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"ABSTRAKLatar Belakang: Temulawak Curcuma xanthorrhiza Roxb. merupakan tanaman obat asli Indonesia yang diketahui memiliki efek antijamur. Infeksi jamur yang paling umum terjadi di rongga mulut yaitu kandidiasis oral sering disebabkan oleh jamur Candida albicans. Salah satu faktor virulensi C. albicans yaitu kemampuannya untuk membentuk biofilm. Pada biofilm C. albicans fase menengah terjadi perubahan bentuk dari ragi menjadi hifa muda dengan matriks ekstraseluler yang dapat meningkatkan resistensi agen antijamur. Tujuan: Menganalisis efek ekstrak etanol temulawak dalam menghambat pertumbuhan fase menengah biofilm C. albicans. Metode: Pemaparan ekstrak etanol temulawak pada biofilm C. albicans strain klinis dan ATCC 10231 usia 1.5 jam selama 24 jam untuk mencapai biofilm fase menengah. MTT assay digunakan untuk menguji viabilitas biofilm C. albicans. Hasil: Ekstrak etanol temulawak memiliki nilai Konsentrasi Hambat Biofilm Minimal KHBM50 untuk biofilm C. albicans strain klinis dan ATCC 10231 pada fase menengah berturut-turut sebesar 30 dan 35 . Kesimpulan: Ekstrak etanol temulawak berpotensi dalam menghambat pertumbuhan fase menengah biofilm C. albicans.

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ABSTRACTBackground Javanese turmeric Curcuma xanthorrhiza Roxb. is an Indonesian rsquo s native medicinal plant which is known to have antifungal effect. The most common fungal infection occurs in the oral cavity is oral candidiasis caused by Candida albicans. One of the virulence factors of C. albicans is the ability to form biofilm. In intermediate phase of biofilm, C. albicans may change forms from yeast into hyphae with extracellular matrix which can inhibit the penetration of antifungal agent. Objective To invesitigate the inhibitory effect of Javanese turmeric ethanol extract againts C. albicans biofilm in intermediate phase. Method Javanese Turmeric ethanol extract was exposed to 1.5 hours aged of C. albicans clinical strain and C. albicans ATCC 10231 biofilm for 24 hours to achieve intermediate phase. MTT assay was used to asses the viability of C. albicans biofilm. Result The Minimum Biofilm Inhibitory Concentrations MBIC50 of Javanese turmeric ethanol extract for C. albicans clinical strain and ATCC 10231 in intermediate phase were 30 and 35 , respectively. Conclusion Javanese turmeric ethanol extract had potential to inhibit the the growth of Candida albicans biofilm in intermediate phase."

"Latar Belakang: Kandidiasis Oral adalah infeksi pada rongga mulut yang terutama disebabkan oleh jamur C. albicans. C. albicans dalam bentuk biofilm bersifat virulen. Pembentukan biofilm C. albicans diawali dengan proses adhesi sel diikuti dengan proliferasi dan pembentukan biofilm. Temulawak Curcuma Xanthorrhiza Roxb. merupakan tanaman obat asli Indonesia yang mengandung zat aktif xanthorrhizol yang memiliki efek antijamur. Tujuan: Menganalisis efek hambat ekstrak etanol temulawak terhadap biofilm C. albicans pada fase awal. Metode: Paparan ekstrak etanol temulawak diberikan pada kultur C. albicans isolate klinis dan ATCC 10231 usia 1.5 jam selama 6 jam untuk mencapai fase awal. Viabilitas C. albicans diuji dengan MTT assay. Hasil: KHM Ekstrak etanol temulawak terhadap C. albicans isolat klinis dan ATCC 10231 secara berturut-turut adalah 15 dan 20 . KHBM50 ekstrak etanol temulawak terhadap biofilm C. albicans isolat klinis dan ATCC 10231 pada fase awal secara berturut-turut adalah 20 dan 25. Kesimpulan: Hasil penelitian ini menunjukkan bahwa Ekstrak Etanol Temulawak dapat menghambat biofilm C. albicans pada fase awal.

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Background: Oral Candidiasis is an oral cavity infection caused by C. albicans. C. albicans in the form of biofilm is virulent. C. albicans biofilm formation initially starts with the fungal cell adhesion followed by the proliferation and the formation of biofilm. Javanese Turmeric Curcuma Xanthorrhiza Roxb. is an Indonesian medicinal plant that contains xanthorrhizol as the active substance which has antifungal effects.

Objective: To investigate the inhibitory effect of Javanese turmeric ethanol extract on C. albicans biofilm in the initial phase.

