Influence of Age, Obesity, Smoking, Sleep duration, and Sleep Quality on Concentration, Morphology, and Sperm Motility: A Cross-Sectional Study.

BACKGROUND: Age, smoking, sleep duration, sleep quality, and obesity are risk factors that can affect the amount of sperm concentration, morphology, and motility. The aim of this study is to assess the lifestyle effects: of age, smoking, sleep duration, sleep quality, and obesity on the amount of concentration, morphology, and motility of sperm. MATERIALS AND METHODS: The study utilized an analytical observational approach with a cross-sectional design. The study subjects comprised 70 male partners of infertile couples admitted to the Sekar Fertility Clinic at the Dr. Moewardi General Hospital between March and August 2022. The study assessed variables including age, body mass index (BMI), smoking status, sleep duration, sleep quality, sperm concentration, sperm morphology, and sperm motility. Furthermore, the data were analyzed using univariate, bivariate, and multivariate methods with SPSS 25 software. RESULTS: The research findings demonstrate that obesity is significantly associated with abnormal sperm concentration [odds ratio (OR)=40.07, confidence interval (CI)=3.90-411.67, P=0.002]. Furthermore, moderate or heavy smoking is significantly associated with abnormal sperm concentration (OR=17.45, CI=1.83-166.15, P=0.013) and sleep quality with severe disorders (OR=5.73, CI=1.12-29.21, P=0.036). Moreover, obesity is significantly associated with abnormal sperm motility (OR=12.97, CI=2.66-63.15, P=0.002), while moderate or heavy smoking (OR=5.89, CI=1.23- 28.20, P=0.026) and poor sleep duration (OR=6.21, CI=1.43-26.92, P=0.015) also exhibit significant associations with abnormal sperm motility. However, no significant findings were observed regarding sperm morphology. CONCLUSION: The findings of this study indicate that obesity, moderate or heavy smoking, and sleep quality have statistically significant effects on sperm concentration, while obesity, moderate or heavy smoking, and sleep duration have statistically significant effects on sperm motility. However, no statistically significant influence was observed on sperm morphology. Further research with larger sample sizes and more diverse populations is needed to validate these findings and explore other potential factors that may impact male fertility.

The social capital effect on HIV/AIDS preventive efforts: a meta-analysis.

HIV/AIDS is one of the sexually transmitted diseases that cause death worldwide. Its prevalence increases due to low prevention behaviour. The study aimed to estimate the effect of social capital on HIV/AIDS preventive efforts. This study was a meta-analysis and systematic analysis. We retrieved articles from PubMed, Science Direct, and Google Scholar from 2008-2021. The inclusion criteria were full-text articles with observational design and articles published in English. We focused on the problems of the PICO study, namely: population=men and women who were sexually active; intervention=high social capital; comparison=low social capital; outcome=HIV/AIDS prevention efforts. The articles were collected using the PRISMA flow diagram. Meta-analysis was performed using RevMan 5.3 with a random effect model. The study included 12 articles. The likelihood of sexually active men and women with high social capital to perform HIV/AIDS prevention efforts was 1.55 times higher than those with low social capital (aOR=1.55; CI 95%=1.11 to 2.16; p=0.009).

Simple tuberculosis screening tool using signs, symptoms, and risk factors to reduce the missed opportunity in the older population.

BACKGROUND: There is a growing concern on how to increase tuberculosis (TB) case detection in resource-poor settings. The healthcare facilities routinely providing services to the elderly for chronic diseases often failed to detect TB cases, causing a missed opportunity. This study aimed to develop a simple and sensitive screening tool using signs, symptoms, and risk factors for TB case detection in the elderly. METHODS: This was a cross-sectional study conducted from August to December 2020. A random sample of 302 subjects was taken from the elderly aged ≥ 60 years attending the outpatient polyclinic at Mangunharjo hospital, Madiun, East Java, Indonesia, for a chronic disease problem. The test was developed using 16 TB signs, symptoms, and risk factors. Test performance was assessed by comparing it against the GeneXpert MTB/RIF. RESULTS: Marginal analysis resulted in the optimal cut-point of ≥ 7 for the test, which gave an area under the curve (AUC) of 0.62, with the maximum marginal AUC of 0.04 (p < 0.001). The sensitivity and specificity were 60.26% and 64.29%, meaning 60 TB cases for every 100 elderly with TB would be otherwise left undetected if this screening test did not take place. CONCLUSION: A simple TB screening tool with moderate sensitivity and AUC has been developed using TB signs, symptoms, and risk factors. It can be used as an initial step of the systematic TB screening in the elderly visiting healthcare facilities for routine chronic disease examination, with the additional utility of reducing the missed opportunity.

