Purpose This study aimed to investigate the rate and profile of bacterial infections, mortality-associated predictors, and report the most common microorganisms and antibiotic use in coronavirus disease-19 (COVID-19) patients. Patients and Methods This study used a retrospective approach to evaluate the bacterial culture, antibiotic use, comorbidities, imaging, and laboratory discoveries of patients with COVID-19 (hospitalized) confirmed by reverse transcription polymerase chain reaction (RT-PCR) between May and December 2020. We have selected 906 COVID-19 positive patients using a consecutive sampling technique and analyzed data using IBM SPSS-22 statistical software. Statistical analysis included univariate, bivariate, and multivariate analysis. It was carried out using multivariable logistic regression analysis to predict the mortality of COVID-19 patients. Results A total of 410 patients, which involved 247 males with a mean age of 53.9 years were evaluated. Based on the results, the positive bacterial culture was detected in 18.3% of all patients who sent the culture sample test, representing bacterial infections. The Acinetobacter baumannii was the most commonly identified organism, while the proportion of patients treated with antibiotics was 83.4%. Furthermore, azithromycin was prescribed in the highest number of patients with approximately 44.3% of all antibiotics. The total mortality rate was 39.8% and its ratio was higher in COVID-19 patients with bacterial infections (65.3%, X 2 = 25.1, P <0.001). Patients mortality who used antibiotics were also higher compared to those who did not (89% vs 11%, P <0.014). Age, length of hospitalization, bacterial infection, shortness of breath, neutrophil-to-lymphocyte ratio (NLR), and diabetes mellitus were also associated predictors to increased hospital mortality (adjusted OR (aOR) 0.382, P <0.013; aOR 4.265, P <0.001; aOR 3.720, P <0.001; aOR 3.889, P <0.001; aOR 6.839, P <0.003; aOR 1.844, P <0.030), respectively. Conclusion This study discovered that there is high use of antibiotics amongst COVID-19 patients; however, the bacterial infection rates did not exceed one-fifth of the total patients. Furthermore, older age, bacterial infections, a longer length of hospitalization, diabetes mellitus, shortness of breath, and higher NLR have a significant impact on the mortality of COVID-19 patients.

Pendahuluan: Kanker paru merupakan kanker dengan insiden paling tinggi dan menyebabkan mortalitas yang signifikan pada pria. Leptin, sitokin derivat adiposit, memainkan peran penting pada proses karsinogenesis kanker paru. Kurkumin dan silibinin adalah komponen herbal alami dengan karakteristik antikanker bersifat multitarget. Diskusi: Teknologi nanopartikel magnetik (Fe3O4) memiliki sifat super-paramagnetik yang unik, sehingga meningkatkan kemampuan untuk mencapai target spesifik. Nanopartikel magnetik dilapisi dengan kopolimer polyethylenecaprolactone-polyethylene glycol (PCL-PEG) untuk meningkatkan stabilitas dan mengeliminasi kemungkinan agregasi permukaan substansi kurkumin dan silibinin yang dilapisi nanopartikel. Substansi kurkumin dan silibinin dalam nanopartikel magnetik (Fe3O4) berbasis PCL-PEG termodifikasi digunakan sebagai inhibitor ekspresi leptin. Simpulan: Tinjauan pustaka menunjukkan berbagai manfaat farmakologi kurkumin dan silibinin ter-enkapsulasi nanopartikel magnetik berbasis kopolimer PCL-PEG termodifikasi sebagai inhibitor ekspresi leptin yang efektif tanpa toksisitas pada jaringan normal. Penemuan ini dapat digunakan sebagai alternatif tata laksana kanker paru di Indonesia. Introduction: Lung cancer is the highest incidence of cancer and causes significant mortality in male. Leptin, an adipocyte derivative cytokine, plays a role in carcinogenesis in lung cancer. Curcumin (CUR) and silibinin (SIL) are natural herbal compounds with multitargeted anticancer properties. Discussion: Magnetic nanoparticle (Fe3O4) technology has unique super-paramagnetic properties, increasing the ability to reach specific targets. Magnetic nanoparticles are coated with polyethylene-caprolactone-polyethylene glycol (PCL-PEG) copolymers to improve stability and to eliminate the possibility of surface aggregation of nanoparticles-load curcumin and silibinin substances. The modified PCLPEG-based magnetic nanoparticles (Fe3O4) of curcumin and silibinin are used as inhibitors of leptin expression. Conclusion: Literature studies reveal various pharmacological advantages of curcumin and silibinin encapsulated with modified PCL-PEG copolymers magnetic nanoparticles as effective inhibitors in leptin expression without toxicity in normal tissue. It can be used as an alternative in lung cancer management in Indonesia.

