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Acceptance, safety, and impact on quality of life of exergame for elderly patients with neurodegenerative diseases: A systematic review and meta-analysis Tsurayya, Ghina; Duta, Teuku F.; Naufal, Muhammad A.; Alina, Meulu; Isitua, Chinwe C.; Ohanu, Ernest C.
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.94

Abstract

The aim of this study was to evaluate the efficacy, safety, adherence, and acceptance of exergame in improving the quality of life (QoL) among elderly patients with neurodegenerative diseases. A systematic search was conducted in PubMed, Embase and Scopus for relevant studies up to 16 March 2023. Quality of the included studies were assessed using Cochrane’s Risk of Bias tool version 2.0. Meta-analysis using a random effect was conducted on outcomes reported at least by two studies to calculate the standard mean difference (SMD) and its 95% confidence interval (CI). The difference of influence between exergame and conventional therapy was judged based on Z- and p-values. Heterogeneity was determined by I2 score. As many as 15 studies were included (n=466 participants) published between 2013–2023. Nine studies had ‘high quality’ five studies had ‘some concerns’, and one had ‘high risk’. Results from meta-analyses suggests that the exergame does significantly not improve the QoL among patients with Parkinson’s diseases. Similarly, no statistically significant difference (p>0.05) of QoL improvement among Alzheimer’s disease patients receiving exergame intervention. No adverse effects were reported to be associated with the intervention, and in fact, the patients experienced reduced fatigue and fear of falling. Patients in intervention group showed high acceptance and adherence to the therapy, which could be attributed to exergame being enjoyable, easy-to-use, and motivational. In conclusion, despite exergame being highly acceptable and relatively safe, the intervention does not improve the QoL of the elderly patients.
Vitamin D supplementation improves foot ulcers among diabetic patients: Pooled analysis of randomized controlled trials Putra, Muhammad IA.; Gusti , Naufal; Duta, Teuku F.; Alina, Meulu; Qanita, Intan; Naufal, Muhammad A.; Henira, Najlaika; Tsurayya, Ghina; Amirah, Shakira
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.104

Abstract

Serum vitamin D level is associated with the development of diabetic foot ulcer (DFU), and it is intriguing to determine if the vitamin supplementation could reverse the diabetic complication. The aim of this study was to investigate the efficacy of vitamin D supplementation in DFU management through qualitative and quantitative systematic review. A systematic search was conducted to screen the records identified in PubMed, Scopus, Embase, Scillit, Sci-Finder, LILACS, EuropePMC, medRxiv, bioRvix, Google Scholar, Semantic Scholar, and Garuda databases as of 10 March 2023. Studies investigating the efficacy of a single dose supplementation of vitamin D in DFU management were included. Quality of the included studies was appraised by Cochrane ‘Risk of Bias’ 2.0. Random-effects-based pooled analysis using Cohen’s d was performed on the wound healing progress as the primary outcome. A sensitivity test with leave-one-out method and meta-regression were also conducted to analyze the effect of heterogenous data. Five studies with a total of 245 patients (123 versus 122 for experimental and control groups, respectively) were finally included in the qualitative and quantitative analysis. The pooled estimate suggested that administering vitamin D to DFU patients could reduce the wound area or depth significantly as compared to control group (p<0.001; Cohen’s d: 2.72; 95% CI: 1.02 to 4.42). The value remained positive throughout the leave-one-out analysis. Vitamin D supplementation significantly contributed to the increased level of serum vitamin D (p=0.026, Cohen’s d: -0.719; 95% CI: -1.35 to -0.09). Elevation of high-density lipoprotein was observed in pooled estimate with p=0.016 and Cohen’d: 1.34 (95% CI: 0.25 to 2.44). Qualitatively, significant reduction of HbA1C, total cholesterol, and C-reactive protein were reported in at least two trials. Significantly improved quantitative insulin sensitivity check index (QUICKI) and decreased malondialdehyde, fructosamine, and fasting blood glucose were reported in at least one trial each. There were conflicting results on the change of low-density lipoprotein level. This study highlights that vitamin D supplementation promotes wound healing process among DFU patients; however, it is too premature to draw solid conclusions as the efficacy could be affected by multiple factors. Therefore, clinical trials from various demographics and ethnicities by using a high- versus low-dose model are needed.
Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis Tsurayya, Ghina; Nazhifah, Cut A.; Pirwanja, Muhammad R.; Lemu, Yohannes K.
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.111

