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A potential treatment for erectile dysfunction: Effect of platelet-rich plasma administration on axon and collagen regeneration in cavernous nerve injury
Get PDFRecent studies highlighted the role of platelet-rich plasma (PRP) in progenitor cell homing, migration, and nerve cell regeneration while also inhibiting fibrosis and apoptosis in cavernous nerve injury (CNI). The aim of this study was to investigate the effect of PRP administration on axon and collagen regeneration in CNI. A true experimental study using a post-test-only control group design was conducted. Twenty-five male Wistar rats (Rattus norvegicus), weighing 200–300 grams, were divided into five groups: two control groups (sham procedure and negative control), and three experimental groups receiving local PRP, intraperitoneal PRP, and a combination of local and intraperitoneal PRP. The cavernous nerve was injured with a hemostasis clamp for one minute before 200 µL of 200 PRP was injected locally, intraperitoneally, or both, depending on the group. After four weeks, the rats were euthanized, tissue segments (2 mm) from each cavernous nerve and mid-penis were collected and analyzed for collagen density, axon diameter, and number of myelinated axons. Our study found that collagen growth was slower in CNI group without PRP (sham procedure) compared to all PRP groups (local, intraperitoneal, and combination). The intraperitoneal PRP group had the highest collagen density at 5.62 µm; however, no significant difference was observed in collagen density among all groups (p=0.056). Similar axon diameter was found across the groups, with no statistically significant difference observed (p=0.856). In the number of myelinated axons, a significant difference was found among all groups with significantly more axons in local PRP and combined local and intraperitoneal PRP groups compared to others (p=0.026). In conclusion, PRP administration improved a number of myelinated axons in CNI, suggesting PRP role in CNI regeneration and the potential for an innovative approach to treating erectile dysfunction associated with CNI
Aerobic exercise improves spatial memory in a rat model of meningitis
Get PDFInfections of the nervous system, such as acute bacterial meningitis, pose serious health problems that require immediate intervention. In experimental animals, exposure to lipopolysaccharide (LPS) is used to induce meningitis. Aside from drug intervention to reduce inflammation in meningitis, aerobic exercise helps to maintain the regulatory mechanisms of brain homeostasis through anti-inflammatory mechanisms. The aim of this study was to evaluate the effect of aerobic exercise on malondialdehyde (MDA), nuclear factor-kappa B (NF-κB), insulin-like growth factor 1 (IGF-1), endothelial nitric oxide synthase (eNOS), brain-derived neurotrophic factor (BDNF), apoptosis, and spatial memory. A four-week experimental study was conducted using 18 rats, which were randomly divided into three different groups (six rats per group): healthy rats as negative controls (non-meningitis), a treatment group treated with antibiotic treatment (meningitis group), and a third group (aerobic exercise group) treated with antibiotics and aerobic exercise following LPS-induced meningitis. Data were analyzed using a one-way analysis of variance (ANOVA) test, and the comparison between groups used the Bonferroni post-hoc test. The results showed that aerobic exercise significantly reduced MDA (p<0.001), NF-κB (p=0.035), and apoptosis (p=0.020) while increasing the serum levels of IGF-1 (p<0.001), eNOS (p=0.011), and BDNF (p=0.001) levels. Improvement in spatial memory was significant in the aerobic exercise group (p<0.001). This study suggested that aerobic exercise could be a promising adjunct therapy in meningitis management strategies, particularly due to its effect on improving spatial memory. Further clinical trials are needed to confirm these findings for clinical use
Improving maternal health literacy among low-income pregnant women: A systematic review
Get PDFPrevious studies on maternal health have highlighted the need to improve health literacy, particularly among women from lower socioeconomic backgrounds. Some crucial factors for improving maternal health literacy are midwife capacity and systems support that can help ensure women's ability and motivation to access timely health services. However, the extent of roles midwives need and the system that must be developed require further elaboration. The aim of this systematic review was to investigate approaches for enhancing maternal health literacy in low-income pregnant women. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic search was conducted on two databases: PubMed and ScienceDirect. All English articles published from 2011 to 2023 were searched using the keywords pregnant, antenatal, prenatal, perinatal, midwife, health literacy, midwife-led care, helpline, and photo novel. Of the 1539 articles, 15 were included for final assessment. The results suggest that improving maternal health literacy among low-income pregnant women is related to empowering these women, midwives as frontline care providers engaging with them, and the health care system as a health literacy organization. In conclusion, improving the healthcare system and strengthening midwives' leadership as proximal caregivers is crucial for improving maternal health literacy among low-income pregnant mothers. These efforts could be realized with support from government roles, educational institutions, and professional associations
