(1) Background: The current treatment for osteoarthritis is ineffective due to its focus on pain relief and lack of cartilage repair. Viscosupplementation such as hyaluronic acid improves symptoms but remains unnoticed for several months. Researchers are exploring cell-based therapies such as mesenchymal stem cells secretome and mesenchymal stem cells, which can repair cartilage damage. The objective of the research is to evaluate and compare the effectiveness of the secretome derived from umbilical cord mesenchymal stem cells (UC-MSCs) with hyaluronic acid (HA). (2) Methods: An open-label clinical trial involving 30 knee osteoarthritis patients divided into two groups received UC-MSC secretome and hyaluronic acid doses. The study assessed clinical outcomes using VAS and WOMAC and measured MMP-3 and TGF-β1 levels before and after treatment. (3) Results: A study of 30 subjects found that the UC-MSC secretome group showed a decrease in pain in the OA knee compared to the HA group. The therapy was most effective after the third injection, and the group showed a decrease in the MMP-3 ratio and an increase in TGF-β1 compared to the hyaluronic acid group. (4) Conclusions: UC-MSC secretome intra-articular injections showed superior clinical improvement, biomarker changes, and no side effects compared to hyaluronic acid over a 5-week interval.

(1) Background: Current treatments for knee osteoarthritis (KOA), such as intra-articular corticosteroids or hyaluronic acid (HA) injections, are controversial due to their ineffectiveness in preventing disease progression. Platelet-rich plasma (PRP) has become a promising and possible treatment for KOA. It is thought to enhance articular cartilage regeneration and reduce OA-related impairment. PRP contains growth factors such as PDGF-BB, which stimulates growth and inhibits joint damage. Based on numerous studies, after a certain amount of time, it was found that multiple PRP treatments reduced pain more than a single injection. This study evaluates the efficacy of multiple PRP (m-PRP) injections compared to multiple HA (m-HA) injections for KOA treatment, focusing on their correlation with PDGF-BB levels. (2) Methods: In this single-center, open-label, randomized, comparative clinical trial, 30 KOA patients received m-PRP and m-HA injections. VAS and WOMAC were used to evaluate clinical outcomes and PDGF-BB concentrations. (3) Results: The study analysis revealed a statistically significant reduction in pain indices. In both the m-PRP and m-HA groups after 12 weeks, m-PRP showed superior results. PDGF-BB concentrations also increased, with a strong negative correlation and statistical significance using Spearman’s rho. (4) Conclusions: Multiple PRP injections are safe and associated with elevated PDGF-BB, reduced VAS and WOMAC scores, providing the potential for articular cartilage regeneration and inhibiting knee osteoarthritis progression.

Background. Osteoarthritis (OA) is a prevalent disease of the musculoskeletal system that affects over 528 million individuals worldwide, with 73% of those diagnosed being aged 55 or older. The knee joint is most commonly affected, along with the hip and hand joints. Vitamin D is essential for maintaining bone and cartilage metabolism. In chondrocytes, the presence of the vitamin D receptor (VDR) regulates the expression of metalloproteinase. The purpose of this investigation is to examine the correlation between vitamin D (25(OH)D) and cartilage oligomeric matrix protein (COMP) serum in knee osteoarthritis. Methods. The cross-sectional study was conducted by the Rheumatology Division at RSMH Palembang. Patients diagnosed with knee osteoarthritis based on the 1990 ACR criteria were included. The chemoluminescent immunoassay and the Human Cartilage Oligometric Matrix Protein ELISA Reagent were used to measure the levels of vitamin D (25(OH)D) and COMP serum. Results. Thirty participants took part in this study from July to December 2022. According to this study, 33% had insufficiency and 67% had a deficiency of vitamin D. Spearman's Rho test shows that there is a strong negative correlation between vitamin D (25(OH)D) and COMP serum. Conclusion. Vitamin D (25(OH)D) and COMP serum levels were significantly correlated in knee osteoathritis.

