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Hydroxyurea therapy for children with sickle cell anemia: A systematic review and meta-analysis Khansa, Firyal; Ghifari, Muhammad H.; Daffa, Muhammad B.; Nasywa, Fiola; Enitan, Seyi S.; Eleojo , Itodo G.; Ali, Mazen EI.
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.v2i2.164

Sickle cell anemia (SCA) is a major global health issue, particularly among pediatric population, influenced by factors such as malaria susceptibility and genetic distribution. On the other hand, hydroxyurea therapy has been a well-established and accepted treatment for SCA, with over 25 years of clinical experience. It has been proven to be safe and effective in preventing vaso-occlusive events and chronic organ damage. The aim of this study was to assess the efficacy of hydroxyurea in alleviating pediatric SCA. This study was comprised of a systematic literature search and meta-analysis in accordance with the PRISMA and the Cochrane Handbook guidelines. A systematic search was performed on PubMed, Cochrane, and ScienceDirect databases for relevant literature published as of January 2024. Placebo-controlled clinical trials reporting the efficacy of hydroxyurea in managing SCA among pediatric patients were included in the systematic review. The eligible studies were further assessed for its reporting quality using Risk of Bias 2.0. Pooled analysis was carried out using a random effect model, where the effect size was calculated based on the mean difference (MD) and 95% confidence interval (95%CI). Three randomized clinical trials comprised of 423 participants were included in the studies. Among patients receiving hydroxyurea, significant improvement was observed in fetal hemoglobin (HbF) with MD of 9.45% (95%CI: 2.15–16.75), but not in mean corpuscular volume (MCV) (MD=8.77 fL (95%CI: -28.85–46.39). Hydroxyurea also significantly reduced white blood cell (WBC) (MD=-4.21 cells/mm3; 95%CI: -5.68–-2.93), absolute neutrophil count (ANC) (MD=-1.43 cells/mm3; 95%CI: -2.11–-0.74), absolute reticulocyte count (ARC) (MD=-141.85 cells/mm3; 95%CI; -172.77–-110.94), and platelet count (MD=-74.92 cells/mm3; 95%CI: -117.05–-32.78). In conclusion, hydroxyurea is efficacious in treating pediatric SCA, as observed in the HbF, WBC, ANC, ARC, and platelet count.

Acceptance of COVID-19 vaccination at different hypothetical efficacy and safety levels in ten countries in Asia, Africa, and South America Rosiello, Dott F.; Anwar, Samsul; Yufika, Amanda; Adam, Rashed Y.; Ismaeil, Mohajer IH.; Ismail, Asma Y.; Dahman, Nesrine BH.; Hafsi, Montacer; Ferjani, Manel; Sami, Farah S.; Monib, Fatma A; R, Subramaniam; Anandu, Sunil; Haque, Md Ariful; Ferreto, Lirane ED.; Aburto, José TO.; Rojas, Jorge ET.; Enitan, Seyi S.; Yomi, Akele R.; Ezigbo, Eyiuche D.; Babadi, Elham; Kakemam, Edris; Malik, Najma I.; Ullah, Irfan; Sallam, Malik
Narra J Vol. 1 No. 3 (2021): December 2021
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v1i3.55

Vaccine hesitancy, defined as the reluctance or rejection in receiving a vaccine despite its availability, represents a major challenge to global health efforts aiming to control the ongoing COVID-19 pandemic. Understanding the possible factors correlated with COVID-19 vaccine hesitancy using a refined well-informed approach can be helpful to address the phenomenon. The current study aimed to evaluate COVID-19 vaccine acceptance rates using four hypothetical scenarios of varying levels of vaccine efficacy and safety profiles in ten Asian, African and South American countries. These scenarios included: 95% efficacy and 20% side effects (Vaccine A), 75% efficacy and 5% side effects (Vaccine B); 75% efficacy and 20% side effects (Vaccine C) and 50% efficacy and 5% side effects (Vaccine D). This study used a self-administered online survey that was distributed during February–May 2021. The total number of study respondents was 1337 with countries of residence as follows: India (21.1%), Pakistan (12.9%), Sudan (11.2%), Nigeria (9.3%), Iran (8.2%), Bangladesh and Brazil (7.9%), Chile (7.7%), Tunisia (7.6%), and Egypt (6.2%). The overall acceptance rates for COVID-19 vaccination were variable based on varying degrees of safety and efficacy as follows: 55.6% for Vaccine C, 58.3% for Vaccine D, 74.0% for Vaccine A and 80.1% for Vaccine B. The highest levels of COVID-19 vaccine acceptance were observed in Brazil followed by Chile across the four different safety and efficacy scenarios. The lowest COVID-19 vaccine acceptance rates were reported in Egypt and Tunisia for the low safety scenarios (20% side effects), and the low efficacy scenario (50% efficacy). The study revealed the potential effect of vaccine safety and efficacy on the intention to get COVID-19 vaccination. At the same efficacy level, higher possibility of side effects caused a large drop in COVID-19 vaccine acceptance rate. This indicates the importance of accurate communication regarding vaccine safety and efficacy on attitude towards the vaccine and intentions to get vaccinated. Regional differences in COVID-19 vaccine acceptance were observed with the Middle East/North African countries showing the lowest rates and the South American countries displaying the highest vaccine acceptance rates.

