Researching Pomegranate and Turmeric for TB, FK UII National Champion in Makassar

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MAKASSAR (fk.uii.ac.id) - Faculty of Medicine Universitas Islam Indonesia (FK UII) again made scientific achievements at the national level by winning the 1st place in the National Scientific Essay Ibn Sina Medical Competition (ISMC) Vol. 5 FK Indonesian Muslim University (UMI), after competing with various leading campuses in Indonesia, such as Airlangga University, Brawijaya University, Andalas University, and so on.

ISMC Vol. 5 in total attended by 384 delegates from medical-health students in Indonesia. The big theme raised is "Knitting the Spirit of Togetherness and Sportsmanship to Realize Unlimited Creativity during the Pandemic".

In the final round which took place online on March 27 2021 with host On the UMI Makassar FK campus, the UII FK delegation consisting of Salama Suci Nurani, Endah Sari Ratna Kumala, and Muhammad Luthfi Mahrus presented a scientific work entitled: “Combination of Quercetin from Pomegranate Peel Extract and Curcumin from Turmeric Extract Encapsulated in PLGA in a Nano-Spray Inhaler : Curative Modalities of MDR-TB Patients (multidrug resistant tuberculosis-red)”. The initial idea of ​​making this work was motivated by the fact that case tuberculosis (TBC) are still commonly found in Indonesia and Indonesia itself is included in the category high burden countries (high burden countries) based on TB and MDR-TB cases.

"MDR-TB is a particular concern due to resistance to anti-tuberculosis drugs (OAT-red). In addition, many and long OAT regimens can also reduce patient compliance so that it can also cause resistance. On the other hand, Indonesia itself is the largest spice-producing country in the world and there are still many Indonesian plants or herbs that have great potential but are still little studied. So we hope this combination can be the answer," said Salama. (etc)

TBC: A Legendary Disease That Still Exists

FAR before Robert Koch discovered Mycobacterium tuberculosis (MTB) in 1882 as the cause of tuberculosis, this disease has been known since 410 BC. It was Hippocrates who noted the existence of a tuberculosis-like disease in ancient Greece as "ptysis" (spitting). Before the discovery of OAT, TB became a frightening specter for the world community because of its widespread transmission and high mortality rate.

In Indonesia, TB has long been known and has a long history. The image of a TB patient with an emaciated condition is sculpted in one space reliefs on the walls of Borobudur Temple. This suggests that this disease has even been known to our people since around the 8th century. During the Dutch colonial era, the colonial government established Centrale Vereniging Voor Tuberculosis Bestrijding (CVT) in 1908. In 1939, as many as 15 sanitariums were established to treat tuberculosis patients supported by 20 consultatie bureaux responsible for providing counseling and treatment to patients.

In 1950, the Government of the Republic of Indonesia (RI) established the Institute for the Eradication of Lung Disease (LP4) in Yogyakarta, which was then spread to 53 locations in Indonesia. In the same year, one of the major figures in Indonesian history, namely the Commander in Chief, General Soedirman, died of tuberculosis.

In the period between 1969-1973, the Indonesian Ministry of Health made a major breakthrough by carrying out eradication efforts combined with TB prevention through BCG immunization. This program is often known as P2TBC/BCG which is an acronym for the TB and BCG Tuberculosis Eradication Program. At this time the diagnosis of patients with sputum examination has been done and the patient's treatment period takes up to 1-2 years.

Between 1976-1994, developments in TB therapy were increasingly visible in Indonesia. This is the time for testing Directly Observed Treatment Short course (DOTS) for the first time. This strategy makes it possible to cut the TB treatment period to be much shorter, from 1-2 years to only 6 months.

Even though TB ​​treatment has progressed a lot, the fact is that the number of TB sufferers in Indonesia is still very high today. Referring to the data listed in Global Tuberculosis Report World Health Organization (WHO GTR) 2019, Indonesia ranks third as the country with the most TB sufferers in the world after India and China.

A year earlier, the WHO GTR also explained that every day 301 people died from tuberculosis in Indonesia. In addition, from the estimated number of TB cases which reached 842.000 people (including children and adults), only 446.732 cases were reported. The number of patients with drug-resistant TB is estimated at 12.000, but only 5.070 cases have been reported. The large number of cases that are not reported is very at risk of accelerating the spread or transmission of TB disease widely.

