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Showing papers in "Open Access Macedonian Journal of Medical Sciences in 2021"


Journal ArticleDOI
TL;DR: The study concluded that the global pandemic has created a whole new experience for businesses and organizations around the world and business executives cannot sit on their laurels any longer and they cannot put off a digital transformation organizational focus.
Abstract: The emergence of coronavirus (COVID-19) has caused us to reconsider our everyday lives around the world. While the ability to work from home is an advantage to many workers, other businesses lack the foundation of the technological infrastructure to give the capacity of “business as usual” without some compromises. The goal of this paper is to develop a conceptual framework on digital transformations antecedents of global workplaces and organizations post-pandemic outbreak. The study emphasized that the most effective transformations point to four antecedents; smart capital allocation for digital initiatives, engagement of appropriate digital tools, talent recruitment, and brand permission. The study concluded that the global pandemic has created a whole new experience for businesses and organizations around the world. Therefore, business executives cannot sit on their laurels any longer and they cannot put off a digital transformation organizational focus. Henceforth, taking the right decisions today would help ensure that businesses are better placed after the pandemic is over.

16 citations


Journal ArticleDOI
TL;DR: In this paper, the determinants of stunting prevention in relation to mothers with children aged 6-24 months in Madura Indonesia were analyzed using a questionnaire and then analyzed using the Chi-square test with a significance level of α ≤ 0.05.
Abstract: AIM: The purpose of this study was to analyze the determinants of stunting prevention in relation to mothers with children aged 6–24 months in Madura Indonesia. METHODS: The design of this study was cross-sectional. The number of samples totaled 109 respondents using a purposive sampling technique. The independent variables were knowledge, attitudes, income, cultural values, and parenting. The dependent variable was stunting prevention. The data were collected using a questionnaire and then analyzed using the Chi-square test with a significance level of α _< 0.05. RESULTS: The factors associated with stunting prevention were knowledge (p = 0.007), attitude (p = 0.034), income (p = 0.006), cultural values (p = 0.016), and parenting patterns (p = 0.000). CONCLUSIONS: Knowledge, attitude, income, cultural values, and parenting influenced the parent’s strategy when it came to prevent stunting in their children. Stunting prevention programs should focus on improving parental behavior by modifying these factors.

11 citations


Journal ArticleDOI
TL;DR: The ultrasonic extracts of two chemotypes of T. serpyllum L. of Central Kazakhstan can be considered as a potential drug with a wide spectrum of antimicrobial activity, except for a rosmarinic acid.
Abstract: BACKGROUND: The medicinal plant of Thymus serpyllum L. in nature, depending on the geographical region, climatic conditions, and growing environment, is represented with some chemotypes. Composition and quantitative content of the basic groups of the biologically active substances can be differed, and thus their biological properties are also various. AIM: The aim of the study was to determine possibility of the using the ultrasonic extracts of two chemotypes of T. serpyllum L. of Central Kazakhstan as an antimicrobial agent against test strains of microorganisms. MATERIALS AND METHODS: Two samples of T. serpyllum were extracted with 70% ethanol using ultrasound. The polyphenol content of the ultrasound extracts was determined using the LC-ultraviolet-ESI- tandem mass spectrometry technique. A study of an antimicrobial activity of the ultrasonic extracts was performed with eight strains of Gram-positive bacteria, six strains of Gram-negative bacteria, and four cultures of fungi. RESULTS: The ultrasonic extracts of two chemotypes of T. serpyllum L. are similar in composition of phenolic compounds but differ in a quantitative content of phenolic acids and flavonoids, except for a rosmarinic acid. The ultrasonic extracts have a wide spectrum of antimicrobial activity, exhibit the bactericidal or bacteriostatic activity against all tested bacteria and fungi at a concentration of 0.0625–20 mg/ml, but differ in their strength of action against test strains of microorganisms. CONCLUSION: The ultrasonic extracts of two chemotypes of T. serpyllum L. of Central Kazakhstan can be considered as a potential drug with a wide spectrum of antimicrobial activity. The results of chromatographic analysis will be used for standardization of a drug.

10 citations


Journal ArticleDOI
TL;DR: It is expected for the institution to conduct training about more interactive online learning accessible by the student and train a positive coping mechanism to cope with burnout and fatigue.
Abstract: BACKGROUND: The nursing students should ideally represent relevant and skillful behavior in developing science Recently, the classical teaching and learning process involving interaction between students was shifted into online learning due to the coronavirus disease 2019 (COVID-19) pandemic That ideal condition could not be reached As a result, the online learning during the COVID-19 pandemic triggers students to deal with stressors such as academic assignments, the difficulty in adapting to home environment, no face-to-face meeting with the fellow students AIM: The researcher was aimed to analyze students’ coping strategies for burnout and fatigue from online learning during the COVID-19 pandemic METHODS: It was a quantitative research with a descriptive correlation design and cross-sectional approach The population of the research was the students in the second semester of the undergraduate program in nursing Universitas Muhammadiyah Semarang The sample of the research was 83 respondents, which were taken using a purposive sampling technique RESULTS: Most of the nursing students were positive coping with 47 respondents (56 6%), severe burnout with 71 respondents (85 5%), and fatigue was found in 40 respondents (48 2%);meanwhile, the rest 43 respondents (52 8%) did not experience fatigue Base on Pearson test, there was a significant correlate between nursing students coping and fatigue (0 00) with moderate correlation at 0 518, although no correlation coping with burnout CONCLUSION: It is expected for the institution to conduct training about more interactive online learning accessible by the student and train a positive coping mechanism to cope with burnout and fatigue © 2021 Tri Nurhidayati, Desy Ariyana Rahayu, Dera Alfiyanti

