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Anti-dandruff effects of butterfly pea flowers (Clitoria ternatea)-based shampoo: A pretest-posttest control study
Get PDFButterfly pea flower (Clitoria ternatea) may serve as an alternative anti-dandruff treatment; however, its effects on Malassezia spp. remain unexplored. The aim of this study was to explore the effects of C. ternatea as an herbal-based anti-dandruff treatment on Malassezia spp. DNA expression, plakoglobin levels, IL-8 levels, sebum levels, dandruff severity scores, adverse effects, and patient satisfaction. An experimental study with a pretest-posttest control design was conducted at Outpatient Clinic of Dermatology and Venereology, Arifin Achmad Hospital, Pekanbaru, Indonesia, from November 2023 to January 2024. The flower of C. ternatea was used to formulate the shampoo. The study involved 70 female patients aged 18–25 with dandruff, who were divided into two groups: (a) experimental group using 20% C. ternatea shampoo; and (b) control group using 2% ketoconazole shampoo. The present study found that 2% ketoconazole shampoo significantly reduced Malassezia spp. DNA expression compared to 20% C. ternatea shampooo (Clitoria ternatea: ΔCq=1.76±3.18; ketoconazole: ΔCq=3.77±2.90; p=0.008). No significant difference was observed in plakoglobin levels (C. ternatea: ΔCq=1.98±3.63; ketoconazole: ΔCq=2.50±2.36; p=0.427) or IL-8 levels (C. ternatea: ΔCq=3.46±4.00; ketoconazole: ΔCq=4.16 ± 3.62; p=0.459). C. ternatea significantly reduced sebum levels more than ketoconazole (C. ternatea: 1.16±0.98%; ketoconazole: 0.22±0.38%; p<0.001). Dandruff scores and patient satisfaction were similar for both shampoos (p=0.115 and p=0.336, respectively). Adverse effects were more common in the 2% ketoconazole shampoo group, affecting 21.2% of the patients. In conclusion, 2% ketoconazole shampoo is more effective in reducing Malassezia spp. DNA expression, while 20% C. ternatea shampoo offers better sebum control. Both shampoos are similarly effective in ameliorating dandruff severity and are well-tolerated, with fewer adverse effects reported for C. ternatea
Role of ACE2 and TMPRSS2 polymorphisms on COVID-19 outcome and disease severity in adult patients: A prospective cohort study in a tertiary hospital, Indonesia
Get PDFCoronavirus disease 2019 (COVID-19) has led to a significant number of infections and deaths worldwide, yet its pathogenesis and severity remain incompletely understood. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), play crucial roles as receptors and molecules responsible for the virus's entry into host cells, initiating the infection process. Their polymorphisms have been extensively studied in relation to COVID-19 severity. The aim of this study was to examine the association of ACE2 (rs2074192) and TMPRSS2 (rs12329760) polymorphisms with COVID-19 outcome and severity. A prospective cohort study was conducted in 2022 at Haji Adam Malik Hospital, Medan, Indonesia. We randomly recruited hospitalized adult patients with COVID-19, confirmed by real-time polymerase chain reaction (RT-PCR). The baseline demographic data, disease severity, underlying disease, comorbidities, and COVID-19 vaccination status were collected. The single-nucleotide polymorphism (SNP) was assessed using TaqMan SNP genotyping assay, and the levels of TMPRSS2 and ACE2 proteins were measured using enzyme-linked immunosorbent assay (ELISA). A total of 151 COVID-19 patients were recruited and there were significant associations between age and severity with mortality outcomes. The age, kidney and lung diseases, and vaccination status were associated with severity levels. The results showed the CC genotype of ACE2 had the highest proportion, followed by TT and CT genotypes among patients, while CT was the most prevalent genotype, followed by CC and TT for TMPRSS2. This study did not find a significant association between ACE2 and TMPRSS2 genetic variants with disease severity and outcome but highlighted a specific association of TMPRSS2 SNP with mortality within the group. In addition, ACE2 concentration was significant different between mild-moderate and severe-critical COVID-19 groups (p=0.033)
Global prevalence and potential factors influencing willingness for renal transplantation in end-stage renal disease patients: A systematic review and meta-analysis
