Objective: The need for long-term medication in diabetes mellitus has led to a search for herbal medicines as alternative treatments. Several studies have shown that extract or isolates of Garcinia mangostana can help prevent and treat type 2 diabetes mellitus (T2DM). Methods: This review was conducted by searching various databases, including PubMed, ClinicalKey, ScienceDirect, and EBSCOhost. We analyzed papers published within the previous 10 y. Results: All in vitro, in vivo, and clinical studies that evaluated the pharmacological effects of extract or isolates of G. mangostana in T2DM were reviewed. G. mangostana was found to suppress adipogenesis and regulate lipid homeostasis, thus improving lipid profiles and preventing T2DM. G. mangostana also demonstrated hypoglycemic properties, including the ability to decrease fasting blood glucose and mildly increase pancreatic β-cell numbers and activity. The mangosteen-treated group in one study showed a decrease in Homeostatic Model Assesment for Insulin Resistance (HOMA-IR), indicating improved insulin sensitivity, along with a significant decrease in the high-sensitivity CRP (hs-CRP) levels. Histopathology showed that the α-mangostin-treated group had less damage to pancreatic β cells, healthier hepatocytes and central veins, and less glomerular and tubular epithelial necrosis than the diabetic control group. Moreover, the antioxidant effect of G. mangostana was shown to protect against the micro-and macrovascular damage caused by T2DM. Conclusion: Extract or isolates of G. mangostana possess strong potential to prevent and treat T2DM. Further research evaluating long-term outcome biomarkers in humans is needed to confirm the drug’s glycemic control capacity.

Background: At present, the standard examination for diagnosing streptococcal upper respiratory tract infection is throat culture. As throat culture is time-consuming and relatively expensive, efforts are made to develop certain criteria that will still lead to proper diagnosis and rational use of antibiotics, that is Centor score. Even so, the accuracy of Centor score is still debatable. Purpose: To provide evidence on the accuracy of Centor scoring system compared to throat culture in diagnosing GABHS upper respiratory tract infection. Case Report: A 25-years old male came to primary health care with primary complain of sore throat. Centor score was used to diagnose GABHS infection and as a guide to give antibiotics. Clinical question: “In patients with sore throat, how accurate is the Centor score compared to throat culture in diagnosing Group A Beta-Haemolytic Streptococcal (GABHS) Infection?” Methods: Literature searching was conducted through 4 databases. Critical appraisal based on the Centre of Evidence-Based Medicine (CEBM)-University of Oxford University, Diagnostic Critical Appraisal Sheet and Systematic Review Sheet. Results: All the selected studies were considered valid. They revealed a high specificity, low sensitivity, high negative predictive value (NPV), and low positive predictive value (PPV) in the importance aspect assessment. The Centor scoring system was applicable to our patient. It was available, affordable, and accurate in adult patients, yet less accurate in children. Conclusion: In conclusion,Patient with sore throat and suspicion of GABHS infection could be diagnosed with Centor scoring system as the first line diagnosis in primary care and as a guide to whether to give giving antibiotics or not.ABSTRAKLatar belakang: Saat ini, kultur tenggorok merupakan pemeriksaan baku emas yang digunakan untukmendiagnosis infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus. Namun, kulturtenggorok merupakan pemeriksaan yang mahal dan hasilnya memakan waktu yang lama, sehinggaberbagai kriteria dikeluarkan untuk dapat dipakai sebagai alat diagnostik dan sebagai panduanpenggunaan antibiotik yang rasional pada kasus infeksi saluran napas atas. Salah satunya yaitu Centorscore, tetapi akurasinya masih kontroversial. Tujuan: Menyediakan laporan kasus berbasis buktiterhadap akurasi dari Centor score sebagai alat diagnostik infeksi saluran napas atas yang disebabkanoleh bakteri Streptococcus dibandingkan dengan pemeriksaan kultur tenggorok. Laporan kasus: Seorang laki-laki berusia 25 tahun datang ke fasilitas kesehatan tingkat pertama dengan keluhan utama nyeri tenggorokan. Centor score digunakan untuk mendiagnosis pasien ini dan sebagai panduan pemberian antibiotik. Pertanyaan klinis: Pada pasien dengan radang tenggorok,seberapa akurat Centor score dibandingkan dengan kultur tenggorok dalam diagnosis GABHS? Metode: Pencarian literatur dilakukan melalui 4 database dan telaah kritis literatur menggunakan tilikan dari CEBM, University of Oxford University. Hasil: Seluruh studi yang ditelaah valid. Seluruh studi menunjukkan spesifisitas dan negative predictive value (NPV) yang tinggi, serta sensitivitas dan positive predictive value (PPV) yang rendah. Centor score dapat diaplikasikan untuk pasien pada skenario klinis karena bersifat mudah digunakan, biaya yang dikeluarkan terjangkau, dan akurat khususnya pada pasien dewasa. Kesimpulan: Pasien dengan nyeri tenggorok yang dicurigai memiliki infeksi saluran napas atas yang disebabkan oleh bakteri Streptococcus dapat ditegakkan diagnosisnya melalui penilaian Centor score di fasilitas layanan tingkat pertama, serta dapat menjadi panduan dalam pemberian antibiotik.

Background Gross motor is one of the skill domain with the highest parental concern as mastering it determines the autonomy of a child. Several internal risk factors including perinatal asphyxia, prematurity, low birth weight, wide fontanelle, and microcephaly have been studied in predicting gross motor delay with varied results. This study is made to arrange a strategic intervention on the prevention of delayed development.Objective To evaluate perinatal asphyxia, gestation age <37 weeks, birth weight <2500 grams, microcephaly, and wide fontanelle as predictors of gross motor delay in children aged 6-24 months. Methods A case control study design was used. Data collection was conducted by direct assessment of gross motor skill and parents' interview in Cipto Mangunkusumo National Hospital and Anakku Clinic, South Jakarta. Children with gross motor delay were included in the case group and children with normal gross motor were included in the control group. Data was analyzed using bivariate and multivariate analysis with a statistical significance value of P<0.05 and 95% confidence intervals. Results One hundred and twenty-six subjects were studied, with 63 children in the case group and 63 children in the control group. Baseline characteristics of subjects were similar between the two groups. Microcephaly and gestation age <37 weeks were predictors of gross motor delay [(aOR 4.613; 95%CI 2.023 to 10.521; P<0.001) and (aOR 3.668; 95%CI 1.153 to 11.673; P=0.028)], respectively. Conclusion Microcephaly and gestation age <37 weeks are significant predictors of gross motor delay in children aged 6-24 months.