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Background: Neuromyelitis optica (NMO) is a rare autoimmune disease that covers 20-30% of diseases related to autoimmune disorders and about 1% of demyelination diseases. NMO symptoms are vary between individuals, there are generally 2 main symptoms, transverse myelitis and optic neuritis. This article reported a child with NMO disease based on The Consensus of the International Panel for NMO Diagnosis (IPND) 2015. Case Presentation: An 8-year old boy with spastic tetraparesis, bilateral nervus opticus dysfunction, urinary retention, and allodynia et causa suspected NMO. Patient received therapy using high-dose intravenous methylprednisolone and showing a clinical improvement. Conclusion: This patient was diagnosed NMO based on IPND 2015 with an unknown AQP4-Ab status accompanied by supporting clinical symptoms. The management of NMO with high-dose intravenous methylprednisolone in this patient provides a meaningful response to the clinical improvement of the disease.

Prostatic calculi are often found incidentally during a clinical and radiological examination. However, in some instances, large or multiple calculi may cause severe lower urinary tract symptoms (LUTS). Its current significance concerning urological diseases and symptoms remains obscure. Minimal awareness regarding the disease among physicians could lead to improper assessment and treatment. In Indonesia, reports regarding prostatic calculi are still limited. We report a 50-year-old male with symptomatic multiple prostatic calculi.

BACKGROUND: The purpose of this research is to understand the secondary metabolites of Momordica charantia L. extract, as well as to disclose the potential of M. charantia extract in the phagocytic activity and capacity of peritoneum macrophages. METHODS: Examination of immunomodulatory effect was done by giving M. charantia ethanol extract on 5 treatment groups, given intra-peritoneally to mice daily. Echinacea extract as positive control and double distilled water as negative control were also given. On the 8th day, mice were infected with Staphylococcus epidermidis. After 30 minutes, peritoneum fluid was obtained to observe the activity and capacity of macrophage cells. RESULTS: The results showed significant phagocytic activity (p0.05). The highest phagocytic activity was the group treated with 1,200 ppm (62%), significantly higher than other groups. CONCLUSION: The secondary metabolite content of M. charantia is alkaloids, flavonoids, tannins, saponins, and triterpenoids. The 1,200 ppm M. charantia ethanol extract is potential in inducing phagocytic activity and capacity. These results indicate that the M. charantia can be suggested as a natural immunomodulator. KEYWORDS: pare fruit, Momordica charantia L., phagocytosis, macrophage, immunomodulator

Background: Inflammation is a protective physiological response to tissue injury that can be caused by harmful stimuli. If the inflammatory process is prolonged and cannot restore to homeostatic conditions, this may lead to pathological effects that can damage cells and cause various diseases. Elephantopus scaber is a plant that can easily be found in Indonesia. Elephantopus scaber is a type of plant that is often used as a traditional medicines. Several studies have shown that the compound bioactive content contained in plants has enormous potential as alternative medicine. Objective: This present study was to investigate the anti-inflammatory activity of ethanolic extract of Elephantopus scabe leaves. Methods: The Elephantopus scaber leaves were extracted using ethanol solvent into different concentration (50 mg/mL, 100 mg/mL, and 120 mg/mL). Diclofenac sodium was used as the standard. Anti-inflammatory assays were performed by the human red blood cell (HRBC) membrane stabilization method and heat-induced hemolysis method. Phytochemical screening that used in the present study was a conventional method. Results: Phytochemical screening showed the presence of flavonoids, tannins, and saponins. In the present study, ethanolic extract of Elephantopus scaber leaves has anti inflammatory activity by protecting the stability of red blood cell membrane. The highest protection capability possessed by the ethanolic extract of Elephantopus scaber leaves in both human red blood cell (HRBC) membrane stabilization method and heatinduced hemolysis method was at a concentration of 100 mg/mL. Conclusion: The ethanolic extract of Elephantophus scaber has antiinflammatory activities by in vitro assays.