9 citations


Journal ArticleDOI
TL;DR: HMSCs have a robust ability to accelerated wound closure improvement to the optimum wound healing by controlling α-SMA expression depending on wound healing phases.
Abstract: BACKGROUND: The active myofibroblast producing extracellular matrix deposition regarding wound closure is characterized by alpha-smooth muscle actin (α-SMA) expression. However, the persistence of α-SMA expression due to prolonged inflammation may trigger scar formation. A new strategy to control α-SMA expression in line with wound closure improvement uses hypoxic mesenchymal stem cells (HMSCs) due to their ability to firmly control inflammation for early initiating cell proliferation, including the regulation of α-SMA expression associated with wound closure acceleration. AIM: This study aimed to explore the role of HMSCs in accelerating the optimum wound closure percentages through controlling the α-SMA expression. MATERIALS AND METHODS: Twenty-four full-thickness rats wound model were randomly divided into four groups: Sham (Sh), Control (C) by NaCl administration only, and two treatment groups by HMSCs at doses of 1.5×106 cells (T1) and HMSCs at doses of 3×106 cells (T2). HMSCs were incubated under hypoxic conditions. The α-SMA expression was analyzed under immunohistochemistry staining assay, and the wound closure percentage was analyzed by ImageJ software. RESULTS: This study showed a significant increase in wound closure percentage in all treatment groups that gradually initiated on days 6 and 9 (p < 0.05). In line with the increase of wound closure percentages on day 9, there was also a significant decrease in α-SMA expression in all treatment groups (p < 0.05), indicating the optimum wound healing has preceded. CONCLUSION: HMSCs have a robust ability to accelerated wound closure improvement to the optimum wound healing by controlling α-SMA expression depending on wound healing phases.

9 citations


Journal ArticleDOI
TL;DR: The prevalence of sleep disorders in adolescents is considerably high and there is an association between screen time and sleep disorders that occur in adolescents during the COVID-19 pandemic era.
Abstract: BACKGROUND: Sleep disorders encompass disturbances in the amount, quality, or timing of sleep. Several factors have contributed to sleep disorders in adolescents, including the use of electronic devices. In the COVID-19 pandemic era, there is a rising trend of screen time. AIM: The objective of the study was to identify the prevalence of sleep disorders in adolescents and its relation with screen time during the COVID-19 pandemic era. METHODS: This is a cross-sectional study involving students aged 15–18 years at three State High School, Denpasar, and Santo Yoseph Senior High School, Denpasar, in August 2020, using purposive sampling method. Data collections on characteristics of the subjects and Pittsburgh Sleep Quality Index (PSQI) were performed using Google Forms. Statistical analysis was performed using Chi-square test. RESULTS: A total of 243 students participated in this study, of which 39 students were excluded due to chronic diseases and consumption of caffeine within 6 h before bedtime. Sleep disorder was found in 30.4% of subjects and mostly characterized by sleep duration of <8 h (62.9%). Analysis of the association between screen time and sleep disorders showed a significant result (PR = 3.8, 95%CI = 1.09–13.1, p = 0.02). CONCLUSION: The prevalence of sleep disorders in adolescents is considerably high. There is an association between screen time and sleep disorders that occur in adolescents during the COVID-19 pandemic era.

9 citations


Journal ArticleDOI
TL;DR: Analysis of factors related to the incidence of stunting in children under-five in the working area of the Palu City Health Center is considered necessary in supporting the government in determining policies to tackle stunting problems.
Abstract: OBJECTIVE: In Indonesia, stunting is a nutritional problem that is a threat to the growth and development of toddlers since the beginning of life. The total stunting of children under-five in 2018 in Palu city was 30.8%. Hence, it is necessary to strengthen the system that supports the determination of continued government policies in achieving a reduction in the incidence of stunting. METHODS: A case control with research subjects totaling 520 toddlers. The sampling technique used was proportional stratified random sampling at all Puskesmas Kota Palu. RESULTS: There is a multifactorial relationship between knowledge variables (p = 0.019), children have been sick (p = 0.000), mother’s height (p = 0.050), and mother’s education (p = 0.000) against the incidence of stunting. Low knowledge has a chance of 1.581 times and the status of the child having been sick has a chance of 9.166 times the incidence of stunting. CONCLUSION: Multiple factors play a role in causing stunting in the city of Palu. Analysis of factors related to the incidence of stunting in children under-five in the working area of the Palu City Health Center is considered necessary in supporting the government in determining policies to tackle stunting problems.

8 citations


Journal ArticleDOI
TL;DR: Training of health Cadres effectively increases the knowledge, attitudes, and skills of health cadres about early detection and risk factors of stunting in the working area of Tomini Public Health Centre.
Abstract: AIM: This study aimed to determine the effectiveness of training in improving health cadres’ ability in early detection and risk factors of stunting in toddlers. METHODS: The research method used was a quasi-experimental non-randomized pre- and post-test only control design. The independent variable was cadre training. The training was conducted through learning activities on health cadres using lecture method, question and answer method, and brainstorming accompanied by training booklets/modules and demonstrations. The dependent variable was knowledge, attitudes, and skills in detecting stunting and risk factors for stunting in children under-five. There were 53 health cadres as samples scattered in the Tomini Community Health Center with the purposive sampling technique. The data analysis technique used was a parametric statistical paired sample t-test. RESULTS: Training of health cadres effectively increased health cadres’ ability to detect stunting and risk factors for stunting in children under-five. The different test results for each variable that showed the pre-post-test p-value for knowledge, attitudes, and health cadres’ skills were 0.000, smaller than the significance level of 0.05 (p 12.264, attitudes 33.603 >27.226, and skills 90.019 >62113. Those are means that cadres’ training effectively increased the knowledge, attitudes, and skills of health cadres in detecting stunting and risk factors for stunting in children under-five. CONCLUSION: Training of health cadres effectively increases the knowledge, attitudes, and skills of health cadres about early detection and risk factors of stunting in the working area of Tomini Public Health Centre, Parigi Moutong Regency.

