Orthodontic Treatment of Unilateral Cleft Lip and Palate Associated with Agenesis of Maxillary Lateral Incisors: A Case Report Cleft lip and palate (CLP) is a common congenital condition presenting significant orthodontic challenges due to maxillofacial growth disturbances, associated malocclusions, and dental anomalies. Patients with CLP often have complex dental and skeletal issues, requiring a comprehensive, interdisciplinary approach to address functional and aesthetic concerns. An 11-year-old female presented with unilateral cleft lip, alveolus, and palate (UCLP) associated with dental anomalies, which included a skeletal Class I relationship with Angle Class II malocclusion, bimaxillary retrognathia, bidental retroclination, negative overjet, lower dental midline shifting, anterior crossbite, microdontia #12, agenesis #22, and several malpositioned teeth. The patient was treated with fixed orthodontic appliances, including the extraction of remaining deciduous teeth, mesialisation of the teeth on the upper left side to close the space resulting from agenesis, and space management in the mandible. Significant improvements were observed in overjet, dental alignment, occlusion, and aesthetics after a 17-month treatment period. Following orthodontic treatment, restorative procedures were performed on teeth #12 and #23. Adhering to the prescribed retainer schedule is essential to preserving dental esthetics and the stability of the treatment results. Comprehensive orthodontic treatment with fixed appliances effectively addressed the complex dental and skeletal issues of this patient with UCLP. The treatment led to improved dental function and aesthetics, highlighting the importance of a personalised approach in addressing cleft cases.

Background: Calcium is essential for bone health, but its intake remains inadequate in populations with limited dairy consumption. Fish bones, abundant in calcium and phosphorus, represent a largely untapped natural resource for dietary calcium supplementation. The application of high-energy ball milling (HEM) presents a promising strategy to enhance calcium bioavailability by producing particles at the nanoscale. Methods: This study used HEM to convert fish bones from Euthynnus affinis (tuna) and Lutjanus sp. (snapper) into nanoparticles. The resulting powder was analyzed for particle size, morphology, crystallinity, thermal, flowability, hygroscopicity, mineral composition, and proximate constituents. Results: The HEM process successfully reduced the particle size of snapper and tuna bone powder to 729.83 and 847.93 nm, respectively, without altering their crystallinity. Morphological analysis revealed irregularly shaped particles, while thermal analysis indicated an exothermic decomposition pattern. No hygroscopic properties were observed in any of the samples. The nanonization process preserved the intrinsic mineral composition of the fish bones. Calcium/Phosphorus ratios remained >1.8. Elemental analysis confirmed high levels of calcium, phosphorus, and essential minerals such as potassium, magnesium, and sodium, while the protein and ash contents met nutritional standards. Conclusions Fish bone-derived nanoparticles produced via HEM exhibit advantageous physicochemical characteristics for nutraceutical applications and represent a promising source of bioavailable calcium to support bone health.

Introduction: Tobacco production is increasing in certain regions of Indonesia due to its high economic value. Tobacco and its products can have harmful effects on the health of consumers, producers and processing workers. Analysis of blood samples has shown that tobacco farmers are at risk of developing occupational diseases related to pesticide exposure and nicotine absorption through the epidermis of wet tobacco leaves. The aim of this study was to compare blood cholinesterase levels in tobacco plantation workers in relation to their working hours and use of personal protective equipment (PPE). Methods: This cross-sectional observational study was conducted in ten subdistricts in Jember district, Indonesia, and included 50 participants selected using proportional sampling. Spearman’s test was used to analyse the relationship between variables. Results: The significance value of the relationship based on Spearman’s test between working hours and blood cholinesterase levels of tobacco farmers in Jember was 0.058 > α (0.05). Meanwhile, the significance value of the relationship between working hours and complete blood count, specifically mean corpuscular haemoglobin concentration (MCHC), was 0.00 < α (0.05), and between PPE use and blood cholinesterase levels was 0.035 < α (0.05). Conclusion: Working hours were not associated with blood cholinesterase levels, but were associated with blood MCHC levels. Meanwhile, the use of PPE was found to be associated with cholinesterase levels in tobacco farmers.

