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"Latar Belakang: Penyakit periodontal tidak hanya mempengaruhi kesehatan mulut, tetapi juga berkontribusi pada berbagai gangguan sistemik termasuk hiperlipidemia yang merupakan salah satu faktor risiko utama dari penyakit kardiovaskular. Mekanisme inflamasi yang mendasari penyakit periodontal diyakini dapat memengaruhi metabolisme lipid, sehingga memperburuk profil lipid pasien. Perawatan periodontal non-bedah telah diusulkan sebagai intervensi potensial untuk dapat mengurangi peradangan sistemik dan memperbaiki profil lipid pada beberbagai studi, tetepi hasil penelitian sebelumnya menunjukkan temuan yang tidak konsisten. Tujuan: Mengetahui pengaruh perawatan periodontal non-bedah pada pasien dengan hiperlipidemia dan periodontitis terhadap kadar biomarker pro-inflamasi TNF-α, IL-1β, IL-6, dan CRP serta profil lipid. Metode: Pencarian studi melalui basis data elektronik menggunakan pedoman Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA). Studi yang sesuai dengan kriteria inklusi dan ekslusi, kemudian dinilai risiko biasnya. Selanjutnya, dilakukan meta-analisis. Hasil: Sintesis kualitatif menunjukkan adanya hasil yang signifikan terhadap pengaruh perawatan periodontal non-bedah pada penurunan kadar TNF-α, IL-1β, dan IL-6 pasca perawatan, tetapi tidak ditemukan adanya penurunan kadar yang signifikan pada biomarker CRP dan profil lipid pasca perawatan. Meta-analisis sebelum dan sesudah perawatan periodontal non-bedah menunjukkan adanya pengaruh yang signifikan secara statistik pada kadar IL-6 dengan perbedaan rerata -0,74 pg/mL (95% CI:[-0.90;-0.57], p<0,00001) dan kadar TC dengan perbedaan rerata -36,19 (95% CI: [-61,00; - 11,38], p = 0,004) serta tidak terdapat pengaruh signifikan terhadap kadar HDL dengan perbedaan rerata 0,12 (95% CI: [-2,28; 2,52], p = 0,92). Kesimpulan: Perawatan periodontal non-bedah pada pasien dengan hiperlipidemia dan periodontitis menunjukkan pengaruh yang signifikan pada kadar TNF-α, IL-1β, dan IL-6, tetapi kadar CRP dan profil lipid tidak menunjukkan padanya pengaruh yang signifikan pasca perawatan pada pasien dengan hipelipidemia dan periodontitis.

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Background: Periodontal disease not only affects oral health but also contributes to a variety of systemic disorders including hyperlipidemia which is one of the major risk factors for cardiovascular disease. The inflammatory mechanisms underlying periodontal disease are believed to affect lipid metabolism, thereby worsening the lipid profile of patients. Non-surgical periodontal treatment has been proposed as a potential intervention to reduce systemic inflammation and improve lipid profiles in various studies, despite previous findings showing inconsistent findings. Objective: To determine the effect of non-surgical periodontal treatment in patients with hyperlipidemia and periodontitis on the levels of pro-inflammatory biomarkers, TNF-α, IL-1β, IL-6, and CRP as well as lipid profile. Methods: Study searches were conducted through electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Studies that meet the inclusion and exclusion criteria are then assessed for bias risk. Next, a meta-analysis was carried out. Results: Qualitative synthesis showed significant results on the effect of non-surgical periodontal treatment on the reduction of TNF-α, IL-1β, and IL-6 levels after treatment, but no significant reduction in CRP and lipid profile was found after treatment. Meta-analyses before and after non-surgical periodontal treatment showed a statistically significant effect on IL-6 levels with a mean difference of -0.74 pg/mL (95% CI:[-0.90;-0.57], p<0.00001) and TC levels with a mean difference of -36.19 (95% CI: [-61.00; - 11.38], p = 0.004). There is no significant effect on HDL levels with a mean difference of 0.12 (95% CI: [-2.28; 2.52], p = 0.92). Conclusions: Non-surgical periodontal treatment in patients with hyperlipidemia and periodontitis showed a significant effect on TNF-α, IL-1β, and IL-6 levels, but CRP levels and lipid profiles did not show a significant post-treatment effect on patients with hyperlipidemia and periodontitis."

