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Meta-analysis of the effectiveness of educational programs about HIV prevention on knowledge, attitude, and behavior among adolescents 关于预防艾滋病教育计划对青少年知识、态度和行为的影响的元分析
Pub Date : 2024-07-22 DOI: 10.52225/narra.v4i2.870
Diah Ratnawati, Mega H. Huda, Muhammad A. Mukminin, Widyatuti Widyatuti, Agus Setiawan
The 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.
由于缺乏全面的知识,人类免疫缺陷病毒(HIV)在青少年中的流行率呈上升趋势,导致青少年的态度和行为不尽人意,这就强调了采取有针对性的干预措施的迫切需要。本综述研究旨在通过评估教育干预措施对青少年的知识、态度和行为的影响,来评价其预防艾滋病的效果。本研究对七个数据库进行了系统回顾:通过对 PubMed、Science Direct、Cochrane、JSTOR、Embase、Scopus 和 EBSCO 七大数据库的系统性检索,共纳入了 14 项截至 2023 年 6 月发表的符合条件的随机对照试验。两位独立作者使用 Risk of Bias 2.0 进行了质量评估。研究结果采用随机效应模型的标准平均差(SMD)和95%置信区间进行测量。为探讨异质性,进行了分组分析和元回归。结果显示,在接受艾滋病预防教育项目后,参与者的知识(SMD:1.13,95%CI:0.78-1.49)、行为意向(SMD:1.22,95%CI:0.37-2.07)和态度(SMD:0.48,95%CI:0.02-0.95)均有明显改善。研究发现,以理论原则为基础并结合技术、小组环境和视听辅助手段的干预措施能有效提高人们对艾滋病预防知识的了解,并促进行为意向的形成。同伴教育对知识和态度都有积极影响。此外,将家长排除在这些项目之外被认为是提高青少年艾滋病预防知识的关键因素。总之,以艾滋病为重点的教育项目能有效提高青少年的知识、态度和行为意向。规划干预措施的专业人员在设计综合策略时应考虑到这些影响因素。
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引用次数: 0
New zeolite-based composite pads with high-volume blood absorption for early warning of postpartum hemorrhage 新型沸石基复合垫吸血量大,可用于产后出血早期预警
Pub Date : 2024-07-18 DOI: 10.52225/narra.v4i2.835
Sulastri Sulastri, T. Siregar, Muhammad Adlim, H. Hasanuddin, Muktaridha Muktaridha
Medical 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).
分娩过程中严重失血的医疗处理至关重要,而产后出血(PPH)的早期预警指标对分娩医疗处理至关重要。传统的失血测量方法看起来很脏、很不情愿,而且由于部分血液可能会溢出产床而不太卫生,而市面上现有的血垫吸血能力较低。我们制作并鉴定了一种由纤维素人造丝、超强吸水聚合物(SAP)和沸石等吸水材料组成的新型设计复合垫。SAP 和沸石分别具有晶体和非晶体材料的特性。天然沸石的表面积为 19.79(m2/g)。新制成的复合垫具有很高的吸血能力(>500-600 mL),吸血速率为 55.56-85.84 mL/min(取决于血量),与商用垫相比性能更好。这些特性表明,新型复合垫不仅可以作为卫生垫使用,而且在吸血率和血量达到危险类别(≥600 mL 或吸血率≥13 mL/min)时,还可以作为 PPH 的预警指标。
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引用次数: 0
Global prevalence and determinants associated with the acceptance of monkeypox vaccination 猴痘疫苗接种在全球的流行情况及相关决定因素
Pub Date : 2024-07-17 DOI: 10.52225/narra.v4i2.866
Dewi Indiastari, Jhonny K. Fajar, Fredo Tamara, Odis Runesi, Lukman N. Hakim, Kusnul Chotimah, Alinda Rahmani, Teguh D. Saputro, Dian Afrilla, Ervin Firmansyah, Daniel Dau, V. Dzhyvak
Assessing the acceptance of the monkeypox vaccine is crucial for the success of vaccination programs, yet the prevalence reports remain inconclusive. The aim of this study was to determine the global prevalence of monkeypox vaccine acceptance and identify its associated factors. A meta-analysis was conducted with a comprehensive search strategy on the following databases, including Scopus, Embase, and PubMed, for articles published up to April 5, 2024. This study utilizes a single-arm meta-analysis to calculate the pooled prevalence of monkeypox vaccine acceptance. A Z-test was employed to identify factors associated with the vaccine acceptance. Our study analyzed 51 articles encompassing 98,746 participants, revealing an overall monkeypox vaccine acceptance rate of 65%. Notably, the highest acceptance rates were observed among men who have sex with men (MSMs), while healthcare workers (HCWs) showed the lowest acceptance rates. Additionally, our findings indicated an increased acceptance in individuals with educational attainment beyond a bachelor’s degree, a history of COVID-19 and influenza vaccination, homosexual orientation, and HIV-positive status. Conversely, lower acceptance risk was associated with those with educational attainment below a bachelor's degree, heterosexual orientation, and bisexual orientation. In conclusion, our current study has determined the rate of monkeypox vaccine acceptance and identified its associated factors. These findings offer valuable insights as the foundation for targeted policies to manage and increase acceptance rates.
