Background Coronavirus disease 2019 (COVID-19) elicits robust inflammatory reaction that may result in a declining albumin serum level. This meta-analysis aimed to evaluate the prognostic properties of hypoalbuminemia for poor prognosis and factors that may influence the relationship. Method A systematic literature search of PubMed was conducted from inception to April 22, 2021. The main exposure was albumin level below normal range–defined by the included studies. The outcome of interest was composite poor outcome that comprises of mortality, severity, and the requirement of mechanical ventilation or intensive care unit. Results There were 6200 patients from 19 studies. Meta-analysis showed that hypoalbuminemia was associated with composite poor outcome (OR 6.97 (95% CI 4.20–11.55), p<0.001; I 2 =91.3%, p<0.001). Meta-regression analysis showed that age (p=0.44), gender (p=0.76), HT (p = 0.97), DM (p = 0.40), CKD (p = 0.65), liver disease (p = 0.72), and malignancy (p = 0.84) did not affect the association. Subgroup analysis showed that hypoalbuminemia increased mortality (OR 6.26 (95% CI 3.26–12.04), p<0.001; I 2 =69.6%, p<0.01) and severity of the disease (OR 7.32 (95%CI 3.94-13.59), p<0.001; I 2 =92.5%, p<0.01). Pooled diagnostic analysis of hypoalbuminemia yielded a sensitivity of 0.63 (95% CI 0.52-0.72), specificity of 0.81 (95% CI 0.73-0.87), and AUC of 0.77. The probability of poor outcome was 70% in patients with hypoalbuminemia and 24% in patients with normal albumin level. Conclusion Hypoalbuminemia was associated with poor prognosis in COVID-19 patients.

Introduction: Cigarette smoke causes oxidative stress which results in reduced sperm concentration, motility and morphology, also increased levels of 8-OHdG as a marker of DNA damage. Vitamin C and E have potential role in repairing spermatozoa damages. The aim of this study was to determine the effect of vitamin C and E combination on sperm quality and cement 8-OHdG level of smoke exposed rats.Methods: This study used a post test only control group design among 18 male Wistar rats subject, aged 8 week, 150-200 grams body weight (BW). The subject was randomly divided into 3 groups, K1: control, K2: cigarettes smoke exposed, K3: cigarettes smoke exposed and given a combination of 0.045 mg/gBW vitamin C and 0.036 IU/gBW vitamin E per oral. Analysis was done on day 21 using one-way ANOVA and post-hoc LSD for sperm concentration, motility and morphology; using Kruskal-Wallis and Mann-Whitney tests for cement 8- OHdG levels.Results: The lowest sperm concentration was found in   K2 (K2  32.59  million/mL,  K1 47.91 million/mL, K 339.43 million/mL); the lowest normal sperm motility was found in K2 (K 238.97%, K 164.57%, K3 51.43%); the lowest normal sperm morphology was found in K2 (K2 27.56%, K 138.36%, K 331.18%); and the highest cement 8- OHdG level was found in K2 (K2 20.18ng/mL, K1 3.43ng/mL, K3 5.28ng/mL).Conclusion: Combination of vitamin C and E can improve sperm concentration, motility and morphology and decrease cement 8-OHdG levels of smoke exposed rats.

Introduction. Achievement of energy target in critically ill Covid-19 patients in Intensive Care Unit (ICU) is challenging. This study was aimed to depict the possibility of achieving energy target and its determinants in critically ill Covid-19 patients. Methods. A cross sectional study was conducted in ICU of dr. Kariadi Hospital Semarang, Indonesia. Secondary data were obtained from Covid-19 patients who were in ICU for minimum 3 days, from March to December 2020. Data collected included age, sex, Body Mass Index (BMI), comorbidities, Modified Nutrition Risk in Critically Ill (mNUTRIC) score, energy intake, route of nutrition delivery (enteral or combination of enteral and parenteral nutrition), lactate status, ICU length of stay (LOS), duration of mechanical ventilator and mortality. Risk Prevalence calculations were conducted to measure risks. Variables with significant associations and p< 0.25 were included in multiple logistic regression. Results. A total of 188 subjects were included in the analysis. Most patients were male (62.8%) and obese (61.8%). As much as 56.9% patients were able to achieve energy target of 20 kcal/kgBW on day 3 of ICU stay. Those with low risk mNUTRIC score and nutrition delivery was through enteral and parenteral route were more likely to achieve target energy of 20 kcal/kgBW in the first 3 days in the ICU. Conclusions. Achieving energy target of 20 kcal on day 3 of ICU stay for critically ill Covid-19 patients is feasible. Low mNutric score and nutrition delivery through enteral and parenteral route were two determinants for the achievement.

