Controlled Clinical Trial Effect of Noni Fruit Extract (Morinda citrifolia) Toward Overactive Bladder Women through Observation of High-Sensitivity C-reactive Protein in Urine Levels

BACKGROUND: The prevalence of overactive bladder (OAB) appears to increase with age (aging), and free radicals most contribute to an increase in the aging process. But now, some researchers have found the efficacy of Morinda citrifolia in inhibiting the oxidative stress process so that it is expected to be beneficial for the treatment of OAB. AIM: The aim of this study was to find out the effect of M. citrifolia extract on overactive women bladder (OAB) through observation of high-sensitivity C-reactive protein (hs-CRP) urine level. METHODS: This research is an experimental study using double-blind randomized controlled trial design conducted at General Hospital H. Adam Malik Medan, USU Pharmacy Laboratory for extraction of noni fruit (M. citrifolia) and the Integrated Laboratory of Biochemical-Biomolecular USU Faculty of Medicine for the examination of hs-CRP urine levels. A t-dependent test is performed if data distribution is normally distributed or if not normally distributed, the median values are compared with the Mann–Whitney U-test. The effect of noni in hs-CRP levels performed by wilcoxon signed-Ranks Test. The statistical significance test with CI 95% and significant difference value p<0,05. RESULTS: These results indicate that the noni fruit extract has weak antioxidant activity (IC50 >150 ppm). From the statistical analysis, a significant difference (p < 0.05) was obtained in hs-CRP urine level after compared to before treatment. These results indicate that after treatment, there was an improvement in the degree of OAB symptom scores in Group A and Group B. CONCLUSIONS: Noni fruit extract (M. citrifolia) is proven to be able to inhibit oxidative stress in urothelium through observation of hs-CRP urine levels in overactive women bladder (OAB).

Iot based Healthcare System for Coma Patient

Coma is a state of unconsciousness where the patient fails to respond. These patients need utmost care and 24*7 observations. This paper presents a continuous monitoring and recording of patient data without human intervention. If there is any sudden changes occur in the normal range of body parameters such as body temp falls or rise, blood pressure (B. P.) increases or decreases causing high or low B.P. where both are not stable conditions for better health, then it has facility to automatically alert the medical person. The movement sensor detects the patient movement and also generates an alert message to the medical person. As comatose losses their sensation for urination, medical person needs to continuously monitor urine output, thus we are using ultrasonic sensor to check on urine level. Medical person can keep the track of patient using login to the system. The software IoT API we are using isThingSpeak.

Evaluation of colistin nephrotoxicity and urinary level of kidney injury molecule-1 in hospitalized adult ICU patients

Introduction: Colistin is a cationic polypeptide antibiotic used for treatment of gram-negative infections. Nephrotoxicity is one of the most common adverse effects of colistin. Objectives: To determine the epidemiology of colistin nephrotoxicity and also to compare the changing pattern of kidney injury molecule 1 (KIM-1) in urine with serum creatinine and urine during the treatment with colistin in patients admitted to intensive care unit (ICU). Patients and Methods: During 13 months, all patients admitted to adult ICUs of two university hospitals without any documented history of acute or chronic kidney diseases receiving at least one week of colistin were included. Required demographic, clinical, and paraclinical data of the study population was collected. Urinary and serum levels of creatinine, urea, sodium, potassium, magnesium, and KIM-1 were measured at six time points including days zero, 3, 5, 7, 10, and 14 of colistin treatment. Results: Six patients (18.18%) developed nephrotoxicity during colistin treatment. Nephrotoxicity was resolved without any intervention in three individuals. None of studied demographic, clinical and laboratory characteristics of the patients had a significant association with the incidence of colistin nephrotoxicity. The pattern of KIM-1 urine level during the course of colistin treatment did not differ significantly among patients with and without nephrotoxicity. The accuracy of KIM-1 urine level in detecting colistin nephrotoxicity was significantly lower than that of serum creatinine on days 0th, 3rd, 5th and 7th. Conclusion: Nephrotoxicity of colistin is a common complication, usually reversible, KIM-1 was not more accurate than serum creatinine or urine in detecting nephrotoxicity of colistin.

