Understanding Anorexia and Eating Capability of Older Adults in Attempt to Prevent Malnutrition

Because of the rise of life expectancy, the older adults are now a big part of world’s population. In United States, prevalence of adults aged more than 65 years old increased from 36.6 million in 2005 to 47.8 million in 2015. In Indonesia, percentage of older adults increased two-fold from 1971 – 2019 as much as 9,6% or more than 25 million people. Along with this aging population, eating problems and malnutrition are getting more frequent. Aging causes several changes and degradation of body function which physiologically lead to anorexia and eating difficulty in older adults. Moreover, the other age-related factors such as social factor, economic factor, psychological factor, diseases and polypharmacy also have significant impact on food intake in older adults. Prevalence of inadequate energy intake and malnutrition in older adults are increasing, which lead them to become susceptible to acute and chronic diseases or worsening of their disease, increase hospitalization, and increase mortality rate. Even so, the signs of malnutrition of older adults are often late to be recognized, whereas the recovery of malnutrition in older adults is much more complicating than in younger adults. This review discusses about problems encountered by older adults that decrease their intake and cause malnutrition, to help clinicians recognize the cause of malnutrition in older adults earlier.

Assembling an Anti-COVID-19 Artillery in the Battle against the New Coronavirus

The panic and confusion surrounding the pandemic caused by the novel coronavirus requires a systematic study of the disease (COVID-19) and the arsenal of weapons available to the biochemist in the fight against infection. When developing a particularly bad flu in January 2020 while in India after the visit of a friend, who had just travelled back from Wuhan (China), it gave me an early opportunity to study the tricky diagnosis of this dreaded disease first-hand. The somewhat unusual symptoms and a lingering weakness and malaise for months suggested that it was no ordinary influenza virus. Since that time, a baffling number of disparate symptoms have been ascribed to COVID-19 infection including respiratory, gastrointestinal, circulatory, urinary tract and nerve dysfunction that have even resulted in multi-organ failure in some cases. Naturally, an array of risk factors have also been identified ranging from age, sex, obesity, diabetes, and hypertension to cigarette smoking that can increase mortality rate dramatically. In the intervening period, much research has appeared on biochemical compounds that may help to prevent this infection and, possibly, aid in patient recovery. Among these bioactive molecules are certain anti-inflammatory substances such as vitamin D, zinc, chloroquine, soy isoflavones like genistein, and glycyrrhizic acid, some of which may be successful in attacking different biochemical processes of the new coronavirus and disarming its deadly artillery against the human host. In a few instances, the viral processes that are inhibited by these chemicals are essential for the replication and reproduction of this RNA virus thereby striking a lethal blow to its machinery. Thus, taken together, these compounds may form a worthy arsenal against a formidable foe in the absence of an effective vaccine, and, especially, if relapse or re-infection proves to be a common occurrence in recovered COVID-19 patients.

VRSurvival Runner: Aplikasi Exergaming Survival berbasis Virtual Reality

Exercising is not something that many people enjoy, and often a burden. In Indonesia, the prevalence of overweight and obesity is on a steady rise since 2013. One of the cause of these trend is the sedentary lifestyle. Lack of physical activities in this lifestyle has lead to poor cardiorespiratory fitness which proven to increase mortality rate. The purpose of this research is to create android game based on virtual reality and with the genre of exergaming. This research aims to create a new and variative ways to exercise without going out of your home dan to create a new atmosphere of exercising that is fun because of the survival horror genres. This research is using prototyping models and using Unity 3D as the game-engine that allow the application to run on Android Devices. The result of this research is VRSurvival Runner, an android game that allows the player to run, jump, to avoid zombies that are chasing the player, and also this game has a feature of counting the estimated burned calories while playing the games. A trial test on the app also has been done without any problem.

A LAPAROSCOPIC COMPARATIVE STUDY OF RIGHT AND LEFT PARADUODENAL HERNIAE : A TALE OF TWO CITIES

It was the best of times, it was the worst of times…’, thus began Charles Dickens in his classic novel ‘A Tale Of Two Cities’. We revisit right and left Paraduodenal herniae(PDH) in this article. Our ‘two cities’ are the fossae of Waldeyer and Landzert respectively. We think the times are the best as of present day, since cutting edge diagnostic tools(CECT abdomen) offer us an unambiguous diagnosis of PDH. Also the advent of minimal access surgery from the last decade of the twentieth century onwards, has afforded us the luxury of treating PDH by laparoscopy. However these are also the worst of times since PDH, though rare, constitutes 53% of all internal hernias and if undiagnosed, can increase mortality rate upto 20%[1]. In this article, we attempt to make a side by side comparison of right and left PDH vis-à-vis their embryology, diagnosis, laparoscopic ‘first look appearance’, surgical therapy and the endresult.

