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  1. Poerwosusanta H, Aditia D, Gunadi, Halim PG, Yuliana M
    Med J Malaysia, 2024 Aug;79(Suppl 4):77-82.
    PMID: 39215420
    INTRODUCTION: Congenital diaphragmatic hernia (CDH) is a failure of closure of the pleuro-peritoneal canal due to faulty embryogenesis caused herniation of intra-abdominal contents into the chest. There needs to be more clarity about the optimal surgical timing for CDH. The aim of this study is to determine the optimal surgical timing for CDH using a systematic review analysis.

    MATERIALS AND METHODS: Our study used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. The literature search approach used publications between 2013 and 2023 using Pubmed and SagePub databases. Studies were included if they contained reports of the best timing for emergency surgery for CHD repair. We did not include review articles and unpublished data.

    RESULTS: Five articles met the criteria. The overall result, the first pre-operative 24-hour oxygenation index mean, was temporally reliable and representative (intraclass correlation coefficient = 0.70, 95% CI = 0.61-0.77). Within any severity level, there were no differences in 90-day survival or mortality rate between delayed repair and early repair (p = 0.002). As a result, there is no optimal timing for surgery in severe cases of CDH. A delay in repair did not predict an increased risk of death, nor did it suggest an increased need for post-operative extracorporeal membrane oxygen therapy.

    CONCLUSION: Regardless of the severity of the illness, the timing of CDH repair does not affect the mortality rate.Surgery is done after the physiology index achievement.

  2. Dalimunthe A, Carensia Gunawan M, Dhiya Utari Z, Dinata MR, Halim P, Estherina S Pakpahan N, et al.
    Front Pharmacol, 2024;15:1461478.
    PMID: 39605919 DOI: 10.3389/fphar.2024.1461478
    Lupeol, a naturally occurring lupane-type pentacyclic triterpenoid, is widely distributed in various edible vegetables, fruits, and medicinal plants. Notably, it is found in high concentrations in plants like Tamarindus indica, Allanblackia monticola, and Emblica officinalis, among others. Quantitative studies have highlighted its presence in Elm bark, Olive fruit, Aloe leaf, Ginseng oil, Mango pulp, and Japanese Pear bark. This compound is synthesized from squalene through the mevalonate pathway and can also be synthetically produced in the lab, addressing challenges in natural product synthesis. Over the past four decades, extensive research has demonstrated lupeol's multifaceted pharmacological properties, including anti-inflammatory, antioxidant, anticancer, and antibacterial effects. Despite its significant therapeutic potential, clinical applications of lupeol have been limited by its poor water solubility and bioavailability. Recent advancements have focused on nano-based delivery systems to enhance its bioavailability, and the development of various lupeol derivatives has further amplified its bioactivity. This review provides a comprehensive overview of the latest advancements in understanding the pharmacological benefits of lupeol. It also discusses innovative strategies to improve its bioavailability, thereby enhancing its clinical efficacy. The aim is to consolidate current knowledge and stimulate further research into the therapeutic potential of lupeol and its derivatives.
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