Chronic wounds are a considerable health burden with high morbidity and poor rates of healing. Colonisation of chronic wounds by bacteria can be a significant factor in their poor healing rate. These bacteria can develop antibiotic resistance over time and can lead to wound infections, systemic illness, and occasionally amputation. When a large number of micro-organisms colonise wounds, they can lead to biofilm formation, which are self-perpetuating colonies of bacteria closed within an extracellular matrix, which are poorly penetrated by antibiotics. Platelet-rich plasma (PRP) is an autologous blood product rich in growth factors and cytokines that are involved in an inflammatory response. PRP can be injected or applied to a wound as a topical gel, and there is some interest regarding its antimicrobial properties and whether this can improve wound healing. This study aimed to evaluate the in vitro bacteriostatic effect of PRP. PRP was collected from healthy volunteers and processed into two preparations: activated PRP-activated with calcium chloride and ethanol; inactivated PRP. The activity of each preparation against Staphylococcus aureus and Staphylococcus epidermis was evaluated against a control by three experiments: bacterial kill assay to assess planktonic bacterial growth; plate colony assay to assess bacterial colony growth; and colony biofilm assay to assess biofilm growth. Compared with control, both preparations of PRP significantly inhibited growth of planktonic S aureus and S epidermis. Activated PRP reduced planktonic bacterial concentration more than inactivated PRP in both bacteria. Both PRP preparations significantly reduced bacterial colony counts for both bacteria when compared with control; however, there was no difference between the two. There was no difference found between biofilm growth in either PRP against control or against the other preparation. This study demonstrates that PRP does have an inhibitory effect on the growth of common wound pathogens. Activation may be an important factor in increasing the antimicrobial effect of PRP. However, we did not find evidence of an effect against more complex bacterial colonies.

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Introduction Invasive aspergillosis (IA) is a fungal infection caused by Aspergillus species (spp.). Aspergillosis is the most common source of opportunistic fungal infection in humans. IA can cause serious complications related to high morbidity and mortality in immunocompromised patients. Presentation of case We report a case of a 22-year-old female with a chief complaint of having a hole in the roof of her mouth. She was diagnosed with SLE in 2009. She had been consuming oral methylprednisolone ever since. In 2018, she experienced worsened symptoms and was hospitalized. She experienced swelling and bleeding of her gums and some of her teeth becoming loose and falling out, and then developing a hole in the roof of her mouth. Subsequently, she was treated with oral cyclophosphamide, oral mycophenolate sodium, and oral fluconazole. She was asked to stop taking oral methylprednisolone. In 2019, the palate biopsy was performed and showed Aspergillus spp. invading the palate. Afterward, the patient was referred to our clinic for defect closure. The patient was operated on for debridement and reconstruction of the defect. There was no recurrence of the defect or complications observed in the follow-up. The patient was satisfied with the surgical results. Discussion IA is a destructive and potentially harmful opportunistic fungal infection and treatments with surgical interventions should be well-thought-out in immunocompromised patients. Conclusion The management of IA are controlling any underlying diseases and surgical debridement or necrotomy. Generally, antifungal therapy and prompt surgical intervention are successful in managing invasive aspergillosis.

