Narra J (Journal)
Not a member yet
500 research outputs found
Sort by
Low-intensity aerobic cycle ergometer effects on lung function of myasthenia gravis patients: A randomized controlled trial
Get PDFPatients with generalized myasthenia gravis (MG) often show restrictive spirometry results. Although regular exercise and physical fitness are linked to better respiratory function, there is limited research assessing the effects of aerobic exercise on lung function in MG patients. The aim of this study was to analyze the effect of low-intensity aerobic exercise using a cycle ergometer on lung function parameters in MG patients. A randomized controlled trial with pre- and post-test was conducted at the Medical Rehabilitation Outpatient Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, in 2023. MG patients classified as I−IIb based on the Myasthenia Gravis Foundation of America (MGFA) classification were recruited and randomly divided into treatment and control groups. The treatment group was given low-intensity aerobic exercise using a cycle ergometer, education on lifestyle changes, and breathing exercises (deep and pursed lip breathing). Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume ratio (FEVR), were then measured. Measurements were conducted before and after eight weeks of low-intensity aerobic cycle ergometer exercise and compared with those of a control group. A total of 17 MG patients were included in this study. The results showed a significant increase in FVC in the treatment group (p=0.003), whereas no significant change in the control group (p=0.068). A significant increase in FEV1 was observed both in the treatment (p=0.029) and the control group (p=0.016). There was no improvement in FEVR in either group. After the intervention, significant differences were observed in FVC (p=0.009) and FEV1 (p=0.029) between the treatment and control groups. There was no significant difference in FEVR values after the intervention between both groups (p=0.491). In conclusion, eight weeks of low-intensity aerobic cycle ergometer exercise led to significant improvements in FVC and FEV1 among MG patients
Burden of rheumatic diseases among people with diabetes: A systematic review and meta-analysis
Get PDFDiabetes mellitus type 2 (DM2) is a prevalent metabolic condition affecting over 500 million people globally and associated with serious comorbidities, including various rheumatologic conditions. Some studies have reported a significant association between rheumatological conditions and DM2. However, the global burden of rheumatological conditions among people with DM2 remains unknown. The aim of this study was to assess the cumulative prevalence of rheumatological conditions in DM2 patients. An extensive electronic search was conducted utilizing multiple databases of studies published until January 2024. The quality of the studies included in the review was evaluated using a modified version of the Newcastle-Ottawa Scale (NOS). The overall quality of the studies included was rated as moderate. The review included a total of 13 studies, with 830,649 DM2 patients reported to have rheumatological conditions. Eleven studies were used to determine the individual results of rheumatoid arthritis (RA), gout, and osteoarthritis (OA). The pooled prevalence of OA was 26% (95%CI: 19–32%) and the prediction interval ranged from 6% to 51%. The pooled prevalence of gout disease was 1% (95%CI: 0.0–5.0%), and the prediction interval ranged from 0% to 99%. For RA, the combined prevalence was 0.3% (95%CI: 0.2–0.5%) and the prediction interval ranged from 0% to 5%. In conclusion, this review suggests a considerable prevalence of OA among DM2 patients, while the prevalence of RA and gout was minimal. Early diagnosis and management of certain rheumatologic conditions in individuals with DM2 may help improve health outcomes and prevent premature mortality. Further research is warranted to explore and understand the mechanisms underlying the association between DM2 and rheumatological conditions
Meta-analysis of the effectiveness of educational programs about HIV prevention on knowledge, attitude, and behavior among adolescents
Get PDFThe prevalence of human immunodeficiency virus (HIV) among adolescents is on the rise due to a lack of comprehensive knowledge, leading to suboptimal attitudes and behaviors, which emphasizes the critical need for targeted interventions. The aim of this review study was to evaluate the effectiveness of educational interventions for HIV prevention among adolescents by assessing their impact on knowledge, attitude, and behavior. A systematic review of seven databases: PubMed, Science Direct, Cochrane, JSTOR, Embase, Scopus, and EBSCO were identified, and 14 eligible randomized controlled trials published until June 2023 were included. Two independent authors assessed quality appraisal using the Risk of Bias 2.0. Outcomes were measured using the standard mean difference (SMD) with random effects model and a 95% confidence interval. Subgroup analyses and meta-regression were performed to explore heterogeneity. The results showed significant improvements in participants' knowledge (SMD: 1.13, 95%CI: 0.78–1.49), behavior intentions (SMD: 1.22, 95%CI: 0.37–2.07), and attitude (SMD: 0.48, 95%CI: 0.02–0.95) after receiving HIV prevention education programs. Interventions grounded in theoretical principles and incorporating technology, group settings, and audio-visual aids were found to be effective in enhancing knowledge of HIV prevention and promoting behavioral intentions. Peer-led education positively impacted both knowledge and attitude. Moreover, excluding parents from these programs was identified as a crucial factor in improving adolescents' knowledge of HIV prevention. In conclusion, educational programs focused on HIV effectively enhance adolescents' knowledge, attitudes, and behavioral intentions among adolescents. Professionals planning interventions should consider these impactful components in designing comprehensive strategies