Low Social Support and Risk for Depression in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

OBJECTIVES: Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis. METHODS: PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I2 statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias. RESULTS: Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I2= 87%). CONCLUSIONS: Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

Electroacupuncture Effectiveness for Treating Idiopathic Male Infertility.

Background: Male infertility accounts for ∼50% of all infertility cases. The reasons for male infertility may vary, and one of them is related to an idiopathic factor that may impair spermatogenesis. Acupuncture is one of the most well-known and widely accepted alternative treatments and is becoming known as an effective complementary therapy for infertility. Case: The case in this article demonstrated the effectiveness of electroacupuncture (EA) for improving male fertility by referring to the total motile sperm count (TMSC), sperm morphology and motility, DNA Fragmentation Index (DFI) of the sperm before and after EA, and pregnancy success in a couple with male infertility. Couples are given therapy with EA twice per week for up to 12 sessions and planned intercourse during the fertile period (ovulation). After planned intercourse, the wife became pregnant; an intrauterine gestational sac (GS) was seen on transvaginal ultrasound and her human chorionic gonadotropin urine test was positive. Results: The TMSC parameter, sperm morphology and sperm motility, post-EA DFI was improved, compared to pre-EA. The couple was became pregnant after undergoing EA 12 times to treat male infertility. Conclusions: This case illustrated that EA therapy for idiopathic male infertility has an effect toward improvement of the spermiogram test result, DFI, and success in achieving a pregnancy. However, further research is needed because there are many patients with different causes for their infertility.

The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis.

OBJECTIVES: Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes. METHODS: A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration's Risk of Bias tool was employed to assess the risk of bias. RESULTS: Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes. CONCLUSIONS: DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.

HIV/AIDS treatment funding system to support the people affected by HIV/AIDS in Surakarta, Indonesia.

People Living with HIV/AIDS (PLWHA's) quality of life (QoL) is determined by the lifetime treatment sustainability. Republic of Indonesia Minister of Health's Decree Number 328 of 2003 stated that government subsidies the PLWHA's medication and treatment, despite not covering entire medication and treatment cost. The objective of research was to analyse the cost assumed by PLWHA in accessing HIV/AIDS treatment service in Surakarta, Indonesia. The target group in this case study was PLWHAs, and related stakeholders of medical treatment in one of Public Health Centers and a Public Hospital in Surakarta; AIDS Commission of Surakarta City; Solo Plus Peer Support Group and AIDS-Care NGO selected purposively. Data collection was carried out using observation, in-depth interview, and documentation. Method and data source triangulations were used to validate data that was then analysed using Grossman's Demand for Health Capital theory. The result of research showed that the sources of HIV/AIDS treatment cost were self-income, Social Insurance Administration Organization (BPJS) fund and Local Government subsidy. Admission and physican services are given for free to PLWHA because it has been paid by BPJS Fund or has been subsidied by Local Government. Otherwise, they should pay registration cost of IDR 50,000, in Public Hospital and IDR 75,000 in Private Hospital. Physician service costs IDR 50,000-IDR 200,000. VCT Counsellor costs IDR 35,000-IDR 150,000. Non-Subsidy ARV costs IDR 687,000. 1 bottle containing 60 TB meningitis drug capsules costs IDR 145,000 for 10-20 d use and maximally IDR 210,000, while herpes drug costs IDR 295,000. CD4 examination costs IDR 126,000-IDR 297,000, RNA Viral load IDR 1,275,000-IDR 1,471,000, Haematology IDR 60,000-IRD 90,000, Cholesterol and triglyceride IDR 100,000-IDR 250,000, and SGOT/SGPT IDR 100,000-IDR 200,000. There is monthly non-medical cost the patient should spend, including transportation cost to go to health centre, and food, beverage, and newspaper cost while waiting for the service. BPJS fund and local government subsidy relieved health economic burden of PLWHAs, so that the average HIV/AIDS treatment cost in PLWHAs was relatively low, less than 10% of expense. National Insurance System including BPJS fund and local government subsidy as the answer to the integration of HIV/AIDS treatment funding management into national insurance system had provided PLWHA a funding access involving prevention, care, support, and treatment, and mitigated the effect despite less optimum.

