F. Yusuf, A. Abubakar, Desi Maghfirah, Mirza Heltomi, C. C. Isitua
Ingestion of corrosive substances is most common in children, while in adults causes more severe damages. Massive ingestion of corrosive substances results in severe damage to the gastrointestinal tract and oropharynx if not treated properly. Corrosive substances with pH<2 or >12 can result in severe esophageal damage with either colliquative (alkaline) or coagulative (acidic) necrosis and, at the same time various gastrointestinal injuries could lead to late post-corrosive complications. The aim of the case study was to report the gastrointestinal mucosal damages due to hydrochloric acid (HCl) and sodium hydroxide (NaOH) ingestion. A 55-year-old male patient was presented to the emergency room with a chief complaint of vomiting an hour before admission. Continuous vomiting with a volume of approximately 10–20 cc per vomit. The vomit was initially bluish and turned in to blackish brown over time. Other complaints included nausea, rapid breathing, heartburn, and burning mouth and throat, and had weakness and dizziness. The patient accidentally drank floor cleaning liquid containing HCl. The patient was diagnosed with hematemesis due to ulceration of esophageal, gastric, and duodenal mucosa induced by HCl. Tracheoesophageal fistula developed later in the patient as a long-term complication. Another a 22-year-old male patient was presented to the emergency room with chief complaints of nausea and vomiting an hour before admission. Headache and slight tightness were also experienced. The patient mouth felt burned pain in the solar plexus and frothy saliva. An hour earlier, the patient attempted suicide by drinking two bottles of floor cleaning liquid due to economic problems. The patient was diagnosed with erosive mucosal esophagogastroduodenum induced by NaOH. These cases highlight that intoxication with corrosive substances can complicate damage to the gastrointestinal mucosal and damage features depend on the type of substance concentration and quantity of the corrosive substance.
{"title":"Gastrointestinal mucosal damages caused by ingestion of corrosive substances: A case study of hydrochloric acid and sodium hydroxide","authors":"F. Yusuf, A. Abubakar, Desi Maghfirah, Mirza Heltomi, C. C. Isitua","doi":"10.52225/narra.v3i3.259","DOIUrl":"https://doi.org/10.52225/narra.v3i3.259","url":null,"abstract":"Ingestion of corrosive substances is most common in children, while in adults causes more severe damages. Massive ingestion of corrosive substances results in severe damage to the gastrointestinal tract and oropharynx if not treated properly. Corrosive substances with pH<2 or >12 can result in severe esophageal damage with either colliquative (alkaline) or coagulative (acidic) necrosis and, at the same time various gastrointestinal injuries could lead to late post-corrosive complications. The aim of the case study was to report the gastrointestinal mucosal damages due to hydrochloric acid (HCl) and sodium hydroxide (NaOH) ingestion. A 55-year-old male patient was presented to the emergency room with a chief complaint of vomiting an hour before admission. Continuous vomiting with a volume of approximately 10–20 cc per vomit. The vomit was initially bluish and turned in to blackish brown over time. Other complaints included nausea, rapid breathing, heartburn, and burning mouth and throat, and had weakness and dizziness. The patient accidentally drank floor cleaning liquid containing HCl. The patient was diagnosed with hematemesis due to ulceration of esophageal, gastric, and duodenal mucosa induced by HCl. Tracheoesophageal fistula developed later in the patient as a long-term complication. Another a 22-year-old male patient was presented to the emergency room with chief complaints of nausea and vomiting an hour before admission. Headache and slight tightness were also experienced. The patient mouth felt burned pain in the solar plexus and frothy saliva. An hour earlier, the patient attempted suicide by drinking two bottles of floor cleaning liquid due to economic problems. The patient was diagnosed with erosive mucosal esophagogastroduodenum induced by NaOH. These cases highlight that intoxication with corrosive substances can complicate damage to the gastrointestinal mucosal and damage features depend on the type of substance concentration and quantity of the corrosive substance.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. Parikesit, Rio Hermantara, Gregorius Kevin, Elizabeth Sidhartha
