Narra J最新文献

Tuberculosis (TB) remains one of the most widespread infectious diseases in the world, with high mortality and morbidity rates, contributing to a significant disease burden, particularly in developing countries. The aim of this study was to determine the risk factors of TB among the population aged 17 years (late adolescent) and above in one of the high TB prevalence countries, Indonesia. A case-control study was conducted in Banda Aceh, Indonesia, involving newly diagnosed pulmonary TB patients who visited one of the eleven community health centers in Banda Aceh. The controls were individuals matched by age and sex who lived near the cases and had no TB infection. A total of 16 risk factors were assessed. Hierarchical multivariable logistic regression models were used to examine the association between the risk factors and the occurrence of TB. A total of 196 cases and 196 controls were included in the study. Multivariable logistic regression analysis identified 11 independent predictors for the occurrence of TB after controlling possible confounders. Patients who lived in houses with insufficient light exposure were 77 times more likely to develop TB compared to those living in houses with sufficient light exposure (adjusted odds ratio (AOR): 77.69; 95%CI: 27.09, 222.79). The study also showed that people who had close contact with TB patients (AOR: 25.39; 95%CI: 2.10, 306.52), had poor knowledge of TB (AOR: 24.2; 95%CI: 6.89, 85.17), had comorbidities (AOR: 4.49; 95%CI: 1.35, 14.89), insufficient food utilization (AOR: 3.41; 95%CI: 1.51, 7.71), negative preventive behavior (AOR: 3.39; 95%CI: 1.49, 7.72), low education level (AOR: 3.08; 95%CI: 1.26, 7.55), and insufficient housing humidity (AOR: 2.89; 95%CI: 1.18, 7.12) were associated with increased the odds of having TB. Being employed, having income above minimum wage, and having good nutritional intake were protective factors for developing TB. In conclusion, the determinants of TB among people aged 17 years and older are a clear indication of the need for TB prevention programs targeting not only individual risk factors but also environmental risk factors, particularly providing adequate housing conditions. This study provided useful information that might help to develop and adopt effective policies for TB control in Indonesia.

Social media platforms, including TikTok, have become influential sources of health information. However, they also present as potential sources for the spread of vaccine misinformation. The aim of this study was to assess the quality of measles-rubella (MR) vaccine-related contents on TikTok in Jordan and to analyze factors associated with vaccine misinformation. A systematic search for MR vaccine-related TikTok contents in Jordan was conducted using pre-defined keywords and a specified time range. Content metrics (likes, comments, shares, and saves) were collected while the content quality of health information was evaluated using a modified version of the DISCERN, a validated instrument by two expert raters. The average modified DISCERN score ranged from 1, denoting poor content, to 5, indicating excellent content. A total of 50 videos from 34 unique content creators formed the final study sample. The majority of MR vaccine-related content was created by lay individuals (61.8%), followed by TV/news websites/journalists (23.5%), and healthcare professionals (HCPs) (14.7%). The Cohen κ per modified DISCERN item was in the range of 0.579-0.808, p<0.001), indicating good to excellent agreement. The overall average modified DISCERN score was 2±1.2, while it was only 1.3±0.52 for lay individuals' content, which indicated poor content quality. For the normalized per number of followers for each source, content by lay individuals had a significantly higher number of likes, saves, and shares with p=0.009, 0.012, and 0.004, respectively. Vaccine misinformation was detected in 58.8% of the videos as follows: lay individuals (85.7%), TV/news websites/journalists (25.0%), and HCPs content had none (p<0.001). Normalized per the number of followers for each source, videos flagged as having MR vaccine misinformation reached a higher number of likes, saves, and shares (p=0.012, 0.016, and 0.003, respectively). In conclusion, substantial dissemination of TikTok MR vaccine-related misinformation in Jordan was detected. Rigorous fact-checking is warranted by the platform to address misinformation on TikTok, which is vital to improve trust in MR vaccination and ultimately protect public health.

