Aerobic glycolysis is commonly used as the main energy source for cancer cell growth. Adenylate kinase 2 (AK2) plays an important role in maintenance of ATP production in the mitochondria. Neoandrographolide in Andrographis paniculata potentially inhibit AK2 activity in silico. This study aimed to investigate the inhibitory effect of A. paniculata extract on proliferation of breast cancer cell line. This experimental laboratory used MCF-7 cell line and A. paniculata plants, which were extracted using the maceration method with 70% ethanol. Neoandrographolide concentration in A. paniculata extract was determined using HPLC. A total 1x104 MCF-7 cells were incubated for 24 hours with or without 0.4% (v/v) dimethyl sulfoxide as solvent (SC) or negative control (NC) group. The same amount of MCF-7 cells was treated with A. paniculata extract with 3 different dosages: 222 ppm (AE1), 111 ppm (AE2) and 55.5 ppm (AE3). The inhibition of cell proliferation used the 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium bromide (MTT) assay. Data were analyzed using ANOVA and LSD tests with p value <0.05.Ethanol extract of A. paniculata contained 4.43 µM neoandrographolide. The inhibition of MCF-7 cell proliferation was found in AE1 (47.98%) and AE2 (30.50%) groups and was significantly different from the NC group. While the percentage of MCF-7 cell inhibition in the AE1 group differed from NC (p = 0.002) and SC (p = 0.013) groups. Ethanol extract of A. paniculata can inhibit MCF-7 cell proliferation. Further Study is needed to investigate the role of neoandrographolide on inhibition of AK2 activity in MCF-7 cells.

Dyspepsia still becomes a major challenge in upper gastrointestinal disease in Indonesia. This disease often correlated with Helicobacter pylori infection. However, the prevalence of this bacterium is generally low in Indonesia. Therefore, several considerations should be taken into consideration during the management of dyspepsia and H. pylori infection. “Management of dyspepsia and H. pylori infection in Indonesia: The Indonesian consensus report” comprises information gathered from 22 gastroenterology centers across Indonesia. The experts gathered to evolve a consensus, that consists of the statements, grades of recommendations, evidence levels, and rationales for the dyspepsia and H. pylori infection management for daily clinical practice. The report explains several aspects from the updated epidemiology information to comprehensive management therapy. After the experts worked together on all statements in the recommendations, the results are presented with the final agreement as a consensus to help clinicians in understanding, diagnosing, and treating dyspepsia and H. pylori infection patients in daily clinical practice in Indonesia.

No abstract

Primary hepatic leiomyosarcoma (PHL) is a very rare primary liver tumour. These tumours usually arise from intrahepatic vascular structures, gallbladder, or ligamentum teres. The pathogenesis of this disease is still unknown. We report a 53-year-old man with complaints of intermittent right upper abdominal pain for one month, decreased appetite, nausea, weight loss, and tea-coloured urination. The patient denied any complaints of defecation pattern. On physical examination, jaundice was present in both eyes and the whole-body skin, tenderness in the right hypochondriacal region, and enlarged liver with a lumpy surface. The laboratory examination demonstrated increased transaminase enzymes and bilirubin, while hepatitis B and C were negative. The patient underwent several tests for tumour markers, such as CA 19-9 50 (<37 U/mL), AFP 1.23 (<5.81 IU/mL), and CEA 0.83 (<3 ng/mL). Ultrasound demonstrated an enlarged liver, multiple liver nodules, and cholelithiasis. Meanwhile, the abdomen’s computerised tomography (CT) scan shows a solid heterogeneity image with an irregular border in segments 1 and 4b and a tumoral thrombus in the inferior vena cava. The diagnosis was confirmed by biopsy and immunohistochemistry (IHC); vimentin and smooth muscle actin (SMA) results were positive, while CD 34, CD 117, and cytokeratin were negative. Our patient was diagnosed with PHL stage IVa (T4N2M0). PHL is a particularly rare tumour with a poor prognosis. The patient died after one month of diagnosis. Diagnosis of PHL is challenging. It was based on clinical features, physical examinations, laboratory examinations, and other supporting investigations.

Pancreatic cancer is difficult to diagnose in early stage. Malignant bile duct obstruction is a severe complication of pancreatic cancer, which can lead to poor outcomes including cholangitis, delayed treatment, reduced quality of life, and increased mortality. Perendoscopic placement of stents is a method widely used in the management of various malignant and benign pancreatico-biliary abnormalities. A 70-year-old woman came to Dr Moewardi General Hospital in Surakarta with the chief complaint of yellowish skin and eyes since one month before hospital admission. Patient was diagnosed with obstructive jaundice due to suspected of advanced stage pancreatic cancer. Subsequently, patient underwent endoscopic retrograde cholangiopancreatography (ERCP) which revealed an intrahepatic and extrahepatic bile ducts dilatation due to pancreatic tumor which infiltrated common bile duct, thus self expandable metallic stent (SEMS) placement was performed. Furthermore, patients received palliative therapy due to inadequate chemotherapy requirement.