Identifying reliable fitness proxies for growing animals responding to anthropogenic changes

ABSTRACTAnthropogenic influences on habitats often affect predation on species by introducing novel predators, supporting additional predators, or reducing animals’ ability to detect or avoid predators. Other changes may reduce the ability of animals to feed, or alter their energy use. An increase in predation risk is assumed to reduce prey populations by increasing mortality, reducing foraging and growth. Often animals don’t appear to have been adversely affected, or may even increase growth rate. However, theoretical predictions that may have been overlooked suggest that optimal foraging rate, mortality rate and growth rate may change in counter-intuitive ways, depending on exactly how predation risk or costs have been increased. Increasing predator density may increase mortality rate when foraging, reduce the safety of refuges, or alter the relationship between vigilance and attack likelihood. Increasing temperature may increase metabolic costs in ectotherms and reduce thermogenesis costs in endotherms, which affects the costs of active foraging and inactivity differently. Here, I review the theory on how predation risk and metabolic costs should affect foraging behaviour, mortality and growth in order to explain the great variation in behavioural responses. I show that in some situations animals may not respond behaviourally even though a change severely affects survival, and the mortality may be a poor metric of the impact of a change on population viability. In other situations a fitness proxy may change dramatically whilst fitness is unaffected due to compensatory changes in behaviour or life history. Other measures may change in a positive way whilst fitness declines. I describe how to identify the situations in the field and thereby make reliable measure of fitness in particular study systems. Overall, this work shows how behavioural theory can help understand the impacts of environmental change and highlights promising directions to better understand and mitigate their effects on ecosystems.

Antibacterial Activity of Hoya Diversifolia Ethanolic Leaves Extract

The rapid emergence of resistance bacteria toward various antibiotics may associate with higher medical cost and increase mortality rate. Hoya diversifolia was used to cure skin diseases and alleviate rheumatism pain. The aim of this study is to evaluate in vitro antibacterial properties of H. diversifolia ethanolic leaves extract against several Gram positive and Gram negative bacteria. The antibacterial study was determined based on pattern of inhibition zones using disc diffusion assay and also minimal inhibitory concentration (MIC). It is shown that the extract can inhibit the growth of methicillin-resistant Staphylococcus aureus, Escherichia coli and Bacillus cereus. The lowest MIC values of extract were 25 mg/mL for MRSA and E. coli as well as 100 mg/mL for B. cereus at 24 and 48 hours of incubation period. The plant had potential to act as antibacterial agent that can be applied in pharmaceutical and cosmetic fields.

TRANSARTERIAL CHEMOEMBOLIZATION(TACE) EFFICACY IN PATIENTS WITH HEPATOCELLULAR CARCINOMA(HCC): CAN SIGNIFICANT PROGNOSTIC FACTORS BE REVEALED?

Material and methods. A total of 125 patients(pts) with HCC (stage BCLC-B) underwent TACE from 2009 to 2016. If pts had been found inoperable, radiological intervention was used as monotherapy or in combination with systemic therapy at different stages of the disease. Results. Median overall survival (OS) for pts subjected to at least one TACE session was 20.5 months (95 per cent confidence interval 16.4-24.59). Such factors as ECOG status (р=0,012, RR= 1,65), protein synthesis (albumin >37 г/л; р=0,005, RR = 0,47) and detoxication (total bilirubin ≤ 14 мкмоль/л; р=0,037, RR = 1,64) hepatic functions, functional hepatic ability according to Child-Pugh classification (А vs. B; p=0,016, RR = 2,5) ALBI categories (A1 vs. A2 vs. A3; р=0,007, RR = 1,66) as well as HCC invasion: tumour size (р=0,001, RR=2,1), level AFP ≥ 5 IU/ml (р=0,003, RR 2,25), bilobar involvement (р=0,024; RR=1,64) independently influence OS. Pronounced TACE effect (р<0,001, RR 1,93) and Time before Progression duration were found to influence significantly the fatality rate. Multifactorial analysis for OS confirmed increased mortality (RR=1,92) if total bilirubin was ≥14 umol/L (р=0,018); Impaired hepatic functions according to ALBI (р=0,007) and Child-Pugh classification (р=0,002) are associated with significant OS reduction (RR 1.73 и 3,41respectively). HCC invasion (BCLC; р=0,03) AFP level ≥5 IU/ml (р=0,008, RR=2,26) and the biggest tumour node size >10 см (р=0,01, RR 1,95) independently increase mortality rate. Effective TACE (р<0,001) is associated with significant OS increase and mortality decrease. Conclusion. TACE is most effective if HCC pts have satisfactory condition and preserved liver function (Child Pugh A or ALBIA1) and limited intrahepatic invasion (BCLCA/B), with tumour size being... cm and normal AFP level. Under conditions of intrahepatic progression subsequent local therapy was found to be significantly associated with OS increase.

