Accuracy and Pitfalls in the Smartphone-Based Audiometry Examination.

Introduction: Approximately 466 million people suffer from hearing loss worldwide, with Indonesia ranking fourth in Southeast Asia. However, conventional pure-tone audiometry is not yet available in many areas because of its high cost. Numerous available smartphone-based audiometry applications are potential alternative screening tools for hearing loss, especially in Indonesia. This study examined the findings on the validation of smartphone-based audiometry applications to assess hearing functions available in Indonesia. Materials and Methods: Based on the established eligibility criteria, this study was conducted by browsing the relevant literature validating smartphone-based audiometry applications in Indonesia. Relevant study data, such as the author, year, location, implementation procedures, and outcomes, were extracted and summarized. Results: This systematic review found 17 relevant and eligible publications. Of the six applications tested, 5 were found to have good validity, such as uHearTM, Audiogram MobileTM, AudCalTM, Hearing TestTM e-audiologia, and WuliraTM. All smartphone-based audiometry was tested only for the air conduction threshold and was influenced by several factors. Conclusion: Because smartphone-based audiometry is inexpensive, simple, and more accessible than conventional audiometric testing, it can be useful as a screening modality or alternative approach to assess hearing function. Unfortunately, smartphone-based audiometry cannot replace conventional audiometry in diagnosing hearing impairment.

Physical Activity Maintain Immune Response Through TLR-2/TLR-4 Gene Expression in Type-2 Diabetes Mellitus Patient at Medan City.

Background: The Increasing in type-2 diabetes mellitus (T2DM) needs to solve comprehensively and holistically. Patients with T2DM should have self-coping due to lifestyle modification. Abdominal fat accumulation can release pro-inflammatory cytokine that leads TLR-2 and TLR-4 to the response. These two kinds of toll-like receptors exist on the monocyte surface membrane which is an innate immunity cell. Objective: The aims of this study were to get the profile of physical activity, metabolic state, and mononuclear cell response to the expression of the TLR2 and TLR4 genes in T2DM patients. Methods: It was a descriptive-analytic study with a cross-sectional study design. Thirty-two eligible patients with inclusion criteria participated as subjects. All subjects answered questions by IPAQ, and checked metabolic state with body composition analysis. The TLR2 and TLR4 gene expression was determined with quantitative Real- Time PCR. Results: This study result found that most T2DM patients were in a highly active category in which most of their activity was walking (light intensity). The average abdominal circumferences were 91.81 ± 15.4 cm, body fat percentage was 29.5 ± 8.8%, and fasting blood sugar was 187.07 ± 67.03 mg/dl. Mononuclear cells number were normal. The expression of the TLR2 gene was lower by 0.71 fold and TLR4 gene expression was lower by 0.9 fold compared with non-DM (p<0.05). By chi-square test, there was a positive correlation between TLR2 gene expression with fasting blood glucose (p=0.011, and a positive correlation between the abdominal circumference and TLR4 gene expression (p=0.011). Conclusion: Type-2 Diabetes mellitus patients in primary health care keep walking as their physical activity to maintain blood glucose. Patients need to do moderate to vigorous exercise regularly to reduce body fat percentage especially abdominal fat to reduce Toll-like receptor gene expression, so insulin resistance and blood glucose level might decline to normal.

Anti Inflammatory Action of Allium Sativum Ethanol Extract to Prevent Lung Damage in Smoker Rat Model.

Background: Smoking is the leading cause of death in worldwide and is known as one of the risk factors in the development and pathogenesis of several diseases and most are respiratory and cardiovascular diseases. Secondhand smoke (SHS) exposure is associated with negative health consequences including respiratory tract infection, asthma, and cancer. One of the pathogenesis that has known to cause these diseases is inflammation. Garlic (Allium sativum) is a medicinal herb that contains Allicin and other active constituents that are known to have anti-inflammatory ability by suppressing the expression and production of proinflammatory cytokines that will cause inflammation. Objective: The aim of this study is; to analyze the anti-inflammatory action of Allium sativum ethanol extract to prevent lung damage in the smoker rat model. Methods: This is a case-control study with five groups of rats each group contains of three rats. The five groups were negative control (KN), 10 days (10d) smoker (K1), 20 days (20d) smoker (K2), 20d smoker treated with Allium sativum for 10 days (K3) and 20d smoker treated with Allium sativum for 20 days (K4). After 20 days all animals were sacrificed and histological preparation of lung organs was observed under a microscope with 100 dan 400 times magnification and then captured by photomicrograph for analyzed. Results: There were improvements in lung structure both in group K3 and K4 . there was a decrease of leucocytes and inflammatory cells infiltration that covered almost all alveolar surface to 10-20% surface area and the dilated alveoli decrease from more than 50% to less than 30% area. The bronchus was clean in both two groups compared to the groups that were not treated with Allium sativum. Conclusion: This study shows that Allium sativum ethanol extract has the ability to prevent lung damage in the smoker rat model.

