Exploring the Therapeutic Potential of Vitamin D in Kawasaki Disease and Its Interplay with the COVID-19

Objective: Several studies have reported outbreaks of Kawasaki disease among children amid the coronavirus disease 2019 (COVID-19) pandemic. Vitamin D possesses high utility in modulating the immune system to repair and prevent severe inflammation in COVID-19. This study aims to explore the association between Kawasaki disease and vitamin D levels in pediatric patients and describe the potential role of vitamin D in promoting recovery and preventing complications associated with Kawasaki disease in pediatric patients with COVID-19. Materials and Methods: The association between Kawasaki disease and vitamin D was explored adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, utilizing databases such as PubMed, Google Scholar, and ScienceDirect. The association between COVID-19 and Kawasaki disease was also assessed by reviewing relevant literature. Results: Most studies indicated that patients with Kawasaki disease had lower vitamin D levels. Vitamin D supplementation was also found to be deficient in the pediatric population with Kawasaki disease. Inflammation of the endothelium, cytokine storms, and endothelial dysfunction in patients suffering from COVID-19 may contribute to the development of Kawasaki disease. Vitamin D is believed to have protective potential for Kawasaki disease outcomes by modulating the inflammatory response. Conclusion: Administering vitamin D to pediatric patients with viral infections like COVID-19 is expected to accelerate clinical improvement and prevent complications from Kawasaki disease.</p

Performance of fecal S100A12 as a novel non-invasive diagnostic biomarker for pediatric inflammatory bowel disease:a systematic review and meta-analysis

Objective: The incidence and prevalence of inflammatory bowel disease (IBD) in pediatric patients are increasing. Currently, the diagnostic method for IBD is inconvenient, expensive, and difficult. S100A12, a type of calcium-binding protein, detected in the feces of patients with IBD has recently been suggested as a promising diagnostic tool. Hence, the authors aimed to evaluate the accuracy of fecal S100A12 in diagnosing IBD in pediatric patients by performing a meta-analysis. Methods: The authors performed a systematic literature search in five electronic databases for eligible studies up to July 15, 2021. Pooled diagnostic accuracies of fecal S100A12 were analyzed as the primary outcomes. Secondary outcomes were standardized mean difference (SMD) of fecal S100A12 levels between IBD and non-IBD groups and a comparison of diagnostic accuracies between fecal S100A12 and fecal calprotectin. Results: Seven studies comprising 712 children and adolescents (474 non-IBD controls and 238 IBD cases) were included. Fecal S100A12 levels were higher in the IBD group than in the non-IBD group (SMD = 1.88; 95% confidence interval [CI] = 1.19–2.58; p &lt; 0.0001). Fecal S100A12 could diagnose IBD in pediatric patients with a pooled sensitivity of 95% (95% CI = 88%–98%), specificity of 97% (95% CI = 95%–98%), and area under the receiver operating summary characteristics (AUSROC) curve of 0.99 (95% CI = 0.97–0.99). Fecal S100A12 specificity and AUSROC curve values were higher than those of fecal calprotectin (p &lt; 0.05). Conclusion: Fecal S100A12 may serve as an accurate and non-invasive tool for diagnosing pediatric IBD.</p

Breast Cancer Screening in Georgia:Choosing the Most Optimal and Cost-Effective Strategy

Objectives: To define the optimal and cost-effective breast cancer screening strategy for Georgia. Methods: We used the Microsimulation Screening Analysis-Breast (MISCAN-Breast) model that has been adapted to the Georgian situation to evaluate 736 mammography screening strategies varied by interval (biennial and triennial), starting ages (40-60 years), stopping ages (64-84 years), and screening modality (with and without clinical breast examination [CBE]). Quality-adjusted life-years (QALYs) and additional cost (healthcare perspective) compared with no screening per 1000 women were calculated with 3% discount. Major uncertainties (eg, costs) are addressed as sensitivity analyses. Results: Strategies using a combination of mammography and CBE yielded in substantially higher costs with minimal differences in outcomes compared with mammography-only strategies. The current screening strategy, biennial mammography screening from the age of 40 until 70 years with CBE, is close to the frontier line but requires high additional cost given the QALY gains (€16 218/QALY), well above the willingness-to-pay threshold of €12 720. The optimal strategy in Georgia would be triennial mammography-only screening from age 45 to 66 years with an incremental cost-effectiveness ratio of €12 507. Conclusions: Biennial screening strategies are resource-intensive strategies and may not be feasible for Georgia. By switching to triennial mammography-only strategy from the age of 45 until 66 years, it is possible to offer screening to more eligible women while still gaining substantial screening benefits. This is to address capacity issues which is a common barrier for many Eastern European countries.</p

