2023) Can salivary microbiome become a biodetector for type-2 diabetes? Opinion for future implications and strategies.
Background: Spinal cord injury is not only caused by trauma but also by non-trauma, such as spinal epidural abscess (SEA). Tuberculous SEA is a rare infectious disorder, a delayed diagnosis associated with morbidity and mortality. The problems of tuberculous SEA is not only infection but also neurological deficit, axial back pain, pathological fracture, deformity, and socioeconomic and psychogenic problem. There are a few cases of SEA caused by Mycobacterium tuberculosis, mostly caused by Staphylococcus aureus with decreasing body’s defense mechanism caused by a deficiency of vitamin D. This study aimed to evaluate the neurological recovery of non-traumatic spinal cord injury caused by spinal tuberculosis with spinal epidural abscess and vitamin D deficiency that treated with vitamin D as an adjuvant. Case Report: A 31-year-old female came to the orthopedic clinic with paraparesis ASIA grade C, axial back pain, and spinal deformity for three months, with vitamin D levels of 15.5 ng/ml. MRI showed epidural abscess at the level of the 10th-11th thoracic vertebrae, spondylodiscitis of the 10th-11th thoracic vertebrae accompanied by paraspinal abscess of the 8th thoracic vertebrae to the 1st lumbar vertebra. The diagnosis was confirmed by cultured and histopathological examination. The treatment was surgery, followed by anti-TB drugs and daily vitamin D 5000 IU for one year. After one year of follow-up, the patient returned to work without a neurological deficit and axial back pain. Conclusion: This report describes the importance of early diagnosis and proper treatment of spinal cord injury in tuberculous SEA with a deficiency of vitamin D.
Introduction: Indonesia is one of the developing countries that have various cultures, ethnicities, and mysticism. Those things influence their society, especially the people in the low middle class and uneducated well. Many people still believe that a disease can occur due to mystical things, so they believe that a dukun can treat it, even if the process is illogical. This phenomenon nowadays still exists in society. Dukun usually has his way to cure or solve someone’s diseases, even though his methods to cure someone’s diseases usually do not have evidence-based and the diseases need to see professionals. It shows in this case. Dukun in this case used ice blocks as his method to cure someone’s disease. This “ice blocks therapy” may trigger hypothermia conditions in someone and also may cause death, especially in a person with chronic disease. The range temperature in the Jember Regency between 21-31oC which makes hypothermia rarely found here. The case will present in this paper. In this case, we present an interesting case about the use of ice blocks, called “ice blocks therapy” and then considered as a therapy method and an unexpected death. Conclusions: Review of patient history, postmortem findings, forensic pathology, and socio-cultural aspects are some of the keys to solving the problem. In this case, hypothermia through ice block therapy plays a role in decreasing organ function which results in death
Retinoblastoma (RB) is the most common primary intraocular malignancy of childhood. There is no therapies that can eradicate specifically the whole cancer cells without any side effects. The disialoganglioside 2 (GD2), one of the cancer’s cell markers that can be treated using immunotherapy, is expressed in RB. Through this fact, immunotherapy based on chimeric antigen receptor (CAR)-engineered T cells targeting cancer-specific antigens has shown great potential in treating this cancer. Although in recent studies show that immune cells are not able to destroy cancer cells because in every cancer cells there is protein programmed death ligand 1 (PD-L1). This literature review also shows the potential technology using Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR associated protein (Cas9) method to silence PD-1 in CAR T cell, so PD-L1 can not deactivate CAR T Cell through PD-1 signaling. The combination using CAR T cell and CRISPR-Cas9 will be the great therapy to eradicate RB without any side effect.
Background and purpose: Air quality is an important determinant of a healthy life. One indicator of air pollutants in the room is fungi, which in hospital setting may cause nosocomial infection. This research aims to find out a correlation between physical characteristics of the indoor environment  toward the concentration of fungi in the inpatient rooms of dr. Soebandi Regional Hospital Jember, East Java.Methods: This research uses a cross-sectional method with a total of four inpatient rooms. We measured physical room characteristics including room temperature, humidity, light intensity, and room density. The concentration of fungi was measured by collecting air sample using passive air sampling method with a potato dextrose agar as the media to optimize the fungal growth. The data was processed with Saphiro-Wilk and Pearson correlation analysis using SPSS 25.0.Results: The ranges of room temperature and humidity were 29.6-32.2°C and 41-59%, respectively; while the light intensity and room density were 10-30 and 1.88-2.38 person/10 m2. The bivariate analysis showed a correlation between two components of physical characteristic of the indoor environment, room temperature and room density, with the concentration  of fungi.Conclusion: There is a correlation between room temperature and room density with the concentration of fungi in the inpatient rooms of dr. Soebandi Regional Hospital Jember. The management of hospitals should take measures to improve the air quality within inpatient rooms.
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