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Indonesia merupakan negara ketiga dengan jumlah perokok terbesar (Afiati,2016). Asap rokok mengandung senyawa racun organo klorin yang dapat memicu pertumbuhan bakteri Klebsiella pneumoniae yaitu salah satu bakteri penyebab bronkitis kronik (Ikawati,2011). Saat ini pengobatan untuk bronkitis kronik telah dilakukan dengan antibiotik, akan tetapi memiliki kekurangan yaitu alergi, iodosinkranasi dan dapat menyebabkan resistensi bakteri. Disisi lain, kulit kakao merupakan limbah utama dari pengolahan biji kakao untuk berbagai produk coklat. Diketahui bahwa terdapat senyawa flavonoid dari kulit buah kakao (Hu dan Li, 2011). Flavonoid merupakan senyawa yang diduga mampu menghambat pertumbuhan bakteri Klebsiella pneumoniae penyebab penyakit bronkitis (Kandou, 2016). Pada penelitian ini kami memanfaatkan limbah kulit kakao sebagai solusi pengobatan bronkitis kronik dengan menggunakan metode nanospray yang berbasis gelasi ionik. Prinsip nano digunakan untuk memperkecil ukuran zat aktif sediaan obat sehingga lebih mudah diabsorpsi kedalam sel target. Metode isolasi flavonoid yang digunakan adalah maserasi serbuk kulit kakao dengan etanol 96% perbandingan 1:10 selama 24 jam. Isolat kemudian di saring dan pelarut pada filtrat diuapkan dengan rotary evaporator sehingga diperoleh ekstrak kental kulit kakao yang mengandung flavonoid. Pembuatan nanospray isolat kulit kakao yang mengandung flavonoid menggunakan metode gelasi ionik dengan bahan NaTPP 0,1% b/v dan beberapa variasi konsentrasi kitosan yaitu 0,1%; 0,3%; 0,4% (b/v). Sediaan koloid yang diperoleh dengan ukuran paling kecil adalah menggunakan konsentrasi kitosan 0,1% dengan ukuran partikel 470,7 nm. Diharapkan dengan adanya pembuatan nanospray inhaler dari limbah kulit kakao ini menjadi langkah inovatif yang memberikan tiga keuntungan sekaligus yaitu (i) nilainya yang ekonomis (ii) sebagai solusi alternatif pengobatan penyakit bronkitis kronik yang tepat sasaran dan (iii) mampu mengatasi permasalahan lingkungan akibat limbah kulit kakao

Breast cancer is the most common malignant tumor and the leading cause of death among females. Most women with breast cancer will undergo breast-conserving surgery (BCS) or lumpectomy, simple or total mastectomy, modified radical mastectomy or bilateral mastectomy. Breast reconstruction solves many of the problems. The goal is to return the patient to a near-normal state so that she is not handicapped in her daily living. Breast reconstruction is also intended to offer psychological benefits to women treated by mastectomy following a diagnosis of possibly terminal cancer. In these case reports, we reported two successful cosmetic reconstruction cases. The first case was a 39-yearsold female with non-recurrent breast cancer consulted and was referred by the oncology surgeon to the Plastic Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Dr. Sardjito General Hospital. She wanted to undergo breast reconstruction. We planned to operate three years following mastectomy. She was diagnosed with 3B-stage of right breast cancer before. After the surgery, the patient received six series of chemotherapy. She also underwent radiotherapy 25 times and hormonal therapy. We decided to perform a transverse rectus abdominis myocutaneous (TRAM) flap surgery on her with 22 months follow up. The procedure provided good results, and the patient was satisfied. The second case was a 32-year-old woman who after excision of a phyllodes tumor and wanted breast reconstruction. Reconstruction was performed four years after tumor removal using latissimus dorsi myocutaneous (LDM) flap. The surgery provided good results, and the patient was satisfied. We reported two successful cosmetic reconstruction cases of non-recurrent 3B-stage of right breast cancer post-mastectomy after pedicled TRAM flap surgery and left breast post excision of phyllodes tumor after LDM flap surgery. ABSTRAKKanker payudara adalah tumor ganas yang paling umum dan merupakan penyebab utama kematian pada wanita. Sebagian besar wanita dengan kanker payudara akan menjalani bebeapa jenis operasi yang melibatkan operasi pengangkatan tumor atau lumpektomi, mastektomi simpel atau total, mastektomi radikal yang dimofidikasi dan mastektomi bilateral. Rekonstruksi payudara dapat mengatasi masalah akibat mastektomi dan bertujuan mengemballikan kondisi pasien mendekati normal sehingga tidak mengalami disabilitas dalam kehidupan sehari-hari. Rekonstruksi payudara juga dimaksudkan untuk menawarkan manfaat psikologis bagi wanita yang diobati dengan mastektomi setelah diagnosis kemungkinan kanker stadium akhir. Pada laporan kasus ini, dilaporkan keberhasilan dua kasus rekonstruksi payudara. Kasus pertama adalah seorang wanita berusia 39 tahun dengan kanker payudara non-rekuren berkonsultasi untuk dilakukan rekonstruksi payudara ke Divisi Bedah Plastik, Rekonstruksi, dan Estetika, Departemen Bedah, RSUP Dr. Sardjito, Yogyakarta. Rekonstruksi payudara direncanakan tiga tahun setelah mastektomi. Pasien terdiagnosis dengan kanker payudara stadium 3B sebelum mastektomi. S...