8 citations


Journal ArticleDOI
TL;DR: In this article, the relationship between serum brain-derived neurotrophic factor (BDNF) levels and obesity predictor markers (body mass index and waist to hip ratio) and inflammation (interleukin-6 and Tumor Necrosis Factor-alpha) levels in females with obesity was investigated.
Abstract: BACKGROUND: Obesity has been widely associated with structural and functional changes in the brain, whereas inflammation is one of the potential mechanisms involved in these changes. OBJECTIVE: This study aims to prove the relationship between serum brain-derived neurotrophic factor (BDNF) levels and obesity predictor markers (body mass index and waist to hip ratio) and inflammation (interleukin-6 and Tumor Necrosis Factor-alpha) levels in females with obesity. METHODS: This study used a cross-sectional study method using 33 females with obesity aged 19-23 years, body mass index (BMI) > 27.5 kg/m2, normal blood pressure, normal resting heart rate (RHR), normal hemoglobin (Hb), and fasting blood glucose (FBG) ≤ 100 mg/dL. The examination of serum BDNF, IL-6, and TNF-α levels using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The data were analyzed using Pearson product-moment test with a significant levels p<0.05. RESULTS: The results indicated that there is a negative correlation between serum BDNF levels and BMI (r = –0.759; p<0.001), WHR (r = –0.675; p<0.001), IL-6 levels (r = –0.530; p<0.001) and TNF-α levels (r = –0.561; p<0.001). CONCLUSION: Based on the results of the study, there is a negative correlation between serum BDNF levels and BMI, waist to hip ratio, and inflammation (interleukin-6 and Tumor Necrosis Factor-alpha) levels in females with obesity. Further studies are needed to confirm the present findings.

8 citations


Journal ArticleDOI
TL;DR: Specific interventions to prevent stunting in children under 2 years after natural disasters are breastfeeding children up to 2 years, and mothers need to be informed about the risks and assistance from local and central government.
Abstract: BACKGROUND: Nutrition specific reflects most of the evidence of programmatic successes, such as improving breastfeeding. Specific intervention is an action or activity that is specifically directed at the first 1000 days of life. In general, these activities are carried out by the health sector. AIM: Study aims to analyze specific interventions for preventing stunting in children under 2 years of age in post-natural disaster areas. METHODS: This type of quantitative analytic research with a cross-sectional design conducted in Palu City central of Sulawesi Indonesia from October until November 2020. The population in this study were mothers and children under 2 years. Sampling using consecutive sampling technique with a total of 384 samples. Data analysis using a frequency distribution, height Z score table according to the Ministry of Health of the Republic of Indonesia. RESULTS: The prevalence of stunting in children under 2 years of age in Palu was 37.24%. The only specific intervention behavior in preventing stunting that was statistically significant was breastfeeding for up to 2 years (p = 0.025). CONCLUSIONS: Specific interventions to prevent stunting in children under 2 years after natural disasters are breastfeeding children up to 2 years. The prevalence of stunting in children under 2 is 37.24%. To reduce stunting problems in the city of Palu Central Sulawesi, Indonesia, mothers need to be informed about the risks and assistance from local and central government.

7 citations


Journal ArticleDOI
TL;DR: Egyptian participates had good level of knowledge, positive attitude about COVID-19 infection and, poor practice; however, community educational campaigns are necessary to ensure to improve on practice campaigns.
Abstract: BACKGROUND: The outbreak of coronavirus pandemic in Wuhan, China, since December 2019 has been the major public health concern. With the absence of an effective vaccine or treatment for the disease, current control measures are directed toward preventive measures to lessen disease burden and to curb the spread of the virus. AIM: The aim of the study was to assess knowledge, attitudes, perceptions, and practices (KAPP) of adult Egyptians toward COVID-19 and to study their determinants. METHODS: A community-based cross-sectional survey of a random sample of 999 Egyptian residence aged 16 years and above, it was conducted between April and June 2020 using self-administrated online questionnaire. It consisted of 15, five, and eight questions pertaining to knowledge, attitude, and practices toward COVID-19, respectively, in addition to demographic data. Data were analyzed using SPSS Statistics 23.0 at a level of significant at p ≤ 0.05. RESULTS: Out of the 999 participants, 628 (62.8%) were aged (20-<40y), 666 (66.7%) were females 576 (57.6) from urban residence, 665 (66.7%) were married with university educated or higher 605 (60.5%), and only 105 (10.5%) had chronic diseases. The total knowledge score was significantly higher among highly educated, females, in rural areas, married, and governmental workers, while higher educational status, females, married, smokers, and being without chronic diseases and governmental workers were significantly associated with higher practice scores. CONCLUSIONS: Egyptian participates had good level of knowledge, positive attitude about COVID-19 infection and, poor practice;however, community educational campaigns are necessary to ensure to improve on practice campaigns. © 2021 Doaa I. Omar, Samar A. Amer.

