Objective:Studies have reported intradialytic hypertension and inadequate antihypertension drugs in hemodialysis patients. Garlic and its components like Allicin have biological activities in lowering blood pressure by induction of endothelin nitric oxide synthase (eNOS) to hydrogen sulfide (H2S), which leads to calcium channel closure and relaxation, which leads to vasodilation of vessels. This study aims to analyze the effect of garlic extract supplementation on lowering blood pressure in chronic hemodialysis patients at Moh Hoesin General Hospital, Palembang, Indonesia.Design and method:This study was a crossover randomized, placebo-controlled, double-blind trial. The subjects were 40 CKD stage 5 patients with chronic hemodialysis, randomly divided into 2 groups, namely the group that received 1000 mg of garlic extract per day (2x500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks, and then the two groups were crossover. Each group measured the blood pressure before and after treatment.Results:The wilcoxon test revealed that systolic blood pressure before and after garlic extract administration was 144,5 ± 12,1 mmHg and 140 (125–164) mmHg with p = 0,037, respectively (vs placebo, p = 0,55). Diastolic blood pressure before and after garlic extract administration was 80 (70–100) mmHg and 80 (70–100) mmHg, with p = 0,703 (vs placebo, p = 0,9).Conclusion:There was an effect of garlic extract on lowering systolic blood pressure in patients with chronic HD at Moh Hoesin Hospital, Palembang, Indonesia.
Introduction: Echinococcosis is a zoonotic disease caused by the larva stage of a Taeniidae parasite of Echinococcus. Echinococcus granulosus (E. granulosus) causes cystic echinococcus (CE) and is the most common species causing disease in humans. A pleural hydatid cyst should be considered initially with a corresponding chest radiograph. It can develop into fatal complications, including secondary infection, severe bleeding, bronchial rupture and pleural or pericardial cavities. This case report shows a rare case of a pleural hydatid cyst. Case: We reported a 59-year-old woman with shortness of breath and a productive cough for three months. The chest radiography and computed tomography (CT) scan revealed a cystic lesion measuring 14.2 x 18.5 cm with edge calcification thick around 3 mm. The pleural histopathology revealed that the cyst wall was made of fibrocollagen with a red oval echinococcus. The patient received oral albendazole/ABZ (400mg BID) for three months, paracetamol (500mg TID), and n-acetylcysteine (200mg TID). After three months, the patient had no complaints, only shortness of breath with heavy activity. Conclusion: It is important to be aware of this condition to avoid inappropriate and potentially dangerous underdiagnoses and treatment, which could endanger the patient.
Tuberkulosis paru merupakan masalah kesehatan global. Menurut laporan tuberkulosis dunia tahun 2022, Indonesia menempati peringkat 2 di dunia dengan estimasi 969.000 kasus. Jumlah kasus tuberkulosis paru yang ditemukan dan dilaporkan hanya 443.235 kasus. Masih ada sekitar 500.000 kasus yang belum ditemukan dan dilaporkan. Penyakit penyerta seperti hipertensi dan diabetes mellitus juga merupakan penyakit yang sering di jumpai namun sering diabaikan saat masih fase dini. Hipertensi dan diabetes mellitus pada pasien tuberkulosis paru dapat berpengaruh buruk dalam hasil pengobatan. Peran penting dalam meningkatkan penemuan kasus tuberkulosis paru serta deteksi dini komorbid nya dapat dilakukan oleh kader tuberkulosis. Oleh karena itu, dibutuhkan peningkatan dayaguna kader tuberkulosis di Palembang, agar tercapai peningkatan penemuan kasus serta komorbidnya. Melalui organisasi kader tuberkulosis yaitu, Masyarakat Sehat Sriwijaya, 15 kader tuberkulosis diberikan penyuluhan dengan pengayaan materi penemuan kasus serta deteksi dini hipertensi dan diabetes mellitus. Melalui kuesioner sebelum dan sesudah penyuluhan, didapatkan peningkatan pemahaman tentang penemuan kasus tuberkulosis serta deteksi dini hipertensi dan diabetes mellitus, dengan rerata skor sebelum 56,7, dan rerata skor sesudah 91,3. Dilakukan juga simulasi pelatihan deteksi dini hipertensi dan diabetes mellitus, agar dapat diterapkan oleh kader kepada masyarakat.
In December 2020, Indonesia was introduced to the long Coronavirus disease 2019 (COVID-19) phenomenon. The Centers for Disease Control and Prevention (CDC) introduced the term "post-COVID condition" as a health problem that persists after four weeks from the first exposure to COVID-19. The National Institute for Healthcare and Care Excellence (NICE) classifies COVID-19 infections into three categories based on disease duration: (1) acute infection for up to 4 weeks; (2) ongoing infection within 4-12 weeks; and (3) post-COVID-19 syndrome for more than 12 weeks and not associated with an alternative diagnosis. One of these phenomena is lung fibrosis. About 80% of COVID-19 survivors had mild to severe chest X-rays in 6 months of follow-up with decreasing lung function. COVID-19-related lung fibrosis is still not widely researched. COVID-19 survivors who develop lung fibrosis usually recover independently, but some develop persistent lung fibrosis. The use of antifibrotic agents, such as nintedanib, has long been approved for idiopathic pulmonary fibrosis (IPF). However, its use in the cases of lung fibrosis due to COVID-19 has not been widely studied. Nintedanib is a tyrosine kinase inhibitor. It inhibits receptor activity of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), and fibroblast growth factor (FGF). Those actions will eventually inhibit the proliferation, migration, and transformation of fibroblasts into myofibroblasts in lung fibrogenesis. Therefore, an antifibrotic agent is potentially needed to inhibit COVID-19-related lung fibrosis to improve quality of life and prevent further lung damage.
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