Objective: To determine the risk factors associated the incidence of NPC, particularly in Indonesia. Methods: This systematic review and meta-analysis was conducted according to PRISMA statement. Database including PubMed, Scopus, Science Direct, Web of Science, and GARUDA were retrieved. Newcastle-Ottawa scale was used to assess the quality of published study and analyse the risk of bias of included study. Random-effect model and reported pooled Odds Ratio (OR) with 95%CI was carried out in our meta-analysis. Results: A pooled of 7 studies were included in our study which included 764 participants. We found that female gender was not associated with the incidences of NPC (OR 1.45, 95% CI: 0.61-3.45, p=0.40), and smoking was highly increased the incidence of NPC (OR 4.39 95% CI (0.79-24.40), but not statistically significant (p=0.09). Furthermore, salted fish consumption and some HLA alleles were associated with increased risk. Conclusion: The incidence of NPC is not associated with female gender nor smoking habits. However, the risk of NPC is higher for those who consume salted fish and have some susceptible HLA alleles. Further investigations in larger studies are needed to confirm these findings.

Highlights: This article reports the use of the Y-maze as a simple yet effective method to measure spatial working memory in mice. The Y-maze method can be used safely without exposing the animals to additional stressors, as evidenced by the absence of mortality following the test.   Abstract: Spatial working memory (SWM) in humans and animal models with impaired cognitive functions has been analyzed through a number of methods. However, this is still understudied in animal models treated with a high-calorie diet (HCD) and moderate-intensity exercise (MIE). The Y-maze was utilized as the assessment method in this study. A 40 x 9 x 9 cm3 Y-maze was employed to observe the animal models’ spontaneous alternation (SA) as the representation of their SWM. This was done by calculating the total alternation percentage divided by total entry minus two. A total of 17 female Mus musculus mice aged 8 weeks were tested in the Y-maze to investigate their SWM using SA calculations. Each mouse was analyzed for eight minutes and recorded in a dark and quiet room to minimize bias due to environmental noise and lighting. Comparing the treatment group’s (HCD+MIE) SA to the control group’s SA revealed no statistically significant difference (p=0.451). Seven mice in the treatment group performed similarly to the mice in the control group in the Y-maze test, with no significant difference in their ability to complete the task. The mice in the treatment group exhibited no motor impairment, as indicated by complete movements of all their extremities while exploring the Y-maze within the allotted time. In conclusion, the Y-maze can be used as a reliable method to analyze SWM in overweight/obese Mus musculus animal models treated with moderate-intensity physical exercise.

Background Social restrictions due to the COVID-19 pandemic have shifted most learning methods into online courses, especially for medical skills education. However, the effects of online courses on medical skill education amongst medical students are still arguable. The study aims to analyse medical students’ knowledge, attitude, practice and satisfaction towards medical skills between online and offline courses. Method We performed a case–control study conducted among 533 medical students with online (as a case group, n = 288) and offline courses (as a control group, n = 245). We evaluated three fundamental medical skills, including history taking [HT], lung physical examination [LPE], and heart physical examination [HPE]. We tested the knowledge and skills among students through theory and practical examinations. Students’ attitudes and satisfaction were assessed using a validated questionnaire. Results The scores for knowledge and practical skills among the online group were significantly higher ( p = 0.016, p = 0.004, respectively). In comparison, the scores for the students’ attitudes and satisfaction were substantially lower ( p = 0.000, p = 0.003, respectively) compared to the control group. Most of the students in both groups passed the exam (case vs. control = 81.94%; 83.27%, respectively). Males were the only factor associated with a higher rate of passing the examination (OR 0.42, 95% CI [0.27–0.67], p = 0.000). Conclusions Online learning could be an alternative approach on improving student’s knowledge and practice towards medical skill especially amidst COVID-19 pandemic, however further consideration on student’s attitude and satisfaction are mandatory to achieve appropriate competence as future general practitioner.

New-onset diabetes mellitus (DM) has been lately observed among patients with post-COVID-19 syndrome. ACE2 and TMPRSS22 receptors were found expressed in the pancreas, thus acting as an entry gate leading to infection-induced pancreatic injury. Moreover, COVID-19 and DM have been reported to interact bidirectionally, in which existing DM comorbidity increases the patient's chance of getting severe COVID-19 and vice versa. Hyperbaric oxygen therapy (HBOT) is one of the therapy modalities given by applying administration of oxygen 100% under pressure of more than 1.4 ATA. HBOT has been shown to improve cellular function such as decreasing oxidative stress, inflammation, and mitochondrial dysfunction. These protective effects might correlate with preserved pancreatic cells, which improved insulin homeostasis. However, the potency and mechanism of HBOT to these patients remain unclear. Hence, we conduct a review of the available evidence concerning the potential mechanisms of HBOT in improving new-onset DM among post-COVID-19 syndrome patients. Current literature showed that HBOT might be beneficial for these patients, thus this modality might be a new breakthrough for researchers and health workers considering post-COVID-19 syndrome incidence tends to rise as the pandemic grows.

