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"ABSTRAKIn the past 10 years, recent development of targeted therapy in metastatic renal cell carcinoma (mRCC) has provided a new hope and significantly enhanced the prognosis of the disease. Three class of targeted therapy were developed, including multi-targeted tyrosine kinase inhibitors (TKI), the mammalian target of rapamycin (mTOR) complex-1 kinase inhibitors, and the humanized antivascular endothelial growth factor (VEGF) monoclonal antibody. Hence, the objective of this article was to critically examine the current evidence of targeted therapy treatment for patients with mRCC. In the majority of trials evaluating targeted therapy, patients were stratified according to Memorial Sloan Kattering Cancer Center (MSKCC) risk model and the recommendation of targeted treatment based on risk features. In first-line setting (no previous treatment), sunitinib, pazopanib, or bevacizumab plus IFN-α were recommended as treatment options for patient with favorable- or intermediate- risk features and clear cell histology. Patients who progressed after previous cytokine therapy would have sorafenib or axitinib as treatment options. Clear-cell mRCC with favorable- or intermediate- risk features and failure with first-line TKI therapy might be treated with sorafenib, everolimus, temsirolimus or axitinib. However, the current evidence did not show the best treatment sequencing after first-line TKI failure. In patients with poor-risk clear-cell and non-clear cell mRCC, temsirolimus was the treatment option supported by phase III clinical trial. In addition, several new drugs, nowadays, are still being investigated and waiting for the result of phase II or III clinical trial, and this might change the standard therapy for mRCC in the future."

"AbstrakA 43-year old male presented with persistent discomfort and pain upper abdomen (epigastrium) more on left side associated with fever on and off, along with fatigue and loss of appetite for the last four months. Physical examination revealed mass on left hypochondrium extending to epigastrium with mild distension of the abdomen. Imaging studies of the patient showed dextrocardia on chest x-ray postero-anterior (PA) view, thoracic and abdominal CT scan showed situs inversus totalis with multiple SOL (space occupying lesion) in right lobe of liver with largest measuring 8x6 cm2 in the 4th segment. USG-guided FNAC of the mass showed features of hepatocellular carcinoma. Thereupon, hepatocellular carcinoma in situs inversus totalis was diagosed to this patient and was clinically staged as T3aN0M0. He was given sorafenib 400 mg orally twice daily with an advice to come for regular assessment every 4 week."

"ABSTRAKLupus nephritis (LN) is involvement of the kidney in patient with systemic lupus erythematosus (SLE) and one of the most common target organ in SLE. The diagnosis of LN will significantly impact the clinical outcome and therapy of the patient. Therapy regiment of LN is divided into two stages, induction and maintenance treatment. The main objective of the induction therapy is to achieve complete or partial remission as soon as possible since it is correlated with better prognosis and fewer relapse incidence. In the maintenance stage, the main aim of the therapy is to maintain the remission status and avoid future relapse. It is also important to evaluate the effectiveness of the therapy as it will affect the duration and the regiment therapy being used. Corticosteroid, cyclophosphamide, mycophenolate mofetil, azathrioprine, cyclosporine and tacrolimus are example of drugs used in LN therapy. Currently, studies are being conducted to evaluate and develop targeted drug therapy to further add treatment options for LN."

"Tamarindus indica (tamarind) is an established traditional medicine. Pulpa tamarindorum includes vitamin C, protein, fat, glucose, citric acid, etc. Citric acid is a root canal irrigant and vitamin C an antioxidant. This study aimed to elucidate the cytotoxicity of 5% tamarind extract as a root canal irrigant to the cell line BHK-21. Eighteen cultures of cell line BHK-21 were divided into 2 groups. Sterile aquabidest was placed on the group 1 cultures (as control), and 5% tamarind extract was on the group 2, for 2.5 minutes each, and then the percentage of the living and dead cells were counted. The collected data were statistically analyzed by using independent t test to 0.05 limit of significance. The results showed 1% of dead cells in group 1 and 22% in group 2, and that there was a significant difference between the effect of 5% tamarind extract and that of sterile aquabidest (p<0.05). It was concluded that 5% tamarind extract is cytotoxic to the cell line BHK-21."