Abstract

In managing severe acute malnutrition (SAM) among children, the World Health Organization has endorsed the use of ready-to-use therapeutic foods (RUTF), especially the peanut and milk-based (PM-RUTF), which has been proven for its efficacy. Unfortunately, the distribution of PM-RUTF is challenged by high financial cost and reliance on imports for milk and peanuts. Researchers explore the Soy-Maize-Sorghum (SMS)-RUTF as the alternative, in which the formulation has two types; milk-free soya-maize-sorghum (FSMS)-RUTF and low milk content SMS (MSMS)-RUTF. The aim of this study was to evaluate the efficacy, safety, and acceptance of SMS-RUTFs in the management of SAM among children as compared with PM-RUTF. Eligible studies were searched through PubMed, Scopus, and Embase up to July 14, 2023. Studies reporting the effects of SMS-RUTF, FSMS-RUTF, or MSMS-RUTF intake on SAM with PM-RUTF as the control were considered eligible. The included randomized controlled trials were then assessed for the risk of bias using Cochrane Risk of Bias 2.0. Odds Ratio (OR) and mean difference (MD) were calculated using a random-effects meta-analysis. The analysis focused on investigating the recovery, mortality, weight gain, and hemoglobin levels. Five randomized controlled trials involving a total of 5,513 children were incorporated in this review. Of which, four studies were included in the statistical analysis. Those receiving SMS-RUTF was 0.77 times less likely to recover from SAM as compared to control (95% CI: 0.66–0.90, p<0.01). The SMS-RUTF group had 1 kg lower weight gain as compared to control (95% CI: -1.25–0.75, p<0.01). However, the SMS-RUTF group had significantly higher increase of hemoglobin level than control (MD: 0.80 g/dL [95% CI: 0.68–0.93], p<0.01). Adverse effects were observed similar in both SMS-RUFT and control groups. SMS-RUFT received low acceptance from the participants suspected to be caused by poor packaging. In conclusion, SMS-RUTF is less effective than PM-RUTF in managing SAM among children but can be used to improve anemia as indicated by increased hemoglobin levels.
Efficacy of acetazolamide and loop diuretics combinatorial therapy in congestive heart failure: A meta-analysis Duta , Teuku F.; Zulfa , Putri O.; Alina, Meulu; Henira, Najlaika; Tsurayya, Ghina; Fakri, Fajar; Acharya, Yogesh
Narra X Vol. 2 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i1.124

Abstract

Acetazolamide, one of the carbonic anhydrase inhibitors, has been known to improve the efficacy of diuretic therapy in patients with in congestion heart failure. The aim this study was to investigate the effectiveness of acetazolamide when combined with loop diuretics in ameliorating diuresis and natriuresis in congestive heart failure using systematic review and meta-analysis. Randomized controlled trials (RCTs) and cohort studies were searched on PubMed, Scopus, and Embase on March 7, 2023, by using combinations of ‘acetazolamide’, ‘heart failure’ and along with their respective synonyms. The protocol had been registered on PROSPERO (CRD42023409864). The studies must investigate the effect of oral acetazolamide as the add-on to loop diuretic therapy to be included. Successful decongestion, natriuresis, and diuresis were set as the primary outcomes. The quality of the included studies was assessed using the Cochrane risk-of-bias tool for RCTs and Newcastle Ottawa Scale for observational studies. We identified 1176 titles in the initial search, and further reduced to five studies (three RCTs and two cohort studies) after in-depth screening. A total of 625 patients were recruited in the included studies published from 2015 to 2022. Results from meta-analysis revealed that acetazolamide and loop diuretics combination therapy ameliorated natriuresis (n=4; standardized means difference (SMD)=0.65; 95%CI: 0.07–1.24; p=0.03) and diuresis (n=2; SMD=0.29; 95%CI: 0.12–0.46; p=0.0009) when compared to loop diuretics alone. Acetazolamide and loop diuretics combinatorial therapy is efficacious in alleviating congestion in heart failure patients.
Exergame for post-stroke rehabilitation among elderly patients: A systematic review and meta-analysis Duta, Teuku F.; Tsurayya, Ghina; Naufal, Muhammad A.
Narra X Vol. 1 No. 1 (2023): April 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i1.73