Get PDFThe prevalence of willingness to undergo renal transplantation and its potentially associated factors have been documented in multiple prior studies across different regions, yet certain findings are conflicting. The aim of this study was to determine the global prevalence of willingness for renal transplantation and identify its associated factors through meta-analysis methods. Databases such as Scopus, PubMed, and Embase were utilized for the search strategy, covering the period from April to May 2024. Data collection focused on gathering information regarding the prevalence and potential contributing factors of renal transplantation. Statistical analysis involved examining the cumulative prevalence of willingness for renal transplantation using single-arm meta-analysis. Factors associated with willingness for renal transplantation were analyzed using the Mantel–Haenszel test for categorical variables and the inverse variance method for numerical variables. A total of nine articles, covering 3935 patients with end-stage renal disease (ESRD) were included. The pooled estimates revealed that the overall prevalence of willingness to undergo renal transplantation among ESRD patients was 57% (95%CI: 0.46–0.67). Furthermore, we observed a higher likelihood of willingness among men and those of younger age, attainment of at least a bachelor's degree or higher in education, employment status, higher income levels, and a shorter duration of hemodialysis (<5 years). Our study has documented the global prevalence and potential associated factors of willingness to undergo renal transplantation, providing valuable insights for policymakers aiming to enhance the acceptance of renal transplantation
Factors associated with awareness of and undergoing Pap smear tests among Jordanian women
Get PDFSeveral screening methods are used to detect cervical cancer, with Pap smear test is considered as one of the most reliable screening methods to diagnose cervical cancer. The aim of this study was to investigate the factors associated with awareness of undergoing Pap smear tests among Jordanian women. A cross-sectional study was conducted among 525 Jordanian women attending the outpatient maternity hospital consecutively from February to July 2023. Data encompassed demographic characteristics (age, occupation, and education), awareness of Pap smears, beliefs regarding their importance, sources of information, and the history of undergoing Pap smear tests were collected using a structured questionnaire. Of the total 525 Jordanian women, 87.6% were aware of Pap smears. The awareness varied significantly depending on age and education level. Women aged 41–50 (adjusted odds ratio (AOR): 6.0; 95%CI: 2.3–15.3) and with a university education (AOR: 2.6; 95%CI: 1.4–4.8) were associated with increased odds of being aware of Pap smears. Among the women who were aware of Pap smears, the majority (94.1%) expressed belief in the importance of undergoing Pap smear tests and 61.7% reported having undergone the procedure at least once in their lives. In the multivariate analysis, women aged 30–40 years (AOR: 1.7; 95%CI: 1.1–2.8), 41–50 years (AOR: 4.1; 95%CI: 2.3–7.3), and older than 50 years (AOR: 9.8; 95%CI: 4.2–23.0) had a higher likelihood of undergoing Pap smear tests than those of under 30 years old. Being a housewife (AOR: 1.7; 95%CI: 1.1–2.7) and those who believed in the importance of Pap smear testing (AOR: 2.6; 95%CI: 1.1–6.0) were also more likely to have a Pap smear test. Nearly half of the women who had undergone Pap smears reported doing so every 2–3 years, while 25.7% indicated annual screening. Importantly, the overwhelming majority (97.9%) preferred the procedure to be performed by a gynecologist. In conclusion, the majority of women were aware of Pap smears. Two-thirds of women reported having undergone the procedure at least once. Prevention programs targeting cervical cancer and Pap smear tests should be tailored to women with low education, younger than 30 years, and those employed to maximize screening uptake for cervical cancer
Positive correlation between body weight and body mass index with blood pressure in young adults
Get PDFStudy assessing the correlation between body weight and body mass index (BMI) with blood pressure (DBP) in young adults is still limited. The aim of this The aim of the study was to investigate the link between body weight and BMI with blood pressure, as well as how much increasing body weight and BMI contribute to raising blood pressure in young men and women. A cross-sectional study was conducted among 1,107 young adults aged 18–22 years (women, n=705; men, n=402). Chi-squared test was used to assess the association between body weight and BMI with blood pressure. The Pearson correlation and linear regression analysis were used to determine the correlation and direction of the relationship between body weight and BMI with blood presure. Our data indicated associations between body weight and BMI with blood pressure (both had p=0.001). There was a strong significant correlation between body weight and systolic blood pressure (SBP) (r=0.709; p<0.001), whereas the correlation between body weight and diastolic blood pressure (DBP) was moderate (r=0.374; p<0.001). BMI moderately influenced SBP and DBP (r=0.488 and r=0.358; p<0.001). A linear correlation analysis revealed a positive association between body weight, BMI, and blood presure, where an increase in body weight of 1 kg results increase in SBP of 0.725 mmHg and DBP of 0.318 mmHg. In addition, an increase in BMI of 1 kg/m2 followed by an increase in SBP and DBP of 1.6 mmHg and 0.834 mmHg, respectively. This study highlights that nutritional status in young men and women is linked and has a positive correlation with blood pressure