Introduction Vitamin B12 plays a role during pregnancy in maintaining folate metabolism. Together with folate and vitamin B6, B12 is involved as a coenzyme in DNA synthesis and various methylation reactions in developing embryos. This study aims to compare plasma folate, vitamin B6 and B12 blood levels with respect to the presence of probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10TM) among pregnant women in Indonesia. Methods: This study is part of a larger study entitled “Effects of Bifidobacterium animalis subsp. lactis HNO19 (DR10TM), inulin, and micronutrient fortified milk on fecal DR10TM, immune markers, and maternal micronutrients among Indonesian pregnant women.” Further analyses were performed using independent-t test or Mann Whitney test, GLM-repeated measures and chi-square test, to compare folate, vitamin B6 and B12 intake and blood concentration during pregnancy with presence (n=22) and absence (n=55) subjects of fecal DR10TM at third trimester. Results: At the first trimesters there was no difference in plasma vitamin B6 and vitamin B12 levels between the two groups, based on the presence or absence of fecal DR10TM. However, at the second and third trimester, vitamin B6 blood concentration (p=0.034 and p=0.001) and vitamin B12 blood concentrations at the third trimester (p=0.035) were significantly higher in the fecal DR10TM positive group, while having a similar vitamin B6 and B12 intake. Conclusion: Consumption of pre- and probiotics during the periconceptional period may be a useful strategy for improving maternal vitamin B’s vitamins, especially vitamin B6 and B12 status and therefore provide benefits for the offspring’s quality of life.

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Introduction: In Indonesia, homebrew, commercial powder and ready-to-use enteral formula have been used in hospital and at home. However, the decision to choose enteral formula is influenced by various things and often does not based on evidence-based practice. This study aims to compare macronutrient accuracy and microbial contamination status of homebrew, commercial powder and ready-to-use enteral formula. Furthermore, this result was expected to become a reference in deciding the enteral formula to use. Methods: The design was a cross sectional comparative study. We collected 63 enteral nutrition samples from 7 different ICUs, wards and homes, in Jakarta from April to June 2012. Macronutrient accuracy was assessed by comparing energy, carbohydrate, protein and fat to their nutritional fact labels. The macronutrient accuracy was considered to be good if the deviation was <10% and bad if >10%. Microbial contamination was considered to be acceptable if the contamination in enteral formula by coliform was <3 MPN/mL, total plate count (TPC) <10 CFU/mL, and Staphylococcus aureus < 10 CFU/mL. Results: Homebrew had bad accuracy in calorie, carbohydrate and fat; commercial powder enteral formula had slightly bad accuracy in fat; ready-to-use enteral formula had bad accuracy in carbohydrate and fat. There was no sample contaminated by Staphylococcus aureus. Contamination by coliform and TPC was most acceptable in ready-to-use enteral formula than others, and the least in homebrew. Conclusion: Commercial and ready-to-use enteral nutrition are more acceptable than homebrew in macronutrients accuracy and microbial contamination status.

Background: Including Indonesia, the elderly population worldwide is on the rise. This situation is closely related to the increase in the incidence and prevalence of non-communicable diseases. Eating behavior is related to the risk of non- communicable the risk of NCDs in the elderly. Therefore, nutrition intervention should be carried out from old age.Objectives: The purpose of this study is to review potential nutritional interventions to prepare for a healthy ageing process in an Indonesian context.Discusion: This review uses social cognition theory to emphasize the importance of nutrition education, the development of nutritional products with biologically active compounds, and practical guidelines that influence individual dietary behavior. Nutritional interventions should take into account Indonesia’s existing food-based balanced nutrition diet guidelines and the dietary patterns of adults and the elderly. Indonesia has a large population, ethnic and cultural diversity, which together affect people’s daily consumption of various foods.Conclusions: Customized nutrition education programs and the development of functional foods are appropriate interventions that can be implemented in Indonesia.

Introduction: Hyperglycemia commonly occurs in critically ill patients due to metabolic stress. Hyperglycemia can cause gastric motility disturbance in which can cause high gastric residual volume (GRV). The objective of this study is to determine the relationship between hyperglycemia and high GRV status in ICU patients.Methods: This study used cross sectional method with consecutive sampling of 96 adult ICU patients. Blood glucose level were measured every 12 hours and GRV every 4 hours on first and second day admission to ICU. Data were analyzed with Statistical Package for Social Science Program (SPSS) version 20.0. The relationship between hyperglycemia status and high GRV status were analyzed using Chi-Square test.Results: Hyperglycemia status was found in 45.8% subjects on day 1 and 35.4% on day 2. High GRV status was found in 28.1% on day 1 and 25% on day 2. There was no significant relationship between hyperglycemia and high GRV status on day 1 and 2 (p=0.34 and 0.81).  However, in 12 subjects, we found high GRV occurred 19.67 ± 11.06 hours after the onset of hyperglycemia.Conclusion: There was no significant relationship between hyperglycemia status and high GRV status, but high GRV could be found later after hyperglycemia.