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"Plasmodium falciparum menggunakan protein EBA140 sebagai salah satu protein yang berperan pada proses invasi ke dalam sel darah merah. Polimorfisme domain F1 gen EBA-140 diketahui memengaruhi spesifisitas perlekatan protein EBA-140 pada reseptor di permukaan sel darah merah. Variasi tipe alel Gerbich pada gen GYPC yang merupakan reseptor bagi EBA-140 juga dapat memengaruhi kemampuan protein ligan EBA-140 dalam berikatan dengan reseptor GYPC di permukaan sel darah merah. Penelitian mengenai keragaman sekuens asam amino domain F1 gen EBA-140 dan variasi alel Gerbich gen GYPC telah dilakukan terhadap 18 isolat klinis P. falciparum yang berasal dari kabupaten Bangka Barat (n = 5), kabupaten Bangka Tengah (n = 4), dan kabupaten Mimika (n = 9). Amplifikasi gen EBA-140 dari isolat parasit malaria dilakukan dengan teknik Polymerase Chain Reaction (PCR). Selanjutnya fragmen DNA parasit diperbanyak dengan metode kloning ke dalam sel bakteri Escherichia coli. Analisis hasil sekuens asam amino domain F1 menunjukkan adanya 7 haplotipe gen EBA-140 dari ketiga daerah tersebut. Tiga haplotipe yaitu ISTK, DSTK, dan ISRE merupakan haplotipe baru yang belum pernah dilaporkan sebelumnya. Analisis variasi alel Gerbich pada gen GYPC menunjukkan tidak ada delesi ekson 3 pada gen GYPC pada ketiga daerah tersebut. Informasi mengenai keragaman haplotipe gen EBA-140 dan gen GYPC dapat dijadikan sebagai acuan dalam mendesain vaksin berbasis gen EBA-140 yang efektif memberantas P. falciparum di Indonesia.

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Plasmodium falciparum utilizies the EBA140 as one of its proteins to invade the red cells. Polymorphisms at the domain F1 of EBA-140 gene have been known to affect the ligand recognition to its corresponding protein receptors glycophorin C (GYPC) or Gerbich antigen. Deletion on the GYPC gene, known as Gerbich blood-type, is known to prevent the parasite invasion using this pathway. Polymorphisms on the GYPC gene could alter the ability of EBA-140 ligand to bind to GYPC receptor on the surface of erythrocyte. Plasmodium falciparum clinical isolates from West Bangka (n = 5), Central Bangka (n = 4), and Mimika regencies (n = 9) were studied for their EBA-140 and GYPC gene polymorphisms. Parasite DNA was amplified using Polymerase Chain Reaction (PCR) and subsequently cloned into Escherichia coli.

Amino acid sequence analysis of the F1 domain showed that there were seven haplotypes of EBA-140 gene from all locations. Three haplotypes of EBA-140 (ISTK, DSTK, ISRE) detected in this study were new haplotypes that had not been reported previously. Analysis on the Gerbich allele detected no exon 3 deletion on the GYPC gene from all location. These findings provide useful information if the vaccine involving the EBA-140 component would be developed."

"Traveler's Malaria is a new emerging health problem in the whole world due to (I) increasing inability of international travelers and (2) recurrence of diseases in areas that was once, partially or fully freed from the disease.We report 2 cases of severe traveler's malaria found in a man from Greece and a man from the Philippines aged 54 tears. Both patients were ship captains. They have stayed in Kenya prior to the catching the disease. In the first case, we found acute kidney failure with anuria and lung edema, pneumonia, and a progressive decline in hemoglobin concentration. In the second cases we found reduced consciousness, disorder of liver function with jaundice, disorder of kidney function, bleeding from the upper digestive tract, pneumonia, severe anemia, and signs of DIC (Disseminated Intra-va.icttlar Coagulation). The second patient was admitted to the ICU( Intensive Care Unit). Peripheral blood smears found ring forms and growing Plasmodiumfalc.iparum trophozoits. Both cases were assumed to be resistant to Chloroquine and Fansidar. Both of them were treated with oral Quinine Sulphate {we could hardly find Quinine injection in Medan), With such treatment for seven days, we found significant clinical and laboratory improvements. Asexual parasites were no longer found in the peripheral blood smear. During the hospitalization, both patients required Packed Red Cell (blood) transfusion to overcome the progressive drop in hemoglobin level. With the disappearance of the parasites from the patients' blood, the disorders of the organs mentioned above, gradually became normal. The conditions of the patients also showed satisfactory improvement."