"Latar Belakang: Disfungsi ereksi (DE) adalah salah satu penyakit sering ditemukan pada mereka yang menderita penyakit ginjal stadium akhir (ESRD). Meskipun transplantasi ginjal memperbaiki masalah ini pada beberapa pasien, sebanyak 20 hingga 50% penerimanya terus menderita DE. Sampai saat ini, literatur mengenai efek transplantasi ginjal terhadap DE masih kontroversial. Mayoritas penelitian menunjukkan bahwa pasien mendapatkan kembali fungsi ereksi setelah transplantasi ginjal, sedangkan penelitian lain menunjukkan efek minimal transplantasi terhadap status DE. Kami melakukan tinjauan sistematis untuk merangkum efek transplantasi ginjal terhadap status DE.Metode: Pencarian literatur sistematis di PubMed, Cochrane, dan Scopus, dilakukan pada bulan April 2020 dengan menggunakan kata bebas dan istilah MeSH. Kami memasukkan semua penelitian prospektif yang menyelidiki skor IIEF sebelum dan sesudah transplantasi pada penerima transplantasi ginjal dengan DE.Hasil: Pencarian database awal di PubMed dan Google Scholar menghasilkan 4.052 makalah. 42 makalah dipertimbangkan untuk analisis teks lengkap. Dari 42 teks lengkap yang dicari, empat diantaranya dimasukkan dalam tinjauan sistematis. Sebanyak 152 dari 230 subjek menunjukkan peningkatan fungsi ereksi melalui skor IIEF-5 setelah transplantasi ginjal. Meta-analisis yang dilakukan terhadap skor IIEF dan kadar Testosteron menunjukkan perbedaan yang signifikan sebelum dan sesudah transplantasi.Kesimpulan: Temuan kami telah mengkonfirmasi bahwa transplantasi ginjal meningkatkan fungsi ereksi. Dengan demikian, peningkatan signifikan dalam skor testosteron dan IIEF pasca transplantasi terbukti secara statistik dalam penelitian ini. Namun, karena jumlah penelitian yang ada terbatas, bukti yang ada pun terbatas. Penelitian lebih lanjut dengan metodologi yang lebih baik dan ukuran sampel yang lebih besar diperlukan untuk menyelidiki pengaruh transplantasi ginjal pada fungsi ereksi.

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Introduction: Erectile dysfunction (ED) is a major health burden worldwide frequently found in those with end-stage renal disease (ESRD) Although renal transplant improves the problem in some patients, as many as 20 to 50% of recipients continue to suffer ED. To this date, literature regarding the effect of kidney transplantation on ED has been contradictory. Majority of studies have shown that patients regain erectile function following renal transplant, whereas other studies showed minimal effect of transplantation on the status of ED.1,2 We did a systematic review to summarize the effects of kidney transplantation on the status of ED.

Methods: A systematic literature search on PubMed, Cochrane, and Scopus, were carried out in April 2020 by using both free words and MeSH terms. We included all prospective studies investigating the pre- and post-transplant IIEF scores of renal transplant recipients with ED.

Results: The initial database search on PubMed and Google Scholar produced 4,052 papers. 42 papers were considered for full-text analysis. Out of 42 full texts sought, four were included in the systematic review. A total of 152 out of 230 subjects showed improvement of erectile function by means of IIEF-5 score after renal transplantation. Meta-analysis performed on IIEF score and Testosterone level show significant differences pre and post-transplantation.

Conclusion: Our findings have confirmed that renal transplantation improves erectile function. Thus, significant improvement in testosterone and IIEF score post- transplantation were proven statistically in this study. However, as there were only a limited number of studies, the evidence is limited. Further studies with better methodology and larger sample size are needed to investigate the effect of renal transplantation on erectile function."

