Background: Coronavirus disease 2019 (Covid-19) caused by SARS-Cov-2 had been spreading worldwide including Indonesia, but In Indonesia, it was difficult to diagnose confirmation Covid-19 by Polymerase Change Reaction (PCR). and in clinical practice to treat covid-19, Indonesia Health Ministry use term probable covid-19 for patients under observation Covid-19, but study for neurological manifestation on probable Covid-19 is very lacking. Objective: Knowing the neurological manifestation of patient probable Covid-19. Methods: Observational study from Covid-19 medical record and neuro-Covid-19 medical record of all probable Covid-19 hospitalized in the isolation ward of Saiful Anwar Hospital (RSSA) Malang since March-May, 2020 (3 months). Probable Covid-19 criteria were given by Covid-19 task force team based on Health Minister Indonesia criteria. This criterion was based on clinical manifestation (severe upper respiratory symptoms, or mild-severe pneumonia), radiologic examination (lung infiltrate and or chest CT scan), and laboratory examination. Neurological manifestation is based on clinical symptom appeared while patient hospitalized, supported with radiologic and laboratory data which was supervised by neurologist or neurologist resident. All data was inputted to neuro-Covid-19 e-registry on the smartphone application, sent periodically to the data center in Neurology Department RSSA Malang. Results: A hundred and fourteen probable Covid-19 was registered with mean age 34,5 year old and mostly at the young age of 20-50 years (38%). The neurological manifestation was observed in 4 patients (3,4% from all possible Covid-19 patients) with thrombotic stroke as the most common manifestation (50%), followed by myelum tumor (25%) and hypoxia encephalopathy (25%). Stroke patients in probable Covid-19 had old age (72 and 82 years) accompanied by several comorbid such as hypertension, DM and CVA history and Covid symptoms of cough, shortness of breath and fever. Hemiparesis was found improved with aspirin and neurotropic therapy. Patient with myelum tumor had a covid symptom of shortness of breath, cough, and fever with UMN tetraparesis. Previous MRI examination results suspected meningioma. The patient died while hospitalized. Patients with hypoxia encephalopathy admitted with decreased consciousness due to shortness of breath with acidosis respiratory symptoms (pH 7,22 ). This condition improved after oxygenation without focal neurologic deficit. Conclusion:Neurological manifestation in probable Covid-19 was 3,4% of all patients. The most common diagnosis was a thrombotic stroke, followed by myelum tumor, hypoxia encephalopathy, and mortality rate is 25%.

ABSTRAKMengendalikan epidemi tuberkulosis pada anak adalah prioritas kesehatan global. Efikasi vaksin Bacillus of Calmette and Guerin (BCG) sangat bervariasi sehingga memerlukan pengembangan vaksin baru. Antigen rekombinan 38 Kda Mycobacterium tuberculosis sebagai kandidat vaksin harus melalui uji imunogenitas. Tujuan studi ini untuk + mengidentfikasi apakah antigen 38 Kda dapat menstimuli ekspresi IFN-γ dan IL-4 limfosit TCD4 pada kultur PBMC anak dengan kontak TB. Studi ini dilakukan pada kultur PBMC dari 8 kontak TB dan 8 anak sehat yang diinduksi oleh antigen 38 + Kda (kelompok 1), PPD (kelompok 2) dan tanpa perlakuan (kelompok 3). Ekspresi IFN-γ dan IL-4 limfosit TCD4 diukur dengan flowcytometry. Rerata kadar IFN-γ untuk kontak TB tertinggi pada kelompok 3 (p=0,76), sedangkan rerata IL-4 tertinggi pada kelompok 2(p=0,68).RerataIFN-γ untukkelompok sehattertinggi pada kelompok3(p=0,78) sedangkanrerata IL-4 tertinggi pada kelompok 2 (p=0,32). Rerata ekspresi IFN-γ dan IL-4 yang diinduksi oleh antigen 38 Kda, masing-masing lebih tinggi pada kontakTB daripada subjek sehat (p=0,62 dan 0,39). Pengaruh respon imun yang protektif ditunjukkan oleh rasio ekspresi IFN-γ dan IL-4 yang lebih dari 1, baik pada kontak TB dan sehat (1,22 dan 1,28). Tidak ada perbedaan signifikan antara perlakuan pemberian antigen38 kDa, PPD dan tanpa perlakuan. Dapat disimpulkan bahwa antigen 38 + Kda dapat menstimuli ekspresi IFN-γ dan IL-4 limfosit TCD4 pada kultur PBMC kontak TB. + Kata Kunci: Antigen rekombinan 38 Kda, Mycobacterium tuberculosis, IFN-γ, IL-4, limfositTCD4 ABSTRACT Controlling the epidemic of tuberculosis in children is a global health priority. Efficacy of BCG is varies widely so the development of new vaccine is needed. The 38 kDa recombinant antigen of Mycobacterium tuberculosis as a vaccinecandidate must pass imunogenity test. The purpose was to determine that 38 kDa antigen can stimulate expression of IFN-+ γ and IL-4 lymphocyte TCD4 in PBMC cultures from contact TB children. This was a study on PBMC culture from 8 contact TB and 8 healthy children induced by 38 kDa antigen (group 1), PPD (group 2) and without challenge (group 3). The expression + of IFN-γ and IL-4 lymphocyte TCD4 were measured by flowcytometry. The highest mean of 76), while the highest expression of 68). The highest mean of IFN-γ level for healthy subject was in group 3 (p=0,78), while the highest expression of 32). Mean of IFN-γand IL-4 induced by 38 kDa antigenin contact TB were higher than healthy group (p=0,62 and p=0,39). Protective effect of immune respon was showed by ratio of exspression for IFN-γ and IL-4 more than 1, both in contact TB and health group (1,22 and 1,28). There was no significantly difference between challenge with 38 kDa antigen, PPD and no challenge. The 38 kDa + antigen could stimulate the expression of

