Kumboyono Kumboyono

Purpose: Young adult smokers represent a population in which smoking-related health risks may accumulate silently before the onset of clinically apparent disease. Although smoking-related changes in malondialdehyde (MDA) and superoxide dismutase (SOD) have been widely reported, less is known about their combined oxidant–antioxidant pattern in apparently healthy young adults during the early smoking trajectory. This study aimed to compare serum MDA and SOD levels between young adult smokers and non-smokers and to evaluate the MDA–SOD interplay as a marker of early redox imbalance. Patients and Methods: A comparative cross-sectional study was conducted involving 190 participants aged 18– 25 years, comprising 95 smokers and 95 non-smokers recruited from university communities. Smoking exposure was assessed using structured interviews and quantified by the Heaviness of Smoking Index and serum cotinine level. Serum MDA, SOD, and cotinine levels were measured using enzyme-linked immunosorbent assay methods. Group comparisons were performed using appropriate parametric or non-parametric tests, and associations between oxidative stress biomarkers were analysed using Spearman and Pearson correlation. Results: Smokers exhibited significantly higher serum MDA concentrations than non-smokers [median 3.28 nmol/mL (range, 1.75– 5.89) vs 2.27 nmol/mL (range, 0.99– 5.83); p < 0.001] and significantly lower SOD activity (132.4 ± 26.7 vs 158.3 ± 29.1 U/L; p < 0.001). Across all participants, serum cotinine was positively associated with MDA (Spear man’s ρ = 0.576, p < 0.001) and inversely associated with SOD (Pearson’s r = − 0.518, p < 0.001). MDA was also inversely associated with SOD (Spearman’s ρ = − 0.318, p < 0.001). These findings indicate a measurable oxidant–antioxidant imbalance associated with biochemical tobacco exposure in young adults. Conclusion: Young adult smokers exhibit early oxidant–antioxidant imbalance indicative of subclinical biological vulnerability associated with smoking exposure. These findings highlight the relevance of the MDA–SOD redox interplay as a biologically coherent marker pair for assessing early smoking-related redox disturbance in young adults.

Introduction: Introduction: Nicotine dependence remains a major global public health challenge, with relapse remaining high despite the availability of conventional cessation therapies. In traditional medicine, lemongrass (Cymbopogon citratus) has been widely used for calming, respiratory, and stress-related conditions, and modern evidence suggests that citral, its primary phytochemical, may modulate nicotinic acetylcholine receptors (nAChRs) involved in nicotine addiction. These properties provide a biological and traditional rationale for investigating lemongrass inhalation as a supportive intervention to reduce dependence. This study aims to evaluate the efficacy of a 3% lemongrass essential oil inhaler in reducing nicotine dependence through modulation of nAChRs. methods: A randomized, pretest-posttest controlled group design was conducted involving 100 adult smokers (aged 18–30 years) with moderate-to-high nicotine dependence (FTND ≥ 5). Participants were allocated to receive either a 3% lemongrass inhaler or a placebo, administered four times daily for eight weeks. The primary outcomes were changes in FTND scores and serum nAChRs levels measured using ELISA. ANCOVA was used to assess treatment effects while controlling for demographic covariates. results: The lemongrass group demonstrated significantly greater reductions in FTND scores (mean difference = 2.3; p < 0.001) and serum nAChRs levels (mean difference = 0.6 ng/mL; p = 0.003) compared with placebo. After adjustment for baseline FTND and demographic covariates, ANCOVA confirmed a large treatment effect (partial η² = 0.390). Multivariable logistic regression further demonstrated that participants receiving lemongrass inhalation had significantly lower adjusted odds of remaining highly nicotine-dependent after the intervention. discussion: These findings show that lemongrass inhalation significantly reduces both subjective dependence levels and biological markers associated with nicotine addiction, consistent with traditional medicinal uses and mechanistic evidence for the interaction of citral with nAChRs. conclusion: This natural and accessible intervention may serve as an effective adjunct to smoking- cessation strategies and warrants further long-term evaluation.