"COVID-19 merupakan penyakit penyebab pandemi pada akhir 2019. Perbedaan manifestasi klinis pada infeksi SARS-CoV-2 ini memicu banyak pertanyaan di kalangan peneliti dan medis. Perbedaan klinis COVID-19 tersebut dapat dipicu oleh faktor hospes, patogen maupun lingkungan. Infeksi SARS-CoV-2 terutama melalui saluran napas atas, tempat kolonisasi mikroba komensal dan patogen. Bagaimana interaksi antara mikroba yang berkolonisasi dengan SARS-CoV-2 dalam menimbulkan respons inflamasi di saluran napas atas masih belum diketahui dengan jelas. Penelitian ini bertujuan menganalisis hubungan antara karakteristik mikrobiota, serta rasio kadar sitokin pro- dan anti-inflamasi dari saluran napas atas dengan beratnya COVID-19.Penelitian ini merupakan studi potong lintang menggunakan 74 swab nasofaring dan orofaring di dalam viral transport medium (VTM) dari pasien COVID-19 berusia 18–64 tahun. Profil mikrobiota di saluran napas atas dan kadar IL-6, IL-1β, IFN-γ, TNF-α dan IL-10 diperiksa dengan metode sekuensing 16S ribosomal RNA dan Luminex assay, secara berurutan. Selanjutnya dilakukan analisis hubungan antara beratnya COVID-19 dengan OTU, keragaman alfa dan beta dari mikrobiota saluran napas atas.Lima filum terbanyak di saluran napas pasien COVID-19 di Indonesia berusia 18-64 tahun adalah Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) dan Actinobacteria (7,1%). Analisis indeks Shannon dan ACE menunjukkan bahwa tidak ada penurunan keragaman microbiota saluran napas atas dengan bertambah beratnya penyakit. Namun, ada perbedaan bermakna keragaman beta pada mikrobiota saluran napas atas antara COVID-19 ringan dan berat. Keberlimpahan filum Firmicutes (p = 0,012), dan genus Streptococcus (p = 0,033) dan Enterococcus (p = 0,031) lebih tinggi pada COVID-19 berat dibandingkan yang ringan, sedangkan keberlimpahan filum Fusobacteriota (p = 0,021), Proteobacteria (p = 0,030), Campilobacterota (p = 0,027), genus Neisseria (p = 0,008), dan Fusobacterium (p = 0,064), spesies Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) dan Fusobacterium nucleatum (p = 0,022) lebih tinggi pada COVID-19 ringan dibandingkan berat. Keberadaan bakteri Prevotella buccae (p = 0,005) dan Prevotella disiens (p = 0,043) lebih rendah pada COVID-19 berat. Rasio TNF-α/IL-10 lebih tinggi pada COVID-19 berat (p < 0.05). Selanjutnya, rasio IL-6/IL-10, IFN-γ/IL-10, dan IL-1β/IL-10 juga lebih tinggi pada COVID-19 berat, namun tidak berbeda bermakna jika dikaitkan dengan beratnya penyakit.Penelitian ini mendukung adanya hubungan antara karakteristik mikrobiota di saluran napas atas dengan beratnya COVID-19 pada pasien dewasa. Studi lebih lanjut diperlukan untuk memeriksa mekanisme bagaimana mikrobiota mencegah beratnya COVID-19. Rasio TNF-α/IL-10 dari saluran napas dapat menjadi prediktor beratnya penyakit dan sebagai alternatif pemeriksaan kadar sitokin pada COVID-19 yang kurang invasif dibandingkan serum.

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COVID-19 is a disease that caused a pandemic at the end of 2019. Clinical manifestations difference in SARS-CoV-2 infection has raised many questions in research and medical provider. The clinical differences in COVID-19 can be triggered by host, pathogen and environmental factors. SARS-CoV-2 mainly enters through the upper airway, with colonization of commensal and pathogenic microbes. How the interaction between colonized microbes and SARS-CoV-2 in causing an inflammatory response in the upper airway is still not clearly known. Therefore, we examined the association between the diversity of microbiota, pro- and anti-inflammatory cytokines ratio of upper respiratory and COVID-19 severity.

This research is an observational cross-sectional study using 74 nasopharyngeal and oropharyngeal swabs in viral transport medium from COVID-19 patients aged 18-64 years. We examined microbiota profile in the upper airway using 16S ribosomal RNA sequencing method and levels of IL-6, IL-1β, IFN-γ, TNF-α and IL-10 were examined by Luminex assay. We also examined the association between COVID-19 severities with OTU analysis, alpha and beta diversity of upper respiratory microbiota.

The top five phyla in upper respiratory tract of Indonesian COVID-19 patients with aged of 18–64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in upper airway with the increase of disease severity. However, there were significant differences of beta diversity in the upper airway microbiota between mild and severe COVID-19. The abundance of the Firmicutes phylum (p = 0,012), Streptococcus (p = 0,033) and Enterococcus (p = 0,031) genera were significantly higher in severe COVID-19 than mild, while the abundance of the Fusobacteriota (p = 0,021), Proteobacteria (p=0,030), and Campilobacterota (p = 0,027) phyla, Neisseria (p = 0,008), and Fusobacterium (p = 0,064) genera, Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) and Fusobacterium nucleatum (p = 0,022) species were significantly higher in mild. The presence of Prevotella buccae (p=0.005) and Prevotella disiens (p=0.043) bacteria was lower in severe COVID-19. The TNF-α/IL-10 ratio was significantly higher in severe COVID-19 (p < 0.05). Furthermore, IL-6/IL-10, IFN-γ/IL-10, and IL-1β/IL-10 ratio was also higher in severe, but those were not significantly related to the disease severity.

This research supports the relationship between the severity of COVID-19 and microbiota diversity in the upper airway in adults. Further studies are needed to examine the mechanism by which microbiota prevents the COVID-19 severities. The ratio of TNF-α/IL-10 from upper airway swab may be as a predictor of disease severity and alternative for examining cytokine levels in COVID-19 which is less invasive than serum."

