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The Prevalence of Irritable Bowel Syndrome Using Rome IV Criteria in Medical Student and The Related Factors Ahani, Ardhi Rahman; Syam, Ari Fahrial; Putranto, Rudi; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Introduction. Medicine is a long study time. Medical student will take five years study to accomplish the education. Because the lot of task and some taken test, some medical student will face irritable bowel syndrome in their study periods. This study aims to identify the prevalence of IBS in medical student and related factors.Methods. A cross-sectional study of 350 medical student Universitas Indonesia from first grade until fifth grade was done during November-December 2016. This study used stratified randomized sampling. The Rome IV criteria was used for diagnosing IBS. Interview with questionnaire guided was applied to all subjects. A bivariate analysis was done to know relationship between IBS and its related factors using chi-square, unpaired t-test, and their alternatives. Multivariate analysis was done using logistic regression test.Results. The IBS proportions were 18.3% in the female medical students and 9.7% in the male medical students (95% CI 1.11- 3.91). The highest subtype was diarrhea subtype (53.1%). Both student-life stress inventory score (stressor and response to stressor) were higher in IBS group than in non-IBS group (For stressor (66.4 (SB 11.4) vs 60.0 (SB 12.2), p=0,001) and for responseto stressor (64.0 (41-97) vs 55,0 (35-88), p<0,0001). Female sex and anxiety were related to IBS ((aOR 2.14; 95% CI 1.12-4.08) and (aOR 2.89; 95% CI 1.43-5.83)).Conclusions. The IBS proportions were 18.3% in the female medical students and 9.7% in the male medical students (95% CI 1.11- 3.91) with predominant diarrhea subtype (53.1%). Anxiety and woman were related to IBS.
Peningkatan Leukosit, Neutrofil, dan Prokalsitonin Persisten Tanpa Bukti Infeksi pada Kanker Stadium Akhir: Sebuah Laporan Kasus Yanuar, Santosa; Ahani, Ardhi Rahman; Setiabakti, Andrian; Rizka, Aulia; Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Elevation of leukocyte, neutrophil, and procalcitonin (PCT) has been known as a marker of bacterial infection independent of the underlying disease. This article will describe a case of end-stage cancer with persistent elevation of leukocyte, neutrophil, and procalcitonin with no evidence of infection. A 45-year-old female presented with abdominal distension for three months prior to hospital admission. The patient was suspected to have breast cancer with hepatic metastasis based on diagnostic tests. Throughout treatment, the patient experienced persistent elevation of leukocytes, neutrophils, and PCT despite no signs or symptoms of infection from history, physical examination, and diagnostic tests. The patient received antibiotic therapy including ciprofloxacin escalated to meropenem, but leukocytes, neutrophils, and PCT did not decrease. A breast tumor biopsy was performed. The result of biopsy revealed after the patient had passed away. The histopathology was invasive carcinoma, No Special Type (NST) of right breast. The immunohistochemistry showed luminal B type, HER2 positive. The persistent increase in leukocytes and neutrophils in this patient indicates poor prognosis, disease progression, metastasis, and pro-cancer activity of neutrophils. The elevated PCT in this patient may be due to systemic inflammation and/or aberrant secretion from the cancer itself.
Assessing the Potential of Valproic Acid as an Adjuvant Agent among Various Histological Subtypes of Thyroid Cancer: A Systematic Review Makbul, Firshan; Ahani, Ardhi Rahman
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1169

Abstract

Background: Valproic acid (VPA) has gained attention as an anticonvulsant drug with potential anti-cancer effects, including in thyroid cancer. It hampers the viability of cancer cells by blocking their cell cycle progression, specifically in the G1 or sub-G1 phases. However, the clinical role of VPA as an adjuvant agent, in addition to the thyroid cancer primary treatment, remains an area of investigation.Methods: We conducted a comprehensive systematic literature review from the first publication available to July 2021. We comprised clinical trials and preclinical investigations that explored VPA’s underlying mechanisms and treatment strategies in thyroid cancer.Results: Fifteen eligible studies were included. Thirteen preclinical studies revealed that VPA significantly enhances therapeutic responses across various histological subtypes of thyroid cancer cells. Regarding clinical implications, recent clinical studies indicated no significant effect on tumor response or overall survival.Conclusions: Our findings highlight the key role of VPA as an alternative therapeutic strategy for thyroid cancer, considering its favorable impact on various histological subtypes. Further welldesigned studies in clinical settings are required to identify the knowledge gap regarding its use in other multimodal treatments such as chemotherapy, surgery, and radiotherapy.
Stimulation Effect of Exosome From Healthy Sera to Natural Killer (NK) Cells of Hepatocellular Carcinoma Subject In Vitro Deby, Deby; Antarianto, Radiana Dhewayani; Barasila, Atikah Chalida; Irawan, Cosphiadi; Ahani, Ardhi Rahman; Jasirwan, Chyntia Olivia Maurine; Damayanti, Lia; Ritchie, Ni Ken; Aditya, Robby Nur
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1122

