BACKGROUND Stress is one of the factors that cause apoptosis in neuronal cells. Centella asiatica has a neuroprotective effect that can inhibit apoptosis. This study aimed to examine the effect of Centella asiatica ethanol extract on B-cell lymphoma 2 (Bcl-2) protein expression in the prefrontal cortex of rats. METHODS An experimental study was conducted on 34 brain tissue samples from male Sprague Dawley rats exposed to chronic restraint stress for 21 days. The samples were taken from following groups: non-stress group K, negative control group P1 (stress + arabic gum powder), P2 (stress + C.asiatica at 150 mg/kgBW), P3 (stress + C.asiatica at 300 mg/kg BW), P4 (stress + C.asiatica at 600 mg/kg body weight) and positive control group P5 (stress + fluoxetine at 10 mg/kgBW). The samples were made into sections that were stained immunohistochemically using Bcl-2 antibody to determine the percentage of cells expressing Bcl-2. Data were analyzed using one way ANOVA test followed by a post - hoc test. RESULTS There were significant differences in mean Bcl-2 expression between the groups receiving Centella asiatica compared with the non-stress group and stress-only group (negative control group) (p<0.05). The results were comparable to those of the fluoxetine treatment group. CONCLUSION The Centella asiatica ethanol extract was able to increase Bcl-2 expression in the prefrontal cortex of Sprague Dawley rats exposed to restraint stress. This study suggests that Centella asiatica may be useful in the treatment of cerebral stress.

BACKGROUND Soursop leaf contains annonaceous acetogenins and alkaloids. The acetogenins act as inhibitors of mitochondrial complex I, suppress ATP production and cause cell degeneration, whereas the alkaloids act as neurotoxins. Neuronal degeneration will be followed by an increase in neuroglia (gliosis). Hepatic clear cell foci represent the morphology of liver degeneration. The purpose of this study was to evaluate the effect of soursop leaf extract on number of neuroglia brain gliosis and hepatic clear cells in female rats. METHODS This study was an experimental study with a post-test only control group design. Ten female Sprague-Dawley strain rats were divided into one control and one treatment group. The control group was gavaged with distilled water, while the treatment group was gavaged with aqueous soursop leaf extract at a dose of 1000 mg/kgBW/day for 90 days. Rat brain tissue samples were taken at day 91 with a transcardial perfusion technique. The number of neuroglia in rat cerebral cortex, hippocampus, substantia nigra, and nucleus accumbens and the number of hepatic clear cells were determined. Independent t-test was used to examine the differences in the numbers of neuroglia and hepatic clear cells between control and treatment groups RESULTS The results of independent t-test analysis found a significant difference in the number of neuroglia in the cerebral cortex (p=0.015) and nucleus accumbens of the rats (p=0.030), and significant differences in the number of hepatic clear cells (p=0.029). CONCLUSIONS Aqueous soursop leaf extract orally increases neuroglia of the cerebral cortex and nucleus accumbens, and hepatic degeneration in female rats.

BACKGROUND The presence of Plasmodium falciparum resistance and decreased efficacy of artemisinin and its derivatives has resulted in the issue of malaria becoming increasingly complex, because there have been no new drugs as artemisinin replacements. The aims of this research were to evaluate in vitro changes in ultrastructural morphology of P. falciparum 2300 strain after exposure to artemisinin. METHODS The research used an experimental design with post test only control group. Cultures of P. falciparum 2300 strain in one control and one mutant group were treated by exposure to artemisinin at IC50 10-7 M for 48 hours. Ultrastructural phenotypic examination of ring, trophozoite and schizont morphology and developmental stage in the control and mutant group were done at 0, 12, 24, 36, 48 hours by making thin blood smears stained with 20% Giemsa for 20 minutes and examined using a microscope light at 1000x magnification. RESULTS Dormant forms occurred after 48 hours of incubation with IC50 10-7 M artemisinin in the control group. In the mutant group, dormant forms, trophozoites with blue cytoplasm and normal schizont developmental stages were seen. Ultrastructural phenotypic morphology at 0, 12, 24, 36, 48 hours showed that in the control group dormant formation already occurred with exposure to IC50 10-7 M, while in the mutant group dormant formation occurred only with exposure to IC50 2.5x10-5 M. CONCLUSION Exposure to artemisinin antimalarials in vitro can cause phenotypic morphological changes of dormancy in P. falciparum Papua 2300 strain.