评估对猴痘疫苗的接受程度对于疫苗接种计划的成功与否至关重要,但有关接种率的报告仍无定论。本研究旨在确定猴痘疫苗的全球接受率,并找出其相关因素。本研究采用荟萃分析的方法,在Scopus、Embase和PubMed等数据库中对截至2024年4月5日发表的文章进行了全面检索。本研究采用单臂荟萃分析法计算猴痘疫苗接受率。采用Z检验来确定与疫苗接受度相关的因素。我们的研究分析了51篇文章,涉及98746名参与者,结果显示猴痘疫苗的总体接受率为65%。值得注意的是,男男性行为者(MSMs)的接受率最高,而医护人员(HCWs)的接受率最低。此外,我们的研究结果表明,受教育程度超过学士学位、有 COVID-19 和流感疫苗接种史、同性恋取向和 HIV 阳性的人对疫苗的接受度更高。相反,教育程度低于学士学位、异性恋倾向和双性恋倾向者的接受风险较低。总之,我们目前的研究确定了猴痘疫苗的接受率,并找出了其相关因素。这些发现为制定有针对性的政策以管理和提高接受率提供了宝贵的依据。
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引用次数: 0
Effect of black garlic (Allium sativum) on gonadosomatic index, follicle-stimulating hormone level and spermatozoa quality: A study in monosodium glutamate-exposed rat model 黑蒜(Allium sativum)对性腺指数、卵泡刺激素水平和精子质量的影响:谷氨酸钠暴露大鼠模型研究
Pub Date : 2024-07-17 DOI: 10.52225/narra.v4i2.617
I. I. Bani, Zulkarnain Zulkarnain, G. Gholib, Dedy Syahrizal, T. P. Nugraha, Akmal Ramadhan, Muslim Akmal, Nora Maulina
Infertility rates have risen significantly, one of which is due to monosodium glutamate (MSG) consumption. Recent studies have shown that flavonoids in black garlic (Allium sativum) act as antioxidants. The aim of this study was to assess the effect of black garlic extract (BGE) on gonadosomatic index, follicle-stimulating hormone (FSH) levels, and spermatozoa quality in rats exposed to MSG. Twenty-five healthy rats, aged ten to twelve weeks, were divided equally into five experimental groups: (1) negative control (NC), no intervention; (2) positive control (PC), fed with MSG 8 mg/kg; and (3) fed with MSG + BGE 200 mg/kg; (4) fed with MSG + BGE 400 mg/kg; and (5) fed with MSG + BGE 600 mg/kg. Oral MSG was administered once a day for two weeks before BGE administration was started for two weeks. The measured endpoints were gonadosomatic index, FSH levels, and spermatozoa concentration and quality (spermatozoa motility and abnormality). Analysis of variance (ANOVA) followed by Duncan's post hoc analysis was used to assess the measurement differences. The result suggested that the administration of BGE did not significantly affect the gonadosomatic index (p=0.513). Significant decreases in FSH levels (p=0.005) and spermatozoa concentration were observed in the PC group compared to other groups (p<0.001). Additionally, spermatozoa motility was significantly lower in the PC group compared to NC, BGE200, BGE400, and BGE600 (p<0.001), with higher motility noted in BGE200, BGE400, and BGE600 compared to PC (p<0.001). Furthermore, PC had significantly higher spermatozoa abnormalities compared to NC, BGE200, BGE400, and BGE600 (p<0.001). In conclusion, administration of BGE had a significant effect on the improvement of FSH levels and the quality of spermatozoa in rats exposed to MSG.
