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The Relationship of Blood Eosinophils Levels with Degree of Exacerbation in COPD Patient at Usu General Hospital Deneuve, Olivia Monica; Pradana, Andika; Tarigan, Amira P.
Journal of Society Medicine Vol. 3 No. 7 (2024): July
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i7.155

Introduction: During acute exacerbations of chronic obstructive pulmonary disease (COPD), blood eosinophil count has the potential to predict treatment response. Nevertheless, there hasn't been enough research done to determine whether blood eosinophil numbers in a stable state can forecast an eosinophilic exacerbation. Methods: This study was a retrospective cohort analysis performed July-August 2022 to July-August 2023. Subject were 44 COPD patients who were treated at the outpatient clinic. Blood samples measured blood eosinophil levels. We determined an absolute cut-off point for blood eosinophil count at stable COPD in order to identify the rate of exacerbation. Results: Based on the Kruskal-Walli’s test, there was a significant relationship between blood eosinophils and the level of exacerbations in COPD patients (p value = 0.003). Conclusion: We established a relationship between the rate of exacerbation and blood eosinophil counts during stable COPD. The rate of exacerbation and eosinophil counts showed a strong positive relationship. Our findings should be confirmed by prospective and further research in different populations.

The Association of Electric Cigarette Using Period with Respiratory Symptoms in Male E-Cigarette User Saragih, M. Khairul Aswin; Tarigan, Amira P.
Journal of Society Medicine Vol. 3 No. 8 (2024): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i8.163

Introduction: The increasing trend of e-cigarettes user is often found in productive young people, especially those who are undergoing education. The use of electric cigarettes can cause respiratory complaints such as coughing, coughing up phlegm and shortness of breath. To identify the subject characteristic and to examine association between e-cigarette using period with respiratory symptoms in e-cigarrette male user who are undergoing education in Senior High School and Medical Education in Medan Methods: This study took samples of research subjects using two groups, where each group numbered 15 people, these groups were entered according to the inclusion and exclusion criteria, with the pearson correlation test using the ATSQ instrument to assess respiratory symptoms. Results: The age range of 21-25 years is the most users of e-cigarettes (43.4%), the most education is in the form of professional general practitioner education in this study (43.3%). Respiratory complaints that were often felt by subjects were coughing in the morning which occurred most often 1-2 times a week and shortness of breath during exercise which appeared less than once per week. The pearson test shows r count > r table (0.883 > 0.641) and is positive. Conclusion: There is an association between e-cigarette using period with respiratory symptoms, where the longer you use, the more severe the respiratory symptoms will be.

Functional capacity and quality of life improvement in stable chronic obstructive pulmonary disease (COPD) patients following physical exercise and chicken egg white supplementation Sihombing, Benny; Tarigan, Amira P.; Pandia, Pandiaman; Zaluchu, Fotarisman; Sinaga, Bintang YM.; Monica, Nanda S.; Rhinsilva, Ella; Zulkarnain, Zulkarnain
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.404

The pillars of comprehensive pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD) patients include physical exercise and good nutrition. The aim of this study was to evaluate the efficacy of pulmonary rehabilitation, which included physical exercise and chicken egg white supplementation, on the quality of life (QoL) and functional capacity among patients with stable COPD. The COPD patients were enrolled prospectively in this quasi-experimental study and completed a 12-week smartphone-guided home-based physical exercise program that comprised strength and resistance training three times per week for 30 minutes each session. Participants were divided into two groups: the control group who underwent physical exercise only, and the intervention group who had physical exercise and chicken egg white supplementation as a protein source. Patient characteristics including sex, age, nutritional status, comorbidities, smoking status, and obstruction severity, were evaluated. The COPD assessment test (CAT) score and six-minute walk test (6MWT) were used as the parameters to evaluate QoL and functional capacity, respectively. Of the total 50 patients included in the study, 12 were excluded due to follow-up and adherence problems. Our data indicated there were significant CAT score reduction and 6MWT improvement in both control and intervention groups after 12 weeks compared to baseline data. However, reduction of mean CAT score was higher in intervention compared to control group (-13.47±6.49 vs -5.42±5.07, p<0.001). In addition, the improvement of 6MWT was also higher in intervention group compared to control group (145.47±69.2 vs 32.42±17.3 meters, p<0.001). In conclusion, chicken egg white supplement to male patients with stable COPD who exercise with resistance and strength training could improve the QoL and functional capacity.

Physical exercise and chicken egg white supplementation increase muscle mass of stable COPD patients Amin, Mona N.; Tarigan, Amira P.; Pradana, Andika; Ashar, Taufik; Osareniro, Osakue E.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.406