Perbandingan kadar merkuri (Hg), kreatinin dan urea di Kotagede dan Banguntapan, Yogyakarta sebagai parameter indikasi pencemaran

Study from the Environmental Office of Yogyakarta, indicates in Kotagede found the pollution of mercury from the environment because of improper disposal of wastewater. This study aims to assess the levels of mercury, creatinine and urea in the serum and urine of people working in several industries in Kotagede and Banguntapan. Subjects of this study were 52 employees in several industries in Kotagede Yogyakarta with a range of ages between 20 - 71 years and length of work between 3 - 38 years. A total of 42 people with the age range was 21 - 63 years and the length of work between 1 - 20 years were taken from industrial employees in Bantul who have almost the same geographical conditions as Kotagede. Determination of mercury levels using the Atomic Absorption Spectrophotometry (AAS) method while the determination of urea and creatinine levels by a Dyasis kit. In Kotagede, there were 3 people (5.8%) with the average mercury serum of 0.217 ppb and no mercury in the urine was found in all subjects. In Banguntapan, one person (2.4%) had 0.200 ppb mercury serum and 6 people (14.3%) had an average mercury urine level of 0.395 ppb. Urine creatinine and urea levels in subjects from Kotagede were higher than those from Banguntapan (p<0.05), despite being on the normal range. The presence of mercury in several industrial employees in Kotagede and Banguntapan is still on the low range even though it was correlated to creatinine levels.

N-Acetyl-Glucosamidase as Biomarker for Acute Kidney Injury

Background : The estimated inci­dence of Acute Kidney Injury (AKI) is two to three cases per 1,000 patients. Seven percent of hospitalized patients and about two-thirds of patients in intensive care units develop acute kidney injury and the mortal­ity rates range between 25 and 80 percent. Disruption in epithelial brush border of proximal tubular cell causes N-Acetyl-β-D-Glucosaminidase (NAG) to be released to the urine and the amount of enzyme could be directly correlated with tubular disruption. Objective : The aims of this research is to determine the sensitivity and specificity of NAG urine examination as an early biomarker for acute kidney injury. Methods : There’s 66 subjects who met the inclusion criteria. All the subject were checked for the NAG urine level with Cloud Clone kit and creatinine serum were also checked 48 hours after admission. Results : The results showed in the cut-off point of 7.98 Ng/mL, urine NAG has a sensitivity of 68.6% and specificity 77.4%, positive predictive value 77.42%, negative predictive value 68.57 % and accuracy of 72.73% Conclusions : The result shows that urine NAG examination is more sensitive and specific as an early biomarker for Acute Kidney Injury compared to creatinine serum. Key words : Acute Kidney Injury, N-Acetyl-β-D-Glucosaminidase , sensitivity, spesificity

Sensitivity and Spesificity of Interleukin 18 as Biomarker for Acute Kidney Injury

Background : Incidence of AKI in intensive care unit patients reach 60-70%, and the mortality rate is about 60%. IL-18 is a pro-inflammatory cytokine which increased in endogenous inflammation process. Studies in human showed that IL-18 concentration increased prior to AKI. Objective : The aims of this research is to determine the sensitivity and specificity of Interleukin-18 urine examination as an early biomarker for acute kidney injury. Methods : There’re total of 66 subjects who met the inclusion criteria. All the subject were checked for the IL-18 urine level with Cloud Clone kit and creatinine serum were also checked 48 hours after admission. Results :The results showed in the cut-off point of 411.25 Pg/mL , urine IL-18 has a sensitivity of 54.3 % and specificity 83.9%, positive predictive value 79.17%, negative predictive value 61.9% and accuracy of 68.18% Conclusions : Our result suggest that IL-18 urine holds a promise as an early biomarker of AKI and more sensitive and specific as an early biomarker for AKI compared to creatinine serum. Key words : Acute Kidney Injury, Interleukin-18, sensitivity, spesificity

