Background: Depression and anxiety have become the most common mental health disorders worldwide during the COVID-19 pandemic, and increasing interest in telemedicine has led to the innovation of using internet-based cognitive behavioral therapy (iCBT). Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of iCBT for depression and anxiety among the global population during the COVID-19 pandemic. Methods: A literature search was conducted on PubMed, Scopus, Cochrane, ProQuest, Wiley, and Web of Science using the PRISMA framework, and only randomized controlled trials (RCTs) were included in the study. A critical appraisal was also performed using Cochrane’s Risk of Bias (RoB) 2. The meta-analysis used random-effects models to analyze pooled mean difference (MD) and its p-value. Results: Twelve RCTs were included for qualitative analysis and nine RCTs, which yielded 6778 patients with depression and 6556 patients with anxiety during the COVID-19 pandemic, were included for quantitative analysis. Despite high heterogeneity, all studies had a low risk of bias. Pre- and post-iCBT intervention in the depression forest plot depicts a significant effect (p < 0.00001) with a pooled MD of 4.73 (95% CI: 4.55–4.90), while the pre- and post-iCBT intervention depicts a significant effect (p < 0.00001) with a pooled MD of 4.50 (95% CI: 4.34–4.67). This demonstrates that iCBT was found to significantly decrease depression and anxiety scores in patients during the COVID-19 pandemic. However, substantial heterogeneity was also found (I2 = 93%; p < 0.00001 and I2 = 90%) for the pre-/post-depression and anxiety forest plots, respectively. Conclusions: This meta-analysis comprises an evidence-based result for iCBT to treat depression and anxiety in the COVID-19 population, as indicated by the significantly lower assessment scores. Delivering iCBT in this situation needs to be considered more extensively, as it has promising results and yields the benefits of technological advancement in psychotherapy.
This study aimed to highlight and focus on curcumin’s role in enhancing the body defense mechanism against tuberculosis (TB) infection, using a narrative review. This review was identified by four search engines: PubMed, Science Direct, Research Gate, and Google Scholar. We found that as an immunomodulator, curcumin reduces the production of specific cytokines by inhibiting the transcription factor. In the same mechanism, curcumin also activates the host macrophages, dendritic maturation, and modulation of the antigen-presenting cell process. Curcumin also increases apoptosis as a defence mechanism against TB infection. Curcumin also increases B-cell proliferation and downregulates oxidative stress on B-cells. As results, curcumin is a potential immunomodulator that complements M. TB treatment, especially in Indonesia. It can be stated that curcumin is proven to be a promising strategy in complementing TB prevention also treatment.
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