Patients with chronic obstructive pulmonary disease (COPD) commonly exhibit muscle atrophy and dysfunction due to a reduction in muscle mass; and protein supplements such as chicken egg whites have been reported to improve muscle mass. The aim of this study was to evaluate the impact of physical exercise and egg white supplementation on the muscle mass of COPD patients. An experimental study was conducted among stable COPD patients at Universitas Sumatra Utara Hospital Medan, Indonesia, between August and October 2022. The patients were divided into two groups, control and interventional groups, with each patient subjected to a pre- and post-muscle mass assessment. All the patients performed respiratory endurance and upper extremity muscle strength training three times/week for a total of 12 weeks. In addition, the patients in the intervention group were also given egg white supplementation (10 eggs/day) during the period of intervention in addition to the physical training. The Wilcoxon and Mann-Whitney tests were performed to identify the significance of the difference between pre- and post-intervention and between the control and intervention groups, respectively. A total of 38 COPD patients were included in the study, 19 from each group. Our data suggested no significant difference in muscle mass of the patients in the control group before and after 12 weeks of physical exercise (pre-intervention 27.37±4.54% and post-intervention 27.68±4.5% with p=0.174). However, there was a significant muscle mass increment of patients in the intervention group upon 12 weeks of physical training and egg white supplementation (pre-intervention 27.18±4.15%, post-intervention 29.95±3.76%, p<0.001). A significant difference in muscle mass was observed between patients in the control and the intervention groups (p=0.046) after the intervention. The study highlights that physical exercise in combination with egg white supplementation may serve as potential and effective non-pharmacological treatment for muscle mass restoration in COPD patients as compared to physical exercise alone.

Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients Adida, Fiony; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Ashar, Taufik; Dangana, Amos; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.412

Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the “Paru Sehat” smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient’s quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of “Paru Sehat” in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the “Paru Sehat” twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients’ characteristics and the knowledge scores within pre- and post-treatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although “Paru Sehat” application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.

Effectiveness of upper arm and breathing exercises to improve inflammatory markers in severe COVID-19 patients Tarigan, Amira P.; Firdaus, Ruby; Pandia, Pandiaman; Pradana, Andika; Abdullah, Muntasir; Sinaga, Sudirman P.; Wijanarko, Wahyu; Triwahyudi, Bibit; Vera, Yeni; Maryaningsih, Maryaningsih; Eyanoer, Putri C.; Listyoko, Aditya S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.417

Studies have suggested associations between inflammatory markers with the severity of coronavirus disease 2019 (COVID-19). Therefore, exercises that could reduce the level of inflammatory markers might be beneficial. The aim of this study was to determine the effect of upper arms and breathing exercises on inflammatory markers such as ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in severe COVID-19 patients. A quasi-experimental with pre-test and post-test control group design was conducted among severe COVID-19 aged 18–70 years old, with or without comorbidities. Baseline data of inflammatory markers (ferritin, LDH, and CRP) were measured before the exercises and repeated post-exercise. The upper arm and breathing exercises were performed for ten days, twice a day (morning and evening) for ten minutes. A paired Student t-test was used to assess the changes in the inflammatory markers’ levels. Our data indicated that levels of ferritin and CRP were not significantly different between pre- and post-exercise. However, the level of LDH decreased significantly from 481.35 U/L to 331.80 U/L (p=0.001). This study highlights that pulmonary rehabilitation exercises might be beneficial to enhance the recovery process in severe COVID-19 patients.

Comparison of exhaled carbon monoxide levels and its association with nicotine dependence between electronic and tobacco cigarettes: A cross-sectional study among teenage smokers Raffael, Frans; Pandia, Pandiaman; Tarigan, Amira P.; Mutiara, Erna; Osakue, Osareniro E.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.418

Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.

Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises Monica, Nanda S.; Tarigan, Amira P.; Pradana, Andika; Mutiara, Erna; Pandia, Pandiaman; Sinaga, Bintang YM.; Sihombing, Benny; Rhinsilva, Ella; Zulkarnain, Zulkarnain; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.420

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher’s exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.

Comparative analysis between PUMA and CAPTURE questionnaires for chronic obstructive pulmonary disease (COPD) screening in smokers Sebayang, Risa RB.; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Wahyuni, Arlinda S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.654

Chronic obstructive pulmonary disease (COPD) presents a significant global challenge, impacting health systems, economies, and societies. Its prevalence is anticipated to rise owing to an aging demographic. Although the PUMA and CAPTURE questionnaires are available for COPD screening, their comparative effectiveness has not been studied in Indonesia. The aim of this study was to evaluate the effectiveness of the PUMA and CAPTURE questionnaires as screening tools for COPD among smokers. A cross-sectional study was conducted at Universitas Sumatera Utara Hospital and H. Adam Malik General Hospital, Medan, Indonesia, from December 2022 to February 2023. Smokers aged over 40 or above with a history of smoking more than 100 cigarettes in their lifetime and no previous COPD diagnosis were included in the study. To collect the responses to PUMA and CAPTURE questionnaire, face-to-face interviews were conducted, followed by a spirometry test. A total of 76 smokers were included in the study; the predominant age group was 51–60 years (36.8%), with the majority being male (81.6%). Most participants began smoking at ages 15−20 years (65.8%) and had been smoking for 20–30 years (36.8%) at a moderate intensity (44.8%). Spirometry tests indicated obstructive patterns in 50 participants, with 17 classified as severe obstruction. At a cut-off score of ≥6, the PUMA questionnaire yielded a sensitivity of 72.55% and a specificity of 84%. In contrast, the CAPTURE questionnaire, with a cut-off score of ≥4, exhibited a sensitivity of 70.83% and a specificity of 64.29%. These results imply that the PUMA questionnaire could be more efficient in COPD screening compared to the CAPTURE questionnaire.

Role of digital education through smartphones in improving knowledge among asthma patients: A preliminary study Pohan, Indah TS.; Tarigan, Amira P.; Pandia, Pandiaman; Mutiara, Erna
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.657

Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.

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