Electroacupuncture to Improve Endometrial Receptivity and Folliculogenesis in Polycystic Ovary Syndrome.

Objective: Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting folliculogenesis and endometrial receptivity. PCOS causes low fertility due to failures in folliculogenesis and ovulation. Electroacupuncture (EA) may help improve folliculogenesis and endometrial receptivity. EA can decrease tonic activity in the sympathetic vasoconstrictor pathway to the uterus. This study was conducted to determine the effect of the addition of EA therapy on folliculogenesis and endometrial receptivity in women with PCOS. Materials and Methods: This case-control study was conducted at the Dr. Moewardi General Hospital, in Jawa Tengah, Indonesia. The subjects were women with PCOS, ages 20-45, who were infertile. They were divided into a control group (17 women) and an experimental group (17 women). The control group received letrozole therapy, and the experimental group received EA + letrozole therapy. Folliculogenesis is determined by measuring the growth of follicle diameter on days 2, 6, 8, 10, and 12 of the menstrual cycle. Endometrial receptivity is determined by resistance index (RI) and pulsatility index (PI) examinations on days 19 and 21; endometrial thickness is measured on day 12. Results: There was a significant difference in folliculogenesis on days 2, 6, 8, 10, and 12. Folliculogenesis with letrozole versus EA + letrozole, respectively, were: day 2 = 5.59 ± 1.06 versus 7.01 ± 1.53, P = 0.004; day 6 = 6.71 ± 1.59 versus 9.11 ± 1.23, P < 0.001; day 8 = 9.51 ± 2.68 versus 12.44 ± 1.49, P < 0.001; day 10 = 11.30 ± 3.08 versus 15.53 ± 2.34, P < 0.001; and day 12 = 13.92 ± 3.61 versus 19.86 ± 0.75, P < 0.001. RI value with letrozole versus EA + letrozole were, respectively, day 19 = 0.91 ± 0.07 versus 0.88 ± 0.07, P = 0.150; day 21 = 0.88 ± 0.07 versus 0.79 ± 0.09, P < 0.001. PI value with letrozole versus EA + letrozole were respectively, day 19 = 3.00 ± 0.89 versus 2.30 ± 0.65, P = 0.009; and day 21 = 2.72 ± 0.88 versus 2.02 ± 0.55, P = 0.009. Endometrial thickness with letrozole versus EA + letrozole were, respectively, day 12 = 6.95 ± 1.82 versus 8.22 ± 1.76, P = 0.005. Conclusions: The addition of EA to letrozole therapy improved folliculogenesis, RI, PI, and endometrial thickness in patients with PCOS. Further studies are needed to gain a better understanding of the dosage and timing of this therapy and its potential synergy with other current treatments.

The Effect of Hypnosis on Adherence to Antituberculosis Drugs Using the Health Belief Model.

An RCT on the efficacy of hypnosis in improving adherence to antituberculosis treatment using the Health Belief Model (HBM). Sixty study subjects were sampled at random from tuberculosis patients who visited the Center for Pulmonary Community Health in Solo, Indonesia. Hypnotherapy with posthypnotic suggestions was delivered once a week over 6 months. The data on pretested 7 HBM constructs were analyzed using t test and path analysis. Hypnotherapy had a positive effect on perceived susceptibility, seriousness, threat, benefit, and self-efficacy. It indirectly had a positive effect on adherence. Hypnotherapy had a negative effect on perceived barrier. This study supports the hypothesis that hypnotherapy effectively improves adherence to tuberculosis treatment, by enhancing health-related perception and beliefs in the HBM.