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Background: Nonalcoholic fatty liver disease (NAFLD) is associated with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the first-line therapy for OSA. However, the effect of CPAP on NAFLD in patients with concomitant OSA is still unclear. This study aims to identify the use of CPAP on NAFLD in patients with OSA. Method: A systematic literature search was performed using particular keywords and medical subheadings in three journal databases: Cochrane, PubMed, and EBSCOhost. The results were screened and assessed using inclusion and exclusion criteria by three independent authors. The Randomized controlled trial (RCT) quality was evaluated with Jadad scale and the cohort studies quality was assessed with Newcastle-Ottawa quality assessment scale.Results:  Two RCTs and three cohort studies were eligible to fulfil the inclusion criteria, consisting of 620 total patients. Two RCTs showed no statistically significant improvement after CPAP treatment in NAFLD based on intrahepatic triglyceride (measured by proton magnetic resonance spectroscopy), liver stiffness measurement, serum cytokeratin-18 fragment, and liver function blood test parameters. Meanwhile, 2 cohort studies in adults and 1 cohort study in children showed significant improvement in ALT, AST, and APRI. However, one cohort study showed no significant improvement in serum fibrosis markers and transient elastography measurement after CPAP treatment.Conclusion: CPAP might be beneficial in some patients with OSA to improve NAFLD, but further research that includes many subjects and longer duration of CPAP therapy is needed to confirm this result.

Background: Menopause is considered an important determinant of hypertension in women, with 41% of postmenopausal women are hypertensive. Increased blood pressure (BP) in postmenopausal women can be caused by arterial stiffness, renin-angiotensin system activation, endothelial dysfunction, lack of estrogens, sympathetic activation, anxiety, and depression. Hence, they should be given special treatment, such as exercise therapy, to improve the quality of their hypertensive therapy. Whole-body vibration training (WBVT) is a resistance training known for its ability to improve arterial stiffness. However, its ability to decrease BP is still controversial.Objective: This study aims to identify the effects of WBVT on blood pressure in postmenopausal women with hypertension.Method: A systematic literature search was performed using particular keywords with medical subheading (MeSH) terms on three journal databases, including Pubmed, Proquest, and Cochrane. The search results were screened and assessed using inclusion and exclusion criteria, double article, and full text availability by three independent authors. The quality of the randomized control trial (RCT) was evaluated using the Jadad scale.Result: Four Randomized controlled trials (RCTs) consisting of 114 total patients were eligible to fulfil the criteria. All studies showed that WBVT significantly decreased systolic (10-12 mmHg) and diastolic (5-6 mmHg) BP compared with the control group. One study also showed a reduction of mean arterial pressure (9 mmHg).Conclusion: WBVT might be beneficial as an adjuvant therapy to reduce blood pressure in postmenopausal women with hypertension, but further research that includes more subjects is needed to confirm this result.

Radiotherapy can potentially cause damage to the salivary gland, muscles, and nerve that is important to oropharyngeal swallow, leading to xerostomia and dysphagia. Reporting a case of radiotheraphy-induced xerostomia and dysphagia in HNC patients. A 34 years old man with NPC stage IV B (T4N3M0) came with difficulty swallowing, dryness in the throat and mouth, coughing while eating and drinking, choking, hoarseness, and pain when swallowing. The patient had done 14 times of radiation administration with a total dose of 60 Gy with conformal 3D radiation technique. The amount of saliva measured 0.02 ml/minute. A standing secretion was found in the vallecula, right and left piriformis and postkrioid sinuses in preswallowing assessment. The presence of penetration or aspiration of secretions into the airway were detected. The patient was diagnosed with neurogenic dysphagia and advised to use NGT for diet and consult medical rehabilitation. Literature searching was conducted on March 31, 2021 in the 3 journal database, including PubMed, Cochrane, and EBSCOhost, using particular keywords based on PICO. The inclusion criteria were full text article, observational studies, case-control, cohort, randomized controlled trial, systematic review, written in English, and studies investigating the correlation between HNC patient with radiotherapy and dysphagia or xerostomia. There were 3 systematic reviews, 1 cohort, and 2 cross-sectional studies investigating the correlation between chemoradiotherapy in head and neck cancer and xerostomia/dysphagia. Chemoradiotherapy correlated with dysphagia and xerostomia in head and neck cancer. Xerostomia and disfagia were prevalent in HNC patients after radiotherapy. Besides, there was association between the dose of radiotherapy and incidence or severity of xerostomia and dysphagia.