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Effectiveness of Tai Chi as a non-invasive intervention for mild cognitive impairment in the elderly: A comprehensive review and meta-analysis Rampengan, Derren DCH.; Gunawan, Felicia A.; Rampengan, Jade AH.; Ramadhan, Roy N.; Iqhrammullah, Muhammad; Yufika, Amanda
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.v4i1.724

Abstract

The aging population warrants the increase of mild cognitive impairment (MCI) prevalence, a condition that could progress to dementia. Efforts have been made to improve the MCI and prevent its progression, including the introduction of Tai Chi, a Chinese traditional exercise. The aim of this systematic review and meta-analysis was to evaluate the efficacy of Tai Chi in attenuating MCI among the elderly population. Records investigating the effect of Tai Chi exercise intervention on cognitive function among elderly patients were searched systematically from PubMed, ScienceDirect, Google Scholar, and Europe PMC as of April 13, 2023. The risk of bias (RoB 2.0) quality assessment was employed in the quality appraisal of the studies included. Review Manager 5.4.1 was used for data extraction and meta-analysis, where the standard mean difference (SMD) and 95% confidence interval (95%CI) were computed. Eight randomized control trials with a total of 1379 participants were included in this meta-analysis. Six trials assessed Montreal Cognitive Assessment scores, where its pooled analysis suggested that Tai Chi was as effective as conventional exercise (SMD=0.15, 95%CI: -0.11 to 0.40, p=0.26). However, pooled analysis of the Mini-Mental Status Examination suggested that Tai Chi intervention more effectively improved cognitive function and reduced the rate of cognitive impairment in elderly patients (SMD=0.36, 95%CI: 0.18 to 0.54, p<0.01) as compared to the control group. This systematic review and meta-analysis suggest that, in some extent, Tai Chi is efficacious in improving cognitive function and slowing down the rate of cognitive impairment among elderly patients.
Predictors for 30-day mortality in hepatocellular carcinoma patients undergoing liver resection Prabowo, Erik; Susilaningsih, Neni; Suharti, Catharina; Purnomo, Hery D.; Riwanto, Ignatius; Fuadi, Ahmad F.; Ar, Ardiyana; Bulandari, Beatrice LA.; Tjandra, Kevin C.; Respati, Danendra RK.; Rampengan, Derren DCH.
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.v4i3.1001

Abstract

Hepatocellular carcinoma (HCC) ranks among the most prevalent and fatal liver cancers globally. Liver surgery, particularly resection, offers the potential for cure but poses challenges, especially in Indonesia, where patients often present in advanced stages. This study aimed to determine the intraoperative and perioperative factors associated with 30-day mortality of HCC patients undergoing liver resection at a tertiary referral hospital. The study included HCC patients undergoing liver resection at Karadi General Hospital, Semarang, Indonesia, between January 2018 and September 2023. Demographic data, intraoperative, perioperative, and postoperative factors were collected, with the primary outcome being 30-day mortality. Factors influencing 30-day survival were assessed using a log-rank test and the survival analysis employed Kaplan-Meier curves. Among 58 HCC patients who had liver resection, 62.1% were males, with a mean age was 57.27±9.56 years old. Preoperative comorbidities, notably hepatitis B, affected 34.4% of patients. Child-Pugh Score categorized 91.4% as class A. The study found a 30-day mortality rate of 10.3% with no subsequent increase in incidence. The failure-to-rescue rate (FTR) of this study was found to be 46%. Factors associated with 30-day mortality were Child-Pugh classification (p<0.001), intraoperative bleeding (p=0.001), creatinine levels (p=0.005), Clavien-Dindo classification (p<0.001), and posthepatectomy liver failure (PHLF) (p<0.001). This study suggests that pre-operative (Child-Pugh classification), intraoperative (blood loss volume) and postoperative factors (Creatinine level, Clavien-Dindo classification, and PHLF) could predict the mortality rate of HCC patients undergoing liver resection.
Efficacy of angiotensin receptor neprilysin inhibitor in hypertension management: A systematic review and meta-analysis of clinical trials Ramadhan, Roy N.; Rampengan, Derren DCH.; Puling, Imke MDR.; Willyanto, Sebastian E.; Tjandra, Kevin C.; Thaha, Mochammad; Multazam, Chaq ECZ.; Suryantoro, Satriyo
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.v4i3.1247

