CASE REPORT: COLITIS ULCERATIVE AND ANCYLOSTOMA DUODENALE INFECTION IN 66 YEARS OLD MAN

ABSTRAKUlcerative colitis merupakan peradangan kronis dari colon dengan etiologi pasti yang belum diketahui. Ancylostoma duodenale adalah salah satu jenis cacing tambang yang berinfestasi pada manusia yang dapat mengakibatkan gejala anemia dan malnutrisi. Artikel ini melaporkan kasus pasien laki-laki berusia 66 tahun dengan keluhan utama BAB berdarah. BAB berdarah sejak 2 minggu sebelum masuk RS. BAB dikatakan pasien berdarah, disertai lendir, 5-6 kali per hari. Pasien juga mengeluhkan nyeri perut pada bagian tengah atas. Pada pasien ditemukan konjungtiva anemis bilateral, dan nyeri tekan pada epigastrium. Pada pemeriksaan penunjang ditemukan anemia normokrom normositik dengan normal fecal analysis, ditemukan adanya colitis dan infestasi Ancylostoma duodenale pada kolonoskopi. Hasil fecal analysis yang normal pada infeksi Ancylostoma duodenale bisa disebabkan oleh kemungkinan infeksi awal pada pasien, low infectivity, subjektivitas pemeriksa, sehingga, diperlukan analisis feses dengan perhatian atau teknik khusus.Kata kunci: Ulcerative colitis , Ancylostoma duodenale ABSTRACTUlcerative colitis (UC) is a chronic inflammation in colon with unknown etiology. Ancylostoma duodenale is one of the hookworms that infects human, it can manifest as anemia and malnutrition. This article reported a man 66 years old with bloody stool since 2 weeks before admission. The stool was bloody, with mucous, 5-6 times per day. Patient was also complained about epigastric pain. Physical examination showed bilateral conjunctival pallor and epigastric tenderness. Laboratory examination showed normochromic normocytic anemia, with normal fecal analysis. Colitis and Ancylostoma duodenale were established in colonoscopy. Normal fecal analysis in this patient maybe due to early infection stage, low infectivity, or examiner subjectivity, so it is suggested with special attention or certain technique of fecal analysis. Keywords: Ulcerative colitis , Ancylostoma duodenale

Nanoparticles as Budding Trends in Colon Drug Delivery for the Management of Ulcerative Colitis

Inflammatory Bowel Disease (IBD) is a disorder of the gastrointestinal tract, which is characterized by Crohn’s disease and Ulcerative colitis. Ulcerative colitis (UC) is a chronic idiopathic relapsing colon disease distinguishes by the interference of epithelial wall and colonic site tenderness. For the treatment of ulcerative colitis, various side effects have been reported, due to the non-specific delivery of the targeted drug of the conventional system. This review will explain the reader about various considerations for the preparation of orally administered NPs drug delivery systems for the treatment of ulcerative colitis. Moreover, principles and novel strategies for colon targeting based on the physiology of colon so that the tract of gastro intestine can be used as the identification marker for a target site for drugs. Besides this, the role of phytomedicines in controlling and managing the ulcerative colitis has been discussed. Additionally, the major problem for the smart delivery of NPs in clinical applications with their difficulties in Intellectual Property Rights (IPR) was also discussed. Finally, this review provides various potential approaches to NPs for the treatment of UC.

Administration of Vitamin D3 Improves Hemoglobin Level by Regulating TNF-a and IL-6 in DSS-induced Colitis Mice

BACKGROUND: Anemia is frequently found in ulcerative colitis (UC) patients and assumed to be related to inflammatory process. Vitamin D3 (VD) is known to have anti-inflammatory and immunomodulatory effects. It also has the potential to be an alternative treatment of the inflammatory process that occurs at UC, however its mechanism has not been clearly established. This study aimed to assess the effect of VD on histopathology and hemoglobin levels in UC through its regulation in tumor necrosis factor (TNF)-α and interleukin (IL)-6.METHODS: Total samples of 24 mice were divided equally into Sham group, UC group, UC+VD group (given 3% dextran sodium sulfate (DSS) followed by VD), and VD+UC group (given VD followed by 3% DSS). Mouse Colitis Histology Index (MCHI) was used to measure histopathological changes. Immunohistochemical staining was used to observe expression of TNF-α and IL-6 in colon. Evaluation of anemia was determined by hemoglobin levels.RESULTS: Based on MCHI scores, significant epithelial damage was found in colon sample of UC group (8.25±3.05) compared to Sham (0.33±0.26), UC+VD (2.33±1.07), and VD+UC group (2.83±0.75) (p<0.05). Significant lower numbers of TNF-α were found in Sham (27.33±3.42), UC+VD (36.33±1.86), and VD+UC group (36.68±1.86) compared with UC group (44.66±4.87) (p<0.05). Significant less IL-6 expression was found in Sham (18.05±2.96), UC+VD (24.78±0.79), and VD+UC group (25.09±2.79) compared to UC group (38.85±3.51) (p<0.05). Differences in hemoglobin levels were significantly lower in UC group (11.85±0.97) compared to Sham (14.25±0.47), UC+VD (13.68±0.68), VD+UC group (13.52±1.07) (p<0.05).CONCLUSION: VD significantly reduced proinflammatory cytokines, increased mucosal repair, and improved hemoglobin levels.KEYWORDS: colitis, ulcerative, interleukin-6, tumor necrosis factor-alpha