Journal of the Asian Medical Students Association
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Evidence on the Efficacy of Omega-3 Polyunsaturated Fatty Acids as an Adjunct Therapy for Chronic Obstructive Pulmonary Disease
Get PDFBackground: As the fourth leading cause of death worldwide, Chronic Obstructive Pulmonary Disease (COPD) places a significant burden on healthcare-related costs. COPD is characterized by airflow impairment, including chronic bronchitis, small airways obstruction, and emphysema. COPD pathophysiology involves inflammation correlated with lung decline, body composition alteration, and decreased quality of life. Since preceding studies have shown its roles in inflammatory processes, omega-3 is proposed as a potential adjunct treatment in slowing down COPD progression.Aim: To analyse the efficacy of omega-3 as a potential adjunct therapy in COPD management.Method: A literature review was conducted by retrieving studies published from 2010-2020 through PubMed, EBSCOhost, Cochrane Controlled Register of Trials (CENTRAL), Scopus, Clinical Key, Wiley, and Science Direct that evaluate the effect of omega-3 supplementation in COPD management.Outcome: The search yielded 12 studies with a total of 6,474 subjects. Outcomes suggested that omega-3 leads to a reduction in inflammation, improved body composition, enhanced exercise capacity, higher quality of life, and lower exacerbation occurrences. Association found for lung function was weak, but this might be due to the study designs. The only potential adverse effect was diarrhoea, but this is insignificant.Conclusion: To conclude, omega-3 supplementation in COPD management showed promising results, considering its efficacy in slowing down COPD progression, minimal side effects, cost-effectiveness, and feasibility. However, the incorporation of this intervention into management guidelines require more trials with larger samples to establish more substantial evidence and more in-depth understanding of its roles
Immunogenicity and Safety Analysis of Inactivated Virus Vaccine against SARS-CoV-2: A Systematic Review of Phase 1/2 Clinical Trials
Get PDFIntroduction: The lingering Severe Acute Respiratory System-Coronavirus-2 (SARS-CoV-2) pandemic worldwide has called scientists to accelerate vaccine production and reduce the spread of the virus. The inactivated virus vaccine has been administered widely due to its potency. Following its recent public use, we aim to summarize the efficacy and safety of the inactivated vaccine, especially following Indonesia’s settlement on the SinoVac vaccine.
Materials and Methods: A systematic review was performed, searching for randomized controlled trials, according to the PRISMA statement throughout four online databases with studies published up to 2 February 2021. Critical appraisal was further conducted utilizing the Cochrane Risk of Bias Tool 2.0.
Results and Discussions: The search yielded six phase ½ clinical trials with a total of 3251 subjects. The outcome was obtained in seroconversion rates (%) after two doses of vaccine. Four studies administered the CoronaVac inactivated vaccine and resulted in a high seroconversion rate, ranging from 89—90%. The other two studies administered the BBV152 and BBIBP-CorV inactivated vaccine and showed similar results. Furthermore, a dose dependent relation is shown with higher doses showing higher seroconversion rates. The safety analysis reported injection site pain as an insignificant but most prevalent local adverse reaction, with other adverse reactions being mild to moderate respiratory tract infections
Conclusion: The inactivated vaccine’s efficacy has been proven to stimulate antibody response regardless of dosage, period of administration, and age, with insignificant adverse effects. Further phase 3 clinical trials and widespread administration with the help of non-governmental and medical student organizations are recommende
A scoping review of psychiatric care in traumatic brain injury patients in low-and middle-income countries in the Asia-Pacific region
Get PDFIntroductionAsia has the highest percentage of Traumatic Brain Injury (TBI)-related outcomes, among other regions in the world. Lower-middle income countries (LMICs) report thrice the total TBIs compared with Higher-income countries (HICs). Despite the high prevalence of patients with TBI in the region, TBI-related psychiatric disorders are often given the least priority in trauma management.