An evaluation of phototherapy device performance in a tertiary health facility

Introduction: A range of phototherapy devices are commercially available. The American Academy of Pediatrics (2004) recommends routine intensity measurement of phototherapy devices to ensure that babies affected by hyperbilirubinemia receive effective phototherapy. Objective: The aims of this study were to calculate the irradiance decay velocity of phototherapy devices used in a tertiary care hospital to evaluate whether current maintenance procedures for phototherapy devices are effective, and to contribute to the improvement of a standardized maintenance procedure in daily practice, thus helping to ensure that all babies affected by hyperbilirubinemia receive prompt treatment. Methods: This research represents a prospective observational study conducted at Dr. Soetomo Academic Teaching Hospital in Surabaya, Indonesia from February 2019–July 2019. The intensities of 11 phototherapy devices were measured at specific times using a Bili Blanket Meter II. We calculated the Δ irradiance differences in μW/cm2/nm and calculated them as velocity μW/cm2/nm/hour of use. Results: Among the 11 phototherapy devices included in this study, nine were fluorescent and two were light-emitting diode (LED) machines. The mean (standard deviation) irradiance decay velocity of the fluorescent lamps was 0.02 (±0.03) μW/cm2/nm/hour of use, while that of the LED lamps was 0.015 (±0.007) μW/cm2/nm/hour of use. The fastest irradiance decay velocity was 0.08 μW/cm2/nm/hour of use, while the slowest irradiance decay velocity was <0.01 μW/cm2/nm/hour of use, both of which were from fluorescent-based devices. There was one fluorescent-based device that provided an intensity lower than the therapeutic level. Conclusion: Irradiance decay occurred in all phototherapy device lamps. It is important to perform routinely intensity measurements, regardless of manufacturer recommendations, to avoid ineffective phototherapy resulting from intensities lower than the required therapeutic levels

Mental health and health-related quality of life among healthcare workers in Indonesia during the COVID-19 pandemic:a cross-sectional study

OBJECTIVES: Healthcare workers (HCWs) are the front lines during the COVID-19 pandemic. They are more exposed to COVID-19 than other professions. Studies from other countries have shown that the mental health and health-related quality of life (HRQoL) of HCWs were affected during this pandemic. However, studies on mental health in Indonesia remain scarce and no study has evaluated the HRQoL among HCWs. Thus, this study was designed to explore the mental health status and HRQoL among HCWs in Indonesia. DESIGN: This was a cross-sectional study. SETTING: This was an open online survey in Indonesia conducted from December 2020 to February 2021. PARTICIPANTS: This study involved HCWs who worked during the COVID-19 pandemic. Of the 502 respondents who accessed the online questionnaire, 392 were included in the analysis. OUTCOMES: Mental health status was measured using the 21-item Depression, Anxiety and Stress Scale and HRQoL was measured using the second version of the 12-item Short-Form Health Survey (SF12v2). RESULTS: The prevalence of depression, anxiety and stress among HCWs was 29.4%, 44.9% and 31.8%, respectively. Using the SF12v2 questionnaire, 354 (90.3%) HCWs were found to have impaired physical component and 156 (39.8%) HCWs have impaired mental component. CONCLUSION: The prevalence of mental health problems among HCWs was high in Indonesia. HRQoL, particularly the physical component, was affected in most HCWs. Thus, policymakers should give more attention to the mental health and HRQoL of HCWs during the COVID-19 pandemic

Mental health and health-related quality of life among healthcare workers in Indonesia during the COVID-19 pandemic: A cross-sectional study

