Background: Keloid is an abnormal scar in previously traumatic skin after going through the wound healing process. One hundred million cases have been found in developing countries with the main complaint of scar appearances. To overcome this problem, 24 literatures from various journals and textbooks are reviewed. Reviews: Keloid formation is based on high melanin amount which inhibits the collagenase enzyme. Moreover, the high melanin amount would block interleukin (IL)-1B work resulting in collagen synthesis and collagenase reduction. Depigmentation effort with 4% hydroquinone is implemented to reduce the amount of melanin presented in the skin. With melanin reduction, IL-1B can work optimally by inhibiting fibroblast growth in keloid tissue without affecting on normal skin. It also induces Matrix Metalloproteinase (MMP)-1 which is an interstitial collagenase. IL-1B has an opposing effect compared to Transforming Growth Factor (TGF)-B, thus TGF-B antibody is needed to potentiate IL-1B therapeutic effect. TGF-B antibody can neutralize TGF-B ligand and avB6 integrin resulting in blocking of COL1A1 gene expression which is responsible for MMP-1 production and type-I collagen synthesis. These three components are combined in cream with liposome as a drug carrier. This combination is applicated for adjuvant therapy after scar excision. Liposomes are chosen because of their high biocompatibility, low toxicity, and low biodegradability. Liposomes also can release slowly in the extravascular area such as skin. This advantage may carry drug components effectively to the target location. Summary: The combination of depigmentation, IL-1B, and TGF-B antibodies has a potency to be developed as a future adjuvant therapy of keloid.

Introduction: Stroke is the fifth leading cause of disability-adjusted life years (DALYs) in the world. Cognitive impairment is one of the disabilities found in the acute phase of stroke and persists in long-term outcomes which can be assessed using the Mini-Mental State Examination (MMSE). However, a clinical classification to predict the cognitive outcome remained unclear. This study is aimed to identify differences of MMSE results in stroke patients between right and left hemisphere lesions to ensure the mentioned location classifications may contribute to cognitive outcome prediction.Method: With the cross-sectional analytic observational design, 32 acute phase patients hospitalized in the Neurology Department Soetomo General Hospital from October–December 2019 were assessed using the Indonesian version of MMSE with purposive sampling and analyzed using the chi-square test.Result: There was no significant difference between MMSE scores in right or left hemisphere lesion. This might happen because (1) MMSE was insensitive and not a domain-specific test; (2) a more specific infarct location was needed to predict cognitive outcome post-stroke, including microarchitecture of the brain especially those involved in the cortico-striato-thalamocortical loop.Conclusion: The right or left hemisphere lesion classification did not contribute significantly to predict cognitive impairment.

Background: Menopausal women experience amenorrhea for 12 consecutive months. In Indonesia, one of four women aged 50 – 80 years has a risk of osteoporosis. This age range is related to the menopause phase. Low estrogen levels in menopausal women cause decreased bone mineral density resulting in osteoporosis. Osteoporosis is a degenerative disease characterized by decreased bone density and bone strength that causes fractures. This literature review aims to determine the potential of soy isoflavones (Glycine max) and magnetic hydroxyapatite nanoparticles as alternative therapies for osteoporosis in menopausal women. Reviews: Soy isoflavones are phytoestrogens because they have estrogen-like structures and functions. Some studies explain that phytoestrogens have benefits in osteoporosis therapy by maintaining bone density through decreasing osteoclast resorption and stimulating osteoblasts. Consuming enough soy supplements everyday has been shown to increase bone mineral density. This effect is strengthened by coating the soy isoflavones with magnetic hydroxyapatite nanoparticles through two mechanisms, as a therapeutic agent and drug carrier. The magnetic field of the magnetic nanoparticles produces force and torque to increase the temperature until 42°C and trigger organelles movement, causing apoptosis of osteoclasts. Hydroxyapatite is a major component of bone mineral that replaces bone tissue deformity and has an osteoblastic effect in bone regeneration. Nano-sized hydroxyapatite will increase material properties and stability in high temperatures. However, hydroxyapatite has less magnetic activity so this function is completed by magnetic nanoparticles. Summary: Therefore, the combination of soy isoflavones and magnetic hydroxyapatite nanoparticles works synergistically as an alternative therapy for osteoporosis in menopausal women.

Background: Colorectal cancer is the second leading cause of death in the world. Currently, resection and adjuvant chemotherapy are the main therapies for colorectal cancer. Resection is an invasive procedure and chemotherapy often causes side effects due to non-specific work targets. Purpose: This study examines the potential of soursop leaf extract and curcumin with magnetic and mucus-penetrating nanoparticles as an alternative therapy for colorectal cancer. Review: Soursop leaf extract has acetogenin agent as an anti-tumor, anti-inflammatory, and cytotoxic agent that acts specifically on target organs. Curcumin from turmeric extract has antioxidant, anti-inflammatory, antimutagenic, antiangiogenic, and anticancer effects. Curcumin works molecularly on cyclooxygenase-2 (COX-2) to prevent inflammation, thereby inhibit the growth of cancer cells and reducing the risk of metastasis. Curcumin also plays a role in the inhibition of nuclear factor κ-light-chain-enhancer of activated B (NF-κB) cells, thus inhibits carcinogenesis. For drug delivery, magnetic nanoparticles and mucus-penetrating nanoparticles could be used. The magnetic field of magnetic nanoparticles generates force and torque to increase the temperature and movement of the organelles, so that apoptosis occurs from cancer cells. Mucus-penetrating nanoparticles are more resistant to mucus degradation because they can avoid mucoadhesive effects, penetrate the mucus adherent layer, and are easily absorbed by the intestinal epithelium. Conclusion: Soursop leaves, curcumin, magnetic nanoparticles, and mucus-penetrating nanoparticles are potential to be an alternative therapy for colorectal cancer.