Genes associated with drug resistance of first line drugs for Plasmodium falciparum have been identified and characterized of which three genes most commonly associated with drug resistance are P. falciparum chloroquine resistance transporter gene (PfCRT), P. falciparum multidrug drug resistance gene 1 (PfMDR1), and P. falciparum Kelch protein K13 gene (PfKelch13). Polymorphism in these genes could be used as molecular markers for identifying drug resistant strains. Nucleic acid amplification test (NAAT) along with DNA sequencing is a powerful diagnostic tool that could identify these polymorphisms. However, current NAAT and DNA sequencing technologies require specific instruments which might limit its application in rural areas. More recently, a combination of isothermal amplification and CRISPR detection system showed promising results in detecting mutations at a nucleic acid level. Moreover, the Loop-mediated isothermal amplification (LAMP)-CRISPR systems offer robust and straightforward detection, enabling it to be deployed in rural and remote areas. The aim of this study was to develop a novel diagnostic method, based on LAMP of targeted genes, that would enable the identification of drug-resistant P. falciparum strains. The methods were centered on sequence analysis of P. falciparum genome, LAMP primers design, and CRISPR target prediction. Our designed primers are satisfactory for identifying polymorphism associated with drug resistant in PfCRT, PfMDR1, and PfKelch13. Overall, the developed system is promising to be used as a detection method for P. falciparum treatment-resistant strains. However, optimization and further validation the developed CRISPR-LAMP assay are needed to ensure its accuracy, reliability, and feasibility
目前已发现与恶性疟原虫一线药物耐药性相关的基因，其中最常见的三个耐药基因是恶性疟原虫氯喹耐药转运体基因（PfCRT）、恶性疟原虫多药耐药基因1（PfMDR1）和恶性疟原虫凯尔奇蛋白K13基因（PfKelch13）。这些基因的多态性可作为鉴定耐药菌株的分子标记。核酸扩增试验（NAAT）和 DNA 测序是一种强大的诊断工具，可以识别这些多态性。然而，目前的核酸扩增试验和 DNA 测序技术需要特定的仪器，这可能会限制其在农村地区的应用。最近，等温扩增与 CRISPR 检测系统的结合在核酸水平上检测突变方面取得了可喜的成果。此外，环路介导等温扩增（LAMP）-CRISPR 系统具有强大和直接的检测功能，可在农村和偏远地区使用。本研究旨在开发一种新型诊断方法，该方法基于目标基因的 LAMP，能够识别耐药恶性疟原虫菌株。这些方法主要包括恶性疟原虫基因组序列分析、LAMP 引物设计和 CRISPR 目标预测。我们设计的引物在鉴定 PfCRT、PfMDR1 和 PfKelch13 中与耐药性相关的多态性方面效果令人满意。总之，所开发的系统有望用作恶性疟原虫耐药菌株的检测方法。然而，还需要对所开发的 CRISPR-LAMP 检测方法进行优化和进一步验证，以确保其准确性、可靠性和可行性。
{"title":"Designing hybrid CRISPR-Cas12 and LAMP detection systems for treatment-resistant Plasmodium falciparum with in silico method","authors":"A. A. Parikesit, Rio Hermantara, Gregorius Kevin, Elizabeth Sidhartha","doi":"10.52225/narra.v3i3.301","DOIUrl":"https://doi.org/10.52225/narra.v3i3.301","url":null,"abstract":"Genes associated with drug resistance of first line drugs for Plasmodium falciparum have been identified and characterized of which three genes most commonly associated with drug resistance are P. falciparum chloroquine resistance transporter gene (PfCRT), P. falciparum multidrug drug resistance gene 1 (PfMDR1), and P. falciparum Kelch protein K13 gene (PfKelch13). Polymorphism in these genes could be used as molecular markers for identifying drug resistant strains. Nucleic acid amplification test (NAAT) along with DNA sequencing is a powerful diagnostic tool that could identify these polymorphisms. However, current NAAT and DNA sequencing technologies require specific instruments which might limit its application in rural areas. More recently, a combination of isothermal amplification and CRISPR detection system showed promising results in detecting mutations at a nucleic acid level. Moreover, the Loop-mediated isothermal amplification (LAMP)-CRISPR systems offer robust and straightforward detection, enabling it to be deployed in rural and remote areas. The aim of this study was to develop a novel diagnostic method, based on LAMP of targeted genes, that would enable the identification of drug-resistant P. falciparum strains. The methods were centered on sequence analysis of P. falciparum genome, LAMP primers design, and CRISPR target prediction. Our designed primers are satisfactory for identifying polymorphism associated with drug resistant in PfCRT, PfMDR1, and PfKelch13. Overall, the developed system is promising to be used as a detection method for P. falciparum treatment-resistant strains. However, optimization and further validation the developed CRISPR-LAMP assay are needed to ensure its accuracy, reliability, and feasibility","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inke ND. Lubis, Sara Farah, A. Pasaribu, Rita Evalina, R. S. Daulay, Hendri Wijaya
Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in case studies or series. The aim of this case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.
