BackgroundPreviously thought to be rabies free, Bali experienced an outbreak of animal and human rabies cases in November 2008. We describe the epidemiological and clinical data of human rabies cases occurring in the first two years of the outbreak.MethodsWe analysed the patient records of all rabies cases from the Sanglah General Hospital in Denpasar, and district hospitals in Buleleng and Tabanan. A conventional reverse transcriptase polymerase chain reaction was developed to detect the rabies virus genome in saliva, corneal swabs, and ante- and post-mortem cerebrospinal fluid (CSF).ResultsThere were 104 human rabies cases in Bali during November 2008-November 2010. Patients' mean age was 36.6 years (range 3-84 years; SD 20.7), most were male (56.7%), and originated from rural districts. Almost all (92%) cases had a history of dog bite. Only 5.8% had their wounds treated and received an anti-rabies vaccine (ARV) after the bite incident. No patients received rabies immunoglobulin (RIG). The estimated time from dog bite to the onset of signs and symptoms was 110.4 days (range 12-720 days; SD 118.2). The mean length of medical care until death was 21.8 hours (range 1-220 hours; SD 32.6). Less than 50% of patients had prodromal symptoms. The most frequent prodromal symptom was pain or paraesthesia at the bite site (37.6%). The two most common central nervous system infection signs were agitation (89.2%) and confusion (83.3%). Signs of autonomic nervous system dysfunction included hydrophobia (93.1%), hypersalivation (88.2%), and dyspnea (74.4%). On admission, 22 of 102 patients (21.6%) showed paralytic manifestations, while the rest (78.4%) showed furious rabies manifestations. The case-fatality rate was 100%. The rabies virus genome was detected in 50 of 101 patients (49.5%) with the highest detection rate from post-mortem CSF samples.ConclusionsRabies is a major public health problem in Bali. Human fatalities occur because of a lack of knowledge regarding rabies risk, the poor management of dog bites, and the limited availability of RIG. Increasing public awareness of dog bite management, increasing the availability of ARV and RIG, and implementing an island-wide dog vaccination campaign will help prevent human rabies cases.

BACKGROUND:Ischemic stroke occurs due to the abrupt occlusion in the brain which leads to neuronal death. Neuronal death in ischemic stroke is due to increase production of reactive oxygen species (ROS). Neuronal death occurs via necrosis and apoptosis mechanisms. Apoptosis can either occur via extrinsic or intrinsic pathway. Meanwhile, the intrinsic pathway can be caspase-dependent or independent. Anthocyanin is a natural pigment with antioxidant, anti-inflammatory, anti-cancer, and neuroprotective properties. Balinese cultivate of purple potato extract contains a high level of anthocyanin and has been proven for its antioxidant activity.AIM:Antioxidant effect of Balinese cultivates purple potato extract has not been studied on an animal model with ischemic stroke. Accordingly, we would like to study the effect of antioxidant properties from Balinese cultivate of purple potato extract by assessing the neurological score, BNDF concentration, and caspase-independent apoptosis by measuring AIF concentration on Wistar rats with ischemic stroke.METHODS:This was an experimental study using male Wistar rats age between 12-14 weeks weigh between 200 to 250 g.RESULTS:This study demonstrated a significant difference of neurological score on day 3 among control versus treatment groups. Balinese cultivate of purple potato extract markedly reduced AIF, increased BDNF, and suppressed apoptosis among treatment group when compared with the control group.CONCLUSION:We have proven the efficacy of antioxidant activity of anthocyanin derived from Balinese cultivar of purple sweet potato by elevated AIF levels, lower apoptosis rate, improved neurological score on day-3 to day-7 post-stroke, as well as increased BDNF levels.

Background: Premature rupture of membrane (PROM) remains a problem in obstetrics, the mechanisms of PROM have not been clearly defined. Apoptosis is thought to play a key role in the mechanism, via caspase-dependent and caspase-independent pathways. Caspase-3, Apoptosis-inducing factor (AIF), and anti-apoptosis B-cell lymphoma 2 (Bcl-2) are hypothesized to be involved in PROM. Objective: To determine the role of caspase-dependent and caspase-independent pathways in the mechanism of PROM. Materials and Methods: This was a case-control study involving 42 pregnant women with gestational age between 20-42 wk. Participants were divided into the case group (with PROM) and control group (without PROM). Amniotic membranes were collected immediately after the delivery, and samples were taken from the site of membrane rupture. Immunohistochemical examination was done to determine the expression of Caspase-3, AIF, and Bcl-2. Results: The expressions of Caspase-3 (OR = 9.75; 95% CI = 2.16-43.95; p = 0.001) and AIF (OR = 6.60; 95% CI = 1.48-29.36; p = 0.009) were significantly increased, whereas, Bcl-2 expressions (OR = 8.00; 95% CI = 1.79-35.74; p = 0.004) were significantly decreased in the case group. Conclusion: High Caspase-3, AIF, and low Bcl-2 expression were the risk factors for PROM. Thus, it is evident that caspase-dependent and caspase-independent pathways are involved in the mechanism of PROM. Key words: Premature, Membrane, Apoptosis, Caspase, Pregnancy.

The liquor that was consumed by the teenagers continuously could lead to the health and behavior disorders. The research type was a quasi-experiment with the randomized pre-test post-test control group design. The technique of collecting the data in the present study was the Random Sampling. The respondents included 40 students in SMAN 1 as the treatment group and 40 students in SMAN 3 as the control group. The study result was obtained, there indicated that the health education interventions in the treatment group succeeded significantly improving knowledge and changing the teenager attitude for drinking.