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Background: Hepatocellular carcinoma has a poor prognosis due to limitations of therapy such as late diagnosis, lack of specific biomarkers, and insensitivity to this tumor agent. This study aims to develop immunotherapy using autologous natural killer cells (NK cells) with exosome stimulation for hepatocellular carcinoma patients, addressing treatment limitations.Methods: Experimental research conducted from October 2022 to June 2023 at Universitas Indonesia’s Faculty of Medicine involved three hepatocellular carcinoma patients at Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. NK cells from hepatocellular carcinoma patients were isolated from peripheral venous blood, and exosomes were isolated from the blood serum of healthy donors. Exosome characterization with a particle size analyzer and flow cytometry. Stimulation of exosomes on NK cells for 24 hours, then evaluation of expression of NKp44, NKp46, NKp30, NKG2D, KIR2D, and NKG2A receptors, as well as perforin and granzyme B expression. Visualization of interactions of NK cells with other mononuclear cell fractions (CD4, CD8, CD11c, and CD19) by immunofluorescence. The study compares stimulated and unstimulated NK cells, analyzing their expression of activated and inhibitory receptors, using either the One-Way Anova parametric test or the Kruskal-Wallis non-parametric test for non-normally distributed data.Results: Particle size 100 nm, negative electric charge, and CD63+CD81+ (double positive) exosome isolated results. There was increased expression of receptors NKp44, NKp46, NKp30, NKG2D, decreased expression of NKG2A, and increased expression of perforin and granzyme B in exosome-induced NK cells. There was no cell interaction in the form of immune synapses between exosome-induced NK cells and other mononuclear cell fractions in hepatocellular carcinoma patients. Conclusions: Induction of exosomes into NK cells of hepatocellular carcinoma patients restores the cytotoxic ability of NK cells
Histodynamics of Natural Killer Cells from a Healthy Donor Exposed to Exosomes from the Blood of Hepatocellular Carcinoma Patients Asrinda, Indria; Antarianto, Radiana Dhewayani; Jusuf, Ahmad Aulia; Ahani, Ardhi Rahman; Jasirwan, Chyntia Olivia Maurine; Ritchie, Ni Ken; Nur Aditya, Robby; Irawan, Cosphiadi
Makara Journal of Health Research
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Background: Hepatocellular carcinoma (HCC) is the leading form of liver cancer and the second leading cause of cancer-related deaths globally. Exosomes in the HCC microenvironment can induce significant changes in natural killer (NK) cells during endocytosis. The present study aimed to distinguish exosomes in the blood of HCC patients, analyze changes in NK cell phenotype, and evaluate peroxidase and toluidine blue staining as alternative methods for observing the changes. Methods: NK cells were collected from healthy donors, and exosomes were extracted from the blood of HCC patients. The exosomes were characterized in accordance with MISEV 2018 guidelines, and NK cells were incubated with HCC-derived exosomes. NK cell phenotype changes were assessed using immunofluorescence, toluidine blue staining, and peroxidase staining. Results: The identified exosomes measured 34.7 nm, had a charge of −4.33 mV, and were positive for CD81+. Changes in NK cell receptor expression following exposure to HCC exosomes were not significant (p > 0.05). Immunofluorescence confirmed exosome endocytosis by NK cells, toluidine blue staining revealed negative metachromasia and peroxidase staining indicated morphological NK cell changes. Conclusions: This study demonstrates that peroxidase and toluidine blue staining are effective for observing exosome endocytosis in NK cells, enhancing our understanding of HCC exosome-NK cell interactions and beneficial in developing future therapeutic strategies targeting the HCC microenvironment.