Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

It is paramount to assess the risk of biases in may arise from diagnostic test accuracy (DTA) study as it will affect the accuracy and validity of the tests. These biases can be found in published researches and here we look at COVID-19 DTA studies. The evaluation of bias risk in diagnostic research is mainly performed using QUADAS-2. The aim of this review was to determine potential selection and information biases in diagnostic test accuracy studies and strategies to minimize risk of biases. Literature review related to diagnostic test accuracy study is identified through an online search of databases namely PubMed, ScienceDirect, Research Gate, Google Scholar, and official government websites range. Six potential biases in four QUADAS-2 domains are identified in COVID-19 diagnostic test accuracy study which are 1) spectrum bias in patient selection; 2) interpretation bias in index test; 3) differential misclassification bias and nondifferential misclassification bias in reference standard; and 4) partial verification bias and differential verification bias in patient flow. The identified biases exert effects on accuracy of COVID-19 diagnostic tests. Six strategies are recommended to reduce these biases, hence, improving the accuracy of COVID-19 diagnostic tests. The best diagnostic test can give benefits to the population in the mass screening program during COVID-19.

Introduction: Persistent exposure to stress can lead to a wide range of pathological effects, including reproductive dysfunctions. Tualang honey, renowned for its antioxidant properties has been utilised in traditional and modern medicine. This study aims to investigate the protective effects of Tualang honey against stress-induced testicular damage in male rats. Method: Twenty-four male rats were divided into control group, stress-exposed group, Tualang-honey-supplemented group and stress-exposed with Tualang-honey-supplemented group. Restraint stress test (RST) and Forced swimming test (FST) were imposed on the rats for 21 days. Serum testosterone and corticosterone concentration were measured using ELISA. Testes were harvested, weighed, processed and stained for spermatid counts and measuring seminiferous epithelial height and diameter. One-way analysis of variance (ANOVA) was used to compare the numerical data between groups. Results: The testosterone concentration, spermatid count, seminiferous epithelial height and diameter in stress group were significantly lower compared to control group (p < 0.05). Corticosterone concentration was significantly greater in the stress group than in the control group. The spermatid count and seminiferous epithelial height and diameter of honey-treated groups were significantly higher than the stress-only group (p < 0.05). The corticosterone concentration of honey-treated groups was significantly higher compared to the stress-only group. Meanwhile, the testosterone concentration of honey-treated groups was higher than the stress-only group although the results were insignificant. Conclusion: Tualang honey has the potential to ameliorate corticosterone concentration and induce morphological alterations by increasing spermatid counts and seminiferous epithelial thickness and diameter in rat testes exposed to prolonged stress.

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18–59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m2 ), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio;NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. RESULTS: Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). CONCLUSIONS We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.

Introduction: Astrocytes are responsible for many essential functions of neurons in CNS. It has been recognised that chronic stress affects the morphology of astrocyte. Natural antioxidant such as honey has been used as one of the therapeutic strategies to lessen the damaging effect of chronic stress on our body. Therefore, the aim of the study is to explore the effect of natural antioxidant, Tualang honey (TH) on the morphology of astrocytes following chronic stress exposure. Methods: Thirty-two male rats were randomly divided into the 4 groups: (i) control, (ii) stress, (iii) honey, (iv) stress plus honey groups.TH was administered via oral gavage at dose of 1.0 g/kg body weight pre and post experiment. Chronic stress was exposed to animals in group (ii) and (iv) for consecutive 21 days. Anti GFAP immunohistochemistry method was employed to label astrocytes in the medial prefrontal cortex. The number of GFAP+ astrocytes and several parameters related to astrocyte processes were measured. Results: The present study showed that chronic stress reduced the GFAP immunoreactive astrocyte number and percentage of GFAP immunoreactive material. Chronic stress also caused a reduction in astrocyte process ramification as indicated by a reduction in astrocyte total number of processes, average length of processes and maximum number of intersections. However, antioxidant treatment using TH could not reverse these stress-induced changes to the astrocytes. Conclusion: These results demonstrate that chronic stress decreases the number of GFAP immunoreactive astrocyte and cause shrinking of astrocyte processes in stress-sensitive brain region, but these changes cannot be reversed by antioxidant treatment.