Journal ArticleDOI
TL;DR: P Piper betle L. leaf extract is a suitable, cheap, and environmentally safe method for controlling M. domestica, and mortality was affected by concentration, contact time, and the interaction between concentration and contact time.
Abstract: BACKGROUND: The housefly, Musca domestica L., spreads disease by contaminating food. However, chemical insecticides used to combat houseflies can pollute the environment and can harm non-target insects and humans; this demands safer alternatives and pest control options. AIM: This study aims to evaluate the effectiveness of Piper betle L. leaf extract as a bio-pesticide against houseflies. METHODS: This study using a factorial design with six variations in concentration (0%, 5%, 10%, 15%, 20%, and 25%), four variations in contact time (15, 30, 60, and 120 minutes), and 5-day-old M. domestica adults that were bred from residential areas. RESULTS: The results show that mortality was affected by concentration (p-value < 0.000), contact time (p-value < 0.000), and the interaction between concentration and contact time (p-value = 0.0007). Of the three, concentration had the greatest effect. CONCLUSION: As such, the use of Piper betle L. extract is a suitable, cheap, and environmentally safe method for controlling M. domestica.

Journal ArticleDOI
TL;DR: Significant variability in the transcriptional activity of the genes of encoding neurotrophins and their receptors in the peripheral blood in people with thyroid diseases is indicated.
Abstract: Objective. Thyroid hormone has an especially strong impact on central nervous system development, and thyroid hormone deficiency has been shown to result in severe mental retardation. It is crucial to identify compensatory mechanisms that can be involved in improving cognitive function and the quality of life of patients with hypothyroidism. Methods: We used the pathway-specific PCR array (Neurotrophins and Receptors RT2 Profiler PCR Array, QIAGEN, Germany) to identify and validate neurotrophins genes and their receptor expression in patients with thyroid pathology and control group. Results: The analysis of gene expression of neurotrophins and their receptors showed that CRHBP, FRS2, FRS3, GFRA1, GFRA2, GMFB, NGF, NRG2, NRG4, NTF4, TRO, and VGF significantly decreased their expression in Group 3, which includes the patients with postoperative hypothyroidism. The patients with primary hypothyroidism stemming from AIT had significantly reduced expression of CRHBP, GFRA1, GFRA2, GMFB, NGF, PTGER2, and VGF, while the expression of NRG4 and TRO increased. In Group 3, which includes the patients with AIT and elevated serum anti-Tg and anti-TPO autoantibodies, the mRNA levels of GFRA2, NGF, NRG2, NTF4, NGF, PTGER were reduced, and the expression of CRHBP, FRS2, FRS3 GFRA1, GMFB, NRG4, TRO, and VGF significantly increased. Conclusion: These results indicate significant variability in the transcriptional activity of the genes of encoding neurotrophins and their receptors in the peripheral blood in people with thyroid diseases.

Journal ArticleDOI
TL;DR: Recognizing the basic principles of managing brachial plexus injuries is indispensable for all clinicians who treat these injuries.
Abstract: Brachial plexus injury is known to be one of the most serious upper limb injuries, causes paralysis of the upper limbs and changes in activity of daily living, with the consequence disruption of activity of daily living, socio-economic problems, depression, and hopelessness. Management must be done properly. The evaluation and examination consist of detailed anamnesis on chronological events, complete physical examination, imaging studies, and electrophysiology study. Management can be done nonsurgically and surgically. Knowledge of the history of injury, timing of surgery, priority in restoring function, and managing patient expectations are important concepts in treating patient with brachial plexus injury. Timing is a very important thing. The results of these interventions vary depending on several parameters. Recognizing the basic principles of managing brachial plexus injuries is indispensable for all clinicians who treat these injuries.

Journal ArticleDOI
TL;DR: It is implied that diabetes mellitus patients need support from their families to accept the disease and eventually volunteer to carry out their disease care at home.
Abstract: BACKGROUND: Perspectives of diabetes mellitus patients on family support received during the treatment of their disease at home has high complexity. The family’s intention to help patients to take care of themselves at home can lead to misperceptions or is not well accepted by diabetes mellitus patients. AIM: The aim of the study was to explore the support provided by families in the care of diabetes mellitus patients at home based on the patient’s perspective. METHODS: A phenomenological study using semi-structured questions was chosen as a design in this study. A total of 19 participants were recruited using criteria including being diagnosed with diabetes mellitus for at least 1 year, outpatient, and willing to participate in the study. Data analysis used seven steps of descriptive phenomenological analysis from Colaizzi including data recognition, identification of significant statements, formulating meanings, grouping themes, developing complete descriptions, producing fundamental structures, and seeking verification of fundamental structures. RESULTS: This research shows that the support needed by participants comes from the nuclear family. The first theme identified is the family function as participants’ perceived support. The second theme identified is the family role as participants’ perceived support. The fourth third theme identified is perceptions of family support received. Moreover, the final theme found in this study is perception of spiritual support by the family. CONCLUSION: This research implies that diabetes mellitus patients need support from their families to accept the disease and eventually volunteer to carry out their disease care at home.