"ABSTRAKPengobatan TB lini kedua pada pasien TB lini MDR diketahui memiliki beberapa efek samping. Etionamid adalah salah satu obat dalam pengobatan TB MDR lini kedua. Hipotiroid merupakan efek samping dari pemberian etionamid. Sikloserin merupakan salah satu dari komponen pengobatan kedua yang bersifat bakteriostatik. Efek samping psikiatri seperti antesietas, halusinasi, depresi, euforia, perubahan kebiasaan, dan bunuh diri dilaporkan sebanyak 9,7-50% pada pasien yang menjalani pengobatan dengan sikloserin. Seorang perempuan berusia 46 tahun dengan diagnosis TB MDR, menjalani pengobatan TB lini kedua sejak januari 2016. Regimen pengobatan terdiri dari levofloksasin, sikloserin, etionamid, pirazinamid, etambutol, dan PAS. Evaluasi pengobatan dibulan pertama menunjukan adanya lelah, komunikasi yang berkurang, dan perubahan perilaku. Pasien sering merasa sedih, putus asa, dan sangat memikirkan penyakitnya. Pasien juga berpikir untuk mengakhiri hidupnya. Kemudian pasien menjalani rawat inap dan didiagnosis sebagai depresi imbas pengobatan TB, kemungkinan disebabkan sikloserin. Kemudian pemberian sikloserin dihentikan. Dalam waktu yang bersamaan, pemeriksaan laboratorium menunjukan adanya peningkatan TSH tanpa disertai gejala klinis hipotiroid. Dilakukan pemberian levotiroksin sebesar 1x100mkg. Pada akhir minggu ke-3 pengobatan, kadar TSH tetap meningkat sehingga pemberian etionamid dihentikan selama 3 bulan. Evaluasi setelah penghentian pemberian etionamid menunjukkan kadar TSH terkendali. Pemberian etionamid kemudian dilanjutkan dengan dosis titrasi per bulan. Kesimpulannya, pada pengobatan TB MDR, timbul efek samping pemberian etionamid perlu diperhatikan. Neorotoksisitas berat yang disebabkan sikloserin dapat ditangani dengan penundaan pemberian obat sementara. Hal lain yang perlu diingat adalah kondisi hipotiroid dapat memperlihatkan gejala depresi. Oleh karena itu, pemantauan efek samping pada obat TB diperlukan. "

"Saat ini telah terjadi resistensi parasit terhadap obat-obat antimalaria sehingga diperlukan alternatif pengobatan baru. Penelitian ini bertujuan untuk membuktikan bahwa ekstrak kulit batang Delonix regia dengan daun Carica papaya L memiliki aktivitas antiplasmodium pada mencit Swiss Webster yang diinfeksi Plasmodium berghei dan mengetahui perbandingan dosis kombinasi yang paling efektif sebagai antiplasmodium. Penelitian ini menggunakan desain eksperimental yang dilakukan secara in vivo. Terdapat 5 kelompok perlakuan yang terdiri dari kelompok kontrol positif, kontrol negatif, dan 3 kelompok perlakuan yang terdiri dari dosis kombinasi 1:1, 3:1, dan 1:3. Perlakuan diberikan selama lima hari berturut-turut. Setiap kelompok diamati densitas parasitnya dari hari ke-0 hingga hari ke-5 serta dihitung persentase peningkatan dan penghambatan parasitemia yang terjadi pada hari ke-4. Data persentase peningkatan parasitemia hari ke-4 dianalisis dengan menggunakan uji hipotesis Kruskal Wallis. Hasil penelitian menunjukan dosis kombinasi 1:1 memiliki perbedaan bermakna dengan kontrol negatif (p<0,05) dan menunjukan aktivitas antiplasmodium paling baik dengan persentase penghambatan parasitemia sebesar 99%. Sedangkan dosis kombinasi 3:1 dan 1:3 tidak menunjukan aktivitas antiplasmodium.

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Nowadays, the resistance toward malaria medicine has developed and required a new alternative medicine. This study is proposed to prove that the combination of Delonix regia's stem bark and Carica papaya L.’s leaves has an antiplasmodium activity on Swiss Webster mice infected by Plasmodium berghei, and also to compare each ratio combination to find the most effective one. The design used is an inv vivo experimental design. There were 5 group of mice tested, consisted of the positive control, negative control, and three combination ratio of 1:1, 3:1, and 1:3. This treatment were given daily for 5 day and on each day, the parasite density were evaluated. On day 4, the percentage of inhibition was measured. Also, on day 4, the increase in percentage of parasitemia was calculated. The data was then analyzed with Kruskal-Wallis test and the result is that combination 1:1 had a significant difference compared to negative control (p<0.05). It also shows the most effective antiplasmodium activity with a 99% of inhibition. In other hand, the combination of 3:1 and 1:3 shows no antiplasmodium activity."

"Telah dilakukan analisis hasil pemeriksaan Renogram Ginjal di Instalasi Kedokteran Nuklir RSP-Pertamina pada 30 pasien menggunakan metode Cacahan Kamera Gamma dengan Tc-99m DTPA. Mekanisme ini bertujuan untuk mencari korelasi dari ERPF dengan GFR menggunakan analisis Schlegel pada ERPF, dan analisis Gates pada GFR, serta mencari faktor koreksi untuk kedua variabel tersebut. Dari proses pengolahan data menggunakan analisis statistik Pearson, didapatkan hasil dengan korelasi positif pada semua data, dengan nilai ERPF dan GFR (display) menunjukkan Strongly Positive Correlation (r = 0.82 dan nilai p < 0.05), dengan Deviasi Standar sebesar 27.58 dan 107.64 untuk GFR dan ERPF (display) secara berturut-turut.

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Analysis of kidney renogram has been performed at Nuclear Medicine Unit RSP-Pertamina to thirty patient images acquired using gamma camera with counting method using Tc-99m DTPA. The purpose of this study was to find the correlation from ERPF with GFR using Schlegel analysis for ERPF, Gates analysis for GFR, as well as to find correction factor between both variables. Pearson?s statistical analysis resulted on Positive Correlation for all data, with ERPF and GFR (display) showing Strongly Positive Correlation (r = 0.82; p-value < 0.05). Standard deviation was found to be 27.58 and 107.64 for GFR and ERPF (display), respectively."