Toxoplasma gondii is a persistent protozoan parasite capable of infecting almost any warm-blooded vertebrates. SAG1 (p30) is the prototypic member of a superfamily of surface antigens called SRS (SAG1-related sequence). It constitutes the most abundant and predominant antigen. In this paper the primary structure of mature SAG1 gene of an Indonesian T. gondii isolate is described and sequence comparison is made with published sequence data of 7 other strains or isolates. Sequence comparison indicated that SAG1 is highly conserved through evolution and despite parasite spreading world-wide. Sequences may be divided into two major families, independent of the strain/isolate geographic origin. Variations were mainly localized at the C-terminal half or domain 2 and some clustered in restricted areas. Sequence comparison allowed us to define the Indonesian isolate as genuine virulent RH strain. A phylogenetic tree of Toxoplasma strains/isolates was constructed based on SAG1.
Amino Acid Sequence ; Animals ; Antigens, Protozoan/chemistry/*genetics ; Base Sequence ; Cloning, Molecular ; DNA, Protozoan/chemistry/genetics ; Goat Diseases/parasitology ; Goats ; Indonesia ; Molecular Sequence Data ; Phylogeny ; Polymerase Chain Reaction ; Protozoan Proteins/chemistry/*genetics ; Sequence Alignment ; Sequence Analysis, DNA ; Toxoplasma/*genetics/*immunology/isolation&purification ; Toxoplasmosis/parasitology ; Zoonoses/parasitology

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions (SCAR) with high mortality and have a significant public health impact because of high mortality and morbidity. OBJECTIVE: To describe data the epidemiological features, etiology, and treatment of retrospectively reviewed data of all patients with SJS and TEN. METHODS: Retrospective study was conducted in patients with SJS and TEN treated from January 1, 2009 to December 31, 2013 in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. RESULTS: A total of 57 patients were enrolled in the study. Thirty-nine cases of SJS (21 males and 18 females), 7 cases of SJS overlapping TEN (4 males and 3 females), and 11 cases of TEN (5 males and 6 females) were reported. All cases of SJS and TEN were caused by drugs, such as paracetamol (16.56%), carbamazepine (7%), amoxicillin (5.73%), ibuprofen (4.46%), rifampicin (3.18%), and trihexyphenidyl (3.18%). All cases were treated systemically with corticosteroid alone (100%). Seven from 57 patients (12,28%) died; 5 cases developed sepsis and 2 cases developed respiratory failure. The mortality rate was 7.69% in SJS, 0% in SJS/TEN overlap, and 36.36% in TEN. CONCLUSION: The role of systemic corticosteroids in SJS and TEN are still controversial, but with a prompt and earlier treatment reduces mortality and improves outcomes of SJS and TEN patients.
Acetaminophen ; Adrenal Cortex Hormones ; Amoxicillin ; Carbamazepine ; Hospitals, General ; Humans ; Ibuprofen ; Indonesia ; Male ; Mortality ; Public Health ; Respiratory Insufficiency ; Retrospective Studies ; Rifampin ; Sepsis ; Stevens-Johnson Syndrome ; Trihexyphenidyl

Introduction: Tuberculosis (TB) is the most common opportunistic infection experienced by HIV patients that can affect the success of antiretroviral (ARV) therapy. This study aimed to determine the association between tuberculosis infection and loss to follow-up (LTFU) among HIV patients after ARV therapy initiation. Methods: This retrospective cohort study was conducted by observing HIV patients in Saiful Anwar General Hospital, Indonesia who were diagnosed in 2015 for 39 months based on medical records data. The number of samples that met the inclusion and exclusion criteria was 170 patients. Kaplan Meier and Cox Regression were the statistical tests used to analyze data in this study. Results: The probability of HIV patients to retain in ARV therapy for 39 months was 90% among HIV co-infected TB patients and 84% among HIV without TB co-infection. However, no significant difference was found (p-value = 0.41). Most of the incidence of LTFU in both groups occurred in the first year after ARV initiation. Cox Regression analysis showed that TB infection did not have a significant relationship with the incidence of LTFU ARV therapy (HR 0.62; 95% CI 0.18 – 2.08; p-value = 0.44). Conclusion: This study found that TB infection did not have a significant association with LTFU after ARV initiation. However, most of LTFU in both groups (the co-infection group and without TB co-infection) occurred in the first year of ARV therapy. Providing intensive counseling in the initial phase could increase the commitment of HIV patients for staying in ARV therapy.

BACKGROUND: Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD. OBJECTIVE: The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians. METHODS: Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017. RESULTS: The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included. CONCLUSION: The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.
Adrenal Cortex Hormones ; Asia ; Asian Continental Ancestry Group ; Atrophy ; Calcineurin Inhibitors ; Consensus ; Dermatitis, Atopic ; Dermatology ; Eczema ; Humans ; Indonesia ; Phenotype ; Phototherapy ; Skin ; Skin Care ; Steroids ; Venereology

Introduction: Dyslipidemia is a significant factor in cardiovascular and other diseases. Corn can be used to treat dyslipidemia. This study is to determine the effect of boiled corn water on levels of HDL-C, LDL-C, triglycerides (TG), and total cholesterol (TC) in people with dyslipidemia in certain areas in Indonesia. Methods: We used a quasi-experimental pretest-posttest control group design. A sample of 40 people for each group was taken using a purposive sampling technique. The group was given the intervention of corn-boiled water @ 200cc twice daily for seven days. Blood lipid profile using fasting and examined by Fluorometric-enzymatic assay method. All procedures are carried out based on operational standards. Within-group comparisons used the Wilcoxon test, while between-group comparisons used the Mann-Whitney U and Independent T-Test. Results: The LDL-C control group experienced an increase of 65.1 mg/dL, and the entire group’s lipid profile variation showed no difference between the pretest and posttest (p>.05). The intervention group showed an increase in HDL-C (0.1 mg/dL), a decrease in LDL-C (30.2 mg/ dL), TG (27.0 mg/dL), and TC (35.6 mg/dL). Within-group comparison of the intervention group showed HDL-C (p.153), LDL-C (p.001), TG (p.023), and TC (p<.001). A between-group comparison showed HDL-C (p.101), LDL-C (p.034), TG (p.003), and TC (p.006). Conclusion: Whole corn boiled water provides good evidence that it is effective in lowering LDL-C, TG, and TC, as well as improving dyslipidemia in HDL-C patients. This intervention can be used as an alternative treatment for dyslipidemia in terms of nutrition.