BACKGROUND: Typhoid fever has become one global health problem. Typhoid fever is caused by a Gram-negative bacterium, Salmonella typhi. Eel (Anguilla spp.) is a fish which lives in the sea or in freshwater. Several previous studies have found that Anguilla spp. mucus has the ability as antibacterial against Gram-positive and negative. Although the antibacterial activity of Anguilla spp. against various pathogens had been reported, very little is known about its activity against Salmonella typhi. The aim of this study was to investigate antibacterial activity of Anguilla spp. mucus against Salmonella typhi bacteria. METHODS: Present study was an experimental in vitro test. Antibacterial activity assays were carried out by the disc diffusion method. Antibacterial activity was determined by the clear zone formed around the paper disc and minimum inhibitory concentration was determined by observing the lowest concentration which could inhibit the growth of Salmonella typhi. RESULTS: Result of the present study showed that the Anguilla spp. mucus has inhibitory effects against Salmonella typhi. Minimum inhibitory concentration from the Anguilla spp. mucus was 12.5%. CONCLUSION: Anguilla spp. mucus has antibacterial activity against the Salmonella typhi bacteria. KEYWORDS: eel fish mucus, Anguilla spp., antibacterial activity, Salmonella typhi

Background: Cervical cancer is ranked as the second most common cancer in India. This study aims to assess the cervical cancer burden at the national and subnational level in India, projecting it for the year 2025 in terms of years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs)., Methods: Twenty-eight population based cancer registries within the National Cancer Registry Programme network contributed cancer incidence and mortality data for this analysis. The DisMod-II tool, WHO lifetables, disability weights, mortality to incidence ratio, sample registration system, and census data were used to estimate the burden of cervical cancer. The projection estimates for 2025 were performed using a negative binomial regression model., Results: In 2016, the cervical cancer burden in India was 223.8 DALYs per 100,000 women. The highest age-standardised DALYs were found in the northeast region (290.1 DALYs per 100,000 women) and the lowest in the eastern region (156.1 DALYs per 100,000 women). The states of Mizoram, Arunachal Pradesh, Karnataka, and Nagaland had a higher cervical cancer burden with DALYs exceeding 300 per 100,000 women. The projected cervical cancer burden for India in 2025 was estimated to be 1.5 million DALYs., Conclusions: The study has found a significant cervical cancer burden across the regions of India, providing a baseline for monitoring impact of actions. Enhancing awareness of cervical cancer, advocating for the significance of screening, and promoting HPV vaccination among adolescents, families, and communities through informative communication campaigns are essential steps in managing and ultimately eliminating cervical cancer in India., (© 2024. The Author(s).)

Purpose: Female breast cancer (BC) is the leading cause of cancer incidence and mortality in India, and accounted for 13.5% of new cancer cases and 10% of cancer-related deaths in 2020. This study aims to estimate and report the female BC burden in India at state level from 2012 to 2016 in terms of years of life lost, years lived with disability, and disability-adjusted life years (DALYs), and to project the burden for the year 2025., Methods: The cancer incidence and mortality data from 28 population-based cancer registries were analysed. The mean mortality to incidence ratio was estimated, and mortality figures were adjusted for underreporting. The burden of female BC was estimated at national and subnational levels using Census data, World Health Organisation's lifetables, disability weights, and the DisMod-II tool. A negative binomial regression is employed to project burden for 2025., Results: The burden of BC among Indian women in 2016 was estimated to be 515.4 DALYs per 100,000 women after age standardization. The burden metrics at state level exhibited substantial heterogeneity. Notably, Tamil Nadu, Telangana, Karnataka, and Delhi had a higher burden of BC than states in the eastern and north-eastern regions. The projection for 2025 indicates to a substantial increase, reaching 5.6 million DALYs., Conclusion: The female BC burden in India was significantly high in 2016 and is expected to substantially increase. Undertaking a multidisciplinary, context-specific approach for its prevention and control can address this rising burden., (© 2024. The Author(s).)

Background: Cancer is the major cause of morbidity and mortality worldwide. The cancer burden varies within the regions of India posing great challenges in its prevention and control. The national burden assessment remains as a task which relies on statistical models in many developing countries, including India, due to cancer not being a notifiable disease. This study quantifies the cancer burden in India for 2016, adjusted mortality to incidence (AMI) ratio and projections for 2021 and 2025 from the National Cancer Registry Program (NCRP) and other publicly available data sources., Methods: Primary data on cancer incidence and mortality between 2012 and 2016 from 28 Population Based Cancer Registries (PBCRs), all-cause mortality from Sample Registration Systems (SRS) 2012-16, lifetables and disability weight from World Health Organization (WHO), the population from Census of India and cancer prevalence using the WHO-DisMod-II tool were used for this study. The AMI ratio was estimated using the Markov Chain Monte Carlo method from longitudinal NCRP-PBCR data (2001-16). The burden was quantified at national and sub-national levels as crude incidence, mortality, Years of Life Lost (YLLs), Years Lived with Disability (YLDs) and Disability Adjusted Life Years (DALYs). The projections for the years 2021 and 2025 were done by the negative binomial regression model using STATA., Results: The projected cancer burden in India for 2021 was 26.7 million DALYs AMI and expected to increase to 29.8 million in 2025. The highest burden was in the north (2408 DALYs AMI per 100,000) and northeastern (2177 DALYs AMI per 100,000) regions of the country and higher among males. More than 40% of the total cancer burden was contributed by the seven leading cancer sites - lung (10.6%), breast (10.5%), oesophagus (5.8%), mouth (5.7%), stomach (5.2%), liver (4.6%), and cervix uteri (4.3%)., Conclusions: This study demonstrates the use of reliable data sources and DisMod-II tools that adhere to the international standard for assessment of national and sub-national cancer burden. A wide heterogeneity in leading cancer sites was observed within India by age and sex. The results also highlight the need to focus on non-leading sites of cancer by age and sex. These findings can guide policymakers to plan focused approaches towards monitoring efforts on cancer prevention and control. The study simplifies the methodology used for arriving at the burden estimates and thus, encourages researchers across the world to take up similar assessments with the available data., (© 2022. The Author(s).)

