Narra J最新文献

Synovial chondromatosis is a rare disorder characterized by cartilaginous growths within the joint lining, often confused with conditions like pigmented villonodular synovitis and rheumatoid arthritis. Primary treatment typically involves surgical synovectomy to remove the affected tissue and loose bodies. Documented cases are limited globally. The aim of this study was to present a case series of synovial chondromatosis and evaluate the functional outcomes by assessing the post-surgical Musculoskeletal Tumor Society (MSTS) score following different surgical interventions (synovectomy alone versus synovectomy with total knee replacement) in a resource-limited setting. Four cases of synovial chondromatosis were reported. A 61-year-old woman with a soft tissue tumor underwent synovectomy and total knee replacement on the right knee, then experienced a periprosthetic infection requiring revision arthroplasty, resulting in an MSTS score of 24. Another case was a 48-year-old woman who had a synovectomy for a lump on the right knee, also achieving an MSTS score of 24. Two additional cases involved women in their mid-to-late 60s who underwent synovectomy for knee lumps, with post-operative MSTS scores of 21 and 19, respectively. This case series underscores the diagnostic and management challenges of synovial chondromatosis in the knee joint, demonstrating various surgical interventions. This case series also suggested that the post-operative MSTS scores were slightly higher (indicating better outcomes) for synovectomy alone compared to synovectomy with total knee replacement, highlighting the need for further research to determine the most effective treatment approach.

Several 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.

Endometriosis remains a significant challenge for reproductive-aged women and is frequently associated with infertility. Although in vitro fertilization (IVF) is used to address infertility in women with endometriosis, its effectiveness in this context is still debated, particularly in developing countries such as Indonesia, where IVF remains a major challenge. The aim of this study was to investigate the success rates of early stages of IVF in women with and without endometriosis. A retrospective cohort study was conducted at the Graha Amerta Fertility Clinic, located within Dr. Soetomo Academic General Hospital in Surabaya, Indonesia. The quantity and quality of oocytes (the number of oocytes obtained by ovum pick-up (OPU) and the number of metaphase II (MII) oocytes), fertilization quality (the number of two-pronuclei oocytes and fertilization rate), embryo development quality (cleavage rate and blastocyst rate), biochemical pregnancy, clinical pregnancy, and live birth rate were collected from IVF patients between 2017-2022. Independent Student's t-test or Mann-Whitney test was used accordingly for comparison analysis. A total of 410 IVF patients were included in the study; 93 had endometriosis, while 317 had no endometriosis. Oocyte quantity obtained by OPU (p = 0.016) and oocyte quality (p = 0.045), as measured by the number of MII oocytes, were significantly lower in the endometriosis group compared to the non-endometriosis group. However, there were no significant differences between the two groups in terms of the number of two-pronuclei oocytes (p = 0.105), fertilization rate (p = 0.987), cleavage rate (p = 0.467), blastocyst rate (p = 0.128), biological pregnancy rates (OR: 0.98; 95%CI: 0.60- 1.60; p = 0.940), clinical pregnancy rate (OR: 0.69; 95%CI: 0.39-1.24, p = 0.219), or live birth rate (p = 0.609). These findings suggest that while endometriosis may reduce oocyte quantity and quality, it does not significantly impact the success rates of IVF.

Understanding the significance of handgrip strength is essential for identifying frailty in heart failure patients. The aim of this study was to identify the association between handgrip strength and cardiorespiratory endurance while highlighting the importance of the musculoskeletal system in cardiac rehabilitation for patients with heart failure. An observational cross-sectional study was conducted at Harapan Kita Hospital, Jakarta, Indonesia, from April 2022 to April 2023, among patients with heart failure with reduced ejection fraction (HFrEF) attributed to cardiomyopathy or coronary artery disease. Patients were classified by a 6-minute walk test (6MWT) distance into <400 meters (low endurance) or ≥400 meters (high endurance). The short physical performance battery (SPPB), handgrip strength, ultrasonographic forearm muscle thickness, left ventricle ejection fraction, tricuspid annular plane systolic excursion, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured. Results indicated significant differences in non-dominant handgrip strength, gait speed, and sit-to-stand SPPB scores between patients achieving a 6MWT distance of ≥400 meters and those below this threshold, with values of 31.11 ± 6.88 kg vs 27.66 ± 6.66 kg (p = 0.049), 0.52 ± 0.08  m/s vs 0.61 ± 0.13  m/s (p = 0.001), and 10.71 ± 2.47 seconds vs 12.85 ± 4.11 seconds (p = 0.014), respectively. Stronger non-dominant handgrip strength (>30 kg) was associated with higher endurance (odds ratio (OR): 3.80; 95%CI: 1.35-10.67; p = 0.010) and thicker forearm muscles (>1.9 cm) as measured by ultrasonography (AUC: 0.713; 95%CI: 0.585- 0.840, p = 0.001). In conclusion, a cut-off of ≤30 kg for non-dominant handgrip strength could effectively stratify the male patients into a lower endurance group (6MWT ≤400 meters), which is associated with elevated NT-proBNP levels and reduced forearm muscle thickness.

