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.
Chronic kidney disease (CKD) is defined as decreasing kidney function (GFR < 60 ml/minute/1.73 m2 ) for more than 3 months. Anemia is a common complication of CKD due to a decrease in the hormone erythropoietin related to hemoglobin levels. One of the anemia therapies involves using folic acid. Folic acid helps the process of nucleoprotein synthesis and erythropoiesis maintenance. The objective of this study was to determine the pattern of folic acid applied to CKD patients with anemia at University of Muhammadiyah Malang General Hospital. Observational, descriptive, and retrospective data collection methods were used. The results showed that there were 17 patients (47%) with a single use of folic acid (3x1 mg, oral); the most common pattern of the two-combination was folic acid (3x1 mg, oral) and PRC (250 ml, intravenous [iv]), which was given to 11 patients (65%); and the most common pattern of threecombination was folic acid (3x1 mg, oral), Promavit® (3x1 tab, oral), and PRC (250 ml, iv), which was given to 2 patients or 100%. Of the 16 switch patterns, the most of common combination was a single pattern of folic acid (3x1 mg, oral) and a combination of folic acid (3x1 mg, oral) and PRC (250 ml, iv), given to 7 patients (44%). Keywords: folic acid, anemia, chronic kidney disease
In the case of infection control, one of our primary concerns is typhoid fever. According to WHO, typhoid prevalence in Indonesia is highly endemic. There is also the problem with the low efficacy of the available vaccine to prevent the disease. Therefore, there is an urgent need to develop a highly effective typhoid vaccine. One of the phases in vaccine development is an exploratory phase, a research-intensive phase of the vaccine development process designed to identify natural or synthetic antigens that might help prevent or treat a disease through computer in silico prediction targets. The vaccines developed through epitope peptide are designed to be safer, more efficacious, and less expensive than traditional vaccines. A thorough understanding of the disease agent, particularly critical epitopes to induce the appropriate immunological reaction, is required to achieve these aims. Mapping epitope sequences or antigenic peptides from pathogenic proteins recognized by B cells and T cells is crucial for vaccine development. Once the epitopes were identified, the polypeptide production could be produced through protein recombinant technology. The polypeptide vaccine, in the end, could be delivered using a liposomal delivery system.
Chronic kidney disease is defined as kidney disease occurring for more than three months and is characterized by a decreasing glomerular filtration rate, reaching below 60 mL/min/1.73 m2 . Decreased kidney function can reduce the kidney’s capacity to excrete sodium. Excess extracellular fluid will cause hypertension, and lower and upper extremity edema. Loop diuretics, such as furosemide, are known to increase sodium excretion by 20%, thereby reducing the amount of extracellular fluid. This study aimed to determine the patterns of furosemide use in chronic kidney disease patients at University of Muhammadiyah Malang General Hospital. Observational, descriptive, and retrospective data collection methods were used. The use of a single furosemide pattern was given to 25 patients (40%); a two-combination to 12 patients (20%); a three-combination to 9 patients (15%); a four-combination to 12 patients (20%); and a five-combination to 4 patients (5%). The most commonly used single furosemide was furosemide (3 x 40 mg, intravenous [iv]), which was administered to 16 patients (73%); the most common two-combination was furosemide (3 x 40 mg, iv) + amlodipine (1 x 10 mg, oral), which was given to 2 patients (20%); the most common three-combination was furosemide (3 x 40 mg, iv) + candesartan (1 x 16 mg, oral) + amlodipine (1 x 5 mg) and furosemide (3 x 40 mg, iv) + candesartan (1 x 16 mg, oral) + amlodipine (1 x 10 mg, oral), which was given to 2 patients (23%); the most common four-combination was furosemide (3 x 40 mg, iv) + nifedipine (3 x 10 mg, oral) + clonidine (3 x 0.15 mg, oral) + captopril (2 x 25 mg, oral), which was given to 3 patients (28%); and the most common five-combination was given to 1 patient (25%) with 4 patterns. In short, there were 22 patterns of furosemide switch therapy. Keywords: furosemide, edema, chronic kidney disease
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