Narra J (Journal)
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Physical exercise and chicken egg white supplementation increase muscle mass of stable COPD patients
Get PDFPatients with chronic obstructive pulmonary disease (COPD) commonly exhibit muscle atrophy and dysfunction due to a reduction in muscle mass; and protein supplements such as chicken egg whites have been reported to improve muscle mass. The aim of this study was to evaluate the impact of physical exercise and egg white supplementation on the muscle mass of COPD patients. An experimental study was conducted among stable COPD patients at Universitas Sumatra Utara Hospital Medan, Indonesia, between August and October 2022. The patients were divided into two groups, control and interventional groups, with each patient subjected to a pre- and post-muscle mass assessment. All the patients performed respiratory endurance and upper extremity muscle strength training three times/week for a total of 12 weeks. In addition, the patients in the intervention group were also given egg white supplementation (10 eggs/day) during the period of intervention in addition to the physical training. The Wilcoxon and Mann-Whitney tests were performed to identify the significance of the difference between pre- and post-intervention and between the control and intervention groups, respectively. A total of 38 COPD patients were included in the study, 19 from each group. Our data suggested no significant difference in muscle mass of the patients in the control group before and after 12 weeks of physical exercise (pre-intervention 27.37±4.54% and post-intervention 27.68±4.5% with p=0.174). However, there was a significant muscle mass increment of patients in the intervention group upon 12 weeks of physical training and egg white supplementation (pre-intervention 27.18±4.15%, post-intervention 29.95±3.76%, p<0.001). A significant difference in muscle mass was observed between patients in the control and the intervention groups (p=0.046) after the intervention. The study highlights that physical exercise in combination with egg white supplementation may serve as potential and effective non-pharmacological treatment for muscle mass restoration in COPD patients as compared to physical exercise alone
Hemostatic and liver function parameters as COVID-19 severity markers
Get PDFCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease newly discovered in December 2019 which affects coagulation cascade and liver functions. The aim of this study was to investigate the potential of hemostatic and liver function parameters as severity markers in COVID-19 patients. This study was an observational analytic with cohort retrospective design using total sampling method. Data were retrieved from medical record of COVID-19 patients admitted to provincial hospital in Banda Aceh, Indonesia from March 2020 to March 2022. There were 1208 data eligible for the study after applying certain criteria. Mann–Whitney, logistic regression, and receiving operating characteristic (ROC) analyses were used to analysis the data. Thrombocyte count (p<0.001), prothrombin time (p<0.001), activated partial thromboplastin time (p<0.001), D-dimer (p<0.001), fibrinogen (p<0.001), aspartate aminotransferase (p<0.001), and alanine transaminase (p<0.001) significantly increased in severe compared to mild COVID-19 patients. After being adjusted, age (odds ratio (OR); 1.026 (95% confidence interval (CI): 1.016–1.037) was the most significant factor in predicting COVID-19 severity. Fibrinogen (cut-off 526.5 mg/L) was the best parameter associated with COVID-19 severity with 70% sensitivity and 66.4% specificity. Meanwhile, D-dimer (cut-off 805 ng/mL) had a sensitivity of 72.3% and specificity of 66.4%. Combining the parameters resulted in improved sensitivity to 82.0% with a slight decline of specificity to 65.5%. In conclusion, fibrinogen and D-dimer level on admission could be used as biomarkers in predicting COVID-19 prognosis. Routine monitoring and evaluation of laboratory testing especially D-dimer and fibrinogen could be implemented in order to reduce morbidity and mortality rate of COVID-19
Online educational intervention: Improving maternal knowledge and attitudes in providing developmental stimulation for stunting toddlers