Backgrounds: People who work in the bird market have a high exposure risk of air pollution in large numbers, particulate pollutans including organic dust, loose feathers, insects or ticks, food aerosol particles, bird’s excreta (amonia) and various of gram bacteria, fungal and virus. Exposure to particles will stimulate the immune system against harmful pathogens in the form of an inflammatory response. An infection or injury will stimulate secretion of KL-6/MUC1 (Krebs von den Lungen-6 is a high molecular weight, mucin-like glycoprotein in human (MUC1)) by AEC type II and bronchial epithelial cells in response to cell damage and regeneration. Methods: This was an observational analytic cross-sectional study on 35 subjects, which examined and analyzed the characteristics of workers, percentage count of neutrophils, lymphocytes in induced sputum and KL-6/MUC1 serum levels using ELISA sandwich. Results: Mean KL-6/MUC1 serum levels in the bird market workers increased (1152.67+583.92 U/ml) from normal levels (105.3-401.2 U/ml). There was a significant positive correlation between the length of exposure and KL-6/MUC1 serum levels (r=0.624; P

Kebiasaan merokok di tempat kerja merupakan suatu masalah yang belum bisa terselesaikan hingga saat ini, meskipun sudah ada peraturan dari pemangku kebijakan terkait larangan merokok serta undang-undang yang mengatur, namun masih banyak di temukan data-data terkait para karyawan yang masih merokok di tempat kerja. Pajanan asap rokok lingkungan di tempat kerja seperti industri marmer meningkatkan risiko terhadap kesehatan dan penyakit paru   pada pekerja.  Kegiatan pengabdian masyarakat dengan  metode ARRIF yang terdiri dari Analisis, Rumusan, Rencana Intervensi, Forum Komunikasi dilakukan sebagai bentuk pemecahan masalah yang terjadi di lingkingan kerja industri marmer Kecamatan Tjampurdarat Kabupaen Tukunganung. Dari 40 respondenn  didapatkan  jumlah perokok yaitu 22 orang  (55%), bekas perokok 5 orang (12,5%) dan sisanya bukan perokok 13 orang. Diantara perokok, 20 orang (90,9%) adalah perokok ringan dan sisanya adalah perokok sedang. Pekerja yang tidak merokok juga terpajan asap rokok lingkungan atau bekerja pada lingkungan dengan polusi udara yang tinggi Intervensi berupa edukasi kesehatan paru dan respirasi dengan melakukan penyuluhan menggunakan media peraga. Edukasi meliputi bahaya rokok, manfaat berhenti merokok dan upaya berhenti merokok.

Background: Toxic particles within tobacco smoke are responsible for several respiratory system problems. Among these toxic particles is Carbon Monoxide (CO), produced from environment and Heme Oxygenase induction. Expiratory CO levels can be measured using CO analyzer. CC16 is a pneumoprotein produced by club cells in distal respiratory tract. In acute condition, CC16 level will increase to maintain homeostasis and anti-inflammation. In chronic condition, i.e. in smokers, CC16 will decrease, following destruction of Club cell. This study aims to determine exhaled CO (eCO) levels and serum CC16 levels in active smokers. Methods: This cross-sectional analytical study design has 40 samples of healthy smokers in Brawijaya University who consents to the research from October 2019 until June 2020. The minimum consumption amount is 1 cigarette per day for at least 1 year. eCO levels are measured using CO analyzer (Smokelyzer), while ELISA is used to measure serum CC16 levels. Results: Among 40 subjects, mean eCO level is 10.18 ± 7.42 ppm. Mean serum CC16 level is 3.17 ± 1.78 ng/mL, lower than normal value of 6.4 ng/mL (Lomas et al., 2008). Conclusion: eCO levels increases and serum CC16 level decreases in active smokers, who smokes at least 1 cigarette/day for at least 1 year. This indicates that CO from tobacco smoke could irritate and damage the Club cells in the respiratory system.