Narra J (Journal)
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Tuberculosis treatment outcomes and associated factors: A retrospective study in West Nusa Tenggara, Indonesia
Get PDFSuccessfully treating tuberculosis (TB) could significantly help reduce its spread. The aim of this study was to identify factors associated with successful TB treatment. A retrospective study was conducted in West Nusa Tenggara, Indonesia, using data from the National TB Information System (SITB) covering patients from January 1 to December 31, 2022. Patients were classified into two groups: those with successful treatment outcomes (cured or completed treatment) and those with unsuccessful outcomes (including treatment failure, loss to follow-up, or death). Univariate and multivariate logistic regression analyses were performed to identify factors associated with treatment outcomes, providing odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals (CIs). A total of 2,225 TB patients (1,382 males and 843 females) were included in the study. Of these, 2,048 (92.1%) achieved successful treatment outcomes. Univariate analysis indicated that older age (OR: 0.47; 95%CI: 0.28–0.78) and a high number of AFB in sputum smears (OR: 0.23; 95%CI: 0.09–0.66) were associated with a higher likelihood of unsuccessful TB treatment. In contrast, having no HIV infection (OR: 13.44; 95%CI: 6.22–29.08), clinical TB cases (diagnosed clinically rather than bacteriologically) (OR: 1.50; 95%CI: 1.04–2.20) and longer duration of TB treatments were associated with successful treatment outcomes. Multivariate analysis suggested that the TB treatment durations of 4–6 months (aOR: 1256.95; 95%CI: 431.89–3658.19) and 7–12 months (aOR: 575.5; 95%CI: 99.1–3342.06) were associated with a significantly higher likelihood of success compared to durations of 0–3 months. In conclusion, this study highlights that a minimum treatment duration of three months was crucial for increasing the likelihood of successful TB treatment. These findings emphasize the importance of comprehensive support programs to ensure adherence to treatment guidelines and improve outcomes
Global prevalence and contributing factors of transplant renal artery stenosis in renal transplant recipients: A systematic review and meta-analysis
Get PDFTransplant renal artery stenosis (TRAS) is a serious complication of renal transplantation, with its prevalence and associated factors remaining inconclusive. The aim of this study was to assess the global prevalence and risk factors associated with TRAS incidence in renal transplant recipients. We conducted a meta-analysis by collecting data on the prevalence and factors associated with TRAS from articles in Scopus, Embase, and PubMed. The prevalence of TRAS was determined using a single-arm meta-analysis. The factors associated with TRAS were determined using Mantel-Haenszel analysis or inverse variance analysis. Out of 28,599 articles from the searches, 31 of them were included in the analysis. The global prevalence of TRAS was 6% among renal transplant recipients. Diabetes mellitus, hypertension, longer duration of dialysis before transplant, deceased donor, acute rejection, delayed graft function, longer cold ischemic time, and prolonged peak systolic velocity were associated with an increased risk of TRAS. Age, gender, peripheral artery disease (PAD) comorbidity, causes of end-stage renal disease (ESRD), previous dialysis modality, and cytomegalovirus infection were not associated with TRAS incidence. In conclusion, the global prevalence of TRAS in renal transplant recipients is relatively high, and some of the contributing factors to the development of TRAS are preventable. These findings could serve as a guideline for informing the management of TRAS in the future
Uncovering anti-inflammatory potential of Lantana camara Linn: Network pharmacology and in vitro studies
Get PDFLantana camara Linn contains a diverse array of metabolites that exhibit therapeutic potential. The aim of this study was to evaluate the potential of L. camara leaves, which were collected at the Ie-Seu'um geothermal area in Aceh, Indonesia, as an anti-inflammatory through network pharmacology and in vitro analysis. The ethanolic extract derived from L. camara underwent identification utilizing gas chromatography-mass spectrometry (GC-MS) to verify chemical constituents for drug-likeness properties. The evaluation of anti-inflammatory activity included network pharmacology and a series of in vitro investigations using two methods: protein inhibition and albumin denaturation assays. The findings