不孕不育率大幅上升,其中一个原因就是食用味精。最近的研究表明,黑蒜(Allium sativum)中的类黄酮具有抗氧化作用。本研究旨在评估黑蒜提取物(BGE)对暴露于味精的大鼠的性腺指数、卵泡刺激素(FSH)水平和精子质量的影响。25 只健康大鼠(10 至 12 周龄)被平均分为五个实验组:(1) 阴性对照组(NC),无干预措施;(2) 阳性对照组(PC),喂食味精 8 毫克/千克;(3) 喂食味精 + BGE 200 毫克/千克;(4) 喂食味精 + BGE 400 毫克/千克;(5) 喂食味精 + BGE 600 毫克/千克。每天口服一次味精,连续两周,然后开始服用 BGE,连续两周。测量终点为性腺指数、FSH水平、精子浓度和质量(精子活力和畸形率)。采用方差分析(ANOVA)和邓肯事后分析来评估测量差异。结果表明,服用 BGE 对性腺指数没有明显影响(P=0.513)。与其他组相比,PC 组的 FSH 水平(p=0.005)和精子浓度明显下降(p<0.001)。此外,与 NC、BGE200、BGE400 和 BGE600 相比,PC 组的精子活力明显降低(p<0.001),与 PC 相比,BGE200、BGE400 和 BGE600 的精子活力更高(p<0.001)。此外,与 NC、BGE200、BGE400 和 BGE600 相比,PC 的精子畸形率明显更高(p<0.001)。总之,服用 BGE 对改善暴露于味精的大鼠的 FSH 水平和精子质量有明显作用。
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引用次数: 0
Role of digital education through smartphones in improving knowledge among asthma patients: A preliminary study 通过智能手机开展数字教育对提高哮喘患者知识水平的作用:初步研究
Pub Date : 2024-07-16 DOI: 10.52225/narra.v4i2.657
Indah TS. Pohan, A. P. Tarigan, P. Pandia, Erna Mutiara
Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.
哮喘是一种慢性气道炎症性疾病,是印度尼西亚十大发病和死亡原因之一,因此需要采取有效的管理策略。本研究旨在评估使用 "Paru Sehat "智能手机应用进行数字教育前后哮喘知识水平的变化。印度尼西亚棉兰市苏门答腊大学医院门诊部在三个月内对 18 岁以上的哮喘患者进行了一项采用前后测试设计的准实验研究。患者在安装 "Paru Sehat "应用程序之前填写了哮喘患者知识问卷(PAKQ),以确定基线知识。患者每周会收到一次提醒,提醒他们获取有关哮喘概述、峰值流量计使用、用药差异和管理技巧的资料。干预四周后,使用 PAKQ 对参与者的知识进行重新评估。采用配对学生 t 检验或 Wilcoxon 检验对数据进行分析,以评估知识的提高情况。结果显示,哮喘常识、哮喘诱发因素和哮喘诊断方面的知识都有所增长,每个领域的中位数得分都提高了一分(p=0.003、p=0.001 和 p=0.002)。哮喘管理领域的变化最大,中位数增加了两分(p<0.001)。总分平均增加了 5 分(p<0.001),表明患者对哮喘知识的整体了解有所提高。Paru Sehat "应用程序在提高多个领域的哮喘知识方面表现出了巨大的潜力。我们有必要开展进一步研究,探索该应用在不同人群和环境中的长期有效性,最终为改善哮喘管理和患者预后做出贡献。
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引用次数: 0
Remedial effects of Formula-100 therapeutic milk and Bregas Nutriroll ready-to-use therapeutic food on Indonesian children with severe acute malnutrition: A randomized controlled trial study Formula-100食疗奶和Bregas Nutriroll即食食疗食品对印度尼西亚严重急性营养不良儿童的补救效果:随机对照试验研究
Pub Date : 2024-07-15 DOI: 10.52225/narra.v4i2.846
Anwar Lubis, Hadi Riyadi, A. Khomsan, R. Rimbawan, Indhira Shagti
Severe acute malnutrition (SAM) is a global health concern that affects children and leads to delayed growth. The aim of this study was to compare the impact of F100 milk and Bregas Nutriroll, a local ready-to-use therapeutic food (RUTF), on SAM children. An unmasked, non-blinded, two-group, and simple randomized controlled trial was conducted. Indonesian children aged 12–59 months with SAM were randomly assigned to receive either F100 milk or Bregas Nutriroll. After eight weeks, the increase in the mean weight gain in both groups was assessed. The Bregas Nutriroll group (n=19) had a mean weight gain of 1.07±0.09 kg, while the F100 group (n=17) had a mean weight gain of 1.05±0.11 kg. The Bregas Nutriroll group had a slightly higher gain of mid-upper arm circumference (MUAC) than the F100 group (0.62±0.34 cm vs 0.50±0.37 cm). The gain of children’s height of the Bregas Nutriroll group was 0.96±0.42 cm, while the F100 group was shorter at a mean of 0.81±0.44 cm. Statistically significant differences (p<0.001) in nutritional status were observed based on weight, MUAC, and height/length after F100 and Bregas Nutriroll interventions. The intervention with F100 increased hemoglobin (Hb) levels of 0.71±1.25 mg/dL, while the Bregas Nutriroll intervention led to an increase of 0.11±1.39 mg/dL. In conclusion, our study showed that community-based treatment with F100 milk or Bregas Nutriroll resulted in nutritional status in children with SAM. These findings suggested that both treatments could be effective in treating SAM in improving nutritional status and child health outcomes.