Prevalence and distribution of intestinal parasitic infections in taeniasis endemic area of North Sumatera, Indonesia
Get PDFA group of helminthic and intestinal protozoa causes intestinal parasitic infections (IPIs), affecting more than 2.5 billion people worldwide. IPIs are diseases closely associated with poor hygiene and sanitation, concentrated in underdeveloped regions and among populations with low socioeconomic status. Consequently, most prevalence is in Sub-Saharan Africa and Asia, with local habits or risk factors that could affect its prevalence. The aim of this study was to determine how hygienic practices, sanitation, and local behavior of eating raw meat (hinasumba) contributed to the prevalence of IPI. A cross-sectional study was conducted in the Simalungun District of North Sumatera Province, involving 428 people of Batak Simalungun. There were 15 villages randomly selected across the district based on the local registry, which consequently, non-purposive sampling was conducted. Face-to-face interviews assessed various risk factors, such as demographic characteristics, water source, traditional raw meat consumption, or hinasumba as local risk factors, hygienic practices, and sanitation. The findings indicated that an overall prevalence rate of IPI was 42.9%, consisting of 87.5% with helminthic infection and 12.5% with protozoal infection. More than half of IPI cases were associated with Taenia sp. infections (21.8%), followed by hookworms’ infections with a 6.1% positivity rate. Based on multivariate analysis, farming and consuming traditional delicacies, namely hinasumba, increased the likelihood of IPI occurrence among the population by 1.7 and 3 times, respectively. It can be concluded that the high prevalence of taeniasis in the study area was associated with local behavior and hinasumba consumption, which may contribute to determining the dominance of specific IPI species
More severe comorbidities, advanced age, and incomplete vaccination increase the risk of COVID-19 mortality
Get PDFNumerous studies have stated that comorbidities are risk factors for coronavirus disease 2019 (COVID-19) mortality, but few have considered the severity or stage of these comorbidities. The aim of this study was to determine the association between the severity of comorbidity, age, and number of COVID-19 vaccinations with COVID-19 mortality. This case-control study was conducted from July 2021 until December 2022 at the Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The patients were divided into non-survived patients (case group) and survived patients (control group). The inclusion criteria for cases were adult patients hospitalized with confirmed COVID-19, based on reverse transcriptase-polymerase chain reaction (RT-PCR) testing of nasopharyngeal swabs. Using total sampling, 1,046 confirmed COVID-19 patients, which consisted of 450 (43%) non-survived patients and 596 (57%) survived patients, were included. The most common comorbidity was diabetes mellitus (DM) (82.7%), chronic kidney disease (CKD) (43%), hypertension (25.7%), and obesity (23.6%). Our multivariate analysis indicated that older age (aOR: 1.03; 95%CI: 1.02–1.04, p<0.001), male sex (aOR: 1.29; 95%CI: 1.11–2.00, p=0.007), severe COVID-19 at first admission (aOR: 3.13; 95%CI: 2.08–4.73, p<0.001), having pneumonia (aOR: 1.99; 95%CI: 1.21–3.33, p=0.005), poorly controlled DM with HbA1c≥9% (aOR: 2.90; 95%CI: 1.72–4.89, p<0.001), severe obesity with body mass index (BMI)≥30 (OR: 2.90; 95%CI: 1.72–4.89, p<0.001), hypertension stage 2 (aOR: 1.99; 95%CI: 1.12–3.53, p=0.019) or stage 3 (aOR: 6.59; 95%CI: 2.39–18.17, p<0.001), CKD stage 3 (aOR: 2.50; 95%CI: 1.36–4.59, p=0.003), stage 4 (aOR: 5.47; 95%CI: 2.18–13.69, p<0.001) or stage 5 (aOR: 1.71; 95%CI: 1.04–2.81, p=0.036), and having chronic lung disease (aOR: 3.08; 95%CI: 1.22–7.77, p=0.017) significantly increased the risk of COVID-19 mortality. In contrast, COVID-19 vaccination reduced the risk of COVID-19-associated death. This study highlights that more severe comorbidities, advanced age, and incomplete vaccination were associated with COVID-19 mortality
