Background and Aims Although extensive research has been conducted on the psychological impact after exposure to the COVID‐19 pandemic, very few studies simultaneously investigated the negative and positive impacts on urban and rural residents. This study aims to compare the extent of psychological impact on Indonesian living in urban and rural areas a year after the first case of COVID‐19 was reported. Design, Methodology and Approach We employed a cross‐sectional study design. A total of 428 participants completed a set of web‐based questionnaires from February to March 2021, consisting of the Impact of Event Scale‐Revised (IES‐R), the Perceived Social‐Support (PSS), the mental health‐related lifestyle (MHLS), and 6‐item negative impacts, and the Jenkins' Sleep Scale (JSS). Findings Over 40% of the participants reported moderate to severe trauma‐related distress; 30%–40% increased stress at work, home, and financial stress, and 50% more social support gained from their family and friends. Although 62.1% of participants paid more attention to their mental health, only 30% engaged in a healthier lifestyle, and 36.7% had sleep problems. No significant differences were found between urban and rural residents on psychological impact, changes in mental health and related lifestyles, and sleep quality. Urban residents perceived more negative impacts, in parallel with increased social support, compared to rural residents. We also found a significant correlation between psychological impact, sleep disturbance, and increased social support. However, there was no significant association between mental health‐related lifestyles and other scales. Originality and Value This is among the first studies that examine the urban–rural disparity on the positive and negative impact of the COVID‐19 in the later stage of the pandemic. Our findings offer insights to provide equal effort to mitigate the negative impacts of the COVID‐19 crisis as well as promote healthy lifestyle behaviors in both urban and rural residencies.
Background: Late diagnosis of COVID-19 in young patients in a hypercoagulable state can cause a high mortality rate. Clinical manifestations of COVID-19 include respiratory and extrapulmonary symptoms such as a hypercoagulable state, increased transaminase enzymes, and multiple-organ failure. Case and outcomes: A 34-year-old male presented to the emergency room after 3 days of high fever, weakness, and flatulence. The patient had thrombocytopenia and elevated liver transaminase enzymes and was initially diagnosed with dengue hemorrhagic fever. He was given hydration intravenous fluids, oxygen, antipyretic, and hepatoprotector. On day 4, the patient was diagnosed with COVID-19 and received therapy to decrease the Alanine transaminase and Aspartate transaminase levels. While waiting for outsourced D dimer and prothrombin time results, the patient was given low molecular weight heparin (LMWH) on day 5. On day 13, his condition deteriorated with cephalgia and shortness of breath, but the patient's family refused intubation. The chest CT scan revealed large ground-glass opacities in both lungs. The patient was given additional medications, such as Meropenem, Dexamethasone, and Remdesivir. On day 15, the patient passed away. Discussion: Intermediate LMWH dosage seems to be associated with a lower mortality incidence than standard Deep Vein Thrombosis (DVT) prophylaxis in hospitalized COVID-19 patients. However, due to the late COVID-19 diagnosis, the patient was not given LMWH at the beginning of treatment. Conclusion: A hypercoagulable state is partly responsible for the high mortality rate of COVID-19 patients. Early detection and management of the hypercoagulable state, including the use of LMWH, can decrease the severity of COVID-19 symptoms.
Pulmonary fibrosis causes scar tissue formation that disrupts the functioning of the lungs. Uncaria gambir (Hunter) Roxb (hereafter gambir)—a plant native to West Sumatra in Indonesia—contains flavonoid (+)-catechin, which has strong antioxidant activity and can be used to combat pulmonary fibrosis. This random in vivo experimental study analyzed the antifibrotic effect of gambir on the lungs of rats with bleomycin-induced fibrosis. The subjects were 10 groups of 10-week-old male rats weighing around 200–250 g. All groups were terminated at the end of the seventh week or on day 50. The lungs were cleaned, and tissues were taken to analyze inflammatory cell counts and TGF-β1 levels using bronchoalveolar lavage (BAL) with ELISA; type I collagen and tissue inhibitor of metalloproteinase 1 (TIMP-1) levels using immunohistochemistry (IHC); and activation of NF-κB using ELISA and Western blot assays. The most severe histopathological characteristic based on the modified Ashcroft score was in the bleomycin group (BG), whereas the mildest was in the 262 mg/kg of the bodyweight antifibrotic gambir-dosed group (AF G262). The results showed a significant difference in the BAL inflammatory cell count ( p = 0.017 ; p < 0.05 ). AF G262 differed most from the other antifibrotic groups in terms of the number of inflammatory cells (0.63), TGF-β1 levels (3.80), and NF-κB levels (0.48), followed by the 131 mg/kg of the bodyweight antifibrotic gambir-dosed group (AF G131), which also differed most from other antifibrotic groups in terms of NF-κB (0.48), TIMP-1 (11.74), and collagen I (14.50) levels. Western blot analysis showed that the fibropreventive and antifibrotic groups had a specific band size of p65, whereas no specific band binding existed in the control group. This study concluded that the administration of AF G262 could improve fibrosis by lysing the extracellular matrix (ECM) in rat lungs.
Melaleuca cajuputi is a herb often used for respiratory infections, laxatives, general muscle relaxants, and sedatives. Herein, the efficacy of melaleuca cajuput oil as an adjuvant to the standard treatment of COVID-19 patients was assessed. A total of 127 COVID-19 patients aged ≥ 18-60 years with mild and moderate symptoms were treated at the Bhayangkara Brimob Hospital from November 2020 to February 2021 in a randomized, standard treatment compared with standard treatment plus melaleuca cajuput oil as an adjuvant therapy clinical trial study. The diagnosis of COVID-19 was confirmed by the results of a nasopharyngeal swab polymerase chain reaction test. All patients received standard therapy with melaleuca cajuput oil (n = 67) and without melaleuca cajuput oil (n = 60) for 7 days. The study protocol was approved by the Ethics Committee of the Bhayangkara Brimob Hospital. Of all the observed symptoms, including fever, nausea, anosmia, cough, dyspnea, limp, flu, ageusia, diarrhea, and bloating, the most common symptom of COVID-19 in the cajuput oil group was cough (47%), while the control group most reported fever (73%). The length of stay in the melaleuca cajuput oil group (10.23 ± 5.44 days) was significantly shorter than that in the control group (13.38 ± 4.62 days), as analyzed by the Mann-Whitney test (U = 1126.50; p < 0.01; r = −0.32). clarifyThe monocyte counts before (7.5%) and after (10.8%) in the cajuput oil group were significantly different (p < 0.001). The similar finding was also found for the control group (before: 29.2%, after: 45%, p < 0.001). No serious side effects occurred. This work identified M. cajuputi, one of Indonesia's traditional herbs, as an effective adjuvant to the standard therapy for mild and moderate COVID-19 patients. Further research is necessary to explore this possibility.
Gambir or Uncaria gambir (Hunter) Roxb. is a specific local plant in South East Asia, especially Indonesia and Malaysia. Gambir contains polyphenol substances with its main component of ABSTRACT Aim: The aim of this study is to finding inhibitor potential from several compounds in gambir plant by using in vitro MTT assay and study interaction with molecular docking. The interaction of amino acids on the binding site with substances in the gambir plant was analyzed to determine its potential as a herbal-based therapy candidate for pulmonary fibrosis. Material and Methods: Protein target using TGFβ1 and NF-κB and compounds from gambir plant ((+)-Catechin. Epigallocatechin gallate,
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