严重急性营养不良(SAM)是一个全球关注的健康问题,它影响儿童并导致生长发育迟缓。本研究旨在比较 F100 牛奶和 Bregas Nutriroll(一种当地即食食疗食品)对严重急性营养不良儿童的影响。该研究进行了一项无掩蔽、非盲法、两组和简单随机对照试验。印度尼西亚 12-59 个月大的 SAM 儿童被随机分配接受 F100 牛奶或 Bregas Nutriroll。八周后,对两组儿童的平均体重增长情况进行评估。Bregas Nutriroll 组(19 人)的平均增重为 1.07±0.09 公斤,而 F100 组(17 人)的平均增重为 1.05±0.11 公斤。Bregas Nutriroll 组的中上臂围(MUAC)增长略高于 F100 组(0.62±0.34 厘米对 0.50±0.37 厘米)。Bregas Nutriroll 组儿童身高的平均增长为 0.96±0.42 厘米,而 F100 组儿童身高的平均增长为 0.81±0.44 厘米。根据 F100 和 Bregas Nutriroll 干预后的体重、MUAC 和身高/身长,可以观察到营养状况有明显的统计学差异(p<0.001)。F100 干预疗法使血红蛋白(Hb)水平提高了 0.71±1.25 mg/dL,而 Bregas Nutriroll 干预疗法使血红蛋白水平提高了 0.11±1.39 mg/dL。总之,我们的研究表明,使用 F100 牛奶或 Bregas Nutriroll 进行社区治疗可改善 SAM 儿童的营养状况。这些研究结果表明,这两种治疗方法都能有效治疗 SAM,改善营养状况和儿童健康状况。
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引用次数: 0
Perindopril and losartan affect ACE-2 and IL-6 expression in obese rat model 培哚普利和洛沙坦影响肥胖大鼠模型中 ACE-2 和 IL-6 的表达
Pub Date : 2024-07-15 DOI: 10.52225/narra.v4i2.681
Andrianto Andrianto, H. Hermawan, P. M. Harsoyo, B. S. Zaini, A. R. Muhammad
Obesity has emerged as a worldwide health concern due to its increasing prevalence. Adipocytes have the ability to express angiotensin-converting enzyme 2 receptors (ACE2) and several adipocytokines. These expressions could lead to the activation of a cytokine storm, which in turn promotes the development of cardiovascular diseases. The aim of this study was to investigate the impact of perindopril and losartan exposure on the ACE2 and interleukin 6 (IL-6) levels in adipocyte cells. This study used an in vivo true experimental design utilizing a post-test-only control group. A total of 24 adult male albino rats were divided into four groups, one group served as the non-obese (negative control), while the other three groups were obese: (1) the positive control (untreated obese rats); (2) perindopril group (2 mg/kg BW/day orally for 4 weeks); and (3) losartan group (20 mg/kg BW/day for 4 weeks). Afterwards, the rats were euthanized, and the visceral fat tissue were obtained during dissection. The levels of ACE2 and IL-6 were measured using the enzyme-linked immunosorbent assay (ELISA). Losartan administration in obese rats resulted in a notable elevation in ACE2 levels compared to both the perindopril group (losartan vs perindopril, p=0.011) and the positive control (p=0.004). In addition, the treatment of perindopril and losartan in obese rats resulted in a significant reduction in IL-6 levels when compared to the positive control (perindopril vs positive control, p=0.020; losartan vs positive control, p=0.002, respectively). This study provides insight into the administration of perindopril and losartan, which could suppress the pro-inflammatory (IL-6) but increase the ACE2 levels in adipose tissue.
