Many studies reveal the determinant factor of children under five years of malnutrition problem in Indonesia. However, there is only a few analysis conducted on indigenous communities and its comparison to non-indigenous communities. This study analyzes the determinant factors of malnutrition in children under five years in indigenous communities (Suku Baduy) and non-indigenous communities. This study is a comparative study using cross-sectional data, where the samples are households that have children under five years in indigenous communities (n=60) and in non-indigenous communities (n=60), with sample techniques using purposive random sampling. To calculate nutrition status, this study uses the anthropometric index based on weight-for-age according to WHO standards presented in the Z-score and Standard Deviations (SD). The result of this study indicates that the prevalence of children under five years suffering from malnutrition in indigenous communities is lower than in non-indigenous communities, which is 21,7% to 43,3%. Two factors influence the high prevalence of malnutrition in children under five years, namely, the education of the head of a family with OR=0.120 (95%C1: 0.021-0.675) and prenatal care in the fourth trimester with OR 9.890 (95%C1: 1.349-72.531). It is necessary to increase public knowledge on balanced nutrition in children under five years and improved maternal health access to resolve children under five years of malnutrition in those communities.

Objective: To investigate the anti-inflammatory effect of the protein derived from the soluble factor of Heligmosomoides polygyrus (H. polygyrus) excretory-secretory in a colitis model.
Methods: Colitis was induced by providing drinking water containing 3% dextran so-dium sulfate (DSS) for a week. DSS was administrated in a cycle protocol, each cycle consisted of 7 days of 3%DSS in the drinking water and followed by 7 days of regular water. This study consisted of five treatment groups, including Groups A (control) received untreated water, B (DSS only, without excretory-secretory), and C–E injected (i.p.) with excretory-secretory protein (H. polygyrus excretory-secretory total, excretory-secretory 28 kDa and excretory-secretory 55 kDa, respectively). Mice received injection every week. The injection of excretory-secretory was started from the 6th weeks and continued until 11 weeks. At the end of 11 weeks of the experiment, mice were sacrificed, colon tissue was removed and then subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, flow cytometry, real-time PCR and histology examination.
Results: Mice received H. polygyrus excretory-secretory 55 kDa reduced mono-nuclear cell infiltrations. H. polygyrus excretory-secretory 55 kDa induced the down-regulation of mRNA interferon-g expression. There were significant differences in the expression of mRNA interferon in the colon of mice after the administration of the excretory-secretory 55 kDa protein fraction compared with other groups (P < 0.001), whereas mRNA transforming growth factor-b expression up regulated in the colon of mice after the administration of the excretory-secretory 55 kDa protein fraction compared with total excretory-secretory group (P < 0.05). The treatment of colitis in mice with excretory-secretory 55 kDa protein fractions modulated interleukin-10 (IL-10) expression, whereas excretory-secretory total and excretory-secretory 28 kDa protein fractions insufficient promoted IL-10 expression. Excretory-secretory 55 kDa proteins fraction promoted IL-10 expression via Foxp3-independent pathways.
Conclusions: Excretory-secretory 55 kDa protein could reduce inflammation and have potential therapy. H. polygyrus excretory-secretory 55 kDa was the soluble factor that may help in the development of novel treatments to cure colitis.

Fine-needle aspiration (FNA) is a well accepted initial approach in the management of thyroid lesions. It has come a long way since its introduction for nearly a century ago. In the Philippines, FNA of the thyroid was first introduced 30 years ago and has been utilized until now as a mainstay in the diagnosis of thyroid malignancy. The procedure is performed by pathologists, endocrinologists, surgeons, and radiologists. Most pathologists report the cytodiagnosis using a combination of the aspiration biopsy cytology method that closely resembles the histopathologic diagnosis of thyroid disorders and the six-tier nomenclature of The Bethesda System for Reporting Thyroid Cytopathology. Local endocrinologists and surgeons follow the guidelines of the 2015 American Thyroid Association in the management of thyroid disorders. There is still a paucity of local research studies but available data deal with cytohistologic correlations, sensitivity, specificity, and accuracy rates as well as usefulness of ultrasound-guided FNA. Cytohistologic correlations have a wide range of sensitivity from 30.7% to 73% and specificity from 83% to 100%. The low sensitivity can be attributed to poor tissue sampling since a majority of the thyroid FNA is done by palpation only. The reliability can be improved if FNA is guided by ultrasound as attested in both international and local studies. Overall, FNA of the thyroid has enabled the diagnosis of thyroid disorders with an accuracy of 72.8% to 87.2% and it correlates well with histopathology.
Biopsy, Fine-Needle* ; Biopsy, Needle ; Cytodiagnosis ; Diagnosis ; Methods ; Palpation ; Philippines* ; Sensitivity and Specificity ; Surgeons ; Thyroid Gland* ; Ultrasonography