Journal ArticleDOI
TL;DR: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.
Abstract: BACKGROUND: Chronic kidney disease (CKD) is a chronic illness with complex disease which could lead to other underlying diseases such as diabetes mellitus (DM), hypertension, and dyslipidemia. Urban population must manage their illness due to their occupation. Coaching support is an advanced method to help individuals manage their illnesses, especially chronic illness. Symptoms and complaints in early-stage renal disorders tend to be mild, making it difficult to diagnose only by clinical examination. Impaired kidney function can lead to progressive kidney damage. AIM: This study aimed was to analyze the effect of coaching support in maintaining kidney function in patients with CKD. METHODS: This research used quasi-experiment with pre-test and post-test with control group design. Respondents in this study were 40 CKD patients which were taken by consecutive sampling technique and divided into two groups, namely, control group and treatment group. Data were collected using blood urea nitrogen and creatinine values observation sheet. Coaching support was divided into four steps of therapy, identify the disturbance, identify based on experience, use a family support system, and evaluating the results. Data were analyzed using paired t-test and independent t-test with a significance of p < 0.05. RESULTS: This study found that there was a significant difference in kidney function between the control group and the treatment group (p = 0.000). Coaching support interventions were effective on kidney function in patients with CKD. The implementation of coaching support went well because respondents and families were proactive. CONCLUSION: Coaching support should be applied by nurses as daily activity management of CKD patients at early stage to inhibit the kidney function damage progression.

Journal ArticleDOI
TL;DR: The result suggested that five factors model of EPS which includes: the suppression, sign of unprocessed emotion, unregulated emotion, avoidance, and impoverished emotional experience model fit the data well be most appropriated for Iranian population.
Abstract: BACKGROUND: Emotional processing scale (EPS) is a fundamental test for measurement of the abnormal processing of emotion and psychosomatic disorders in psychotherapy sessions. Despite its importance, EPS has not been yet translated and validated in the Iranian population. AIM: To fill this gap, this study aims to adapt and examined the psychometric properties of five EPS in the Iranian population. Using cluster sampling, we selected 1283 university students. METHODS: The structural equation modeling and confirmatory factor analysis used to analyze the assessment of validity. RESULTS: The result showed the Cronbach’s alpha, split half, and test re-test reliability in acceptable ranges; 0.91, 0.90, and 0.91, respectively, for total scores scale. Root Mean Square Error of Approximation, Standardized Root Mean Square Residual, goodness of fit, and comparative fit index were at an acceptable range, 0.07, 0.05, 0.90, 0.90, 0.89, and 0.85, respectively. The total scores of EPS also showed a positive correlation (0.63, p < 0.001) with GHQ 28. CONCLUSION: The result suggested that five factors model of EPS which includes: The suppression, sign of unprocessed emotion, unregulated emotion, avoidance, and impoverished emotional experience model fit the data well be most appropriated for Iranian population.

Journal ArticleDOI
TL;DR: Efforts to minimize the negative impacts of tourism should be undertaken to improve community support for tourism development, as shown in the results of a systematic review.
Abstract: BACKGROUND: Tourism development can have a positive or negative impact on the lives of local communities. AIM: This systematic review aims to determine the impact of tourism on the quality of life (QoL) of people in tourist destination areas. METHODS: The search was conducted on the Science Direct database, Taylor Francis, EBSCO Host, Wiley Online Library, and Google Scholar. The keywords used were “residents’ QoL” AND impacts of tourism. Inclusion criteria were articles that focus on the QoL of people in tourist destination areas, published from 2015 to 2019 in peer-reviewed journals, in English. Articles were excluded if they were qualitative studies, literature reviews, and if full papers were unavailable. The review was conducted on 18 articles selected from 673 articles obtained in the initial search. RESULTS: Tourism has an impact on the QoL of local communities. In general, the domains that are perceived as being positively affected are the improvement of the economy, employment opportunities, community pride, cultural exchanges, and increased facilities availability. Meanwhile, the domains that are negatively affected in most of the studies are health, safety, quality of the physical environment, cost of living, accessibility to public facilities, and social relations. Apart from that, there is also dissatisfaction with the types of jobs available and the low level of community involvement in tourism development. CONCLUSIONS: Tourism can have both positive and negative impacts on the QoL of local communities. Efforts to minimize the negative impacts of tourism should be undertaken to improve community support for tourism development.

Journal ArticleDOI
TL;DR: Birth weight and mother’s occupation are the determinant cause of stunting in children under 5 years of age in urban slums areas in Yogyakarta District, Indonesia.
Abstract: BACKGROUND: In Indonesia, health indicators in urban areas are better than in rural areas. It is related to the health services’ accessibility. However, in some regions, the stunting rate among children under five in urban areas is higher than in rural areas, including in Yogyakarta. AIM: The research purpose was to analyze the determinant factor influencing the stunting incidence in children under five in urban slums areas. MATERIALS AND METHODS: The study design employed a case control with a sample of mother and 29 children under five as a case group and 42 children under five as a control group in Yogyakarta District during the December–January 2020 period. The inclusion criteria were children aged 6–59 months living in the urban slum area, while the exclusion criteria were children who had physical and mental disabilities, suffering from illness or were hospitalized, and had congenital diseases. The data collection was conducted by questionnaire and anthropometric measurements. Data analysis used central tendency, Chi-square, and logistic regression. RESULTS: The results showed that the majority of children were girls in the case group and boys in the control group with a history of non-exclusive breastfeeding. Most respondents have mothers with low levels of education and work as housewives. The results of the correlation test showed that of the seven variables studied as a risk factor, there are two factors which were birth weight and mother occupation which were related with stunting in children under five with p = 0.041 and 0.047, respectively. CONCLUSION: This study concluded that birth weight (AOR = 3.49) and mother’s occupation (AOR = 0.25) are the determinant cause of stunting in children under 5 years of age in urban slums areas. The pregnant women’s health promotion needs to be improved because it will affect birth weight, a risk factor for stunting in children under five.