Get PDFStunting remains a significant public health concern, impacting physical growth and impeding children's development. Mothers, who play a crucial role in stimulating children's development, often encounter barriers in providing effective stimulation, primarily due to limited access to appropriate resources and information. Online education can bridge this gap by offering easily accessible learning. This aim of this study was to determine the effect of online education on maternal knowledge and attitudes in providing developmental stimulation for stunting toddlers. A quasi-experimental research design was employed, comprising a treatment group and a control group, each consisting of 46 mothers with stunting toddlers, sampled purposively. The treatment group received an online developmental stimulation educational intervention through WhatsApp groups for twelve meetings, each lasting 1.5 to 2 hours. Meanwhile, the control group participated in a stunting assistance program provided by the community health centers (Puskesmas). To compare the knowledge and attitudes between groups, Mann-Whitney and independent Student t-test were used. The assessment of intervention effects on knowledge and attitudes was conducted using Wilcoxon and paired Student t-test within each group. Following the educational intervention on developmental stimulation, there was a significant increase in knowledge; however, there was no significant difference in attitudes. The treatment group (mean score 3.9±1.76) had a higher increase in knowledge scores compared to the control group (2.0±2.25) with a p<0.001. Nonetheless, no significant difference in attitudes was observed between the two groups with the mean change scores was 5.8±15.31 in treatment group and 2.5±18.69 for control group, with a p=0.335. This study suggests that providing online education leads to increased knowledge scores but does not impact attitudes significantly. Additional educational approaches should be considered to enhance maternal attitudes
Fatigue in healthcare workers with mild COVID-19 survivors in Indonesia
Get PDFPersistent symptoms after the coronavirus disease 2019 (COVID-19, known as post-COVID syndrome (PCS), presented an ongoing health burden among COVID-19 survivors, including health workers. The existence of fatigue in mild COVID-19 survivors has not been widely reported. The aim of this study was to present the symptoms of fatigue in healthcare workers who experienced mild COVID-19 and the factors associated with fatigue. A cross-sectional study was conducted at H. Adam Malik General Hospital in Medan, Indonesia, from September to December 2022, included doctors, nurses, ancillary workers, and medical support workers who experienced mild COVID-19. Fatigue was measured by a fatigue assessment scale (FAS). The assessed possible risk factors were gender, age, vaccination history, comorbid, presence of PCS, duration of PCS symptoms, and number of PCS symptoms. The chi-squared or Fisher’s exact test was used to assess the association between the incidence of fatigue and risk factors. A total of 100 healthcare workers of mild COVID-19 survivors were included. Most of them were nurses (58%), women (81%), and aged 19−30 years old (36%). The majority had incomplete vaccination history (64%), experienced PCS (71%), no comorbidities (61%), and experienced <3 months of PCS symptoms (55%). Mild to moderate fatigue was found in 23% of healthcare workers and only 1% experienced severe fatigue. No significant association was found between gender, vaccination history, and comorbidities with the incidence of fatigue. However, a significant association was observed between age (p=0.021), the presence of PCS (p=0.041), and the number of PCS symptoms (p=0.047) with fatigue incidence. Furthermore, there were significant associations between symptoms of PCS (confusion (p=0.004), insomnia (p=0.001), myalgia (p=0.035), arthralgia (p=0.028), throat pain (p=0.042), headache (p=0.042), and chest pain (p=0.011)) with fatigue. These findings can contribute to providing the necessary support for mild COVID-19 survivors and persistent fatigue
Role of stress and physical activity on primary dysmenorrhea: A cross-sectional study
Get PDFThe initial physiological change in adolescent girls is the onset of menstruation. The most prevalent challenge they face regarding menstruation is primary dysmenorrhea, characterized by persistent or intermittent pelvic pain in the lower abdomen. The aim of this study was to investigate the influences of stress levels and physical activities on primary dysmenorrhea. A cross-sectional was conducted in Cirebon, Indonesia, in 2023 included young women who had never given birth (nullipara), aged 17–25 years old, had menstruated, and had no history of smoking and alcohol. The data were collected using a set of questionnaires consisting of the Numeric Rating Scale (NRS) to determine primary dysmenorrhea pain, the Depression Anxiety Stress Scales 42 (DASS 42) to determine the level of stress and the International Physical Activity Questionnaire (IPAQ) to determine physical activity. Pearson's correlation test was used to assess the correlation between the variables (stress levels, physical activity, and dysmenorrhea). A total of 150 young women were included in the study. Moderate stress levels (23.3%) and high physical activity (90.7%) were the most prevalent categories observed among studied participants. Approximately 42% of them experienced mild dysmenorrhea pain. Our analysis indicated that stress levels and physical activities had strong positive correlations with dysmenorrhea pain levels, with r=0.782 and r=0.748, respectively, with both had p<0.001. This highlights that controlling stress could be beneficial in preventing dysmenorrhea pain among young women