Adolescent hypertension is emerging as a significant health challenge. Peer-led interventions utilizing engaging multimedia platforms have demonstrated the potential to enhance prevention behaviors among adolescents. However, there remains a gap in the literature comparing the effectiveness of multimedia intervention with traditional lecture-based approach in adolescent hypertension prevention in Indonesia. The aim of this study was to compare the traditional lecture-based approach and interactive multimedia intervention (e-module, animated videos, and infographics) on adolescents' knowledge, attitudes, and practices regarding adolescent hypertension prevention. A quasi-experimental study with pre-test and post-test control group study was conducted from June to December 2023 in two senior high schools in districts of Pedurungan and Kedungmundu, Semarang, Central Java, Indonesia. To prepare the multimedia model, the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) framework and mapping intervention approach were employed to ensure effective decision-making at each step. A total of 100 high school students were involved, with 50 assigned to the intervention group and 50 to the control group. The intervention group received a multimedia model from the peer educators, while the control group received a traditional PowerPoint-based presentation from the community healthcare workers. The hypertension prevention knowledge, attitude, and practice were assessed using validated questionnaires with 20, 15, and 15 items, respectively. This study found that, after model implementation, significant improvements were observed in students' knowledge, attitudes, and practices regarding hypertension prevention (all had p<0.001). Specifically, knowledge scores increased by 4.78 points, attitude scores by 10.64 points, and practice scores by 2.9 points. This study highlights that multimedia interventions could significantly improve hypertension prevention behaviors among adolescents by enhancing their knowledge, attitudes, and practices through engaging and interactive multimedia materials.

Fall is the leading cause of disability and mortality due to unintentional injury in older adults. The aim of this study was to determine the prevalence and risk factors associated with knee pain, fear of falling, and quality of life among community-dwelling older adults in Northern Thailand. A cross-sectional study was conducted among older adults aged 60 and over. A total of 369 participants were enrolled from April to May 2024. Oxford knee score, a short version of the Falls Efficacy Scale International (FES-I) and World Health Organization quality of life-BREF-Thai, was measured. The results showed that the mean age was 69.4 years and 47 (12.7%) had a history of falls in the previous year. The prevalence of fear of falling was 39.3% for low, 22.5% for moderate, and 38.2% for high concern. Age, marital status, alcohol, history of falls, hypertension, arthritis, and osteoporosis were associated with fear of falling. After adjusting to age, gender, body mass index, education, marital status, smoking, alcohol, history of falls, and chronic disease, osteoarthritis of the knee was positively associated with increasing fear of falling (β: 0.361; p<0.001), while quality of life was negatively associated with fear of falling (β: -0.064; p<0.011). In conclusion, the identified determinants of fear of falling among the elderly indicated the need for fear of falling prevention programs targeting not only individual lifestyles but also chronic diseases. This study provides useful information that might help to develop and adopt effective policies for fear of falling control in Thailand.

Atherosclerosis is a leading cause of cardiovascular disease-related death worldwide. Some studies suggested that the natural ingredients in coffee may negatively affect cardiovascular diseases, while other studies indicated that coffee contains anti-inflammatory compounds that are beneficial for cardiovascular diseases. The aim of this study was to measure the expression of P-selectin in aortic endothelial cells and the level of serum apolipoprotein A-1 (ApoA-1) in an atherosclerosis rat model after the administration of arabica and robusta coffee bean extracts at mild-moderate and high doses. An experimental study was conducted with a complete randomized design using 36 adult male white rats (Rattus norvegicus) divided into six groups: negative control (NC), positive control (PC), arabica mild-moderate dose (A1), arabica high dose (A2), robusta mild-moderate dose (R1), and robusta high dose (R2). Animals were induced atherosclerosis with atherogenic feed and then were treated with arabica and robusta coffee bean extracts at two different doses for four weeks. The results showed that the expression of P-selectin in the group of rats treated with robusta coffee bean extract was lower than arabica coffee bean extract group. Rats with robusta coffee bean extract mild-moderate dose had the highest ApoA-1 levels compared to other groups significantly (p<0.05). The level of ApoA-1 was higher in both mild-moderate and high dose of robusta coffee groups compared to the negative control group (both with p<0.001). In conclusion, mild-moderate intake of robusta coffee bean extract could reduce aortic P-selectin immunoexpression and increase serum ApoA-1 levels in an atherosclerosis rat model.