Introduction: Sleep disturbances are common among smokers, largely due to nicotine- induced circadian rhythm disruption, REM suppression, and withdrawal-related hyperarousal. Lemongrass (Cymbopogon citratus), rich in citral and geraniol, exhibits sedative and anxiolytic properties through modulation of γ-aminobutyric acid type A (GABA-A) receptors, suggesting potential as a safe phytopharmacological intervention. To evaluate the efficacy of a lemongrass aromatherapy inhaler in improving sleep quality and reducing nicotine dependence among smokers. methods: A randomized, placebo-controlled, pretest–posttest trial was conducted with 100 smokers (aged 18–30 years) presenting poor sleep quality (PSQI >5) and moderate–high nicotine dependence (FTND ≥5). Participants were randomized into an intervention group receiving a 3% lemongrass essential oil inhaler and a placebo group receiving sunflower oil, both administered four times daily for 60 days. Sleep quality (Pittsburgh Sleep Quality Index, PSQI) and nicotine dependence (Fagerström Test for Nicotine Dependence, FTND) were assessed pre- and postintervention. Data were analyzed using ANCOVA and path analysis, with ANCOVA adjusting for baseline outcome values (pre-intervention PSQI/FTND). results: The intervention significantly improved sleep quality (PSQI: 7.84 → 4.42) compared with controls (7.68 → 7.54; p < 0.001). Nicotine dependence also decreased in the intervention group (FTND: 7.36 → 5.02) but remained unchanged in controls (p < 0.001). discussion: Path analysis showed that the intervention had a significant direct association with post-intervention PSQI, whereas the indirect effect through post-intervention FTND was not significant. conclusion: Lemongrass (Cymbopogon citratus) inhalation significantly improved sleep quality among smokers, likely through the neuromodulatory effects of citral and geraniol. However, replication in older age groups and across diverse smoking histories is needed to establish broader applicability.

Heart failure is a chronic condition associated with high morbidity and frequent hospital readmissions, requiring effective self-management strategies. Therapeutic adherence and somatic symptom perception are essential components of self-management, enabling early symptom recognition and timely intervention. However, evidence regarding the relationship between these two factors remains limited. This scoping review aimed to map current evidence on the relationship between therapeutic adherence and somatic symptom perception in patients with heart failure and to identify influencing factors. The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Literature searches were conducted in ProQuest, ScienceDirect, Springer, and Google Scholar for studies published between 2016 and 2025. Eligible studies involved adult patients with heart failure and assessed therapeutic adherence and somatic symptom perception using validated instruments. Eight studies were included, comprising four cross-sectional studies, three randomized controlled trials, and one quasi-experimental study. Findings indicated a positive association between adherence to self-care behaviors and improved somatic symptom perception. Patients with consistent symptom monitoring demonstrated better recognition of early deterioration signs. However, a greater symptom burden was associated with lower adherence in several studies. Integrating symptom perception training, motivational strategies, and caregiver involvement may improve adherence, enhance early symptom detection, and reduce hospital readmissions.

Nursing care plays an important role in supporting postoperative recovery and optimizing clinical outcomes in patients undergoing Open Reduction and Internal Fixation (ORIF). However, nursing interventions that support bone healing in this population have not been comprehensively mapped. This scoping review aimed to identify and map nursing interventions that support bone healing and postoperative recovery in patients undergoing ORIF. Literature searches were conducted in PubMed, ScienceDirect, ProQuest, and Google Scholar using keywords based on the Population–Concept–Context (PCC) framework for studies published between 2015 and 2025. Article screening and selection were conducted using predefined inclusion and exclusion criteria in accordance with the PRISMA-ScR guidelines. Data from the included studies were extracted, categorized, and synthesized thematically. A total of 20 studies were included in this review. The findings demonstrated that nursing interventions could be classified into four major domains: observational, therapeutic, educational, and collaborative interventions. Frequently reported interventions included pain management, early mobilization and rehabilitation support, clinical monitoring, health education, discharge planning, nutritional support, and multidisciplinary collaboration. The reviewed studies suggested that these interventions were associated with improved postoperative clinical outcomes, including reduced pain and complications, enhanced mobility and functional recovery, improved self-care ability, and better quality of life. However, most studies evaluated indirect clinical outcomes rather than direct radiographic indicators of bone healing. Further research is needed to evaluate the effectiveness of specific nursing interventions on radiographic bone healing outcomes across different fracture types and patient populations.

