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All Journal Narra J
Pamungkasari, Eti P.
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Effect of walking and bone joint exercise on enhancing bone remodeling in menopausal women: A randomized controlled trial Pasa, Chusairil; Pamungkasari, Eti P.; Doewes, Muchsin; Purwanto, Bambang; Hartono, Hartono; Cilmiaty, Risya; Dirgahayu, Paramasari
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.v4i3.1321

Abstract

Osteoporosis increases fracture risk and reduces quality of life in menopausal women. Although physical activity, such as walking and bone joint exercise, is known to help maintain bone health, its effectiveness needs further examination. The aim of this study was to analyze the effects of physical activity, in particular walking and bone joint exercise, on enhancing bone remodeling in menopausal women. A randomized controlled trial was conducted among menopausal women and allocated into three groups: walking, bone joint exercise, and control groups. The intervention was provided for eight weeks, with the outcomes measured before and after the intervention. The study assessed five bone remodeling biomarkers: estrogen, parathyroid hormone (PTH), receptor activator of nuclear factor kappa-β ligand (RANKL), tumor necrosis factor-alpha (TNF-α), and bone mineral density (BMD). The paired sample student t-test and ANOVA were used to assess the effects of the interventions. The results indicated that, compared to pre-intervention, both walking and bone joint exercise significantly increased the estrogen (p=0.026 and p=0.023, respectively), decreased RANKL (p=0.019 and p=0.002, respectively), decreased PTH levels (p=0.022 and p=0.048, respectively) and increased the BMD scores (p=0.001 and p<0.001, respectively). In the control group, none of the remodeling biomarkers significantly changed except the mean level of TNF-α, which was increased significantly (p=0.001). This study highlights that structured exercise, such as walking and bone joint exercise, can significantly enhance bone remodeling markers in menopausal women. Therefore, implementing such physical activities into management may provide benefits to menopausal women.
Evaluating autologous peritoneum grafting for enhanced healing of bile duct injuries: A preliminary data from an animal study Nugroho, Anung N.; Mudigdo, Ambar; Soetrisno, Soetrisno; Yarso, Kristanto Y.; Nurwati, Ida; Indarto, Dono; Pamungkasari, Eti P.
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.v5i1.1873

Abstract

Increased incidence of laparoscopic cholecystectomy-related bile duct injuries (BDIs), combined with its risk of serious complications and mortality, highlights the need for a more effective repair technique. Although the use of autologous graft in BDI repair has been promoted, the role of autologous parietal peritoneum remains underexplored. The aim of this study was to evaluate the effect of autologous parietal peritoneum grafts in rabbit models of partial BDI, emphasizing its effect on the expression of cluster of differentiation 68 (CD68) and transforming growth factor-β (TGF-β). An experimental post-test-only design was employed, using 27 male New Zealand rabbits (Oryctolagus cuniculus) aged 8–10 months. The rabbits were allocated into three groups: control (primary closure), autologous parietal peritoneum graft, and autologous gallbladder graft. Partial BDI measuring 15×5 mm were surgically created and repaired according to group assignments. The expression of CD68 and TGF-β were measured via enzyme-linked immunosorbent assay (ELISA), while the anastomosis was pathologically examined through hematoxylin and eosin (H&E) staining on days 3, 7, and 14 post-surgery. Statistical analysis was performed using analysis of variance (ANOVA) followed by Bonferroni post hoc tests. No statistically significant difference was observed in the expression of CD68 or TGF-β among the three treatment groups on days 3, 7, and 14 post-surgery, indicating that the effects of autologous parietal peritoneum graft were comparable to the control and the autologous gallbladder graft in promoting wound healing. Fibroblast density on day 3 was significantly lower in the parietal peritoneum group (p=0.040), reflecting delayed recruitment, but normalized by day 14, indicating successful integration and remodeling. The study highlights the potential role of autologous parietal peritoneum grafts for BDI.
Key contents of health education and their impact on improving medication adherence among hypertensive patients: A systematic review and meta-analysis Mustara, Mustara; Hartono, Hartono; Pamungkasari, Eti P.
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.v5i2.2080

Abstract

Hypertension is a global health issue with significant effects on morbidity and mortality, and medication adherence is crucial for effective management. Despite its importance, adherence remains low among hypertensive patients. Health education has been shown to improve medication adherence, though its effectiveness varies across studies. The aim of this study was to systematically synthesize evidence on the impact of health education in enhancing medication adherence among hypertensive patients. This study followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and employed the population, intervention, control, and outcome (PICO) approach to develop keywords for a search across five databases: Emerald, ProQuest, PubMed, ScienceDirect, and Scopus. All randomized control trials published between 2019 and 2024 in English, evaluating health education's impact on medication adherence in hypertensive patients aged ≥18 years were included. The protocol was registered on PROSPERO (CRD42024532890), and study quality was assessed using the CEBMa scale. Twelve high-quality articles (CEBMa score of ≥7) involving 1,827 participants were included, identifying four key themes in health education for hypertension: an overview of hypertension and complications, medication and side-effect management, healthy lifestyle modification, and medication adherence strategies. Health education significantly improved medication adherence by 33% (risk ratio (RR): 1.33; 95%CI: 1.08–1.64; p=0.008), with a medium-large effect on improving medication adherence (d=0.70; 95%CI: 0.34–1.05; p<0.0001) and a small-medium effect on reducing non-adherence (d=-0.45; 95%CI: -0.66–(-0.24); p<0.0001). Health education delivered 1 to 3 months and with individualized approaches showed better adherence outcomes compared to more than three months and group-based methods. Face-to-face education was more effective than the digital method. In conclusion, health education improves medication adherence in hypertensive patients when delivered comprehensively over 1–3 months through individualized face-to-face sessions. These findings support its integration as a key strategy in hypertension management to enhance adherence.
Co-Authors Ambar Mudigdo Bambang Purwanto Dono Indarto Hartono Hartono Ida Nurwati Muchsin Doewes Mustara, Mustara Nugroho, Anung N. Paramasari Dirgahayu pasa, chusairil Risya Cilmiaty, Risya Soetrisno Soetrisno Yarso, Kristanto Y.