Narra J

Navigating the intersection of COVID-19 and lower extremity acute limb ischemia: A retrospective cohort study of clinical characteristics and outcomes at Dr. Cipto Mangunkusumo Hospital

Akhmadu Muradi — 2025-08-01

Acute limb ischemia (ALI), a critical condition threatening limb viability and patient survival, has demonstrated an increased incidence during the COVID-19 pandemic, primarily due to virus-associated thrombotic complications. The pandemic has also led to delays in the diagnosis and treatment of non-COVID conditions, including ALI. The aim of this study was to evaluate the clinical characteristics and outcomes of ALI patients treated at Dr. Cipto Mangunkusumo Hospital between 2018 and 2022, comparing outcomes before and during the COVID-19 pandemic. Patients were categorized into two cohorts: pre-pandemic (n=28) and pandemic (n=53), with March 2020 marking the onset of the pandemic period. Treatment outcomes—revascularization success, re-intervention, and mortality—were assessed using multivariate logistic regression. Among the 81 patients, 34.6% were treated before the pandemic and 65.4% during the pandemic. Revascularization success was significantly higher during the pandemic (relative risk (RR): 2.46; 95% confidence interval (CI): 1.16–5.24; p=0.013), whereas no significant differences were observed in re-intervention or mortality rates (both with p>0.05). A prior history of COVID-19 was not significantly associated with revascularization outcome (p=0.933). The use of fluoroscopic guidance was significantly associated with improved revascularization success (RR: 36.58; 95%CI: 6.54–204.6; p=0.001). Rutherford classification was a significant predictor of re-intervention success (p=0.022), while the presence of dyslipidemia and cardiovascular disease were independently associated with mortality (RR: 0.08–0.76, p=0.0o5, and RR: 2.24–25.18, p=0.001, respectively). In conclusion, fluoroscopy appears to enhance revascularization outcomes in the treatment of ALI. Comorbidities such cardiovascular disease, and COVID-19 history should be taken into account when managing patients with ALI.

Biopsychosocial determinants of anxiety and depression among working mothers in China: A public mental health perspective

Jia Jiao — 2025-08-01

Working mothers often face dual demands from work and parenting, increasing their risk for anxiety and depression. However, the prevalence and contributing factors among Chinese working mothers remain underexplored. The aim of this study was to examine the prevalence and biopsychosocial determinants of anxiety and depression in this population. A cross-sectional survey was conducted between October 17 and November 21, 2024 through WeChat online among 330 working mothers aged 30–45 years old using validated instruments, including the Outcome Inventory-21 (OI-21), Parental Stress Scale (PSS), Experiences in Close Relationships-revised (ECR-R-10), Inner Strength-based Inventory (I-SBI), and the Multidimensional Scale of Perceived Social Support (MSPSS). Sociodemographic, socioeconomic and biological factors, including age, marital status, annual income, and physical disease, were also collected through a self-administered general information questionnaire. Data were analyzed using t-test, analysis of variance, Pearson’s correlation, and hierarchical linear regression. This study found the prevalence was 26.1% for anxiety symptoms and 38.2% for depression symptoms in this group based on the screening tools. Anxiety was significantly associated with both biological (e.g., hormonal changes, family psychiatric history) and psychological factors (e.g., attachment anxiety, parental stress). At the same time, depressive symptoms were primarily predicted by psychological and lifestyle-related factors (e.g., smoking, alcohol use). Notably, inner strength was a protective factor across both conditions. The findings highlight the importance of early detection and integrative care strategies for addressing mental health concerns in working mothers. Incorporating psychological screening, lifestyle assessment, and resilience-building interventions into workplace and community-based healthcare services may improve work-family balance outcomes in this population.