Liver injury in tuberculosis patients, associated with noncompliance with treatment, is further exacerbated by viral hepatitis, which not only directly harms the liver but also increases susceptibility to drug-induced liver injury. The aim of this study was to analyze the associated risk factors for viral hepatitis in tuberculosis patients. This systematic review and meta-analysis adhere to the PRISMA 2020 statement, and the protocol has been registered with PROSPERO (CRD42023477241). Screening and selection of articles were carried out according to predetermined inclusion and exclusion criteria, utilizing four databases: Embase, Medline, Scopus, and ProQuest. Baseline characteristics and patient-related risk factors from each included study were extracted, followed by a meta- analysis of factors that potentially had significance, with the heterogeneities also being analyzed. Of the 21 included studies out of 6,415 identified records, 12 potential risk factors for hepatitis B and 15 for hepatitis C were subjected to meta-analysis. Some key risk factors included for hepatitis B and C were HIV infection (OR: 3.42; 95%CI: 2.19- 5.34 and OR: 6.99; 95%CI: 5.09-9.61, respectively), smoking (OR: 1.55; 95%CI: 1.19-2.02 and OR: 3.06; 95%CI: 1.63-5.75, respectively) and alcohol consumption (OR: 2.38; 95%CI: 1.06-5.37 and OR: 4.32; 95%CI: 2.76-6.78, respectively). Furthermore, meta- analysis indicated that other significant risk factors for hepatitis B and/or C include injecting and non-injecting drug use, multiple sexual partners, tattooing, ear-nose piercing, blood transfusion, dental interventions, homelessness, incarceration, living with prisoners, sexually transmitted diseases, and diabetes mellitus. In conclusion, patients with tuberculosis who have risk factors such as smoking, HIV, or alcohol consumption should be screened for hepatitis B and C to prevent liver injury.

Sexual quality of life is greatly influenced by sexual function, yet thorough measures remain limited and vary across regions. In Indonesia, diverse cultural and religious contexts notably shape sexual quality of life. Thus, it is important to have a tool that considers both internal and external aspects. The aim of this study was to develop a valid and reliable scale that specifically measures Indonesian sexual quality of life for women (ISQOL-W), considering cultural and social factors. A total of 228 participants were recruited from April 30, 2023, to September 30, 2023. The ISQOL-W was developed through two phases: item generation and psychometric evaluation. In the first phase, 68 items were drafted based on definitions and dimensions of sexual quality of life. In the second phase, exploratory factor analysis resulted in 34 items with a loading factor greater than 0.4 (ranging from 0.41 to 0.84) which were categorized into four domains/factors: sexual-related emotion, sexual fantasy, sexual arousal, and sexual relationship. The Cronbach's α coefficient for the overall questionnaire was 0.915, with subscale reliability ranging from 0.826 to 0.903. Further analysis revealed significant differences in ISQOL-W scores across relationship status, educational level, history of last sexual activity, and type of sexual activity. In conclusion, the ISQOL-W demonstrated robust psychometric properties, supporting its use in future studies. This study represents the first effort to develop and validate a sexual quality of life scale specifically for Indonesian women.

A worldwide issue, vitamin D deficiency affects pregnant mothers and babies everywhere, including Indonesia. It involves the adaptive immune system by controlling the production of pro-and anti-inflammatory cytokines and the balance between humoral (Th2) and cell-mediated (Th1) immunity. The aim of this study was to investigate the relationship between vitamin D and the cytokines IL-6 and IL-10 in infants. It also examined the relationship between ferritin and IL-6/IL-10 in newborns. The study collected 114 umbilical cord blood samples from term-born mothers without clinical symptoms. IL-6 and IL-10 were among the cytokine profiles measured by the enzyme-linked immunosorbent assay (ELISA). SPSS was used for statistical analysis, and an in -silico investigation was carried out to examine the molecular relationships between vitamin D and IL-6/IL-10. Using the 20 ng/mL as the cut-off for vitamin D insufficiency suggested the insignificant association of vitamin D with IL-6 (p=0.42), IL-10 (p=0.76), and ferritin (p=0.47). When the umbilical cord vitamin D level was categorized into four quartiles, the association with the highest statistical significance (quartile 4 versus quartile was observed for IL-6 (p<0.001), IL-10 (p<0.001), and ferritin (p<0.001). However, the linear regression did not suggest the significant correlations of vitamin D with IL-6 (p=0.40) and IL-10 (p=0.45). A significant correlation based on the linear regression was found between ferritin and IL-10 (p=0.03). Molecular docking studies demonstrated binding affinities of -8.04 kcal/mol for IL-6-vitamin D and -8.53 kcal/mol for IL-10 -vitamin D complexes, with stable root mean square deviation throughout the simulations. This study contributes valuable insights into the clinical and computational analysis of the relationship of vitamin D with IL-6 or IL-10.

