Narra J (Journal)
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    Coenzyme Q10 as adjuvant therapy could reduce oxidative stress and enhance sperm quality in cryptorchidism animal models

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    The role of coenzyme Q10 (CoQ10) as an antioxidant in the context of cryptorchidism is increasingly recognized due to its potential protective effects against oxidative stress, a key contributor to testicular dysfunction in this condition. The aim of this study was to evaluate the antioxidant activity of CoQ10 and its impact on sperm parameters as an adjuvant therapy in a cryptorchidism mouse model. A total of 36 male Sprague Dawley mice were divided into six groups: control (negative control), cryptorchidism (positive control), orchidopexy only, and orchidopexy treated with CoQ10 at 5, 10 and 20 mg/kg body weight (BW). After seven days of induction into the cryptorchidism model, the mice underwent orchidopexy, and CoQ10 was administered orally from day 1 to day 7 post-orchidopexy. At the end of the treatment period, all mice were euthanized, and the left testes were collected for immunohistochemical analysis of malondialdehyde (MDA) and superoxide dismutase (SOD), as well as histological examination and sperm parameter assessment. Testicular tissue damage was assessed using the Cosentino grade, while spermatogenesis was evaluated using the Johnsen scoring system. Additionally, sperm parameters were analyzed from the left testis. MDA expression in the cryptorchidism group was significantly lower than in all CoQ10-treated groups (p<0.001). In contrast, SOD expression was significantly higher in the cryptorchidism group compared to the 10 mg/kg BW and 20 mg/kg BW CoQ10 groups (both had p<0.001). Cosentino grade and Johnsen score showed no significant differences between the control group and the group treated with 20 mg/kg BW CoQ10 (p=0.891 and p=0.123, respectively). Furthermore, the 20 mg/kg BW CoQ10 group had significantly greater sperm concentration and motility compared to the cryptorchidism group (p<0.001 for both). These findings demonstrated that CoQ10 had significant antioxidant activity as an adjuvant therapy in a cryptorchidism mouse model. CoQ10 supplementation could reduce oxidative stress markers, enhance antioxidant enzyme expression, and improve sperm parameters, supporting its potential to mitigate testicular damage associated with cryptorchidism

    Exploring factors contributing to falls in home-dwelling older adults: A cross-sectional study in Northeastern Thailand

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    Falls are the most common accidents among older adults in home settings. Older adults experience falls due to several risk factors. In 2005, Thailand became an aging society, with projections indicating that by 2021, older adults would represent the majority of the population, and by 2035, approximately 30 percent of the population would be older adults. Approximately 3 million fall episodes transpire among older adults each year in Thailand, leading to almost 60,000 hospitalizations. The aim of this study was to examine the factors associated with falls among older adults in northeastern Thailand, hypothesizing that characteristics such as cognitive capacity, visual acuity, hearing acuity, balance ability, and mobility are associated with fall risk in this population. A cross-sectional analytical study involved 264 older adults aged 60 years or older using a questionnaire and a battery of tests that assessed the participants’ cognitive capacity, eyesight proficiency, hearing ability, balancing ability, and mobility. The variables that exhibited a statistically significant association (p<0.05) were employed in a binary logistic regression analysis. The results revealed that falls among home-living older adults were significantly associated with sex, family size, congenital issues, and mobility. Older adults who were female and had a large family, congenital disorders, or mobility impairments were at a higher risk of falls, which emphasizes the need for personalized prevention strategies. It is recommended to adopt a proactive healthcare strategy to prevent falls and ensure safe living conditions. Interventions aimed at improving balance, mobility, and mental health, as well as encouraging an active lifestyle, may reduce the risk of falls among older adults living in the community. The findings may aid private and government agencies in developing effective fall prevention programs for older adults living at home

    Apium graveolens leaf ethanolic extract triggers apoptosis in human tongue cancer cells via caspase-3 and poly(ADP-ribose) polymerase pathways: An in vitro study

