BACKGROUND: The outbreak of coronavirus disease-19 (COVID-19) which is now a pandemic has become a problem that occurs in every area of life. Coronaphobia, a new term in the psychiatry literature referring to excessive fear of being infected by SARS-COV2 or COVID 19. Infected by influenza, having close relatives or friends with this fatal virus, and strong fear of infection have been reported as important predictors of stress posttrauma. We report a case report-related COVID-19 in Indonesia. CASE PRESENTATION: A 23-year-old female, dentistry student living in a boarding house in East Java, Indonesia, along with her friend and coming from a middle-up income family background, came to psychiatric consultation with complaints of difficulty of breathing for 1 month ago. This anxiety began to get heavy, especially since the severe acute respiratory syndrome coronavirus 2 (COVID 19) outbreak appeared in Indonesia. In addition, she also recently experienced a failure in her final examination so that her study period as a dentistry student must be extended. Exploration of history revealed that the patient initially experience a feeling of heaviness in the chest, difficulty breathing, palpitation, and sometimes feeling sad due to her failure before. She was then given pharmacological interventions in the form of fluoxetine and clobazam and psychotherapy and progressive muscular relaxation through online. CONCLUSION: General anxiety disorder, especially due to the COVID-19 outbreak, should be managed appropriately and comprehensively. The pandemic situation and widespread spread of the disease cause psychotherapy to be modified in such a way that assistance can be carried out online.

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune disorder mediated by inflammatory cytokines. Decreasing vitamin D levels is a common feature in SLE patients. Vitamin D has the capacity in suppressing inflammatory cascade. Seluang fish (Rasbora spp.) contained a high level of vitamin D with the potential as a new therapeutic modality. AIM: This study aimed to assess the efficacy of Seluang fish oil against proinflammatory cytokines, vitamin D levels, and clinical conditions of SLE. METHODS: A randomised, double-blind, clinical trial study design was conducted. The subjects were 16 SLE subjects treated with 500uL Seluang fish oil capsules and 16 SLE subjects with placebo capsules. Measurement of vitamin D, IL-1, IL-6 and IL-17 levels were performed with ELISA. Clinical assessment of SLE was performed with MEX-SLEDAI. Bivariate analysis, T-test, was performed. Data were presented in the form of mean ± SD. RESULTS: The administration of Seluang fish oil was clinically able to show efficacy assessed by the MEX SLEDAI score. Significant results were also shown by increased vitamin D levels and reduced levels of IL-1, IL-6 and IL-17, in Seluang fish oil group. CONCLUSION: Seluang fish oil possessed the efficacy of reducing the inflammatory response in SLE patients by increasing serum vitamin D levels.

BACKGROUND: Extensive intracellular and extracellular formation of advanced glycation end-products (AGEs) is considered a causative factor for vascular injury triggered by hyperglycemia in diabetes. The hyperglycemia will cause accumulation of AGEs, damage to pericytes, nerve growth factor (NGF), glial acid fibrillary protein (GFAP) and increase in vascular endothelial growth factor (VEGF). AIM: This study aimed to assess the efficacy of RAGE inhibition in suppressing the development and progression of diabetic retinopathy through modulation of the inflammatory pathway involving NGF, GFAP, and VEGF. METHODS: The design was in vivo experimental study. Thirty white rats were induced with Alloxan monohydrate. Rats were divided into 5 groups, normal, negative control, groups with an anti-RAGE dose of 1 μg/uL, the dose of 10 μg/uL and 100 μg/uL. After 4 weeks of treatment, HbA1c, NGF, and GFAP levels were measured using ELISA. Quantification of VEGF expression was done using the ImageJ® application. Data was expressed with mean ± SD. Independent T-test with ANOVA and Tukey's post hoc was done. RESULTS: RAGE inhibitors yielded a significant decrease in blood glucose and HbA1c levels. VEGF and RAGE expression were reduced in anti-RAGE groups in various doses. Inhibition of RAGE reduced the damage of retinal pericytes, by reducing GFAP and increasing NGF, and reduced the formation of new blood vessels, by decreasing VEGF expression, in diabetic retinopathy. CONCLUSION: Inhibition of receptor for advanced glycation end-products (RAGE) was effective in suppressing the development and progression of diabetic retinopathy.