Effect of Massage Therapy with Lime (Citrus Aurantifolia) Essential Oil on the Recovery of Delayed Onset of Muscle Soreness in Athletes.

Background: Physical exercise is a systematic exercise to increase muscle strength achieve goals such as improving the athlete's physical and preventing injury. Athletes must do is massage therapy to prevent muscle fatigue and pain due to physical exercise or during competition. The increase of lactic acid levels affects the maximum working ability of muscle fibers, decreases physical performance, and is fatigue in which the onset of pain. Lime essential oil as a topical oil contains high ester substances that have pharmacological effects such as natural analgesic effects to relieve pain. Objective: The purpose of this study was to determine the effect of massage therapy with lime essential oil as a topical oil on the recovery of delayed-onset muscle soreness (DOMS) in athletes. Methods: The participants are boxing athletes, 30 men, 20-22 years old, and non-smokers. Participants were divided into three groups. The exercise group (E) was doing exercises and was not given massage therapy; the exercise massage (EM) group, namely, doing exercises and being massaged with ordinary lotion as a topical oil; and the EM lime (EMC) group did exercises and was given a massage with lime essential oil as the topical oil. Results: The results showed that there was a significant difference in the average levels of lactic acid (p = 0.000) and the athlete's pain intensity (p = 0.000) in the three groups, namely, the exercise group (E), the exercise and massage group (EM), and the exercise and massage with lime essential oil (EMC). Conclusion: This study finds that lime essential oil used as topical massage therapy oil is better for accelerating the DOMS.

Effect of Moderate Intensity Continuous Training and Slow Type Interval Training to Gene Expression of TGF-ß in Type 2 Diabetes Mellitus Model Wistar Rats.

Background: Physical exercise is a process of increasing contraction of skeletal muscles involving several organ systems to increase energy formation and it is one of the pillars for the management of type 2 diabetes mellitus (TDM2). T2DM affects the expression of the TGF-ß gene. Objective: This study aims to determine the effect of moderate intensity continuous training and slow interval training in expression of TGF-ß gene in wistar rats T2DM model. Methods: A moderate intensity continuous training physical activity given to the diabetic rat group in the form of running on a treadmill with a running speed of 20 m/min for 30 minutes while the slow type interval training physical activity given to the diabetic rat group was in the form of running on a treadmill with a running speed of 20 m/minute for 10 repetition sessions, with a duration of 2 minutes per session with interspersed active breaks for 1 minute. TGF-ß gene expression was measured using real-time methods. Results: The results in the continuous group, TGF-ß significant decreased p < 0.05. In the interval group, TGF- ß insignificant decreased p > 0.05. Moderate intensity continuous training was insignificantly better at decreasing the expression of the TGF-ß genes. Conclusion: This research concluded that there is an effect of moderate intensity continuous training and slow interval training on the expression of TGF-ß genes in wistar rats T2DM.

Effect of Garlic Ethanol Extract Administration on Gluthatione Levels to Prevent Oxidative Stress in Smoker Rat Model.

