Background: Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide and genetic mutation plays a vital role in CRC development. A previous study has suggested that genetic ...alterations among Indonesian patients with CRC might differ from those known in developed countries. This study aimed to describe the genomic profiles of Indonesian patients with CRC.
Methods: A total of 13 patients were recruited for this study from May to July 2019. Tissue samples were collected, and genomic DNA was extracted from the samples. AmpliSeq for Illumina Cancer HotSpot Panel v2 Next-generation sequencing was used for DNA sequencing and a genome analysis toolkit was used for local realignment around the discovered variants.
Results: A total of 45 genes comprising 391 single nucleotide variants (SNVs) with a depth >10 were observed. The genes with the most variants were STK11, SMAD4, EGFR, and ERBB4 and the genes with the most non-synonymous variants were SMAD4, TP53, FGFR3, CDKN2A, and STK11. Genes and SNVs in at least 90% of all samples consisted of 43 genes comprising 286 variants. Genes with the most non-synonymous SNVs were EGFR, SMO, FGFR3, TP53, STK11, CDKN2A. Genes related to the chromosomal instability pathway, such as TP53, SMAD4, KRAS, and APC, are also found in the analysis.
Conclusions: Our findings showed that all patients with CRC in this study had genetic mutations in the chromosomal instability pathway. Analysis of genetic mutation of Indonesian patients with CRC might be crucial for advanced targeted therapy and for better clinical outcomes.
Inflammation in chronic functional constipation (CFC) occurs systemically and has association with depressive symptoms. Biomarkers of inflammation can be assessed by the neutrophil to lymphocyte ...ratio and platelet to lymphocyte ratio. These inflammation biomarkers are stable, cheap, and widely available. This study aimed to determine the profile and the correlations between depressive symptoms and inflammation in CFC patients.
This cross-sectional study involved subjects aged 18-59 years with chronic functional constipation. We use validated Beck Depression Inventory-II (BDI-II) to assess depressive symptoms. We collected the data regarding complete peripheral blood examination, liver function, kidney function, electrolytes, and neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR). Bivariate analysis with Chi-Square test for categorical data and t-test or ANOVA test for numerical data. Multivariate analysis used logistic regression to look at risk factors for depression with p < 0.05 as a statistical significant level.
A total of 73 subjects with CFC were recruited with a mean age is 40.2 years, mostly women and working as housewives. Proportion of depressive symptoms in CFC patients was 73.0%, including mild depression 16.4%, moderate depression 17.8%, and severe depression (28.8%). The mean NLR in non-depressive subjects was 1.8 (SD 0.7), while in depressive subjects was 1.94 (SD 0.1) (p>0.05). The mean NLR in mild depression subjects was 2.2 (SD 1.7), in moderate depression was 2.0 (SD 0.7), and in severe depression was 1.9 (SD 0.5) (p>0.05). The mean PLR in non-depressive subjects was 134.3 (SD 0.1), whereas in depressive subjects it was 138.9 (SD 46.0) (p>0.05). The mean PLR in mild depression subjects was 142.9 (SD 60.6), in moderate depression was 135.4 (SD 41.2), and in major depression was 139.0 (SD 37.1) (p>0.05).
This study found that CFC patients were middle-aged, mostly women and working as a housewife. In general, biomarkers of inflammation were found to be higher in depressive subjects than non-depressive subjects, although not statistically significant.
The COVID-19 outbreak abruptly restricted gastrointestinal (GI) endoscopy services during the first wave of the pandemic. We aimed to assess the impact of COVID-19 on the practice of GI endoscopy in ...Asian countries.
This was an International Questionnaire-based Internet Survey conducted at multiple facilities by the International Gastrointestinal Consensus Symposium. A total of 166 respondents in Japan, China, Hong Kong, South Korea, Philippines, Thailand, Indonesia, and Singapore participated in this study.
