A recent modeling study estimated that there could be as many as 20,000 human melioidosis cases per year in Indonesia, with around 10,000 potential deaths annually. Nonetheless, the true burden of melioidosis in Indonesia is still unknown. The Indonesia Melioidosis Network was formed during the first melioidosis workshop in 2017. Here, we reviewed 101 melioidosis cases (99 human and two animal cases) previously reported and described an additional 45 human melioidosis cases. All 146 culture-confirmed cases were found in Sumatra (n = 15), Java (n = 104), Kalimantan (n = 15), Sulawesi (n = 11) and Nusa Tenggara (n = 1). Misidentification of Burkholderia pseudomallei was not uncommon, and most cases were only recently identified. We also evaluated clinical manifestations and outcome of recent culture-confirmed cases between 2012 and 2017 (n = 42). Overall, 15 (36%) cases were children (age <15 years) and 27 (64%) were adults (age ≥15 years). The overall mortality was 43% (18/42). We conducted a survey and found that 57% (327/548) of healthcare workers had never heard of melioidosis. In conclusion, melioidosis is endemic throughout Indonesia and associated with high mortality. We propose that top priorities are increasing awareness of melioidosis amongst all healthcare workers, increasing the use of bacterial culture, and ensuring accurate identification of B. pseudomalleiand diagnosis of melioidosis.

Background: Streptozotocin can cause hyperglycemia in guinea pig through the mechanism of oxidative stress which damages pancreatic  cells. Ethanol extract of chayote can decrease oxidative stress. This study aimed to determine the effect of Ethanol Extract of Chayote ((EEBLS) Ekstrak Etanol Buah Labu Siam) on decreasing blood sugar content and increasing the activity of glutathione peroxide enzyme. Subjects and Method: This was an experimental study. The samples were using random sampling technique. The control group was using male white mice (Musmusculus L.) Strain DD Webster which randomized into four groups: negative control group, positive control group, group which got EEBLS of 100 mg/kgBB, and group which got EEBLS of 200 mg/kgBB. Results: The result of the research showed that there was significant decrease in blood sugar, compared with the control group. There was insignificant decrease in the activity of glutathione peroxide enzyme, compared with the control group. Conclusion: The conclusion of the research was that EEBLS of 200 mg/kgBB decreased blood sugar content of mice significantly, but there was no significant change in the activity of glutathione peroxide enzyme when EEBLS was given to the mice.

BACKGROUND: Although the prevalence of cardiovascular disease decreases in the general population, this pattern is not followed in hemodialysis patients. Hence cardiovascular events still occur in 50% of cases resulting in hemodialysis patients. One of the risk factors is vascular calcification. The pathogenesis is not yet fully understood, but recent years studies have shown that vascular calcification in chronic kidney disease (CKD) occurs as a result of the interaction of stimulatory and inhibitory factors. One of the inhibitory factors is Fetuin-A. Until now there has been no data on levels of Fetuin-A as a risk factor for abdominal aortic calcification in Indonesia. AIM: To determine the effect of Fetuin-A levels on abdominal aortic calcification in regular hemodialysis patients. METHODS: This study was a cross-sectional study on 76 regular hemodialysis patients at Rasyida Renal Hospital Medan. Fetuin-A level was examined by enzyme-linked immunosorbent assay (ELISA). Assessment of abdominal aortic calcification was done by lateral lumbar X-ray. RESULTS: Most patients (68.4%) had abdominal aortic calcification, in both layers; intima and media (44.7%). Abdominal aortic calcification was associated with Fetuin-A level and age. Multivariate analysis showed that high Fetuin-A levels were significantly associated with abdominal aortic calcification. CONCLUSION: High Fetuin-A level appeared to be a protective factor against abdominal aortic calcification in regular hemodialysis patients in Indonesia.

The incidence of infection often occurs in patients with Diabetes Mellitus (DM) due to hyperglycemia that causes dysfunction of chemotaxis, phagocytic activity, malfunction of neutrophils and glycosuria. It is followed by other complications that lead to the malfunction of the bladder. Highly urinary glucose level is an exellent medium for pathogenic microorganisms growth. Asymptomatic Bacteriuria (ASB) is a risk factor for symptomatic urinary tract infection spontaneously or due to urinary catheters. This study aimed to analyze the association between the incidence of ASB of type 2 DM and glycemic control. The study was conducted during June-August 2016 with a cross-sectional method. Subjects were type 2 DM patients with age ≤60 years, who were treated in the Endocrinology Out-Patient Clinic of the Adam Malik Hospital. HbA1c was measured by Indiko automatic analyzer. Its association with urine culture results was analyzed. A total of 50 samples were enrolled, consisting of 25 females, and 25 males, with 19 having an exellent glycemic control (HbA1c <7%) and 31 with poor glycemic control (HbA1c ≥7%). Thirteen positive ASB were found, 5 with good glycemic control and 8 with poor glycemic control. Statistical analysis revealed a nonsignificant association between glycemic control and culture results (p = 1.000). Somers’d did not show a significant association between glycemic control and the incidence of ASB (p=0.968, d=-0.005). However, significant differences in culture results between gender, in which the ASB were found in samples of four females and two males (p=0.004). Somers’d revealed a significant association between culture results and gender (p=0.001; d=-0.360). Most of the bacteria found were Gram-negative. There was no significant association between glycemic control with an incidence of ASB. However, gender had significant differences in the incidence of ASB, which occurred more frequently in DM females than males. Urinalysis should be performed in patients with type 2 DM with ASB. However, further study was needed to analyze the relationship between glycemic control with the incidence of ASB and other factors that might affect the incidence of ASB.

Introduction: Lactate is an intermediate metabolic that is non-toxic and were produced by all cells. In sepsis patients, increased lactate occurs due to tissue hypoperfusion and represent a sign of tissue hypoxia. A clinical scoring system such as Sequential Organ Failure Assessment (SOFA), was commonly utilized to assess the severity of sepsis periodically based on several clinically significant organ dysfunction. The purpose of this study was to investigate the correlation of lactate levels with SOFA scores on sepsis patients treated in ICU.Method: This is a prospective cohort study, involving 57 patients with sepsis who met the inclusion and exclusion criteria. The blood lactate levels were measured, and the SOFA scores were calculated, which then analyzed with Spearman correlation test.Results: There was a weak but significant correlation between lactate levels and 24-hour SOFA Score (r = 0.303, p = 0.022). An intermediate correlation was obtained with 48 hours SOFA Score (r = 0.449, p = 0.000). Organ dysfunction that plays a significant role in increased lactate in this study were the central nervous system, respiratory system, liver, and kidneys.Conclusion: There was an association between lactate levels and SOFA scores at 24th and 48th hour. SOFA Score can be considered as proper parameters to evaluate the deterioration of septic patients treated in the ICU.