In the first article in this 2-part series, we outlined a psychobiological model of psychiatric treatment and reviewed the evidence showing psychotherapy to be a form of biological intervention that induces lasting alterations in brain structure and function. In this second article, we focus on the adaptive model of psychopathology, the effectiveness of psychotherapeutic interventions, the synergistic effects of combined psychotherapy and psychopharmacology treatments, and attention to the patient's subjective experience and the doctor-patient alliance to complement an "objective" case formulation. The evidence strongly suggests the need for an integrated treatment approach based on the objective, subjective, and intersubjective science that forms the foundation of psychiatry as a clinical discipline, in which psychotherapy and psychopharmacology are seen as complementary treatments within a systemic approach to psychiatric care and training. What emerges is the integrated psychobiological model of care with a complex treatment matrix unique to each patient-provider pair and comprised of biological, experiential, and relational domains of treatment which form the foundation of psychiatry as a science of attachment and meaning.

Introduction: Debridement and disinfection of the root canal system is a critical step in endodontic treatment. Most of the irrigants presently used in the endodontic treatment can have an impact on the microbes surviving in the biofilm but none of them are able to do all of the required tasks. Researches are going on its full swing in order to produce an endodontic irrigant having ideal properties., Aim: To compare the antimicrobial efficacy of different irrigants like QMiX, guava leaf extract, aloevera extract, 2.5% sodium hypochlorite and 2% chlorhexidine gluconate against Enterococcus faecalis and Candida albicans., Materials and Methods: The antimicrobial activity was determined using agar diffusion test. The solutions were divided into five groups: Group I- QMiX, Group II- Guava leaf extract and Group III-Aloevera extract, Group IV-2.5% Sodium hypochlorite and Group V-2% Chlorhexidine. The zones of inhibition of growth were recorded., Results: Statistical analysis was performed using one way ANOVA with post-hoc Tukey's HSD. Values obtained were statistically analyzed (p<0.05). QMiX showed maximum inhibitory effect against Enterococcus faecalis and Candida albicans followed by, 2% chlorhexidine, 2.5% sodium hypochlorite, guava leaf extract and aloevera extract. Results obtained were statistically significant., Conclusion: Guava leaf extract showed significant inhibitory effects against Enterococcus faecalis and Candida albicans. QMiX demonstrated the best results among the tested solutions and can be considered as a potential alternative to existing root canal irrigants.

Economic, political, and ideological landscapes have impacted the practice of psychiatry throughout its evolution as a medical discipline. Despite enormous scientific advances over the course of the past century, many psychiatrists continue to operate with a split Cartesian picture of mind versus brain and entrenched ideological positions ranging from biological "chemical imbalance" to rigidly followed manualized psychotherapy approaches, both of which frequently result in fractured clinical care. With the impact of systemic economic and political pressures in Canada and the United States, the attention to the doctor-patient relationship has taken a back seat to high-volume practices, computerized assessment tools, and the focus on evidence-based treatments for behaviorally defined syndromes in the Diagnostic and Statistical Manual of Mental Disorders that often come at the expense of the patient's experience of his or her illness. We spend much time teaching the next generation of psychiatrists what to prescribe versus how to prescribe; what manualized treatments to administer versus questioning why our patients engage in dysfunctional patterns of thinking, feeling, and relating to others, and what impact these patterns may have on their interaction with us in the here-and-now of the treatment setting. In this paper, we propose an integrative psychobiological model, in which biological interventions carry personal meanings, and relational transactions in the treatment setting are a form of learning that results in lasting physiological changes in the brain. Psychiatry needs to reconnect with its roots as a science of attachment and meaning, in which attention to the objective, subjective, and relational domains of the patient-provider experience is equally foundational for any successful treatment outcome.