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Relationship between urinary bisphenol A and age at menarche among adolescent girls: A study in Sumatera Utara Province, Indonesia Putri, Vriancha A.; Arto , Karina S.; Lubis , Aridamuriany D.; Dangana, Amos; Chiu, Yao-Hsuan
Narra X Vol. 2 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i2.161

Bisphenol A (BPA) is an endocrine-disrupting chemical widely used in various consumer products. Due to its estrogenic properties, BPA exposure is suspected to influence reproductive development, particularly the timing of menarche in adolescent girls. The aim of this study was to assess the relationship between urinary BPA levels and the age at menarche among adolescent girls in Sumatera Utara Province, Indonesia. A cross-sectional study was conducted in January 2023 involving 30 adolescent girls aged 9–14 years attending junior high school in Sumatera Utara. Data on age, body weight, height, and body mass index (BMI) were collected. Urinary BPA levels were detected using high-performance liquid chromatography (HPLC). The Mann-Whitney U test was employed to determine the association between BPA detection and age at menarche. BPA was detected in the urine of 3 out of 30 participants. The median age at menarche for girls with detectable BPA was 11 years, while those without detectable BPA had a median age of 11 (ranging from 10 to 12 years). The difference in age at menarche between the two groups was not statistically significant (p=0.646). In conclusion, this study did not find a significant association between urinary BPA levels and the timing of menarche among adolescent girls in Sumatera Utara Province. Further research with a larger sample size and consideration of additional confounding factors is recommended to better understand the potential impact of BPA on pubertal development.

Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients Adida, Fiony; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Ashar, Taufik; Dangana, Amos; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.412

Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the “Paru Sehat” smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient’s quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of “Paru Sehat” in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the “Paru Sehat” twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients’ characteristics and the knowledge scores within pre- and post-treatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although “Paru Sehat” application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.

Relationship of left ventricular diastolic dysfunction with quality of life in heart failure patients with reduced ejection fraction (HFrEF) Khaidirman, Sophia K.; Hasan, Harris; Andra, Cut A.; Lubis, Hilfan AP.; Dangana, Amos; Haykal, T. Bob
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.707

Heart failure is a complex clinical manifestation due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). Diastolic dysfunction of the LV plays an important role in worsening the quality of life (QoL) in heart failure patients. The aim of this study was to assess the relationship between the severity or grade of LV diastolic dysfunction and QoL in heart failure with reduced ejection fraction (HFrEF) patients. A retrospective cohort study was conducted at the Cardiac Center of H. Adam Malik Hospital, Medan, Indonesia, from January 2022 to December 2022. This study included inpatients and outpatients aged above 18 years who were diagnosed with HFrEF, identified by echocardiography with an ejection fraction of ≤40%. Echocardiography was performed to evaluate left ventricular diastolic dysfunction, and QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6–12 months after the severity of LV diastolic dysfunction was confirmed. The MLHFQ was classified into good and poor QoL. The severity of LV diastolic function was measured using the E/A ratio, mean E/e' ratio, tricuspid regurgitation velocity (TR Vmax), and left atrial volume index (LAVI), and was classified into grades I, II, and III. The relationships between the severity of diastolic dysfunction and other factors with QoL were measured using Chi-squared, Fisher's exact test, or Mann-Whitney test, as appropriate. A total of 96 patients were included in the study, of which 56 (58.3%) patients had grade I, 12 (12.5%) had grade II, and 28 (29.2%) patients had grade III of LV diastolic dysfunction. There were 77 (80.2%) and 19 (19.8%) patients with good and poor QoL, respectively. This study revealed a significant relationship between the severity of LV diastolic dysfunction and QoL in HFrEF patients with p=0.040. In conclusion, the degree of LV diastolic dysfunction is related to the QoL of HFrEF patients and therefore better comprehensive management strategies should be considered in HFrEF cases to address the impact of LV diastolic dysfunction on QoL.

Exploring the co-infection of tuberculosis and hepatitis B virus in people living with HIV: Implications for diagnosis and treatment Dansura, Mangpin L.; Dangana, Amos; Samuel, Bwede E.; Gagari, Villeng F.; Miri, Nanpon; Gyang, Nyiri M.; Adejuyigbe, Zacchaeus; Ugwu, Chinwe N.; Nanbol, Helen D.; Uzoebo, Nkiruka
Trends in Infection and Global Health Vol 4, No 2 (2024): December 2024
Publisher : School of Medicine, Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/tigh.v4i2.40662