Abstract

Dysregulation of renin-angiotensin-aldosterone system (RAAS) often leads to hypertension and severe cardiorenal complications. Although RAAS-targeted therapies have proven effective, it remains yet optimal in reducing cardiovascular events. The aim of this study was to evaluate the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI) compared to control in patients with hypertension. The primary outcomes were systolic and diastolic blood pressure (BP) control, along with the incidence of adverse events. A systematic review and meta-analysis was conducted according following PRISMA guidelines. A comprehensive literature search was performed across five databases: PubMed, ScienceDirect, EBSCO, Cochrane, and ProQuest, with studies identified up until 3 October 2024. The study included nine clinical trials that met the predefined eligibility criteria: (1) randomized clinical trials; (2) adult patients diagnosed with hypertension; and (3) comparison of ARNI versus control, reporting either BP control or adverse events. Quality appraisal using RoB 2.0 revealed that eight studies had a low risk of bias, and one had a high risk of bias. The pooled analysis demonstrated that ARNI is significantly more efficacious in achieving targeted systolic BP as compared to the control group (OR: 1.80; 95%CI: 1.41-2.30; p<0.001; I²=0%), and there was no statistical difference for the efficacy on diastolic BP compared to control (OR: 0.92; 95%CI: 0.75–1.13; p=0.45; I²=75%). The incidence of adverse events was not associated with ARNI (OR: 1.07; 95%CI: 0.90–1.27; p=0.46; I²=72%). In conclusion, ARNI demonstrated a favorable outcome only in systolic BP, but in diastolic BP which could be associated with inadequate duration of observation. Further studies are warranted to assess BP-lowering effect and safety profile of ARNI in a longer observation time.
Ecological study on child nutrition in Indonesia: National urban–rural patterns and local-level variation Qanita, Intan; Abshori, Nuril F.; Rampengan, Derren DCH.; Ramadhan, Roy; Adji, Arga S.; Nurkolis, Fahrul; Al-Abdullah, Hatem B.; Al-Dubai, Sami A.
Narra X Vol. 3 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v3i3.235

Abstract

Indonesia continues to face a double burden of malnutrition, characterized by persistent undernutrition and a growing prevalence of overweight among children. Although urban children typically show lower rates of stunting and underweight, emerging evidence indicates rising obesity due to unhealthy behavior. At the same time, national indicators may mask substantial heterogeneity at the provincial and district levels. This study aimed to compare urban–rural disparities in child nutrition and maternal care at the national level and examines intra-provincial variation that may be obscured by aggregated statistics. An ecological analysis was conducted using data from the 2024 Indonesian Nutritional Status Survey. Urban–rural differences were evaluated using odds ratios (OR) and Chi-square tests. Sub-provincial analyses were undertaken in selected districts of Central Java and South Sulawesi to assess patterns of variation across smaller administrative units. At the national level, urban children exhibited lower odds of severe underweight (OR: 0.78; 95%CI: 0.75–0.81), underweight (OR: 0.82; 95%CI: 0.80–0.84), and stunting (OR: 0.77; 95%CI: 0.75–0.78). In contrast, they had higher odds of being at risk of overweight (OR: 1.35; 95%CI: 1.31–1.40) and of consuming unhealthy foods (OR: 1.22; 95%CI: 1.19–1.25). Rural areas showed poorer dietary diversity and lower coverage of antenatal care. District-level analyses revealed marked contrasts, where in Central Java, Magelang Municipality had lower odds of severe underweight than Surakarta and Tegal Municipalities. Meanwhile, in South Sulawesi, Makassar Municipality performed better than Pare-pare Municipality but still lagged behind Tana Toraja. These intra-provincial patterns suggest that urban residence does not uniformly confer nutritional advantage. Significant inequities persist not only between urban and rural populations but also across districts within the same province. Smaller cities with stronger health service access, such as Magelang Municipality, tend to show better child nutrition outcomes.
Prevalence of surgical site infections in Gulf Cooperation Council countries: A systematic review and meta-analysis Al-Gunaid, Seba T.; Rampengan, Derren DCH.; Khadra , Jomana B.; Elgohari, Aya T.; Mouzhir, Rim M.; Alzahrani, Abdulrahman A.; Osman, Mousab MAH.; Alabbad, Zahra A.; Adista, Muhammad A.; Al-Dubai, Sami A.; Aleid , Layan K.
Narra X Vol. 4 No. 1 (2026): April 2026 (In Press)
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v4i1.243

Abstract

Surgical site infections (SSIs) rank among the most prevalent healthcare-associated infections, leading to higher patient morbidity, extended hospitalizations, and increased healthcare expenses. Despite advancements in surgical practices within the Gulf Cooperation Council (GCC) nations, information on SSI prevalence remains fragmented and inconsistent. The aim of this study was to determine the overall prevalence of SSIs in GCC countries and to assess variations according to surgical procedure type. A systematic search of PubMed, PubMed Central (PMC), ScienceDirect, and Google Scholar was conducted for studies reporting SSI prevalence in the six GCC countries up to May 2025. The quality of the study was evaluated using the Newcastle-Ottawa Scale. Pooled prevalence estimates were calculated using a random effects model, with subgroup analyses performed based on surgical procedure type. A total of 23 studies involving 32,366 patients were included in the analysis. The overall pooled prevalence of SSIs was 7% (95%CI: 4–10%; I²=92.9%), which suggests a significant level of variability. The highest SSI prevalence was observed in coronary artery bypass graft (CABG) procedures (42%), followed by colorectal surgeries (28%) and coronary artery surgeries (18%). Lower prevalence rates were reported for laparotomies (2%) and cholecystectomies (1%). Caesarean section, the most frequently reported procedure (n=12,419), had an SSI prevalence of 3% (95%CI: 2–4%; I²=84.5%). Smaller studies tended to report higher SSI prevalence estimates. In conclusion, the elevated incidence of SSIs in high-risk procedures, particularly CABG and colorectal surgeries, highlights the necessity for enhanced regional surveillance systems and targeted preventive measures across GCC healthcare settings.