Recent progress in the roles of microRNAs in pulmonary arterial hypertension associated with congenital heart disease
Get PDFResearch on noncoding RNA, particularly microRNAs (miRNAs), is growing rapidly. Advances in genomic technologies have revealed the complex roles of miRNAs in pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD). It has been demonstrated that the progression of PAH associated with CHD is characterized by particular dysregulation of miRNAs and is related to cardiovascular remodeling, cell death, and right ventricle dysfunction. This review provides a comprehensive overview of the current state of knowledge regarding the involvement of miRNAs in the pathogenesis and progression of PAH associated with CHD. We commence by explaining the process of miRNA synthesis and its mode of action, as well as the role of miRNA in PAH associated with CHD. Moreover, the article delves into current breakthroughs in research, potential clinical implications, and prospects for future investigations. The review provides the insight into novel approaches for diagnosis, prognosis, and therapy of PAH associated with CHD
Association between chest X-ray score and clinical outcome in COVID-19 patients: A study on modified radiographic assessment of lung edema score (mRALE) in Indonesia
Get PDFRadiological examinations such as chest X-rays (CXR) play a crucial role in the early diagnosis and determining disease severity in coronavirus disease 2019 (COVID-19). Various CXR scoring systems have been developed to quantitively assess lung abnormalities in COVID-19 patients, including CXR modified radiographic assessment of lung edema (mRALE). The aim of this study was to determine the relationship between mRALE scores and clinical outcome (mortality), as well as to identify the correlation between mRALE score and the severity of hypoxia (PaO2/FiO2 ratio). A retrospective cohort study was conducted among hospitalized COVID-19 patients at Dr. Soetomo General Academic Hospital Surabaya, Indonesia, from February to April 2022. All CXR data at initial admission were scored using the mRALE scoring system, and the clinical outcomes at the end of hospitalization were recorded. Of the total 178 COVID-19 patients, 62.9% survived after completing the treatment. Patients within non-survived had significantly higher quick sequential organ failure assessment (qSOFA) score (p<0.001), lower PaO2/FiO2 ratio (p=0.004), and higher blood urea nitrogen (p<0.001), serum creatinine (p<0.008) and serum glutamic oxaloacetic transaminase (p=0.001) levels. There was a significant relationship between mRALE score and clinical outcome (survived vs deceased) (p=0.024; contingency coefficient of 0.184); and mRALE score of ≥2.5 served as a risk factor for mortality among COVID-19 patients (relative risk of 1.624). There was a significant negative correlation between the mRALE score and PaO2/FiO2 ratio based on the Spearman correlation test (r=-0.346; p<0.001). The findings highlight that the initial mRALE score may serve as an independent predictor of mortality among hospitalized COVID-19 patients as well as proves its potential prognostic role in the management of COVID-19
Relationship between blood lead (Pb) concentration with risk of diabetes mellitus in women living in mining area
Get PDFDiabetes is a global health concern with significant implications for individuals and societies. Diabetes results from a complex interaction between genes and environmental factors, including metal exposure. Lead or plumbum (Pb) is a heavy metal pollutant and is predicted to be associated with the morbidity of diabetes. The aim of this study was to assess the relationship between blood Pb level and possible risk factors (body mass index insulin resistance, carbohydrate intake, sugar intake, and physical activity) with fasting blood sugar (FBS) level in women living in the mining area. A cross-sectional study was conducted in a mining area of Indonesia located in Pemali District, Bangka Belitung Regency, involving women