[Bahasa]: Pandemi COVID-19 berdampak pada berbagai aspek, termasuk kesehatan mental mahasiswa. Berbagai studi menunjukkan adanya peningkatan kejadian gangguan mental di masa pandemi. Gangguan mental terbanyak adalah depresi, kecemasan, dan stres. Pengetahuan kesehatan mental merupakan salah satu cara untuk menekan kejadian gangguan mental. Namun, data mengenai pengetahuan kesehatan mental terhadap gangguan mental pada mahasiswa masih terbatas. Oleh karenanya, peneliti mengadakan kegiatan edukasi melalui webinar daring untuk memberikan edukasi kesehatan mental yang mencakup penelitian untuk menganalisis tingkat pengetahuan kesehatan mental dan kejadian gangguan mental terbanyak, perbedaan keduanya berdasarkan aspek sosiodemografi, serta hubungan antara dua aspek tersebut pada mahasiswa di Indonesia selama pandemi. Data diolah menggunakan analitik komparatif dan korelasi dengan teknik pengambilan consecutive sampling. Respon diambil menggunakan kuesioner DASS-21 untuk mengetahui status psikologis responden dan 16 item pertanyaan yang telah diuji validitas dan reabilitas untuk mengetahui tingkat pengetahuan responden. Sebanyak 265 responden didominasi oleh jenis kelamin perempuan (81,5%), berusia 15 – 19 tahun (57,4%), dan berasal dari Jawa (62,3%). Sebagian besar responden memiliki tingkat pengetahuan depresi kurang (42,6%), kecemasan baik (61,9%), dan stres sangat baik (48,3%), dengan tingkat depresi normal (40,3%), kecemasan sedang (30,6%), dan stres sedang (27,2%). Hasil uji komparatif tidak ditemukan perbedaan signifikan pada variabel, kecuali tingkat pengetahuan kecemasan menurut kelompok usia (p=0,033). Uji korelasi Spearman Correlation menunjukkan tidak ada hubungan antara tingkat pengetahuan kesehatan mental terhadap tingkat depresi (p=0,250), kecemasan (p=0,819), dan stres (p=0,403). Kata Kunci: kesehatan mental, depresi, kecemasan, stres [English]: COVID-19 pandemic affects many aspects of human life, including college students’ mental health. Some studies showed increase on mental disorder in pandemic era. The most common mental disorders are depression, anxiety, and stress. Mental health knowledge is a means to suppress mental disorder. However, studies that concerned in mental health knowledge on mental disorder amongst college students are limited. Therefore, we held online webinar for mental health education, including a research aimed to analyze the most common mental health knowledge and disorder level, difference of both according to sociodemographic aspects, and correlation between those two aspects in college students during pandemic. All data was processed by using comparative and correlation statistical analytic with consecutive sampling. The instruments used were DASS-21 questionnaire to assess psychological status of respondents and another questionnaire with 16 items that had passed validity and reability tests to assess mental health knowledge. A total of 265 respondents were included, dominated by female (81.5%), aged 15 – 19 years old (57.4%), and from Java (62.3%). Most of respondents had less depression knowledge (42.6%), good anxiety knowledge (61.9%), very good stress knowledge (48.3%), normal depression level (40.3%), moderate anxiety (30.6%), and moderate stress (27.2%). The results of the comparative test show no significant difference on variables, except anxiety knowledge on age group (p=0.033). The result of Spearman Correlation show no correlation on mental health knowledge to depression level (p=0.250), anxiety level (p=0.819), and stress level (p=0.403). Keywords: mental health, depression, anxiety, stress

Highlight:Moderate negative significant correlation between HbA1c and MCV levels in T2DM was yet reported widely.MCV levels could mirror health indicator in adult T2DM patients.Abstract:HbA1c showed the average level of blood sugar in the recent 2-3 months. This parameter can be used to help physicians to diagnose T2DM and to plan appropriate treatment. Meanwhile, the mean corpuscular volume (MCV) is established from the erythrocytes levels as one of the blood corpuscles, in which hemoglobin is bound to. We hypothesize that MCV is correlated to the HbA1c levels and could be an indicator of blood sugar levels in adult T2DM patients. A retrospective cross-sectional study based on the medical record of patients admitted to the Outpatient Section of Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Indonesia from January to December 2019 was done. Patients under 18-years old, and incomplete medical record data were excluded. Adult patients diagnosed with T2DM and have been received initial treatment in this section were included (n=1.688). Data was analyzed using correlation test in SPSS 17.0 (USA), p-value less than 0.05 was considered significant. We found a significant negative correlation between HbA1c and MCV levels in these patients (r=-0.312; p<0.001). MCV levels showed a paradoxical pattern against the blood glucose levels in T2DM and could serve as the health indicator in these patients.