Purpose: Pediatric acute appendicitis has a stable incidence rate in Western countries with an annual change of -0.36%. However, a sharp increase was observed in the Asian region. The Indonesian Health Department reveals appendicitis as the fourth most infectious disease, with more than 64,000 patients annually. Hence, there is an urgent need to identify and evaluate the risk factors and diagnostic modalities for accurate diagnosis and early treatment. This study also clarifies the usage of pediatric appendicitis score (PAS) for children <5 years of age. Methods: The current study employed a cross-sectional design with purposive sampling through demographic and PAS questionnaires with ultrasound sonography (USG) results. The analysis was performed using the chi-square and Mann–Whitney tests and logistic regression. Results: This study included 21 qualified patients with an average age of 6.76±4.679 years, weighing 21.72±10.437 kg, and who had been hospitalized for 4.24±1.513 days in Siloam Teaching Hospital. Compared to the surgical gold standard, PAS and USG have moderate sensitivity and specificity. Bodyweight and stay duration were significant for appendicitis (p<0.05); however, all were confounders in the multivariate regression analysis. Incidentally, a risk prediction model was generated with an area under the curve of 72.73%, sensitivity of 100.0%, specificity of 54.5%, and a cut-off value of 151. Conclusion PAS outperforms USG in the sensitivity of diagnosing appendicitis, whereas USG outperforms PAS in terms of specificity. This study demonstrates the use of PAS in children under 5 years old. Meanwhile, no risk factors were significant in multivariate pediatric acute appendicitis risk factors.

Native and artificial extracellular matrices (ECMs) have been widely applied in biomedical fields as one of the most effective components in tissue regeneration. In particular, ECM-based drugs are expected to be applied to treat diseases in organs relevant to urology, because tissue regeneration is particularly important for preventing the recurrence of these diseases. Native ECMs provide a complex in vivo architecture and native physical and mechanical properties that support high biocompatibility. However, the applications of native ECMs are limited due to their tissue-specificity and chemical complexity. Artificial ECMs have been fabricated in an attempt to create a broadly applicable scaffold by using controllable components and a uniform formulation. On the other hands, artificial ECMs fail to mimic the properties of a native ECM; consequently, their applications in tissues are also limited. For that reason, the design of a versatile, hybrid ECM that can be universally applied to various tissues is an emerging area of interest in the biomedical field.
Clothing ; Extracellular Matrix* ; Hand ; Recurrence ; Regeneration ; Tissue Engineering* ; Urology

No abstract available.
Multiple Sclerosis, Chronic Progressive* ; Self-Injurious Behavior*

A 65-year-old man consulted with a history of chronic snorting with a sensation of obstruction in the left side of the nasopharynx particularly when in supine position. A few days prior to consult, the patient had blood-tinged nasal discharge, thus this admission. No other symptoms were reported.

Nasal endoscopy showed a sessile exophytic lesion with a vaguely nodular surface, seen as a polypoid nasopharyngeal mass on Computed Tomography scan. (Figure 1)

Excision of the mass was performed. Received in the surgical pathology laboratory was a 1.8 x 1.5 x 0.6 cm red to brown, rubbery to firm, vaguely ovoid mass with a nodular external surface. Cut section showed a light gray solid surface. 

Microscopic examination shows a broad-based exophytic mass with invaginations of the surface epithelium and proliferated glands within the stroma. (Figure 2) The glands are tubular or variably dilated - many are lined by a respiratory-type epithelium with goblet cells and a thickened basement membrane, while the tubular glands are lined by a monolayered cuboidal epithelium. (Figure 3) Based on these features, we signed the case out as a respiratory epithelial adenomatoid hamartoma (REAH).

REAH is a benign proliferation of sinonasal tract glands derived from the surface epithelium.1 It occurs primarily in male adults, with a median age in the sixth decade of life. Most cases arise in the posterior nasal septum, while less common sites of involvement include other parts of the nasal cavity, the nasopharynx, and paranasal sinuses.2 Common symptoms include nasal obstruction, stuffiness, and epistaxis.1,3,4

REAH presents as a polypoid lesion and may measure up to 6 cm in widest diameter.1 Microscopically, there is a proliferation of small to medium-sized glands dispersed in abundant stroma. Invagination of the glands from the surface epithelium may be seen.3 The glands are round to oval, lined by respiratory-type epithelium with admixed goblet cells. Thickened basement membranes surround some of the glands, and smaller seromucinous glands lined by cuboidal epithelium may also be admixed among the latter. Other alterations may include squamous, chondroid, and osseous metaplasia.1,4

Rarely, REAH may occur synchronously with inverting sinonasal papillomas or inflammatory polyps.1 It may be mistaken for these two entities along with sinonasal low-grade adenocarcinomas. Careful attention to the typical morphology including absence of an infiltrative growth pattern and atypia allow distinction from these entities particularly the malignant mimics.3 A related entity is a seromucinous hamartoma with which REAH is believed to form a morphological spectrum.1

REAH is benign and complete excision confers cure.1 Malignant transformation has not been reported.1,3,4