Ciprofloxacin is currently the drug of choice for typhoid fever, but Salmonella typhi resistance to ciprofloxacin is increasing, while levofloxacin has been shown to be very effective in a few open studies. This study aimed to compare the efficacy, and safety of levofloxacin and ciprofloxacin for typhoid fever. From 110 patients with confirmed typhoid fever, 54 patients received oral levofloxacin 500 mg once daily with one drop out, while 56 received ciprofloxacin 500 mg twice daily for 7 days with two drop outs. Defervescence of fever was achieved on an average of 3 days after initiating levofloxacin and 5 days after starting ciprofloxacin and one microbiologically non confirmed typhoid fever relapse occurred in the levofloxacin group while two relapses with positive Salmonella microorganism occurred in the ciprofloxacin group. No carrier of Salmonella typhi was found in both groups at day 30. Adverse reactions were more pronounced in the ciprofloxacin group compared to the levofloxacin group. In conclusion, oral levofloxacin 500 mg once daily for one week showed faster fever clearance compared to ciprofloxacin 500 mg twice daily in typhoid fever in Indonesia, and less adverse reactions occurred with levofloxacin compared to ciprofloxacin. This electronic document is a "live" template. The various components of your paper (title, text, heads, etc.) are already defined on the style sheet, as illustrated by the portions given in this document.

Probiotics ("for life") is a live microbial feed supplement or defined as mono-or mixed cultures of live microorganisms which when administered in adequate amounts confer a health benefit to the host by improving its microbial balance. Common descriptives for probiotics include "friendly", "beneficial" or "healthy" bacteria. Under natural conditions a protective gut microflora develops and there is no need for probiotics supplement, but under rather unnatural conditions such like intestinal infections, post antibiotic treatment syndromes, pseudomembranous colitis, the probiotics preparations are needed. The beneficial effects of probiotics in the host are promotion of the gut maturation and integrity, antagonisms against pathogens and immune modulation. Beyond those, the microflora seems to play a significant role in diet induced superinflammation, mucosal immune system, neuroendocrine regulation, immunoglobulin production, macrophages factor restoration, apoptosis stimulation, lymphocyte function modulation, cytokine release, mucin production, intestinal immune homeostasis and inflammation prevention. However, many studies proved that probiotics have "upregulation and downregulation" effects on immune system of the host. This review article will summarize the increasing scientific attention to mechanisms of the immune response of the host towards different components of the microflora and suggest a potential role for selected probiotic bacteria in the regulation of intestinal inflammation and other diseases. Although many clinical studies with probiotics daily products demonstrating positive therapeutic effect, there is still a core question: "how regular consumption of probiotics will affect the health and the risk of infection of healthy consumers", cannot be answered at this point in time. Longterms, prospective studies are still needed.

BACKGROUND: The development of an oral typhoid fever vaccine need more effective and having high-efficacy in preventing typhoid fever. The use of liposomes as a vaccine vehicle can be formulated to target a specific location or trigger the release of antigens on its target. β-Glucan derived from Candida albicans cell wall as immunoadjuvant can strengthen the immune response and increases the protection against Salmonella Typhi bacterial invasion. AIM: This study aimed to determine the immune response in typhoid fever mice by administering a combination of AdhO36 S. Typhi liposome vaccine with β-Glucan and determine the protectivity to inhibit bacterial colonization in typhoid fever. METHODS: Mice were divided into five groups include negative and positive control also treatment group. IL-12 was evaluated after 4-h immunization while the other (was IL-12, IL-10, Th1 (IL-2), Th2 (IL-4), and the protective test against bacterial invasion) evaluated after 96-h. RESULTS: IL-12 level in the combination of β-Glucan and AdhO36 groups showed significantly lower than infected groups (p = 0.034), whereas IL-10 level significantly increase (p = 0.0009). The percentage of Th-1 (IL-2) cells significantly lower than infected groups (p = 0.000), this also happened on the percentage of Th-2 (IL-4) cells that significantly lower than infected groups (p = 0.018). The protective test toward bacterial invasion showed no bacterial colonization in all tissues intestine, liver, spleen, and mesenteric lymph node. CONCLUSION: The administration of a combination of liposome containing β-Glucan from C. albicans and AdhO36 S. Typhi has a potential effect on cellular and humoral immune response.

