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The COVID-19 disease, which is caused by the novel coronavirus, SARS-CoV-2, has affected the world by increasing the mortality rate in 2020. Currently, there is no definite treatment for COVID-19 patients. Several clinical trials have been proposed to overcome this disease and many are still under investigation. In this review, we will be focusing on the potency of mesenchymal stem cells (MSCs) and MSC-derived secretome for treating COVID-19 patients. Fever, cough, headache, dizziness, and fatigue are the common clinical manifestations in COVID-19 patients. In mild and severe cases, cytokines are released hyper-actively which causes a cytokine storm leading to acute respiratory distress syndrome (ARDS). In order to maintain the lung microenvironment in COVID-19 patients, MSCs are used as cell-based therapy approaches as they can act as cell managers which accelerate the immune system to prevent the cytokine storm and promote endogenous repair. Besides, MSCs have shown minimal expression of ACE2 or TMPRSS2, and hence, MSCs are free from SARS-CoV-2 infection. Numerous clinical studies have started worldwide and demonstrated that MSCs have great potential for ARDS treatment in COVID-19 patients. Preliminary data have shown that MSCs and MSC-derived secretome appear to be promising in the treatment of COVID-19. Lay Summary The COVID-19 disease is an infection disease which affects the world in 2020. Currently, there is no definite treatment for COVID-19 patients. However, several clinical trials have been proposed to overcome this disease and one of them is using mesenchymal stem cells (MSCs) and MSC-derived secretome for treating COVID-19 patients. During the infection, cytokines are released hyper-actively which causes a cytokine storm. MSCs play an important role in maintaining the lung microenvironment in COVID-19 patients. They can act as cell managers which accelerate the immune system to prevent the cytokine storm and promote the endogenous repair. Therefore, it is important to explore the clinical trial in the world for treating the COVID-19 disease using MSCs and MSC-derived secretome.

Lung cancer is the second most common type of cancer after breast cancer. It ranks first in terms of mortality rate among all types of cancer. Lung cancer therapies are still being developed, one of which makes use of nanoparticle technology. However, conjugation with specific ligands capable of delivering drugs more precisely to cancer sites is still required to enhance nanoparticle targeting performance. Monoclonal antibodies are one type of mediator that can actively target nanoparticles. Due to the large number of antigens on the surface of cancer cells, monoclonal antibodies are widely used to deliver nanoparticles and improve drug targeting to cancer cells. Unfortunately, these antibodies have some drawbacks, such as rapid elimination, which results in a short half-life and ineffective dose. As a result, many of them are formulated in nanoparticles to minimize their major drawbacks and enhance drug targeting. This review summarizes and discusses articles on developing and applying various types of monoclonal antibody ligand nanoparticles as lung cancer target drugs. This review will serve as a guide for the choice of nanoparticle systems containing monoclonal antibody ligands for drug delivery in lung cancer therapy.

Propionibacterium acnes ATCC 11827 and Methicillin-Resistant Staphylococcus aureus ATCC BAA-1683 are bacteria that cause skin infections, namely acne vulgaris and skin and soft tissue infection/SSTI. The increase in the number of resistant bacterial strains, such as MRSA,  requires the search for alternative antibiotics, including using natural ingredients. Red yeast rice is a product of rice fermentation by Monascus purpureus, which is known to have antibacterial, antifungal, antitumor, antioxidant, anti-inflammatory, anti-cholesterol and immunomodulator. This study aims to determine the antibacterial activity of several red yeast rice extracts against these bacteria that cause skin infections. The research was carried out through the stages of collecting materials and identifying the yeast isolates, extracting of red yeast rice, phytochemical screening of red yeast rice extract, confirmation of bacterial test, preparation of bacterial test suspension, testing for bacterial resistance, testing for antibacterial activity of red yeast rice extract and determining the value of Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the most active extract. The results showed that the ethyl acetate and ethanol extracts had antibacterial activity against P. acnes ATCC 11827 and MRSA ATCC BAA-1683. Both extracts contain compounds from the polyphenols, flavonoids, quinones and saponins group. Ethyl acetate extract was the most active extract with MIC values against P. acnes ATCC 1182 and MRSA ATCC BAA-1683 of 50 mg/mL and 12.5 mg/mL. The MBC values of ethyl acetate extract against these bacterial tests were 100 mg/mL and 25 mg/mL. The ethyl acetate extract is more active against MRSA ATCC BAA-1683 than against P. acnes ATCC 11827. From the results of this study it is known that red yeast rice has activity against bacteria that cause skin infections, especially against MRSA

Tuberculosis is a devastating disease caused by Mycobacterium tuberculosis. If left untreated or not properly treated, it could lead to progressive tissue damage and even death. Short-term chemotherapy containing isoniazid, rifampicin. and pyrazinamide were proven to be very effective in the treatment of TB. However, the concern regarding its potential hepatotoxicity might hinder the completion of treatment. Information regarding risk factor of hepatotoxicity among Indonesian tuberculosis patients were limited. This study aimed to investigate risk factors of hepatotoxicity among Indonesian tuberculosis patients. This was a case-control study with retrospective approach conducted at one of the public hospital in Lampung, Indonesia. We included 320 tuberculosis patients who were classified as case (64 patients who were diagnosed with hepatotoxicity during hospitalization) and control (256 patients). Results of multivariate logistic regression analysis showed that age was significant risk factor of hepatotoxicity (adjusted odds ratio (OR) 1.056, 95% CI 1.0121, 1.091), while longer duration of hospitalization had a 1.4 lower odds of hepatotoxicity compared to control (adjusted OR 0.757, 95% CI 0.682, 0.839) (p<0.005). The results indicated that older patients were more likely to have hepatotoxicity, while patients with shorter duration of hospitalization tend to have higher risk of hepatotoxicity. In conclusion, age was the risk factor associated with hepatotoxicity among tuberculosis patients.