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    Recent advances in cancer treatment have focused on developing alternative therapies with reduced adverse effects. Chemoprevention using natural products derived from plants has gained significant attention. Apium graveolens has demonstrated anticancer properties against various cancer cell types, suggesting its potential efficacy against tongue cancer cells. The aim of this study was to evaluate the cytotoxic effects and mechanisms of action of Apium graveolens leaf ethanolic extract (AGLEE) on the HSC-3 tongue cancer cell line. The leaves were processed and extracted with 70% ethanol to obtain an ethanolic extract. HSC-3 cells were cultured, subjected to starvation, and pre-treated with or without Z-DEVD-FMK, a caspase-3 inhibitor. Subsequently, the cells were treated with or without doxorubicin or varying concentrations of AGLEE. To assess cell viability and apoptosis, MTT and sub-G1 assays were performed. Additionally, treated HSC-3 cells were collected, lysed, and analyzed for levels of cleaved-caspase-3 and cleaved-poly (ADP-ribose) polymerase (cleaved-PARP) using ELISA. The inhibitory concentration (IC50) value of AGLEE for reducing viable HSC-3 cells was determined to be 48.29 μg/mL. AGLEE significantly decreased HSC-3 cell viability and increased the percentage of apoptotic cells. It exhibited a concentration-dependent reduction in cell viability and an increase in apoptosis. Furthermore, the extract elevated the levels of cleaved-caspase-3 and cleaved-PARP in HSC-3 cells. Pre-treatment with Z-DEVD-FMK reduced the levels of cleaved-caspase-3 and cleaved-PARP induced by AGLEE. Taken together, AGLEE could be proposed as a potential natural therapeutic agent by inducing apoptosis through the caspase-3/PARP pathway in tongue cancer cells

    Acceptance for a booster dose of COVID-19 vaccine in Indonesia: A follow-up study

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    The coronavirus disease 2019 (COVID-19) vaccination program in Indonesia has been implemented as a key strategy to mitigate the spread of the virus within communities. The success of this program depends on public acceptance of COVID-19 vaccines, including booster doses. The aim of this study was to assess the acceptance of the COVID-19 booster dose in Indonesia and to identify factors influencing individuals' acceptance. A cross-sectional study was conducted across 34 provinces in Indonesia on June 2023. Logistic regression analysis was used to identify the factors associated with booster dose uptake. The findings revealed that 88.8% (2,049/2,308) of respondents were willing to receive a booster dose if provided free of charge by the Indonesian government. However, acceptance decreased to 61.7% when respondents were informed of a 20% likelihood of side effects, even with a reported 95% vaccine efficacy. Adjusted logistic regression analysis identified ten significant factors associated with booster dose acceptance: sex, age, religion, history of previous COVID-19 infection, type of primary vaccine received, belief in vaccine-related conspiracy theories, trust in traditional medicine conspiracies, confidence in natural immunity, perceived vaccine efficacy, and perceived vaccine effectiveness. These findings suggest that acceptance of COVID-19 booster doses in Indonesia is influenced by intrinsic and extrinsic factors, including limited knowledge of booster dose benefits and concerns about potential side effects. To enhance public acceptance, targeted health campaigns and educational initiatives should be intensified, emphasizing the safety, efficacy, and importance of booster vaccinations in controlling the COVID-19 pandemic

    BMPR-II, caspase-3, HIF-1α, and VE-cadherin profile in Down syndrome children with and without congenital heart disease and pulmonary hypertension

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    Several cellular markers have been identified as effective in detecting vascular remodeling recently. The reduced activity of bone morphogenetic protein receptor type-II (BMPR-II), commonly observed in Down syndrome, results in insufficient production of vascular endothelial cadherin (VE-cadherin). This, in turn, increases hypoxia-inducible factor-1α (HIF-1α) levels and leads to excessive production of caspase-3. The aim of this study was to compare the plasma levels of BMPR-II, VE-cadherin, HIF-1α, and caspase-3 between pediatric Down syndrome with and without congenital heart disease (CHD) and pulmonary hypertension (PH). This was to investigate the role of these biomarkers in the pathogenesis of PH associated or not associated with CHD. A cross-sectional study was conducted on Down syndrome children aged two months to five years at a tertiary hospital between January and December 2023. The children were classified into four groups: CHD with PH, CHD without PH, non-CHD with PH and normal heart. Plasma levels of BMPR-II, caspase-3, HIF-1α, and VE-cadherin were measured using ELISA and compared based on the presence or absence of CHD and PH using Kruskal-Wallis followed by post hoc Bonferroni tests. Elevated plasma HIF-1α levels were observed in all patients with PH, with significantly higher levels in those with CHD-PH. Elevated levels of caspase-3 were also observed among children with PH groups, with the highest levels observed in the non-CHD PH group. Plasma levels of BMPR-II and VE-cadherin were elevated in PH, with significantly higher levels in the non-CHD PH group compared to other groups