"Latar belakang: Populasi di Asia memiliki beberapa faktor risiko periodontitis terkaitanatomi dan mikroorganisme dalam rongga mulutnya. Periodontitis merupakan ancamanbesar terhadap kesehatan mulut dan dapat menimbulkan gejala perubahan klinis sepertimunculnya tanda-tanda inflamasi serta terjadinya peningkatan pocket probing depth(PPD) dan clinical attachment loss (CAL) yang dapat menyebabkan rasa tidak nyamanpada penderitanya baik dalam aspek fisik, psikologis, maupun sosial. Tujuan: Untukmenganalisis pengaruh terapi periodontal terhadap nilai OHRQoL pada penderitaperiodontitis di Asia dari studi yang menggunakan kuesioner OHIP-14. Metode: Ujimeta-analisis serta penyusunan systematic review (PROSPERO CRD42020203254)dengan pencarian literatur pada online database yaitu PubMed, Scopus, dan EBSCO.Studi yang diidentifikasi kemudian melalui tahapan skrining, penilaian eligibilitas, daninklusi menggunakan pedoman Preferred Reporting Items for Systematic Reviews andMeta-Analyses (PRISMA). Hasil: Sebanyak enam studi memenuhi kriteria inklusi untukdilakukan systematic review dan empat studi dengan intervensi terapi periodontal nonbedahdiikutsertakan dalam meta-analisis. Analisis kuantitatif dilakukan pada tigarentang waktu follow-up yaitu minggu ke-1 dan 2 dengan mean difference [95% CI]: -13,31 [-33,71 ; 7,10], minggu ke-4 dan 5 dengan mean difference [95% CI]: -16,12 [-35,27 ; 3,03], serta minggu ke 9 hingga 12 dengan mean difference [95% CI]: -4,14 [-6,85 ; -1,43]. Kesimpulan: Terapi periodontal dapat meningkatkan OHRQoL penderitaperiodontitis di Asia. Peningkatan tersebut dapat terlihat paling signifikan pada mingguke-4 dan 5 pasca terapi.

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Background: Asians have periodontitis risk factors regarding to the anatomy andmicroorganisms found in their oral cavity. Periodontitis is one of the most prevalentdiseases that affects the oral cavity, causing several symptoms such as inflammation andincrease in pocket probing depth (PPD) and clinical attachment loss (CAL). Symptomscaused by periodontitis may cause discomfort in some aspects of life such as physical,psychological, and social aspect. Objective: To analyze the impacts of periodontaltherapy on OHRQoL in periodontitis patients in Asia from studies using OHIP-14questionnaire. Methods: Meta-analysis and systematic review (PROSPEROCRD42020203254) of the studies obtained from three databases (PubMed, Scopus, andEBSCO). Identified studies were screened and assessed following the PreferredReporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: From 641 studies retrieved, six met the criteria for qualitative analysis. Studiesusing non-surgical periodontal treatment are also included for meta-analysis. Quantitativeanalysis were conducted by categorizing the follow-up period into three groups: 1-2weeks follow-up with mean difference [95% CI]: -13.31 [-33.71 ; 7.10], 4-5 weeksfollow-up with mean difference [95% CI]: -16.12 [-35.27 ; 3.03], and 9-12 weeks followupwith mean difference [95% CI]: -4.14 [-6.85 ; -1.43]. Conclusion: Periodontal therapycan enhance the OHRQoL of periodontitis patients in Asia. The most significant impactcan be seen on the follow-up period of 4-5 weeks"

"Tesis ini disusun untuk mengetahui manfaat dari penambahan terapi latihan berfokus skapula pada pasien dengan gangguan rotator cuff dengan luaran primer berupa perbaikan keluhan nyeri dan kemampuan fungsional. Penelitian ini adalah penelitian telaah sistematis dan meta-analisis. Studi dijaring dari database MEDLINE, Embase, CENTRAL, dan PEDro disertai pencarian tambahan melalui registry studi klinis dan referensi dari penelitian-penelitian topik serupa. Kriteria eligibilitas penelitian ini meliputi studi uji klinis acak terkendali tanpa batasan waktu publikasi, partisipan dewasa yang memiliki spektrum kelainan rotator cuff, dan membandingkan terapi latihan berfokus skapula dibandingkan terapi konvensional non-bedah lain atau tanpa terapi. Gangguan rotator cuff akibat cedera traumatik akut, sekunder akibat kelainan neurologis dan/atau keganasan, kelainan struktur skeletal pada bahu, serta yang memiliki riwayat tindakan pembedahan pada kompleks bahu dieksklusikan. Dua peneliti secara independen melakukan seleksi studi dan mengevaluasi risiko bias masing-masing studi menggunakan skala PEDro. Total didapatkan delapan studi dengan total 422 partisipan diinklusikan di penelitian ini dengan risiko bias “fair” hingga “good” berdasarkan skala PEDro. Dari meta-analisis didapatkan latihan berfokus skapula memberikan luaran perbaikan nyeri dan kemampuan fungsional yang lebih baik dibandingkan kontrol (MD -0,84 p<0,001 dan SMD -0,58 p<0,001) khususnya jika diberikan selama lebih dari delapan minggu. Secara kesimpulan, terapi latihan berfokus skapula memberikan perbaikan terhadap keluhan nyeri dan kemampuan fungsional pasien dengan gangguan rotator cuff.