Monkeypox: Immune response, vaccination and preventive efforts Ophinni, Youdiil; Frediansyah, Andri; Sirinam, Salin; Megawati, Dewi; Stoian, Ana M.; Enitan, Seyi S.; Akele, Richard Y.; Sah, Ranjit; Pongpirul, Krit; Abdeen, Ziad; Aghayeva, Sevda; Ikram, Aamer; Kebede, Yohannes; Wollina, Uwe; Subbaram, Kannan; Koyanagi, Ai; Al Serouri, Abdulwahed; Nguendo-Yongsi, H. Blaise; Edwards, Jeffrey; Sallam, Dina E.; Khader, Yousef; Viveiros-Rosa, Sandro G.; Memish, Ziad A.; Amir-Behghadami, Mehrdad; Vento, Sandro; Rademaker, Marius; Sallam, Malik
Narra J Vol. 2 No. 3 (2022): December 2022
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v2i3.90

Infectious threats to humans are continuously emerging. The 2022 worldwide monkeypox outbreak is the latest of these threats with the virus rapidly spreading to 106 countries by the end of September 2022. The burden of the ongoing monkeypox outbreak is manifested by 68,000 cumulative confirmed cases and 26 deaths. Although monkeypox is usually a self-limited disease, patients can suffer from extremely painful skin lesions and complications can occur with reported mortalities. The antigenic similarity between the smallpox virus (variola virus) and monkeypox virus can be utilized to prevent monkeypox using smallpox vaccines; treatment is also based on antivirals initially designed to treat smallpox. However, further studies are needed to fully decipher the immune response to monkeypox virus and the immune evasion mechanisms. In this review we provide an up-to-date discussion of the current state of knowledge regarding monkeypox virus with a special focus on innate immune response, immune evasion mechanisms and vaccination against the virus.

Comparison of vascular cell adhesion molecule 1 (VCAM-1) during pregnancy, after placental detachment and during puerperium between normal and pregnancy with COVID-19 Pasaribu, Hotma P.; Lumbanraja, Sarma N.; Varenni, Wijitha; Enitan, Seyi 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.v3i3.413

Pregnant women have a number of physiological changes that lower the immune responses to avoid embryonic rejection, which increases the risk of problems after contracting coronavirus disease 2019 (COVID-19). Multiple inflammatory cytokines are dysregulated in this process and expressed inappropriately during systemic inflammatory responses associated with COVID-19. The aim of the study was to compare the levels of vascular cell adhesion molecule 1 (VCAM-1), a marker of endothelial damage in pregnancies with and without COVID-19. A cohort prospective study was conducted at H. Adam Malik General Hospital and the Universitas Sumatera Utara Hospital, Indonesia. Pregnant women without COVID-19 and pregnant women with moderate and severe degrees of COVID-19 were recruited. The level of VCAM-1 was measured at three different time points (during pregnancy, within an hour of placental detachment, and 24 hours postpartum). The ANOVA and Student t-test were used to compare the VCAM-1 levels among different time points and between groups, respectively. The mean VCAM-1 levels at the hospital admission, one hour of placental detachment and 24 hours postpartum in non-COVID-19 and COVID-19 pregnancies were 591.29 vs 1176.27 pg/mL; 558.2 vs 1136.2 pg/mL; and 508.59 vs 985.2 pg/mL, respectively. There was a significant different in VCAM-1 levels in normal pregnancy at the time of hospital admission, one hour after detachment of the placenta and 24 hours postpartum (p=0.04). The mean VCAM-1 levels in pregnant women with COVID-19 also had significant differences between three time points (p=0.033). The levels of VCAM-1 were statically higher among pregnancy in the COVID-19 group compared to the non-COVID-19 group during hospital admission (p=0.023), one hour after placenta detachment (p=0.040) and 24 hours postpartum (p=0.043).The results suggested the usefulness of identifying the VCAM-1 level as a marker of endothelial dysfunction in pregnancy with COVID-19.