BACKGROUND: Surgical pain and prolonged hospital length of stay (LOS) affect a large proportion of patients after thoracotomy. Inflammation plays a crucial role in the mechanism and progression of pain and the outcomes. AIM: The objective of this study was to investigate the association between the pre-operative neutrophil-to-lymphocyte ratio (NLR) and post-operative pain and LOS in patients undergoing thoracotomy. METHODS: This was a retrospective, observational study on 157 patients who underwent thoracotomy under general anesthesia. We classified the subjects into two study groups: Group with for patients with NLR <2 and Group 2 for NLR ≥2. We measured the post-operative pain by gathering the data of post-operative opioid needs. We used Pearson’s and Spearman’s correlation tests to assess the association of the parameters. RESULTS: The mean of total oral morphine equivalent in the first 48 h following thoracotomy in Group 1 was 140.8 ± 60.4 mg compared to Group 2’s 109.7 ± 55.8 (p < 0.05). The median hospital’s LOS was longer in Group 2 compared to Group 1 (7 vs. 10, p < 0.001). We found a weak positive correlation between pre-operative NLR (R = 0.267, p = 0.002) and post-operative opioid requirements, and a weak positive correlation between pre-operative NLR and the hospital’s LOS (R = 0.345, p < 0.001). CONCLUSION: Pre-operative NLR correlates with post-operative opioid requirements and the time hospital’s LOS in patients who underwent elective thoracotomy.

<p><strong>Pendahuluan: </strong>Kanker paru merupakan kanker dengan insiden paling tinggi dan menyebabkan mortalitas yang signifikan pada pria. Leptin, sitokin derivat adiposit, memainkan peran penting pada proses karsinogenesis kanker paru. Kurkumin dan silibinin adalah komponen herbal alami dengan karakteristik antikanker bersifat multitarget. <strong>Diskusi: </strong>Teknologi nanopartikel magnetik (<em>Fe₃O₄</em>) memiliki sifat super-paramagnetik yang unik, sehingga meningkatkan kemampuan untuk mencapai target spesifik. Nanopartikel magnetik dilapisi dengan kopolimer <em>polyethylene-caprolactone-polyethylene glycol</em> (PCL-PEG) untuk meningkatkan stabilitas dan mengeliminasi kemungkinan agregasi permukaan substansi kurkumin dan silibinin yang dilapisi nanopartikel. Subtansi kurkumin dan silibinin dalam nanopartikel magnetik (Fe₃O₄) berbasis PCL-PEG termodifikasi digunakan sebagai inhibitor ekspresi leptin. <strong>Simpulan: </strong>Tinjauan pustaka menunjukkan berbagai manfaat farmakologi kurkumin dan silibinin ter-enkapsulasi nanopartikel magnetik berbasis kopolimer PCL-PEG termodifikasi sebagai inhibitor ekspresi leptin yang efektif tanpa toksisitas pada jaringan normal. Penemuan ini dapat digunakan sebagai alternatif tata laksana kanker paru di Indonesia.</p><p><em></em><br /><em><br /></em><strong>Introduction: </strong>Lung cancer is the highest incidence of cancer and causes significant mortality in male. Leptin, an adipocyte derivative cytokine, plays a role in carcinogenesis in lung cancer. Curcumin (CUR) and silibinin (SIL) are natural herbal compounds with multitargeted anticancer properties. <strong>Discussion: </strong>Magnetic nanoparticle (Fe₃O₄) technology has unique super-paramagnetic properties, increasing the ability to reach specific targets. Magnetic nanoparticles are coated with polyethylene-caprolactone-polyethylene glycol (PCL-PEG) copolymers to improve stability and to eliminate the possibility of surface aggregation of nanoparticles-load curcumin and silibinin substances. The modified PCL-PEG-based magnetic nanoparticles (Fe₃O₄) of curcumin and silibinin are used as inhibitors of leptin expression.  <strong>Conclusion: </strong>Literature studies reveal various pharmacological advantages of curcumin and silibinin encapsulated with modified PCL-PEG copolymers magnetic nanoparticles as effective inhibitors in leptin expression without toxicity in normal tissue. It can be used as an alternative in lung cancer management in Indonesia.<br /> <br /> </p>

BACKGROUNDS: Breast cancer or breast carcinoma is the most common type of malignancy in women globally. According to the previous studies that indicate the usage of antihypertensive drugs may become a risk factor of cancer (beta-blockers [BBs], calcium channel blockers [CCBs], and diuretics). Both angiotensin-converting enzymes inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), on the other hand, have been associated to an increased or decreased risk of breast cancer. AIM: To compare each type of antihypertensive medicines as a risk factor for breast cancer, we did a systematic review and meta-analysis of current evidence. METHODS: We utilized the terms “antihypertensive”, “anti-hypertensive”, “anti-hypertensive medications”, “breast cancer”, “risk”, “case control”, and “cohort” in PubMed, ScienceDirect, and Google Scholar databases. RESULTS: Our data calculation found that the risk of antihypertensive drugs was significantly different in overall analysis (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.42–0.83, p = 0.003). Five studies with 39.503 breast cancer patients and 372.037 controls were included in the ARBs user sub-group. Our results found significant different of antihypertensive drugs among breast cancer patient (OR = 1.47, 95% CI = 1.02–2.11 p = 0.04). Our data calculation also confirmed no significant different in antihypertensive drugs among breast cancer patient (OR = 1.07, 95% CI = 0.99–1.16, p = 0.09) in diuretics user, (OR = 1.08, 95% CI = 0.99–1.18, p = 0.08) in CCBs user, (OR = 1.11, 95% CI = 0.98–1.26, p = 0.09) in BBs user, and (OR = 1.27, 95% CI = 0.64–2.50, p = 0.50) in ACEIs user. CONCLUSIONS: Although, the finding reveal that antihypertensive drugs (diuretics, CCBs, BBs, and ACEIs) in overall are significant for the risk of breast cancer and also found that ARBs have a low potential in the risk of breast cancer.