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This thesis aims to determine the effect of adding scapular-based therapeutic exercise for patient with rotator cuff pathology with the primary outcome being improvement in pain and functional ability. The research design is systematic review and meta-analysis. Studies were searched from MEDLINE, Embase, CENTRAL and PEDro database in addition to clinical registry search and references searching from affiliated studies. Eligibility criteria of this research include randomized clinical trial with no time restriction, adult participant with rotator cuff pathology and study comparing effect of scapular-based therapeutic exercise versus other non-surgery intervention or no intervention. Rotator cuff pathology due to traumatic injury, neurological and/or malignancy disease, structural abnormalities of shoulder and history of shoulder surgery were excluded. Two reviewers independently select the study and did risk of bias evaluation using PEDro scale. In total, eight studies with 422 participants were included with risk of bias “fair” to “good” based on PEDro scale. From meta-analysis, scapular-based therapeutic exercise resulted in better improvement in pain and functional ability compared to control (MD -0,84 p<0,01 and SMD -0,58 p<0,01) especially if given as intervention for at least eight weeks. In conclusion, scapular-based therapeutic exercise is shown to be be more effective in improving shoulder pain and functional ability for patient with rotator cuff pathology."

"Latar Belakang: Poket periodontal merupakan karakteristik periodontitis. Scaling dan root planing merupakan standar emas untuk perawatan periodontitis. Antimikroba lokal tambahan direkomendasikan pada pasien dengan kedalaman probing ≥5 mm. Tujuan: Untuk mengetahui efektivitas klorheksidin dibandingkan dengan antimikroba lokal lainnya pada periodontitis. Metode: Pencarian dilakukan dengan menggunakan panduan Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA). Meta-analisis dilakukan pada studi yang memenuhi kriteria inklusi setelah penilaian risiko bias. Hasil: Meta-analisis antara chip klorheksidin dan antimikroba lain menunjukkan perbedaan rata-rata kedalaman probing setelah satu bulan sebesar 0,58 mm (p<0,00001) sedangkan setelah tiga bulan perbedaan rata-rata kedalaman probing adalah 0,50 mm (p=0,001), indeks plak 0,01 (p=0,94) dan indeks gingiva -0,11 mm (p=0,02). Antara gel chlorhexidine dan antimikroba lainnya menunjukkan perbedaan rata-rata kedalaman probing 0,40 mm (p=0,30), indeks plak 0,20 mm (p=0,0008) dan indeks gingiva -0,04 mm (p=0,83) setelah satu bulan. Kesimpulan: Chip klorheksidin lebih efektif pada indeks gingiva dibandingkan antimikroba lainnya setelah tiga bulan. Antimikroba lainnya lebih efektif daripada chip klorheksidin pada kedalaman probing setelah satu dan tiga bulan, dan dari gel klorheksidin pada indeks plak setelah satu bulan.

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Background: Periodontal pockets are characteristic of periodontitis. Scaling and root planing is the gold standard for periodontitis treatment. Additional local antimicrobials are recommended in patients with a probing depth of ≥5 mm.

Objective: To determine the effectiveness of chlorhexidine compared to other local antimicrobials in periodontitis.

Method: Searches were conducted using the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. Meta-analysis was performed on studies that met inclusion criteria after risk of bias assessment.

Results: Meta-analysis between chlorhexidine chips and other antimicrobials showed a mean difference in probing depth after one month of 0.58 mm (p<0.00001) whereas after three months the mean difference in probing depth was 0.50 mm (p=0.001), index plaque 0.01 (p=0.94) and gingival index -0.11 mm (p=0.02). Between chlorhexidine gel and other antimicrobials showed a mean difference in probing depth of 0.40 mm (p=0.30), plaque index of 0.20 mm (p=0.0008) and gingival index of -0.04 mm (p=0.83) after one month.

Conclusion: Chlorhexidine chips were more effective on the gingival index than other antimicrobials after three months. The other antimicrobials were more effective than chlorhexidine chips on probing depth after one and three months, and than chlorhexidine gels on plaque index after one month."

