Infeksi Human Immunodeficiency Virus (HIV), baik tipe 1 yang tersebar ke seluruh dunia maupun tipe 2 yang terisolasi di Afrika, masih menjadi tantangan di bidang kesehatan dunia termasuk Indonesia. Angka HIV yang tinggi ini penting untuk ditangani karena bahaya komplikasi yang mengintai. Penatalaksanaan dan terapi HIV yang ada saat ini dengan penggunaan antiretroviral memiliki keterbatasan dilihat dari efek terapi dan efek samping yang ditimbulkan. Pengembangan dan penemuan modalitas terapi yang memiliki potensi efek terapi yang lebih optimal merupakan suatu tantangan yang terus diupayakan dalam penanganan HIV ini. Salah satunya adalah pengembangan imunoterapi berbasis sel dendritik. Literature review ini ditulis secara sistematis mengenai laporan studi terkait hal di atas dari berbagai sumber termasuk Google Scholar, PubMed, Research Gate untuk menguraikan potensi sel dendritik sebagai imunomodulator pada penderita HIV-1. Modalitas imunoterapi ini dikonstruksi dalam bentuk vaksin berbasis sel dendritik, sel yang berperan pada patogenesis HIV, yang diadministrasikan secara intradermal. Vaksin yang diberikan akan menstimulasi respon imun dan dapat digunakan tidak saja sebagai upaya terapi pada penderita tapi berpotensi digunakan sebagai pencegahan.

Background: Heart failure is a clinical syndrome with shortness of breath, fluid retention, and the heart's structural and functional disorder. Each year, there were 7,2 cases every 1000 people on male and 4,7 cases every 1000 people on the female. Aortic dissection is an emergency disease in which the symptoms are similar to ischemic heart disease, that 38% of patients got misdiagnosed on the first evaluations. Because of the clinical course of heart failure and misdiagnosed aortic dissection that frequently happened, authors are interested in making a case report with both conditions.Case report: A male patient, 39 years old, complained of shortness of breath and epigastrium pain. The patient was diagnosed with Acute Decompensated Heart Failure (ADHF) profile B with emergency hypertension and suspected aortic dissection based on history and physical examination. The patient was also diagnosed with acute kidney injury stage 1. CT angiography showed widening of the aorta ascending until arcus aorta with a Stanford type A aortic dissection diagnosis.Conclusion: The condition of aortic dissection can coincide with acute heart failure. Therefore, a clinician must be aware of the emergency of dissection and know the initial symptoms of dissection. The typical clinical symptoms of dissection lead us to perform imaging studies that ultimately lead to a thoracoabdominal CTA to diagnose the dissection.

Pseudomonas aeruginosa is gram-negative bacteria with high adaptability by forming biofilms and quorum-sensing mechanisms to avoid immune responses and antimicrobial agents which tend to develop into Multidrug Resistance (MDR) related to Healthcare-Associated Infection (HAI) with a prevalence of 3,8% in Indonesia and a mortality of up to 69%. Polyphenol compounds found in pomelo peels ( Citrus maxima ) have been shown to have antibiofilm and antiquorum-sensing effects but are less investigated. Therefore, this study aimed to investigate those effects on MDR P. aeruginosa . In vitro study design is performed to evaluate the inhibition effect of ethanolic extract on bacterial growth (Kirby-Bauer test), biofilm formation (biofilm assay), and quorum-sensing activity (pyocyanin and pyoverdine assay) on clinical isolates of MDR and ATCC strain as comparator. Furthermore, we employed computational methods using docking protein analysis. Biofilm formation was significantly inhibited by 71.1% ± 4.4% in MDR (pLasR and LasI ) by active compounds of Citrus maxima . Molecular docking was used to further strengthen this hypothesis, showing no significant differences in bonding energy of polyphenol compounds found in pomelo peel with LasR and LasI compared to the native ligand and inhibitors. Pomelo peel extract can be considered as a potential therapy for MDR P. aeruginosa infection mediated based on its antibiofilm and antiquorum-sensing effects.

Background: Hypertension is the most common comorbid disease which can cause further complications in COVID-19 patients. On the contrary, the pandemic has also caused lower health services and adherence to hypertension therapy. This study aimed to examine the impact of the COVID-19 pandemic on medication adherence in people with hypertension in Indonesia.Methods: The research was conducted using an analytical quantitative method. Patients with hypertension from seven islands across Indonesia were recruited based on eligibility criteria during Bulan Bakti 2021, a social outreach by Ikatan Senat Mahasiswa Kedokteran Indonesia about basic health across Indonesia. The demographic and medication history of the respondents were recorded. The Indonesian version of the Morisky Medication Adherence Scale (MMAS-8) questionnaire was distributed, and the medication adherence level was assessed.Results: A total of 1155 patients, mainly females (62.2%) participated in this study. More than half of the patients had low adherence (55.25%). Males (Adjusted Odd Ratio (AOR) 0.777 [CI 95% 0.529–1.019]), employed (AOR 0.857 [CI 95% 0.495–1.483]), higher income (AOR 0.522 [CI 95% 0.393–0.713]), and those who had information from healthcare worker (AOR 0.583 [CI 95% 0.361–0.878]) were found to have better medication adherence in multivariate logistic regression test.Conclusion: Medication adherence level in patients with hypertension during the pandemic is markedly low. Integrated preventive and promotive measures, especially from healthcare workers, are needed to prevent further morbidity and mortality.

ABSTRACT Introduction: Colorectal cancer is a type of cancer, originates in the colon tissue. Colorectal cancer causes 2 million new cases and 1 million deaths globally. The prevalence of colorectal cancer in Indonesia is 12.8% per 100,000 adult population with a 9.5% mortality rate. Current treatment of colorectal cancer are surgery, radiotherapy, and administration of anti-cancer drugs is considered less effective because expensive and its side effects. Discussion: Quercetin and kaempferol are flavonoids that could manage colorectal cancer through a series of mechanisms at carcinogenesis process stage, blocking proliferation by inhibiting NF-kB, increase apoptosis process by affecting CASP2, CLEC4M, and NTR3K genes, cause antiangiogenesis effects by decreases the expression of MMP-2 and MMP-9. Limitation of this modality is the low bioavailability, therefore it packaged in chitosan polymerized nanoparticles. Quercetin is most obtained from the skin of onions while kaempferol is obtained from leeks. Quercetin-kaempferol chitosan nanoparticles were prepared using the top down method (maceration) and administered orally. Chitosan as a polymer will dissolve when it enters gastric acid. The pharmacokinetics will begin with absorption by small intestine, excretion by kidneys, and elimination by large intestine. Quercetin 15 ?M-30 ?M was able to reduce cell viability to 63 ± 1.3% to 41 ± 0.3%. Meanwhile, kaempferol 30 ?M-60 ?M was able to reduce cell viability to 62 ± 0.83% to 26 ± 0.91%. Conclusion: Combination of quercetin and kaempferol can increase apoptosis process externally and internally also inhibit proliferation and angiogenesis of colorectal cancer cells. Keyword: Colorectal cancer, Quercetin, Kaempferol