Recognize To Avoid

STILL many of the people who are unfamiliar with TB, even though knowledge of this disease is important to raise an attitude of vigilance. So far, many people think that the symptoms of TB are just coughing up blood, even though everyone who has had a cough for 2 weeks or more (even without blood) needs to confirm the possibility of TB by going for a check-up immediately.

In addition, TB can also cause other symptoms such as fever (usually subfebrile; body temperature above normal, but still less than 37,7⁰C), shortness of breath, chest pain, decreased appetite, decreased body weight, body weakness, and night sweats even without activity. In TB cases that have invaded organs outside the lungs, various symptoms can also be found according to the location affected, such as diarrhea, skin disorders, enlarged lymph nodes, and so on.

TOSS TB

BESIDE lack of knowledge, many also underestimate this disease, both in terms of awareness to make prevention efforts or early detection for those who are starting to show symptoms. This is one of the triggers for the high incidence of TB in Indonesia. For this reason, it is important for the community to implement a government program which is often known by the acronym TOSS TB (Find and Treat Until TB is Cured) which is an approach to finding, diagnosing, treating and curing patients in order to stop TB transmission in the community.

TOSS TB steps include: finding symptoms in the community, treating TB properly and quickly (at the same time to prevent TB-MDR or Extensive drug-resistant tuberculosis (XDR-TB), monitoring TB treatment until cured. In each individual who experiences or finds people with If you have TB symptoms, you must immediately seek treatment/deliver the patient to the health center or the nearest health service so that further tests can be carried out regarding whether or not there is a possibility of having the disease.

As a step to prevent TB transmission, the public must also understand the ethics of coughing (and sneezing) which include:

1. Using a mask

2. Cover mouth and nose with inside of upper arm, or

3. Cover your mouth and nose with a tissue and don't forget to throw it in the trash

4. Washing hands using soap and running water

According to the Ministry of Health of the Republic of Indonesia, in the last 7 decades, around 300.000 TB patients have been served and treated annually. As for success rate TB treatment in Indonesia reaches 90% of patients, which means that 90% of TB patients treated are successfully cured. It is this understanding that needs to be built among all members of society: that TB therapy can provide maximum results as long as the patient/family is also proactive in self-examination so that diagnosis and treatment can be carried out as soon as possible. (etc)

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MAKASSAR (fk.uii.ac.id) – The Faculty of Medicine, Universitas Islam Indonesia (FM UII) once again made scientific achievements at the national level by winning the First place in the National Scientific Essay of Ibnu Sina Medical Competition (ISMC) Vol. 5 FM Indonesian Muslim University (UMI), after competing with various leading campuses in Indonesia, such as Airlangga University, Brawijaya University, Andalas University, and many more.

ISMC Vol. 5 followed by 384 delegates from medical-health students in Indonesia. The big theme that was raised was "Knitting the Spirit of Togetherness and Sportsmanship to Realize Unlimited Creativity in a Pandemic Era".

The final round took place online on March 27, 2021 and was held at the host of the event, FM UMI Makassar campus. The FM UII delegates consisting of Salama Suci Nurani, Endah Sari Ratna Kumala, and Muhammad Luthfi Mahrus presented a scientific paper entitled: “The Combination of Quercetin from Pomegranate Peel Extracts and Curcumin from Turmeric Extract Encapsulated Plga in Nano-Spray Inhaler: Curative Modalities of Patients with MDR-TB (multidrug resistant tuberculosis-ed)”. The initial idea of ​​creating this work was motivated by the fact that tuberculosis (TB) cases are still found in Indonesia and Indonesia itself is included in the category of high burden countries based on TB and MDR-TB cases.

"MDR-TB is a concern due to resistance to anti-tuberculosis drugs (OAT-ed). In addition, multiple and prolonged OAT regimens can also reduce patient compliance so that it can also lead to resistance. On the other hand, Indonesia itself is the largest spice-producing country in the world and there are still many Indonesian plants or herbs that have great potential but are still little studied. So we hope that this combination can be the answer," said Salama. (etc)

TB: A Legendary Disease that Still Exists

LONG before Robert Koch discovered Mycobacterium tuberculosis (MTB) in 1882 as the cause of tuberculosis, this disease has been known since 410 BC. It was Hippocrates who recorded the existence of a disease similar to tuberculosis in ancient Greece which was called "ptysis” (spitting). Prior to the discovery of OAT, TB became a frightening image for the world community because of its wide transmission and high mortality rate.