The volume of endoscopic screening or follow-up endoscopies and therapeutic endoscopies were markedly reduced during the first wave of the pandemic, which was mainly attributed to the decreased number of outpatients, cancellations by patients, and adherence to the guidelines of academic societies. The most common indications for GI endoscopy during the first wave were GI bleeding, cholangitis or obstructive jaundice, and a highly suspicious case of neoplasia. The most common GI symptoms of COVID-19 patients during the infected period included diarrhea, nausea, and vomiting. The pandemic exacerbated some GI diseases, such as functional dyspepsia and irritable bowel syndrome. There were cases with delayed diagnosis of cancers due to postponed endoscopic procedures, and the prescription of proton pump inhibitors/potassium-competitive acid blockers, steroids, immunosuppressive agents, and biologics was delayed or canceled. The personal protective equipment used during endoscopic procedures for high-risk patients were disposable gloves, disposable gowns, N95 or equivalent masks, and face shields. However, the devices on the patient side during endoscopic procedures included modified surgical masks, mouthpieces with filters, and disposable vinyl boxes or aerosol boxes covering the head. Furthermore, the time for education, basic research, clinical research, and daily clinical practice decreased during the first wave.
This study demonstrated that the COVID-19 pandemic profoundly affected the method of performing GI endoscopy and medical treatment for patients with GI diseases in Asian countries.
"Background and Objectives: Using a linear programming approach, an optimized food-based recommendations (FBRs) had been formulated for Minangkabau women of reproductive age with dyslipidemia in ...Indonesia. This study aimed to assess the effectiveness of the promotion of the FBRs for improving dietary practices and nutrient intakes.
Methods and Study Design: A community-based, clustered-randomized trial was conducted among Minangkabau women of reproductive age (20-44 years) with dyslipidemia. The subjects were assigned either into the FBR group (n=48), or the non-FBR group (n=54). Baseline and end-line dietary data were assessed through interviews using a one-week semiquantitative food frequency questionnaire (SQ-FFQ) and two replicate 24-hour dietary recalls. The changes in dietary practice and nutrient intakes were analysed using ANCOVA test.
Results: Significant changes were observed (p<0.005) in the consumption of the promoted food items and subgroups (sea fish, soy protein, dark green leafy vegetables, and potatoes). Significant changes were also observed in nutrient intake, especially energy intake from carbohydrates and unsaturated fatty acids (total PUFA, MUFA, n-3 and n-6 fatty acids), as well as the dietary P/S ratio and fiber intake.
Conclusions: With current dietary practices, intakes of some typical problem nutrients such as n-6, zinc, iron, and fiber still could not achieve 100% of the RNIs, while the intake of SFA still exceeded the recommended intake. Further approaches are needed to expand the population food basket and promote behavioral change to address established cultural food habits, including reducing the use of cooking oil in food preparation and increasing vegetable consumption."
Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current ...role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience.
This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated.
Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and five cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively.
EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.
Dietary and plasma carboxymethyl lysine (dCML, pCML) and plasma tumor necrosis factor-α (pTNF-α) may be associated with obesity in affluent society. However, evidence in women from low-middle income ...countries with predominantly traditional diets is lacking. We investigated the mediator effects of dCML, pCML and pTNF-α on body mass index (BMI) and waist circumference (WC) among Indonesian women. A cross-sectional study was conducted among 235 non-diabetic, non-anemic and non-smoking women aged 19-50 years from selected mountainous and coastal areas of West Sumatra and West Java. Dietary CML, pCML, pTNF-α were obtained from 2 × 24-h recalls, ultra-performance liquid chromatography-tandem mass spectrometry and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by the Chi-square or Mann-Whitney test and mediator effects by Structural Equation Modeling. The medians and interquartile-ranges of dCML, pCML and pTNF-α were 2.2 (1.7-3.0) mg/day, 22.2 (17.2-28.2) ng/mL and 0.68 (0.52-1.00) IU/mL, respectively, and significantly higher in the WC ≥ 80 cm than in the WC < 80 cm group, but not in BMI ≥ 25 kg/m
compared to BMI < 25 kg/m
group. Plasma CML and pTNF-α were positively and directly related to WC (β = 0.21 95% CI: 0.09, 0.33 and β = 0.23 95% CI: 0.11, 0.35, respectively). Dietary CML that correlated with dry-heat processing and cereals as the highest contributions was positively related to WC (β = 0.33 95% CI: 0.12, 0.83). Ethnicity, level of education, intake of fat, and intake of energy contributed to dCML, pCML and pTNF-α, and subsequently affected WC, while only ethnicity contributed to BMI through dCML, pCML and pTNF-α (β = 0.07 95% CI: 0.01, 0.14). A positive direct effect of dCML on pCML and of pCML and pTNF-α on WC was seen among Indonesian women. Dietary CML seems to have several paths that indirectly influence the increases in WC if compared to BMI. Thus, intake of CML-rich foods should be reduced, or the foods consumed in moderate amounts to avoid the risk of central obesity in this population.