ObjectivesThis study focuses on LMICs in the Asia-Pacific region and examines existing literature within the past decade to (1) identify the common psychiatric conditions associated with TBI; (2) determine the most commonly used pharmacologic and nonpharmacologic psychiatric interventions in the management of TBI-related psychiatric disorders; and (3) identify the barriers in the screening, diagnosis, and management of these TBI-related psychiatric conditions.
MethodsThe researchers used a scoping review methodology to search relevant articles through nine online databases (e.g., PubMed, Google Scholar, Cochrane). Findings were reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Upon review, 75 journals were included in the current study. Among the articles, there are limited studies among Asia-Pacific LMICs that focus on this topic.
ResultsPost-traumatic stress disorder, major depressive disorder, and substance-related disorders were among the common psychiatric sequelae of TBI reported in 54 studies. Forty-two articles highlighted the effectiveness of antidepressants and Cognitive Behavioral Therapy (CBT) in managing TBI-related psychiatric disorders. Barriers to managing these conditions in Asia-Pacific LMICs include low socioeconomic status, psychiatric illness stigma, and the scarcity of healthcare resources.
ConclusionThe psychiatric care in the management of TBI patients is clearly recognized but often overlooked. As LMICs struggle to provide a holistic approach to TBI cases in the face of limited resources, there emerges the need to raise awareness and encourage resourcefulness in utilizing accessible management and treatment strategies that can be used in different trauma centers in the region
Profile of HER2/neu, Estrogen Receptor and Heat Shock Protein 27 Expression in Early And Late Onset Indonesian Breast Cancer Patients
Get PDFIntroduction: Early onset breast cancer (occuring under age 40) tend to exhibit a different, aggressive phenotype, and are usually associated with hereditary BRCA1 or BRCA2 mutations. We investigated the levels of Hsp27 and HER2/Neu, as well as ER positivity, in early onset breast cancer patients.
Materials and methods: Eighteen paraffin blocks of tissues from patients diagnosed with invasive ductal carcinoma of no specific type (IDC-NST) regardless of grade or stage, age below 39 years (mean 34 years) who underwent surgery or surgical biopsy in Dr. Soetomo General Hospital, Surabaya, within the period of January 2014 - December 2014, were examined for Hsp27 expression, estrogen receptor status, and HER2/Neu amplification. The control group consisted of blocks from 112 patients diagnosed with IDC-NST aged older than 40 who underwent resection within the same period; all specimen in the control group is also stained for Hsp27 and tested for ER and HER2/Neu status.
Results: Examined blocks gained from the younger patient pool typically has higher grade, were negative for estrogen receptor status and show less Hsp27 expression. Sixteen (88.9%) of early-onset patients has grade II or III cancer, with 55.55% presenting with grade III cancer. Meanwhile, 79 (70.53%) of late onset patient has grade II or III cancer, with 26.78% presenting with grade III cancer. Seventy-seven out of 112 (68.75%) patients aged 50 or older has positive ER status, while only 8 out of 18 (45.45%) of early-onset patients have positive ER status. All patients aged 50 years and below show Hsp27 score that is less than the median score, while from all patients aged 50 or above, 64 out of 96 (66.66%) samples exceed the median score. Meanwhile, HER2/Neu scoring distribution seem to be similar across age groups.
Conclusion: Difference in estrogen receptor expression and Hsp27 levels show a significant difference between early-onset and late-onset breast cancer patients. Meanwhile, HER2/Neu amplicafication shows similarities between early-onset and late-onset patients
AMSC 2019 Special Issue
No full textWelcome to the Asian Medical Students’ Conference 2019 hosted by Singapore. Our theme for this year’s AMSC was ‘Healthcare Without Borders: The Problem of Access’.
There is no such thing as a universal healthcare issue – across the globe, each individual, community and nation deals with challenges unique to them and their situation. The healthcare landscape is fluid and nuanced, and therefore, few problems can be considered truly ‘global’ in nature. However, the problem of access itself is certainly one of them.
The fundamental truth is that healthcare - be it prevention, treatment etc. - is pointless if people do not have access to it. As such, we chose to focus on the concept of access to healthcare in order to address what we feel is one of the most prominent issues at the moment - because no matter where you are from, there is always someone unable to receive the care they need. This is not attributed to just one problem alone but rather a widespread manifestation of many individual issues that we hope to address in a multi-tiered approach, with sub-themes focusing on barriers experienced by the individual, the community, and the world.