Methods: exposing Javanese Turmeric ethanol extract was given to C. albicans culture aged 1.5 hours for 6 hours to achieve initial phase of biofilm. The viability of C. albicans was assesed by MTT assay.

Result: The MIC Minimum Inhibitory Concentration of Javanese turmeric ethanol extract against C. albicans clinical isolated and ATCC 10231 were 15 and 30 , respectively. The concentration of temulawak ethanol extract which had MBIC50 value on C. albicans clinical isolated and ATCC 10231 in the adhesion phase were 20 and 25, respectively.

Conclusion: The results showed Javanese turmeric ethanol extract could inhibit C. albicans biofilm in initial phase."

"Latar Belakang: Candida albicans merupakan flora komensal yang dapat berubah menjadi virulen pada keadaan tertentu yang dipengaruhi oleh faktor predisposisi dan virulensi. Salah satu faktor virulensi C. albicans  adalah kemampuan membentuk biofilm dengan gambaran morfologi yang berubah pada setiap fasenya. Pembentukan biofilm dapat meningkatkan resistensi terhadap agen antijamur. Temulawak merupakan tanaman obat unggulan Indonesia yang diketahui memiliki khasiat antijamur. Tujuan: Mengetahui perkembangan berbagai fase biofilm C. albicans ATCC 10231 setelah paparan ekstrak etanol temulawak (Curcuma xanthorrhiza Roxb.) Metode: Uji MTT-assay digunakan untuk mengetahui konsentrasi minimum ekstrak etanol temulawak dalam menghambat pembentukan biofilm C. albicans (KHBM₅₀). Gambaran mikroskopis perkembangan biofilm C. albicans diobservasi dengan menggunakan  Scanning Electron Microscope (SEM). Hasil: Nilai Konsentrasi Inhibisi Biofim Minimal (KHBM₅₀) ekstrak etanol temulawak terhadap biofilm C. albicans ATCC 10231 pada fase awal (adhesi dan proliferasi), fase menengah, dan fase maturasi berturut turut adalah 25%, 35%, dan 40%. Kemampuan ekstrak etanol temulawak dalam menghambat perkembangan biofilm C. albicans  menurun seiring dengan peningkatan fase biofilm.  Pada fase adhesi, morfologi C. albicans ATCC 10231 yang dipaparkan ekstrak etanol temulawak dan nystatin masih berbentuk blastospora, berbeda dengan kontrol negatif yang sudah menunjukkan germinasi. Pada fase proliferasi, menengah, dan maturasi C. albicans ATCC 10231 yang dipaparkan temulawak maupun nystatin menunjukkan adanya pertumbuhan hifa yang lebih pendek namun dengan jumlah dan densitas yang jauh lebih sedikit jika dibanding dengan kontrol negatif. Kesimpulan: Ekstrak etanol temulawak mempengaruhi viabilitas C. albicans ATCC 10231 dan menghambat perkembangan biofilm C. albicans ATCC 10231 dengan cara menghambat pertumbuhan hypha serta menurunkan densitas biofilm. Semakin meningkat fase perkembangan biofilm, dibutuhkan konsentrasi ekstrak etanol temulawak yang lebih tinggi.

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Background: Candida albicans is a commensal flora that can turn into virulent in certain circumstances that are influenced by predisposing and virulence factors. One of the virulence factors of C. albicans is the ability to form biofilm with morphologic changes in every phase. Biofilm formation can increase resistance towards antifungal agents. Javanese turmeric is an Indonesian medical plant that is reported to have antifungal effect which can inhibit the development of C. albicans biofilm. Objective: To observe the development of Candida albicans ATCC 10231 biofilm formation after exposed to Javanese turmeric ethanol extract (Curcuma xanthorrhiza Roxb.) Method: MTT-assay was used to measure the minimum inhibitory concentration of Javanese turmeric ethanol extract in inhibiting C. albicans ATCC 10231 biofilm formation (MBIC₅₀). The morphological changes of the various stages of C. albicans biofilm were observed using Scanning Electron Microscope (SEM). Results: The Minimum Biofilm Inhibitory Concentration (MBIC₅₀) of Javanese turmeric ethanol extract towards formation of C. albicans biofilm ATCC 10231 in the early phase (adhesion and proliferation), intermediate phase, and maturation phase as follows; were 25%,  35%, and 40% respectively. In the adhesion phase, the morphology of C. albicans ATCC 10231 exposed javanese turmeric ethanol extract and nystatin is still in the form of blastospores, unlike negative controls that have shown germination. In the proliferation, intermediate, and maturation phase C. albicans ATCC 10231 exposed to Javanese turmeric ethanol extract and nystatin showed the growth of shorther hyphae and slightly lesser amounts and densities compared negative controls. The ability of javanese turmeric ethanol extract in inhibiting the development of C. albicans biofilm decreased along with the increased of biofilm phase. Conclusion:  Javanese turmeric ethanol extract affected the viability of C. albicans cells and inhibit the development of C. albicans biofilm by inhibiting the hyphal formation and decreasing the biofilm density."