INTRODUCTION/BACKGROUND Latent autoimmune diabetes forms a continuous age-related spectrum from LADY to LADA, where LADY exhibits greater autoimmunity. Latent autoimmune diabetes in youth (LADY) is diagnosed in individuals aged 15 to 29 years. A high prevalence of LADY is observed among youth with the T2DM phenotype. The TCF7L2 rs12255372 polymorphism is linked to an increased risk of developing T2DM at a young age and is associated with lower levels of GADA in individuals with either T2DM or latent autoimmune diabetes. CASE A 28-year-old female with no history of T2DM was admitted to the emergency room due to altered mental status. She had experienced a weight loss of approximately 10 kg and frequent nocturnal urination; however, she had never consulted a physician. Both her parents and her sister have a known history of T2DM. A physical examination revealed excess body weight and acanthosis nigricans. Laboratory results indicated elevated glucose levels, a high A1C level, a normal fasting C-peptide, negative ketones in the urine and a high HOMA-IR score. Following the patient's clinical improvement, we transitioned from insulin to oral hypoglycemic drugs. After several weeks, we identified a positive anti-GAD result and the TCF7L2 gene polymorphism, rs12255372 (G/T). CONCLUSION The clinical diagnosis of latent autoimmune diabetes (LAD) can be quite challenging. Young individuals exhibiting a T2DM phenotype should undergo assessment for pancreatic islet cell autoantibodies. Common TCF7L2 gene polymorphisms are linked to T2DM and latent autoimmune diabetes but not type 1 diabetes.

Introduction: The SARS-CoV-2 virus is the cause of coronavirus illness (COVID-19). The WHO classified the outbreak a pandemic on March 9, 2020. The COVID-19 vaccine has been widely utilized to manage the pandemic. However, some high-risk conditions that can compromise the vaccine's efficacy require careful consideration. Patients over 60 years old are at a greater risk for COVID-19. Due to the involution of the thymus and the transformation of the cortex and medulla tissue into adipose tissue, CD8+ T cell numbers decline. In addition, undernutrition reduces the number of CD8+ T cells. The purpose of this study is to examine the relationship between nutritional status and CD8+ T cell counts in elderly patients following the second COVID-19 vaccination. Methods: This study is a pilot project employing a cross-sectional design. The sampling employed a technique of sequential sampling. On day 28, following the administration of the second vaccine, the Mini Nutritional Assessment (MNA) and the amount of CD8+ T cells in the blood were utilized to evaluate the nutrition status. Results: Between May and November of 2021, forty subjects were collected. The average number of CD8+ T cells was 517.32±41.67. Therefore, five people (12.5%) were at risk of malnutrition, whereas thirty-five (87.5%) had a normal nutritional status. Conclusion: There is a significant relationship between MNA and CD8+ levels (P<0.05) and a positive correlation between nutritional status and CD8+ T cell counts in the elderly who have received the second covid-19 vaccination in Palembang.

Background. Delirium is a common condition in geriatric patients. One of the trigger factors for this condition is an infection, such as COVID-19 infection. Elderly with COVID-19 show atypical symptoms such as delirium. Elderly patients with COVID-19 who present with delirium, either as a primary symptom or showing symptoms or signs, have a poor prognosis. This study were aimed to presents covid-19 elderly patient with comorbid delirium. Case presentation. A 77-year-old woman with disorientation for one day came to Emergency Department with her family. She had no history of headaches, blurred vision, or seizures. However, she had a fever, did not want to eat for three days, and had a purulent decubitus ulcer. The patient was diagnosed with acute delirium syndrome, confirmed COVID-19 with sepsis, malnutrition, hypercoagulation, grade III decubitus ulcer, suspected dementia, immobilization, total dependence. The patient admitted to the isolation ward. The patient had meropenem 500 mg every 12 hours, anticoagulants and favipiravir according to the dose and parenteral nutrition. Conclusion. Patients with COVID-19 who present with delirium, either as a primary symptom or presenting symptoms or signs, have a worse outcome. Delirium relationship with comorbid factors can increase mortality and morbidity in the elderly with COVID-19.