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Journal : Narra J

Comparison of exhaled carbon monoxide levels and its association with nicotine dependence between electronic and tobacco cigarettes: A cross-sectional study among teenage smokers Raffael, Frans; Pandia, Pandiaman; Tarigan, Amira P.; Mutiara, Erna; Osakue, Osareniro E.
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.v3i3.418

Abstract

Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.
Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises Monica, Nanda S.; Tarigan, Amira P.; Pradana, Andika; Mutiara, Erna; Pandia, Pandiaman; Sinaga, Bintang YM.; Sihombing, Benny; Rhinsilva, Ella; Zulkarnain, Zulkarnain; 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.v3i3.420

Abstract

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher’s exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.
Role of digital education through smartphones in improving knowledge among asthma patients: A preliminary study Pohan, Indah TS.; Tarigan, Amira P.; Pandia, Pandiaman; Mutiara, Erna
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.v4i2.657

Abstract

Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.
Relationship between interleukin-6 (IL-6) levels and chest X-ray severity scoring in COVID-19 patients Kardiasyah, Alzi; Syarani, Fajrinur; Bihar, Syamsul; Lubis, Netty D.; Mutiara, Erna; Syahputra, Hafid
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.v4i1.690

Abstract

The severity of coronavirus disease 2019 (COVID-19) may be measured by interleukin-6 (IL-6) and chest X-rays. Brixia score of the chest radiographs is usually used to monitor COVID-19 patients’ lung problems. The aim of this study was to demonstrate the relationship between IL-6 levels and chest radiographs (Brixia score) that represent COVID-19 severity. A retrospective cohort study was conducted among COVID-19 patients who had a chest X-ray and examination of IL-6 levels at H. Adam Malik General Hospital, Medan, Indonesia. A multinomial logistic regression analysis was conducted to evaluate the association between IL-6 levels and the severity of the chest radiograph. A total of 76 COVID-19 patients were included in the study and 39.5% of them were 60–69 years old, with more than half were female (52.6%). A total of 17.1%, 48.7%, and 34.2% had IL-6 level of <7 pg/mL, 7–50 pg/mL and >50 pg/mL, respectively. There were 39.5%, 36.8% and 23.7% of the patients had mild, moderate and severe chest X-rays based on Brixia score, respectively. Statistics analysis revealed that moderate (OR: 1.77; 95% CI: 1.05–3.32) and severe (OR: 1.33; 95% CI: 1.03–3.35) lung conditions in the chest X-rays were significantly associated with IL-6 levels of 7–50 pg/mL. IL-6 more than 50 pg/mL was associated with severe chest X-ray condition (OR: 1.97; 95% CI: 1.15–3.34). In conclusion, high IL-6 levels significantly reflected COVID-19 severity through chest X-rays in COVID-19 patients.
Mesenchymal stem cells for immune modulation in systemic lupus erythematosus: From bench research to clinical applications Ginting, Andi R.; Munir, Delfitri; Amin, Mustafa M.; Darlan, Dewi M.; Putra, Agung; Rusda, Muhammad; Mutiara, Erna; Mayasari, Evita; Rozi, Muhammad F.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.994

Abstract

Systemic lupus erythematosus (SLE) is a prevalent autoimmune disease affecting multiple organ systems. Disease progression is inevitable as part of its natural course, necessitating aggressive therapeutic strategies, particularly with the use of immunosuppressants. Long-term use of steroids and other immunosuppressants is associated with significant adverse effects. Mesenchymal stem cells (MSCs) have been shown to modulate the immune response, leading to immunosuppressive effects against self-antigens. MSCs have demonstrated the ability to modulate several immune cell populations, contributing to favorable outcomes in controlling immune and inflammatory conditions. Recent evidence has shown an increase in Treg and Breg cell subsets following MSC administration, along with modulation of other immune cells, including dendritic cells, B cells, and T cells. However, the balance between MSC pro-inflammatory and anti-inflammatory phenotypic activation remains a critical factor in determining therapeutic outcomes. Various covariates also influence the efficacy of MSC therapy. The aim of this study was to provide a comprehensive overview of the utilization of mesenchymal stem cells (MSCs) in SLE treatment, leveraging their immunomodulatory and immunosuppressive capabilities. Understanding the fundamental preclinical effects of MSCs and recent findings from clinical studies may enhance the potential of MSC therapy in the management of SLE patients.
Co-Authors Agung Putra Alam Bakti Alas Sriwahyu Amin, Mustafa M. Amra, Ricca Nophia Andika Pradana Andika Pradana Andika Pradana Andriany, Anita Annisa, Lia Mutia Arfah Mardiana Lubis Arifa Masyitah Asfriyati ,MKes Ayu Yulia Ningsih Sirait Bihar, Syamsul Darlan, Dewi M. darmaisuri harahap Delfitri Munir Evita Mayasari Eyanoer, Puteri Chairani Fajrinur Syarani Fazidah Aguslina Siregar, Fazidah Aguslina Ginting, Andi R. Hafid Syahputra Halinda Sari Lubis Hargiani, Fransisca Xaveria Heru Santosa Hiswani Hiswani Johannes H. Saing, Johannes H. Juanita Juanita Juanita4 julia alistawaty purba Jumirah . Kardiasyah, Alzi Lamtiar, Rebecca Rumesty Lia Mutia Annisa Listyoko, Aditya S. Lubis, Aridamuriany D. Lubis, Netty D. Lubis, Sri Novita Mahyuni, Eka Lestari Maya Fitria Maya Fitria Monica, Nanda S. Mova Rita Sitompul Mursyida, Rika Namora Lumongga Lubis, Namora Lumongga novianti damanik Olga R. Siregar, Olga R. Osakue, Osareniro E. Pandia, Pandiaman Pane, Cindy Suci Veronika Pohan, Indah TS. Pratiwi, Tika Ayu Priyanti Anti Raffael, Frans Rahayu Lubis Raja, Sarma N Lumban Rhinsilva, Ella Ria Masniari Lubis risa amalia amalia Rista Riviani Rizkani, Ratih Sufra Rochadi, Raden Kintoko Rozi, Muhammad F. Rusda, Muhammad Sihombing, Benny Sinaga, Bintang YM. Sinaga, Budi Junarman Sinaga, Budi Junarman Siti Khadijah Nasution siti zubaidah harahap Situmorang, Friza Novita Sari Sri Rahayu Sanusi Susanti, Dia Tri Syahri, Isyatun Mardhiah Syahri, Isyatun Mardhiah Syahri, Isyatun Mardhiyah Syarani, Fajrinur Syarifah Tarigan, Amira P. Taufik Ashar Tukiman Tukiman uci kirana Utama, Surya Yanni, Gema Nazri Yesica Siallagan Yusniwarti Yusad Zulhaida Lubis Zulkarnain Zulkarnain