由于肥胖症的发病率越来越高,肥胖症已成为全球关注的健康问题。脂肪细胞能够表达血管紧张素转换酶 2 受体(ACE2)和多种脂肪细胞因子。这些表达可导致细胞因子风暴的激活,进而促进心血管疾病的发展。本研究旨在探讨培哚普利和洛沙坦暴露对脂肪细胞中 ACE2 和白细胞介素 6(IL-6)水平的影响。本研究采用体内真实实验设计,只设试验后对照组。共将 24 只成年雄性白化大鼠分为四组,一组为非肥胖组(阴性对照组),其余三组为肥胖组:(1) 阳性对照组(未经治疗的肥胖大鼠);(2) 培哚普利组(2 毫克/千克体重/天,口服 4 周);(3) 洛沙坦组(20 毫克/千克体重/天,口服 4 周)。随后,对大鼠实施安乐死,并在解剖过程中获取内脏脂肪组织。采用酶联免疫吸附试验(ELISA)测定 ACE2 和 IL-6 的水平。与培哚普利组(洛沙坦与培哚普利相比,p=0.011)和阳性对照组(p=0.004)相比,肥胖大鼠服用洛沙坦会导致 ACE2 水平显著升高。此外,与阳性对照组相比,肥胖大鼠接受培哚普利和洛沙坦治疗后,IL-6 水平显著降低(培哚普利与阳性对照组相比,p=0.020;洛沙坦与阳性对照组相比,p=0.002)。这项研究深入探讨了服用培哚普利和洛沙坦可抑制促炎物质(IL-6)但增加脂肪组织中 ACE2 水平的问题。
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引用次数: 0
Role of pediatric risk of mortality (PRISM IV) score at 24 and 72 hours of hospitalization in predicting mortality among critically ill pediatric patients treated in PICU 住院 24 小时和 72 小时时的儿科死亡风险(PRISM IV)评分对预测在重症监护病房接受治疗的儿科重症患者死亡率的作用
Pub Date : 2024-07-12 DOI: 10.52225/narra.v4i2.780
A. D. Lubis, B. B. Nasution, A. Lubis, Kelvin Supriami
Pediatric patients with multiple organ failures in the pediatric intensive care unit (PICU) are at a higher risk of mortality. Assessing the mortality risk when patients are admitted to PICU is important to allocate treatment and care properly. The aim of this study was to compare the performance of the PRISM IV score within the first 24 and 72 hours to predict mortality in the PICU. Demographic, clinical, and laboratory data were collected to compute the PRISM IV in the first 24 and 72 hours among critically ill pediatric patients in the PICU at H. Adam Malik General Hospital, Medan, Indonesia, from April 2021 to February 2022. The comparison of the PRISM IV scores and its components within the first 24 and 72 hours was analyzed using the Wilcoxon test, Student’s independent t-test or McNemar test.  The role of PRISM IV score in predicting mortality was assessed using the receiver operating characteristic (ROC) curve. Out of 35 pediatric patients, 17 (48.6%) of them died. Platelet count (p=0.022), pCO2 (p=0.026), HCO3 (p=0.009), total CO2 (p=0.015), and base excess (p=0.001) were statistically different between 24 and 72 hours groups. The area under curve (AUC) for the first 24 hours using PRISM IV scores was 47.4% with p=0.792 (95%CI, 27.7%–67.1%). Meanwhile, the AUC of 72 hours group was 65.4%, p=0.121 (95%CI, 47.1%–83.6%). This study suggested that PRISM IV scores in the first 24 and 72 hours may not be a reliable screening tool for predicting mortality. However, further studies are suggested to validate these findings.