"Latar belakang: Temulawak yang mengandung xanthorrhizol diketahui memiliki efek antijamur. Xanthorrhizol dilaporkan mampu mengeradikasi biofilm Candida albicans. Tujuan: Menganalisis korelasi antara efek hambat ekstrak etanol temulawak EET dengan perkembangan biofilm C. albicans isolat klinis pada berbagai fase, serta mengamati gambaran mikroskopis biofilm C. albicans. Metode: Uji MTT digunakan untuk menguji viabilitas C. albicans pada biofilm dan dikonversikan persen hambat ekstrak etanol temulawak KHBM50 . Efek EET terhadap gambaran mikroskopis setiap fase perkembangan biofilm C. albicans diamati dengan Scanning Electron Microscopy. Hasil: Nilai Konsentrasi Hambat Biofilm Minimal KHBM50 EET terhadap biofilm C. albicans isolat klinis pada fase awal, menengah, dan maturasi secara berturut-turut adalah 20 , 30 , dan 35 . Gambaran mikroskopis pada setiap fase perkembangan biofilm C. albicans terlihat penurunan jumlah sel dan densitas C. albicans, serta terhambatnya pembentukan filamen dibandingkan dengan kelompok tanpa perlakuan. Kesimpulan: EET mampu menghambat perkembangan fase awal, menengah, dan maturasi biofilm C. albicans isolat klinis. Semakin matur fase perkembangan biofilm, C. albicans akan semakin resisten terhadap ekstrak temulawak. Paparan ekstrak temulawak memengaruhi kemampuan C. albicans isolat klinis dalam membentuk filamen serta menurunkan jumlah sel dan densitas biofilm.

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Background: Javanese turmeric which contains xanthorrhizol is known to have antifungal effect. Xanthorrhizol is reported to be able to eradicate Candida albicans' biofilm formation.

Objective: Analyze the correlation between inhibition concentration of Javanese turmeric ethanol extract JTEE and each development phase of C. albicans' biofilm, and observing microscopic appearance of each phase of C. albicans biofilm.

Method: MTT assay was used to test the viability of C. albicans towards biofilm and converted to Minimum Biofilm Inhibitory Concentration MBIC50 . JTEE' s effect on each phase of microscopic appearance of C. albicans' biofilm is observed by Scanning Electron Microscopy.

Result: MBIC50 of JTEE towards development of clinical isolate of C. albicans' biofilm in the early adhesion and proliferation , intermediate, and maturation phase as follows 20, 30, and 35 respectively. The microscopic appearance on each phase of C. albicans' biofilm development shows decrease in cell number and density, as well as inhibiton of filament formation compared with control group.

Conclusion: JTEE can inhibit the development phases of C. albicans' biofilm. The potency of JTEE to inhibit development of C. albicans' biofilm was decreased along with the maturation of biofilm. The JTEE' s exposure leads to changes of microscopic appearance of C. albicans' biofilm development. "