Coronavirus disease 2019 (COVID-19) has led to a significant number of infections and deaths worldwide, yet its pathogenesis and severity remain incompletely understood. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), play crucial roles as receptors and molecules responsible for the virus's entry into host cells, initiating the infection process. Their polymorphisms have been extensively studied in relation to COVID-19 severity. The aim of this study was to examine the association of ACE2 (rs2074192) and TMPRSS2 (rs12329760) polymorphisms with COVID-19 outcome and severity. A prospective cohort study was conducted in 2022 at Haji Adam Malik Hospital, Medan, Indonesia. We randomly recruited hospitalized adult patients with COVID-19, confirmed by real-time polymerase chain reaction (RT-PCR). The baseline demographic data, disease severity, underlying disease, comorbidities, and COVID-19 vaccination status were collected. The single-nucleotide polymorphism (SNP) was assessed using TaqMan SNP genotyping assay, and the levels of TMPRSS2 and ACE2 proteins were measured using enzyme-linked immunosorbent assay (ELISA). A total of 151 COVID-19 patients were recruited and there were significant associations between age and severity with mortality outcomes. The age, kidney and lung diseases, and vaccination status were associated with severity levels. The results showed the CC genotype of ACE2 had the highest proportion, followed by TT and CT genotypes among patients, while CT was the most prevalent genotype, followed by CC and TT for TMPRSS2. This study did not find a significant association between ACE2 and TMPRSS2 genetic variants with disease severity and outcome but highlighted a specific association of TMPRSS2 SNP with mortality within the group. In addition, ACE2 concentration was significant different between mild-moderate and severe-critical COVID-19 groups (p=0.033).

Osteoarthritis (OA) is a complex and common condition, especially affecting the knees due to their weight-bearing role. Traditionally seen as a degenerative disease, OA is now understood to have both mechanical and inflammatory causes. Despite its increasing prevalence, there is limited data on OA in Indonesia, resulting in low awareness among clinicians and the public. The aim of this study was to describe the OA burden in Indonesia, focusing on its prevalence, incidence, and years lived with disability (YLD) from 1990 to 2019, using data from the Global Burden of Disease (GBD) study 2019. A descriptive cross-sectional study was conducted to examine the prevalence, incidence, and YLD of OA in Indonesia from the GBD study 2019. OA prevalence and YLD were compared to other countries according to similar social demographics and geographical proximity. OA YLD was also compared to the top causes of death and disability YLD in Indonesia. The study found that OA cases in Indonesia more than doubled from 1990 to 2019, with increases of 153.12% in males and 143.36% in females. Similar trends were observed for knee OA. The age-standardized prevalence rate in Indonesia increased by 11.03% in males and 8.42% in females, and these were higher compared to China, India, Singapore, and the global average. Younger people had a higher OA prevalence rate growth than older groups. The incidence rate for OA also rose significantly, with males seeing a 10.89% increase to 290 per 100,000 people and females with an 8.57% increase to 384 per 100,000 people. Despite lower overall burden rates compared to some countries, Indonesia experienced significant growth in YLD due to OA (12.16% in males and 9.65% in females) since 1990. Although OA was less burdensome than stroke, diabetes, low back pain, and chronic obstructive pulmonary disease (COPD), its YLD growth rate was higher. In conclusion, OA prevalence and incidence in Indonesia significantly increased from 1990 to 2019, with a notable rise among younger populations. OA had a higher YLD growth compared to several other major diseases in Indonesia, highlighting the need for early detection and preventive measures, particularly for the younger population.

