Preeclampsia is a multi-systemic hypertensive disorder in pregnant women after two weeks of gestation and can cause complications in about 6-10% of all pregnancies. The incidence of preeclampsia in Indonesia is 128,273/year or about 5.3%. However, the handling of preeclampsia in Indonesia is still not optimal. This disease is difficult to detect and often appears suddenly, so prevention efforts need to be taken as an essential step in reducing morbidity and mortality due to this disease. Previous studies have shown that L-Arginine exhibits potential properties in preventing preeclampsia. This literature review aims to determine the potential for oral L-Arginine supplementation to prevent preeclampsia in pregnant women. Search for literature using search engines such as Google Scholar, Science Direct, ResearchGate, and NCBI. Inclusion and exclusion criteria are used to eliminate unrelated journals so 38 journals are obtained. L-Arginine has great potential as a preventive supplementation of preeclampsia by increasing the vascular NO synthesis where NO deficiency in pregnant women can induce changes in the uteroplacental structure. Supplementation of the dietary L-Arginine at a low dose of 3 g/day for three to four weeks is required in early pregnancy. The use of chitosan-coated gold nanoparticles (c-AuNPs) as encapsulation on a protein increases the bioavailability of oral supplementation and improves the patient's clinical state. Further research regarding the effectiveness of L-Arginine supplementation orally with c-AuNPs and the optimal dosage as a preeclampsia preventive supplement is needed.
Background: There is still a limited number of studies related to overall survival in breast cancer patients in Indonesia. This study determines the overall survival and the factor which can affect the survival of stage III breast cancer patients.Methods: This study was a retrospective study. Patients first diagnosed with stage III breast cancer from January 1 to August 31, 2018, at DR. Mohammad Hoesin General Hospital Palembang had been studied. The primary outcome of this study was overall survival. The sociodemographic, clinicopathology, and treatment factors were analyzed to identify the independent variables associated with overall survival using Kaplan-Meier and Cox proportional hazard regression.Results: In this study, 78 samples were included. The 3-year overall survival for stage III breast cancer was 71%. In the bivariate analysis, several factors including older age (> 40) (HR = 2.795, 95% CI 1.223–6.387), higher stages for IIIB (HR = 7.155, 95% CI 0.960–53.334), and IIIC (HR = (HR = 33.450, 95% CI 3.013-371.354), history of not undergoing surgical intervention (HR = 3.999, 95% CI 1.684–9.495), and adjuvant chemotherapy (HR = 2.768, 95% CI 1.211–6.327) have been associated significantly to lower overall survival. Multivariate analysis showed IIIC breast cancer stage as an independent factor and had a significantly increased probability of mortality (HR = 14.677, 95% CI 1.268–169.948).Conclusions: The stage at diagnosis was the only significant predictor for the survival outcome, indicating that early diagnosis may need more attention.
Background Indonesia still has the highest maternal mortality rate (MMR) compared to other countries in Southeast Asia. In Indonesia, most maternal deaths occur before, during, or after delivery. Therefore, Indonesia’s government has rolled out various health insurance schemes so they have access to maternal healthcare services. This review aims to evaluate the impact of health insurance on maternal health care in Indonesia.Methods All searches for relevant studies were performed in PubMed, Science Direct, Cochrane, and Garuda databases. This review focuses on RCT or observational study, and only articles written in English and Indonesian were retrieved. The main outcome was the utilization of maternal services and patient satisfaction.Results A total of 140,555 participants were enrolled with ten studies that met the inclusion criteria. Of these, seven studies reported on National Health Insurance (NHI) and the remaining reported on Local Health Insurance (LHI). Both NHI and LHI studies showed that insurance increases the use of maternal health care services significantly, including antenatal, delivery, and postnatal care services. Only two studies reported patient satisfaction. The LHI study showed that insurance increases the patient’s level of satisfaction significantly. On the other hand, the NHI study showed there is no difference between NHI and non-NHI patients’ levels of satisfaction. This was due to complicated procedures and long examination times for NHI users.Conclusion The implementation of health insurance appears to increase the utilization of maternal health care services, although the result on patients’ satisfaction is inconsistent between NHI and LHI studies.
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This virus infects the respiratory, digestive, and nervous systems with a rapid transmission and a fairly high mortality rate. However, there has been no specific therapy to treat COVID-19. Previous studies have shown that antisense oligonucleotide (ASO) has good efficacy in DNA and RNA viral infections. This literature review aims to investigate the potential of inhaled ASO based on gold nanoparticles (AuNp) delivery system in inhibiting the replication and transcription of SARS-CoV-2. Literature searching using several databases, such as Google Scholar, Science Direct, ResearchGate, and NCBI. Inclusion and exclusion criteria are used to eliminate the journals that does not match the criteria, thus 28 journals are obtained. The results show that ASO has the potential to inhibit the replication and transcription of the SARS-CoV-2 virus through different mechanisms by binding to the target RNA and modulating the viral protein synthesis. One form of ASO modification that is often used is LNA GapmeR. LNA GapmeR stimulates viral RNA cleavage and can be administered by inhalation with nebulized ASO solution. AuNP as an ASO delivery system through inhalation can reduce toxicity and increase ASO concentrations in reaching target cells. Therefore, ASO therapy with AuNP through inhalation needs to be considered for COVID-19 treatment. Further clinical study about the ideal delivery system and optimal dosage of ASO based AuNP via inhalation for COVID-19 are needed to investigate soon.
Background: Hypertension is the most common comorbid disease which can cause further complications in COVID-19 patients. On the contrary, the pandemic has also caused lower health services and adherence to hypertension therapy. This study aimed to examine the impact of the COVID-19 pandemic on medication adherence in people with hypertension in Indonesia.Methods: The research was conducted using an analytical quantitative method. Patients with hypertension from seven islands across Indonesia were recruited based on eligibility criteria during Bulan Bakti 2021, a social outreach by Ikatan Senat Mahasiswa Kedokteran Indonesia about basic health across Indonesia. The demographic and medication history of the respondents were recorded. The Indonesian version of the Morisky Medication Adherence Scale (MMAS-8) questionnaire was distributed, and the medication adherence level was assessed.Results: A total of 1155 patients, mainly females (62.2%) participated in this study. More than half of the patients had low adherence (55.25%). Males (Adjusted Odd Ratio (AOR) 0.777 [CI 95% 0.529–1.019]), employed (AOR 0.857 [CI 95% 0.495–1.483]), higher income (AOR 0.522 [CI 95% 0.393–0.713]), and those who had information from healthcare worker (AOR 0.583 [CI 95% 0.361–0.878]) were found to have better medication adherence in multivariate logistic regression test.Conclusion: Medication adherence level in patients with hypertension during the pandemic is markedly low. Integrated preventive and promotive measures, especially from healthcare workers, are needed to prevent further morbidity and mortality.
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