Narra J (Journal)
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A comparison study of headache characteristics and headache-associated quality-of-life of COVID-19 and non-COVID-19 patients
Get PDFHeadache is prevalent in coronavirus disease 2019 (COVID-19) patients. The main objective of this study was to compare the characteristics of COVID-19-associated headache to non-COVID-19 headache. The quality-of-life (QoL) and its associated determinants between COVID-19 and non-COVID-19 patients were also compared. A cross-sectional study was conducted in Banda Aceh, Indonesia. Headache and QoL were assessed using the International Classification of Headache Disorders, version 3 (ICHD-3), and the 36-item Short Form Health Survey (SF-36), respectively. Factors associated with poor QoL in COVID-19 and non-COVID-19 patients were examined using logistic regression. A total of 356 headache patients were included: 215 COVID-19 and 141 non-COVID-19 patients. Our data suggested that the headache in COVID-19 patients was bilateral; pain centered on one specific area with a pulsating or pressing sensation; pain intensity ranging from moderate to severe; and the frequency ranging from more than twice per week to every day. Non-COVID-19 headache was bilateral; pain centered on one side of the head resembling a migraine with pulsating or pressing sensation; mild to moderate pain intensity; and the frequency of one or two times per month. In COVID-19, low QoL was associated with unemployment status, having non-health-related jobs, having used painkillers to reduce the pain, having long duration of headache, having more frequency of attacks, and having headaches that were worsened by activities or light, and having additional symptom during a headache attach. In non-COVID-19 patients, poor QoL was associated with the use of painkillers, long duration of headache, and having conditions that aggravate the headache. To prevent long-term effects of headache associated with COVID-19, studies exploring the photobiology of headache are needed, along with the necessity of having standardised guideline on headache prevention
Genetic, antimicrobial resistance profile and mortality rates of Acinetobacter baumannii infection in Brazil: A systematic review
Get PDFThe increase of multidrug-resistant bacteria - including Acinetobacter baumannii (A. baumannii) - has been reported globally. The aim of this systematic review was to determine the risk factors of A. baumannii infection, its resistance profile, reservoirs and mortality rates in Brazil. Data from over 3,000 patients were included. Results suggested that A. baumannii is widely transmitted in Brazil and the endemic clones ST1, ST15, ST 25, ST79, ST162 and ST730 were the most reported; also, blaOXA23, blaOXA51 and blaOXA143 were common resistant genes. The risk factors for A. baumannii infectionincluded the procedure of using invasive devices, previous antibiotic therapy, hemodialysis, comorbidities and higher scores on the Sequential Organ Failure Assessment (SOFA). Two out of five studies identified multidrug resistant A. baumannii to polymyxin. Mortality rates varied between 43.7% to 81%, except for the ST25 strain in which there was a 100% mortality rate. Mortality was associated with sepsis, respiratory infection, septic shock, old age (>60 years) and administration of norepinephrine. Nonetheless, this review highlights the need for more data on A. baumannii infectionacross Brazil to support public policies aiming to control and prevent the dissemination of this bacteria
Challenges on tuberculosis care in health care facilities during COVID-19 pandemic: Indonesian perspective
Get PDFIndonesia is among the top three countries globally with the highest tuberculosis burden. During the past decades, Indonesian health authorities have struggled to improve tuberculosis care quality in health care facilities by optimizing the regulation and strengthening the private sector contributions. The coronavirus disease 2019 (COVID-19) pandemic has hardly affected the Indonesian health care system, including the National Tuberculosis Control Program. While the end of the COVID-19 pandemic in Indonesia is uncertain, the measure to control tuberculosis must not be weakened. Early identification and measurement of the problem size are essential to decide the most appropriate approach to maintain the sustainability of National Tuberculosis Control Program, particularly in health care facilities during the COVID-19 pandemic. This article points out the possible threats to the sustainability of TB care in Indonesia during the COVID-19 pandemic, including some approaches to overcome those problems
Titer disparity of anti-Spike receptor binding domain SARS-CoV-2 antibody between vaccinated and naturally infected individuals