Drug-resistant epilepsy presents significant challenges in treating epileptic patients, leading to recurrent seizures and necessitating the use of polypharmacy with anti-epileptic drugs. Both of these conditions contribute to increased oxidative stress, which is detrimental to the brain. The aim of this study was to determine the role of vitamins C and E in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients. This was a double-blinded, randomized clinical trial with a placebo, parallel design, and block randomization. The subjects were drug-resistant epileptic patients aged 1-18 years who received routine treatment. Randomization was performed on 100 patients who were divided into the treatment or placebo groups. The patients received a combination of vitamin C (100 mg/day) and vitamin E (200 IU/day for those <5 years or 400 IU/day for those ≥5 years) or a placebo for eight weeks. Malondialdehyde (MDA) levels and seizure frequency were measured prior to and after the intervention. A total of 42 and 46 patients were followed till the end of the study in the intervention and placebo groups, respectively. Our data indicated that the MDA levels prior to treatment were not significantly different between the treatment and placebo groups (0.901 vs 0.890 mmol/mL, p=0.920) and were significantly reduced after the treatment in both the treatment group (p<0.001) and placebo group (p=0.028). The changes in MDA levels (between post- and pre-treatment) were also not significantly different between the two groups (p=0.181). Our per-protocol analysis indicated that the reduction in seizure frequency was significantly higher in the treatment group compared to the placebo group (95% vs 35%, p<0.001), with 92% and 60% relative and absolute risk reduction, respectively. The intention-to-treat analysis also indicated that the reduction in seizure frequency was significantly higher in the intervention group than in the control group (80% vs 32%, p<0.001), with relative and absolute risk reduction of 70% and 48%, respectively. There was no significant relationship between changes in MDA levels and seizure frequency in either group. In conclusion, vitamins C and E could reduce seizure frequency and, therefore, could be considered as adjuvant therapy in drug-resistant epileptic patients.

The triglyceride-glucose (TyG) index is a simple and reliable indicator of insulin resistance, which is an important contributor to the development of hypertension. The aim of this meta-analysis was to determine the dose-response association between the TyG index and the incidence of hypertension. An extensive search was conducted through several databases, including PubMed, EMBASE, ScienceDirect, and Scopus, until June 1, 2024. The TyG index was used as the exposure, and the incidence of hypertension was measured throughout the TyG index intervals. The effect estimates were presented as odds ratios (OR) in both the unadjusted and adjusted models. Adjusted OR were carried out from all included studies to eliminate the possibility of confounding factors being involved in the incidence of hypertension. A total of 108.936 participants (mean age: 48.2 years old, male: 47%, mean body mass index: 23.9 kg/m2) from 14 observational studies were included. The TyG index in the most eminent category was related to a higher risk of hypertension in both unadjusted (OR: 2.59, 95%CI: 2.03-3.31, p<0.001; I2: 97.1%, p<0.001) and adjusted model (OR: 1.74, 95%CI: 1.39-2.19, p<0.001; I2: 92.2%, p<0.001). The dose-response meta-analysis for the adjusted OR showed that the linear association analysis was not significant per 0.1 increase in the TyG index. The dose-response curve became increasingly steeper at the TyG index above 8.5. In conclusion, the TyG index was shown to be strongly linked with hypertension in a non-linear dose-response manner.

Human sparganosis, a parasitic infection prevalent in Asia, can progress to cerebral sparganosis, a severe condition with significant neurological symptoms. Diagnosis and treatment are challenging due to its clinical similarity to other infections, highlighting the need for improved detection and management strategies. The aim of this study was to observe research trends, key contributors, gaps in the existing knowledge, diagnosis challenges, effective treatment options, and prevention strategies, providing recommendations for future research directions and clinical practice improvements on cerebral sparganosis. A bibliometric analysis was conducted by extracting 139 documents from the Scopus database in June 2024. The retrieved data were analyzed using the R package's Bibliometrix (Biblioshiny) and VOSviewer. Spanning 97 different sources, the research exhibited an annual growth rate of 2.5%. Annual scientific production revealed fluctuating research activity with peaks in 2010 and 2011 and notable citation peaks in 1996 and 2005, indicating pivotal studies that significantly influenced subsequent research. Early studies focused on diagnosis and specific parasites, while recent studies (2010-2024) have increasingly addressed clinical outcomes, treatment strategies, and advanced diagnostic techniques. Trends revealed a shift towards clinical and diagnostic advancements, with recent emphasis on diagnostic imaging, immunoassays, and the relationship between cerebral sparganosis and brain tumors. In conclusion, the studies on cerebral sparganosis underscore the potential for enhancing clinical practice by improving diagnostic accuracy, informing treatment decisions, and implementing targeted screening efforts based on epidemiology and risk factors. Recommendation to further study needs to notify the cerebral sparganosis in high-risk countries with similar socioeconomic and cultural characteristics to endemic regions, including Indonesia.