Enhancing oxytocin and prolactin levels to address oligogalactia through emotional management and massage in working mothers
Get PDFEmotional management, combined with oxytocin massage and breast care, offers a comprehensive approach to boost prolactin release, enhance milk production, and improve breastfeeding outcomes. The aim of this study was to evaluate the effectiveness of combining emotional management with oxytocin massage and breast care in increasing oxytocin and prolactin hormone levels to address oligogalactia in working postpartum mothers. A quasi-experimental study was conducted at Kudus Community Health Center, Kudus Regency, Central Java, Indonesia, from January to March 2024. A total of 93 postpartum mothers were randomly assigned to three groups: (1) emotional management with oxytocin massage; (2) emotional management with breast care; and (3) lactation education only. Blood samples were collected before and after the interventions to measure oxytocin and prolactin levels. The present study found that emotional management combined with oxytocin massage significantly increased oxytocin levels from 505.0±264.0 pg/mL to 600.0±231.3 pg/mL (mean difference: 103 pg/mL; p=0.002) and prolactin levels from 191.0±67.3 ng/mL to 233.0±86.8 ng/mL (mean difference: 27 ng/mL; p=0.001). The emotional management and breast care group showed a smaller increase in oxytocin (362.0±175.1 pg/mL to 418.0±185.1 pg/mL; mean difference: 23 pg/mL; p=0.048) and a significant increase in prolactin (195.0±48.8 ng/mL to 255.0±82.3 ng/mL; mean difference: 38 ng/mL; p=0.049). In contrast, the lactation education group showed no significant changes in oxytocin (p=0.756) or prolactin levels (p=0.341). In conclusion, emotional management combined with oxytocin massage significantly increased both oxytocin and prolactin levels, suggesting that integrating emotional management and oxytocin massage may be an effective strategy for postpartum lactation support
Examining the prevalence and antimicrobial resistance profiles of multidrug-resistant bacterial isolates in wound infections from Indonesian patients
Get PDFThe emergence of multidrug-resistant (MDR) infections in wounds is a significant public health issue. The aim of this study was to investigate the prevalence and antimicrobial resistance profiles of MDR bacterial isolates in wound infections. Through a cross-sectional study, 1035 bacterial isolates were collected from wound infection patients at Tugurejo Hospital in Semarang, Indonesia, over a three-year period (January 2020 to December 2022). Initial identification involved Gram staining and colony morphology assessment, followed by biochemical assays and antimicrobial susceptibility testing using the VITEK®2 Compact system. Gram-negative bacteria constituted the majority of isolates (60.77%, n=629). The predominant strains included were Staphylococcus spp. (30.92%, n=320), Escherichia coli (18.45%, n=191), and Klebsiella pneumoniae (13.04%, n=135). Notably, Gram-negative bacteria exhibited a significantly higher likelihood of MDR development compared to their Gram-positive counterparts (p<0.001), with Gram-negative bacteria having a 2.05 times higher probability of acquiring MDR. These findings underscore the urgent need for comprehensive surveillance of antimicrobial resistance patterns and the implementation of tailored antimicrobial stewardship programs to address the pressing public health challenge of MDR wound infections. Further research is warranted to elucidate the complex interplay of factors contributing to MDR development in wound infections, thereby informing targeted intervention strategies and improving patient outcomes
Development of the Indonesian sexual quality of life scale for women (ISQOL-W)
Get PDFSexual quality of life is greatly influenced by sexual function, yet thorough measures remain limited and vary across regions. In Indonesia, diverse cultural and religious contexts notably shape sexual quality of life. Thus, it is important to have a tool that considers both internal and external aspects. The aim of this study was to develop a valid and reliable scale that specifically measures Indonesian sexual quality of life for women (ISQOL-W), considering cultural and social factors. A total of 228 participants were recruited from April 30, 2023, to September 30, 2023. The ISQOL-W was developed through two phases: item generation and psychometric evaluation. In the first phase, 68 items were drafted based on definitions and dimensions of sexual quality of life. In the second phase, exploratory factor analysis resulted in 34 items with a loading factor greater than 0.4 (ranging from 0.41 to 0.84) which were categorized into four domains/factors: sexual-related emotion, sexual fantasy, sexual arousal, and sexual relationship. The Cronbach’s α coefficient for the overall questionnaire was 0.915, with subscale reliability ranging from 0.826 to 0.903. Further analysis revealed significant differences in ISQOL-W scores across relationship status, educational level, history of last sexual activity, and type of sexual activity. In conclusion, the ISQOL-W demonstrated robust psychometric properties, supporting its use in future studies. This study represents the first effort to develop and validate a sexual quality of life scale specifically for Indonesian women