"Latar Belakang: Temulawak (Curcuma xanthorrhiza Roxb.) merupakan tanaman obat asli Indonesia yang mengandung zat antijamur. Faktor virulensi berperan penting dalam proses infeksi Candida albicans, salah satunya adalah sekresi enzim fosfolipase yang dapat merusak membran sel inang. Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh penghambatan dan pemberantasan aktivitas enzim fosfolipase pada fase awal, intermediet, dan pematangan biofilm C. albicans ATCC 10231. Metode: Efek penghambatan ekstrak etanol temulawak diamati dengan menginkubasi C. albicans selama 1,5 jam, kemudian dipapar ekstrak KHBM50. etanol temulawak kemudian diinkubasi selama 6, 24, dan 48 jam untuk mencapai fase awal, intermediet, dan pematangan biofilm C. albicans. Efek eradikasi diamati dengan menginkubasi C. albicans selama 6, 24, dan 48 jam, kemudian dipapar KEBM50 EET dan diinkubasi pada suhu 37ºC selama 24 jam. KHBM50 dan KEBM50 EET (kelompok perlakuan), nistatin 100.000 IU (kontrol positif), dan SDB (kontrol negatif). Aktivitas enzim fosfolipase dianalisis berdasarkan luas zona pengendapan yang terbentuk pada agar kuning telur. Hasil: KHBM50 EET pada fase awal 15%, intermediate 15%, dan pematangan 25%. Nilai KEBM50 EET untuk ketiga fase biofilm C. albicans adalah 35%. Pada kontrol positif baik inhibisi maupun eradikasi, tidak terlihat adanya zona presipitasi pada ketiga fase biofilm C. albicans. Sementara itu, kelompok penghambatan dan pemberantasan menunjukkan ukuran zona pengendapan yang lebih kecil jika dibandingkan dengan kelompok kontrol negatif pada ketiga fase biofilm C. albicans. Kesimpulan: Aktivitas enzim fosfolipase cenderung menurun pada fase awal, menengah, dan pematangan biofilm C. albicans setelah penghambatan dan eradikasi ekstrak etanol temulawak.Background: Temulawak (Curcuma xanthorrhiza Roxb.) is a medicinal plant native to Indonesia that contains antifungal substances. Virulence factors play an important role in the process of Candida albicans infection, one of which is the secretion of phospholipase enzymes that can damage host cell membranes. Objective: This study aimed to analyze the effect of inhibition and eradication of phospholipase enzyme activity in the early, intermediate, and maturation phases of C. albicans ATCC 10231 biofilm. Methods: The inhibitory effect of temulawak ethanol extract was observed by incubating C. albicans for 1.5 hours, then exposed to KHBM50 extract. Temulawak ethanol was then incubated for 6, 24, and 48 hours to reach the initial, intermediate, and maturation phases of the C. albicans biofilm. The eradication effect was observed by incubating C. albicans for 6, 24, and 48 hours, then exposed to KEBM50 EET and incubated at 37ºC for 24 hours. KHBM50 and KEBM50 EET (treatment group), nystatin 100,000 IU (positive control), and SDB (negative control). The activity of the phospholipase enzyme was analyzed based on the area of ​​the deposition zone formed on egg yolk agar. Results: KHBM50 EET in early phase 15%, intermediate 15%, and maturation 25%. The KEBM50 EET value for the three phases of the C. albicans biofilm was 35%. In the positive control, both inhibition and eradication, no precipitation zones were seen in the three phases of the C. albicans biofilm. Meanwhile, the inhibition and eradication groups showed a smaller deposition zone size when compared to the negative control group in all three phases of the C. albicans biofilm. Conclusion: The activity of the phospholipase enzyme tends to decrease in the early, intermediate, and maturation phases of C. albicans biofilm after inhibition and eradication of ethanol extract of temulawak."

"Latar Belakang: Temulawak (Curcuma xanthorrhiza Roxb.), sebagai salah satu tanaman obat unggulan Indonesia, dilaporkan memiliki efek eradikasi terhadap biofilm Candida albicans (C. albicans). Studi analisis Scanning Electron Microscopy (SEM) melaporkan penurunan densitas biofilm serta perubahan morfologi sel C. albicans yang terpapar Ekstrak Etanol Temulawak (EET). Namun bagaimana perubahan ultrastruktur sel C. albicans pada biofilm fase maturasi yang tereradikasi EET belum diketahui. Tujuan: Menganalisis gambaran ultrastruktur sel C. albicans ATCC 10231 pada biofilm fase maturasi setelah paparan EET. Metode: Biofilm C. albicans diinkubasi selama 48 jam agar mencapai fase maturasi, kemudian kelompok perlakuan dipaparkan EET dengan konsentrasi sesuai kadar eradikasi biofilm minimal (KEBM) yaitu 30%, kelompok kontrol positif diberikan paparan nystatin 100000 IU/ml, dan kelompok kontrol negatif tidak diberikan perlakuan. Transmission Electron Microscopy (TEM) dipakai untuk melihat perubahan ultrastruktur sel C. albicans pada biofilm. Hasil: Perubahan gambaran ultrastruktur sel C. albicans pada biofilm fase maturasi yang dipaparkan EET meliputi perubahan bentuk sel, perubahan ketebalan dinding sel, serta kerusakan organel. Kesimpulan: Analisis TEM menunjukkan perubahan sel Candida albicans ATCC 10231 pada sebagian sel biofilm fase maturasi yang tereradikasi EET.