Background: Diarrhea is a symptom of a disease, which is characterized by increased frequency of defecation (more than 3 times a day) with a more fluid of feces. In ayurvedic medicine, the fruit of Malacca (Phyllanthus emblica L.) is often used as an antibacterial and antiviral against various infectious diseases. Objectives: This study aims to determine: (i) The antibacterial activities of ethanol extract and its fraction of Malacca fruit and (ii) determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against diarrhea-causing bacteria such as Bacillus cereus FNCC0057 and Shigella dysenteriae ATCC13313. Methods: The study was conducted through several processes: (i) The determination of the plant and preparation of dried fruit, (ii) extraction of dried fruit, fractionated extract, antibacterial activity test of ethanol extract, and its fractions, (iii) determination MIC and MBC from the most active fractions, and (iv) phytochemical screening of fraction. Results: The results showed that ethanol extract, water fraction, and ethyl acetate fraction of Malacca fruit has antibacterial activities against B. cereus FNCC0057 and S. dysenteriae ATCC13313, where the greatest activity was shown by the fraction of ethyl acetate. This fraction has MIC and MBC values of 0.187-0.375% (w/v) and 0.09375-0.1875% (w/v) against B. cereus FNCC0057 and S. dysenteriae ATCC13313. The antibacterial activity of this fraction was probably derived from alkaloid, flavonoid, tannin, quinone, saponin, monoterpene, or sesquiterpene compounds. Conclusions: The results of the suggested that the extracts of the studied plants can be used as potential leads to discover new drugs to control some enteric-bacterial infections.

Tingginya penggunaan antibiotik akan meningkatkan potensi penggunaannya yang tidak rasional dan berdampak pada tingkat mortalitas, biaya, dan resistensi khususnya dalam lingkungan rumah sakit. Studi observasi dengan data retrospektif telah dilakukan untuk mengevaluasi penggunaan antibiotik dari April 2013-Maret 2014 menggunakan metode ATC/DDD dan DU 90%. Hasil penelitian menunjukkan antibiotik yang masuk ke dalam segmen DU 90% pada periode I adalah kotrikmoksazol 480 mg tablet (40,34 DDD/kunjungan) dan amoksisilin 500 mg tablet (4,53 DDD/kunjungan), periode II adalah sefiksim sirup kering (0,68 DDD/kunjungan), amoksisilin 500 mg tablet (0,41 DDD/kunjungan), siproflokasain 500 mg tablet (0,31 DDD/kunjungan), doksisiklin 100 mg (0,26 DDD/kunjungan), sefiksim 100 mg kapsul (0,15 DDD/kunjungan), sefadroksil 500 mg kapsul (0,12 DDD/kunjungan), seftriakson 1 gr injeksi (0,08 DDD/kunjungan), dan periode III adalah kotrimoksazol 480 mg tablet (74,85 DDD/kunjungan). Tingginya penggunaan antibiotik setiap kunjungan pada penggunaan kotrimoksasol merupakan sebuah tanda ketidakrasionalan dalam penggunaan antibiotik. Diperlukan studi kualititaf untuk mengetahui pola ketidakrasionalan dalam penggunaan antibiotik pada rumah sakit tersebut dan mengembangkan model intervensi yang tepat.

Background Umbilical cord mesenchymal stem cells (UC-MSCs)-derived secretome is currently used in regenerative therapy. MSCs are believed to secrete a wide spectrum of bioactive molecules which give paracrine effects in immunomodulation and regenerative capacities. One group that was found in secretome is interleukins (ILs), a cytokine that plays an essential role in the process of proliferation, differentiation, maturation, migration, and adhesion of immune cells. However, as there are many types of ILs, the profile of ILs in the UC-MSCs-derived secretome has been limitedly reported. Therefore, in this study, we would like to profile and detect the interleukin concentration secreted by UC-MSCs. Methods UC-MSCs-derived secretome was collected from UC-MSCs passage 5 after 24- and 48-hour incubation (n=9). Secretome was filtered using 0.2 µm and stored at −80°C for further detection. All samples were normalized before the interleukin (IL-2, IL-4, IL-6, IL-9, IL-10, IL-12, IL-17A) detection using a MACSPlex Cytokine Kit. Results The IL-6 has the highest concentration among other interleukins in both groups and increases significantly ( p <0.003) after incubation for 48 hours. The pro-inflammatory factors are decreasing while anti-inflammatory factors are increasing after 48-hour incubation. Discussion Our studies show that the UC-MSCs secrete pro- and anti-inflammatory interleukins. The concentration of anti-inflammatory interleukins shows to be increasing, while the pro-inflammatory interleukins are decreasing within the longer incubation time, but this not be applicable for IL-10 and IL-6. IL-6 has the highest concentration among other ILs. These results may provide important clues regarding when is the right time for secretome to be used in therapy patients, because all the molecules in the secretome can lead to many clinical manifestations.