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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.