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Background: Javanese turmeric (Curcuma xanthorrhiza Roxb.), as one of Indonesia’s eminent medicinal plant, had been reported for having eradication effect towards Candida albicans biofilm. SEM studies have shown that the exposure of javanese turmeric ethanol extract decreases the biofilm density and made changes in C. albicans cells morphology. However, the changes in cellular ultrastructure of C. albicans in biofilm at maturation phase which has been eradicated by javanese turmeric extract is not yet known. Objective: Analyzing the image of cellular ultrastructure of C. albicans ATCC 10231 biofilm at maturation phase after exposed to Javanese turmeric ethanol extract using Transmission Electron Microscopy. Method: C. albicans biofilm was incubated for 48 hours to achieve maturation phase, then the treatment group was exposed to 30% javanese turmeric ethanol extract according to the minimum biofilm eradication concentration, the positive control group was exposed to nystatin 100000 IU/ml, and the negative control group wasn’t exposed to anything. TEM was used to observe the cellular ultrastructure changes of the C. albicans biofilm. Result: The changes observed in the image of cellular ultrastructure of C. albicans biofilm treatment group were different cellular shape, different cell wall thicknesses, and damaged organelles. Conclusion: TEM analysis showed the changes occurred in the image of some cells in C. albicans biofilm at maturation phase which has been eradicated by javanese turmeric ethanol extract."

"Pendahuluan: Salah satu faktor virulensi utama yang mempengaruhi perubahan Candida albicans(C. albicans) dari flora komensal menjadi patogen adalah pembentukan biofilm. Pada biofilm fase maturasi, C. albicansmenjadi lebih resisten terhadap agen antifungal. Telah dibuktikan efek inhibisi ekstrak etanol temulawak (Curcuma xanthorrhiza Roxb.) terhadap pertumbuhan biofilm C. albicans. Tujuan: Menganalisis gambaran TEM sel C. albicans ATCC 10231pada biofilm fase maturasi yang terinhibisi ekstrak etanol temulawak (EET). Metode: Penelitian ini dibagi dua kelompok yaitu kelompok perlakuan dan tanpa perlakuan. Sebanyak 100μL suspensi C. albicans ATCC 10231dalam 96-well-plate diinkubasi selama 1.5 jam pada 370C,kemudian diaspirasi dan dibilas menggunakan PBS. Pada kelompok perlakuan dipapar 100μLEET dengan konsentrasi KHBM50(35%), sedangkan kelompok tanpa perlakuan tidak dipapar EET. Kedua kelompok di inkubasi kembali hingga 48 jam, kemudian dipindahkan ke Eppendorf tube untuk difiksasi dalam 2.5% glutaraldehyde dan dilakukan pemeriksaan TEM. Kontrol positif dipapar nystatin oral suspension. Hasil: Pemeriksaan TEM pada kelompok perlakuan, sel C. albicansATCC 10231 pada biofilm fase maturasi yang terpapar ekstrak etanol temulawak terlihat perubahan gambaran ultrastruktur yang berupa perubahan bentuk sel, penebalan dinding sel, pembesaran vakuola, dan iregularitas sitoplasma berikut organel-organel di dalamnya seperti disorganisasi pada nukleus, mitokondria, dan retikulum endoplasma. Sedangkan pada kelompok tanpa perlakuan menunjukan gambaran sel C. albicans ATCC 10231 normal. Kesimpulan: Pemeriksaan TEM dapat menunjukkan perubahan sel C. albicans ATCC 10231 pada biofilm fase maturasi yang terinhibisi ekstrak etanol temulawak.

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Introduction: One of main virulence factor that influence the alteration of Candida albicans (C. albicans) from commensal flora into pathogenic flora is biofilm formation. At the maturation phase, C. albicans ismore resistant to antifungal agent. It has been proven that there is an inhibition effect of Javanese turmeric (Curcuma xanthorrhiza Roxb) on the growth of C. albicans biofilm.

Objective: To analyze the TEM image of C. albicans cell on the maturation phase of biofilm inhibit by Javanese turmeric ethanol extract.

Method: This research divided into two groups, there were treated group and untreated group. A 100μLC. albicans ATCC 10231 suspension on a 96-well-plate incubated for 1.5 hour at 370C, and then aspirated and washed by phosphate buffer saline (PBS). The treated group was exposed to 100μL Javanese turmeric ethanol extract as MBIC50 concentration (35%), while the untreated group was not exposed to Javanese turmeric ethanol extract. Both groups were incubated until 48 h, and then moved into the Eppendorf tube and fixed with glutaraldehyde 2.5% to examine using TEM. The positive control was exposed to nystatin oral suspension.