Down syndrome is the most prevalent genetic condition contributing to intellectual disability. Advancements in medical care have significantly increased the life expectancy of people with this condition, making employment a vital component for independent living and quality of life. The aim of this study was to examine the current literature on the employability and employment experiences of individuals with Down syndrome, focusing on the evolution of the employment rate and factors influencing employment such as cognitive and personal factors, societal attitudes, challenges, and effective support systems. Using Arksey and O'Malley's methodology, a scoping review of relevant qualitative and quantitative articles from PubMed, Scopus, Web of Science (WoS), CINAHL, and Medline was conducted. The search focused on the keywords found in the title and abstract of articles from 1980 to 2023. The search strategy utilized medical subject headings (MeSH), including "work", "Down syndrome", and "employment". All articles employing qualitative, quantitative, and mixed methods that were published in English were included. Of an initial 4,296 articles, 32 full-text articles were evaluated, and nine met the inclusion criteria. The data indicated improved employment rates for people with Down syndrome, with a recent employment rate of 53%. However, jobs are often limited to sectors like food service and are underutilizing their skills. Key factors associated with employment status include cognitive abilities, family support, and social attitudes. Despite positive perceptions, significant barriers such as systemic bias persist. Effective support systems are crucial but are often hindered by limited opportunities. In conclusion, employment opportunities for people with Down syndrome have improved, but challenges such as limited job diversity and systemic barriers remain. Comprehensive policies are recommended to promote inclusive employment practices and tailored support systems.

The most common type of liver cancer is hepatocellular carcinoma (HCC), accounting for 75-85% of cases. Despite its associated side effects, sorafenib remains the standard treatment for HCC. Given the critical need to improve therapeutic efficacy while minimizing adverse effects, alternative drugs must be thoroughly investigated. Numerous studies indicate that combining sorafenib with metformin results in a more favorable treatment profile. The aim of this study was to employ bioinformatics methodologies to elucidate the molecular pathways and genetic underpinnings of metformin's efficacy in HCC treatment. Genes associated with metformin and its action against HCC (Huh-7 and HepG2 cells) were acquired from the NCBI-GEO data collection by utilizing pre-determined keywords. Subsequently, pathways implicated in metformin-mediated HCC treatment were analyzed through the Kyoto Encyclopedia of Genes and Genomes (KEGG). Our analysis revealed the involvement of multiple pathways, with metabolic pathways implicated in 80% of the total cases. Neurodegenerative pathways were involved in only around 60% of the total cases. These findings align with the multifaceted mechanisms of metformin's action, encompassing adenosine monophosphate-activated protein kinase activation, apoptosis induction, insulin regulation, anti-inflammatory responses, and modulation of cell proliferation. This comprehensive investigation sheds light on the intricate molecular landscape underpinning metformin's therapeutic efficacy in HCC, thereby informing potential avenues for optimizing treatment strategies.

The waning immunity following the COVID-19 vaccination become a significant concern and the immunological dynamics of vaccine-induced antibodies after vaccination need to be explored. The aim of this study was to compare anti-SARS-CoV-2 receptor-binding domain (RBD) antibody levels before and after a booster dose with heterologous COVID-19 vaccine and to identify factors influencing the levels after receiving the booster dose. A cross-sectional study was conducted in which individuals who received primary doses of CoronaVac and a booster dose with an mRNA-based vaccine were recruited using a purposive sampling technique. The titers of anti-SARS-CoV-2 RBD antibodies were measured using an enzyme-linked immunosorbent assay (ELISA), and plausible associated factors were collected using a questionnaire-assisted face-to-face interview. The Wilcoxon test was used to compare the titers before and after the booster dose, while the Kruskal-Wallis and Mann-Whitney tests, followed by multivariate linear regression, were used to assess the factors associated with RBD total antibody titers. The results showed that there was a significant increase of anti-SARS-CoV-2 RBD total antibody titers before and after receiving the booster dose (1,558.7 binding antibody units (BAU)/mL vs 140.6 BAU/mL, p<0.001). The analysis revealed that age (p=0.555), sex (p=0.254), type of vaccine (p=0.914), presence of hypertension (p=0.541), diabetes (p=0.975), chronic obstructive pulmonary disease (COPD, p=0.620), and gout (p=0.364) were not associated with anti-SARS-CoV-2 RBD total antibody titers. However, the titers of anti-SARS-CoV-2 RBD total antibody were significantly different between those with and without hyperlipidemia (p=0.021). This study suggests that a booster dose with a heterologous COVID-19 vaccine could significantly enhance immune responses against COVID-19, and therefore, this strategy may be recommended as part of preventive measures to strengthen immunity against COVID-19.