Elevated d-2-hydroxyglutarate during colitis drives progression to colorectal cancer

d-2-hydroxyglutarate (D2HG) is produced in the tricarboxylic acid cycle and is quickly converted to α-ketoglutarate by d-2-hydroxyglutarate dehydrogenase (D2HGDH). In a mouse model of colitis-associated colon cancer (CAC), urine level of D2HG during colitis correlates positively with subsequent polyp counts and severity of dysplasia. The i.p. injection of D2HG results in delayed recovery from colitis and severe tumorigenesis. The colonic expression of D2HGDH is decreased in ulcerative colitis (UC) patients at baseline who progress to cancer. Hypoxia-inducible factor (Hif)-1α is a key regulator of D2HGDH transcription. Our study identifies urine D2HG and tissue D2HGDH expression as biomarkers to identify patients at risk for progressing from colitis to cancer. The D2HG/D2HGDH pathway provides potential therapeutic targets for the treatment of CAC.

Effect of Vitamin E Supplementation on Plasma and Urine Levels of Isoprostane F2α in Randomized Controlled Clinical Trials: A Systematic Review and Meta-Analysis

Vitamin E can reduce the level of lipid peroxidation and the related markers such as urine and plasma levels of isoprostanes. However, effects of vitamin E supplementation on plasma and urine level of isoprostane F2α as markers of lipid peroxidation were conflicting in various clinical trials. The current meta-analysis was carried out to determine the effects of vitamin E supplementation on plasma and urine levels of isoprostanes F2α in randomized clinical trials. A systematic search of RCTs was carried out in PubMed, Scopus, Science Direct and Cochrane Library databases. OF 889 relevantly founded articles, only four articles with five arms met the criteria for meta-analysis of plasma level of isoprostanes F2α. For the urine level of isoprostane F2α, three studies with 14 arms were included in the meta-analysis. After pooled analyzing, a significant reduction of 6.98 ng / l was seen in plasma level of isoprostane F2α in vitamin E receiving group (95% CI = -11.2, -2.76; P < 0.001) while no significant heterogeneity was seen between the studies included in this meta-analysis (P = 0.81 and I2 = 0.0%). However, the pooled effect of vitamin E supplementation on urine level of isoprostane F2α was not statistically significant (-11.31 pg / mg creatinine (95% CI = -26.4, 3.78; P = 0.88). Results of this meta-analysis have shown that vitamin E supplementation can only reduce plasma level of isoprostane F2α and has no significant effect on reducing urine level of this biomarker.

KADAR PROTEIN URIN PADA IBU HAMIL TRIMESTER II DAN III DI PUSKESMAS II DENPASAR BARAT

ABSTRACT The presence of excess level of protein in pregnant women’s urine is one of the cause of preeclampsia, besides hypertension and edema. Some disease that can discover protein in pregnant women’s urine are renal diseases (glomerulus or tubular disease) and non-renal diseases (heart disease, liver disease, fever, stress, diabetes militus, hypertenssion). This study aims at describing the result of proteinuria level based on the examination from pregnant women’s urine of second and third trimester in Puskesmas II Denpasar Barat. This research applied a descriptive survey and the amount of samples was taken by using non-probability sampling method with insidental sampling technique, the data were collected from 39 respondents during the period of February to May 2016.The sample were examined semi-quantitatively by using dipstick test. Results of the examination to 39 samples indicates that 29 urine samples (74,36%) was negative, seven urine samples (17,95%) positive 1 (+), two urine samples (5,13%) positive 2 (++) and one urine samples (2,56%) positive 3 (+++). keywords: pregnant woment; protein urine level; second trimester; third trimester