Development of decellularized mouse auricular scaffolds using sodium dodecyl sulfate immersion-agitation for microtia tissue engineering

Putu KD. Jaya — 2025-08-01

Effective treatment strategies for microtia remain limited due to the side effects and shortcomings associated with current therapeutic approaches. Tissue engineering, particularly the development of biological scaffolds, has emerged as a promising alternative. However, research on auricular scaffold fabrication in murine models using sodium dodecyl sulfate (SDS) and the immersion–agitation decellularization technique remains scarce. The aim of this study was to evaluate the effects of varying SDS concentrations on the decellularization efficiency and extracellular matrix (ECM) preservation of murine auricular tissue for scaffold development. Auricular tissues from mice (n=4) were immersed in Erlenmeyer flasks containing 0.1%, 0.5%, or 1% SDS and subjected to continuous agitation until the tissues became macroscopically translucent. Qualitative assessments included macroscopic appearance and microscopic evaluation using hematoxylin–eosin and Masson's trichrome staining. Quantitative analysis involved counting residual nuclei, while semiquantitative analysis of ECM area fractions was performed using ImageJ software. Statistical comparisons were conducted using one-way analysis of variance (ANOVA), with significance defined as p<0.05. The results demonstrated that the decellularized scaffolds exhibited macroscopic translucency, significantly reduced nuclear content (p=0.001), and preserved ECM integrity (p=0.012). Among the tested concentrations, 0.5% SDS provided the optimal balance between effective decellularization and ECM preservation. These findings support the potential application of murine auricular scaffolds decellularized with 0.5% SDS via the immersion–agitation method for future microtia tissue engineering.

Development of an inactivated viral transport medium for diagnostic testing in low-resource countries

Silmi Rahmani — 2025-08-01

Viral transport medium (VTM) is crucial for retaining clinical specimens, such as the virus or its genetic material from the mucus of respiratory tract of coronavirus disease 2019 (COVID-19) suspected patients. However, the locally produced VTM in Indonesia lacks the ability to inactivate the virus, risking the safety of diagnostic personnel. The aim of this study was to formulate inactive VTM (iVTM) incorporating chaotropic agents like guanidine salt, along with anionic detergents, chelators, buffers, and surfactants, to inactivate the virus while maintaining RNA integrity. Viral RNA stability in iVTM (pH 4 and pH 6) was evaluated for 30 days at 4°C and 25–28°C. In vitro inactivation test was performed on SARS-CoV-2 isolate (variant B1). The stability test revealed that storing the clinical specimens in iVTM at pH 6 maintained severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) detectability by qPCR for up to 30 days at cold and room temperatures. Stability assessments conducted over a 4-month period (at 25–28°C) on iVTM with a pH of 6 revealed clear appearance, consistent pH stability, no alteration in the solution color, and no indications of bacterial or fungal contamination. Results from an in vitro inactivation assay demonstrated that iVTM pH 6 eliminated SARS-CoV-2 infectivity within just five minutes of contact. These findings suggest that iVTM pH 6 offers a safer and cost-effective alternative for handling and transportation of clinical specimens.

Human strongyloidiasis in rural villages of South Kalimantan, Indonesia: A case series

Priska PP. Kristi — 2025-08-01

Strongyloidiasis, caused by the nematode Strongyloides stercoralis, can lead to severe complications, including hyperinfection syndrome and disseminated disease, particularly in immunocompromised individuals. However, data on its epidemiology and clinical significance in Indonesia remain scarce and outdated. The aim of this study was to investigate the presence of S. stercoralis, identify potential sources of infection, and explore associated risk factors. A case series of strongyloidiasis was identified during a soil-transmitted helminth survey conducted in two villages in Banjar District, South Kalimantan, Indonesia, between May and July 2024. S. stercoralis larvae were detected in four individuals out of 224 fecal samples (1.8%) using the Baermann funnel method, with confirmation via quantitative polymerase chain reaction (qPCR). All infected individuals were female farmers who reported nonspecific clinical symptoms. Subsequent environmental sampling revealed viable S. stercoralis larvae in soil from one of the villages. The detection of asymptomatic, infected individuals suggests that humans serve as reservoirs for ongoing transmission. In the context of open defecation practices, sustained transmission is likely unless targeted interventions are implemented. Urgent actions are needed, including community education and the provision of basic sanitation infrastructure such as latrines and access to clean water. These interventions are especially critical given that ivermectin—the first-line treatment for strongyloidiasis—is not currently available in Indonesia.