revealed that the extract contained a domination of terpenoids and fatty acids class, which met the evaluation criteria of drug-likeness. Network pharmacology analysis identified the top five key proteins (peroxisome proliferator-activated receptor gamma, prostaglandin G/H synthase 2, epidermal growth factor receptor, hypoxia-inducible factor 1-alpha, and tyrosine protein kinase-Janus kinase 2) involved in inflammation-related protein-protein interactions. Gene ontology enrichment highlighted the predominance of inflammatory responses in biological processes (BP), cytoplasm in cellular components (CC), and oxidoreductase activity in molecular functions (MF). In vitro analysis showed that the extract inhibited protein activity and protein denaturation with inhibitory concentration (IC50) values of 202.27 and 223.85 ppm, respectively. Additionally, the extract had antioxidant activity with DPPH- and ABTS-scavenging IC50 values of 140 ppm and 163 ppm, respectively. Toxicological assessment by brine shrimp lethality assay (BSLA), yielding a lethal concentration (LC50) value of 574 ppm (essentially non-toxic) and its prediction via ProTox 3.0 that indicated non-active in hepatotoxicity, carcinogenicity, immunotoxicity, mutagenicity, and cytotoxicity. These results suggested that L. camara holds noteworthy effectiveness as a potential candidate for complementary medicine in the realm of inflammatory agents, warranting further investigation in clinical settings
Impacts of Phyllanthus niruri extract on biomarker levels, macrophage count, and lesion area in an endometriotic rat model
Get PDFEndometriosis is a gynecological disorder characterized by chronic inflammation, anatomical changes, prolonged pain, and infertility. On the other hand, Phyllanthus niruri is recognized for its pharmacological effects, which might be beneficial in managing endometriosis. The aim of the study was to investigate the pharmacological effects of P. niruri as a potential therapy for endometriosis by using an animal model. An experimental laboratory study with randomized, controlled trial, pre-test, and post-test design using 40 female Wistar rats (Rattus norvegicus) was conducted at the Integrated Research and Testing Laboratory (LPPT) of Universitas Gadjah Mada, Yogyakarta, Indonesia, from February to June 2023. Endometriosis was induced in female Wistar rats by suturing a 0.5 cm2 flap from the uterine horn to the peritoneal cavity. Changes in serum interleukin 1β (IL-1β), malondialdehyde (MDA), and matrix metalloproteinase 9 (MMP-9), before and after the treatment, were analyzed using enzyme-linked immunosorbent assay. Hematoxylin and eosin (HE) staining were used to evaluate lesion size and macrophage quantity. The results suggested that the P. niruri extract with a dose of 196 mg/200 g body weight (BW) could significantly attenuate serum IL-1β (p=0.004), MMP-9 (p=0.021), and MDA (p=0.021). Rats receiving the P. niruri extract (196 mg/200 g BW) had significantly higher macrophage counts (p=0.003), but similar lesion area (p=0.093) as compared with the negative control. In conclusion, P. niruri demonstrated promising therapeutical effects on endometriosis by modulating IL-1β, MDA, and MMP-9 levels, although the effect was not pronounced on macrophage counts and lesion area
Early activation of macrophage-2 with IL-4 in stromal vascular fraction increases VEGF levels and adipocyte count and maintains volume of fat graft in Wistar rats (Rattus norvegicus)
Get PDFSeveral previous studies have demonstrated the benefits of early macrophage 2 activation fat grafts supplemented with macrophage culture. However, this approach is considered impractical in clinical settings because of intraperitoneal induction use. The aim of this study was to investigate the effect of early stromal vascular fraction (SVF) macrophage-2 activation with IL-4 on fat graft survival compared to SVF alone using an animal model for better fat graft viability. This experimental study included inguinal fat harvesting, isolated with collagenases to retrieve the SVF, and then injected with a combination of fat graft and SVF (0.3 mL) into the scalp region. The intervention group received an IL-4 intralesional injection on the third day, and the fat grafts were biopsied on days 7, 14, and 30. The primary outcomes were the final volume of the fat graft, vascular endothelial growth factor (VEGF) expression, and the adipocyte cell count using perilipin staining on immunohistochemistry examination. The group receiving IL-4 exhibited significantly higher VEGF on days 7, 14, and 30 (p=0.009, 0.009, and 