Effectiveness of ERKADUTA model to increase stunting prevention behaviors among mothers with toddlers in Indonesia: A quasi-experiment
Get PDFStunting, a persistent nutritional issue arising from prolonged inadequate nutrient intake, poses substantial risks such as heightened morbidity, mortality, and compromised cognitive, psychomotor, and verbal development. In Indonesia, addressing stunting in children under two necessitates urgent community empowerment, given its multifaceted nature. The aim of this study was to assess the effects of an intervention targeting mothers of toddlers, called RT kawal baduta (ERKADUTA) model, a local community-based assistance for babies under two years old. A quasi-experiment using pre-test and post-test with a control group design was conducted. Employing a quantitative analytic approach with 112 respondents, the effectiveness of ERKADUTA model to improve the knowledge, attitude, and practice of stunting prevention among mothers with child under two years old was assessed. ERKADUTA program was run for three months. The Wilcoxon test was used to determine score changes before and after program in both groups, while the Mann-Whitney test was used to analyze the score differences of knowledge, attitude and practice between intervention and control groups. Our data indicated that there were changes in knowledge, attitudes, and practices in preventing stunting in both the intervention and control groups. There are significant differences in knowledge (p<0.001, effect size=-0.855), attitude (p<0.001, effect size=-0.864), and practice score (p<0.001, effect size=-0.924) between the intervention and control groups after the intervention. This study highlights that the ERKADUTA model emerged as a potent catalyst in improving stunting prevention behaviors among mothers with toddlers and this model holds promise for addressing the complexities of stunting in Indonesia
Role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in diagnosing neonatal sepsis
Get PDFClinical manifestations of neonatal sepsis are often unspecified. Therefore, sepsis biomarkers could be used to support diagnosis while waiting for blood culture results, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). The aim of this study was to evaluate the role of NLR and PLR as diagnostic markers in neonatal sepsis. A cross-sectional study was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, from April to October 2019. This study included neonates aged less than 28 days, diagnosed with suspected sepsis, and had no previous history of antibiotics administration. Patients underwent clinical assessment, laboratory examination, and blood culture. Patients were grouped into sepsis and non-sepsis based on the blood culture results. The median hematological examination and the range of NLR and PLR in both the sepsis and non-sepsis groups were subjected to analysis using the Mann-Whitney U test to assess differences. NLR and PLR optimal cut-off values were determined using a receiver operator curve (ROC) with a confidence interval of 95%. A total of 137 neonates were enrolled, of which 49 were classified as sepsis and 89 as non-sepsis based on blood culture results. The optimal cutoff values for NLR and PLR were 2.75 and 11.73. Using those cutoff values, NLR and PLR could predict neonatal sepsis with sensitivities of 52.1% and 47.9%, specificities of 50.6% and 47.2%, area under the curve (AUC) of 0.46 and 0.47, with p=0.525 and p=0.662, respectively. Further investigation is warranted to refine the NLR and PLR utility and enhance diagnostic accuracy in clinical practices
Optimizing antimicrobial synergy: Green synthesis of silver nanoparticles from Calotropis gigantea leaves enhanced by patchouli oil