    Role of phosphodiesterase-3 inhibitor in cardiorespiratory fitness and functional class of patients with pulmonary hypertension: A randomized, double-blind, placebo-controlled trial

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    Many patients with acyanotic shunt congenital heart disease (CHD) are diagnosed only in adulthood, by which time pulmonary hypertension (PH) has developed, impairing their functional class and cardiorespiratory fitness. While PH treatments are limited and expensive, cilostazol, a phosphodiesterase-3 inhibitor, has shown potential in reducing pulmonary artery pressure and improving heart function, offering hope for better patient outcomes. The aim of this study was to evaluate the effects of cilostazol on cardiorespiratory fitness and functional class in patients with acyanotic shunt CHD with PH using a randomized, double-blind, placebo-controlled trial. The trial was conducted at Dr. Kariadi Hospital, Semarang, Indonesia, from March 2022 to March 2023. Patients aged 14–75 years were randomly assigned to receive cilostazol (initially 200 mg, later adjusted to 100 mg) or placebo for three months. Cardiorespiratory fitness was assessed using the six-minute walk test (6MWT) and VO2 max at pre-intervention and three months post-intervention. After three months, the mean 6MWT was not significantly different between cilostazol and placebo groups (319.65±50.52 vs 317.65±45.26 meters; p=0.090). Similarly, the VO2 max was also not significantly different between cilostazol and placebo groups (10.74±2.59 mL/kg/min vs 10.73±2.8 mL/kg; p=0.099). However, the percentage of patients who had functional class improvement was significantly higher in the cilostazol group compared to the placebo group (90% vs 30%; p<0.001). This study indicated that cilostazol could improve functional class in acyanotic shunt CHD patients with PH. However, larger and more robust trials are warranted to confirm the potential benefits of cilostazol in this patient population

    Stigma and health-related quality of life (HRQoL) among people with multidrug-resistant tuberculosis (MDR-TB): A cross-sectional study in Indonesia

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    Stigma often accompanies people with multidrug-resistant tuberculosis (MDR-TB) and potentially affects their health-related quality of life (HRQoL). The aim of this study was to investigate the stigma faced by patients with MDR-TB, both from the patients' and community's perspective, and its relationship with HRQoL. Data was gathered at the provincial hospital in Makassar, South Sulawesi, Indonesia. The instrument employed in this research was the Indonesian version of the tuberculosis (TB) stigma instrument to assess MDR-TB stigma from the patient and community perspectives. The patient perspective represents how individuals with TB perceive and experience stigma, including the fear of disclosure, isolation, and guilt (feeling responsible for the burden on their family or their own risky behaviors). Meanwhile, the community perspective reflects how individuals with TB perceive societal attitudes towards them, such as social distancing, avoidance, and reluctance to interact. HRQoL was measured using the European quality of life-5 dimensions-5 level version (EQ-5D-5L) instrument. Notably, the evaluation of anxiety and depression is centered on the fifth dimension of the EQ-5D-5L instrument. A total of 210 patients with MDR-TB were included in the study, all of whom reported experiencing stigma. Most participants perceived stigma at a moderate level, with 76% from the patient perspective and 71% from the community perspective. The average EQ-5D-5L index score was 0.72 (95% confidence interval (95%CI): 0.68–0.76). Measurements from both perspectives show similar scores. There is a substantial negative association between the level of stigma and HRQoL, both from the patient's perspective (R2=-0.33; F=102.52; p<0.001) and the community's (R2=-0.32; F=96.76; p<0.001). The study highlights that the stigma of MDR-TB significantly affects the HRQoL from the patient and community perspective

    Examining the factors associated with disabilities among hypertensive patients in India