"Latar belakang: Asma merupakan penyakit ditandai peradangan saluran napas kronik. Satu dari tiga kasus tidak memberikan respon adekuat. Modalitas alternatif terapi  asma adalah magnesium inhalasi. Inhalasi magnesium memiliki efek samping sistemik minimal. Oleh karena itu, peran magnesium inhalasi perlu diteliti lebih lanTujuan: Penelitian bertujuan untuk mengetahui efektivitas dan keamanan pemberian magnesium inhalasi pada pasien dewasa mengalami  asma akut.Metode: Penelusuran literatur dilakukan dua peneliti independen melalui: PubMed/ MEDLINE, Google Scholar, ProQuest, dan Cochrane dengan kata kunci “magnesium inhalasi” dan “serangan asma” dalam bahasa Inggris dan Indonesia. Pencarian manual dan snowballing dilakukan di portal data nasional. Studi yang dimasukkan adalah uji acak terkontrol mengenai perbandingan magnesium inhalasi dengan terapi standar pada serangan asma akut. Penilaian efektivitas berdasarkan parameter readmisi, tanda vital, perbaikan klinis, serta fungsi paru, sedangkan keamanan berdasarkan parameter efek samping. Protokol telaah sistematis didaftarkan pada PROSPERO.Hasil: Lima artikel diikutsertakan dalam telaah sistematis. Dua artikel diikut-sertakan menilai aspek  readmisi. Tiga studi  menilai hubungan magnesium terhadap tanda vital pasien. Dua studi menilai tingkat keparahan penyakit dan perbaikan klinis. Studi menunjukkan tidak terdapat hubungan bermakna pemberian magnesium inhalasi pada aspek readmisi pasien (RR 1; IK 95% 0.92 - 1,08; p= 0,96), dan saturasi oksigen (MD  1,82; IK 95%: -0.89 - 4.53; p= 0.19). Ada penurunan bermakna laju napas pasien  (MD -1,72; IK 95% -3,1 -0.35; p= 0.01), dan perbaikan gejala pada pasien  (RR 0.29; IK95% 0.18 - 0.47; p <0.001). Ada peningkatan bermakna efek samping pasien magnesium inhalasi (HR 1.56; IK 95% 1.05 – 2.32; p= 0.32). Efek samping relatif ringan  berupa hipotensi dan rasa mual. Kesimpulan: Magnesium inhalasi memperbaiki  klinis pasien asma terutama gejala, laju napas, dan fungsi paru.  Magnesium inhalasi dikatakan aman jika diberikan pada pasien, namun hati-hati penggunaan pada pasien hipotensi.

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Background:  Asthma is a disease characterized by chronic airway inflammation. Asthma occurs to many people worldwide. One third of asthmatic case did not respond adequately to standard therapy (Short Acting Beta Agonist, Anticholinergic, Corticosteroid). One of alternative treatment of asthma is inhaled magnesium.  Theoretically, inhaled magnesium is thought to have less systemic side effect and could act directly to respiratory tract. However, the role of inhaled magnesium therapy is not established yet.

Objective: This review is made to evaluate the effectiveness and safety of nebulized magnesium in adult with acute asthma attack.

Methods: Literature search was conducted by two independent investigators through online databases: PubMed/MEDLINE, Cochrane, ProQuest, and Google scholar using the keywords “inhaled magnesium” and “asthma” in English and Indonesian. Manual searches and snowballing were carried out through national data portals and medical faculty e-libraries. Journal articles included in this study are randomized controlled trials that observed inhaled magnesium in adult with acute asthma attack. All the protocol of this systematic review has been registered in PROSPERO.

Result: There are five articles included in this review. Two of them evaluate the effect of magnesium in term of readmission, three of the studies measures effect of magnesium in vital sign, and two of them evaluate the effect of magnesium in term of severity of asthma There is no significant difference in readmission rate and oxygen saturation in magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI   -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.18 to 0.47; p <0.001, respectively). There was a higher risk of side effect in magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effect is relatively mild such as hypotension and nausea.

Conclusion: Inhaled magnesium improves clinical outcome for patient with asthma attack especially lung function, improvement of clinical outcome, and lung function. Moreover, Inhaled magnesium is considered safe to be given to asthmatic patient. However, the inhaled magnesium is given with caution in patient with hypotension."

