ObjectivesGlobally, there are increasing cases of chronic kidney disease of unknown origin among heat-exposed workers. We aimed to see the kidney damages of indoor heat-exposed workers and whether urine specific gravity can predict any kidney damages.DesignA cross-sectional study.SettingA shoe-making factory in West Java, Indonesia.Participants119 subjects were included. Minimum total sample size was 62. Subjects were indoor heat-exposed workers who were exposed to occupational wet-bulb globe temperature (WBGT) of 28°C–30°C for 8 hours daily with 1 hour break, 5 days a week. The inclusion criterion was healthy subjects according to the result from annual medical check-up in 2019. The exclusion criteria were subjects who were taking vitamins and/or supplements that might cause disturbance in urine specific gravity and/or hydration status, pregnant and fasting.Primary and secondary outcome measuresArea under the curve (AUC), sensitivity and specificity of urine specific gravity for the detection of urinary nephrin and urinary kidney injury molecule-1 (KIM-1) were analysed. Estimated glomerular filtration rate (eGFR) and quantitative albuminuria were also measured.ResultsWBGT in the work area of the subject was 28°C–30°C. There were 15 (12.6%) subjects who had eGFR <90 mL/min, but ≥60 mL/min. High serum vasopressin levels were found in 79 subjects with a mean of 6.54 (95% CI 5.94 to 7.14) ng/mL. Most subjects had nephrinuria (87.4%) with preserved renal function (87.4%). Several subjects had elevated urinary KIM-1 (10.9%) and albuminuria (7.6%). AUC of urine specific gravity for increased urinary nephrin was 81.7% (95% CI 68.8% to 94.6%) and statistically significant (p<0.001). Cut-off value of ≥1.018 for urine specific gravity has sensitivity of 71.2% and specificity of 80% for detecting elevation of urinary nephrin levels.ConclusionUrine specific gravity with a cut-off value of ≥1.018 could be used to detect nephrinuria among heat-exposed workers.

Introduction. Senescent cells have been demonstrated to release High Mobility Group Box 1 (HMGB1) which induces labor through an inflammatory pathway. This research is aimed at demonstrating whether telomere shortening, proinflammatory HMGB1, and oxidative damage marker 8-OHdG play a role in the placenta of preterm birth in comparison to term birth. Method. A cross-sectional study on 67 full thickness of the placenta obtained from mothers with term and preterm birth. Mothers with clinical signs of infection ( fever > 38 ° C , leukocytosis > 18000 / μ L , or abnormal vaginal discharge) and other pregnancy complications were excluded. Real-time polymerase chain reaction was performed to measure T/S ratio and ELISA quantification to measure the amount of HMGB1 and 8-OHdG. Result. A total of 34 placentas from preterm and 33 placentas from term birth were examined. Maternal characteristics were comparable between the two groups. There were no statistical difference of T/S ratio ( p = 0.181 ), HMGB1 ( p = 0.119 ), and 8-OHdG ( p = 0.144 ) between the preterm and term groups. HMGB1 was moderately correlated with 8-OHdG ( r = 0.314 ). Telomere T/S ratio of the placenta did not differ between preterm and term labor despite difference in gestational age, suggesting earlier shortening in the preterm group. It is possible that critical telomere length has been achieved in both term and preterm placenta that warrants labor through senescence process. The result of our study also showed that HMGB1 was not correlated to telomere length, due to the fact that HMGB1 is not upregulated until the critical length of telomere for senescence is exhibited. Conclusion. Similar telomere length might be exhibited due to early telomere shortening in preterm birth that mimics the term placenta. The relationship between placental telomere shortening and HMGB1 release remains to be uncovered. Further research is needed to discover the factors leading to early telomere shortening in the placenta of preterm birth.

Latar belakang: Bayamduri (Amaranthus spinosus L.) dan sambiloto (Andrographis paniculata Burm F) adalah herbal tradisional yang digunakan untuk pengobatan malaria. Tujuan penelitian ini adalah untuk menentukan aktivitas anti malaria skizontisidal kombinasi kedua ekstrak terhadap mencit yang diinfeksi Plasmodium berghei. Metode: Mencit jantan (galur Balb/c) dengan berat 28-30 g, 7-8 minggu, dibagi menjadi 5 kelompok secara acak, tiap kelompok terdiri atas 4 ekor mencit. Kelompok A: kontrol negatif, kelompok perlakuan dengan ekstrak tanaman (kelompok B, C, D) diberikan 1 kali per hari selama 7 hari. Kelompok B: Amaranthus 10 mg/kgBB, kelompok C: Andrographis 2 mg/ kgBB, kelompok D: kombinasi ekstrak Amaranthus + Andrographis 10 mg + 2 mg/kgBB, dan kelompok E: diberi klorokuin 10 mg/kgBB sekali sehari selama 3 hari. Hasil: Terjadi peningkatan berat badan hanya pada kelompok D, peningkatan kadar hemoglobin pada semua kelompok perlakuan (C, D dan E secara bermakna dibandingkan dengan kontrol, p < 0,05). Aktivitas skizontisidal darah terlihat pada semua kelompok perlakuan, aktivitas tertinggi hampir 90% terlihat pada kelompok D dan E. Tingkat survival adalah 100% pada semua kelompok. Kesimpulan: Kombinasi ekstrak Amaranthus dan Andrographis (10 mg + 2 mg/kgBB) menunjukkan aktivitas skizontisidal darah sama baiknya dengan pemberian klorokuin 10 mg/kgBB.

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