In this journal, we publish the works of all the chapters which participated in the Scientific Paper and White Paper competitions. We hope you enjoy these entries and get enriched with knowledge from around the world! Happy reading
Effectiveness of Various Health Insurances in Tackling Health Problems of the 21st Century: A Systematic Review
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Objective:
To investigate the relationship between health insurance and health quality using systematic method.
Background:
Health insurance can be said has strong relation in achieving Goal 3 of Sustainable Development Goals (SDGs), “Ensure healthy lives and promote well-being for all at all ages”. One of the key factor in reaching ‘healthy lives’ is the access to medical care. Health insurance has been implemented across many countries in order to facilitate access for good quality medical care. Some studies indicated that health insurance have positive effect to improve health quality of patient. Another study indicated there is inverted effect between ownership of health insurance and health quality. The link between health insurance and its ability to tackle health problems therefore should be thoroughly investigated.
Methods:
Systematic review was conducted using keywords “Insurance, Health”[Mesh] AND “Health Care Quality, Access, and Evaluation”[Mesh] on Pubmed. Afterwards, titles are screened for relevancy and duplication. Contents then were then screened for inclusion criteria, which include studies with publication age less than five years, observational studies, and studies which look upon effects of health insurance on its users’ health, and exclusion criteria, which include inaccessible articles, articles written in foreign languages, and irrelevant articles. A total of 6 suitable studies were included in the final review and were subjected to STROBE analysis.
Key Findings:
Increased usage of proper health insurance is related to an increase in overall health outcomes of various diseases, including type 1 Diabetes Mellitus (7% decrease of hyperglycemia on patients with more expensive insurance), acuity of thoracic aortic operations (underinsured patients were at greatest risk of getting acute nonelective operation; OR: 2.67), gastritis (insurance coverage reduce prevalence of H. pylori), cardiac arrest (102/100.000 to 85/100.000 incidence after insurance expansion), albuminuria (higher mortality for individuals without private insurance), and peritonitis (better prognosis for individuals with better insurance). These conditions could be explained by increase in health awareness and accessibility of medication by patients with quality health insurance. This finding could become a basis for governments to highly consider quality insurances as means to improve the health of the nation
Community-Based Intervention Strategies to Reduce Tobacco Use in Asia: A Systematic Review of Randomized Controlled Trials
Get PDFIntroduction Tobacco use remains a global health challenge as one-tenth of world’s population consume it regularly–thereby increasing its disease burden. Among all programs implemented, community-based interventions showed great potential, considering its ubiquity and practicableness. However, since tobacco consumption’s prevalence persists, especially in Asia, further reviews are needed.
Objective To analyze prior community-based tobacco control programs in Asia and identify potential approaches to be implemented as a mean to reduce tobacco use
Methods A systematic review was conducted through PubMed, Scopus, and CENTRAL, searching for randomized controlled trials (RCT) implementing community-based programs to control tobacco usage in Asia. Studies selected were assessed for bias risk with Cochrane risk-of-bias tool for randomized trials.
Results The search yielded eleven RCTs with a total of 28,805 subjects. Smoking cessation interventions focusing on education and counselling are proven to be effective in reducing tobacco consumption and increasing quit rate. Moreover, prevention programs which include school-based interventions, reduce the likeliness of adolescents to smoke in the future and also prevent further tobacco use in recent youth smokers.
Conclusions To conclude, community-based interventions showed promising results to be widely implemented as tobacco control and prevention strategies, helping to raise public awareness towards tobacco hazards and reducing the number of tobacco-related diseases and mortality worldwide
INAMSC 2019 Special Issue
No full textWelcome from the Chairs of the Indonesia International (Bio)Medical Students' Congress (INAMSC)
Dear Congress Participant,
As the Chief of the organizing committee, I would like to give you a warm welcome to Indonesia International (Bio)Medical Students' Congress (INAMSC) 2019. INAMSC is a scientific sub event of Liga Medika 2019, and also the largest and most prestigious scientific event held by medical students in Indonesia. INAMSC 2019 is held on 22-25th August 2019 in IMERI Tower, Faculty of Medicine University of Indonesia, Jakarta.