粘孢子菌病是一种新出现的疾病，主要影响免疫力低下的患者；不过，也有免疫力正常的人患上这种疾病的报道。针对儿科人群的研究十分有限，且多为病例研究或系列报告。本病例报告旨在介绍一种源自印度尼西亚苏门答腊岛的小儿粘孢子菌病。一名 13 岁的男孩因面部坏死（涉及鼻腔、口腔和左侧上颌骨区域）以及左侧眶周水肿而被转诊至一家三甲医院。病例中没有任何已知的潜在疾病。组织病理学检查结果表明，该病的菌丝宽阔，呈带状，呈 90° 分枝。由耳鼻喉科、传染科、皮肤科、外科、微生物科和病理科组成的多学科团队对患者进行了治疗。对患者的治疗包括清除坏死病灶、抗生素和抗真菌药物（氟康唑）。由于无法获得抗生素，患者没有接受两性霉素 B 治疗。该病例突出表明，即使是免疫功能正常的儿童，在出现症状和体征时也要高度怀疑侵袭性粘孢子菌病，尤其是在资源有限的环境中。
{"title":"A pediatric case and literature review of mucormycosis: Diagnostic and treatment challenges in a resource poor setting","authors":"Inke ND. Lubis, Sara Farah, A. Pasaribu, Rita Evalina, R. S. Daulay, Hendri Wijaya","doi":"10.52225/narra.v3i3.426","DOIUrl":"https://doi.org/10.52225/narra.v3i3.426","url":null,"abstract":"Mucormycosis is an emerging disease that primarily affects immunocompromised patients; however, it has also been reported in immunocompetent individuals. Studies in the pediatric population are limited and reported mostly in case studies or series. The aim of this case report is to present a pediatric mucormycosis originated from Sumatra Island, Indonesia. A 13-year-old boy was referred to a tertiary hospital with facial necrosis involving the nasal, oral, and left maxillary areas, as well as left periorbital edema. No known underlying conditions were documented. The diagnosis was confirmed by histopathological findings of broad, pauci-septate, ribbon-like hyphae branching at 90°. The patient was managed by a multidisciplinary team consisting of the ear, nose, and throat, infectious diseases, dermatology, surgery, microbiology, and pathology departments. Management of the patient included debridement of the necrotic lesion and antibiotics and anti-fungal (fluconazole). Due to unavailability, the patient was not treated with amphotericin B. The patient died after 30 days of admission. This case highlights the importance of maintaining a high suspicion of invasive mucormycosis, even in immunocompetent children, when symptoms and signs are present, especially in resource-limited settings.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139165825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fiony Adida, P. Pandia, Andika Pradana, A. P. Tarigan, Taufik Ashar, Amos Dangana, Aditya S. Listyoko
Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the “Paru Sehat” smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient’s quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of “Paru Sehat” in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the “Paru Sehat” twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients’ characteristics and the knowledge scores within pre- and post-treatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although “Paru Sehat” application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.
慢性阻塞性肺病（COPD）是全球十大死因之一。Paru Sehat "智能手机应用程序的开发是一项积极的举措，有可能改善慢性阻塞性肺病的疾病管理，提高患者的生活质量，减少与慢性阻塞性肺病相关的并发症。然而，该应用程序在提高慢性阻塞性肺病患者知识水平方面的效果尚不得而知。本研究旨在确定 "Paru Sehat "在增加慢性阻塞性肺病患者对慢性阻塞性肺病及其非药物治疗的了解方面的效果。研究在印度尼西亚棉兰市Chairuddin Panusunan Lubis教授医院的慢性阻塞性肺病稳定期患者中开展，采用一组前测-后测的准实验研究方法。布里斯托尔慢性阻塞性肺病知识问卷（BCKQ）用于评估患者在接触 "Paru Sehat "前后的知识得分，"Paru Sehat "每周两次，为期四周。学生 t 检验用于比较干预前后两个知识领域（即疾病知识和非药物治疗知识）的知识得分。学生 t 检验或单向方差分析用于确定患者特征与治疗前后知识得分之间的关系。我们的数据显示，治疗前后的疾病知识得分有了明显提高（15.92±3.79 vs 19.56±3.68，P<0.001）。治疗后（7.52±2.02）与治疗前（10.08±2.379）相比，非药物治疗知识得分也有明显提高，P<0.001。此外，本研究还发现，受教育程度与两个知识领域的得分有关，其中高中或以上教育程度的个体的知识得分明显提高。本研究强调，虽然 "Paru Sehat "应用程序可提高慢性阻塞性肺病及其非药物治疗的知识，但其对低学历者的效果较差。
{"title":"Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients","authors":"Fiony Adida, P. Pandia, Andika Pradana, A. P. Tarigan, Taufik Ashar, Amos Dangana, Aditya S. Listyoko","doi":"10.52225/narra.v3i3.412","DOIUrl":"https://doi.org/10.52225/narra.v3i3.412","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the “Paru Sehat” smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient’s quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of “Paru Sehat” in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the “Paru Sehat” twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients’ characteristics and the knowledge scores within pre- and post-treatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although “Paru Sehat” application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139174056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. P. Sinaga, B. Y. Sinaga, P. Siagian, P. Eyanoer, I. M. Unata
