Hypertension is a significant risk factor for cardiovascular diseases. It closely related to the inflammatory process and resulting in chronic inflammation, which had a critical role in the progression of atherosclerosis. Carotid Intima-Media Thickness (CIMT) was known as a surrogate marker of atherosclerosis. Anti-hypertensive drugs are expected to affect CIMT. Aim: to examine the difference CIMT between newly diagnosed hypertension and chronic hypertensive treated by ACE-I or CCB. Method: this cross-sectional study was conducted on 12 newly diagnosed hypertensive patients (control or group 1), 9 hypertensive patients treated by CCB (group 2), and 9 hypertensive patients treated by ACE-I (group 3). Their hypertensive condition was controlled at least for 6 months. We compared CIMT of patients and Tumour Necrosis Factor Alfa (TNF-a) also Interleukin-6 (IL-6) among the groups. Result: there was a significant difference in CIMT between the group 1 and 2 (0.86 vs 0.70; p = 0.027), group 1 and 3 (0.86 vs 0.69; p = 0.018). There was no significant difference between group 2 and 3 (0.70 vs 0.69; p = 0.88). There was no association between CIMT and TNF-a, IL-6, Low-Density Lipoprotein (LDL), triglycerides (TGs) levels, and body mass index (BMI), systolic blood pressure. Conclusion: we found that the CIMT of the control group was thicker than those of the treatment groups. Moreover, differences in the thickness of CIMT of the three groups were not associsted with level of TNF-a, IL-6, TG, and LDL, also BMI, and systolic blood pressure.

Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls. Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.

Brotowali (BR) extract (Tinospora crispa) can be used as an antimalarial. Aim: to determine the effect of BR extract in histopathological and expression of NF?B in mice tubules infected by Plasmodium berghei treated by artesunate (AR). Method: we used 42 C57BL / 6J strain mice as experimental animals, which were randomly divided into 7 groups : negative control (NC), positive control (PC), treatment group consist of AR 32 mg/kb (group 1); BR 70 mg/kg (group 2), combination of AR+BR 50 mg/kg (group 3), AR+BR 60 mg/kg (group 4), and AR+BR 70 mg/kg (group 5). Histological examination (hematoxylin-eosin (HE) staining) and expression of NFKB (immunohistochemical staining) in the kidneys were performed on 7th and 14th. Result: compared to PC group, BR with doses of 70 mg until 14th day, improved the degree of tubular necrosis, interstitial fibrosis, tubular degeneration, and inflammatory cell infiltration (p <0.001) but did not reach NC group (p <0.05). The combination of AR+BR until the 14th day with dose of 50, 60, 70 mg all of dose improves significantly in-term of degree of tubular cell necrosis and inflammatory cell infiltration. The degree of interstitial fibrosis on 14th day only improved in group 4 and 5 (p<0.001 and p=0.003). The level of NF-kB expression on day 7 and day 14 was reduced in group 2, group 4, and group 5 compared to PC group. There was positive correlation on 7th and 14th between NF-kß expression and tubular degeneration, tubular cell necrosis, inflammatory cell infiltration, and interstitial fibrosis. Conclusion: the combination of AR+BR extract can improve histopathological features and reduce NF-kß expression in mice tubules infected by Plasmodium berghei with an optimal dose was 60 mg/day for 7-14 days or 70 mg for 7 days.

e majority of studies indicated that elevated levels of established cardiovascular risk factors, such as age, sex, total cholesterol, LDL cholesterol, systolic blood pressure, body mass index, and a decrease in HDL cholesterol, are associated with an increased CIMT in a graded manner. Hypertension is an important risk factor for cardiovascular complications, especially stroke.[1] Hypertension also has an important complex role in the pathogenesis of atherosclerosis. A continual elevated in blood pressure caused changes in vascular endothelial function, such as increased vascular permeability, decreased endothelial vasodilators, and increased adherence of leukocytes on the surface of the endothelium to the accumulation of macrophages in the intima layer.[2] Hypertension also increases vascular smooth muscle cell (VSMC) proliferation. On the other hand, inflammation and endothelial dysfunction also play a critical role in the pathogenesis of hypertension.[3] Isolated systolic hypertension with elevated pulse pressure is an indication of blood vessel stiffness, that can be considered as a marker of atherosclerosis. Several studies have shown a correlation between hypertension and CIMT thickness and blood vessel stiffness.

