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Tjandra, Kevin C.
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Impacts of digital social media detox for mental health: A systematic review and meta-analysis Ramadhan, Roy N.; Rampengan, Derren D.; Yumnanisha, Defin A.; Setiono, Sabrina BV.; Tjandra, Kevin C.; Ariyanto, Melissa V.; Idrisov, Bulat; Empitu, Maulana
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.v4i2.786

Abstract

The impact of social media has been significant on various aspects of life, particularly mental health. Growing concerns about the adverse effects of social media use have prompted the exploration of experimental interventions, defined as digital detox interventions. However, it remains unclear whether digital detox interventions are effective for mental health outcomes. The aim of this study was to provide comprehensive insights into the effects of digital detox interventions on various mental health outcomes, including depression, life satisfaction, stress, and mental well-being. Following the PRISMA guidelines, systematic searches were carried out in online databases, including PubMed and ScienceDirect, within the publication range of 2013 and 2023. A total of 2578 titles and abstracts were screened, and 10 studies were included in the analysis. A risk of bias assessment was conducted using RoB 2.0 and the Newcastle-Ottawa scale, while statistical analysis was conducted using RevMan 5.4.1. Our data indicated a significant effect of digital detox in mitigating depression with the standardized mean difference (SMD: -0.29; 95%CI: -0.51, -0.07, p=0.01). No statistically significant effects were discerned in terms of life satisfaction (SMD: 0.20; 95%CI: -0.12, 0.52, p=0.23), stress (SMD: -0.31; 95%CI: -0.83, 0.21, p=0.24), and overall mental well-being (SMD: 0.04; 95%CI: -0.54, 0.62, p=0.90). These data underscore the nuanced and selective influence of digital detox on distinct facets of mental health. In conclusion, digital detox interventions significantly reduce depressive symptoms, suggesting that intentional reduction or cessation of digital engagement may help alleviate contributing factors. However, no statistically significant effects were observed in mental well-being, life satisfaction, and stress. This discrepancy may be due to the complex nature of these constructs, involving various factors beyond the scope of digital detox interventions.
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.
Role of phosphodiesterase-3 inhibitor in cardiorespiratory fitness and functional class of patients with pulmonary hypertension: A randomized, double-blind, placebo-controlled trial Sofia, Sefri N.; Bahrudin, Udin; Uddin, Ilham; Sobirin, Muhammad A.; Setiawati, Erna; Hardiningsih, Galuh; Tjandra, Kevin C.; Limijadi, Edward KS.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1301

Abstract

Many patients with acyanotic shunt congenital heart disease (CHD) are diagnosed only in adulthood, by which time pulmonary hypertension (PH) has developed, impairing their functional class and cardiorespiratory fitness. While PH treatments are limited and expensive, cilostazol, a phosphodiesterase-3 inhibitor, has shown potential in reducing pulmonary artery pressure and improving heart function, offering hope for better patient outcomes. The aim of this study was to evaluate the effects of cilostazol on cardiorespiratory fitness and functional class in patients with acyanotic shunt CHD with PH using a randomized, double-blind, placebo-controlled trial. The trial was conducted at Dr. Kariadi Hospital, Semarang, Indonesia, from March 2022 to March 2023. Patients aged 14–75 years were randomly assigned to receive cilostazol (initially 200 mg, later adjusted to 100 mg) or placebo for three months. Cardiorespiratory fitness was assessed using the six-minute walk test (6MWT) and VO2 max at pre-intervention and three months post-intervention. After three months, the mean 6MWT was not significantly different between cilostazol and placebo groups (319.65±50.52 vs 317.65±45.26 meters; p=0.090). Similarly, the VO2 max was also not significantly different between cilostazol and placebo groups (10.74±2.59 mL/kg/min vs 10.73±2.8 mL/kg; p=0.099). However, the percentage of patients who had functional class improvement was significantly higher in the cilostazol group compared to the placebo group (90% vs 30%; p<0.001). This study indicated that cilostazol could improve functional class in acyanotic shunt CHD patients with PH. However, larger and more robust trials are warranted to confirm the potential benefits of cilostazol in this patient population.
Impact of vitamin D supplementation on post-stroke rehabilitation outcomes: A systematic review and meta-analysis Murbawani, Etisa A.; Pramukarso, Dodik T.; Muis, Siti F.; Pudjonarko, Dwi; Subagio, Hertanto W.; Tjandra, Kevin C.; Respati, Danendra RP.; Nugraha, Laksmana AK.; Ramadhany, Ghifarie A.; Pranoto, Stephano
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.v5i2.1848

Abstract

Each year, there are approximately 12.2 million new stroke cases and 6.5 million stroke-related deaths, with low- and middle-income countries shouldering a disproportionately high financial burden. Studies have associated vitamin D deficiency with arteriosclerosis, left ventricular hypertrophy, and vascular dysfunction, contributing to an elevated risk of stroke. The aim of this study was to evaluate how vitamin D supplementation affects post-stroke outcomes. A comprehensive literature search was performed across PubMed, Scopus, the Cochrane Library, ScienceDirect, Springer Link, ProQuest, and Epistemonikos from April to May 2024. This study focused on comparing the efficacy of vitamin D supplementation versus no supplementation in stroke patients of all ages. Outcome measures included the Functional Ambulation Classification (FAC), Brunnstrom Recovery Stage (BRS), Modified Rankin Scale (mRS), and National Institutes of Health Stroke Scale (NIHSS). Case reports, reviews, and research on other cardiovascular or metabolic issues were excluded. Five authors extracted data and analyzed bias separately using the Risk of Bias Version 2 (RoB V2) algorithms. The results of continuous variables were pooled into the mean difference (MD) along with 95% confidence intervals (CI) using random-effect models. Review Manager 5.4 was used to evaluate the data. Out of the 1,152,449 papers evaluated, six met the inclusion criteria, with a sample size ranging from 42 to 123 patients. Vitamin D supplementation was found to yield better outcomes after stroke. BRS in lower extremities showed better results (MD: 0.59 (95%CI: 0.27–0.91)), NIHSS improved with an MD of -1.47 (95%CI: -2.03–(-0.90)). Furthermore, there was also an improvement in mRS, with an MD of -0.91 (95%CI: -1.25–(-0.56)). In conclusion, vitamin D improved post-stroke outcomes, which supported its supplementation as a part of stroke rehabilitation.
Co-Authors Ar, Ardiyana Ariyanto, Melissa V. Bulandari, Beatrice LA. Catharina Suharti Dwi Pudjonarko Empitu, Maulana Erna Setiawati, Erna Fuadi, Ahmad F. Hardiningsih, Galuh Idrisov, Bulat Ignatius Riwanto, Ignatius Ilham Uddin Limijadi, Edward KS. MOCHAMMAD THAHA Muis, Siti F. Multazam, Chaq ECZ. Murbawani, Etisa A. Neni Susilaningsih Nugraha, Laksmana AK. Prabowo, Erik Pramukarso, Dodik T. Pranoto, Stephano Puling, Imke MDR. Purnomo, Hery D. Ramadhan, Roy N. Ramadhany, Ghifarie A. Rampengan, Derren D. Rampengan, Derren DCH. Respati, Danendra RK. Respati, Danendra RP. Setiono, Sabrina BV. Sobirin, Muhammad A. Sofia, Sefri N. Subagio, Hertanto W. Suryantoro, Satriyo Udin Bahrudin, Udin Willyanto, Sebastian E. Yumnanisha, Defin A.