"Background: treatment of erythropoietin (EPO) is essential in chronic kidney disease (CKD) patients to maintain optimal hemoglobin (Hb) level. Renogen is a biosimilar epoetin-α, and Eprex is the originator epoetin-α. This study aimed to compare the efficacy and tolerance of Renogen with Eprex in CKD anemia.Methods: Renogen and Eprex were compared in a randomized (2:1), open-label study for 8 weeks, proceeded by 4 weeks adjustment (maintenance) phase, in anemic CKD patients undergoing HD in Cipto Mangunkusumo General Hospital, Jakarta, from June 2017 to October 2018.Results: a total of 45 patients (31 received biosimilar EPO and 14 received originator EPO) were included in the study. At baseline, mean (SD) Hb levels were 10,9 (0,74) g/dL and 10,9 (0,61) g/dL in biosimilar and originator EPO groups, respectively. At end of study (8 weeks), mean (SD) Hb levels were 10,5 (1,28) g/dL and 11,0 (1,13) g/dL in biosimilar EPO and originator EPO groups, respectively. The proportion of patients with Hb levels maintained within the target range (>10 g/dL) during 8 weeks randomization phase were 58,1% and 71,4% in biosimilar EPO and originator EPO, respectively (p=0,60; NS). There were no significant difference in epoetin dose between the 2 groups, and there was no drug-related adverse event in either group.Conclusion: Hb level at >10 g/dL could be maintained for 8 weeks of treatment with both originator and biosimilar EPO (more consistent with originator EPO and more fluctuations with biosimilar EPO), with similar epoetin dose and no drug-related adverse event.

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Latar belakang: terapi eritropoietin sangat penting pada pasien penyakit ginjal kronik (PGK) untuk mempertahankan kadar Hb tetap optimal. Renogen adalah suatu epoetin-α biosimilar, sedangkan Eprex adalah epoetin-α inovator. Penelitian ini bertujuan membandingkan efikasi dan toleransi Renogen dengan Eprex untuk anemia akibat PGK.

Metode: Renogen dan Eprex dibandingkan dalam studi random (2:1), tidak tersamar, selama 8 minggu, didahului dengan fase penyesuaian selama 4 minggu, pada pasien anemia akibat PGK yang menjalani hemodialisis di RSUPN Cipto Mangunkusumo, Jakarta, dari Juni 2017 sampai dengan Oktober 2018.

Hasil: sejumlah 45 pasien (31 mendapat EPO biosimilar dan 14 menerima EPO inovator) diikutsertakan dalam studi. Pada awalnya, rerata (SD) kadar Hb berturut-turut 10,9 (0,74) g/dL dan 10,9 (0,61) g/dL dalam kelompok EPO biosimilar dan EPO inovator. Di akhir studi (8 minggu), rerata (SD) kadar Hb berturut-turut 10,5 (1,28) g/dL dan 11,0 (1,13) g/dL dalam kelompok EPO biosimilar dan EPO inovator. Proporsi pasien dengan kadar Hb yang bertahan dalam kisaran target (>10 g/dL) selama 8 minggu adalah 58,1% dalam kelompok EPO biosimilar dan 71,4% dalam kelompok EPO inovator (p=0,60; TB). Tidak ada perbedaan bermakna dalam dosis epoetin dari EPO biosimilar dan EPO inovator yang digunakan, dan tidak ada efek samping yang terkait dengan obat pada kedua kelompok. Kesimpulan: kadar Hb >10 g/dL dapat dipertahankan selama 8 minggu pengobatan dengan EPO inovator maupun EPO biosimilar (lebih konsisten dengan EPO inovator dan lebih berfluktuasi dengan EPO biosimilar), dengan dosis epoetin yang sama dan tidak ada efek samping yang berkaitan dengan obat"

"Malaria berat yang disebabkan oleh infeksi Plasmodium falciparum memiliki angka mortalitas yang tinggi dan merupakan penyebab utama kematian pada malaria. Pada kematian akibat malaria jarang dilakukan pemeriksaan otopsi karena belum populernya otopsi klinis di Indonesia. Dilaporkan seorang perempuan berusia 43 tahun dari daerah non endemik dengan penyebab kematian malaria berat. Diagnosis ditegakkan melalui otopsi, pemeriksaan histopatologi, dan toksikologi.

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AbstractSevere malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology."

"Until now, malaria is still an important community health problem in Indonesia. Prior to the use of DOT in this year 1959, it can be said that there is no region in Indonesia that was free from malaria except for the high lands.

Lampung is a region that is endemic for malaria, but at the peak of eradication in the year 1963, Lampung was protected from malaria, even though in the year 1965 there were still malaria foci in Lampung, with an SPR? Of more than 2%.' Up to the year 1989, for regions outside of Java and Bali, Lampung has the least prevalence for malaria.1

The halt in malaria eradication using DOT was due to a change in the environment due to large developments that resulted in increased vector nesting sites, might have been the cause for the increase in malaria cases lately in Bandar Lampung."