Background: Sickle Garlic (Allium sativum L.) is known as a spice native to western Asia has a strong antioxidant effect and revealed it functions as an antioxidant by increasing ROS-capture activity, cellular antioxidants, SOD, CAT, and GSH levels in cells. Cigarette smoke is very dangerous because it can cause serious illness and death. Cigarette smoke is a major source of exogenous ROS because its particles are high in free radicals. Smoking is also related to a decrease in the body's natural antioxidant levels. Glutathione (GSH) synthesis and expression were found to increase initially and then decrease after being exposed to cigarette smoke. Objective: The aim of this study is; to analyze effect of garlic ethanol extract administration on gluthatione levels to prevent oxidative stress in smoker rat model. Methods: This was a case-control study with a control group design, with 15 healthy rats (Rattus norvegicus, sp.) divided into three groups, KN untreated animals (control), K1 animals exposed to cigarette smoke for 40 days (smoker), and K2 animals exposed to cigarette smoke for 40 days and treated with Allium sativum 0.1 g per day for 40 days (smoker and Allium sativum L.). After 40 days of treatment, all animals, including the control, were sacrificed with 30 mg/IP ketamine injections, and the blood plasma were taken for examination. Results: there were significant difference in glutathione levels between the treatment groups (K2) with the control group (KN) and the smokers group (K1) (p <0.05). Conclusion: garlic ethanol extract administration can increase gluthatione levels and prevent oxidative stress in smoker rat model.

The potential of Andaliman (Zanthoxylum acanthopodium DC) fruit as an ethanol extract for neuroprotection in aged model rat.

Objective: Dementia is a common aging-related neurodegenerative disease in the elderly worldwide. Alterations in neurogenesis and angiogenesis factors have been linked to cognitive impairment in neurological disorders. However, synthetic drugs to improve memory disorders have uncomfortable side effects. The purpose of this study is to explore the neuroprotective potential of the fruit ethanol extract of andaliman (Zanthoxylum acanthopodium DC) [Andaliman fruit ethanol extract (AEE)] on brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and spatial memory in rat models of aging. Materials and Methods: This study had an experimental design with AEE. The 4 groups were treated as follows: N (normal), M (served as positive control), P1 (AEE 150 mg/kg bw), and P2 (AEE 300 mg/kg BW) for 8 weeks. Aged model rats (M, P1, and P2) were obtained by inducing D-galactose (150 mg/kg bw). BDNF and VEGF expression were determined by RT-PCR, and spatial memory was assessed using the test of the Moris Water Maze (MWM). The Kruskal-Wallis and Mann-Whitney tests were used to assess the statistical analysis. Results: AEE had a tendency to increase BDNF in P2 compared to the normal group (1.98 versus 1). VEGF expression increased in P1 and P2 compared to the normal group (1.14 and 1.29 versus 1). AEE at a dose of 300 mg/kg bw significantly improved spatial memory (p = 0.026). Conclusion: For eight weeks, AEE at a dose of 300 mg/kg bw considerably increased the potential to enhance VEGF and BDNF expression as well as spatial memory.

Anti-Aging Activity of Andaliman (Zanthoxylum Acanthopodium DC) Fruit Ethanol Extract on Brain Weight and p16INK4a Expression of Hippocampus in Aging Model Rats.

Background: Physiological aging and due to oxidative stress in long term will have an impact on cellular response disorders, can caused aging of hippocampus and senility. Brain weight is known to decrease with age and p16INK4a as aging biomarkers have been investigated. Andaliman is one of typical herbal plants from North Sumatra has been widely used as an antioxidant, anti-inflammatory and anti-aging. Objective: This study was evaluated effect of andaliman (Zanthoxylum acanthopodium DC) fruit ethanol extract (AEE) on brain weight and p16INK4a expression in aging model rats. Methods: This study was carried out experimentally of 24 male wistar rats. The treatment group consisted of 4 groups; KN= negatif control (normal), KP= positif control (aging model rat), P1 and P2= aging model rat + AEE at dose 150 and 300mg/kgbw, respectively. The aging model rats were D-galactose-induced at dose of 150mg/kgbw for 8 weeks. Brain weigth were recorded by digital scales. p16INK4a expression using immunohistochemical methods. The data analysis with Anova test. Results: This study showed differences brain weight between groups (p=0.523). Brain weight in P1 (1.34±0,06) and P2 (1.30±0.09) tendency increased than KP (1.29±0.62). The p16INK4a expression between groups significant difference (p=0.041), continued with post hoc Least Significant Difference (LSD) showed p16INK4a expression in KN significant decreased than KP (p=0.027). Likewise, p16INK4a expression in P2 was significant decreased than KP (p=0.010). Conclusion: Andaliman ethanol extract at a dose 300mg/kgbw for 8 weeks was improved aging process caused D-galactose induced.