BACKGROUND: Depression is a psychiatric disorder that has become a serious health problem in the past decade. This disorder is characterized by prolonged dysphoric mood, and in more severe condition would result in decreased self-care and even life-threatening action. Serotonin is believed to play a role in the regulation of mood elation in depressive disorders. Decreased levels of serotonin in the hippocampus will cause an increased dopamine in mesolimbic dopamine neuronal cells. An effective and commonly used drug is the selective serotonin reuptake inhibitor, namely, fluoxetine. However, this agent has so many side effects, one of them is erectile dysfunction. In order to find the better treatment, exploration and discovery of therapeutic modalities need to pursued using natural materials. AIM: This study aimed to explore and evaluate antidepressant effects of cinnamon (Cinnamomum burmannii) extract (CE). METHODS: A total of 30 male Wistar rats were obtained from Eureka Research Laboratory (Palembang, Indonesia). Cinnamon simplisia was obtained from the Institute for Research and Testing of Traditional Medicine, Tawangmangu, Central Java, Indonesia. Rats were induced using chronic mild stress (CMS). CMS was a form of stress induction performed on experimental animals continuously, for 4 weeks. Forced swimming test (FST) was a test conducted to assess mobility in animal model. After induction for 4 weeks, rats were randomly divided into six groups which each contained five rats: Normal control group, CMS group (negative control), CMS + fluoxetin (Fluox 1: mg/kg), CMS + CE 25 mg/kg, the CMS + CE 50 mg/kg, and the CMS + CE 100 mg/kg. Treatment with fluoxetine or CE was given for 14 days intragastrically using gastric sonde. After treatment and FST, organ evacuation was performed and followed by immunohistochemistry and enzyme-linked immunosorbent examination. RESULTS: This study showed that CE with dose of 25 mg/kg BW to dose 100 mg/k BW could reduce the duration of immobility when compared to the CMS group. Clinically, CE possessed the potential to reduce the duration of immobility and potentially reduce symptoms of depression. Histologically, CE showed the potential to improve serotonin levels in the hippocampus with increasing doses. Tumor necrosis factor (TNF)-alpha expression in the hippocampus as a marker of inflammation had increased in the CMS group. CE was able to reduce the expression of TNF-alpha compared to the CMS group. CONCLUSION: CE possessed antidepressant efficacy by inhibiting the inflammatory process in the hippocampus so it was able to optimally increase serotonin levels in the hippocampus.

BACKGROUND: Uncaria gambir (local name: gambir) is a plant native to Sumatera, Malaya and Borneo. This plant is potential as local wisdom for therapeutics. In Sumatera, gambir was used as a traditional treatment for fever, diarrhoea, diabetics and wound healing. AIM: To explore the efficacy of gambir extract on TNF alpha level, prostaglandin E2 level, lesson area, body weight, lipid profile and leptin level in Wistar rat-model gastritis. METHODS: This study was an experimental study, with a pre-post-test control group design. The subjects in this study were 30 male rats, 8 weeks old, weight 150-200 gram. Rats were administered with gambir extract at the dose of 20, 40 and 80 mg/kg BW/day for 3 days. Gambir was extracted by maceration methods. Statistical analysis was performed by SPSS 18. RESULTS: Gambir extract at the dose of 80 mg/kg BW exhibited the highest efficacy in reducing TNF alpha level, lesion area and increasing prostaglandin E2 level compared to gambir extract at doses of 20 mg/kg BW, 400 mg/kg BW, negative control, and positive control. CONCLUSION: Gambir extract was effective in reducing TNF alpha level, lesson area, and increasing prostaglandin E2 level in Wistar rat-model gastritis.