The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on global health. The alterations in quality of life (QoL) and the persistent symptom of dyspnea have been the healthcare workers’ challenges during and after the pandemic. The aim of this study was to assess factors associated with the QoL and persistent dyspnea experienced by COVID-19 survivors, particularly among healthcare workers. A cross-sectional study was conducted among healthcare workers at H. Adam Malik Hospital, Medan, Indonesia, using direct interviews to collect the data. The EuroQol 5-dimensional 5-level (EQ-5D-5L) and the self-assessment EuroQol-visual analog scale (EQ-VAS) were used to assess the QoL of the healthcare workers; and persistent dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Possible risk factors such as demographic characteristics, clinical characteristics (comorbidities, history of hospitalization, oxygen usage, history of COVID-19 vaccination, the severity of previous COVID-19, existence of post-COVID syndrome) and the symptoms of the post-COVID syndrome were collected. Chi-squared test or Fisher’s exact test were used to identify the risk factors associated with the QoL and persistent dyspnea. A total of 100 healthcare workers were included in the study and 2% of healthcare workers experienced pain/discomfortand 4% experienced anxiety/depression. The average healthcare worker’s EQ-VAS score was 87.6±8.1. There was no significant association between studied demographics and clinical characteristics with QoL dimensions. However, post-COVID symptoms of activity limitation (p=0.004), sore throat (p=0.026), headache (p=0.012), myalgia (p=0.006), and arthralgia (p=0.001) were associated with pain/discomfort dimension of QoL. In addition, there was a significant association between activity limitation (p=0.012), headache (p=0.020), myalgia (p=0.015) and arthralgia (p=0.032) with anxiety/depression dimension of QoL. Our data suggested that the presence of post-COVID syndrome (p=0.006) and the presence of post-COVID syndrome symptoms of cough (p=0.021) and fatigue (p=0.015) were associated with the persistent dyspnea. In conclusion, this study suggests that the presence of post-COVID syndrome and its symptoms are associated with low quality of health-related QoL and persistent dyspnea. Therefore, cautions are needed for such patients to prevent low QoL in the future.
冠状病毒病 2019（COVID-19）大流行对全球健康产生了重大影响。大流行期间和之后，生活质量（QoL）的改变和持续的呼吸困难症状一直是医护人员面临的挑战。本研究旨在评估与 COVID-19 幸存者，尤其是医护人员的生活质量和持续呼吸困难相关的因素。这项横断面研究在印度尼西亚棉兰市 H. Adam Malik 医院的医护人员中进行，采用直接访谈的方式收集数据。研究采用了欧洲质量标准五维五级量表（EQ-5D-5L）和自我评估型欧洲质量标准-视觉模拟量表（EQ-VAS）来评估医护人员的 QoL，并使用修改后的医学研究委员会（mMRC）量表来评估持续性呼吸困难。收集了可能的风险因素，如人口统计学特征、临床特征（合并症、住院史、氧气使用情况、COVID-19 疫苗接种史、既往 COVID-19 的严重程度、是否存在后 COVID 综合征）以及后 COVID 综合征的症状。采用卡方检验（Chi-squared test）或费雪精确检验（Fisher's exact test）来确定与 QoL 和持续性呼吸困难相关的风险因素。研究共纳入了 100 名医护人员，其中 2% 的医护人员感到疼痛/不适，4% 的医护人员感到焦虑/抑郁。医护人员的平均 EQ-VAS 得分为 87.6±8.1。所研究的人口统计学和临床特征与 QoL 各维度之间没有明显关联。然而，COVID 后的活动受限（p=0.004）、咽喉痛（p=0.026）、头痛（p=0.012）、肌痛（p=0.006）和关节痛（p=0.001）等症状与 QoL 的疼痛/不适维度相关。此外，活动受限（p=0.012）、头痛（p=0.020）、肌痛（p=0.015）和关节痛（p=0.032）与 QoL 的焦虑/抑郁维度也有显著关联。我们的数据表明，COVID 后综合征（p=0.006）、COVID 后综合征症状咳嗽（p=0.021）和疲劳（p=0.015）与持续性呼吸困难有关。总之，本研究表明，COVID 后综合征及其症状的存在与低健康相关生活质量和持续性呼吸困难有关。因此，需要对这类患者采取谨慎措施，以防止他们今后出现低质量生活水平。