0.021, respectively). Similarly, the IL-4 treatment significantly increased the perilipin concentration on days 7, 14, and 30 (p=0.008, 0.008, and 0.029, respectively). In this group, VEGF concentration was significantly increased on day 14 as compared to day 7 (p=0.009), while no significant difference was observed in the control group (p=0.090). Additionally, the IL-4 group displayed significantly less reduction of fat graft volume than the control group, as observed on days 7, 14, and 30 (p=0.009, 0.009, and 0.021, respectively). Overall, the study underscores the potential benefits of early M2 polarization in fat grafting, as well as providing practical advantages for improving fat graft volume retention
Correlation between serum vitamin D levels and bone mass density evaluated by radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women
Get PDFOsteoporosis is a common condition associated with an increased risk of bone fractures due to fragility. Bone mineral density (BMD) is lower in menopausal women due to estrogen deficiency, age-related decline in osteoblast function, decreased calcium absorption, and reduced synthesis of vitamin D, which lead to osteoporosis. The aim of this study was to determine the correlation between serum vitamin D levels and BMD assessed using radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women. A cross-sectional study was conducted at Prof. Dr. Chairuddin P. Lubis Hospital of Universitas Sumatera Utara, Medan, Indonesia, from May 2023 to August 2023. Consecutive sampling method was employed to sample menopausal women with no history of hysterectomy or oophorectomy (unilateral or bilateral), and no history of hormone replacement therapy or vitamin D supplementation. Interviews and physical examinations were conducted to obtain the characteristics of the subjects (age, duration of menopause, and body mass index). The 25(OH)D level was measured using immunoassay and REMS examination was conducted to assess BMD. The Spearman correlation test was used to assess the correlation between serum vitamin D levels and BMD. A total of 32 menopausal women were included in this study with the average vitamin D level was 18.05±5.81 ng/mL, and the mean BMD level was -2.13±1.23. The data showed a significant positive correlation between serum vitamin D levels and BMD in menopausal women (r=0.710; p=0.020). This study highlights that REMS could be useful as an alternative to dual-energy x-ray absorptiometry (DXA) to assess DMD in postmenopausal women
Wound healing effect of nutmeg (Myristica fragrans) cream on second-degree burn in animal model
Get PDFSecond-degree burn, the most common among burn degrees, underscores the importance of timely and proper treatment in influencing prognosis. Nutmeg (Myristica fragrans), renowned for its potent antibacterial and antifungal properties, also serves as an effective antiseptic for open wounds. The aim of this study was to identify the phytochemical constituents of nutmeg essential oil and analyze the wound healing effect of nutmeg cream on second-degree burns in an animal model. An experimental study with a completed randomized design was conducted on Rattus norvegicus strain Wistar rats with second-degree burn. This study had four groups and each group consisting of four rats: B (burn-treated base cream), B+N (burn-treated 3% nutmeg cream), B+SSD (burn-treated silver sulfadiazine (BSS)), and B+N+SSD (burn-treated 3% nutmeg cream and SSD in a 1:1 ratio). The phytochemical analysis of nutmeg essential oil was conducted by gas chromatography and mass spectroscopy (GC-MS). The burn diameter and burn wound healing percentage were measured from day 0 to 18. One-way ANOVA followed by post hoc analysis using the least significant difference (LSD) was employed to analysis the effect. The phytochemical analysis of nutmeg essential oil found that myristicin, terpinene-4-ol, terpinene, safrole and terpinolene were the most abundant putative compounds in nutmeg essential oil. On day 0, the average burn wound diameters were 1.4 cm in all groups and increases were observed in all groups in day 3. The wound diameter decreased until day 18 with the smallest burn wound diameter was found in the B+N group (0.86±0.37 cm), followed by B+SSD (0.93±0.29 cm). The B+SSD group exhibited the highest percentage of burn wound healing (56.80±14.05%), which was significantly different from the base cream (p<0.05). The percentage of burn wound healing in rats given 3% nutmeg cream was 41.88±13.81% suggesting that nutmeg cream could promote burn wound healing in rats induced by second-degree burns
