Opioid and the usage in chronic non cancer pain

The use of opioid in various guidelines for chronic non-cancer pain is controversial because evidence of their long-term benefits is weak. The potential for serious adverse effects and local regulations warrant caution in both prescribers and users. However, opioids have a role in the management of chronic non-cancer pain in carefully selected patients with regular monitoring and as a part of multimodal therapy. Common adverse effects should be treated promptly to improve patient compliance. We believe that opioid therapy at low doses is beneficial in some patients. It should not be denied but carefully considered on a case-by-case basis

Pengaruh komunikasi dan pemberian insentif terhadap kinerja perawat di RSU Royal Prima Medan

Nurse performance is one of the determinants of hospital success rate in providing health services. Efforts to improve nurse performance include paying attention to nurses' work stress. The purpose of this study was to determine the effect of communication and incentives for nurses' performance in the inpatient room at Royal Prima Hospital Medan. This type of cross-sectional research with an explanatory research method approach. The total population of 41 nurses and all nurses used as respondents (total sampling). Data were analyzed using the chi-square test and logistic regression was used to obtain an OR (Odds Ratio) value. The results showed nurses with good communication would increase performance by 6.7 times (p = 0.012: OR = 6.708) and the provision of incentives would increase performance by 6.6 times (p = 0.006; OR = 6.667).Kinerja perawat merupakan salah satu faktor penentu tingkat keberhasilan rumah sakit dalam pemberian pelayanan kesehatan. Usaha untuk meningkatkan kinerja perawat di antaranya adalah dengan memperhatikan stres kerja perawat. Tujuan penelitian adalah untuk mengetahui pengaruh komunikasi dan pemberian insentif terhadap kinerja perawat di ruang rawat inap RSU Royal Prima Medan. Jenis penelitian cross-sectional dengan pendekatan metode explanatory research. Jumlah populasi sebanyak 41 perawat dan keseluruhan perawat dijadikan sebagai responden (total sampling). Data dianalisis dengan menggunakan uji chi-square dan regressi logistic digunakan untuk mendapatkan nilai OR (Odds Ratio). Hasil penelitian menunjukkan perawat dengan komunikasi yang baik akan meningkatkan kinerja sebesar 6,7 kali (p=0,012 : OR=6,708) dan pemberian insentif akan meningkatkan kinerja sebesar 6,6 kali (p=0,006 ; OR=6,667)

The effect of Andaliman (Zanthoxylum acanthopodium DC.) fruit extracted with ethanol on TNF-α and TRPA-1 levels in type II diabetes-induced mice

Objective: The present study investigated the effects of Andaliman fruit extract on tumor necrosis factor-alpha (TNF-α) and transient receptor potential ankyrin-1 (TRPA-1) levels in type 2 diabetes mellitus (T2DM) mouse models induced with streptozocin (STZ) and a high-fat diet (HFD). Materials and Methods: In this research, mice were allocated into six distinct groups: normal, negative control (HFD and STZ), positive control (metformin, HFD, and STZ), and three treatment groups (HFD, STZ, and Andaliman extract at varying dosages of 100, 300, and 500 mg/kg, respec¬tively). Body weight and blood glucose levels (BGLs) were recorded at weeks 1 (baseline), 8, 12, and 16. The levels of TNF-α and TRPA-1 were measured during the 16th week. Results: Phytochemical screening of the Andaliman extract revealed the presence of flavonoids, alkaloids, tannins, saponins, and glycosides. The one-way ANOVA revealed significantly elevated BGL at week 16 in the negative control group in comparison to the other groups (p < 0.05). The Kruskal-Wallis test followed by Bonferroni-corrected pairwise comparisons showed that the negative control had significantly higher TNF-α levels than the Andaliman-groups (z = 22.11, p < 0.01). TRPA-1 was significantly higher in the negative control group compared to the treatment groups (p < 0.05). Furthermore, Spearman's rho analysis revealed a statistically significant positive associ¬ation between BGL and both TNF-α and TRPA-1, as well as between TNF-α and TRPA. Conclusion: Andaliman extract potentially serves as a therapy for diabetic neuropathy in T2DM by lowering BGL and inhibiting the expression of TNF-α and TRPA-1. [J Adv Vet Anim Res 2024; 11(2.000): 284-290

