BACKGROUND: Excessive use of pesticides is known to cause neurotoxicity. Chronic effects of pesticide poisoning include neuropathy and tremors. AIM: This study aimed to determine the association between pesticide exposure and the occurrence of neurological signs and symptoms, especially neuropathy and tremor, in farmers. METHODS: This was a cross-sectional study. The study location was Seloprojo Village, Ngablak District, Magelang Regency, Central Java Province. Farmers as subjects were recruited to determine neuropathy using Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scoring. Tremor events were measured with Tremor Rating Scale (TRS). Cholinesterase levels were examined using venous blood samples to determine the level of pesticide poisoning. RESULTS: Of the 120 farmers studied, 68.3% experienced pesticide poisoning with cholinesterase levels below normal values. Weakness of the upper limb was found in 10 subjects (8.33%), while weakness of the lower limbs was found in 6 subjects (5%). There were 59.2% farmers who met the neuropathy criteria from the DNS score and those who met the neuropathic criteria from the DNE score were 6.7%. Tremor symptoms were found in 71.7% of the farmers. There was no significant association between cholinesterase levels and DNS score (p = 0.737), but there were significantly lower levels of cholinesterase (p = 0.046) in the neuropathy group measured with DNE score. There was no significant association between cholinesterase levels and TRS (p = 0.204). CONCLUSION: Cholinesterase levels were significantly associated with neuropathy incidence measured with DNE criteria but statistically not related to tremors in farmers exposed to pesticides.
Background: Tambakrejo Health Center is one of the public health services in Surabaya that provides integrated dental and oral health services. As many as 69% of the community in health center working area were exposed to periodontal problems, and around 18% suffered from diabetes mellitus.Objective: This study aimed to identify the factors that play a role in compliance with drug consumption in patients with diabetes mellitus associated with periodontal tissue in the working area of Tambakrejo health center in Surabaya. Methods:This was an observational analytic study with cross sectional method. The study sample was 60 people with diabetes mellitus selected with a random sampling technique. Respondents filled out questionnaires to measure patients' perceptions, knowledge, attitudes, and actions about drugs, diabetes mellitus, periodontal health, and the level of compliance with drug consumption. The sample oral hygiene status was determined using the Russell Index. Results:The data obtained showed that as many as 67% of the samples had low level of compliance. Whereas, 20% of the sample had moderate level of compliance. Only 13% of the sample had high level of adherence. Conclusion:There was a significant correlation between the level of compliance of patients taking antidiabetic drugs and the periodontal health.
INTRODUCTION Gliomas are the most common primary central nervous system tumor. Inflammatory responses are thought to play an important role in cancer progression. Neutrophil-lymphocyte ratio (NLR) is a simple, low cost and easy to measure inflammation marker that has been shown to be a poor prognostic factor in many solid tumors. The preoperative NLR has been shown to be associated with histopathological grading of glioblastoma. This study aimed to find the association of NLR with glioma grading and overall survival in Indonesian patients. METHODS The patients were enrolled from Dr. Sardjito General Hospital, Yogyakarta Province, Indonesia. Neutrophil and lymphocyte counts were extracted from the complete blood count test before surgery. NLR was calculated as neutrophil count divided by lymphocyte count using standard units. Detailed demographic and clinical data were collected from medical records. RESULT A total of 79 patients were included in this study, consisting of 48 (60.8%) males and 31(39.2%) females. Most patients were diagnosed as WHO grade IV gliomas (43%), followed by grade II (26%), grade III (13%), and grade I (7.6%). In multivariate analysis, NLR ≥ 5.01 was significantly associated with high grade glioma (HR 5.50, 95%CI 1.96–15.44, p=0.001). We also found that patients with NLR ≥ 10.5 have significantly shorter median overall survival compared with patients with NLR < 10.5 (4.6 months and 27.2 months respectively, HR 2.13, 95%CI 1.03–4.40, p=0.041). Multivariate analysis using Cox Regression method showed that higher NLR (≥ 10.5) and IDH1 wild type were independent predictors for worse outcome. CONCLUSION In conclusion, NLR is associated with grading and overall survival of glioma patients in Indonesia.
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