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Comparative analysis between PUMA and CAPTURE questionnaires for chronic obstructive pulmonary disease (COPD) screening in smokers Sebayang, Risa RB.; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Wahyuni, Arlinda 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.v4i1.654

Abstract

Chronic obstructive pulmonary disease (COPD) presents a significant global challenge, impacting health systems, economies, and societies. Its prevalence is anticipated to rise owing to an aging demographic. Although the PUMA and CAPTURE questionnaires are available for COPD screening, their comparative effectiveness has not been studied in Indonesia. The aim of this study was to evaluate the effectiveness of the PUMA and CAPTURE questionnaires as screening tools for COPD among smokers. A cross-sectional study was conducted at Universitas Sumatera Utara Hospital and H. Adam Malik General Hospital, Medan, Indonesia, from December 2022 to February 2023. Smokers aged over 40 or above with a history of smoking more than 100 cigarettes in their lifetime and no previous COPD diagnosis were included in the study. To collect the responses to PUMA and CAPTURE questionnaire, face-to-face interviews were conducted, followed by a spirometry test. A total of 76 smokers were included in the study; the predominant age group was 51–60 years (36.8%), with the majority being male (81.6%). Most participants began smoking at ages 15−20 years (65.8%) and had been smoking for 20–30 years (36.8%) at a moderate intensity (44.8%). Spirometry tests indicated obstructive patterns in 50 participants, with 17 classified as severe obstruction. At a cut-off score of ≥6, the PUMA questionnaire yielded a sensitivity of 72.55% and a specificity of 84%. In contrast, the CAPTURE questionnaire, with a cut-off score of ≥4, exhibited a sensitivity of 70.83% and a specificity of 64.29%. These results imply that the PUMA questionnaire could be more efficient in COPD screening compared to the CAPTURE questionnaire.
Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers Sirait, Sondang RA.; Sinaga, Bintang YM.; Tarigan, Amira P.; Wahyuni, Arlinda 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.v4i1.658

Abstract

Prolonged physical and mental health changes, known as post-COVID conditions (PCC), could impair the quality-of-life (QoL) of healthcare workers. The aim of this study was to identify factors that contribute to cognitive impairments and QoL among COVID-19 survivors working as healthcare workers. This cross-sectional study involved healthcare workers at Prof. Dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Medan, Indonesia. The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive function, while the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF) questionnaire was used to evaluate the QoL. Factors associated with cognitive and QoL status were examined using Mann-Whitney and Chi-squared tests. A total of 100 COVID-19 survivors were included in the study, most of whom were female (74%), aged ≤35 years (95%), and were doctors (62%). Only 22% of the participants had a normal BMI, 93% had a history of mild COVID-19, and 54% had one comorbidity. The Overall MoCA score averaged 24.18±2.86, indicating mild cognitive impairment among the groups. The distribution of MoCA scores had similar patterns with no significant differences based on age, gender, comorbidities, BMI, COVID-19 severity, and frequency of infection. Interestingly, the number of vaccine doses received by the participants had a statistically significant associated with MoCA scores of which those receiving more than two doses had higher cognitive scores than those with only two doses (p=0.008). Based on categorized MoCA scores (normal vs cognitive impairment), none assessed factors were not significantly associated with cognitive outcomes. The WHOQOL-BREF scores ranged from 62.5 to 95.5, with a mean of 83.67±7.03. None of the assessed factors were associated with WHOQOL-BREF scores among COVID-19 survivors. These findings highlight the need for further study to explore the protective role of vaccination frequency in cognitive impairment and the factors underlying the resilience in QoL among survivors.
Determinants of COVID-19 severity and mortality in children: A retrospective and multicenter cohort study in Medan, Indonesia Airlangga, Eka; Wahyuni, Arlinda S.; Siregar, Jelita; Malisie, Ririe F.; Lubis, Bugis M.; Adisasmito, Wiku B.; Zarlis, Muhammad; Pasaribu, Ayodhia P.
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.v4i2.865