在儿科重症监护室(PICU)中,患有多器官功能衰竭的儿科患者的死亡风险较高。在患者入住 PICU 时评估其死亡风险对于合理分配治疗和护理非常重要。本研究旨在比较 PRISM IV 评分在最初 24 小时和 72 小时内预测 PICU 死亡率的性能。2021 年 4 月至 2022 年 2 月期间,印度尼西亚棉兰市 H. Adam Malik 综合医院收集了 PICU 重症儿科患者的人口统计学、临床和实验室数据,以计算前 24 小时和 72 小时的 PRISM IV 评分。PRISM IV评分及其组成部分在最初24小时和72小时内的比较采用Wilcoxon检验、学生独立t检验或McNemar检验进行分析。 PRISM IV评分在预测死亡率方面的作用采用接收者操作特征曲线(ROC)进行评估。在 35 名儿科患者中,17 人(48.6%)死亡。血小板计数(p=0.022)、pCO2(p=0.026)、HCO3(p=0.009)、总二氧化碳(p=0.015)和碱过量(p=0.001)在 24 小时组和 72 小时组之间存在统计学差异。前 24 小时使用 PRISM IV 评分的曲线下面积(AUC)为 47.4%,p=0.792(95%CI,27.7%-67.1%)。同时,72 小时组的 AUC 为 65.4%,p=0.121(95%CI,47.1%-83.6%)。这项研究表明,PRISM IV 在最初 24 小时和 72 小时的评分可能不是预测死亡率的可靠筛查工具。不过,建议进一步研究以验证这些发现。
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引用次数: 0
Comprehensive management of Mayer-Rokitansky-Küster-Hauser syndrome management: A case report Mayer-Rokitansky-Küster-Hauser 综合征的综合治疗:病例报告
Pub Date : 2024-07-09 DOI: 10.52225/narra.v4i2.755
Sanskar Mishra, Bhagyesh Sapkale, Shreya Singh, Asha Jha, Kamlesh Chaudhari
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also known as Müllerian aplasia, is a congenital condition characterized by uterine and upper vaginal aplasia. It affects females with a normal female karyotype and typical secondary sex characteristics. The aim of this case report was to highlight the multidisciplinary management approach for MRKH syndrome, focusing on tailored interventions to address physical and psychological challenges and improve reproductive prospects. A 26-year-old married female presented to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, India in January 2023 with primary amenorrhea. Physical examination revealed a blind vagina and a hypoplastic uterus, indicative of MRKH syndrome. Further evaluation, including pelvic magnetic resonance imaging (MRI), confirmed Müllerian duct abnormalities and bilateral ovarian anomalies. The absence of a functional vagina significantly impacted the patient's quality of life, leading to difficulties with sexual intercourse and emotional distress related to infertility. A collaborative approach involving a gynecologist and a psychiatrist at AVBRH was initiated to address these challenges. The patient underwent vaginoplasty to create a neovagina, enhancing the sexual function and intimate relationship with the spouse. However, due to the hypoplastic uterus, achieving motherhood through traditional means was not possible. Therefore, assisted reproductive techniques, in particular surrogacy, were explored. Normal, functional ovaries were harvested from the patient for use in surrogacy procedures. This comprehensive management strategy exemplifies the challenges associated with MRKH syndrome and underscores the importance of tailored interventions and long-term follow-up. The case highlights the significance of collaborative care in improving the quality of life and reproductive prospects for individuals with MRKH syndrome.