Abstract

Advancement in gaming technology, including exergame, is thought to offer a promising innovation in rehabilitative treatment owing to its interactive and joyful natures. Elderly, in addition to being prevalent in stroke, they have different perspectives and adaptability toward the utilization of exergame in post-stroke rehabilitation. The aim of this study was to evaluate the effectiveness of exergame-based rehabilitation in ameliorating stroke-associated cognitive impairment among elderly patients. This systematic review followed the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guideline. The literatures were retrieved from the searches on PubMed, Scopus, and Embase databases using a combination of ‘exergame’, ‘stroke’, and ‘elderly’ along with their respective synonyms. Included studies were controlled observational studies and randomized clinical trials with subjects’ mean age >60 years old, measuring global cognitive and/or five cognitive domains (attention, language, executive function, memory, and visuospatial ability). Quality appraisals were performed based on the Cochrane ‘risk-of-bias tool’ and Physiotherapy Evidence Database Scale. Studies with high and good qualities were included in the meta-analyses. Six randomized controlled trials involving 179 patients were included in meta-analysis. Studies had variations in terms of type (combination of exergame-based and conventional rehabilitation or exergame-based only) and duration of interventions (30–110 min), length of observation (2–6 weeks), and tools used to examine cognitive outcomes. As compared with conventional rehabilitation, exergame-based rehabilitation was significantly more effective to improve global cognitive based on Montreal Cognitive Assessment Score in acute stroke patients (n=4; mean difference (MD) 3.66; 95% confidence interval (95%CI): 2.08, 5.24; p<0.00001), but significantly less effective in chronic stroke patients (n=2; MD -1.54; 95%CI: -2.28, -0.81; p<0.0001). In conclusion, global cognitive of elderly patients with acute strokes could be improved through exergame-based rehabilitation which is more effective as compared with conventional therapy.
Acceptance, safety, and impact on quality of life of exergame for elderly patients with neurodegenerative diseases: A systematic review and meta-analysis Tsurayya, Ghina; Duta, Teuku F.; Naufal, Muhammad A.; Alina, Meulu; Isitua, Chinwe C.; Ohanu, Ernest C.
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.94

Abstract

The aim of this study was to evaluate the efficacy, safety, adherence, and acceptance of exergame in improving the quality of life (QoL) among elderly patients with neurodegenerative diseases. A systematic search was conducted in PubMed, Embase and Scopus for relevant studies up to 16 March 2023. Quality of the included studies were assessed using Cochrane’s Risk of Bias tool version 2.0. Meta-analysis using a random effect was conducted on outcomes reported at least by two studies to calculate the standard mean difference (SMD) and its 95% confidence interval (CI). The difference of influence between exergame and conventional therapy was judged based on Z- and p-values. Heterogeneity was determined by I2 score. As many as 15 studies were included (n=466 participants) published between 2013–2023. Nine studies had ‘high quality’ five studies had ‘some concerns’, and one had ‘high risk’. Results from meta-analyses suggests that the exergame does significantly not improve the QoL among patients with Parkinson’s diseases. Similarly, no statistically significant difference (p>0.05) of QoL improvement among Alzheimer’s disease patients receiving exergame intervention. No adverse effects were reported to be associated with the intervention, and in fact, the patients experienced reduced fatigue and fear of falling. Patients in intervention group showed high acceptance and adherence to the therapy, which could be attributed to exergame being enjoyable, easy-to-use, and motivational. In conclusion, despite exergame being highly acceptable and relatively safe, the intervention does not improve the QoL of the elderly patients.
Vitamin D supplementation improves foot ulcers among diabetic patients: Pooled analysis of randomized controlled trials Putra, Muhammad IA.; Gusti , Naufal; Duta, Teuku F.; Alina, Meulu; Qanita, Intan; Naufal, Muhammad A.; Henira, Najlaika; Tsurayya, Ghina; Amirah, Shakira
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.104

Abstract

Serum vitamin D level is associated with the development of diabetic foot ulcer (DFU), and it is intriguing to determine if the vitamin supplementation could reverse the diabetic complication. The aim of this study was to investigate the efficacy of vitamin D supplementation in DFU management through qualitative and quantitative systematic review. A systematic search was conducted to screen the records identified in PubMed, Scopus, Embase, Scillit, Sci-Finder, LILACS, EuropePMC, medRxiv, bioRvix, Google Scholar, Semantic Scholar, and Garuda databases as of 10 March 2023. Studies investigating the efficacy of a single dose supplementation of vitamin D in DFU management were included. Quality of the included studies was appraised by Cochrane ‘Risk of Bias’ 2.0. Random-effects-based pooled analysis using Cohen’s d was performed on the wound healing progress as the primary outcome. A sensitivity test with leave-one-out method and meta-regression were also conducted to analyze the effect of heterogenous data. Five studies with a total of 245 patients (123 versus 122 for experimental and control groups, respectively) were finally included in the qualitative and quantitative analysis. The pooled estimate suggested that administering vitamin D to DFU patients could reduce the wound area or depth significantly as compared to control group (p<0.001; Cohen’s d: 2.72; 95% CI: 1.02 to 4.42). The value remained positive throughout the leave-one-out analysis. Vitamin D supplementation significantly contributed to the increased level of serum vitamin D (p=0.026, Cohen’s d: -0.719; 95% CI: -1.35 to -0.09). Elevation of high-density lipoprotein was observed in pooled estimate with p=0.016 and Cohen’d: 1.34 (95% CI: 0.25 to 2.44). Qualitatively, significant reduction of HbA1C, total cholesterol, and C-reactive protein were reported in at least two trials. Significantly improved quantitative insulin sensitivity check index (QUICKI) and decreased malondialdehyde, fructosamine, and fasting blood glucose were reported in at least one trial each. There were conflicting results on the change of low-density lipoprotein level. This study highlights that vitamin D supplementation promotes wound healing process among DFU patients; however, it is too premature to draw solid conclusions as the efficacy could be affected by multiple factors. Therefore, clinical trials from various demographics and ethnicities by using a high- versus low-dose model are needed.
Soya-maize-sorghum ready-to-use therapeutic food (SMS-RUTF) for the management of severe acute malnutrition among children: A systematic review and meta-analysis Tsurayya, Ghina; Nazhifah, Cut A.; Pirwanja, Muhammad R.; Lemu, Yohannes K.
Narra X Vol. 1 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v1i3.111