Get PDFIn conjunction with other health promotion strategies, vaccination of coronavirus disease 2019 (COVID-19) is a strategy to alleviate the burden of infection. The aim of this study was to determine the differences in antibody response strength between individuals who received COVID-19 vaccination and those who had a natural infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A cross-sectional study was conducted among post-natural confirmed COVID-19 infection and immunized people in Bali, Indonesia. The vaccination was using Sinovac-CoronaVac with two-weeks interval between the two vaccine doses. To measure the level of anti-Spike receptor binding domain (SRBD) of SARS-CoV-2 antibody, we used Roche electro-chemiluminescence immunoassay (ECLIA) platform. Blood samples were obtained before and 28 days after first immunization in the vaccinated group, as well as two weeks after hospital discharge in the confirmed COVID-19 patients based on real-time reverse transcription polymerase chain reaction (RT-PCR). A total of 58 confirmed COVID-19 patients and 60 vaccinated individuals were included. On the 28th day after the initial vaccination, the seroconversion rate among vaccinated individuals was 91.67%. The mean titer of anti-SRBD SARS-CoV-2 antibody among vaccinated participants was 63.62±82.57 IU/mL (ranged between 0 IU/mL and 250 IU/mL). The mean titer among naturally infected group was 188.47±94.57 IU/mL (ranged between 4.25 IU/mL to 250 IU/mL) regardless the severity of COVID-19. Our data suggested that the titer of anti-SRBD SARS-CoV-2 antibody was significantly higher in naturally infected individuals compared to those who received COVID-19 vaccination (p<0.001). These data suggest that not all individuals vaccinated with Sinovac COVID-19 had protective level of anti-SRBD SARS-CoV-2 antibody and booster dose of heterologous vaccine maybe required
Giant bronchopleural fistula and empyema in a tuberculosis patient with diabetes mellitus: Vista from a high tuberculosis burden country in Southeast Asia
Get PDFBronchopleural fistula is a pathological tract between the bronchial tree and the pleural space, which can be life-threatening due to tension pneumothorax. It is a rare complication in tuberculosis cases with highly variable in clinical manifestations and persistent air leaks which might lead to complications such as empyema. Herein, we present a tuberculosis and diabetic patient complicated with giant bronchopleural fistula and empyema. A 48-year-old man presented with shortness of breath for two weeks and cough with phlegm for two months. The patient was a smoker with severe Brinkman Index and diabetes. Physical examination revealed hyper resonant percussion and vesicular diminished on the left hemithorax. Laboratory results indicated the patient had anemia, leukocytosis, and hypoalbuminemia. GeneXpert sputum confirmed the presence of Mycobacterium tuberculosis and chest X-ray indicated a collapsed left lung. The patient was diagnosed with left secondary spontaneous pneumothorax, pulmonary tuberculosis, and diabetes. The patient was treated with chest tube drainage and anti-tuberculosis drugs. There was no improvement based on serial chest X-ray, and empyema appeared from the chest tube. CT-scan showed tuberculosis lesion, the collapsed of the left lung and fistula in segments 7-8 inferior lobe. Exploratory thoracostomy was performed, in which a giant bronchopleural fistula was detected and then repaired with BioGlue surgical adhesive. Unfortunately, the thoracostomy led to extensive subcutaneous emphysema and was treated by cervical mediastinotomy. The drainage was unable to be removed, and the patient was discharged with Heimlich-type drainage valves on day 28 of treatment. The empyema fluid was cultured and revealed Staphylococcus haemolyticus. This case highlights that tuberculosis could cause a bronchopleural fistula and empyema may occur secondary to late diagnosis that needs immediate surgery
Acute severe hepatitis of unknown etiology in children: A mini-review
Get PDFThe emergence of acute, severe non hepA–E hepatitis of unknown etiology (ASHUE) has attracted global concern owing to the very young age of the patients and its unknown etiology. Although this condition has been linked to several possible causes, including viral infection, drugs and/or toxin exposure, the exact cause remains unknown; this makes treatment recommendation very difficult. In this review, we summarize recent updates on the clinical manifestations, complemented with laboratory results, case numbers with the global distribution and other epidemiological characteristics, and the possible etiologies. We also provide the proposed actions that could be undertaken to control and prevent further spread of this hepatitis. Since many etiological and pathological aspects of the acute non hepA–E hepatitis remain unclear, further research is needed to minimize the severe impact of this disease
Acceptance and willingness to purchase a hypothetical COVID-19 vaccine in a region under Shariah law: A cross-sectional study in Aceh, Indonesia