Get PDFSilver nanoparticles (AgNPs) synthesized from plant extracts have gained attention for their potential applications in biomedicine. Calotropis gigantea has been utilized to synthesize AgNPs, called AgNPs-LCg, and exhibit antibacterial activities against both Gram-positive and Gram-negative bacteria as well as antifungal. However, further enhancement of their antimicrobial properties is needed. The aim of this study was to synthesize AgNPs-LCg and to enhance their antimicrobial and antifungal activities through a hybrid green synthesis reaction using patchouli oil (PO), as well as to characterize the synthesized AgNPs-LCg. Optimization was conducted using the response surface method (RSM) with a central composite design (CCD). AgNPs-LCg were synthesized under optimal conditions and hybridized with different forms of PO—crude, distillation wastewater (hydrolate), and heavy and light fractions—resulting in PO-AgNPs-LCg, PH-AgNPs-LCg, LP-AgNPs-LCg, and HP-AgNPs-LCg, respectively. The samples were then tested for their antibacterial (both Gram-positive and Gram-negative bacteria) and antifungal activities. Our data indicated that all samples, including those with distillation wastewater, had enhanced antimicrobial activity. HP-AgNPs-LCg, however, had the highest efficacy; therefore, only HP-AgNPs-LCg proceeded to the characterization stage for comparison with AgNPs-LCg. UV-Vis spectrophotometry indicated surface plasmon resonance (SPR) peaks at 400 nm for AgNPs-LCg and 360 nm for HP-AgNPs-LCg. The Fourier-transform infrared spectroscopy (FTIR) analysis confirmed the presence of O-H, N-H, and C-H groups in C. gigantea extract and AgNP samples. The smallest AgNPs-LCg were 56 nm, indicating successful RSM optimization. Scanning electron microscopy (SEM) analysis revealed spherical AgNPs-LCg and primarily cubic HP-AgNPs-LCg, with energy-dispersive X-ray spectroscopy (EDX) confirming silver's predominance. This study demonstrated that PO in any form significantly enhances the antimicrobial properties of AgNPs-LCg. The findings pave the way for the exploration of enhanced and environmentally sustainable antimicrobial agents, capitalizing on the natural resources found in Aceh Province, Indonesia
Immunoexpression of aortic endothelial P-selectin and serum apolipoprotein A-1 levels after administration of arabica (Coffea arabica) and robusta (Coffea canephora) coffee bean extracts: In vivo study in atherosclerosis rat model
Get PDFAtherosclerosis is a leading cause of cardiovascular disease-related death worldwide. Some studies suggested that the natural ingredients in coffee may negatively affect cardiovascular diseases, while other studies indicated that coffee contains anti-inflammatory compounds that are beneficial for cardiovascular diseases. The aim of this study was to measure the expression of P-selectin in aortic endothelial cells and the level of serum apolipoprotein A-1 (ApoA-1) in an atherosclerosis rat model after the administration of arabica and robusta coffee bean extracts at mild-moderate and high doses. An experimental study was conducted with a complete randomized design using 36 adult male white rats (Rattus norvegicus) divided into six groups: negative control (NC), positive control (PC), arabica mild-moderate dose (A1), arabica high dose (A2), robusta mild-moderate dose (R1), and robusta high dose (R2). Animals were induced atherosclerosis with atherogenic feed and then were treated with arabica and robusta coffee bean extracts at two different doses for four weeks. The results showed that the expression of P-selectin in the group of rats treated with robusta coffee bean extract was lower than arabica coffee bean extract group. Rats with robusta coffee bean extract mild-moderate dose had the highest ApoA-1 levels compared to other groups significantly (p<0.05). The level of ApoA-1 was higher in both mild-moderate and high dose of robusta coffee groups compared to the negative control group (both with p<0.001). In conclusion, mild-moderate intake of robusta coffee bean extract could reduce aortic P-selectin immunoexpression and increase serum ApoA-1 levels in an atherosclerosis rat model
New zeolite-based composite pads with high-volume blood absorption for early warning of postpartum hemorrhage
Get PDFMedical treatment of severe blood loss during labor is crucial, and the early warning indicator of postpartum hemorrhage (PPH) is essential for labor medical treatment. Measurement of blood loss conventionally looks dirty, reluctant, and less hygienic since some of the blood might be spilled out in the maternity bed, while commercially existing pads have low blood absorption capacity. A new design composite pad composed of absorbent materials including cellulose rayon, super absorbent polymer (SAP), and zeolite was fabricated and characterized. The SAP and zeolite show properties as crystalline and amorphous materials, respectively. The surface area of natural zeolite was 19.79 (m2/g). The newly fabricated composite pad showed a high blood absorption capacity (>500–600 mL) with a blood absorption rate of 55.56–85.84 mL/min (depending on the blood volume), showing better performance as compared to the commercial pads. These characteristics suggest that the new composite pad could function not only as a sanitary pad but also as an early warning indicator for PPH if the rate and blood volume reach the dangerous category (≥600 mL or at ≥13 mL/min rate)