Narra J最新文献

Hair issues, such as hair loss and dandruff, pose significant challenges in hair care. Patchouli oil, rich in bioactive components, has emerged as a promising candidate for addressing these concerns. The aim of this study was to investigate the hybrid functionality of fractionated patchouli oil in hair care formulations designed to promote hair growth and control dandruff caused by Malassezia globosa. Crude patchouli oil (CPO) was fractionated to enhance its efficacy, producing light fraction patchouli oil (LFPO), which was then characterized using gas chromatography-mass spectrometry (GC-MS) analysis. Hair tonic formulations containing three different LFPO concentrations (0.5%, 1.0%, and 1.5%) were developed and evaluated for stability, pH, viscosity, and antifungal activity against M. globosa. The results showed that LFPO contained 2.51% acid number, 0.70% ester number, 0.71 mg/kg iron content, and 25.88% patchoulol. The formulations exhibited stable physicochemical properties, with pH levels of 5.36-5.51 and viscosity ranging from 3.94 to 4.08 centipoise (cP), suitable for hair tonic applications. Formulation of 1.5% LFPO demonstrated the strongest antifungal activity, producing a 31.18±1.37 mm inhibition zone against M. globosa, surpassing ketoconazole (21.72±0.28 mm), suggesting potential as a natural antifungal agent. Histological analysis in rabbits revealed that 1.5% LFPO formulation reduced epidermal cell shedding, increased hair length by 41.6±0.35 mm after six weeks, and promoted dense hair follicle growth. This research provides a foundation for developing natural, effective, and stable hair care formulations. Despite these promising results, the efficacy and safety of LFPO formulations in humans remain unexplored. Therefore, a clinical human trial is necessary to assess skin tolerance, irritation risks, and long-term effects under real-world conditions.

Attention deficit hyperactivity disorder (ADHD), once considered primarily a childhood condition, is now increasingly recognized as a disorder that persists into adulthood and significantly impacts academic and professional success. The aim of this study was to investigate the prevalence of ADHD and identify associated risk factors among university students. A cross-sectional study was conducted over a period of six months at Ras Al Khaimah Medical and Health Sciences University, United Arab Emirates. Data were collected through a self-report questionnaire addressing sociodemographic, lifestyle, and family environment factors. ADHD symptoms were assessed using the World Health Organization Adult ADHD Self-Report Scale version 1.1, based on the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition criteria. The study sample included 472 students, with a mean age of 19.9±1.85 years. The overall prevalence of ADHD was 13.6% (n=64). Logistic regression analysis revealed significant associations between the mother's smoking status (odds ratio (OR): 2.35; 95% confidence interval (95%CI): 1.949- 5.862, p=0.050) and living in shared housing (OR: 3.35; 95%CI: 1.674-6.723, p=0.001) with increased odds of ADHD. Conversely, being male (OR: 0.4; 95%CI: 0.216-0.891, p=0.02) and being born full-term (OR: 0.331; 95%CI: 0.138-0.794, p=0.013) were associated with decreased odds of ADHD. Other factors, such as college affiliation, smoking status, exercise habits, maternal employment, mode of delivery, and pregnancy complications, were not significant risk factors. These findings highlight the need for targeted interventions in university settings, including early screening, tailored support services, and increased staff awareness, to support students with ADHD and enhance their academic success and well-being.

Deoxycorticosterone acetate (DOCA) and N-nitro-L-arginine methyl ester (L-NAME) hydrochloride have been well-reported as pre-eclampsia inducers due to their ability to mimic hypertension, endothelial dysfunction, and inflammatory response. However, no study has compared the two inducers in developing a mice model of preeclampsia characterized by proinflammatory and anti-inflammatory parameters. The aim of this study was to investigate the efficacy of DOCA and L-NAME hydrochloride in inducing pre-eclampsia in pregnant mice, focusing on the expression of regulatory T cells (Tregs), macrophages, anti-inflammatory cytokines TGF-β, and pro-inflammatory cytokines (IL-6 and IL-1β). Twenty-seven female BALB/c mice were grouped into three groups (n=9): healthy pregnant mice (NP), pregnant mice induced with DOCA (PD), and pregnant mice induced with L-NAME hydrochloride (PL). L-NAME hydrochloride was orally given to the pregnant mice at 4.464 mg/30 g body weight (BW) every day after five days of gestation. DOCA was injected subcutaneously in 0.1 mL of corn oil at 0.74 mg/30 g BW before mating and 0.38 mg/30 g BW once a week until dissection. Drinking water for PD and PL groups was replaced with 0.9% saline. On day 16 of pregnancy, the lymphocytes were isolated from the spleen to determine the profile of Tregs, macrophages, TGF-β, IL-6, and IL-1β using flow cytometry analysis. The results showed that administering L-NAME hydrochloride in pregnant mice exhibited a significant increase in the relative number of IL-1β and macrophages compared to DOCA (p<0.05). L-NAME hydrochloride significantly reduced the production of TGF-β compared to DOCA (p<0.05). Both DOCA and L-NAME hydrochloride could decrease Tregs and IL-6 levels. This study also found that L-NAME hydrochloride was more effective in inducing pre-eclampsia in pregnant BALB/c mice than DOCA indicated by the highest increase in pro-inflammatory cytokines and macrophage activity and a low anti-inflammatory cytokine. The present study provides a foundation for understanding the pathophysiological mechanisms of preeclampsia in the inflammatory pathway; however, further exploration of other mechanisms, markers, and target proteins can deepen insights into its development.

Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction, often accompanied by cleft palate. Feeding difficulties and respiratory compromise pose significant challenges in early management. While feeding plates are commonly used to improve feeding and airway stability, their application in infants with severe respiratory infections remains underreported. The aim of this study was to describe the challenges of impression-taking and feeding plate fabrication in an infant with PRS complicated by multiple congenital anomalies and severe respiratory complications, including bilateral pneumonia. A 23-day-old male infant was referred to the pediatric dentistry department of Pandega General Hospital, Pangandaran, Indonesia, with the chief complaints of feeding difficulties, recurrent choking episodes, and respiratory distress. The patient was diagnosed with PRS with a cleft palate, complicated by congenital tuberculosis and bilateral pneumonia, exacerbating respiratory compromise. Given the patient's fragile condition, impression-taking was performed with strict airway precautions, including lateral positioning, continuous oxygen monitoring, and suction readiness. High-viscosity alginate and a perforated stock tray were used to minimize aspiration risk. Two clinicians ensured airway security throughout the procedure. A customized acrylic feeding plate was fabricated with a palatal extension to prevent nasal regurgitation and a contoured surface to aid tongue positioning. The plate was polished for comfort, adjusted for retention, and fitted to accommodate maxillary growth, ensuring safe and effective feeding support. Within one month, the infant's weight increased from 2,200 g to 3,100 g, choking episodes significantly decreased, and a transition from orogastric tube to bottle feeding was achieved. In conclusion, this case highlights the feasibility and benefits of feeding plate adaptation in PRS management, even in the presence of severe respiratory infections. A non-invasive approach using a feeding plate can serve as an initial intervention before surgical correction, particularly in fragile neonates.

The coronavirus disease 2019 (COVID-19) pandemic has triggered a global health crisis and placed unprecedented strain on healthcare systems, particularly in resource-limited settings where access to RT-PCR testing is often restricted. Alternative diagnostic strategies are therefore critical. Chest X-rays, when integrated with artificial intelligence (AI), offers a promising approach for COVID-19 detection. The aim of this study was to develop an AI-assisted diagnostic model that combines chest X-ray images and clinical data to generate a COVID-19 Risk Index (CORI) Score and to implement a deep learning model based on ResNet architecture. Between April 2020 and July 2021, a multicenter cohort study was conducted across three hospitals in Jakarta, Indonesia, involving 367 participants categorized into three groups: 100 COVID-19 positive, 100 with non-COVID-19 pneumonia, and 100 healthy individuals. Clinical parameters (e.g., fever, cough, oxygen saturation) and laboratory findings (e.g., D-dimer and C-reactive protein levels) were collected alongside chest X-ray images. Both the CORI Score and the ResNet model were trained using this integrated dataset. During internal validation, the ResNet model achieved 91% accuracy, 94% sensitivity, and 92% specificity. In external validation, it correctly identified 82 of 100 COVID-19 cases. The combined use of imaging, clinical, and laboratory data yielded an area under the ROC curve of 0.98 and a sensitivity exceeding 95%. The CORI Score demonstrated strong diagnostic performance, with 96.6% accuracy, 98% sensitivity, 95.4% specificity, a 99.5% negative predictive value, and a 91.1% positive predictive value. Despite limitations-including retrospective data collection, inter-hospital variability, and limited external validation-the ResNet-based AI model and the CORI Score show substantial promise as diagnostic tools for COVID-19, with performance comparable to that of experienced thoracic radiologists in Indonesia.