To examine simultaneous alterations in nitric oxide (NO), malondialdehyde (MDA), nicotinic acetylcholine receptors (nAChRs), and cotinine levels in smokers compared with non-smokers, and to clarify early mechanistic pathways linking tobacco exposure with vascular-related and oxidative stress. A cross-sectional study was conducted among 200 adults (100 smokers, 100 non-smokers) meeting predefined eligibility criteria and free from major cardiometabolic disease. Venous blood samples were analyzed for NO, MDA, nAChRs, and cotinine using standardized ELISA methods. Anthropometric and hemodynamic measurements were obtained using validated procedures. Group differences were assessed using independent t-tests and chi-square tests. Correlations were evaluated using Pearson or Spearman coefficients. Multivariable linear regression models adjusted for age, BMI, systolic and diastolic blood pressure to determine the independent association of smoking with biomarker profiles. Smokers demonstrated significantly lower NO levels (70.22 ± 9.54 vs 198.27 ± 13.85 µmol/L; p < 0.001) and markedly higher concentrations of MDA (39.48 ± 4.54 vs 19.72 ± 5.32 nmol/mL; p < 0.001), nAChRs (20.19 ± 3.25 vs 12.05 ± 2.13 ng/mL; p < 0.001), and cotinine (61.07 ± 8.84 vs 4.99 ± 1.95 pg/mL; p < 0.001). After adjustment, smoking remained a strong independent predictor of reduced NO (β = −128.29; p < 0.001) and elevated MDA (β = 19.89; p < 0.001), nAChRs (β = 8.03; p < 0.001), and cotinine (β = 55.50; p < 0.001). These findings indicate persistent oxidative, nitrosative, and receptor-mediated biochemical disturbances associated with smoking, irrespective of baseline physiological differences. Smokers exhibit a distinct biochemical pattern characterized by reduced NO bioavailability, heightened oxidative stress, increased nAChR activation, and elevated cotinine levels. These alterations reflect early vascular-related biochemical disturbances associated with smoking and support the utility of these biomarkers for early cardiovascular risk detection.

Cigarette smoking is a major contributor to health problems worldwide and is highly prevalent in Indonesia, especially among young adult males. Nicotine in cigarettes disrupts lipid metabolism, leading to increased triglyceride levels and dyslipidemia, which are closely related to the double nutrition problem, characterized by abnormalities in the lipid profile. Smoking induces these abnormalities, indicating the need for antioxidant administration. This study aims to investigate the effect of Polysaccharide Peptides from Ganoderma lucidum on lowering triglycerides lipid profile level in active smokers with dyslipidemia. This experimental study used a pretest-posttest control group design involving 28 active smokers aged 18-21 years with dyslipidemia. Subjects were assigned to either a polysaccharide peptide (PsP) therapy group, receiving PsP extracted from Ganoderma lucidum, or a control group. Fasting serum triglyceride concentrations were measured before and after treatment. Statistical analyses used paired and unpaired t-tests to assess triglyceride level changes. The results showed a significant lowering of triglyceride levels in the PsP-treated group (p= 0.006). While the difference before and after PsP administration reached marginal statistical significance (p= 0.059), clinical improvement in triglyceride profiles was observed compared to controls. In conclusion, Ganoderma lucidum-derived PsP lowers triglyceride lipid profiles in smokers with dyslipidemia. These findings support the use of PsP as a therapeutic herbal intervention to improve lipid metabolism disturbed by smoking-induced inflammation.