In Indonesia, TB has also been known for a long time and has a long history. A picture of a TB patient with an emaciated condition is carved in one of the space reliefs on the wall of Borobudur Temple. This shows that this disease has even been known to our society since around the 8th^th centuries. During the Dutch colonial era, the colonial government established the Centrale Vereniging Voor Tuberculosis Bestrijding (CVT) in 1908. In 1939, 15 sanatoriums were established to treat tuberculosis patients with the support of 20 consultatie bureaux whose duty was to provide counseling and treatment to patients.

In 1950, the Government of the Republic of Indonesia established the Institute for the Eradication of Lung Disease (LP4) in Yogyakarta, which was subsequently disseminated to 53 locations in Indonesia. In the same year, one of the great figures in Indonesian history, namely the Commander-in-Chief General Sudirman died of tuberculosis.

In the period of 1969-1973, the Indonesian Ministry of Health made a major breakthrough by carrying out eradication efforts combined with TB prevention through BCG immunization. This program is often known as “P2TBC/BCG” which is an acronym for the TB and BCG Tuberculosis Eradication Program. At this time the patient's diagnosis with sputum examination has been carried out and the patient's treatment period takes up to 1-2 years.

In 1976-1994, the developments in TB therapy were increasingly visible in Indonesia. It was at this time that the Directly Observed Treatment Short course (DOTS) trial was conducted for the first time. This strategy makes it possible to cut the TB treatment period to be much shorter, from 1-2 years to only 6 months.

Although TB ​​treatment has made many advances, the fact is that the number of TB sufferers in Indonesia is still very high today. Referring to the data listed in the Global Tuberculosis Report World Health Organization (GTR WHO) 2019, Indonesia ranks third as the country with the most TB sufferers in the world after India and China.

A year earlier, the WHO GTR also explained that every day 301 people die from TB in Indonesia. In addition, from the estimated number of TB cases which reached 842,000 people (including children and adults), only 446,732 cases were reported. The number of patients with drug-resistant TB is estimated at 12,000, but only 5,070 cases have been reported. This number of unreported cases is very risky to accelerate the spread or transmission of TB disease widely.

Recognize To Avoid

THERE ARE there are still many people who are unfamiliar with TB, even though knowledge of this disease is important to be more aware of. So far, many people think that the symptoms of TB disease are just coughing up blood, even though everyone who has a cough for 2 weeks or more (even without blood) needs to confirm the possibility of TB by immediately getting checked.

In addition, TB can also cause other symptoms such as fever (usually subfebrile; body temperature above normal, but still less than 37.7⁰ C), shortness of breath, chest pain, decreased appetite, weight loss, body weakness, and night sweats without activity. In the case of tuberculosis that has attacked organs outside the lungs, various symptoms can also be found according to the affected location, such as diarrhea, skin disorders, enlarged lymph nodes, and so on.

TOSS TB

IN ADDITION to the lack of knowledge, many people also underestimate this disease, both in terms of awareness to take preventive measures or early detection for those who are starting to show symptoms. This is one of the triggers for the high incidence of TB in Indonesia. For this reason, it is important for the community to implement a government program which is often known as the acronym TOSS TBC (“Find and Treat Until Cured TB”/Find and Treat until Cure from TB) which is an approach to finding, diagnosing , treating, and curing patients in order to stop the transmission of TB in the community.

The TB TOSS steps include: finding symptoms in the community, treating TB appropriately and quickly (as well as preventing MDR-TB or Extensively-drug Resistant Tuberculosis (XDR TB), monitoring TB treatment until it heals. For each individual who experiences or finds someone with symptoms of TB, must immediately seek treatment / take the patient to the Public health center (a kind of government mini hospital in every sub-district in Indonesia) or the nearest health service place so that further examination can immediately be carried out regarding the possibility of contracting the disease.

As a step to prevent TB transmission, the public must also understand coughing (and also sneezing) etiquette which includes:

1. Using a mask

2. Cover the mouth and nose with the inside of the upper arm, or

3. Cover your mouth and nose with a tissue and don't forget to throw it in the dustbin

4. Wash your hands with soap and running water

According to the Ministry of Health of the Republic of Indonesia, in the last 7 decades, around 300,000 TB patients were served and treated per year. The success rate of TB treatment in Indonesia reaches 90% of patients, which means that 90% of TB patients who are treated are successfully cured. It is this understanding that needs to be built on all members of the community: that TB therapy can provide maximum results as long as the patient/family is also proactive in checking themselves so that diagnosis and treatment can be carried out as soon as possible. (etc.)

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