Is It Important to Increase Physical Activity Among University Students During the Second-Wave COVID-19 Pandemic in Asian Countries? A Cross-Sectional Study of the Knowledge, Attitudes, and Practices in Asian Countries.

Background: Difficulties in exercising have occurred for the entire world's population during this COVID-19 pandemic, especially in the second wave at the end of 2021. Most worrying is the lack of physical activity in young adults, as lack of exercise will increase the risk of noncommunicable diseases in the future. The youth such as university student can be agents of change, to increase physical activity, from sedentary to sport life. This study aimed to determine the relationship between knowledge, attitudes, and actions of university students and the correlation between the related variables. Methods: This study is a cross-sectional observational study involving 458 Asian university students based on Asian and African nationalities. This research was conducted from December 2021 to January 2022, during the second wave of the COVID-19 pandemic in Asia. The variables studied were the knowledge, attitudes, and actions of university students with regard to sports, and the statistical test used was the Chi-squared test. Results: The results showed that the research subjects were mainly from Indonesia and India (95.8%), there were more women than men (69.9% vs 30.1%), the most common age range was 18-20 years (61.4%), and 45.4% had a normal body mass index. In total, 48.3% had high knowledge, 93.4% had a positive attitude, and 34.7% had good practice. There was a significant relationship between knowledge and attitude (p=0.002) but not with action. Conclusion: This study found that good knowledge was associated with a good attitude, but due to the COVID-19 pandemic with activity restrictions on university students, there was no relationship with action.

Natural product of gambier (Uncaria gambier Roxb) extracts to counter against hepatotoxicity effects due to monosodium glutamate induction in male mice.

Monosodium glutamate (MSG) is often added in foods to enhance the flavor. It has adverse effect to body organs. Natural remedies, such as: gambier have been known for generations used to improve health. Substances contained in gambier, i.e.: catechins are believed to reduce the occurrence of hepatotoxicity. The study aims to analyze the effects of gambier in reducing the hepatotoxicity of MSG. This study with a posttest only control group design. Mice amount 25 (5 groups, n = 5/group). All interventions are given orally for 4 weeks. At the end of the study, it carried out euthanasia taken the liver of mice to made histopathology preparations then examine by light microscope, ×400, ×5 view field. Liver damage was found in each group with various levels of histological appearance:(I) 2 normal, 2 minimal, 1 moderate and none severe; (II) none normal, 1 minimal, 3 moderate and 1 severe; (III) 1 normal, 4 minimal, none moderate and severe;, (IV) 2 normal, 3 minimal, none moderate and severe; and (V) 4 normal, 1 minimal, none moderate, and severe. The data were analyzed using Kruskal-Wallis test. The level of liver damage among all groups was significantly different (p = 0.017). The same on the Dunn test also showed the level of liver damage in Group-II to compare with other groups (p < 0.05). The present study proves that Gambier (Uncaria gambier Roxb) can reduce occurrence of hepatotoxicity caused by MSG.

Exercise Intensity Alter Insulin Receptor Gene Expression in Diabetic Type - 2 Rat Model.

AIM: To analyse the differential expression of the insulin receptor (IR) gene between moderate continuous and severe continuous training in the T2DM rat model. METHODS: This was an experimental study. Healthy male Wistar was used in this study, which divided into sedentary, moderate continuous training, and severe continuous training. Treated groups were assigned to run on the treadmill three times a week for eight weeks consequently. RESULTS: The result shown that expression of mRNA IR gene in treated groups decline compared to control. There was a difference mRNA IR gene expression after eight weeks of exercise between MCT and control, SCT and control so are MCT and SCT. IR expression on skeletal muscle in treated groups was different compared with control. The distribution of IR on skeletal muscles in treatment groups was significantly increased compared control, but there was no significant difference distribution between MCT and SCT. HOMA-IR post-test in SCT was lower than MCT but FBG post-test lower in MCT than SCT. CONCLUSION: The intensity of exercise makes a difference in IR gene expression between moderate continuous training and severe continuous training after eight weeks of assigned exercise in T2DM rat models.