Get PDFVaccines are urgently needed to control the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to determine the acceptance of and willingness to purchase a hypothetical COVID-19 vaccine in the general population of Aceh, a holistic Shariah law implementation province in Indonesia. An online cross-sectional study was conducted using a quota sampling technique between 1 to 24 September 2021. To determine hypothetical vaccine acceptance, respondents were asked if they were willing to accept vaccines with combinations of either 50% or 95% effectiveness and either 5% or 20% risk of adverse effects. Willingness to purchase was assessed by asking whether the participants would pay for such vaccines at certain price points. Logistic regression analysis was used to assess the associated determinants. Out of 377 respondents included in the final analysis, 86.5% were willing to accept a COVID-19 vaccine with 95% effectiveness and 5% adverse effects. The acceptance rate dropped to 45.1% if the risk of adverse effects was 20%. Vaccines with 50% effectiveness and 5% adverse effects were acceptable to 42.2% but the acceptance went down to 17.2% if the risk of adverse effects increased to 20%. Multivariate analysis found that men were twice as likely to accept a vaccine with 95% effectiveness and 5% adverse effects compared to females (aOR: 2.01; 95% CI 1.05–3.86). We found that 156/377 (41.3%) of respondents were willing to purchase a COVID-19 vaccine and of these participants 71.1% were willing to pay between Indonesian Rupiah (IDR) 50,000–150,000 (US$ 3.33–10.00). In conclusion, the acceptance rate of a hypothetical COVID-19 vaccine varied based on effectiveness and the risk of adverse effects
Monkeypox: Immune response, vaccination and preventive efforts
Get PDFInfectious threats to humans are continuously emerging. The 2022 worldwide monkeypox outbreak is the latest of these threats with the virus rapidly spreading to 106 countries by the end of September 2022. The burden of the ongoing monkeypox outbreak is manifested by 68,000 cumulative confirmed cases and 26 deaths. Although monkeypox is usually a self-limited disease, patients can suffer from extremely painful skin lesions and complications can occur with reported mortalities. The antigenic similarity between the smallpox virus (variola virus) and monkeypox virus can be utilized to prevent monkeypox using smallpox vaccines; treatment is also based on antivirals initially designed to treat smallpox. However, further studies are needed to fully decipher the immune response to monkeypox virus and the immune evasion mechanisms. In this review we provide an up-to-date discussion of the current state of knowledge regarding monkeypox virus with a special focus on innate immune response, immune evasion mechanisms and vaccination against the virus
Hepatitis E virus in pigs and the environment: An updated review of public health concerns
Get PDFHepatitis E virus (HEV) is an important public health problem and is responsible for both acute and chronic viral hepatitis. Public health implications of HEV are derived from its transmission route, either water-borne or food-borne, and its zoonotic potential. Not only in developing countries, but HEV cases are also found in a high number in developed countries. The spread of HEV to the environment might pollute surface waters, which could act as the source of infection for both humans and animals. Identification of the virus in animal products suggests the circulation of HEV within water and food chains. High seroprevalence and circulation of HEV in livestock, in particular pigs, as well as in environmental samples warrants further investigation into pig markets. HEV virulence in different environments and meat supply chains could shed light on the possible sources of infection in humans and the degree of occupational risk. The purpose of this review is to discuss HEV infections with an emphasis on livestock- and environment-related risk factors, and food-borne, water-borne, and zoonotic transmissions
Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic
Get PDFDiabetes mellitus is a chronic progressive disease affecting the metabolic hormonal system and its prevalence in the elderly population is high. Depression is one of the psychiatric disorders in diabetic patients in particular during the coronavirus disease 2019 (COVID-19) pandemic. People with depression are more susceptible to leading an unhealthy lifestyle; therefore, depression and diabetes have a negative influence on life quality and aggravate complications and symptoms. The aim of this study was to determine the association between depression and hemoglobin A1c (HbA1c) levels in elderly with type 2 diabetes mellitus patients. A cross-sectional study was conducted where a total of 42 diabetic patients from the Puskesmas Belakang Padang, Batam of Indonesia was recruited. The HbA1c level, the main determinant of optimum glycemic control, was measured using ion-exchange high-performance liquid chromatography while the level of depression was assessed using Geriatric Depression Scale-15 (GDS-15). The association between depression and HbA1c levels was analyzed using the chi-squared test. Our study found that that 69% of the elderly with diabetes experienced a depression, classified as mild (40.5%), moderate (21.4%) and severe (7.1%). There were 61.9% of the subjects had poor HbA1c control. Our data suggested that the depression level was associated with HbA1c (p=0.002). In conclusion, there is a significant association between depression and HbA1c levels in the elderly with type 2 diabetes mellitus