Abstract

In managing severe acute malnutrition (SAM) among children, the World Health Organization has endorsed the use of ready-to-use therapeutic foods (RUTF), especially the peanut and milk-based (PM-RUTF), which has been proven for its efficacy. Unfortunately, the distribution of PM-RUTF is challenged by high financial cost and reliance on imports for milk and peanuts. Researchers explore the Soy-Maize-Sorghum (SMS)-RUTF as the alternative, in which the formulation has two types; milk-free soya-maize-sorghum (FSMS)-RUTF and low milk content SMS (MSMS)-RUTF. The aim of this study was to evaluate the efficacy, safety, and acceptance of SMS-RUTFs in the management of SAM among children as compared with PM-RUTF. Eligible studies were searched through PubMed, Scopus, and Embase up to July 14, 2023. Studies reporting the effects of SMS-RUTF, FSMS-RUTF, or MSMS-RUTF intake on SAM with PM-RUTF as the control were considered eligible. The included randomized controlled trials were then assessed for the risk of bias using Cochrane Risk of Bias 2.0. Odds Ratio (OR) and mean difference (MD) were calculated using a random-effects meta-analysis. The analysis focused on investigating the recovery, mortality, weight gain, and hemoglobin levels. Five randomized controlled trials involving a total of 5,513 children were incorporated in this review. Of which, four studies were included in the statistical analysis. Those receiving SMS-RUTF was 0.77 times less likely to recover from SAM as compared to control (95% CI: 0.66–0.90, p<0.01). The SMS-RUTF group had 1 kg lower weight gain as compared to control (95% CI: -1.25–0.75, p<0.01). However, the SMS-RUTF group had significantly higher increase of hemoglobin level than control (MD: 0.80 g/dL [95% CI: 0.68–0.93], p<0.01). Adverse effects were observed similar in both SMS-RUFT and control groups. SMS-RUFT received low acceptance from the participants suspected to be caused by poor packaging. In conclusion, SMS-RUTF is less effective than PM-RUTF in managing SAM among children but can be used to improve anemia as indicated by increased hemoglobin levels.
Efficacy of acetazolamide and loop diuretics combinatorial therapy in congestive heart failure: A meta-analysis Duta , Teuku F.; Zulfa , Putri O.; Alina, Meulu; Henira, Najlaika; Tsurayya, Ghina; Fakri, Fajar; Acharya, Yogesh
Narra X Vol. 2 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i1.124

Abstract

Acetazolamide, one of the carbonic anhydrase inhibitors, has been known to improve the efficacy of diuretic therapy in patients with in congestion heart failure. The aim this study was to investigate the effectiveness of acetazolamide when combined with loop diuretics in ameliorating diuresis and natriuresis in congestive heart failure using systematic review and meta-analysis. Randomized controlled trials (RCTs) and cohort studies were searched on PubMed, Scopus, and Embase on March 7, 2023, by using combinations of ‘acetazolamide’, ‘heart failure’ and along with their respective synonyms. The protocol had been registered on PROSPERO (CRD42023409864). The studies must investigate the effect of oral acetazolamide as the add-on to loop diuretic therapy to be included. Successful decongestion, natriuresis, and diuresis were set as the primary outcomes. The quality of the included studies was assessed using the Cochrane risk-of-bias tool for RCTs and Newcastle Ottawa Scale for observational studies. We identified 1176 titles in the initial search, and further reduced to five studies (three RCTs and two cohort studies) after in-depth screening. A total of 625 patients were recruited in the included studies published from 2015 to 2022. Results from meta-analysis revealed that acetazolamide and loop diuretics combination therapy ameliorated natriuresis (n=4; standardized means difference (SMD): 0.65; 95%CI: 0.07–1.24; p=0.03) and diuresis (n=2; SMD: 0.29; 95%CI: 0.12–0.46; p=0.0009) when compared to loop diuretics alone. Acetazolamide and loop diuretics combinatorial therapy is efficacious in alleviating congestion in heart failure patients.