Mayer-Rokitansky-Küster-Hauser(MRKH)综合征又称穆勒氏腺增生症,是一种以子宫和阴道上部增生为特征的先天性疾病。患者为女性,具有正常女性核型和典型的第二性征。本病例报告旨在强调 MRKH 综合征的多学科管理方法,重点是采取有针对性的干预措施,以应对生理和心理挑战,改善生殖前景。2023 年 1 月,一名 26 岁的已婚女性因原发性闭经来到印度沃达省 Sawangi 的 Acharya Vinoba Bhave 乡村医院(AVBRH)就诊。体格检查发现她有一个盲阴道和一个发育不良的子宫,这表明她患有 MRKH 综合征。进一步的评估,包括盆腔磁共振成像(MRI),证实了缪勒管异常和双侧卵巢异常。功能性阴道的缺失严重影响了患者的生活质量,导致性交困难和与不孕有关的情绪困扰。为了应对这些挑战,中美房车医院的妇科医生和精神科医生开始合作治疗。患者接受了阴道成形术,形成了一个新阴道,增强了性功能和与配偶的亲密关系。然而,由于子宫发育不良,通过传统方式做母亲是不可能的。因此,他们开始探索辅助生殖技术,特别是代孕。从患者身上摘取了功能正常的卵巢,用于代孕手术。这一综合管理策略体现了与 MRKH 综合征相关的挑战,强调了有针对性的干预和长期随访的重要性。该病例强调了合作护理在改善 MRKH 综合征患者生活质量和生殖前景方面的重要意义。
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引用次数: 0
Metabolism and diabetes in Ramadan fasting: Exploring health trends and relationships through systematic literature network analysis 斋月斋戒中的新陈代谢与糖尿病:通过系统文献网络分析探索健康趋势和关系
Pub Date : 2024-07-09 DOI: 10.52225/narra.v4i2.850
Baharuddin Baharuddin, Adi Wijaya
Ramadan fasting is widely acknowledged for its positive impacts on health, yet it also presents inherent risks, prompting a need for comprehensive exploration into its metabolic implications and its effects on diabetes. This study introduces a novel methodology called systematic literature network analysis (SLNA), which merges bibliometric analysis with systematic literature review (SLR). The aim of this study was to examine the global research landscape concerning Ramadan fasting, metabolism, and diabetes. Through the systematic search strategy, 206 relevant documents were analyzed. Through co-occurrence analysis mapping, the study uncovered four distinct cluster groups, revealing intricate relationships and evolving trends within the field. Moreover, the trajectory of research publications on Ramadan fasting from 2001 to 2023 was tracked, highlighting a growing interest in this domain. The bibliometric analysis emphasized a consensus regarding the beneficial effects of Ramadan fasting on individual health, particularly in improving lipid profiles, managing body weight, regulating glucose levels, and nutrient intake. However, significant variations in research focus were observed across predominantly Muslim countries, with notable exceptions like Indonesia and Brunei Darussalam absent among the top contributors. Furthermore, the analysis shed light on the balanced selection of research subjects by authors, indicating a nuanced approach to exploring the multifaceted aspects of Ramadan fasting, metabolism, and diabetes. These findings offer significant perspectives for researchers aiming to contextualize their studies within the wider conversation on this subject, thereby aiding in a more profound comprehension of the intricate relationship between fasting, metabolic functions, and the management of diabetes.
斋月斋戒对健康的积极影响已得到广泛认可,但它也存在固有的风险,因此需要对其代谢影响及其对糖尿病的影响进行全面探讨。本研究引入了一种名为系统文献网络分析(SLNA)的新方法,该方法将文献计量分析与系统文献综述(SLR)相结合。本研究旨在考察全球有关斋月禁食、新陈代谢和糖尿病的研究情况。通过系统检索策略,分析了 206 篇相关文献。通过共现分析图谱,研究发现了四个不同的群组,揭示了该领域内错综复杂的关系和不断变化的趋势。此外,研究还追踪了 2001 年至 2023 年有关斋月禁食的研究出版物的发展轨迹,凸显了人们对这一领域日益增长的兴趣。文献计量分析强调了斋月斋戒对个人健康有益影响的共识,尤其是在改善血脂状况、控制体重、调节血糖水平和营养摄入方面。然而,在穆斯林占主导地位的国家中,研究重点存在明显差异,印尼和文莱达鲁萨兰国等明显例外的国家不在研究贡献最多的国家之列。此外,分析还揭示了作者对研究对象的均衡选择,表明他们在探索斋月斋戒、新陈代谢和糖尿病的多方面问题时采用了细致入微的方法。这些研究结果为研究人员提供了重要的视角,使他们能够将自己的研究与这一主题更广泛的对话结合起来,从而有助于更深刻地理解斋戒、代谢功能和糖尿病管理之间错综复杂的关系。
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引用次数: 0
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