Matrix Metalloproteinase-9 Testing of Golden Rice Cookies With Piper Crocatum Active Extract for Preventing Foot Ulcers in Patients With Diabetes: Protocol for a Randomized Controlled Trial.

BACKGROUND: Diabetic foot ulcers (DFUs) present a formidable challenge to both patients and health care systems. DFUs significantly reduce the quality of life for patients, prolong hospital stays, and are the cause of approximately 70,000 lower limb amputations across the globe annually. Prevention of DFUs primarily involves the optimization of blood sugar levels and the effective management of complications, particularly peripheral neuropathy. Golden Rice has been proven to lower blood sugar levels due to its beta-carotene content, and Piper crocatum (P. crocatum) has been found to be effective in reducing the risk factors of DFUs through biomolecular regulation because of its polyphenol content. OBJECTIVE: The principal objective of this study is to identify the efficacy of P. crocatum-enriched cookies, with Golden Rice as their primary ingredient, in preventing DFUs. The evaluation will center on their impact on the expression of matrix metalloproteinase-9 (MMP-9), a pivotal factor in the development of DFUs. METHODS: This study is an experimental clinical research that follows the randomized controlled trial method and uses a single-blind design. The participants in the study are outpatients from primary health centers in Makassar, Indonesia, who have been diagnosed with diabetes mellitus. The sample for the study will be randomly selected and subsequently categorized into 2 groups: the intervention group and the control group. The intervention group consumes P. crocatum-enriched Golden Rice cookies, while the control group receives cookies without these additives. The participants from both groups will consume their respective cookies (packaged identically) twice a day for 14 days. The cookies will be prepared according to a modified recipe with an emphasis on low glucose content, resulting in 51 calories per cookie, comprising 1% carbohydrates, 6% fat, 4% cholesterol, and 4% fiber, excluding gluten, sugar, and salt. They will be baked at 158°C for 20 minutes. The process involves the addition of 20% Golden Rice and 10% P. crocatum ethanol extract, both prepared via maceration with 96% ethanol. The dependent variable in this study is the expression of gelatinases matrix metalloproteinase, to be assessed at 2 distinct time points-preintervention (pretest) and postintervention (posttest)-with the evaluation conducted through the western blotting method. RESULTS: The recruitment and testing phase started in January 2024. The study is scheduled to be completed by the end of March 2024. Data analysis will commence in April 2024, and the publication of the results is anticipated in the same year (2024). The study will report on the changes in primary data, encompassing gelatinases matrix metalloproteinase, as well as secondary data, including the ankle-brachial index, neuropathy score, and random blood glucose level. CONCLUSIONS: The findings of this trial are expected to significantly impact the selection of strategies by health care practitioners to enhance diabetes self-management, particularly in the domain of therapeutic snacking, for patients diagnosed with diabetes mellitus. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20230502001; https://www.thaiclinicaltrials.org/show/TCTR20230502001. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/49940.

Topical Cream Derived From Hylocereus polyrhizus (Red Dragon Fruit) Extract Accelerates Wound Healing Through Increased Hydroxyproline and Fibroblast Growth Factor 2 Levels: A Pilot Study.

The red dragon fruit (Hylocereus polyrhizus) extract (RDFE) is frequently used for a variety of therapeutic purposes (e.g., boosting the immune system, promoting a healthy gastrointestinal system, improving wound healing). We investigated the effects of a topical cream containing 7.5% RDFE on hydroxyproline and fibroblast growth factor 2 (FGF-2) levels and wound healing. On Day 0, we divided a total of 36 albino male Wistar rats into two equal groups. Using an 8-mm punch biopsy, we created a circular excision to fascial depth on the back of each rat. On Day 1, we treated the control group (n = 18) with 20 mg of base cream and the RDFE group (n = 18) with 20 mg of 7.5% RDFE cream. We measured hydroxyproline and FGF-2 levels in the wound tissue using an ELISA method on Days 3, 7, and 14. We found that on Day 3, hydroxyproline levels were significantly lower in the treatment group than in the control group (p = .031). We also found a significant correlation between FGF-2 levels in the treatment group and wound diameter (p = .02). On the basis of the results of this study, we concluded that using a topical cream containing 7.5% RDFE has the potential to accelerate wound healing by increasing levels of hydroxyproline and FGF-2 in the wound.

Moral distress among nurses in caring COVID-19 patients.

During the COVID-19 pandemic, nurses experienced tremendous dilemmas including the need to perform their duties in caring for patients while they have concerns about contracting the disease. This study described the moral distress of nurses in-charge of handling COVID-19 patients which can be used as baseline data for intervention programs in overcoming moral distress among nurses. This descriptive, cross-sectional study was conducted with nurses in-charge of handling COVID-19 treatment rooms. Before conducting the survey, ethical approval was obtained from the Medical Faculty of Universitas Hasanuddin. Questionnaires on moral distress for clinical nurses and the demographic data questionnaire were distributed to 128 respondents. These nurses experienced relatively low levels of moral distress despite the fact that they were generally exposed to morally stressful situations. Education background appeared as a factor influencing this condition, in which higher moral distress was mostly experienced by nurses with undergraduate education.

Massage with lavender aromatherapy reduced sleep disturbances on infant

OBJECTIVE: To determine the effectiveness of lavender aromatherapy's massage on reducing sleep disturbances in infants. METHOD: a pre-experimental one group pre-posttest design involving thirteen infants aged 6-12 months who were selected purposively with criteria having sleep disturbances. Massage is given for 30min in three consecutive days by using two drops of oil lavender aromatherapy mixed in 50ml of oil-based. Data collection used a valid and reliable questionnaire, which is Sleep Disturbances Scale in Children (SDSC), one day before and after the intervention. Data were analyzed using the Wilcoxon Test. RESULTS: Massage using lavender aromatherapy is effective in reducing sleep disturbances in infants especially in the dimension of starting and maintaining sleep, somnolence disorders, and interruption of wakefulness sleep transition dimension (p < 0.001). CONCLUSIONS: Massage with Lavender aromatherapy is recommended as an alternative intervention to reduced sleep disturbances on infants aged 6-12 months

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