Hepatitis B virus (HBV) and tuberculosis (TB) infections are common causes of liver cirrhosis and hepatocellular carcinoma. First-line anti-TB medications are known to cause drug-induced liver injury (DILI). This study aimed to investigate whether HBV and TB co-infection increase susceptibility to liver failure and poor outcomes during anti-TB treatment in HIV-positive patients. HBV infection was detected using the ELISA method, while TB infection was confirmed through Lowenstein-Jensen (LJ) medium culture. The severity and incidence of liver failure and mortality were compared, and risk factors influencing clinical outcomes were identified. Patients were categorized as new TB cases, relapse TB cases, or defaulters. Among the total cases, 64.5% were classified as new, 18% as relapse, and 17.5% as defaulters TB cases. The prevalence of HBV infection among new, relapse, and defaulter cases was 11.5%, 4.8%, and 1.6%, respectively. In terms of TB classification, the prevalence of HBV infection among patients with pulmonary TB and extrapulmonary TB was 10.6% and 7.1%, respectively, with no cases recorded in the defaulter category. The prevalence of triple infection (HIV-TB-HBV) was found to be 13.3% in new TB cases and 3.3% in relapse TB cases. Patients undergoing anti-TB therapy with chronic HBV co-infection were more susceptible to liver failure and had poorer treatment outcomes. Regular monitoring of liver function is essential, and anti-HBV therapy should be considered for patients with high viral loads before initiating anti-TB treatment.

Relationship between urinary bisphenol A and age at menarche among adolescent girls: A study in Sumatera Utara Province, Indonesia Putri, Vriancha A.; Arto , Karina S.; Lubis , Aridamuriany D.; Dangana, Amos; Chiu, Yao-Hsuan
Narra X Vol. 2 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i2.161

Bisphenol A (BPA) is an endocrine-disrupting chemical widely used in various consumer products. Due to its estrogenic properties, BPA exposure is suspected to influence reproductive development, particularly the timing of menarche in adolescent girls. The aim of this study was to assess the relationship between urinary BPA levels and the age at menarche among adolescent girls in Sumatera Utara Province, Indonesia. A cross-sectional study was conducted in January 2023 involving 30 adolescent girls aged 9–14 years attending junior high school in Sumatera Utara. Data on age, body weight, height, and body mass index (BMI) were collected. Urinary BPA levels were detected using high-performance liquid chromatography (HPLC). The Mann-Whitney U test was employed to determine the association between BPA detection and age at menarche. BPA was detected in the urine of 3 out of 30 participants. The median age at menarche for girls with detectable BPA was 11 years, while those without detectable BPA had a median age of 11 (ranging from 10 to 12 years). The difference in age at menarche between the two groups was not statistically significant (p=0.646). In conclusion, this study did not find a significant association between urinary BPA levels and the timing of menarche among adolescent girls in Sumatera Utara Province. Further research with a larger sample size and consideration of additional confounding factors is recommended to better understand the potential impact of BPA on pubertal development.

Co-infection of tuberculosis and hepatitis B virus in HIV patients: Implications for diagnosis and treatment Dansura, Mangpin L.; Dangana, Amos; Samuel, Bwede E.; Gagari, Villeng F.; Miri, Nanpon; Gyang, Nyiri M.; Adejuyigbe, Zacchaeus; Ugwu, Chinwe N.; Nanbol, Helen D.; Uzoebo, Nkiruka
Trends in Infection and Global Health Vol 5, No 1 (2025): June 2025
Publisher : School of Medicine, Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/tigh.v5i1.44389

Hepatitis B virus (HBV) and tuberculosis (TB) infections are common causes of liver cirrhosis and hepatocellular carcinoma. First-line anti-TB medications are known to cause drug-induced liver injury (DILI). The aim of this study was to investigate whether HBV and TB co-infection increases susceptibility to liver failure and poor outcomes during anti-TB treatment in HIV-positive patients. HBV infection was detected using the enzyme-linked immunosorbent assay (ELISA) method, while TB infection was confirmed through Lowenstein-Jensen (LJ) medium culture. The severity and incidence of liver failure and mortality were compared, and risk factors influencing clinical outcomes were identified. Patients were categorized as new TB cases, relapse TB cases, or defaulters. Among the total cases, 64.5% were classified as new, 18% as relapse, and 17.5% as defaulters of TB cases. The prevalence of HBV infection among new, relapse, and defaulter cases was 11.5%, 4.8%, and 1.6%, respectively. In terms of TB classification, the prevalence of HBV infection among patients with pulmonary TB and extrapulmonary TB was 10.6% and 7.1%, respectively, with no cases recorded in the defaulter category. The prevalence of triple infection (HIV-TB-HBV) was found to be 13.3% in new TB cases and 3.3% in relapse TB cases. Patients undergoing anti-TB therapy with chronic HBV co-infection were more susceptible to liver failure and had poorer treatment outcomes. Regular monitoring of liver function is essential, and anti-HBV therapy should be considered for patients with high viral loads before initiating anti-TB treatment.

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