Abstract

This study investigated indicators of the severity and mortality of COVID-19 in children in Medan, Sumatera Utara Province, Indonesia. The aim of this study was to identify determinants of severity and outcome of children with COVID-19 as the lesson learned from the COVID-19 pandemic, particularly the limited health facilities in Indonesia. This retrospective cohort study was conducted in 2020, 2021, and 2022 at multiple centers. Inpatient and outpatient children confirmed to be SARS-CoV-2 positive were randomly recruited in the selected hospitals. Baseline data (demographic, clinical, laboratory and radiological data) were collected, and outcomes were classified as recovered/deceased (for the inpatient group) or returned to the hospital (for the outpatient group). Severity status was identified based on the Indonesia COVID-19 guidelines. The laboratory data were categorized according to international standards, and data were analyzed using univariate analyzes followed by multivariate logistic regression. A total of 303 inpatient and 114 outpatient children were included in the analysis. Out of the total inpatient cases, 11 patients died with 3.6 mortality rate. Our final multivariate indicated that the presence of shortness of breath (SOB), anemia, and abnormal C-reactive protein (CRP) levels were significantly associated with the severity or the presence of emergency signs, while the presence of SOB and comorbidities were significantly associated with mortality in inpatient children with COVID-19. The presence of fever, cough, SOB, muscle ache and diarrhea were the reasons why the children were returned to the hospital from self-isolation at home among outpatient COVID-19 cases; however, the cough was the only significant factor in the final multivariate mode. This study highlights important determinants of COVID-19 severity and mortality in children, which should be considered during clinical decision-making in low-resource settings of healthcare centers in Indonesia.
Role of ACE2 and TMPRSS2 polymorphisms on COVID-19 outcome and disease severity in adult patients: A prospective cohort study in a tertiary hospital, Indonesia Yunita, Rina; Wahyuni, Arlinda S.; Sinaga, Bintang YM.; Yamamoto, Zulham; Soebandrio, Amin; Kusumawati, R. Lia; Sembiring, Rosita J.; Pandia, Pandiaman
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.v4i2.919

Abstract

Coronavirus disease 2019 (COVID-19) has led to a significant number of infections and deaths worldwide, yet its pathogenesis and severity remain incompletely understood. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), play crucial roles as receptors and molecules responsible for the virus's entry into host cells, initiating the infection process. Their polymorphisms have been extensively studied in relation to COVID-19 severity. The aim of this study was to examine the association of ACE2 (rs2074192) and TMPRSS2 (rs12329760) polymorphisms with COVID-19 outcome and severity. A prospective cohort study was conducted in 2022 at Haji Adam Malik Hospital, Medan, Indonesia. We randomly recruited hospitalized adult patients with COVID-19, confirmed by real-time polymerase chain reaction (RT-PCR). The baseline demographic data, disease severity, underlying disease, comorbidities, and COVID-19 vaccination status were collected. The single-nucleotide polymorphism (SNP) was assessed using TaqMan SNP genotyping assay, and the levels of TMPRSS2 and ACE2 proteins were measured using enzyme-linked immunosorbent assay (ELISA). A total of 151 COVID-19 patients were recruited and there were significant associations between age and severity with mortality outcomes. The age, kidney and lung diseases, and vaccination status were associated with severity levels. The results showed the CC genotype of ACE2 had the highest proportion, followed by TT and CT genotypes among patients, while CT was the most prevalent genotype, followed by CC and TT for TMPRSS2. This study did not find a significant association between ACE2 and TMPRSS2 genetic variants with disease severity and outcome but highlighted a specific association of TMPRSS2 SNP with mortality within the group. In addition, ACE2 concentration was significant different between mild-moderate and severe-critical COVID-19 groups (p=0.033).
Factors associated with feeding problems in children with cerebral palsy: A cross-sectional study from Indonesia Maulidia, Dwi S.; Sembiring, Tiangsa; Dimyati, Yazid; Tanjung, Ika CD.; Wahyuni, Arlinda S.; Pratita, Winra; Nasution, Halida R.; Alharbi, Olayan; Pasaribu, Ayodhia P.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.163

Abstract

Children with cerebral palsy are at high risk for feeding difficulties and malnutrition due to motor impairments and associated conditions. The aim of this study was to evaluate the prevalence and types of feeding problems and their association with malnutrition in children with cerebral palsy. A cross-sectional study was conducted involving 54 children under five years old with cerebral palsy. Participants were classified into spastic cerebral palsy subtypes such as quadriplegic, hemiplegic, diplegic, or triplegic. Feeding problems were categorized as inappropriate feeding practices, reduced food intake, parental misperception, and food preferences using the Pediatric Symptom Checklist-17. Nutritional status was assessed using weight-for-age percentiles based on WHO growth charts. History of constipation and dysphagia were also recorded. Data analysis included Chi-square and Mann-Whitney U tests. Among the participants, 38.9% had hemiplegia, 33.3% diplegia, and 25.9% quadriplegia. Feeding problems were prevalent, with inappropriate feeding practices being the most common (70.4%). Malnutrition was identified in 59.3% of the children. However, no significant associations were observed between CP subtype or demographic variables and the types of feeding problems. Similarly, the type of feeding problem was not significantly associated with malnutrition. Constipation and dysphagia were reported in 31.5% and 37.0% of participants, respectively, and were significantly associated with nutritional status (p<0.001). In conclusion, feeding problems and malnutrition are common in children with cerebral palsy, with inappropriate feeding practices being the most prevalent issue. Although no significant associations were found between CP subtypes or the types of feeding problems and malnutrition, the findings emphasize the multifactorial nature of feeding challenges.
Factors associated with feeding problems in children with cerebral palsy: A cross-sectional study from Indonesia Maulidia, Dwi S.; Sembiring, Tiangsa; Dimyati, Yazid; Tanjung, Ika CD.; Wahyuni, Arlinda S.; Pratita, Winra; Nasution, Halida R.; Alharbi, Olayan; Pasaribu, Ayodhia P.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.163