Background Disturbance in the wound healing can cause the wound turn into a chronic wound, which histologically shows fibroblast senescence with weak proliferation ability. Mitomycin-C could block cell proliferation that causes cell senescence which is similar to the chronic wound morphology. Platelet-Rich Fibrin (PRF) contains a large number of platelets, leukocytes, cytokines and growth factors. This study aims to determine whether PRF could improve the fibroblast proliferation after treatment with Mitomycin-C. Methods Cultured normal human skin fibroblasts forth passage divided into five groups. The first group was treated with culture medium, and the second group with 10 μg/mL mitomycin-C for 2 h. The third, 4th and 5th group were treated with mitomycin-C for the same dose and period, then adding it with 100%, 50%, and 25% of PRF. The fibroblast proliferation was measured by MTT assay. Results The fibroblast proliferation in the group with culture medium is 11.366,56 ± 4.073,32, meanwhile in the group with mitomycin-C treatment is 5.690,41 ± 2.834,22. The fibroblast proliferation in group with 100% PRF is 7.909,8 ± 3.392,19; group with 50% PRF 15.347,91 ± 8.413,02; and group with 25% PRF 13.449,56 ± 7.523,83. All of the PRF groups increased significantly compared to the group with Mitomycin-C treatment. Conclusions Platelet-Rich Fibrin can improve normal dermal fibroblast proliferation after treatment with mitomycin-C in vitro.

Pada penelitian ini pengabuan ilalang dilakukan pada suhu 900°C selama 8 jam dan digunakan sebagai katalis basa pada pembuatan biodiesel yang dilakukan dengan proses elektrokatalitik menggunakan elektrode grafit dengan tegangan DC 18,2 V. Proses elektrokatalitik campuran minyak jelantah, metanol dan katalis abu ilalang (2, 3 dan 5% berat katalis terhadap minyak) berlangsung pada suhu kamar dengan rasio molar minyak terhadap metanol sebesar 1:6 selama 60 menit dengan perbandingan volume pelarut THF terhadap metanol sebesar 1:1. Karakterisasi abu ilalang dilakukan dengan menggunakan XRF dan FTIR. Hasil penelitian menunjukkan bahwa kandungan mineral alkalis tertinggi terdapat pada abu akar ilalang (Ca 3,99%) yang menghasilkan 55,65% rendemen biodiesel dengan tingkat efisiensi produksi 41,01% pada aplikasi 5% katalis dengan minyak kedelai sebagai bahan baku produksi. Untuk katalis yang sama pada minyak jelantah dihasilkan 44,47% rendemen biodiesel dengan tingkat efisiensi produksi 41,79%. Selain itu efisiensi produksi biodiesel dengan proses elektrokatalitik menggunakan katalis akar abu ilalang adalah lima kali lebih besar dibandingkan proses tanpa katalis. Melalui penggunanaan abu ilalang sebagai katalis untuk produksi biodiesel dari minyak jelantah diharapkan dapat mengurangi penyebab kebakaran lahan oleh tanaman ilalang sehingga meningkatkan kesuburan lahan pertanian dan mengurangi kuantitas limbah minyak jelantah yang dapat mencemari lingkungan serta tersedianya bahan bakar terbarukan yang ramah lingkungan.