Journal of Diverse Medical Research: Medicosphere

Association between Gender and Occupation with Hypercholesterolemia Risk among Hypertension Population: A Cross-sectional Study

2025-09-23T03:23:01+00:00

Metabolic syndrome is one of the major global health problems. Hypertension and hypercholesterolemia are indicators in the diagnosis of metabolic syndrome. However, the analysis of the relationship between risk factors for hypercholesterolemia in the hypertensive population needs further study. This study aims to analyze the risk factors for hypercholesterolemia in hypertensive patients. This cross-sectional study was conducted at Depok 2 Community Healthcare Center with a focus on adult hypertensive patients. The results of blood pressure measurements, total cholesterol examinations, and participant characteristics were then analyzed using the Chi-Square test. 117 hypertensive patients were analyzed in this study with the majority being women (60.7%), elderly (70.1%), and household-based occupancy (70.1%). The majority of participants were diagnosed with grade I hypertension (53.8%) and hypercholesterolemia (59%). Women have higher risk of developing hypercholesterolemia than men (OR 3.38 (95% CI 1.555 – 7.361); p = 0.002), and non-household based occupancy were protective factor from hypercholesterolemia (OR 0.327 (95% CI 0.144 – 0.742); p = 0.008). Gender and occupation are risk factors for hypercholesterolemia in the hypertensive population. Education at the household level is needed for early detection of the risk of metabolic syndrome in the general population.

Opioid-Sparing and Multimodal Analgesia in Cesarean Delivery: A Systematic Review of Evidence and Implementation Across High and Low-Middle Income Countries

2025-10-06T01:57:11+00:00

ABSTRACT

Introduction: Cesarean delivery is a common surgical procedure worldwide, often accompanied by significant postoperative pain that can negatively impact recovery, early breastfeeding, and maternal mobility. Opioids have traditionally been central to post-cesarean analgesia but are associated with side effects such as nausea, vomiting, pruritus, sedation, and respiratory depression. Recently, opioid-sparing and multimodal analgesia strategies—combining neuraxial opioids, regional blocks (e.g., transversus abdominis plane [TAP] block), and non-opioid systemic agents (NSAIDs, acetaminophen)—have been increasingly adopted to reduce opioid consumption while maintaining effective analgesia.

Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published from January 2021 to August 2025. Eligible studies included randomized controlled trials, cohort studies, and quality improvement projects evaluating opioid-sparing multimodal analgesia in women undergoing cesarean delivery in both high-income countries (HICs) and low- and middle-income countries (LMICs). Primary outcomes were postoperative opioid consumption and pain scores; secondary outcomes included opioid-related side effects, recovery milestones, maternal satisfaction, and neonatal safety. Data extraction and quality assessment were performed independently by two reviewers following PRISMA 2020 guidelines.

Discussion: The review included nine studies from diverse settings. Multimodal analgesia regimens consistently reduced opioid consumption and pain scores, improved maternal satisfaction, and decreased opioid-related adverse effects. Regional techniques such as TAP block were effective adjuncts or alternatives to neuraxial opioids, especially in LMICs where opioid availability and monitoring are limited. Adoption of multimodal protocols was more widespread in HICs, often integrated within enhanced recovery after cesarean (ERAC) pathways. Barriers in LMICs included limited regional anesthesia expertise, drug availability, cost, and institutional protocols, highlighting the need for capacity building and context-specific guidelines.

Conclusion: Opioid-sparing multimodal analgesia is effective, safe, and feasible across various healthcare settings, improving postoperative pain control and recovery after cesarean delivery. Addressing implementation gaps between HICs and LMICs through training, resource allocation, and simplified protocols is essential to optimize global obstetric analgesia. Future research should focus on standardizing regimens, evaluating long-term maternal and neonatal outcomes, and overcoming implementation challenges to facilitate broader adoption.

The Role Of Motility And Gastric Acid Secretion in The Pathophysiology of Gastroesophageal Reflux Disease (GERD)

2025-10-06T01:59:14+00:00

Introduction: Gastroesophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract that involves a complex interaction between physiologic and pathologic factors. The two main components that play a role in this dynamic are gastric motility and acid secretion.

Methods: This review used a narrative literature review approach by searching the current scientific literature from various databases between 2015-2024.

Discussion: Normal gastric motility maintains gastric emptying efficiency and lowers the risk of reflux, while disorders such as delayed gastric emptying increase intragastric pressure and trigger reflux. Excessive secretion of gastric acid, especially HCl and pepsin, amplifies the aggressive nature of gastric contents and exacerbates damage to the esophageal mucosa. These two aspects interact to create an imbalance between protective and aggressive factors in GERD.

Conclusion: The interplay between gastric motility and acid secretion plays a key role in the transition from physiologic to pathologic mechanisms in GERD, so a thorough understanding of both is important in diagnosis and treatment strategies.