KONTESTASI KUASAATAS UNDANG-UNDANG PRODUK TEMBAKAU DI MEDIA (UNDANG-UNDANG NOMOR: 36 TAHUN 2009)

The bacground of this study is the issue of Act Number 39, 2009 concerning Health, which is considered destrimental to tobaccoo industry, especially farmers, and also raises some debates. Theoretical framework of this study consists of agency and stucturization theories. This study was analyzed with discourse analysis using three strategies: (1) institutional strategy, i.e. to see institutionally the pro and contra about health regulation on addictive substances and tobacco; (2) social strategy, i.e. to see arguments of group of society as a respond to the regulation and to defferentiate empowering and disempowering orientation; (3) ironic strategy: to place the discourse of tobacco in relation to public health by explaining the increase of self-monitoring and discipline, which seems to foster the new growth quickly (proleferation), but ironically tends to lower the ceredibility. This study found that: (1) Parties that reject the regulation argue that government does not consider the contribution of the income from tobacco custom, the job vacancy offered by tobacco industry, tobacco farmers, and local government commodity. (2) Parties that support the regulation argue that cigarettes contain addictive substance, are dangerous to active and passive smokers, can cause cancer, heart attack, and increase mortality rate. (3) Nahdlatul Ulama is one of Islamic social organizations that reject the regulation as well as reject the disagree with the statement ’haram’ for smoking with the consideration that there is no text to judge that law. Latar belakang penelitian ini adalah Undang-Undang Nomor 36 Tahun 2009 tentang Kesehatan diundangkan oleh Negara, dianggap merugikan industri pertembakauan, dan khususnya para petani, dan mengundang berbagai perdebatan. Framework teoretis yang membangun sistem berpikir dalam kajian ini adalah agency dan strukturisasi. Teknis analisisnya adalah analisis wacana menggunakan tiga strategi, yaitu (1) Strategi institusional; sejauhmana melihat wacana pro kontra regulasi Kesehatan tentang zat adictive dan tembakau secara institusional. (2) strategi sosial, dengan melihat argumentasi kelompok masyarakat atas respon regulasi tersebut dengan membedakan orientasi pemberdayaan (empowering) dan bukan pemberdayaan (disempowering). (3) strategi ironic, dengan menempatkan wacana tembakau dari perspektif spesifik terkait dengan kesehatan masyarakat yang menjelaskan peningkatan self-monitoring and discipline, yang seolah-olah mendorong pertumbuhan baru secara cepat (proleferation), dan ironis yang cenderung menurunkan kredibilitas. Hasil penelitian ini adalah: 1) Pihak yang menolak pemberlakuan regulasi, berargumentasi bahwa pemerintah tidak memperhatikan kontribusi melalui cukai kepada pendapatan negara, penyerapan tenaga kerja yang sangat signifikan untuk masyarakat industri, dan para petani tembakau dan menjadi komoditas andalan pemerintah daerah. Di samping itu, kontrol industri multinasional asing, WHO, FCTC, dan Kementerian Kesehatan, serta NGO masuk kawasan negara berkembang, baik melalui kegiatan akademis, keagamaan, industri global untuk menguasai dan menggantikan produk rokok yang bebas ’zat adiktif’, dan berakhir meminggirkan produksi kretek lokal. 2) Pihak yang mendukung pemberlakuan regulasi rokok, berdasar pada kandungan rokok yang mengandung zat adiktif; membahayakan bagi perokok aktif dan pasif, dan mengakibatkan kanker, jantung, dan bahkan meningkatkan angka kematian. Hal ini didukung oleh lembaga WHO, FCTC, Kementerian kesehatan, berbagai ormas Islam (Muhammadiyah dan ormas Islam lain) melalui MUI, dan Kelompok LSM yang konsern di bidang kesehatan dan lingkungan hidup. 3) Nahdlatul Ulama adalah salah satu ormas Islam yang menolak atas pemberlakuan regulasi tersebut dan juga menolak penetapan rokok/merokok adalah haram atas pertimbangan secara teks, bahwa tidak ada dalil yang dapat digunakan untuk penetapan “haram mutlak”.