aged 30–49, selected through purposive sampling. Logistic regression was used to assess the relationship between the risk factors and FBS level, while the Spearman correlation was used to analyze the correlations between the risk factors and FBS level. Our data indicated that blood Pb concentration and other risk factors (carbohydrate intake, sugar intake and physical activity) were neither associated nor correlated with FBS level. However, as predicted, insulin resistance was associated with FBS level with OR: 9.66; 95%CI: 1.13–82.29; p=0.038. In addition, the Homeostatic Model Assessment Insulin Resistance (HOMA-IR) score was also correlated with FBS level (r=0.316, p=0.002). This study highlights the level of Pb is not associated with the risk of diabetes in women living in mining area
Neutrophil-to-lymphocyte ratio as a predictor of low cardiac output syndrome after open heart surgery in children with congenital heart disease
Get PDFNeutrophil-to-lymphocyte ratio (NLR) as a predictor in determining low cardiac output syndrome (LCOS) has not been widely reported. The aim of this study was to explore the role of pre-surgery, 0-, 4-, and 8-hour post-surgery NLR as predictors of LCOS incidence after open heart surgery in children with congenital heart disease (CHD). This study used a prognostic test with a prospective cohort design and was conducted from December 2020 until June 2021 at the cardiac intensive care unit (CICU) of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The subject consisted of children aged one month to 18 years who underwent open heart surgery using a cardiopulmonary bypass (CPB) machine. A receiver operating characteristic curve was applied to identify the predictive performance of NLR for poor outcomes (LCOS incidence). Out of 90 patients included in the study, 25 (27.8%) of them developed LCOS between 3 to 53 hours post-surgery. All NLR values (pre-surgery and 0-, 4-, and 8-hours post-surgery) were associated with the incidence of LCOS. Pre-surgery NLR (cut-off value ≥0.88) had a fair predictive value (area under curve (AUC) 70; 95%CI: 57–83) for predicting LCOS incidence with sensitivity and specificity of 64% and 64.62%, respectively. NLR 0-hour post-surgery (cut-off value ≥4.73) had a good predictive value (AUC 81; 95%CI: 69–94) for predicting LCOS incidence, with 80% sensitivity and 80% specificity. NLR 4- and 8-hours post-surgery had very good predictive values (AUC 97%; 95%CI: 92–100 and 98; 95%CI: 94–100, respectively), with cut-off values ≥6.19 and ≥6.78, had the same 92% sensitivity and the same 96% sensitivity. The presence of LCOS was associated with mortality (odds ratio of 5.11 with 95%CI: 3.09–8.46). This study highlights that pre-surgery, 0-, 4-, and 8-hours post-surgery NLR can be predictors of LCOS after open heart surgery in children with CHD
Comparison of leptin and estrone levels between normal body mass index and obese menopausal women
Get PDFPostmenopausal women often experience hormonal changes and shifts in fat composition, affecting weight gain and obesity. Understanding the link between hormones, especially estrogen and leptin, is key to managing weight and lowering disease risk in menopausal women. The aim of this study was to compare the levels of leptin and estrone in menopausal women with normal weight and obesity. A cross-sectional study was conducted on menopausal women, either normal body mass index (BMI) or obese, at H. Adam Malik General Hospital, Medan, Indonesia. Blood samples were collected to measure leptin and estrone levels using the enzyme-linked immunosorbent assay (ELISA) method. The differences in leptin levels between groups were analyzed using the Wilcoxon test, while the correlation between BMI and leptin was examined using the Pearson correlation test. The disparity in estrone levels in both groups was analyzed using the Mann-Whitney test and the correlations between variables were assessed using the Spearman or Pearson correlation tests as appropriate. The mean leptin levels in normal BMI and obesity groups were 17.73±4.96 and 25.46±12.95 ng/mL, respectively, and were statistically different (p=0.006). The mean estrone levels in menopausal women with normal BMI and obesity were 943.23±391.79 and 851.38±282.23 ng/mol, respectively and were not statistically different (p=0.564). A significant positive correlation was found between BMI and leptin level (r=0.59; p<0.001), while BMI and estrone were not significantly correlated (r=0.083; p=0.559). In conclusion, leptin level was significantly different between BMI groups and had a strong positive correlation with BMI. This finding could be an important insight in body weight management and disease risk prevention in menopausal women