Result: Compared to the negative control, C. albicans cell on biofilm maturation phase treated by Javanese turmeric extract ethanol extract shows the alteration on the its ultra structure. The alteration showed in shape, the thickness of cell wall, the enlargement of vacuole, and irregularity of cytoplasm include the organelles in it such as disorganization on nucleus, cytoplasm, and endoplasmic reticulum.

Conclusion: TEM examination showed the alteration of C. albicans ATCC 10231 cell on maturation phase biofilm inhibited by Javanese turmeric ethanol extract."

"Latar Belakang: Temulawak (Curcuma xanthorrhiza Roxb.) merupakan salah satu tanaman obat unggul Indonesia yang memiliki potensi untuk menghambat pembentukan biofilm C. albicans. Faktor virulensi yang dapat menyebabkan C. albicans menjadi fungi patogen diantaranya adalah pembentukan biofilm dan sekresi enzim hidrolitik. Fosfolipase merupakan salah satu enzim hidrolitik yang dapat merusak membran sel inang. Tujuan: Menganalisis aktivitas fosfolipase pada biofilm C. albicans ATCC 10231 fase awal, menengah, dan maturasi yang terhambat ekstrak etanol temulawak (Curcuma xanthorrhiza Roxb.). Metode: Nilai Kadar Hambat Biofilm Minimal (KHBM50) C. albicans ditentukan dengan uji MTT-assay. Ekstrak etanol temulawak dengan konsentrasi sesuai KHBM50 dipaparkan pada biofilm fase awal, menengah, dan maturase. Kontrol negative tidak dipaparkan apapun, kontrol positif dipaparkan Nystatin 100.000 IU. Aktivitas fosfolipase biofilm C. albicans dianalisis dengan mengukur proporsi antara diameterzona presipitasi dengan diameter koloni C. albicans pada medium Egg Yolk Agar (EYA). Hasil: Nilai KHBM50 ekstrak etanol temulawak terhadap biofilm C. albicans ATCC 10231 pada fase awal, fase menengah, dan fase maturasi berturut-turut adalah 25%, 30%, dan 35%. Pada kontrol positif, aktivitas fosfolipase biofilm C. albicans fase awal, fase menengah, dan fase maturasi bernilai 1. Aktivitas fosfolipase biofilm C. albicansfase awal, fase menengah, dan fase maturasi yang terhambat ekstrak etanol temulawak berturut-turut 0.84, 0.80, dan 0.83. Pada kontrol negatif, aktivitas enzim fosfolipase biofilm C. albicans fase awal, fase menengah, dan fase maturasi berturut-turut 0.59, 0.57, dan 0.57. Kesimpulan: Terdapat kecenderungan penurunan aktivitas enzim fosfolipase pada biofilm C. albicans yang terhambat > 50% ekstrak etanol temulawak.

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Background: Javanese turmeric (Curcuma xanthorrhiza Roxb.) is one of medical plant from Indonesia that has potency to inhibit biofilm formation of C. albicans. Biofilm formation and hydrolyticenzymes are two among manyvirulence factors of C. albicans. Phospholipaseisone of hydrolyticenzymesthat could degrade the hostcell membrane.

Objective: To observe the activities ofphospholipase in early phase, intermediate phase, and maturation phase of biofilm C. albicans ATCC 10231 that has been inhibited by Javanese turmeric ethanolic extract.

Method: MTT-assay wasused to measure the minimum biofilm inhibitory concentration (MBIC50) of C. albicans ATCC 10231in three phases of C. albicans biofilm. Those concentrations were used to observe phospholipase activities of biofilm in the relevant phases. The negative control were not exposed to anything, while the positive control were exposed to Nystatin 100.000 IU. Phospholipase activities were determined bymeasuring the proportion of precipitation zone diameter and C. albicans colony diameter onan egg yolk-agar medium.

Results: The MBIC50of Javanese turmeric ethanolic extract towards formation of C. albicans biofilm ATCC 10231 in early phase, intermediate phase, and maturation phase were 25%, 30%, and 35%, respectively. Phospholipase activities value in early phase, intermediate phase, and maturation phase of C. albicans biofilm exposed by Nystatin were 1. Phospholipase activities value in early phase, intermediate phase, and maturation phase of C. albicans biofilms exposed by Javanese turmeric ethanolic extract were 0.84, 0.80, and 0.83, respectively. Phospholipase activities value in early phase, intermediate phase, and maturation phase of unexposed C. albicans biofilm were 0.59, 0.57, and 0.57, respectively.