Dual sgRNA-directed knock out survivin gene expression using CRISPR/Cas9 technology for editing survivin gene in triple-negative breast cancer
Get PDFClustered regularly interspaced short palindromic repeats (CRISPR)-associated nuclease 9 (CRISPR/Cas9) offers a robust approach for genome manipulation, particularly in cancer therapy. Given its high expression in triple-negative breast cancer (TNBC), targeting survivin with CRISPR/Cas9 holds promise as a therapeutic strategy. The aim of this study was to design specific single guide ribonucleic acid (sgRNA) for CRISPR/Cas9 to permanently knock out the survivin gene, exploring its potential as a therapeutic approach in breast cancer while addressing potential off-target effects. Survivin gene knockout was conducted in the TNBC cell line BT549. Intron 1, exon 2, and intron 2 of the survivin gene were selected as sgRNA targets. These sgRNAs were designed in silico and then cloned into a CRISPR/Cas9 expression plasmid. The cleavage activity was assessed using an enhanced green fluorescent protein (EGFP) expression plasmid. The sgRNAs with higher cleavage activity were selected for the establishment of knockout cells. After transfecting the plasmid into the cells, the success of the survivin gene knockout was validated at the deoxyribonucleic acid (DNA) level using polymerase chain reaction (PCR) and sequencing analysis, and at the protein expression level using Western blotting. The study found that sgRNAs survin1A (targeting intron 1), survex2A (targeting intron 2), and survin2A (targeting intron 2) demonstrated higher cleavage activities compared to the other sgRNAs. However, using the single sgRNA, survex2A did not generate mutations in the survivin gene. At the protein level, survivin was still expressed, indicating that a single sgRNA was ineffective in knocking out the survivin gene. In contrast, the combination of sgRNA survin1A and sgRNA survin2A was more effective in generating mutations in the survivin gene, resulting in the deletion of the entire exon 2 and leading to a loss of survivin protein expression. In conclusion, our work provides specific sgRNAs and demonstrates the utilization of dual sgRNAs strategy in the CRISPR/Cas9 technology to knock out the survivin gene, showing potential in breast cancer therapy
Common intestinal parasitic infections in an improved water access, sanitation, and hygiene profile setting in North Jakarta, Indonesia
Get PDFIntestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children. A cross-sectional study involving 338 school-age children in an urban slum area in North Jakarta, Indonesia, was conducted using stool specimens subjected to microscopic and real-time polymerase chain reaction (rt-PCR) examination. The children underwent a finger-prick blood test and anthropometric measurements to determine anemia and nutritional status. Parents whose children participated in stool and blood examinations were interviewed using a modified WASH questionnaire. Helminth infections were not found in this study, whereas the overall prevalence of intestinal protozoa parasitic infection (IPPI) was 18.3% and 52.4% by microscopy and rt-PCR, respectively. Blastocystis spp. was found to have the highest prevalence (microscopy: 12%; rt-PCR: 48.6%), followed by Giardia intestinalis (microscopy: 0.6%; rt-PCR: 6.7%), Cryptosporidium spp. (microscopy: 5.1%; rt-PCR: 1.6%), and Entamoeba histolytica/dispar (microscopy: 0.6%; rt-PCR: 3.2%). Additionally, Dientamoeba fragilis was detected by rt-PCR at 4.1%. Furthermore, the discrepancies between microscopy and rt-PCR were observed in 8.9% (n=28) of the examined specimens. The majority of the respondents had a low-risk category of WASH profile. School children aged 5–10 years old (OR=2.06; 95%CI=1.27–3.33) and those who drank unprocessed cooking water (OR=1.95; 95%CI=1.07–3.57) were significantly associated with IPPI. The present study demonstrated that rt-PCR provides a better understanding of IPI epidemiology and has potential as a monitoring strategy for managing IPIs. Even though this population exhibits an adequate WASH profile and is not directly associated with IPIs, conducting a more in-depth observation of WASH facilities and practices is recommended to ensure a comprehensive assessment of the WASH profile. Additionally, engaging stakeholders in health promotion programs to ensure the sustainability of a good WASH profile and awareness of parasitic infections will be advantageous in achieving optimal urban health