Objectives Healthcare workers (HCWs) are the front lines during the COVID-19 pandemic. They are more exposed to COVID-19 than other professions. Studies from other countries have shown that the mental health and health-related quality of life (HRQoL) of HCWs were affected during this pandemic. However, studies on mental health in Indonesia remain scarce and no study has evaluated the HRQoL among HCWs. Thus, this study was designed to explore the mental health status and HRQoL among HCWs in Indonesia. Design This was a cross-sectional study. Setting This was an open online survey in Indonesia conducted from December 2020 to February 2021. Participants This study involved HCWs who worked during the COVID-19 pandemic. Of the 502 respondents who accessed the online questionnaire, 392 were included in the analysis. Outcomes Mental health status was measured using the 21-item Depression, Anxiety and Stress Scale and HRQoL was measured using the second version of the 12-item Short-Form Health Survey (SF12v2). Results The prevalence of depression, anxiety and stress among HCWs was 29.4%, 44.9% and 31.8%, respectively. Using the SF12v2 questionnaire, 354 (90.3%) HCWs were found to have impaired physical component and 156 (39.8%) HCWs have impaired mental component. Conclusion The prevalence of mental health problems among HCWs was high in Indonesia. HRQoL, particularly the physical component, was affected in most HCWs. Thus, policymakers should give more attention to the mental health and HRQoL of HCWs during the COVID-19 pandemic

Lung Vital Capacity of Choir Singers and Nonsingers: A Comparative Study

Summary: Objectives. The popularity of choir singing among Indonesian university students as an extracurricular activity has increased in the last few years. Choir singers use physiology principles especially respiration roles in the voice production process. This research aims to determine the lung vital capacity difference between singers and nonsingers. Methods. This is a cross-sectional study which uses primary data collected from spirograms of 20 university students. Half of the students were Airlangga University choir singers, and the other half were students who are not members of the choir. The spirometry tests were performed to obtain inspiratory capacity, vital capacity, and forced vital capacity of both groups. Results. The average lung vital capacity of choir singers was higher (3.12 L) than that of the nonsingers (2.73 L). The average inspiratory capacity of the singer group was 1.79 L, and the average inspiratory capacity of the nonsinger group was 1.71 L. The lung vital capacity difference between singers and nonsingers group was statistically significant ( P ¼ 0.02). There was no significant inspiratory capacity difference between singers and nonsingers group in this study ( P ¼ 0.611). The forced vital capacity measurement showed a significant difference ( P ¼ 0.01) between singers (75.28%) and nonsingers (68.14%). Conclusion. It can be understood that the increasing vital capacity in choir singers is most likely from the expiration phase of the respiration. Further studies need to be conducted to confirm the causes of the increasing vital capacity in singer

Neonatal resuscitation: A cross-sectional study measuring the readiness of healthcare personnel

Abstract Background: The optimal neonatal resuscitation requires healthcare personnel knowledge and experience. This study aims to assess the readiness of hospitals through its healthcare personnel in performing neonatal resuscitation. Methods: This study was an observational study conducted in May 2021 by distributing questionnaires to nurses, midwives, doctors, and residents to determine the level of knowledge and experience of the subject regarding neonatal resuscitation. We conducted the research in four types of hospitals A, B, C, and D, which are defined by the Regulation of the Minister of Health of the Republic of Indonesia by the capability and availability of medical services. The type A hospital is the hospital with the most complete medical services, while type D hospitals have the least medical services. The comparative analysis between participants’ characteristics and the knowledge or experience score was conducted. Results: The total 123 participants are included in the knowledge questionnaire analysis and 70 participants are included in the resuscitation experience analysis. We showed a significant difference (p = 0.013) of healthcare personnel knowledge between the A type hospital (Median 15.00; Interquartile Range [IQR] 15.00–16.00) and the C type hospital (median 14.50; IQR 12.25–15.75). For the experience, the healthcare personnel of type A and type B hospitals have significantly higher experience scores than the type D hospital (p = 0.014; p = 0.007), but we did not find a significant difference between others type of hospital comparison. Conclusions: In this study, we found that the healthcare personnel from type A and type B hospitals are more experienced than the type D hospital in conducting neonatal resuscitation. We suggest more neonatal resuscitation training to improve the readiness of healthcare personnel from type C and type D hospital