{"title":"Factors associated with the quality of life and persistent dyspnea severity in COVID-19 survivors: A cross-sectional study among healthcare workers","authors":"J. P. Sinaga, B. Y. Sinaga, P. Siagian, P. Eyanoer, I. M. Unata","doi":"10.52225/narra.v3i3.419","DOIUrl":"https://doi.org/10.52225/narra.v3i3.419","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on global health. The alterations in quality of life (QoL) and the persistent symptom of dyspnea have been the healthcare workers’ challenges during and after the pandemic. The aim of this study was to assess factors associated with the QoL and persistent dyspnea experienced by COVID-19 survivors, particularly among healthcare workers. A cross-sectional study was conducted among healthcare workers at H. Adam Malik Hospital, Medan, Indonesia, using direct interviews to collect the data. The EuroQol 5-dimensional 5-level (EQ-5D-5L) and the self-assessment EuroQol-visual analog scale (EQ-VAS) were used to assess the QoL of the healthcare workers; and persistent dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Possible risk factors such as demographic characteristics, clinical characteristics (comorbidities, history of hospitalization, oxygen usage, history of COVID-19 vaccination, the severity of previous COVID-19, existence of post-COVID syndrome) and the symptoms of the post-COVID syndrome were collected. Chi-squared test or Fisher’s exact test were used to identify the risk factors associated with the QoL and persistent dyspnea. A total of 100 healthcare workers were included in the study and 2% of healthcare workers experienced pain/discomfortand 4% experienced anxiety/depression. The average healthcare worker’s EQ-VAS score was 87.6±8.1. There was no significant association between studied demographics and clinical characteristics with QoL dimensions. However, post-COVID symptoms of activity limitation (p=0.004), sore throat (p=0.026), headache (p=0.012), myalgia (p=0.006), and arthralgia (p=0.001) were associated with pain/discomfort dimension of QoL. In addition, there was a significant association between activity limitation (p=0.012), headache (p=0.020), myalgia (p=0.015) and arthralgia (p=0.032) with anxiety/depression dimension of QoL. Our data suggested that the presence of post-COVID syndrome (p=0.006) and the presence of post-COVID syndrome symptoms of cough (p=0.021) and fatigue (p=0.015) were associated with the persistent dyspnea. In conclusion, this study suggests that the presence of post-COVID syndrome and its symptoms are associated with low quality of health-related QoL and persistent dyspnea. Therefore, cautions are needed for such patients to prevent low QoL in the future.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139239977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vella Vella, Mimi Maulida, Nanda Earlia, Arie Hidayati, Risna Handriani, S. Gondokaryono, R. Dwiyana, Ezigbo E. Doris, Aldilla Pradistha, Mikyal Bulqiah
Harlequin ichthyosis is a severe and fatal presentation of ichthyosis with an autosomal recessive inheritance. Infants with Harlequin ichthyosis have a high mortality rate, and a dismal prognosis; therefore the majority of neonates die shortly after birth from infection, heat loss, dehydration, electrolytic imbalances, or respiratory distress. The aim of this case report was to present a fatal case of Harlequin ichthyosis with no family history of any inherited skin disorder. A 3-day-old baby was presented to the emergency room with congenital abnormalities at birth, fissured hyperkeratotic skin, and thick yellow plates of scales. The parents had no history of consanguineous marriage, no relevant past medical history, and no family history of the same condition. The patient was unwell, pulse 162 times/minute, respiratory rate 48 times/minute, and axillary temperature 36.9oC. APGAR score was 8 in the 1st minute and 9 in the 5th minute. Based on the typical clinical appearance, the patient was diagnosed with Harlequin ichthyosis. Due to a lack of facility, a mutation analysis was not carried out. The patient was then transferred to the neonatal intensive care unit (NICU) and treated in a humidified incubator and medicated with intravenous antibiotics (ampicillin sulbactam 125 mg/12 hour and gentamicin 13 mg/24 hour), topically fusidic acid and mild emollients. A central venous catheter was used for intravenous access. The poor prognosis resulted in the patient dying at the age of 5-day-old. This case highlights that prenatal diagnosis is critical for early detection and disease prevention. Mutation screening for the ABCA12 gene is suggested for consanguinity marriages and with a history of ichthyosis.