Background and Objectives: Annona muricata leaf infusion has traditionally been consumed to maintain health, but is now considered for use in treating cancer patients. The objective of this study was ...to elucidate the effects of 'A. muricata' leaf extract in humans and human cell lines.
Methods and Study Design: Thirty outpatients with colorectal cancer who had undergone primary tumor resection were enrolled in a randomized double-blind placebo- controlled pre-post-trial. They were divided into two groups: those who ingested 'A. muricata' leaf extract (n=14) and those who ingested a placebo (n=14) daily for 8 weeks. Twenty-eight subjects completed the trial; they were equally distributed between the two groups. Serum from patients of both groups was compared for cytotoxicity against colorectal cancer cell lines. The nutritional status of patients was monitored throughout the study.
Results: Ex vivo and clinical studies showed higher cytotoxicity in the supplemented group compared with the placebo group. Further research is required to investigate the long-term effect of 'A.muricata' leaf extract, particularly on parameters directly related to cytotoxic activity toward colorectal cancer cells and nutrition status.
Background: Helicobacter pylori is one of the most important infectious agents in the world. These bacteria infect 50% of the world population. Gastritis due to H. Pylori has been associated with the ...incidence of peptic ulcer, B cell primary lymphoma in the stomach, and gastric carcinoma. In dyspepsia, eradication of H. Pylori helps symptoms improvement and treatment cost efficiency. This study aimed to evaluate urease test in diagnosing H. Pylori infection in dyspepsia patients. It is expected that we could obtain a scientific evidence which can become the basis of routine use of urease examination in diagnosing H. Pylori infection.Method: This study used diagnostic study design. This study was performed in adult dyspepsia patients who underwent endoscopy examination in Gastrointestinal Endoscopy Centre Cipto Mangunkusumo General Hospital in January – November 2018. One biopsy sample was intended for rapid urease test using Helicotec which was performed according to the standard procedure and was interpreted 2 hours later. Biopsy for histopathological examination was preserved in formalin solution and sent to Histopathology Department for analysis and identification of H. Pylori bacteria. Results: Prevalence of H. pylori infection based on histopathology examination was 7.2%. From seven positive results in histopathology examination, four samples were Helocitec positive. The sensitivity and specificity of Helicotec was 57.1% and 98.9%. The positive predictive value and negative predictive value were 80% and 96.7%. Conclusion: Rapid urease examination using Helicotec is one of H. pylori diagnostic tools that is good enough to diagnose faster and cheaper. Interpretation of rapid urease test also need to consider clinical condition of patients who are tested.
Gut microbiota influences our health via multiple mechanisms. Microbiota produced Short Chain Fatty Acid (SCFA) as an energy to maintain gut ecosystem and physiology. Dysbiosis is correlated with ...SCFA imbalance which in turn resulted in physiological abnormalities in the intestine, such as functional constipation.
Randomized Double-Blind Controlled Trial (RCT) was conducted on women with functional constipation (n=37) in the community of Jakarta and profile of SCFA was assessed by using GC-MS from the stool after 21 days supplementation of fermented milk (placebo and probiotic).
Probiotic supplementation significantly influenced acetate titer (p=0,032) marginally significant for propionate and butyrate (p=0.063 and p=0.068, respectively) and the respondent with increasing SCFA's metabolite are higher in probiotic group compared to the respondents in placebo group. Acetate is the highest SCFA titer found in faeces samples of women with functional constipation.
Probiotic
IS 10506 supplementation influenced all the SCFA parameter (acetate, propionate and butyrate).
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