Malnutrition is a major global health concern, especially in developing countries. Although patin fish oil and protein offer benefits, their individual and combined effects on maternal physiology remain unclear, particularly during early pregnancy. The aim of this study was to assess the effect of patin-based nutritional intervention on total serum protein, albumin, hemoglobin levels, body weight during pregnancy, body weight during lactation, heart rate, respiratory rate, body temperature, external appearance, behavioral activity, and milk production in malnourished rats. An in vivo study was conducted using Rattus norvegicus rats. The rats were divided into six groups: (1) healthy control, receiving standard feed; (2) malnourished control, receiving an 8% low-protein diet; (3) malnourished group, receiving standard feed; (4) malnourished treated with patin oil; (5) malnourished treated with patin meat; and (6) malnourished treated with a combination of patin oil and meat. The treatment consisted of 21 days during pregnancy and 23 days during lactation, for a total of 44 days. Our data indicated that patin-based intervention significantly increased total protein (p=0.044), albumin (p=0.001), and hemoglobin levels (p=0.034) compared to malnourished control group. The malnourished animals treated with patin oil showed the highest increases in total protein (1.67%), albumin (17.75%), and hemoglobin (24.26%). Body weight gain improved significantly in patin-treated group in both pregnancy (p=0.032) and lactation (p<0.001) compared to the malnourished control, with the highest gains observed in the patin oil group. Milk production also increased significantly (p<0.05), reaching its peak in the patin oil and meat combination group (6.97 g). Physiological parameters, including heart rate (p=0.021), respiratory rate (p=0.025), and body temperature (p=0.023), were significantly different among groups, of which patin oil and meat groups had the most optimal parameters compared to malnourished control group. In conclusion, patin-based nutritional intervention effectively enhances protein metabolism, hematological parameters, and physiological health in malnourished maternal rats, with patin oil demonstrating the most pronounced effects.

Genetic polymorphisms in cytotoxic T-lymphocyte-associated protein 4 gene (CTLA-4) vary by ethnic background, necessitating population-specific studies. The aim of this study was to assess the association between the CTLA-4 +6230G>A polymorphism, serum CTLA-4 level, and hepatocellular carcinoma (HCC) in Batak patients with chronic hepatitis B, a group with high hepatitis B virus (HBV) endemicity. A case-control study was conducted among cases (Batak patients with chronic hepatitis B and HCC) and controls (chronic hepatitis B without HCC). Genotyping of the CTLA-4 +6230G>A polymorphism was performed using the TaqMan SNP Genotyping Assay. Serum CTLA-4 level was quantified using enzyme-linked immunosorbent assay (ELISA). Patient's demographic, clinical and laboratory data were recorded and assessed including age, sex, body mass index (BMI), smoking history, cirrhosis status, HBV DNA level, liver function markers (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)), hepatitis B e-antigen (HBeAg) status, smoking history, and alcohol consumption. This study found that G allele was significantly associated with an increased risk of HCC (OR: 2.69; 95%CI: 1.21-6.00; p=0.013). Individuals with GG/AG genotypes had a 2.89-fold higher risk of developing HCC compared to those with the AA genotype (p=0.032). Serum CTLA-4 level was significantly elevated in G allele carriers (GG: 159.9±57.1 pg/mL vs AA: 83.7±44.7 pg/mL; p<0.001). Multivariate analysis identified cirrhosis as the strongest predictor of HCC (OR: 7.60; p<0.001), followed by elevated ALT (OR: 3.42; p=0.018) and high HBV DNA levels (OR: 2.31; p=0.024). In conclusion, the CTLA-4 +6230G>A GG/AG genotype and elevated serum CTLA-4 level were significantly associated with an increased risk of HCC in Batak individuals with chronic HBV infection. Further research is needed to explore additional CTLA-4 polymorphisms and immune regulatory mechanisms in HBV-related HCC to improve risk stratification and therapeutic strategies.