Journal ArticleDOI
TL;DR: Medical students who used the ultrasound flashcards to learn POCUS had resulted in better knowledge scores rather than the others who attended the standard ultrasound training course only, however, it was not possible to evaluate the practical skills and the clinical decision-making processes in this study.
Abstract: BACKGROUND: The use of point-of-care ultrasound (POCUS) has recently proposed the integration of ultrasound into undergraduate medical education However, the evidence of learning tool for this integration has not been well studied AIM: The aim of this study was to compare the levels of knowledge improvement of the 6th year medical students before and after receiving the POCUS training in two ways: By employing the traditional methods and by utilizing the new learning tool METHODS: The practical ultrasound flashcards were developed by a Thai physician In the study, the 6th year medical students were enrolled and randomized to become members of either the flashcard group or the control group Participants in both groups attended a 4-week ultrasound training course Before and after the training course, all students were evaluated using the multiple-choice questions In addition, the subjects’ attitudes and perceptions about the flashcards were evaluated using a questionnaire RESULTS: A total of 46 students participated in this study and were randomly assigned to either the flashcard group (n = 23) or the control group (n = 23) It was discovered that the students in the flashcard group had performed better on the POCUS knowledge post-test than those in the control group had Most students had been satisfied with the flashcards (mean 5 Likert scores = 448) However, the students had rated their confidence score to perform POCUS at 396 out of 50 CONCLUSIONS: Medical students who used the ultrasound flashcards to learn POCUS had resulted in better knowledge scores rather than the others who attended the standard ultrasound training course only However, it was not possible to evaluate the practical skills and the clinical decision-making processes in this study

Journal ArticleDOI
TL;DR: Alginate beads containing turmeric extract solid dispersion were effective in treatment of gastric ulcer in rats and were statistically significantly different from negative control.
Abstract: BACKGROUND: Treatment of gastric ulcer using turmeric extract is less effective because curcumin has low solubility and degraded in alkaline intestinal pH. Therefore, it is necessary to convert turmeric extract into turmeric solid dispersion to increase the dissolution of curcumin and the preparation is made in gastroretentive drug delivery system to improve the absorption of curcumin in the stomach. AIM: The aim of the study was to determine the anti-ulcer effect of gastroretentive drug delivery system of alginate beads containing turmeric extract solid dispersion compared to alginate beads containing turmeric extract (without solid dispersion) and negative control. METHODS: Turmeric powder was macerated with 96% ethanol for 8 days. The macerate was evaporated with a rotary evaporator at 50°C to obtain a concentrated extract. Turmeric extract solid dispersion was prepared by the solvent method using polyvinylpyrrolidone as a carrier. The turmeric extract solid dispersion was encapsulated with alginate gel by gelation method. The antiulcer test was performed on rats with gastric ulcer that induced by 0.6 N HCl solution. The ulcer healing was observed macroscopically and microscopically (histopathology). RESULTS: The results of observation on the treatment of rats gastric ulcer that induced by 0.6 N HCl showed the gastroretentive drug delivery system of alginate beads containing turmeric extract solid dispersion effective in healing the gastric ulcer compared to negative control. The effectiveness was statistically significantly different (p 0.05). CONCLUSION: Alginate beads containing turmeric extract solid dispersion were effective in treatment of gastric ulcer in rats.

Journal ArticleDOI
TL;DR: It is concluded that in psychogenic ED, an intersystematic approach is important for determining the root cause of the problem and finding the right core cause will determine the right treatment.
Abstract: Psychogenic erectile dysfunction (ED) is a very common condition in men. About 40% of ED cases are psychogenic. Many of the psychogenic ED patients are young men. The causes of psychogenic ED can be generalized as well as situational. Psychogenic management approaches are different from organic ED. In patients with psychogenic ED, an intersystemic approach is needed for both the patient and his partner. This intersystemic approach will inspect the real cause of the problem. Intersystemic approach: The intersystemic approach not only focuses on the patient side but also on his partner. This approach provides space for partners to explore and understand their sexual life. In this article, we focus to explore a research that conducts intersystemic principle in ED management. We conclude that in psychogenic ED, an intersystematic approach is important for determining the root cause of the problem. Finding the right core cause will determine the right treatment. This therapy can combine with pharmacologic treatments. These therapies can give a better outcome for psychogenic ED.

Journal ArticleDOI
TL;DR: Of all the formulas that have been prepared, sambiloto leaves tea formula F1 was obtained the best chemical and antioxidant properties among all formulas, which were composed of 100% sambILoto leaves, 5% honey, and 45% dates.
Abstract: AIM: The purpose of this study was to develop a tea formula of sambiloto leaves, analyzed the chemical properties (polyphenols, tannins, water, extracts in water, total ash, water soluble ash, water-insoluble ash, insoluble acid ash, and water-soluble ash alkalinity) as well as the antioxidant capacity of the formula. METHODS: This research was divided into two stages. The first stage was the formulation of sambiloto leaves tea and the second stage was the analysis of chemical properties (levels of polyphenols, tannins, water, extracts water, total ash, water soluble ash, water-insoluble ash, insoluble acid ash, and water soluble ash alkalinity) and antioxidant capacity analysis. The analysis was carried out on all of the sambiloto leaves tea formulas to determine the effect of the formulations on chemical properties and antioxidant capacity. This study used Microsoft Excel 2013 in data processing management. RESULTS: The highest extract water was at F4, and the lowest was at F1. Based on the analysis, the formula of sambiloto leaves tea was in the range of 1.026–1.734%. Of all the formulas that have been prepared, sambiloto leaves tea formula F1 was obtained the best chemical and antioxidant properties among all formulas, which were composed of 100% sambiloto leaves, 5% honey, and 45% dates. CONCLUSION: Sambiloto leaves have good antioxidant activity and can be used as a drink in the form of an infusion, such as tea. The result of brewing the sambiloto tea formula has faded green color. The polyphenol content of the sambiloto leaves tea formula still did not meet the Indonesia National Standard (≥5.2%), was 1.5–3.1%.