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    Hypertension is a major contributor to disability and mortality in India. The aim of this study was to examine the factors associated with activities of daily living (ADL) and instrumental activities of daily living (IADL) disabilities among patients with hypertension in India using secondary data from the longitudinal aging study in India (LASI) wave-1, encompassing a sample of 4,618 respondents. The disablement process model was adopted to categorize the variables into risk, intra-individual, and extra-individual factors. A zero-inflated negative binomial model was employed to identify factors associated with the absence of disabilities and those contributing to their progression. The results indicate that the risk and intra-individual factors had a larger variance in explaining disabilities than the extra-individual factor. Variables such as age, sex, depressive symptoms, psychosomatic symptoms, and physical activity were significantly associated with ADL and IADL disabilities. The findings highlight the need for targeted interventions addressing modifiable risk factors, promoting physical activity, managing depressive symptoms, and enhancing social support to reduce the disability burden in this population and improve the quality of life of hypertensive patients in India

    DNA methylation profiles for breast cancer subtype classifications: A translational study from microarray to methylation-specific PCR (MSP)

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    Breast cancer subtypes can be categorized based on their gene expression profiles using immunohistochemistry into Luminal A, Luminal B, human epidermal growth factor receptor 2-positive (HER2+), and triple-negative breast cancer (TNBC) subtypes. However, immunohistochemistry has certain limitations that can lead to misclassification. DNA methylation is an epigenetic modification, and changes in the promoter region can alter gene expression and the quantity of functional protein synthesized, disrupting gene function. The aim of this study was to identify DNA methylation biomarkers for subtype classification in breast cancer using microarray and methylation-specific polymerase chain reaction (MSP) methods. DNA samples were extracted, subjected to bisulfite conversion and then used for both the microarray and MSP methods. This study successfully identified differentially methylated CpGs (DMCs) as biomarker for each subtype classification of breast cancer: Luminal A (hypermethylation of ADAMTSL2 gene; cg14397888), Luminal B (hypomethylation of ADAMTSL2 gene; cg14397888), HER2+ (hypermethylation of PTPRN2 gene; cg25910261), and TNBC (hypomethylation of LCLAT1 gene; cg15652532). The DMC biomarker found for the HER2+ subtype, hypermethylation in the PTPRN2 gene (cg25910261), has the potential to be used by healthcare providers to identify HER2+ patients and provide the HER2-targeted therapy to improve the patient’s survival. In addition, our developed MSP method could produce an effective diagnostic tool for classifying the Luminal A and Luminal B subtypes, with accuracies of 75% and 76%, respectively

    Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool

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    Stunting remains a critical public health issue in East Nusa Tenggara (ENT), Indonesia, with prevalence rates among the highest in the country, despite national efforts to reduce its occurrence. The aim of this study was to project the impact of the 2018–2024 National Strategy to Accelerate Stunting Prevention on children under five years old in ENT, using the Lives Saved Tool. A cross-sectional approach was employed, integrating data from various sources, including the 2020 Census of Indonesia, the Global Data Lab-Area Database, the Central Bureau of Statistics Republic Indonesia, the National Socioeconomic Survey, the 2017 Indonesia Demographic and Health Survey, the 2018 Basic Health Research, and the 2021 Indonesia Nutrition Status Survey. The analysis considered three scenarios: (1) a baseline scenario reflecting ENT’s 2017 coverage, maintained through 2028; (2) a scenario assuming Indonesia achieves the Health Plan Action Stunting targets; and (3) a projection of stunting rates based on ENT-specific coverage. Under scenarios 1 and 2, the prevalence of stunting was projected to decrease from 40.04% in 2018 to 39.82% and 39.78%, respectively, by 2028, with scenario 3 reflecting a similar trend.  The findings revealed a sharp increase in the number of stunting cases averted among children under five years old between 2017 and 2021, followed by a more gradual decline, culminating in the 2028 projections: 2,249 children (scenario 2), 2,130 children (scenario 3), and 1,966 children (scenario 1). Breastfeeding promotion emerged as the most impactful intervention, accounting for over half of the total stunting cases averted under both Indonesia-wide and ENT-specific coverage scenarios. This was followed by interventions such as multiple micronutrient supplementation and vitamin A supplementation. The study highlights that reducing the prevalence of stunting among children requires a comprehensive prioritization of intervention strategies. The implementation of breastfeeding promotion, combined with appropriate complementary feeding practices, is expected to contribute significantly to achieving the sustainable development goal targets

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