{"title":"A fatal case of Harlequin ichthyosis: Experience from low-resource setting","authors":"Vella Vella, Mimi Maulida, Nanda Earlia, Arie Hidayati, Risna Handriani, S. Gondokaryono, R. Dwiyana, Ezigbo E. Doris, Aldilla Pradistha, Mikyal Bulqiah","doi":"10.52225/narra.v3i3.302","DOIUrl":"https://doi.org/10.52225/narra.v3i3.302","url":null,"abstract":"Harlequin ichthyosis is a severe and fatal presentation of ichthyosis with an autosomal recessive inheritance. Infants with Harlequin ichthyosis have a high mortality rate, and a dismal prognosis; therefore the majority of neonates die shortly after birth from infection, heat loss, dehydration, electrolytic imbalances, or respiratory distress. The aim of this case report was to present a fatal case of Harlequin ichthyosis with no family history of any inherited skin disorder. A 3-day-old baby was presented to the emergency room with congenital abnormalities at birth, fissured hyperkeratotic skin, and thick yellow plates of scales. The parents had no history of consanguineous marriage, no relevant past medical history, and no family history of the same condition. The patient was unwell, pulse 162 times/minute, respiratory rate 48 times/minute, and axillary temperature 36.9oC. APGAR score was 8 in the 1st minute and 9 in the 5th minute. Based on the typical clinical appearance, the patient was diagnosed with Harlequin ichthyosis. Due to a lack of facility, a mutation analysis was not carried out. The patient was then transferred to the neonatal intensive care unit (NICU) and treated in a humidified incubator and medicated with intravenous antibiotics (ampicillin sulbactam 125 mg/12 hour and gentamicin 13 mg/24 hour), topically fusidic acid and mild emollients. A central venous catheter was used for intravenous access. The poor prognosis resulted in the patient dying at the age of 5-day-old. This case highlights that prenatal diagnosis is critical for early detection and disease prevention. Mutation screening for the ABCA12 gene is suggested for consanguinity marriages and with a history of ichthyosis.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139253697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One of the most cancers in women that can be fatal is breast cancer. Radiation therapy, chemotherapy, or a combination of the two are often used to treat cancer, and these treatments tend to modify the immune system and weaken defences. Using natural compounds from plants has become a research interest to prevent cancer cell development. The aim of this study was to determine the anticancer activities of ethyl acetate extract of Chromolaena odorata (EACO) against breast cancer cells (MCF-7 and T47D). The viability of the cells was determined by the MTT colorimetry assays. The apoptosis test was performed by using flow cytometry. The IC50 value for MCF-7 cells was 218.78 μg/mL and 307.61 μg/mL for T47D. The extract acted selectively against breast cancer cells, with selectivity indexes against MCF-7 and T47D were 12.77 and 9.08, respectively. The viable cells of T47D cells were decreased from 85±36.5% (24 hours) to 54±34% (48 hours) after treatment with IC50 of EACO. Significant decrease of the MCF-7's viable cells were observed between 48 and 72 hours after treatment with IC50 (68.5±17.7% to 51.01±12.1%, respectively). Apoptosis assay showed that T47D and MCF-7 cells were mainly in the necrosis stage (83.35±0.49% and 95.15±1.76%, respectively). This study suggested that ethyl acetate extract of C. odorata is promising to be developed as an anticancer agent.
{"title":"Cytotoxic activity of ethyl acetate extract of Chromolaena odorata on MCF7 and T47D breast cancer cells","authors":"H. Yusuf, Hijra Novia, Marhami Fahriani","doi":"10.52225/narra.v3i3.326","DOIUrl":"https://doi.org/10.52225/narra.v3i3.326","url":null,"abstract":"One of the most cancers in women that can be fatal is breast cancer. Radiation therapy, chemotherapy, or a combination of the two are often used to treat cancer, and these treatments tend to modify the immune system and weaken defences. Using natural compounds from plants has become a research interest to prevent cancer cell development. The aim of this study was to determine the anticancer activities of ethyl acetate extract of Chromolaena odorata (EACO) against breast cancer cells (MCF-7 and T47D). The viability of the cells was determined by the MTT colorimetry assays. The apoptosis test was performed by using flow cytometry. The IC50 value for MCF-7 cells was 218.78 μg/mL and 307.61 μg/mL for T47D. The extract acted selectively against breast cancer cells, with selectivity indexes against MCF-7 and T47D were 12.77 and 9.08, respectively. The viable cells of T47D cells were decreased from 85±36.5% (24 hours) to 54±34% (48 hours) after treatment with IC50 of EACO. Significant decrease of the MCF-7's viable cells were observed between 48 and 72 hours after treatment with IC50 (68.5±17.7% to 51.01±12.1%, respectively). Apoptosis assay showed that T47D and MCF-7 cells were mainly in the necrosis stage (83.35±0.49% and 95.15±1.76%, respectively). This study suggested that ethyl acetate extract of C. odorata is promising to be developed as an anticancer agent.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Polymyositis is a chronic autoimmune disease that presents with symmetrical progressive proximal muscle weakness. The cause of this disease due to abnormal activation of macrophages that might be associated with systemic diseases such as other autoimmune diseases, malignancy or viral infections including hepatitis B virus. The aim of this case report was to highlight treatment challenges in a patient with polymyositis concomitant with hepatitis B. A 28-years-old man with history of completed hepatitis B treatment with negative viral load presented with symmetrical progressive weakness on both inferior proximal extremities. The patient complained of pain predominantly in both tights and calves. No dermatological manifestation was observed. Elevated muscle enzymes and liver function were observed. Along with the course of the disease, hepatitis B reactivation was discovered as hepatitis B virus DNA was re-detected. Treatment options of this patient (polymyositis concomitant with hepatitis B viral infection) remain challenging. The main treatment of polymyositis consists of high dose methylprednisolone and this immunosuppressant could worsen the hepatitis B virus infection. The patient was finally treated with combination of mycophenolic acid and methylprednisolone for polymyositis and entecavir for hepatitis B. After one month of treatment, the patient showed a clinical improvement. This case highlights that viral screening must be done prior to starting polymyositis treatment as it could concomitant with viral infections such as hepatitis B. Antiviral prophylaxis must be given 1–2 weeks before immunosuppression starts. Management for both polymyositis and hepatitis B is important with entecavir or tenofovir as the optimal agents against hepatitis B virus.
