Obesity is an established risk factor for severe coronavirus disease 2019 , but the contribution of overweight and/or diabetes remains unclear. In a multicenter, international study, we investigated if overweight, obesity, and diabetes were independently associated with COVID-19 severity and whether the BMIassociated risk was increased among those with diabetes. RESEARCH DESIGN AND METHODSWe retrospectively extracted data from health care records and regional databases of hospitalized adult patients with COVID-19 from 18 sites in 11 countries. We used standardized definitions and analyses to generate site-specific estimates, modeling the odds of each outcome (supplemental oxygen/noninvasive ventilatory support, invasive mechanical ventilatory support, and in-hospital mortality) by BMI category (reference, overweight, obese), adjusting for age, sex, and prespecified comorbidities. Subgroup analysis was performed on patients with preexisting diabetes. Sitespecific estimates were combined in a meta-analysis. RESULTSAmong 7,244 patients (65.6% overweight/obese), those with overweight were more likely to require oxygen/noninvasive ventilatory support (random effects adjusted odds ratio [aOR], 1.44; 95% CI 1.15-1.80) and invasive mechanical ventilatory support (aOR, 1.22; 95% CI 1.03-1.46). There was no association between overweight and in-hospital mortality (aOR, 0.88; 95% CI 0.74-1.04). Similar effects were observed in patients with obesity or diabetes. In the subgroup analysis, the aOR for any outcome was not additionally increased in those with diabetes and overweight or obesity. CONCLUSIONSIn adults hospitalized with COVID-19, overweight, obesity, and diabetes were associated with increased odds of requiring respiratory support but were not associated with death. In patients with diabetes, the odds of severe COVID-19 were not increased above the BMI-associated risk.

Hypertension is a major health problem throughout the world, including Indonesia. The use of traditional medicine as part of the treatment of hypertension is increasing in the lastKeywords: pattern of drug use, natural medicine, hypertension ABSTRAK Hipertensi merupakan masalah kesehatan utama di seluruh dunia, termasuk Indonesia. Penggunaan obat tradisional sebagai bagian dari pengobatan hipertensi semakin meningkat dalam dekade terakhir. Hal ini disebabkan adanya beberapa faktor, terutama harga obat tradisional yang dianggap lebih murah dengan efek samping yang dianggap lebih sedikit. Penelitian ini mencoba melihat pola penggunaan obat bahan alam sebagai terapi komplementer pada pasien hipertensi di Puskesmas. Penelitian merupakan studi deskriptif yang dilakukan di Puskesmas Sempaja Kota Samarinda pada periode September 2016, dengan mewawancarai 62 pasien hipertensi terkait penggunaan obat bahan alam. Hasil penelitian menunjukkan 70,9% pasien hipertensi di puskesmas juga menggunakan obat bahan alam. Seluruh pasien menggunakan obat bahan alam yang secara teori memang terbukti menurunkan tekanan darah. Namun demikian tidak ada obat bahan alam yang digunakan termasuk obat herbal terstandar atau fitofarmaka. Hanya 15,2% pasien yang menggunakan obat bahan alam yang sesuai dengan peraturan BPOM tentang kriteria jamu. Kesimpulan penelitian ini menunjukkan masih perlunya edukasi penggunaan obat bahan alam di masyarakat untuk penatalaksanaan hipertensi.Kata kunci: pola penggunaan obat, obat bahan alam, hipertensi

Tujuan: Mengetahui faktor-faktor risiko yang berhubungan dengan terjadinya kanker serviks.

Our effort to find new material for anti cancer from natural resources leads us to focus on stingless bee products such as honey, bee pollen, and propolis. The products were from seven stingless bees named Homotrigona fimbriata, Heterotrigona itama, Heterotrigona bakeri, Tetragonula sarawakensis, Tetragonula testaceitarsis, Tetragonula fuscobalteata, Tetragonula laeviceps. The stingless bee products were evaluated for their cytotoxicity effect on MCF-7, HeLa and Caco-2 cancer cell lines. This is the first time to be reported that the honey, ethanol extracts of bee pollen and propolis of H. fimbriata displayed more potent cytotoxicity than other stingless bee products. By chromatography and biological activity-guided fractionation, ethanol extract of propolis from H. fimbriata was fractionated and isolated its active compound named mangiferonic acid. Mangiferonic acid showed a cytotoxicity effect with IC 50 values 96.76 µM in MCF-7, >110.04 µM in HeLa, and > 110.04 µM in Caco-2, respectively. These results exhibited the potential of ethanol extracts from propolis of H. fimbriata to be further developed for drug and experiments to verify the function are essential.

Objective:Breast carcinoma has no longer been considered as a single and standalone disease. Its subtypes have been known to vary in terms of risk factors, natural histories, and responses to therapies. In particular, intrinsic molecular subtypes based on St. Gallen International Expert Consensus 2013 have classified breast carcinoma into luminal A, luminal B, HER2+, and triple-negative, depending on the expression of ER, PgR, HER2, and Ki-67. Research on intrinsic molecular subtypes of breast carcinoma in Indonesia, however, are rarely conducted, which then triggers the intention to conduct this study. Methods:In this work, a retrospective study was conducted on 92 formalin-fixed paraffin-embedded samples of invasive ductal breast carcinoma patients. These samples were from patients at Abdul Wahab Sjahranie County General Hospital Samarinda, East Kalimantan, Indonesia, in 2016. Next, immunohistochemical staining using anti-ER, PgR, HER2, and Ki-67 antibodies was applied to classify intrinsic molecular subtypes. Then, an association between clinical and immunohistochemical factors with intrinsic molecular subtypes of breast carcinoma were analyzed using Chi-square test. Results:Looking at results of the retrospective study, luminal B was discovered as the most common intrinsic molecular subtypes of breast carcinoma (42.39%) in East Kalimantan, Indonesia. The next ranks of breast carcinoma subtypes in the region included HER2+ (39.13%), triple-negative (10.87%), and luminal A (7.61%). In fact, there was a significant association between age (p = 0.019) with intrinsic molecular subtypes of breast carcinoma. Conclusion:The study found luminal B as the most common intrinsic molecular subtypes of Indonesian breast carcinoma in the region under investigation. In the future, the higher positivity rate of luminal B in breast carcinoma patients compared to prior studies would require further investigations.