BACKGROUND Many tumors express on their receptor tyrosine kinases vascular endothelial growth factor activity associated with angiogenesis. Inhibition of angiogenesis through reduction of tyrosine kinase activity is a promising strategy for cancer therapy. The present study aimed to determine the mechanism and potency of ethyl p-methoxycinnamate (EPMC) isolated from Kaempferia galanga as angiogenesis inhibitor. METHODS A laboratory experimental study was conducted using chorio-allantoic membranes (CAMs) of nine-day old chicken eggs induced by 60ng basic fibroblast growth factor (bFGF). Ethyl p-methoxycinnamate (EPMC) potency was determined at dosages of 30, 60, 90 and 120 µg and compared with celecoxib 60 µg as reference drug and one negative bFGF-induced control group. Neovascularization and endothelial cell count in CAM blood vessels were evaluated. To predict the antiangiogenic mechanism of EPMC, a docking study was performed with the Molegro Virtual Docker program on tyrosine kinase as receptor (PDB 1XKK). RESULTS Angiogenesis stimulation by bFGF was prevented significantly (p<0.05) by EPMC at dosages of 30, 60, 90 and 120 µg and this activity was dose dependent. Molecular docking showed interaction between EPMC functional groups and tyrosine kinase amino acids at Met766, Met793, Thr854, Thr790, Gln791 and Ala743. There was an association between EPMC antiangiogenic activity and docking study results. CONCLUSIONS Ethyl p-methoxycinnamate is a potential new angiogenesis inhibitor through interaction with tyrosine kinase. EPMC could be a promising therapeutic agent for treatment of angiogenesis-related diseases.

BACKGROUND Prematurity refers to live births before 37 weeks of gestation, wherein the baby is born before the body and its organ systems achieve perfect maturity, and this disorder is still a global problem. The high incidence of prematurity is a problem in developing and also in developed countries. Certain conditions accompanying pregnancies like preeclampsia, infection, and placental insufficiency, may trigger uterine hypoxia, causing premature birth. The placental condition is related to the intra-uterine fetal condition. In prolonged placental hypoxia, there occurs a compensatory mechanism, i.e. an increase in placental angiogenesis. This study aimed to evaluate the effect of hypoxia on fetal blood vessel count as compensatory mechanism for tissue hypoxia. METHODS An observational-analytical cross-sectional design using paraffin blocks of conserved premature placentas, comprising 31 samples of hypoxic premature placentas and 28 samples of non-hypoxic premature placentas, selected using non-random consecutive sampling. The samples were made into slides and stained with hematoxylin-eosin for assessment of histological structure, including fetal blood vessel count and integrity, villus conditions, syncytiotrophoblastic nuclear changes, and syncytiotrophoblastic nuclear aggregation. Mann-Whitney test was used to compare the difference of blood vessel count between groups. RESULTS Assessment of histological structure showed a significant increase in fetal blood vessel count in the hypoxic group [8.00 (5-15)] as compared with the non-hypoxic group [7.50 (3-15)]. CONCLUSION The hypoxia in premature placentas caused an increase in the number of fetal blood vessels as a form of compensation for disturbed oxygen homeostasis.

BACKGROUND Hepatocellular carcinoma (HCC) incidence is increasing in Asia and Africa. Locoregional minimally invasive transarterial chemoembolization (TACE) is the palliative therapy of choice, improving survival rate. Adequate lipiodol dose calculation in TACE is necessary to produce good therapeutic effect. Lipiodol retention pattern can predict TACE therapeutic effect. This study aimed to determine correlation of lipiodol volume/tumor volume (L/V) ratio and lipiodol volume/tumor diameter (L/D) ratio with lipiodol retention pattern in post-TACE CT-scans of HCC patients. METHODS This cohort prospective study was done from November 2013 to March 2014 on eighteen HCC patients with post-TACE therapy in Dr.Kariadi Hospital, Semarang, fullfilling inclusion and exclusion criteria. Lipiodol retention pattern was observed on 28 days post-TACE and classified as type I (lipiodol accumulation in tumor and surrounding area), type II (homogenous accumulation in tumor only), and type III (partial accumulation). The Spearman correlation test was used to determine any relationships between the various variables studied. RESULTS Spearman correlation test showed that lipiodol volume had significant moderate correlation with lipiodol retention pattern (r=-0.684; p=0.002). Both L/V and L/D ratios had moderately significant correlation with lipiodol retention pattern (r=0.511; p=0.030; and r=0.518; p=0.028, respectively). CONCLUSION Correlations of L/V ratio L/D ratio with lipiodol retention pattern were both moderately significant. Lipiodol dose calculation based on L/V ratio is suggested considering the irregular three-dimensional form of the tumor, making volumetric measurement more appropriate.