Bibliometric top ten healthcare-related ChatGPT publications in the first ChatGPT anniversary
Get PDFSince its public release on November 30, 2022, ChatGPT has shown promising potential in diverse healthcare applications despite ethical challenges, privacy issues, and possible biases. The aim of this study was to identify and assess the most influential publications in the field of ChatGPT utility in healthcare using bibliometric analysis. The study employed an advanced search on three databases, Scopus, Web of Science, and Google Scholar, to identify ChatGPT-related records in healthcare education, research, and practice between November 27 and 30, 2023. The ranking was based on the retrieved citation count in each database. The additional alternative metrics that were evaluated included (1) Semantic Scholar highly influential citations, (2) PlumX captures, (3) PlumX mentions, (4) PlumX social media and (5) Altmetric Attention Scores (AASs). A total of 22 unique records published in 17 different scientific journals from 14 different publishers were identified in the three databases. Only two publications were in the top 10 list across the three databases. Variable publication types were identified, with the most common being editorial/commentary publications (n=8/22, 36.4%). Nine of the 22 records had corresponding authors affiliated with institutions in the United States (40.9%). The range of citation count varied per database, with the highest range identified in Google Scholar (1019–121), followed by Scopus (242–88), and Web of Science (171–23). Google Scholar citations were correlated significantly with the following metrics: Semantic Scholar highly influential citations (Spearman’s correlation coefficient ρ=0.840, p<0.001), PlumX captures (ρ=0.831, p<0.001), PlumX mentions (ρ=0.609, p=0.004), and AASs (ρ=0.542, p=0.009). In conclusion, despite several acknowledged limitations, this study showed the evolving landscape of ChatGPT utility in healthcare. There is an urgent need for collaborative initiatives by all stakeholders involved to establish guidelines for ethical, transparent, and responsible use of ChatGPT in healthcare. The study revealed the correlation between citations and alternative metrics, highlighting its usefulness as a supplement to gauge the impact of publications, even in a rapidly growing research field
Potential of ant nest extract (Hydnophytum formicarum) for protection of testicular morphometry, epididymal functions, and sperm quality in male rats with alloxan-induced diabetes
Get PDFMedicinal herbs, such as the ant nest plant (Hydnophytum formicarum), are promising for the management of diabetes mellitus-associated infertility. The aim of this study was to evaluate the biological activity of the ant nest plant and its capacity to mitigate the adverse effects of alloxan-induced diabetes on testicular morphology, epididymal function, and sperm quality in male rats. The tuber of the ant nest plant was extracted using methanol and then subjected to phytochemical screenings. For the experiment, 20 male white rats (Rattus norvegicus), aged 3–4 months and weighing 150–200 g, were equally divided into four groups. The ant nest extract was administered orally using oral gavage over 14 days. The testes, epididymis, and sperm were collected for weighing, morphometric measurements, and quality evaluation. Qualitative testing of phytochemical compounds indicated the presence of flavonoids, tannins, steroids, terpenoids, and phenolic compounds in the plants. The results revealed the protective effects of ant nest extract against the adverse fertility effects induced by alloxan and a high-fat diet, as observed in testicular weight (p=0.045), epididymal weight (p=0.041), and sperm quality (p>0.05)
Diagnostic accuracy of GeneXpert in the diagnosis of spinal tuberculosis: A systematic review and meta-analysis
Get PDFTuberculosis remains a significant global health issue, with spinal tuberculosis being a severe form of extrapulmonary tuberculosis. Despite the high morbidity associated with spinal tuberculosis, effective and rapid diagnostic methods are limited. The aim of this study was to evaluate the diagnostic accuracy of the GeneXpert compared to other microbiological methods in diagnosing spinal tuberculosis. A systematic review and meta-analysis were conducted following the PRISMA guidelines. Six databases (PubMed, Scopus, EBSCO, EMBASE, ScienceDirect, and Cochrane Central) were searched for relevant studies as of August 31, 2023. Studies were selected based on predefined inclusion criteria, focusing on patients diagnosed with spinal tuberculosis and comparing GeneXpert to microbiological culture, acid-fast bacilli (AFB) staining, and polymerase chain reaction (PCR). Two authors independently performed data extraction and quality assessment, and the meta-analysis was conducted using Meta-DiSc 2.0. Fourteen studies comprising retrospective cohort, prospective cohort, and cross-sectional designs were included. GeneXpert demonstrated a pooled sensitivity of 92% (85–96%) and specificity of 71% (51–86%) compared to culture. AFB smear had the highest specificity at 80% (70–88%) but the lowest sensitivity at 27% (20–35%). The PCR had sensitivity and specificity of 83% (67–92%) and 58% (31–81%), respectively. Substantial heterogeneity was noted across the studies. This study highlighted that GeneXpert had high sensitivity and moderate specificity in diagnosing spinal tuberculosis, making it an alternative to conventional methods. However, further validation through larger, interventional studies is necessary to standardize its use in clinical practice