The uncovering of the changes in the concentration of aggregation molecules (vWF, PGI2) and cytokines (TNFα, IL-1β, IL-6) in different levels of thrombocytopenia in DHF patients can be used as the basis in predicting the occurrence of thrombocytopenia. A prospective-observational study was undertaken utilizing a 3-day sequentially drawn vein blood of inclusive DHF patients. The TNFα, IL-1β and IL-6 test was conducted utilizing the quantikine high sensitivity human cytokine immunoassay, and the vWF and PGI2 test was conducted utilizing the ELISA procedure. The multivariate and discriminant analyses tests on the deltas between day 1 and 2 observations, and between day 2 and 3 observations of the 6 variables showed Wilks' Lambda =0.638 with p=0.008 and platelets and vWF as the most powerful discriminating variable (70.5.%). The findings of this study indicated that in DHF patients (1) the changing of the concentration of TNFα, IL-1β and IL-6 cytokines do not play a significant role in the mechanism of platelets aggregation, (2) platelets count decreases in a condition in which vWF facilitated platelets aggregation, (3) the changing of a positive contribution of vWF causes a determination of the process of platelets aggregation, and (4) a positive changing of vWF's concentration can be used as a prognostic indicator of a negative changing of platelets count.. PENDAHULUANInsidensi dan penyebaran penyakit demam berdarah dengue (DBD) semakin meningkat dan meluas dari tahun ke tahun (1). Selain berdasarkan kriteria WHO, diagnosis DBD perlu dikonfirmasi dengan penemuan IgM anti dengue positif atau isolasi virus dengue (2,3,4,5). Perdarahan yang terjadi pada penderita DBD akibat agregasi trombosit dapat berkembang menuju DIC dan dapat berakhir dengan kematian (6,7,8). Perkembangan perdarahan tersebut sulit diprediksi dan jika hal itu diketahui, perjalanan penyakit sudah pada tingkat lanjut. Oleh karena itu pengungkapan pengaruh perubahan kadar molekul agregasi vonWillebrand factor, Prostaglandin I2 (vWF, PGI2) terhadap kejadian agregasi trombosit yang menyebabkan trombositopenia pada penderita DBD dapat digunakan sebagai prognostik indikator perdarahan akibat trombositopenia pada penyakit DBD.Trombositopenia pada penderita DBD diduga terjadi melalui mekanisme kompleks imun yang didapatkan pada permukaan trombosit (9,10) dan akibat penurunan produksi trombosit oleh sumsum tulang, peningkatan destruksi trombosit di reticulo endothelial system (RES), serta agregasi trombosit akibat endotel yang teraktivasi (11). Endotel vaskuler yang teraktivasi akibat infeksi virus dengue memberi peluang kepada trombosit dalam sirkulasi pembuluh darah untuk berinteraksi dengan kolagen dalam lapisan sub-endotel yang kemudian memicu agregasi trombosit dan bermuara pada trombositopenia (9,12). Para peneliti telah membuktikan bahwa pada penderita aterosklerosis dan trombosis peningkatan produksi molekul protrombosis vWF dan penurunan produksi molekul antitrombosis PGI2 oleh endotel yang teraktivasi memicu agregasi trombosit (13,14,15,1...

COVID-19 can symptomatically and asymptomatically affect patients. Asymptomatic cases have become a particular concern for public health in the COVID-19 pandemic. One of the simple tests for COVID-19 is the complete blood count that can predict systemic inflammation and disease severity. The description of laboratory tests in asymptomatic COVID-19 patients is rarely reported. This study aimed to compare the laboratory test results of both symptomatic and asymptomatic COVID-19 employees of the Muhammadiyah University General Hospital of Malang. Data were taken from medical records. Diagnoses of COVID-19 were confirmed by nasopharynx-oropharynx PCR swab. Patient characteristics included age, gender, and values of hemoglobin, leukocytes, neutrophils, lymphocytes, platelets, NLR and CRP from two different groups: symptomatic and asymptomatic infected employees. There were 104 COVID-19 infected employees at the hospital from April 2020 to February 2021. Female infected employees (52.9%) were more numerous male infected employees. Employees aged 21-30 years accounted for 53.84% of the total cases. The numbers of symptomatic and asymptomatic employees were 10 employees (9.6%) and 94 employees (90.4%), respectively. There was a significant difference between the symptomatic and asymptomatic groups in the numbers of lymphocytes (p = 0.03) and CRP (p = 0.046). There were no significant differences in the other laboratory results. Lymphopenia and increased CRP numbers more often occurred in the symptomatic group compared to the asymptomatic group. Therefore, these parameters can be an indicator for predicting disease severity. However, further research is needed with a bigger sample. Keywords: COVID-19, symptomatic, asymptomatic, Muhammadiyah University General Hospital of Malang