{"title":"Polymyositis concomitant with hepatitis B virus infection: Treatment challenges","authors":"Andi R. Ginting, Vincent Tandiono","doi":"10.52225/narra.v3i3.514","DOIUrl":"https://doi.org/10.52225/narra.v3i3.514","url":null,"abstract":"Polymyositis is a chronic autoimmune disease that presents with symmetrical progressive proximal muscle weakness. The cause of this disease due to abnormal activation of macrophages that might be associated with systemic diseases such as other autoimmune diseases, malignancy or viral infections including hepatitis B virus. The aim of this case report was to highlight treatment challenges in a patient with polymyositis concomitant with hepatitis B. A 28-years-old man with history of completed hepatitis B treatment with negative viral load presented with symmetrical progressive weakness on both inferior proximal extremities. The patient complained of pain predominantly in both tights and calves. No dermatological manifestation was observed. Elevated muscle enzymes and liver function were observed. Along with the course of the disease, hepatitis B reactivation was discovered as hepatitis B virus DNA was re-detected. Treatment options of this patient (polymyositis concomitant with hepatitis B viral infection) remain challenging. The main treatment of polymyositis consists of high dose methylprednisolone and this immunosuppressant could worsen the hepatitis B virus infection. The patient was finally treated with combination of mycophenolic acid and methylprednisolone for polymyositis and entecavir for hepatitis B. After one month of treatment, the patient showed a clinical improvement. This case highlights that viral screening must be done prior to starting polymyositis treatment as it could concomitant with viral infections such as hepatitis B. Antiviral prophylaxis must be given 1–2 weeks before immunosuppression starts. Management for both polymyositis and hepatitis B is important with entecavir or tenofovir as the optimal agents against hepatitis B virus.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139261229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Indonesian government launched a triple elimination program to eliminate mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), syphilis, and hepatitis B in 2018, aiming to increase screening uptake among pregnant women during antenatal visits and to reduce the rates of these infections in children less than 50 per 100,000 live births. Despite this initiative, a thorough assessment of its effectiveness, particularly in Bandung, the capital city of West Java, as one of the most densely populated cities in Indonesia with a high HIV incidence, has yet to be conducted. The aim of this study was to analyze the impact of this triple elimination program in Bandung by assessing the data between 2017 and 2020. Monthly data was obtained from the Health Office of Bandung for four years, including number of screenings done for HIV, syphilis, and hepatitis B, number of confirmed cases and number of pregnant women treated for those infections. Additionally, data on children under 24 months old afflicted by these infections were also collected. Our data indicated an increase in screening coverage for HIV, syphilis, and HBV among pregnant women; however, it remained below the national set benchmarks for screening coverage. Only 59.5% of HIV-positive pregnant women received anti-retroviral therapy in 2020, while merely 25% of syphilis-positive cases were administered benzathine penicillin G. Syphilis screening was correlated with an increase in positive cases among children, suggesting missed opportunities in managing syphilis-positive pregnant women. Furthermore, management of HIV- and syphilis-positive cases had suboptimal outcomes. Data on hepatitis B was not evaluated since it was not available. To achieve the triple elimination program goals, comprehensive coordination among all relevant stakeholders is required, as is continuous monitoring and evaluation.