POTENTIAL OF CHITOSAN BLACK SOLDIER FLIES (Hermetia Illucens) PUPAE ON POST-EXTRACTION WOUND HEALING PROCESS Chitosan can accelerate the wound healing process by increasing inflammatory cells, such as macrophages, and increases fibroblast proliferation after tooth extraction. The Black Soldier Fly (BSF) pupae containing 35% chitin, which can be processed into chitosan and was found to have potential benefits in post-extraction wound healing. This study aimed to assess the potential of chitosan BSF pupae by monitoring the presence of macrophages and fibroblasts after tooth extraction. Chitosan BSF pupae was made into a gel preparation. Eighteen male Cavia cobaya were divided into control and treatment groups (n = 9 each). BSF pupae chitosan gel was applied to the post-extraction tooth socket in the treatment group (CBSF), while none was applied to the control group (CC). The samples were decapitated on the 2nd, 3rd, and 5th days by cutting the mandibular bone for histopathological examination, which was carried out by measuring the number of macrophages and fibroblasts through microscopic observation and data analysis. There an increase in macrophages evident in CBSF group than in CC group on the 2nd and 3rd days, while a decrease was seen on the 5th day of CBSF group than CC group. There was an increase in fibroblasts evident in CBSF group than in CC group on the 2nd, 3rd, and 5th days. Kruskal Wallis test indicated a significant difference in macrophages between the control and the treatment group (p = 0.006), and the One-way ANOVA test showed a significant difference in fibroblasts between both groups (p = 0.000). In conclusion, the application of chitosan BSF pupae accelerated the post-extraction wound healing process in Cavia cobaya by modulating the number of macrophages and increasing the number of fibroblasts.

THE EFFECT OF ETHANOLIC EXTRACTS FROM VARIOUS TYPES OF BETEL LEAVES ON THE GROWTH OF PORPHYROMONAS GINGIVALIS People in Southeast Asia have widely used betel leaves for traditional daily medicine. Several types of betel leaves have been empirically proven to treat various dental and oral diseases. Four of them are black betel (Piper betle var. Nigra), green betel (Piper betle L.), earth betel (Peperomia pellucida) and red betel (Piper crocatum). This research aimed to compare the effect of the four types of betel leaf extract inhibiting the growth of Porphyromonas gingivalis (P. gingivalis), the periodontal pathogenic bacteria. The design of this study was a post-test control group design using in vitro disc diffusion method. There were 4 test groups, namely the black betel, green betel, earth betel, and red betel groups, each consisting of a concentration of 25%, 50%, 75%, and 100%. Sterile distilled water was used as the negative control, while the positive control is Metronidazole gel 25%. Sixteen repetitions were performed for each group, and then the average diameter of the inhibition zone formed in each group was calculated using a caliper. The results showed that all groups were effective in inhibiting the growth of P. gingivalis bacteria, with the highest effectiveness obtained from 100% concentration, sequentially 19.65(±0.64) mm for black betel, 19.85(±0.61) mm for green betel, 21.70(±0.53) mm for earth betel, and 25.16(±1.00) mm for red betel. Even so, these results are still below the effectiveness of metronidazole, producing an inhibition zone of 27.50(±0.09) mm. There is a significant difference in the comparison between concentrations for each type of betel leaf (P-value < 0.05). Likewise, comparing each concentration between each kind of betel leaf, the result is also a significant difference (P-value: 0.000). These results prove that betel leaf has efficacy as an antibacterial agent, which might be due to the presents of flavonoids, alkaloids, tannins, and essential oils.

Introduction: Breast cancer is now one of the leading causes of death and morbidity worldwide, including in Indonesia. Every health care professional and community member should pay close attention to these issues. Women diagnosed with breast cancer will experience physical, psychological, and social issues. Methods: This study looked into breast cancer patients’ experiences with holistic nursing care. The complexity of the difficulties confronting breast cancer patients will influence their experiences and perceptions, necessitating a holistic approach to nursing services. A qualitative exploratory, descriptive method was adopted in the investigation. During data collection, fifteen participants were recruited and interviewed. Focus Group Discussion (FGD) was utilized to collect data. Result: The study’s findings provide five significant themes: (1) knowledge and understanding of breast cancer; (2) experiences felt at the beginning of breast cancer complaints; (3) non-health breast cancer treatment; (4) perception of nursing services received by breast cancer patients; (5) facts and holistic needs during and beyond treatment; and (6) patients’ expectations of nursing services to help their needs. Conclusion: The findings provide information on how breast cancer patients understand the examination procedure, accept a diagnosis, and proceed to treatments.

