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All Journal KESANS : International Journal of Health and Science
Humaryanto Humaryanto
Faculty of Medicine and Health Sciences, Universitas Jambi, Indonesia
Chemistry Health Professions Medicine & Pharmacology Physics Public Health

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Host, Agent, and Environmental Determinants of Postoperative Nausea and Vomiting Following Spinal Anesthesia: A Systematic Review Using the Epidemiological Triad Framework Mutia Putri Anggraini; Humaryanto Humaryanto; Ummi Kalsum
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.672

Abstract

Introduction: Postoperative nausea and vomiting (PONV) remains one of the most common complications following spinal anesthesia and may adversely affect patient recovery, satisfaction, and healthcare outcomes. Objective: This study aimed to identify and synthesize host, agent, and environmental determinants associated with PONV following spinal anesthesia using the Epidemiological Triad Framework. Method: A systematic review was conducted according to the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2023 and 2025. Eligible studies included randomized controlled trials, cohort studies, observational studies, and quasi-experimental studies involving patients undergoing spinal anesthesia. Data were extracted, critically appraised using Joanna Briggs Institute tools, and synthesized narratively. Results and Discussion: Twelve studies met the inclusion criteria. The most frequently reported host determinants were previous history of PONV, motion sickness, female sex, younger age, and elevated body mass index. Agent-related determinants included opioid exposure, intrathecal morphine, and intrathecal fentanyl, whereas dexamethasone, propofol, clonidine, and opioid-sparing analgesic techniques demonstrated protective effects. Environmental determinants included cesarean section, prolonged fasting, inadequate perioperative hydration, and intraoperative nausea and vomiting. Conclusion: PONV following spinal anesthesia is a multifactorial condition resulting from interactions among host, agent, and environmental factors. Early risk assessment and comprehensive preventive strategies are essential to reduce PONV incidence and improve postoperative outcomes
Comparative Effectiveness of Exercise-Based Interventions on Pain and Physical Function in Knee Osteoarthritis: A Narrative Review of Recent Evidence Syntheses Novin Tri Wahyuni; Ummi Kalsum; Humaryanto Humaryanto; Guspianto Guspianto
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 9 (2026): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i9.673

Abstract

Introduction: Knee osteoarthritis (KOA) is a leading cause of pain and disability among older adults, with exercise-based therapy widely recommended as first-line management. However, findings vary considerably across intervention types, comparators, and outcome measures. Objective: To synthesize and compare recent high-quality evidence regarding the effectiveness of Pilates, traditional Chinese exercise, and multi-modal physiotherapy on pain and physical function in KOA patients. Methods: A narrative synthesis was conducted using three recent evidence sources: a 2025 meta-analysis of Pilates exercise (11 RCTs, n=476), a 2023 meta-analysis of traditional Chinese exercise (17 RCTs, n=1,174), and the MOA Trial evaluating manual and exercise physiotherapy (n=206). Primary outcomes were pain (VAS, NPRS) and physical function (WOMAC) Results and Discussion: Pilates reduced pain versus no intervention (SMD −1.09; 95% CI −2.04 to −0.14) but showed no significant superiority over conventional exercise. Traditional Chinese exercise improved WOMAC pain, stiffness, and function compared with controls, with Tai Chi demonstrating the most consistent benefit. In the MOA Trial, manual physiotherapy produced the greatest WOMAC reduction (−28.5 points; 95% CI −47.8 to −9.2) Conclusion: All three modalities provided modest benefits, though evidence certainty ranged from very low to moderate with substantial heterogeneity. Individualized exercise prescription based on patient preference and access to supervised therapy is recommended over a single universal approach
Co-Authors Guspianto Guspianto Mutia Putri Anggraini Novin Tri Wahyuni Ummi Kalsum