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TL;DR: Combination of CL and PN has potential for the treatment of metastaticBCSCs by targeting ANXA2, EGFR, MMPs, and PKM to resolve stemness and inhibit of BCSCs.
Abstract: AIM: This study aimed to investigate the synergistic effects of the combination between Curcuma longa extract (CL) and Phyllanthus niruri extract (PN) in inhibiting optimally the MDA-MB-231 breast cancer stem cells (BCSCs) growth and metastatic by exploring the target and molecular mechanism using integrative bioinformatics approaches and in vitro. METHODS: CL and PN extracts were prepared by maceration method using ethanol 70%. The antiproliferative effect of CL and PN single and combination treatment was examined by 3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyl-2H-tetrazolium bromide assay. The bioinformatic approach was performed to identify molecular targets, key proteins, and molecular mechanism of curcumin and phyllanthin as CL and PN secondary metabolite, respectively, targeted at stemness and migration pathway of BCSCs. RESULTS: The in vitro study showed that CL and PN possess cytotoxic activity in time- and dose-dependent manner. The combination of CL and PN has a synergistic effect by modulating the sensitivity of cells. Using a bioinformatics approach, the annexin A2 (ANXA2), epidermal growth factor receptor (EGFR), matrix metalloproteinases (MMPs), and pyruvate kinase M1/2 (PKM) as potential targets of curcumin and phyllanthin correlated with metastatic inhibition of BC. In addition, molecular docking showed that curcumin and phyllanthin performed similar or better interaction to stemness differentiation regulator pathway particularly histone deacetylase 1, EGFR, Heat Shock Protein 90 Alpha Family Class B Member 1, Hypoxia Inducible Factor 1 Subunit Alpha, and MMP9. CONCLUSION: Combination of CL and PN has potential for the treatment of metastatic BCSCs by targeting ANXA2, EGFR, MMPs, and PKM to resolve stemness and inhibit of BCSCs.

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TL;DR: In this article, the impact of online game addiction on adolescents using the Preferred Reporting Items for Systematic Reviews (PRISMA) approach was analyzed using 81 articles of which 20 were deemed relevant for this systematic review.
Abstract: : Introduction: The World Health Organization (WHO) in 2019 determined that Internet Gaming Disorders (IGD) were included as mental health disorders. Among adolescents, excessive online gaming has become a lifestyle and is associated with psychological symptoms (psychopathological symptoms and life satisfaction), social health (social interactions) and physical health (general health and body mass index). The IGD has now become a problem all over the world. AIM: This study aims to analyze the impact of online game addiction on adolescents using the Preferred Reporting Items for Systematic Reviews (PRISMA) approach. MATERIALS AND METHODS: Subjects were searched extensively from the Pubmed, Sage, Science Direct, and Scopus databases. The search used the keywords "online game addiction", "mental health", and "youth". The inclusive criteria for the included literature in this study were as follow; the literature had to be sourced from journal article, written in English, available in full text, the published between 2011-2021, and the age of the adolescent subject should be 13-18 years. We identified 81 articles of which 20 were deemed relevant for this systematic review. RESULTS: This review study shows that problematic online gaming behavior has a strong negative correlation with various subjective health outcomes. CONCLUSION: Early relevant prevention for adolescents from the IGD is the appropriate use of internet/ gadgets as the only option to avoid or to reduce the symptoms of internet addiction and online games. Keywords : Online game addiction; Mental health; Adolescents; Good Health and Wellbeing

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TL;DR: In this paper, the authors used the brine shrimp (Artemia salina Leach) lethality test (BSLT) to determine the cytotoxicity of green and red betel leaves.
Abstract: Traditional medicine is currently being explored and developed widely by various countries because its cost effectiveness and reduced side effects. The green betel (Piper betle Linn.) and the red betel (Piper crocatum Ruiz and Pav.) are plants from the same Piper genus that are widely cultivated in Indonesia and have various phytochemical properties and pharmacological effects. The objective of this research is to determine the cytotoxicity of green leaves and red betel leaves. This research was conducted in two main stages: first, the extraction and preparation through the soxhletation method; second, a cytotoxicity test through the brine shrimp (Artemia salina Leach) lethality test (BSLT). The results showed that there were lethal concentration 50 % (LC50) value in both green betel leaves ethanolic extract and red betel leaves ethanolic extract, with 44.975 μg per mL and 31.556 μg per mL, respectively. The red betel (leaves ethanolic extract has a higher cytotoxicity than green betel (leaves ethanolic extract which can be seen from the lower lethal concentration of 50% (LC50) value. The difference in cytotoxicity is due to differences in plant varieties that cause variations in phytochemical content which affects the pharmacological effects. The green betel leaves ethanolic extract and the red betel leaves ethanolic extract are cytotoxic and have potential anticancer properties.