"atar Belakang: Balans energi positif pada obesitas ditandai dengan hiperadipositosis dan merangsang proses inflamasi kronik yang berdampak pada komplikasi penyakit pasien obesitas. Salah satu penatalaksaan obesitas adalah pemberian diet restriksi kalori. Diet restriksi kalori diduga menyebabkan penurunan kondisi inflamasi kronik yang salah satunya ditandai dengan kadar c-reactive protein (CRP). Namun demikian, berbagai studi memberikan hasil yang inkonsisten.Tujuan: Menilai efek diet restriksi kalori terhadap perubahan kadar CRP dan menilai pengaruh durasi diet tertentu terhadap perubahan kadar CRP pasien obesitas.Sumber Data: Pencarian utama dilakukan pada basis data PubMed, ProQuest, EBSCOhost, Embase dan Scopus hingga 30 Oktober 2020. Pencarian sekunder juga dilakukan secara snowballing, Google Scholar, Global Index Medicus, portal basis data nasional, dan perpustakaan digital 40 universitas di Indonesia.Seleksi Studi: Studi uji klinis acak melibatkan pasien dewasa obes yang menilai efek diet restriksi kalori (tanpa mengkombinasikan dengan terapi nondiet lain) terhadap kadar CRP. Tidak ada batasan tahun publikasi dan bahasa. Penilaian terhadap judul, abstrak dan studi dilakukan oleh dua peninjau independen. Dari 2087 artikel, 11 studi diantaranya memenuhi kriteria eligibilitas.Ekstraksi Data: Ekstraksi data dilakukan oleh kedua peninjau. Korespondensi dilakukan dengan menghubungi peneliti dan tidak didapatkan adanya data tambahan.Hasil: Diet restriksi kalori memiliki efek terhadap penurunan kadar CRP pada pasien obesitas dengan nilai Mean Difference -0.22 (IK 95% -0.40 - -0.04, p 0.006). Intervensi restriksi diet ≤ 12 minggu tidak menunjukkan penurunan bermakna pada kadar CRP, sedangkan intervensi restriksi diet > 12 minggu menunjukkan penurunan bermakna pada kadar CRP.KesimpulanDiet restriksi kalori memiliki efek menurunkan kadar CRP pada pasien obesitas.

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Background: Positive energy balance in obesity is characterized by hyperadipocytosis, which stimulates chronic inflammatory processes in obese patients. Management of obesity includes a calorie restriction diet thought to improve chronic inflammatory conditions, characterized by reduced c-reactive protein (CRP). However, studies have yielded inconsistent results.

Objective: To assess the effect of a calorie-restricted diet on changes in CRP levels and the duration of a particular diet that is significant for its effect on changes in CRP levels in obese patients

Data Source: We searched PubMed, ProQuest, EBSCOhost, Embase and Scopus through October 30,2020. Secondary searching was done by snowballing method including references of qualifying articles and manual searching through google scholar, global index medicus, national databases, and digital library of 40 universities in Indonesia

Study Selection: A randomized controlled trial involving obese adult patients assessed the effect of a calorie-restricted diet (without combination with other nondiet therapy) on CRP levels. No restriction regarding year of publication and language. Titles, abstracts, and articles were reviewed by two independent reviewer. Of the 2087 studies identified in our original search, 11 of them met the eligibility criteria.

Data Extraction: Data extraction was done by two reviewers. Correspondence was done by contacting the authors to confirm additional data. No additional data was obtained

Result: The calorie restriction diet has an effect on reducing CRP levels in obese patients with a Mean Difference value of -0.22 (95% CI -0.40 - -0.04, p 0.006). Dietary restriction interventions ≤ 12 weeks did not show a significant decrease in CRP levels, while dietary restriction interventions > 12 weeks showed a significant decrease in CRP levels

Conclusion: A calorie restriction diet has the effect of lowering CRP levels in obese patients"

"Kejadian kardiovaskular adalah penyebab kematian utama pada artritis reumatoid AR . Periodontitis diketahui berperan dalam patogenesis disfungsi endotel pada AR. E-selectin merupakan penanda disfungsi endotel yang spesifik dihasilkan oleh endotel. Tujuan penelitian ini adalah mengetahui efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Penelitian ini merupakan uji klinis randomisasi pada penderita AR yang berobat di Poliklinik Reumatologi RSCM periode Maret-Mei 2017. Pengambilan sampel dilakukan secara konsekutif. Randomisasi dilakukan dengan randomisasi blok. Subyek dibagi menjadi kelompok terapi periodontal dan kontrol. Dilakukan Uji t untuk melihat perbedaan selisih E-selectin awal dan akhir studi antara kelompok intervensi dengan kontrol. Periodontitis ditemukan pada 31 subyek 64,5 . Tidak didapatkan perbedaan selisih E-selectin awal dan akhir studi yang signifikan secara statistik antara kelompok intervensi dengan kontrol p=0,303 . Sebagai kesimpulan tidak didapatkan pengaruh terapi periodontal terhadap kadar E-selectin pada pasien AR.