Antidiabetic Effectiveness Test of Andaliman Fruit (Zanthoxylum acanthopodium) Extract on Histopathological Changes in Peripheral Nerves: An In Vivo Study

Background: Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood sugar levels, and the increase in sugar levels is triggered by low insulin production or the ineffective use of insulin by the body (relatively). Diabetic neuropathy is a complication that often attacks DM patients and is the highest complication of diabetes. This study aims to test the effectiveness of Andaliman fruit (Zanthoxylum acanthopodium) extract on the improved histopathology of Peripheral nerve in alloxan-induced Wistar rats (Rattus norvegicus). Methods: This study is an experimental study using 24 Wistar rats, which were grouped into 6 groups (1: normal, 2: negative control, 3: positive control, 4-6: DM + andaliman extract 150mg/kgBW, 250 mg/kgBW, 350 mg /kgBB). Data analysis used SPSS to determine differences in the histological conditions of peripheral nerves. Results: The administration of andaliman fruit extract at a dose of 350 mg/kgBW was most effective in inhibiting the proliferation of Schwann cells, which showed the potential of andaliman fruit extract in preventing the progression of diabetic neuropathy. The administration of andaliman fruit extract at a dose of 350 mg/kgBW also showed the most effective potential in inhibiting the inflammatory process in the peripheral nerves, which is believed to be responsible for peripheral nerve cell damage. Conclusion: Andaliman fruit (Zanthoxylum acanthopodium) extract is effective against improving the histopathology of peripheral nerves in alloxane-induced Wistar rats (Rattus norvegicus)

Effectiveness Test of Green Betel Leaf Extract (Piper betle L.) on the Growth of Staphylococcus aureus

Background: Diseases due to infection where one of the causes is Staphylococcus aureus is one of the biggest problems faced today. Treatment using penicillin antibiotics tends to cause resistance and side effects, so people prefer to overcome them by means of self-medication or the use of traditional ingredients such as betel leaf. The purpose of the study was to examine the effect of green betel leaf extract (Piper betle L.) on the growth of Staphylococcus aureus on the antibacterial activity. Methods: This study is experimental research in vitro using a well diffusion method. The betel leaf was extracted using the maceration method and made into concentrations of 5%, 10%, 15%, and 20%. Results: The average diameter of the inhibition zones was 9.82 mm, 9.11 mm, 9.28 mm, and 9.01 mm at concentrations of 5%, 10%, 15%, and 20%, sequentially. Conclusion: The antibacterial activity of betel leaf extract in the overall concentration and the most optimal concentration was 5% at 9.82 mm

Effectiveness Test of Green Betel Leaf Extract (Piper betle L.) on the Growth of Candida albicans

Background: Candida albicans is a fungus that often results in opportunistic infections in humans, called candidiasis. People generally practice self-medication to treat candidiasis with azole antifungals. However, this causes resistance due to inappropriate drug or dose selection. Betel leaf extract, which contains active compounds with antifungal properties such as phenols, tannins, and flavonoids, can be used as alternative medicine. The purpose of this study was to determine whether there was an effect of green betel leaf extract (Piper betle L.) on the growth of Candida albicans. Methods: This study is an experimental study and uses the disc diffusion method. The betel leaf was extracted using the maceration method and made into concentrations of 40%, 60%, 80%, and 100%. Results: The mean inhibition zone diameters were 9.12 mm, 8.79 mm, 8.18 mm, and 8.55 mm at concentrations of 40%, 60%, 80%, and 100%, sequentially. Conclusion: Betel leaf extract has an antifungal effect, with the most effective concentration being 40%