To raise awareness of mental health, we raise the theme of Psychiatry as the theme of our congress this year. Various topics including neuropsychiatric diseases, mental health awareness, mental health in young adults, will be discussed during the event. There are also in broader topics from biomedical sciences presented from our research paper and poster competition. Not only increasing your knowledges and skills in our symposium and workshops, this event also aims to build new friendships and networks between our participants in our social program.
Finally, I one again welcome all of the participants to INAMSC 2019. We truly hope that all of you not just compete in this event, but also would get the beneficial, enjoyable, and unforgettable experience
Assessment of Factors Associated with Suboptimal Adherence of HIV Antiretroviral Therapy in Asia: A Systematic Review
Get PDFIntroduction Despite efforts done to battle human immunodeficiency virus (HIV) infection, it still remains as one of the leading cause of deaths worldwide. Asia sits as the second region with most HIV prevalence worldwide. Non-adherence to antiretroviral therapy (ART) is one of the factors which contribute to treatment ineffectiveness. Plenty of studies have tried to research on this problem, yet reviews regarding non-adherence factors in Asia are still lacking.
Objective To analyze factors associated with ART suboptimal adherence in Asia
Methods A systematic review was conducted through PubMed, Scopus, and CENTRAL, searching for observational studies which analyze factors contributing to ART non-adherence in Asia. Studies selected were then assessed for bias risk with STROBE’s criteria.
Results The search yielded twenty observational studies with a total of 18,546 subjects, consisting of 16 cross-sectional studies and 4 cohort studies. Non-adherence to ART was associated with a number of factors. Personal factors, such as gender, age, and personal backgrounds, as well as socioeconomic factors, such as one’s education level and monthly income were significantly associated with adherence. Psychological health of HIV patients also affected their adherence to treatment. Furthermore, distance to health care facilities and patients’ relationship with health care providers were also important.
Conclusions To conclude, addressing factors related to treatment non-adherence is important to enhance treatment effectiveness. Knowledge of these factors is hoped to help improve strategies and guidelines for ART adherence, especially in Asia, therefore helping to increase treatment effectiveness and reducing HIV mortality worldwide
Psychological Impact and Awareness of Androgenetic Alopecia Among Filipino Male Patients Aged 18 to 65 seen at the Outpatient Department of the Ospital ng Maynila Medical Center, Department of Dermatology
No full textBackground Androgenetic alopecia is the most common type of hair loss. Although losing hair is not life-threatening, it can lead to psychological distress.
Objective To investigate the psychological impact using Hospital Anxiety and Depression Scale (HADS) and the awareness among Filipino male patients aged 18 to 65 with androgenetic alopecia.
Methods A cross-sectional study was conducted at the OMMC Dermatology. Psychological impact was assessed using HADS. Age, education, duration of disease, previous investigation experience, previous experience in treating this condition, and satisfaction ratings for the treatment were likewise obtained.
Results 145 Filipino male patients with androgenetic alopecia were included in the study. The risks of anxiety and depression were not statistically associated with severity of AGA (P>0.05). The risk of depression was highest among those with severe AGA. 57% had previous investigation experience and 21% had previous experience in treating the condition, however only 1 or 0.7% was satisfied with the treatment. Age, education, duration of disease, level of awareness and treatment satisfaction and the severity of AGA in Filipino male patients were not statistically associated with anxiety (P>0.05), however, age, education and Hamilton Norwood Classification were statistically associated with depression (P<0.05).
Conclusion Three factors have been found to influence psychological well-being and self-image in AGA patients: age of 50 years and above, lower education level, and a moderate to severe grade of disease according to the Hamilton-Norwood classification. It is hoped that optimal management focusing on these factors can be used to solve one of the mankind’s psychologically debilitating hair diseases