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Cardiovascular event is the main cause of mortality in rheumatoid arthritis RA . Periodontitis is known to be involved in the pathogenesis of endothelial dysfunction in RA. E selectin is a marker of endothelial dysfunction and was expressed specifically in endothelial cells. The objective of this study was to determine the effect of periodontal treatment on E selectin level in RA patients. This was a randomized clinical trial in RA patients visiting Rheumatology Clinic RSCM between March May 2017. Samples were collected using consecutive sampling method. Randomization was done using block randomization. Subjects was divided into nonsugical periodontal treatment group and control group. T test was used to measure the difference of delta E selectin before after study between periodontal treatment group and control. Periodontitis was found in 31 subjects 64,5 . There was no statistically significant difference of delta E selectin before after treatment between periodontal treatment group and control. As a conclusion, periodontal treatment has no effect on E selectin level in RA patients."

"Latar belakang: Frailty merupakan sindrom biologis yang dapat menyebabkan kerentanan terhadap hasil yang lebih buruk terhadap pasien. Penilaian frailty saat ini berkembang pada populasi penyakit lainnya antara lain pada populasi pasien sirosis hati. Modalitas yang dikembangkan dan sudah divalidasi untuk menilai frailty pada populasi sirosis hati adalah dengan Liver Frailty Index (LFI). Prevalensi pasien sirosis hati yang mengalami frail ternyata cukup tinggi. Dipikirkan pasien yang mengalami frail akan meningkatkan mortalitas pada pasien sirosis hati. Tujuan: Menilai apakah frailty berdasarkan Liver Frailty Index dapat menjadi prediktor mortalitas pada pasien sirosis hati Metode: Penelusuran literatur dilakukan melalui basis data daring: PubMed/ MEDLINE, EMBASE, ProQuest, dan EBSCOhost dengan menggunakan kata kunci “sirosis hati” dan “liver frailty index” dalam Bahasa Inggris dan Indonesia. Pencarian manual dilakukan melalui portal data nasional, e-library fakultas kedokteran, dan snowballing. Studi yang dimasukkan ke dalam penelitian adalah studi kohort prospektif dan retrospektif yang mengikutsertakan pasien sirosis hati tanpa keganasan hati dan melaporkan mortalitas pasien berdasarkan status frailty. Hasil: Sebanyak 7 artikel diikutsertakan dalam telaah sistematis ini, 3 diantaranya diikutkan dalam meta-analisis untuk menilai hubungan dengan mortalitas dan 2 studi menilai hubungan dengan kejadian dekompensasi. Risiko mortalitas lebih tinggi pada pasien sirosis dengan frailty (HR 1,68; IK 95% 1,36-2,08; p<0,00001). Frailty berhubungan dengan kejadian asites (OR 1,84 IK 95% 1,41-2,40; p<0,00001). Tidak didapatkan adanya hubungan antara frailty dengan kejadian EH pada pasien sirosis hati (OR 1,57 IK 95% 0,65-3,80; p=0,31). Kesimpulan: Frailty merupakan prediktor mortalitas pada pasien sirosis hati. Pasien sirosis hati dengan frailty memiliki risiko kematian lebih besar dibandingkan pasien sirosis hati tanpa frailty.

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Background: Frailty is a biologic syndrome that can lead to susceptibility to poorer outcomes for patients. Frailty assessment is currently developing in other disease populations, including the population of patients with liver cirrhosis. The developed and validated modality to assess frailty in the liver cirrhosis population is the Liver Frailty Index (LFI). The prevalence of liver cirrhosis patients who experience frail is quite high. It is thought that patients who experience frail will increase mortality in patients with liver cirrhosis.

Objective: Assessing whether frailty based on the Liver Frailty Index can be a predictor of mortality in patients with liver cirrhosis.

Methods: Literature search was conducted through online databases: PubMed/MEDLINE, EMBASE, ProQuest, and EBSCOhost using the keywords “cirrhosis of the liver” and “liver frailty index” in English and Indonesian. Manual searches were carried out through national data portals, medical faculty e-libraries, and snowballing. The studies included in the study were prospective and retrospective cohort studies that included patients with liver cirrhosis without liver malignancy and reported patient mortality based on frailty status.

Results: A total of 7 articles were included in this systematic review, 3 of which were included in a meta-analysis to assess the association with mortality and 2 studies assessed the association with the incidence of decompensation. There was a higher risk of mortality in cirrhotic patients with frailty (HR 1.68; 95% CI 1.36-2.08; p<0.00001). Frailty was found to be associated with the incidence of ascites (OR 1.84 95% CI 1.41-2.40; p<0.00001). There was no association between frailty and the incidence of HE in patients with liver cirrhosis (OR 1.57 95% CI 0.65-3.80; p=0.31).

Conclusion: Frailty is a predictor of mortality in patients with liver cirrhosis. Liver cirrhosis patients with frailty have a greater risk of death than patients with liver cirrhosis without frailty."