ABSTRACT
Background and Aim: Water plays a pivotal role in the body. Alteration of the fluid balance promotes metabolic disorder, thus leading to the development of various diseases, such as diabetes mellitus (DM). Hydrogen-rich water (HW) is recognized as a novel antioxidant. This study aimed to investigate the role of HW on insulin, insulin receptor (IRs), and superoxide dismutase (SOD) levels in streptozotocin (STZ)-induced diabetic rats. Materials and Methods: A total of 30 male Wistar rats were randomly divided into five groups: Normal (N), DM rats, DM+metformin (DM+Met, 45 mg/kg body weight [BW]), DM+Met+HW, and DM+HW. DM rats were induced by feeding them a high-fat diet for 30 days and then injecting with repeated low doses of STZ (35 mg/kg BW) intraperitoneally. Fresh HW was administered orally and ad libitum for 14 days. Insulin, IRs, and SOD were observed in each group. Results: HW therapy increased the level and expression of insulin and IRs. In addition, treatment with HW also elevated the SOD levels in the serum and liver. The study results indicated no significant differences between the administration of HW and metformin. Conclusion: HW has antioxidant activity in STZ-induced DM rats, increasing insulin, IRs, and SOD.
ABSTRACT
Implementing health protocols and preventive measures are the only effective ways to suppress COVID-19 transmission before vaccines and antiviral drugs are developed. The implementation of health protocols and preventive measures are influenced by one's knowledge, attitudes, and practices (KAP) toward this pandemic. Medical students as candidates for healthcare workers and role models for the community should have a good KAP. This study intends 1) to explore the KAP of medical students in Indonesia toward COVID-19 and 2) to assess which demographic factors have a significant effect on their KAP scores. An online questionnaire consisting of 18 items of knowledge, six items of attitudes, and 12 items of practices were used as instruments in this study. After being distributed for two weeks in June 2020, 525 respondents whose data were worth analyzing were obtained. The respondents consisted of male and female students, from diploma to bachelor degree, and came from all four types of higher education institutions in Indonesia. The results, 48% of respondents had good knowledge, 81% had good attitudes, and 43.5% had good practices toward COVID-19. The location of students' residence has no significant effect on their KAP score. Gender has a significant effect on knowledge and practice scores. Age, institution type, and institution status have a significant effect on their three KAP domains. The KAP survey results can be used as a reflection of the importance of the curriculum that prepares medical students for the pandemic. Medical students are also expected to be able to actively participate in educating people around them on how to minimize the transmission of COVID-19 during the pandemic.
ABSTRACT
BACKGROUND AND PURPOSE: The exact prevalence of sleep disorders following stroke or transient ischemic attack (TIA) remains unclear. We aimed to determine the prevalence of sleep-disordered breathing, insomnia, periodic leg movement during sleep, and restless leg syndrome following stroke or TIA in acute, subacute, and chronic phases and examine the moderating effects of patient characteristics (eg, age) and methodological features (eg, study quality) on the prevalence. METHODS: We performed a systematic review and meta-analysis. Embase and PubMed were searched from inception to December 18, 2019. We included 64 047 adults in 169 studies (prospective, retrospective, case-control, and cross-sectional study designs) reporting the prevalence of sleep disorders following stroke or TIA. RESULTS: In the acute phase, the overall prevalence of mild, moderate, and severe sleep-disordered breathing was 66.8%, 50.3%, and 31.6% (95% CIs, 63.8-69.7, 41.9-58.7, and 24.9-39.1). In the subacute phase, the prevalence of mild, moderate, and severe sleep-disordered breathing was 65.5%, 44.3%, and 36.1% (95% CIs, 58.9-71.5, 36.1-52.8, and 22.2-52.8). In the chronic phase, the summary prevalence of mild, moderate, and severe sleep-disordered breathing was 66.2%, 33.1%, and 25.1% (95% CIs, 58.6-73.1, 24.8-42.6, and 10.9-47.6). The prevalence rates of insomnia in the acute, subacute, and chronic phases were 40.7%, 42.6%, and 35.9% (95% CIs, 31.8-50.3, 31.7-54.1, and 28.6-44.0). The pooled prevalence of periodic leg movement during sleep in the acute, subacute, and chronic phases was 32.0%, 27.3%, and 48.2% (95% CIs, 7.4-73.5, 11.6-51.7, and 33.1-63.5). The summary prevalence of restless leg syndrome in the acute and chronic phases was 10.4% and 13.7% (95 CIs, 6.4-16.4 and 2.3-51.8). Age, sex, comorbidities, smoking history, and study region had significant moderating effects on the prevalence of sleep disorders. CONCLUSIONS: Sleep disorders following stroke or TIA are highly prevalent over time. Our findings indicate the importance of early screening and treating sleep disorders following stroke or TIA.
