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All Journal MNJ (Malang Neurology Journal) JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia
Janet, Karensa Abby
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Health Professions Medicine & Pharmacology Neuroscience Public Health

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UNRAVELING THE BEST NON-PHARMACOLOGICAL INTERVENTIONS FOR COGNITIVE FUNCTION AND DEPRESSION IN ELDERLY WITH COGNITIVE IMPAIRMENT: A NETWORK META-ANALYSIS Masykur, Umar Jundullah; Janet, Karensa Abby; Putri, Dwi Sandhi Aulia Pramesti; Jatmiko, Sarazata Indi Rozaany; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.01.16

Abstract

Background: Emerging evidence suggests that non-pharmacological interventions can improve cognitive function and alleviate depressive symptoms in elderly individuals with cognitive impairment. However, the comparative effectiveness of these interventions remains unclear. Objective: This network meta-analysis (NMA) compares the efficacy of eight non-pharmacological interventions—Virtual Reality (VR) or Exergame, Computerized Cognitive Training (CCT), Mind-Body Exercise (MBE), Physical Exercise, Music or Art Therapy, Health Education, Treatment as Usual (TAU), and a Control group (no intervention, placebo)—on cognitive function and depression in elderly individuals with cognitive impairment. Methods: Randomized controlled trials (RCTs) published up to August 10, 2024, were systematically searched in Web of Science, PubMed, Embase, and Cochrane Library databases. A Frequentist random-effects network meta-analysis was conducted using R. Results: Total 46 RCTs with 3043 participants were included. The pooled results showed that CCT (SMD = 2.33, 95% CI [1.34, 3.32]), Physical Exercise (SMD = 2.24, 95% CI [1.24, 3.23]), and VR or Exergame (SMD = 2.09, 95% CI [1.10, 3.08]) significantly improved global cognition. VR or Exergame was also effective in enhancing attention (SMD = -3.49, 95% CI [-6.85, -0.14]), executive function (SMD = -75.54 (95% CI [-118.24, -33.04]), and reducing depressive symptoms (SMD = -2.62, 95% CI [-4.08, -1.15]). Conclusion: This NMA highlights the superior efficacy of CCT, Physical Exercise, and VR or Exergame in improving global cognition in elderly individuals with cognitive impairment. Additionally, VR or Exergame is particularly effective for enhancing attention, executive function, and reducing depressive symptoms, suggesting it should be integrated into cognitive rehabilitation programs.
THE EFFECTIVENESS, IMMUNOGENICITY, AND SAFETY OF THE Escherichia coli BASED BIVALENT HUMAN PAPILLOMAVIRUS (TYPES 16 AND 18) VACCINE PREVENTING CERVICAL CANCER: A Systematic Review Masykur, Umar Jundullah; Janet, Karensa Abby
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 11 No 3 (2025): Vol. 11 No. 3 (2025): JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol. 1
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53366/jimki.v11i3.795

Abstract

Background: Cervical cancer is the fourth most prevalent cancer worldwide and ranks second in Indonesia, with a high mortality rate among women. Cervical cancer ranks highest in treatment costs in Indonesia. HPV-16/18 infection causes nearly all cases of cervical cancer. The HPV-16/18 bivalent vaccine made with E. coli holds potential as a more affordable HPV vaccine than other commercial vaccines. Objective: This systematic review aimed to discuss the effectiveness, immunogenicity, and safety of the bivalent HPV-16/18 vaccine produced by E. coli based on evidence from available studies. Methods: This systematic review included valid experimental studies retrieved from PubMed, Cochrane, ScienceDirect, and Taylor and Francais databases that met the inclusion criteria. The search method used Boolean operators, with the literature cited from 2014 to 2024. Results and Discussion: Seven studies met the inclusion criteria. The results of all studies indicate that the bivalent HPV-16/18 vaccine produced by E. coli has a high effectiveness and good immunogenicity. There were no significant side effects associated with vaccination, and most of the side effects were minor. Conclusion: The bivalent HPV-16/18 vaccine produced by E. coli could serve as a reliable and economical alternative to prophylactic HPV vaccination for cervical cancer prevention.
COMPARATIVE EFFECTIVENESS OF NON-PHARMACOLOGICAL INTERVENTIONS FOR DIABETIC NEUROPATHIC PAIN: A NETWORK META-ANALYSIS OF PAIN INTENSITY AND NEUROPATHIC SYMPTOM OUTCOMES Aqila, Hammadah; Masykur, Umar Jundullah; Janet, Karensa Abby; Sulistomo, Hikmawan Wahyu; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.08

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and a major cause of chronic neuropathic pain, leading to reduced quality of life. Owing to the limited efficacy and tolerability of pharmacological treatments, non-pharmacological interventions have emerged as important alternative or adjunctive options. Objective: This study aimed to compare and rank the effectiveness of non-pharmacological interventions for neuropathic pain management in patients with DPN using a network meta-analysis (NMA). Methods: This systematic review and network meta-analysis was prospectively registered in PROSPERO (CRD420261295534). A systematic literature search was conducted in PubMed, Springer Nature, the Cochrane Library, and Taylor & Francis from inception to May 30, 2025. Randomized controlled trials evaluating non-pharmacological interventions for DPN-related neuropathic pain were included. Pain intensity and neuropathic pain symptom scores were analyzed using a frequentist random-effects NMA. Treatment effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs), and intervention rankings were estimated using the surface under the cumulative ranking curve (SUCRA). Results: Forty-seven RCTs involving 3,354 participants and 10 intervention categories were included. For pain intensity, invasive neuromodulation demonstrated the greatest reduction compared with control (SMD = –5.94; 95% CI –7.78 to –4.11) and ranked highest (SUCRA = 0.97). Acupuncture-based therapies and manual/massage therapies also showed notable effects. For neuropathic pain symptom scores, invasive neuromodulation again ranked highest (SMD = –3.20; 95% CI –5.96 to –0.43; SUCRA = 0.74), followed by acupuncture-based and electromagnetic field therapies. Sensitivity analyses confirmed the robustness of the findings, although potential publication bias was detected for pain intensity outcomes. Conclusion: This NMA provides a comprehensive comparative ranking of non-pharmacological interventions for neuropathic pain in DPN, highlighting invasive neuromodulation as the most effective modality and supporting the role of selected non-pharmacological therapies in clinical practice.
Co-Authors Aqila, Hammadah Jatmiko, Sarazata Indi Rozaany Masykur, Umar Jundullah Putri, Dwi Sandhi Aulia Pramesti Shahdevi Nandar Kurniawan, Shahdevi Nandar Sulistomo, Hikmawan Wahyu