BACKGROUND Few studies have investigated the impact on olfactory functioning of occupational exposure to toluene, an industrial solvent used in paints and cleaning fluids. The estimated olfactory dysfunction prevalence is 0.5–5%. Patients frequently do not complain about olfactory dysfunction. However, occupational exposure to chemicals may affect workers’ health and safety, because of their continuous inhalation. This study aimed to examine the relationship between toluene exposure and olfactory dysfunction in furniture workers. METHODS This was a cross-sectional study involving 65 workers. Data collection was by observation and interview on demographic characteristics, history of habits, and symptoms of chronic rhinitis. Risk of exposure scores were evaluated from potential hazard, exposure level, duration of employment, type of work, use of masks, ventilation of work space, and education and training. Olfactory function was tested using Sniffin’ Sticks, and determination of environmental toluene level was by personal sampling. The odds ratio was used to test correlations between variables. RESULTS Only 44 subjects could be analyzed, 37 (84.1%) of whom had olfactory dysfunction. Workers with high toluene exposure had a significantly 12.5- fold risk of olfactory dysfunction in comparison with those with low exposure (OR=12.5; CI 95% 1.35 – 115.79). CONCLUSIONS Toluene exposure increases risk of olfactory dysfunction in furniture workers. Olfactory function testing should be considered for initial screening or periodic testing of furniture workers. Low toluene levels with a high proportion of olfactory dysfunction indicate that olfactory dysfunction is an early negative impact of chemical inhalation.

BACKGROUND Women with HIV/AIDS (WLWHA) have a complex psychosocial burden and a tendency to negative self-esteem, possibly resulting in mental and emotional problems. They need family support to deal with the HIV/AIDS infection and its psychosocial burden. The purpose of this study was to determine chacteristics of family support, self-esteem, and depression of WLWHA and the relationship between family support and self-esteem and depression. METHOD This was a cross-sectional study of 99 WLWHA infected through their husbands/partners, with no history of drug abuse. The data was taken by a consecutive sampling of two proportions test at Dharmais Cancer Hospital from November 2013 – January 2014. The instruments comprised a demographic questionnaire, the Rosenberg Self-Esteem questionnaire, the Hamilton Depression Rating Scale (HDRS), and a family support questionnaire. The data was analyzed by binary logistic regression. RESULTS There were 99 respondents with mean age of 36 years, of whom 44.4% were high school graduates, 54.5% unemployed, and 91.9% had HIV/ AIDS for more than a year. Binary logistic regression analysis showed no significant relationship between family support and self-esteem (p=0.700) and depression (p=0.396). Good family support has a protective effect of 1.3 times (OR=0.772; 95%CI: 0.138-3.770) towards increasing self-esteem, whereas poor family support increases the risk of depression 1.5 times (OR=1.477; 95%CI: 0.598-3.645) in WLWHA infected with HIV/AIDS from their husband/partner. CONCLUSIONS Good family support tend to have a protective effect towards increasing self-esteem, whereas poor family support increases the risk of depression in WLWHA infected with HIV/AIDS from their husband/partner.

Cardiovascular disease (CVD) incidence increases with age and is frequently higher in the elderly.(1) Therefore prevention of CVD in the elderly through management of risk factors is important in order to reduce the risk of coronary heart disease (CHD). There are several risk factors of CVD that can be modified, such as smoking, physical activity, and unhealthy diet. Cessation of smoking is the most potent measure to prevent thousands of CVD events and death

BACKGROUND Lead acetate (Pb) inhibits heme biosynthesis through inhibition of d-aminolevulinic acid dehydrogenase (d-ALAD), copro porphyrinogen oxidase, and ferro chelatase. Zinc supplementation increases lead-binding metallothionein proteins. The purpose of this study was to find evidence that zinc supplementation prior to lead exposure improves heme biosynthesis in rats METHODS This was a randomized post-test only control-group design study involving 28 rats assigned to 4 groups (1 control and 3 treatment groups). The treatment groups were supplemented with zinc at doses of 0.2, 0.4, and 0.8 mg daily by gavage for 3 weeks. From week 4 to 13, all groups were exposed to lead 0.5 g/kg BW/day by gavage. At the end of week 13, d- ALAD, erythrocyte protoporphyrin (EPP), and heme concentrations were determined by means of ELISA. One-way ANOVA, followed by Bonferroni’s test was used to analyse the data. RESULTS Mean d-ALAD concentrations decreased from the control group down to treatment group 3 (0.24 ± 0.20; 0.15 ± 0.15; 0.12 ± 0.11; 0.05 ± 0.06 ng/ mean per unit). Mean EPP concentrations decreased from the control group down to treatment group 3 (1.96 ± 0.50; 1.24 ± 0.24; 1.03 ± 0.05; 0.62 ± 0.16 ng/mL). Mean heme concentrations increased from the control group up to treatment group 3 (8.07 ± 2.64; 10.11 ± 2.27; 10.04 ± 1.65; 11.41 ± 2.58 µM). ANOVA followed by Bonferroni showed that EPP concentrations differed significantly between the control group and treatment group 3 (p=0.00). CONCLUSION Zinc supplementation prior to lead exposure improves heme biosynthesis in rats exposed to lead.