Conclusion: There istendency of decreased phospholipase activity in early phase, intermediate phase, and maturation phase of biofilm C. albicans that has been inhibited by Javanese turmericethanolic extract."

"Pendahuluan : Infertilitas merupakan salah satu gejala pada endometriosis dengan prevalensi mencapai 40-50%. Endometriosis memiliki dampak merugikan terhadap kualitas oosit, sementara sampai saat ini belum ada biomarker baik dari serum ataupun cairan folikel yang dapat dijadikan acuan penilaian kualitas oosit untuk dapat digunakan pada pasien endometriosis yang menjalani fertilisasi in vitro (FIV). Telah ditemukan bahwa pada serum pasien endometriosis terjadi perubahan ekspresi microRNA dimana miRNA-125b memiliki peningkatan yang paling signifikan dengan sensitifitas dan spesifisitas yang paling tinggi. Pada cairan folikel, miRNA-125b berperan saat transisi fase folikular-luteal dengan mempengaruhi ekspresi leukemia inhibitory factor (LIF). LIF diketahui dapat menginduksi sel kumulus yang kemudian mempengaruhi maturasi oosit.Tujuan: Tujuan penelitian ini adalah untuk mencari apakah terdapat hubungan antara miRNA-125b serta LIF dengan kualitas oosit pada pasien infertil dengan endometriosis.Desain: Studi Analitik korelatif dengan desain potong lintang.Material dan Metode: Sampel penelitian didapatkan dari 31 pasien infertil dengan endometriosis yang menjalankan program FIV di Klinik Yasmin RSCM Kencana, dan Klinik Melati RSAB Harapan Kita. Sesaat sebelum petik ovum, sebanyak 5cc sampel darah dari setiap pasien akan diambil untuk penilaian ekspresi miRNA-125b. Pada saat petik ovum, sebanyak 10cc dari total cairan dari folikel yang didapat akan diambil untuk penilaian ekspresi miRNA-125b dan kadar LIF. Oosit yang didapat dinilai oleh embriolog. Pemeriksaan ekspresi miRNA dilakukan dengan RT-PCR, dan kadar LIF menggunakan metode sandwich ELISA.Hasil:Terdapat korelasi negatif antara miRNA-125b serum dengan LIF cairan folikel (p=0,042; r=-0,34). Tidak terdapat korelasi antara miRNA-125b serum dengan miRNA-125b cairan folikel. Tidak terdapat korelasi antara miRNA-125b cairan folikel dengan LIF cairan folikel. Tidak terdapat korelasi antara miRNA-125b serum, miRNA-125b cairan folikel, dan LIF cairan folikel dengan kualitas oosit. Terdapat hubungan yang bermakna antara kadar ekspresi miRNA-125b cairan folikel dengan angka kehamilan biokimia.Kesimpulan: Terdapat ekspresi miRNA-125b pada serum dan cairan folikel pada pasien endometriosis, namun miRNA-125b belum dapat dijadikan sebagai parameter yang kuat untuk pemeriksaan kualitas oosit pada pasien endometriosis yang menjalani FIV.

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Introduction : Infertility is one of the symptoms in endometriosis with prevalence reaching 40-50%. Endometriosis is known to have detrimental effect on oocyte quality, yet until now there is no biomarker derived from either serum, or even follicular fluid, which can be used as reference for oocyte quality assessment in endometriosis patients going through in vitro fertilization (IVF) procedures. Changes of some microRNAs expression has been found in serum of endometriosis patients, with miRNA-125b showing the most significant increase with the highest sensitivy and specificity. In follicular fluid, miRNA-125b play role during follicular-lutheal phase transition by targeting the expression of Leukemia Inhibitory Factor (LIF). LIF has been studied to have the ability to induce cumulus cell expansion which in turn will affect the oocytes maturation.

Purpose: The purpose of this study is to observe the correlation between miRNA-125b, LIF, and oocyte quality in infertile patient with endometriosis.

Design: this is a cross-sectional study with correlation analysis method.

Materials and Methods: in this study, samples were collected from 31 infertile women with endometriosis undergoing in vitro fertilization procedure at Yasmin Clinic of Dr. Cipto Mangunkusumo Hospital, and Melati Clinic of Harapan Kita Mother and Child Hospital. Shortly prior to ovum pick up (OPU) procedure, 5cc of blood sample from each patients was collected, and 10 cc of total follicular fluid was obtained during OPU. Harvested oocytes during the procedure were assessed and scored by embryologist. MiRNA-125b expressions from serum and follicular fluid samples were analyzed using RT-PCR, and LIF levels were analized using ELISA sandwich method.