{"title":"Evaluating the impact of triple elimination program for mother-to-child transmission of HIV, syphilis, and hepatitis B in Indonesia","authors":"Buti A. Azhali, D. Setiabudi, Anggraini Alam","doi":"10.52225/narra.v3i3.405","DOIUrl":"https://doi.org/10.52225/narra.v3i3.405","url":null,"abstract":"Indonesian government launched a triple elimination program to eliminate mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV), syphilis, and hepatitis B in 2018, aiming to increase screening uptake among pregnant women during antenatal visits and to reduce the rates of these infections in children less than 50 per 100,000 live births. Despite this initiative, a thorough assessment of its effectiveness, particularly in Bandung, the capital city of West Java, as one of the most densely populated cities in Indonesia with a high HIV incidence, has yet to be conducted. The aim of this study was to analyze the impact of this triple elimination program in Bandung by assessing the data between 2017 and 2020. Monthly data was obtained from the Health Office of Bandung for four years, including number of screenings done for HIV, syphilis, and hepatitis B, number of confirmed cases and number of pregnant women treated for those infections. Additionally, data on children under 24 months old afflicted by these infections were also collected. Our data indicated an increase in screening coverage for HIV, syphilis, and HBV among pregnant women; however, it remained below the national set benchmarks for screening coverage. Only 59.5% of HIV-positive pregnant women received anti-retroviral therapy in 2020, while merely 25% of syphilis-positive cases were administered benzathine penicillin G. Syphilis screening was correlated with an increase in positive cases among children, suggesting missed opportunities in managing syphilis-positive pregnant women. Furthermore, management of HIV- and syphilis-positive cases had suboptimal outcomes. Data on hepatitis B was not evaluated since it was not available. To achieve the triple elimination program goals, comprehensive coordination among all relevant stakeholders is required, as is continuous monitoring and evaluation.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139261699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Herison E. Sinulingga, B. Y. Sinaga, P. Siagian, Taufik Ashar
The low treatment rate, low treatment success rate and high mortality rate of patients with pre-extensively drug-resistant tuberculosis (pre-XDR-TB) and extensively drug-resistant TB (XDR-TB) need serious attention. The aim of this study was to describe the profiles of patients with pre-XDR-TB and XDR-TB cases and to determine associated risk factors of their incidence in Indonesia. A retrospective case-control study was conducted at H. Adam Malik General Hospital in Medan, North Sumatra of which all sensitive-drug TB (SD-TB), pre-XDR-TB, and XDR-TB patients aged 18 years or older treated between October 2019 to June 2022 were included. Chi-squared test or Kruskal Wallis test and multiple logistic regression were used to determine the risk factors associated with pre-XDR-TB and XDR-TB incidence. A total 16 patients of case group (15 pre-XDR-TB and one XDR-TB) and 116 SD-TB patients (control group) were included in the final analysis. Out of total patients within case group, 62.5% were male, 43.8% aged between 56–65 years, 62.5% graduated from high school or equivalent, and 25% were unemployed. The majority of patients had no comorbid (62.5%), had history of anti-TB treatment (93.8%), and had secondary resistance (93.8%). Multivariate analysis indicated that age (OR: 10.01; 95%CI: 1.49–66.91, p=0.018) and previous history of anti-TB treatment (OR: 216.25; 95%CI: 18.62–2511.60, p<0.001) were significantly associated with incidence of pre-XDR-TB and XDR-TB. This study highlights that having previous history of anti-TB treatment and older age are the predictors of the incidence of pre-XDR-TB and XDR-TB.
{"title":"Profile and risk factors of pre-XDR-TB and XDR-TB patients in a national reference hospital for Sumatra region of Indonesia","authors":"Herison E. Sinulingga, B. Y. Sinaga, P. Siagian, Taufik Ashar","doi":"10.52225/narra.v3i3.407","DOIUrl":"https://doi.org/10.52225/narra.v3i3.407","url":null,"abstract":"The low treatment rate, low treatment success rate and high mortality rate of patients with pre-extensively drug-resistant tuberculosis (pre-XDR-TB) and extensively drug-resistant TB (XDR-TB) need serious attention. The aim of this study was to describe the profiles of patients with pre-XDR-TB and XDR-TB cases and to determine associated risk factors of their incidence in Indonesia. A retrospective case-control study was conducted at H. Adam Malik General Hospital in Medan, North Sumatra of which all sensitive-drug TB (SD-TB), pre-XDR-TB, and XDR-TB patients aged 18 years or older treated between October 2019 to June 2022 were included. Chi-squared test or Kruskal Wallis test and multiple logistic regression were used to determine the risk factors associated with pre-XDR-TB and XDR-TB incidence. A total 16 patients of case group (15 pre-XDR-TB and one XDR-TB) and 116 SD-TB patients (control group) were included in the final analysis. Out of total patients within case group, 62.5% were male, 43.8% aged between 56–65 years, 62.5% graduated from high school or equivalent, and 25% were unemployed. The majority of patients had no comorbid (62.5%), had history of anti-TB treatment (93.8%), and had secondary resistance (93.8%). Multivariate analysis indicated that age (OR: 10.01; 95%CI: 1.49–66.91, p=0.018) and previous history of anti-TB treatment (OR: 216.25; 95%CI: 18.62–2511.60, p<0.001) were significantly associated with incidence of pre-XDR-TB and XDR-TB. This study highlights that having previous history of anti-TB treatment and older age are the predictors of the incidence of pre-XDR-TB and XDR-TB.","PeriodicalId":507105,"journal":{"name":"Narra J","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139278176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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