Abstract

Children with cerebral palsy are at high risk for feeding difficulties and malnutrition due to motor impairments and associated conditions. The aim of this study was to evaluate the prevalence and types of feeding problems and their association with malnutrition in children with cerebral palsy. A cross-sectional study was conducted involving 54 children under five years old with cerebral palsy. Participants were classified into spastic cerebral palsy subtypes such as quadriplegic, hemiplegic, diplegic, or triplegic. Feeding problems were categorized as inappropriate feeding practices, reduced food intake, parental misperception, and food preferences using the Pediatric Symptom Checklist-17. Nutritional status was assessed using weight-for-age percentiles based on WHO growth charts. History of constipation and dysphagia were also recorded. Data analysis included Chi-square and Mann-Whitney U tests. Among the participants, 38.9% had hemiplegia, 33.3% diplegia, and 25.9% quadriplegia. Feeding problems were prevalent, with inappropriate feeding practices being the most common (70.4%). Malnutrition was identified in 59.3% of the children. However, no significant associations were observed between CP subtype or demographic variables and the types of feeding problems. Similarly, the type of feeding problem was not significantly associated with malnutrition. Constipation and dysphagia were reported in 31.5% and 37.0% of participants, respectively, and were significantly associated with nutritional status (p<0.001). In conclusion, feeding problems and malnutrition are common in children with cerebral palsy, with inappropriate feeding practices being the most prevalent issue. Although no significant associations were found between CP subtypes or the types of feeding problems and malnutrition, the findings emphasize the multifactorial nature of feeding challenges.
Ivermectin and dexamethasone combination induces apoptosis in SUP-B15 cell line Siregar, Olga R.; Wahyuni, Arlinda S.; Pasaribu, Ayodhia P.; Edianto, Deri; Ugrasena, I DG.; Amelia, Rina; Lubis, Inke ND.; Rusda, Muhammad
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1975

Abstract

The development of glucocorticoid resistance has complicated the management of acute lymphoblastic leukemia (ALL), leading to increased mortality rates. Ivermectin, a low-cost and well-established anthelmintic, exhibits anticancer potential and may enhance glucocorticoid toxicity in ALL, offering a possible strategy to overcome resistance. The aim of this study was to evaluate the apoptotic effect of combining ivermectin with dexamethasone in ALL. ALL SUP-B15 cells were cultured under standard conditions before treatment with dexamethasone (200 nM) alone or combined with ivermectin (5, 10, and 20 µM), with an untreated group serving as the control.  Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay by measuring cell viability and inhibition. Apoptosis was evaluated through BAX, BCL-2, and CASP3 gene expression analysis using reverse transcription-polymerase chain reaction (RT-PCR). The findings revealed that the combination of ivermectin and dexamethasone was superior in the repression of ALL cell viability compared to control (p<0.001). The combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated the most significant cell inhibition of 38.16±0.04% (p<0.001) and produced the lowest cell viability of 61.84±0.05% (p<0.001). Moreover, the combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated superior upregulations of BAX (p<0.001) and CASP3 (p<0.001). In conclusion, the addition of ivermectin (5 µM) to dexamethasone regimen (200 nM) increases its cytotoxic and apoptotic activities against SUP-B15 cell line as observed by the CASP3 and BAX upregulation. Studies to confirm the enhanced anticancer activity by this combination by observing the protein levels and animal studies are warranted.
Factors associated with clinical outcomes among children with delayed diagnosis of critical congenital heart disease: A cross-sectional study Fachrozi, Muhammad R.; Adriansyah, Rizky; Pratita, Winra; Wahyuni, Arlinda S.; Tobing, Tina CL.; Trisnawati, Yunnie
Narra X Vol. 3 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i2.191

Abstract

Delayed detection of critical congenital heart disease (CHD) is associated with increased morbidity and mortality. Currently, there is a paucity of data on children with critical CHD in Indonesia. The aim of this study was to investigate the factors contributing to delayed diagnosis of critical CHD and its association with clinical outcomes such as mortality, heart failure, intensive care unit (ICU) admission, and ventilator use. A cross-sectional study was conducted using medical records from Haji Adam Malik Medan General Hospital. The study included all children aged 0 to 18 years diagnosed with critical CHD. The statistical analysis was performed by utilizing SPSS version 25.0. A total of 59 subjects were analyzed. The findings revealed a significant relationship between factors such as age, sex, respiratory tract infections, type of CHD, surgical interventions, and underlying syndromic abnormalities with various clinical outcomes. Delayed diagnosis of critical CHD was associated with increased mortality, heart failure, ICU admission, and ventilator use, with these outcomes influenced by the aforementioned factors.