A new cinnamyl acid derivative, willughbein A (1) along with pinoresinol (2), alyterinate A (3), and scopoletin (4), were isolated from the roots of Willughbeia coriacea Wall. The structure of 1 has been determined based on HRESIMS, 1D, and 2D NMR spectral data. All of the isolates were evaluated for their cytotoxicity against three human cancer cells (HeLa, T47D, MCF-

Purpose: This study investigates natrium iodide symporter (NIS) expression in three breast cancer subtypes to predict radioiodine response. Materials and Methods: Frozen breast tissues from triple negative (TN), human epidermal receptor 2 (HER2+), and luminal A cancers were used in this research. NIS protein expression in each subtype was analyzed using immunohistochemistry (IHC) and western blot (WB). Secondary data such as age, subtypes, and Ki 67 index were drawn from the surgical oncologist database. Breast cancer cell lines were used to investigate the effect of radioiodine by measuring cell proliferation. Results: The forty-one breast cancer samples were analyzed consisted of the following subtypes: TN, HER2+, and luminal A were 58%, 22%, and 20% respectively. The stages of disease were 2A to 4A. Most of samples were at 3B. Ki 67 index of TN, HER2+, and luminal A were 21 ± 12, 19 ± 5, and 7 ± 3 respectively. The NIS expression was detected in 95% of samples in cytoplasm and/or cell membrane; 93% of samples were invasive breast carcinomas. Only 20% of the samples showed NIS expression at cell membrane; four samples were HER2+, and other four were TN subtypes. NIS membrane score was significantly positively correlated with Ki67 index, p = 0.04. NIS protein expression was detected at sizes 88 kDa, 50 kDa, and 27 kDa. Cell proliferation rate means of MDA-MB 231, SKBR3, and MCF7 cells were 81.6 ± 4, 10.6 ± 5, and 15.4 ± 13 respectively (p = 0.009). Conclusion NIS protein expression is detectable in breast cancer cells to varying degrees. HER2+ is the most likely to express NIS in the cell membrane followed by TN subtypes. This indicates that radioiodine could be used as a novel adjuvant treatment in breast cancer.

Aims: This study was conducted to observe the stability of Spondias pinnata leaf (SPL) extract antibacterial at different pH, salt concentration and temperature, to examine its antibacterial effectivity on minced fish, and to determine its fraction’s antibacterial mechanism. Methodology and results: The tested SPL ethanolic extract, n-hexane, chloroform, ethyl acetate and water fractions’ antibacterial activity against Bacillus cereus and Vibrio parahaemolitycus. Its stability against pH, salt, and thermal variation was studied, as well as the mechanism and application in fish. Ethyl acetate fraction and water fraction showed the highest activity against B. cereus (MIC 0.62 mg/mL). Protein profile analysis using gel electrophoresis showed that B. cereus cells exposed with SPL ethyl acetate fraction and water fraction showed thinner protein bands as compared to control. Severe damage of the cells treated with 3 MIC was also observed under SEM. Antibacterial activity of SPL ethanolic against Bacillus cereus and Vibrio parahaemolitycus were stable against heat treatment (80–121 °C for 15 min) and NaCl treatment (0–10% w/v), whereas the inhibition zone respectively at pH 4 (10.31±0.25 and 8.09±0.97 mm) was higher than pH 7 (8.45±0.52 and 6.66±1.84 mm). Application of SPL ethanolic extract in fish broth showed higher antibacterial activity than in fish flesh, which gave bactericidal effect at 3 MIC. Conclusion, significance and impact of study Ethanol extract can be developed as a natural preservative in fish

INTRODUCTIONSince the first human cases of H5N1 avian influenza virus infection were detected in Indonesia in 2005, the Sulianti Saroso Infectious Diseases Hospital in Jakarta has managed 27 confirmed cases from September 2005 to December 2007.

MATERIALS AND METHODSWe reviewed the clinical and epidemiological data of these patients.

RESULTSClinical and radiological features were not specific. Most patients were young and had indirect contact with infected poultry. The majority of cases presented to the Infectious Diseases hospital late when the patients already had features of the systemic inflammatory response syndrome (SIRS). The mortality was high at 77%.

CONCLUSIONThere is clearly an urgent need for better field diagnostics and therapeutics for the management of this emerging pathogen.

Adolescent ; Adult ; Animals ; Birds ; Child ; Child, Preschool ; Female ; Humans ; Indonesia ; epidemiology ; Infant ; Infant, Newborn ; Influenza A Virus, H5N1 Subtype ; isolation & purification ; Influenza in Birds ; diagnosis ; epidemiology ; Male ; Retrospective Studies ; Risk Factors