Schizophrenia is a prevalent mental health disorder often marked by relapses, significantly affecting the health-related quality of life (HRQoL) of both patients and their families. The aim of this study was to compare the EuroQol 5-Dimension 5-level (EQ-5D- 5L) responses of schizophrenia patients and their caregivers. Using an observational cross-sectional design, HRQoL was assessed among schizophrenia patients and their family caregivers recruited from a provincial referral hospital. Sociodemographic (age, sex, education, marital status, income) and clinical variables (diagnosis, treatment duration, comorbidities) were analyzed alongside HRQoL using structured interviews, medical record reviews, and the EQ-5D-5L instrument (self-report by patients and proxy- reported by family caregivers). Statistical analyses included chi-square tests for associations, Wilcoxon tests for patient-family caregiver comparisons, and multivariate modeling of HRQoL determinants. A total of 526 participants (263 patients and 263 accompanying family caregivers) were included. Significant differences were observed between patients and family caregivers in two domains: pain/discomfort and anxiety/depression. Also, the agreement between patients' and family caregivers' reports showed good results. A substantial agreement was observed between patient-reported and family caregiver-assessed HRQoL, as indicated by a Cohen's Kappa value of 0.8. This result suggests a strong level of consistency between the two assessments, supporting the potential use of family caregivers as reliable proxies for evaluating patient HRQoL when self-reports are unavailable or unreliable. In the self-care domain, mobility, and daily activities, patient and caregiver assessments show high agreement. In conclusion, the closeness between patients and caregivers significantly influences patients' HRQoL, providing critical insights for evaluating treatment effectiveness in schizophrenia cases. While discrepancies exist between patient and caregiver assessments, these interactions are particularly impactful in subjective domains like pain/discomfort and anxiety/depression, but not for other domains that are visible.

The development of glucocorticoid resistance has complicated the management of acute lymphoblastic leukemia (ALL), leading to increased mortality rates. Ivermectin, a low-cost and well-established anthelmintic, exhibits anticancer potential and may enhance glucocorticoid toxicity in ALL, offering a possible strategy to overcome resistance. The aim of this study was to evaluate the apoptotic effect of combining ivermectin with dexamethasone in ALL. ALL SUP-B15 cells were cultured under standard conditions before treatment with dexamethasone (200 nM) alone or combined with ivermectin (5, 10, and 20 µM), with an untreated group serving as the control. Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay by measuring cell viability and inhibition. Apoptosis was evaluated through BAX, BCL-2, and CASP3 gene expression analysis using reverse transcription-polymerase chain reaction (RT-PCR). The findings revealed that the combination of ivermectin and dexamethasone was superior in the repression of ALL cell viability compared to control (p<0.001). The combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated the most significant cell inhibition of 38.16±0.04% (p<0.001) and produced the lowest cell viability of 61.84±0.05% (p<0.001). Moreover, the combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated superior upregulations of BAX (p<0.001) and CASP3 (p<0.001). In conclusion, the addition of ivermectin (5 µM) to dexamethasone regimen (200 nM) increases its cytotoxic and apoptotic activities against SUP-B15 cell line as observed by the CASP3 and BAX upregulation. Studies to confirm the enhanced anticancer activity by this combination by observing the protein levels and animal studies are warranted.

Antibiotics are frequently prescribed to coronavirus disease 2019 (COVID-19) patients, often without evidence of bacterial superinfection, increasing the risk of antibiotic resistance and posing a public health threat. The aim of this study was to evaluate antibiotic prescribing patterns in COVID-19 patients with suspected secondary infections and to assess the association between antibiotic use and clinical outcomes, particularly leukocyte count. The study analyzed 376 hospitalized COVID-19 patients from two hospitals in Bandung, Indonesia, between 2020 and 2022. All included patients were aged ≥17 years with confirmed COVID-19, leukocyte count >11,000 μg/L, and received antibiotic therapy. The Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) and drug utilization (DU) 90% were used to assess prescribing patterns. The patients' demographic characteristics, clinical and culture results were also collected. Our data indicated that most patients received multiple antibiotics (>2), with prescribing patterns significantly associated with age, confirmed bacterial pathogen, length of hospital stay and having tuberculosis infection. The most frequently identified pathogens included Gram-positive bacteria Staphylococcus aureus, Staphylococcus haemolyticus and Gram-negative bacteria Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli. The most frequently prescribed antibiotics were azithromycin, levofloxacin, and ceftriaxone. No significant association was found between the number of antibiotics prescribed and clinical outcome (leukocyte normalization). Broad-spectrum antibiotics from the World Health Organization (WHO) AWaRe "Watch" category dominated the antibiotic prescriptions in the patients. While antibiotic selection was generally aligned with pathogen type and comorbidities, standardized guidelines remain crucial to optimizing antibiotic use, particularly in settings with limited pathogen testing.