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TL;DR: It was indicated that GG genotype was common genotype in the IL-6-597 G/A gene polymorphism and the polymorphism was significantly with theIL-6 levels.
Abstract: BACKGROUND: Interleukin-6 (IL-6) pro-inflammatory cytokines play a role in the pathogenesis of inflammatory reactions in type 2 diabetes mellitus (T2DM) The -597G/A is one of IL-6 gene polymorphisms that are associated with the T2DM risk AIM: This study aimed to observe the polymorphism in IL-6-597 G/A gene and their levels on type 2 diabetic patients at Universitas Sumatera Utara Hospital MATERIALS AND METHODS: IL-6 -597 G/A gene polymorphisms and levels were done in 80 type 2 diabetic patients The levels of IL-6 were performed by enzyme-linked immunosorbent assay method Analysis of IL-6-597 G/A gene polymorphism was done using polymerase chain reaction (PCR) and restriction fragment length polymorphism The PCR products were cut by FokI restriction enzyme and then visualized with 4% agarose RESULTS: This study showed that the genotype frequency of GG and GA was 975 % and 25 %, respectively; however, no A/A genotype shown in this population IL-6 levels were higher in GG genotype group compare to GA+AA genotype group, with the association were significant (p < 005) CONCLUSION: This study indicated that GG genotype was common genotype in the IL-6-597 G/A gene polymorphism and the polymorphism was significantly with the IL-6 levels

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TL;DR: Psychiatric nurses ought to motivate and help accompany families to monitor the personal hygiene fulfillment ability of family members with mental disorders, and the use of behavioral therapy (economic tokens) was found to improve the ability of ODGJ to carry out personal hygiene.
Abstract: BACKGROUND: Some common problems experienced by all people with mental disorders (ODGJ) are impaired personal hygiene activities including bathing, dressing up, eating, and toileting. Psychiatric nurses must, therefore, possess the ability and knowledge on how to meet the personal hygiene requirements for these patients by providing caregiving with behavioral therapy (economic tokens), through behavior modification, using positive reinforcement. AIM: This study aimed to apply behavioral therapy (economic tokens) to the ability of ODGJ in the fulfillment of personal hygiene within Medan Sunggal subdistrict. MATERIALS AND METHODS: The research type used was quasi-experiment with the one-group pre-test-post-test approach, while the procedure was performed by providing nursing actions in the form of behavioral therapy (economic tokens). This study involved a total of 31 respondents with mental disorders ODGJ, obtained through total sampling in the unified Medan Sunggal subdistrict. RESULTS: The use of behavioral therapy (economic tokens) was found to improve the ability of ODGJ to carry out personal hygiene, with a mean difference of 1.19 (from 1.87 to 3.06). CONCLUSIONS: Psychiatric nurses, therefore, ought to motivate and help accompany families to monitor the personal hygiene fulfillment ability of family members with mental disorders.

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TL;DR: In this paper, the molecular interaction between the active constituents of Ficus religiosa with TNF-alpha and VEGFR was investigated and the results indicated that it has a strong anti-inflammatory impact.
Abstract: BACKGROUND: Diabetes mellitus contributes to the delayed healing of wounds causes disturbance of inflammatory cytokine. Tumour necrosis factor alpha (TNF-alpha) and Vascular Endothelial Growth Factor Receptor (VEGFR) both have a role in the persistent inflammation associated with diabetic wounds. Ficus religiosa has developed a reputation as a traditional wound healer among some java people in Indonesia. AIM: Our study aims to discover the molecular interaction between the active constituents of F. religiosa with TNF-alpha and VEGFR. MATERIALS AND METHODS: This research was conducted in computerized molecular docking using Protein database, Pymol, Discovery studio, and Pyrex software. A thorough literature search was conducted to identify the potential compound and molecular target for diabetic wounds. Analysis of its anti-inflammatory properties was also carried out using a passonline webserver. Pharmacokinetic analysis was performed using the Lipinski Rule of Five websites and the PreADMET website. RESULTS: Each of the study’s active compounds has a good pharmacokinetic profile. The predictions of the compound’s structure indicate that it has a strong anti-inflammatory impact. Lupenyl acetate and Lanosterol bind more strongly to the TNF-alpha than the natural ligand, but Piperine binds more strongly to VEGFR. CONCLUSIONS: Lupenyl acetate, Lanosterol, and Piperine compounds have anti-inflammatory effects through inhibition of TNF-alpha and VEGFR. In addition, this compound has potential to become a drug because it has good pharmacokinetics. Future studies are required to determine the effectiveness and toxicity of Lupenyl acetate, Lanosterol, and Piperine as potential treatment in diabetic wounds.

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TL;DR: Mechanical reperfusion with PCI procedure may be a superior choice in the settings of acute cardio-cerebral infarction for restoring hemodynamic stability.
Abstract: We report an uncommon case of simultaneous cardio-cerebral infarction, due to Inferior – right ventricle ST Segment Elevation Myocardial Infarction (STEMI) with acute ischemic stroke. Incidence of cardio cerebral infarction is exceptionally rare, with an incidence rate as low as 0.009%. Hemodynamic compromise in patients with acute myocardial infarction may result in the cerebral blood flow reduction that cause hemodynamic stroke. Due to the rarity of this condition, there were no recommended therapeutics strategy. Mechanical reperfusion with PCI procedure may be a superior choice in the settings of acute cardio-cerebral infarction for restoring hemodynamic stability.