Antifungal activity of Durio zibethinus Murray peel extract against Candida albicans: A preliminary study Siregar, Syifa S.; Adella, Cut A.; Enitan, Seyi S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.429

The incidence of antifungal resistance to Candida albicans infections has been growing over the past years; therefore, innovations are required to develop medicinal plants with antifungal properties such as durian fruit peels (Durio zibethinus Murray) that contain significant of bioactive compounds with antifungal properties. The aim of this study was to determine the antifungal activity of D. zibethinus fruit peel extract against C. albicans by analyzing the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). A post-test only control group experiment was conducted from July to October 2020. D. zibethinus peel was collected from Simalungun Regency, Medan, Indonesia, and extracted by maceration technique using 70% ethanol to obtain D. zibethinus peel ethanol extract (DPEE). Samples of C. albicans were obtained from the Laboratory of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. The diffusion method was used to determine the antifungal activity. Six groups with different concentrations of DPEE (6.25%, 12.5%, 25%, and 50%), ketoconazole (positive control) and dimethyl sulfoxide (negative control) were exposed to C. albicans in six replicates. Six lower concentrations (12.5%, 6.25%, 3.12%, 3%, 1.56%, and 0.78%) were divided to perform the liquid dilution method to obtain the MIC and affirmation test for MBC. The diameter of the inhibition zone was analyzed using one-way ANOVA and the Tukey post-hoc test for differences between concentrations. Our data indicated that the DPEE 6.25% had the largest inhibition zone (17.26±5.64 mm) and the inhibition zones were significant different among concentrations of DPEE (p<0.05). Furthermore, the DPEE had a MIC of 0.78% and MBC of 3.125% against C. albicans. This study highlights that the ethanol extract of D. zibethinus has potential antifungal activity against C. albicans. However, a further study is needed to determine its antifungal activities in more precise manner.

Immunoexpression of aortic endothelial P-selectin and serum apolipoprotein A-1 levels after administration of arabica (Coffea arabica) and robusta (Coffea canephora) coffee bean extracts: In vivo study in atherosclerosis rat model Ekawati, Wahyu; Heriansyah, Teuku; Kamarlis, Reno K.; Purnawarman, Adi; Sofyan, Hamny; Enitan, Seyi S.
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.v4i2.794

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.

Hydroxyurea therapy for children with sickle cell anemia: A systematic review and meta-analysis Khansa, Firyal; Ghifari, Muhammad H.; Daffa, Muhammad B.; Nasywa, Fiola; Enitan, Seyi S.; Eleojo , Itodo G.; Ali, Mazen EI.
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.v2i2.164

Sickle cell anemia (SCA) is a major global health issue, particularly among pediatric population, influenced by factors such as malaria susceptibility and genetic distribution. On the other hand, hydroxyurea therapy has been a well-established and accepted treatment for SCA, with over 25 years of clinical experience. It has been proven to be safe and effective in preventing vaso-occlusive events and chronic organ damage. The aim of this study was to assess the efficacy of hydroxyurea in alleviating pediatric SCA. This study was comprised of a systematic literature search and meta-analysis in accordance with the PRISMA and the Cochrane Handbook guidelines. A systematic search was performed on PubMed, Cochrane, and ScienceDirect databases for relevant literature published as of January 2024. Placebo-controlled clinical trials reporting the efficacy of hydroxyurea in managing SCA among pediatric patients were included in the systematic review. The eligible studies were further assessed for its reporting quality using Risk of Bias 2.0. Pooled analysis was carried out using a random effect model, where the effect size was calculated based on the mean difference (MD) and 95% confidence interval (95%CI). Three randomized clinical trials comprised of 423 participants were included in the studies. Among patients receiving hydroxyurea, significant improvement was observed in fetal hemoglobin (HbF) with MD of 9.45% (95%CI: 2.15–16.75), but not in mean corpuscular volume (MCV) (MD=8.77 fL (95%CI: -28.85–46.39). Hydroxyurea also significantly reduced white blood cell (WBC) (MD=-4.21 cells/mm3; 95%CI: -5.68–-2.93), absolute neutrophil count (ANC) (MD=-1.43 cells/mm3; 95%CI: -2.11–-0.74), absolute reticulocyte count (ARC) (MD=-141.85 cells/mm3; 95%CI; -172.77–-110.94), and platelet count (MD=-74.92 cells/mm3; 95%CI: -117.05–-32.78). In conclusion, hydroxyurea is efficacious in treating pediatric SCA, as observed in the HbF, WBC, ANC, ARC, and platelet count.

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