. However it was found to be statistically significant when tested using independent sample test (p < 0.05) on right ear at 2,000 Hz, 4,000 Hz and 8,000 Hz only. The mean hearing threshold is higher in all frequencies in the presence of retinopathy compared to control. However, the difference was found to be only statistically significant in the mean hearing threshold between grade I and control at 4,000 Hz and 8,000 Hz on both sides and at 1,000 Hz and 2,000 Hz on right ear. Hypertensive patient with grade I retinopathy had higher pure tone hearing thresholds at 4,000 Hz and 8,000 Hz compared to hypertensive without retinopathy and normal control.

CONCLUSIONS

Hypertensive retinopathy appears to be associated with high frequency sensor neural hearing loss.