Effects of tobacco smoke on the expression of virulence genes in Escherichia coli
Get PDFIt is widely acknowledged that smoking exacerbates the severity of infectious diseases. A presumed mechanism involves the damage inflicted by tobacco smoke on the organs of host organisms. In this study, an alternative hypothesis was explored: smoking enhances the virulence of bacteria. This possibility was investigated using Escherichia coli as the bacterial agent and Drosophila as the host organism. Our inquiry focused on the potential gene expression changes in E. coli subsequent to exposure to tobacco smoke. Analysis of the transcription promoter activity of genes encoding proteins within the E. coli two-component system, a regulatory machinery governing gene expression, revealed the activation of twelve out of 50 promoters in response to tobacco smoke. Subsequently, Drosophila was infected with E. coli exposed to tobacco smoke or left untreated. Interestingly, there were no significant differences observed in the survival periods of Drosophila following infection with E. coli, whether treated or untreated with tobacco smoke. Contrary to the initial hypothesis, the findings suggest that while tobacco smoke alters gene expression in E. coli, these changes do not appear to impact bacterial virulence. Although this study has illuminated the influence of tobacco smoke on the gene expression of E. coli, further analyses are necessary to elucidate the implications of these changes. Nevertheless, the results imply that smoking affects not only host organisms but may also exert influence on invading bacteria
Effectiveness of upper arm and breathing exercises to improve inflammatory markers in severe COVID-19 patients
Get PDFStudies have suggested associations between inflammatory markers with the severity of coronavirus disease 2019 (COVID-19). Therefore, exercises that could reduce the level of inflammatory markers might be beneficial. The aim of this study was to determine the effect of upper arms and breathing exercises on inflammatory markers such as ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in severe COVID-19 patients. A quasi-experimental with pre-test and post-test control group design was conducted among severe COVID-19 aged 18–70 years old, with or without comorbidities. Baseline data of inflammatory markers (ferritin, LDH, and CRP) were measured before the exercises and repeated post-exercise. The upper arm and breathing exercises were performed for ten days, twice a day (morning and evening) for ten minutes. A paired Student t-test was used to assess the changes in the inflammatory markers’ levels. Our data indicated that levels of ferritin and CRP were not significantly different between pre- and post-exercise. However, the level of LDH decreased significantly from 481.35 U/L to 331.80 U/L (p=0.001). This study highlights that pulmonary rehabilitation exercises might be beneficial to enhance the recovery process in severe COVID-19 patients
Epidemiology and population-based incidence of influenza in two communities, Bandung district, West Java, Indonesia, 2008–2011
Get PDFInfluenza surveillance is important for monitoring influenza virus circulation and disease burden to inform influenza prevention and control measures. The aim of this study was to describe the epidemiology and to estimate the incidence of influenza in two communities in West Java, Indonesia, before and after the 2009 H1N1 pandemic. A population-based surveillance study in the community health care setting was conducted to estimate the annual incidence of influenza. A real-time reverse transcription polymerase chain reaction (RT-PCR) assay was used for influenza case ascertainment. A population census was implemented to calculate the population at risk and estimate community health care utilization rate. The mean annual incidence of influenza A and B, adjusted for healthcare utilization, was 1.6 (95%CI: 1.3–2.0) and 0.7 (95%CI: 0.5–1.0) per 1000 persons, respectively, with the most affected group being young and school-age children. The annual cumulative incidence of influenza A for children under five in 2009, 2010, and 2011 was 7.0 (95%CI: 4.4–11.2), 10.6 (95%CI: 7.3–15.4), and 6.3 (95%CI: 3.8–10.2). For influenza B was 4.3 (95%CI: 2.4–7.8), 2.0 (95%CI: 0.8–4.7), and 0.4 (95%CI: 0.1–2.8), respectively. This study highlights that the incidence of influenza among young and school-age children is consistently higher compared to adults and the elderly throughout these periods. These populations are potential targets for influenza vaccination in Indonesia