Result: negative correlation was found between the expression of miRNA-125b serum and LIF follicular fluid (p=0,042; r=-0,34). No correlation was found between the expression of miRNA-125b in serum and in follicular fluid, as well as the expression of miRNA-125b in follicular fluid and LIF in follicular fluid. No correlation was found between the expression of miRNA-125b in serum, follicular fluid, also LIF in follicular fluid, with oocyte quality. Significant result was found between the expression of miRNA-125b in follicular fluid and biochemical pregnancy rate.

Conclusion: This study found miRNA-125 expression represented in serum and follicular fluid in endometriosis patient, but it still cannot be used as a strong parameter for assessing the oocyte quality in infertile women with endometriosis"

"Latar belakang: Glaukoma merupakan penyakit kronik pada mata yang menjadi penyebab kebutaan kedua setelah katarak di Indonesia. Saat ini, terdapat sejumlah 427.091 penduduk Indonesia yang menjalani rawat jalan terkait glaukoma. Pada tingkat global, glaukoma sudut terbuka merupakan penyebab kebutaan pertama. Pengobatan farmakologis jangka panjang merupakan terapi utama untuk mencegah progresivitas glaukoma yang memerlukan kepatuhan penggunaan obat oleh pasien. Tujuan: Memberikan gambaran mengenai tingkat kepatuhan penggunaan obat pasien glaukoma sudut terbuka di RSCM Kirana sebagai pusat rujukan nasional, disertai pengaruh dukungan pengasuh atau keluarga terhadap derajat kepatuhan tersebut. Metode: Studi dilaksanakan secara potong lintang dengan teknik pengambilan sampel consecutive. Sampel terpilih sejumlah 96 orang merupakan pasien tergolong kriteria inklusi dari RSCM Kirana. Sampel diwawancarai secara daring dengan pertanyaan bersumber dari kuesioner adaptasi Morisky Medication Adherence Scale dan Duke UNC-Functional Social Support Questionnaire. Hasil: Distribusi derajat dukungan pengasuh atau keluarga dari 96 responden adalah 29.2% beroleh dukungan rendah, 51.04% dukungan sedang, dan 19.8% dukungan tinggi. Sementara distribusi derajat kepatuhan penggunaan obat adalah 50% beroleh kepatuhan rendah, 32.3% kepatuhan sedang, dan 17.7% kepatuhan tinggi. Nilai p (p=0.822) menunjukkan bahwa tidak ada pengaruh signifikan antara derajat dukungan pengasuh atau keluarga terhadap derajat kepatuhan penggunaan obat pasien glaukoma sudut terbuka di RSCM Kirana. Simpulan: Derajat dukungan pengasuh atau keluarga tidak memiliki pengaruh signifikan dengan derajat kepatuhan penggunaan obat pasien glaukoma sudut terbuka (p>0.05) dan diperlukan penelitian lebih lanjut untuk mengatasi keterbatasan studi

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Background: Glaucoma is a chronic eye disease which causes blindness second to cataracts in Indonesia. Currently, there are 427,091 Indonesians who undergo outpatient care related to glaucoma. Open-angle glaucoma is the leading cause of blindness globally. Long-term pharmacological treatment is suggested as the main therapy to prevent disease progression therefore requires adherence. Objective: To provide an overview of the level of medication adherence in open-angle glaucoma outpatients at RSCM Kirana along with the effect of family or caregiver support upon it. Methods: The study design was cross-sectional with a consecutive sampling technique. The selected sample of 96 people were RSCM Kirana open-angle glaucoma outpatients who fulfilled the inclusion criteria requirements. The sample was interviewed online with questions adapted from the Morisky Medication Adherence Scale and Duke UNC-Functional Social Support Questionnaire. Results: The distribution regarding the degree of caregiver or family support out of 96 respondents were 29.2% experienced low support, 51.04% had moderate support, and 19.8% had high support. On the other hand, the distribution of medication adherence degree were 50% had low adherence, 32.3% had moderate adherence, and 17.7% had high adherence. The p-value (p = 0.822) indicates the degree of family or caregiver support has no significant effect on the degree of adherence to medication outcome in open-angle glaucoma patients at RSCM Kirana. Conclusions: The degree of family or caregiver support does not significantly affect the degree of adherence to medication use in open-angle glaucoma patients (p> 0.05). Further research is needed to overcome the recent study limitations

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