Endocrine Disrupting compounds (EDCs) are exogenous materials that can interfere with the functions of the endocrine system. Research has demonstrated that pyrethroid compounds affect endocrine function. Transfluthrin belongs to the pyrethroid group that is widely used. These compounds could interact with estrogen receptor a and may increase the expression of estrogen receptor a in rat testis. Aim: to determine the effect of subchronic inhaled transfluthrin exposure on the expression of estrogen receptor a (ERa). Method: we used 35 adult male Wistar rats as experimental animals, which were randomly divided into 5 groups (n=7 per group): negative control group (rats without treatment), solvent control group (rats exposed to n-hexane solvent), and three treatment groups of subchronic inhaled transfluthrin: 0.1 mg/ml (treatment 1), 0.2 mg/ml (treatment 2) and 0.4 mg/ml (treatment 3), treated for 60 days. The immunohistochemical (IHC) staining was used to assess the expression of ERa. Result: there was a tendency for an increase in ERa expression with the addition of a transfluthrin dose. ER a in negative control group, solvent control group, treatment 1 group, treatment 2 group, and treatment 3 group was 16.75 ± 5.01 %; 16.64 ± 13.00 %; 19.31 ± 6.52 %; 25.63 ± 7.08 %, and 28.79 ± 20.31 %; p>0.05, respectively. There was a weak positive correlation between the dose of transfluthrin with ERa expression (r = 0.38, p = 0.025). Conclusion: subchronic inhalation exposure of transfluthrin in rats showed a tendency to increased the expression of ERa (dose-dependent). There is a weak positive correlation between the dose of transfluthrin with ERa expression.

Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition that can develop into advanced liver disease. The NAFLD spectrum includes simple steatosis, non-alcoholic steatohepatitis (NASH), liver fibrosis, and liver cirrhosis to hepatocellular carcinoma. One of the underlying pathophysiologies is insulin resistance found in metabolic syndrome. People with metabolic syndrome are not always obese, and NAFLD can also be found in this group, known as lean NAFLD, which has different metabolic characteristics. Metabolic characteristics of lean NAFLD include high levels of transaminases and insulin, low insulin sensitivity, low fasting glucose, low necroinflammatory activity, and liver fibrosis. Some related factors are methionine and choline deficiency, excessive acyl-coA expression, and PNPLA3 gene polymorphism. Lean NAFLD is an interesting topic to discuss because practitioners awareness of lean NAFLD is lower compared to obese patients. NAFLD is a risk factor for chronic diseases such as cardiovascular disease, kidney disease, colorectal, atrial fibrillation, and hypothyroidism, so it is essential to be recognized by clinicians. To date, there are no guidelines or recommendations that discuss specific treatments in this lean NAFLD population.

Charcot neuroarthropathy (CN) is a progressive degenerative arthropathy of weight-bearing joints, which rarely complicates diabetes mellitus, usually in the foot or ankle. Commonly, when affecting the foot, it seems to be determined by the interaction of neuropathy, osteopenia, and proinflammatory cytokines on a calcified peripheral vasculature that maintains its ability to vasodilate despite widespread arteriosclerosis. Although often unrecalled, this arthropathy is probably triggered by trauma. Diagnosis is primarily clinical, given the lack and non-specificity of radiological and biochemical findings at the acute stage. CN should be considered in the differential diagnosis of any diabetic patient presenting with a warm swollen lower extremity. Offloading is essential and improves limb survival. Failure to institute corrective measures at an early stage results in a foot that is prone to deformity, ulceration, amputation, and loss of function. We report a case of Charcot foot in a 73 years old female and review of diagnostic modalities.