Relationship between neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with the severity of COVID-19
Get PDFCoronavirus disease 2019 (COVID-19) is an infectious disease that spreads rapidly causing a high case fatality rate in vulnerable populations. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are known to be inflammatory biomarkers in certain infections. The aim of this study was to determine the relationship between NLR and PLR with the severity of COVID-19. A cross-sectional study was conducted at Tabanan Regency General Hospital, Bali, Indonesia, from January 2021 to December 2022. All patients included in the study tested positive for COVID-19 by real-time polymerase chain reaction (RT-PCR), aged 18–50 years with no comorbid. Laboratory examinations were carried out on admission. The patients were categorized into two groups based on the severity: moderate and severe/critical. The Mann-Whitney test was used to determine the association between NLR and PLR with the severity of COVID-19. A total of 104 patients were included in the study, the majority of COVID-19 patients had moderate (77.9%) severity. The average NLR was 5.8 and the PLR was 21.7. There was a significant relationship between NLR (p=0.002) and PLR (p=0.001) with the severity of COVID-19. The defined cut-off values of NLR and PLR were ≥3.8 and ≥106, yielding sensitivities of 95% and 70%, and specificities of 74% and 50%, respectively. This study highlights the promising role of NLR and PLR as predictive biomarkers to assess COVID-19 severity
Antifungal activity of Durio zibethinus Murray peel extract against Candida albicans: A preliminary study
Get PDFThe incidence of antifungal resistance to Candida albicans infections has been growing over the past years; therefore, innovations are required to develop medicinal plants with antifungal properties such as durian fruit peels (Durio zibethinus Murray) that contain significant of bioactive compounds with antifungal properties. The aim of this study was to determine the antifungal activity of D. zibethinus fruit peel extract against C. albicans by analyzing the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). A post-test only control group experiment was conducted from July to October 2020. D. zibethinus peel was collected from Simalungun Regency, Medan, Indonesia, and extracted by maceration technique using 70% ethanol to obtain D. zibethinus peel ethanol extract (DPEE). Samples of C. albicans were obtained from the Laboratory of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. The diffusion method was used to determine the antifungal activity. Six groups with different concentrations of DPEE (6.25%, 12.5%, 25%, and 50%), ketoconazole (positive control) and dimethyl sulfoxide (negative control) were exposed to C. albicans in six replicates. Six lower concentrations (12.5%, 6.25%, 3.12%, 3%, 1.56%, and 0.78%) were divided to perform the liquid dilution method to obtain the MIC and affirmation test for MBC. The diameter of the inhibition zone was analyzed using one-way ANOVA and the Tukey post-hoc test for differences between concentrations. Our data indicated that the DPEE 6.25% had the largest inhibition zone (17.26±5.64 mm) and the inhibition zones were significant different among concentrations of DPEE (p<0.05). Furthermore, the DPEE had a MIC of 0.78% and MBC of 3.125% against C. albicans. This study highlights that the ethanol extract of D. zibethinus has potential antifungal activity against C. albicans. However, a further study is needed to determine its antifungal activities in more precise manner
Effect of face masks on dyspnea perception, cardiopulmonary parameters, and facial temperature in healthy adults
Get PDFRespiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study's main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures
Autosomal dominant polycystic kidney disease (ADPKD) with multiple complications: Management challenges
Get PDFAutosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary polycystic kidney disease characterized by renal enlargement, resulting in renal failure. In Indonesia, the exact prevalence of ADPKD is unknown due to limited reports on the disease. The aim of this study was to report a case of a patient with ADPKD with multiple complications. A 54-year-old male presented to the emergency room of Dr. Soetomo Academic General Hospital, Surabaya, Indonesia, with a chief complaint of dark-red-colored urine for one week. There was a progressive abdominal enlargement over the past five years, which had become more tense and rigid for the past one month. The patient had a history of fatigue and hypertension with routine follow-up. Physical examination on admission showed normal vital signs, and the abdominal assessment revealed a palpable hard mass approximately 4 cm in size in the right upper abdomen. Laboratory test indicated anemia, leukocytosis, lymphopenia, proteinuria, hematuria, leukocyturia, and elevated serum creatinine and urea levels. Abdominal imaging using ultrasonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) revealed bilateral kidney and liver enlargement containing multiple cysts, suggesting polycystic kidney and liver disease. There was a ruptured cyst in the middle of the left kidney pole with minimal ascites found in the CT scan. The MRI exhibited the presence of multiple cysts in both kidneys, partially filled with blood. The patient was diagnosed with ADPKD, gross hematuria, acute or chronic kidney disease (CKD), urinary tract infection (UTI), normochromic-normocytic anemia, and metabolic acidosis. Dietary control with high-calorie, high-protein, and low-salt diet; fluid balance; and other symptomatic medications were initiated. It is critical to be aware of risk factors associated with the rapid progression of ADPKD in order to be able to provide a favorable impact on the disease prevention and management