Probiotic for health jurnal presentation nursing departement

PROBITIK

1. The future starts today, not tomorrow. www.umy.ac.id School of Nursing Medical Faculty and Health Sciences Universitas Muhammadiyah Yogyakarta Titik Puspari ( 20244030016) Tiara Alvin Azizah P ( 20244030097 ) Zalfa Mufidha F N (20244030049) JOURNAL RESUME OF THE USE OF PROBIOTICS TO TREAT DIARRHEA

2. The Power of PowerPoint - thepopp.com 2 The Power of PowerPoint - thepopp.com 2 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL Citation Wang, Y., Chen, N., Niu , F., Li, Y., Guo, K., Shang, X., Fenfen , E., Yang, C., Yang, K., & Li, X. (2022). Probiotics therapy for adults with diarrhea -predominant irritable bowel syndrome: a systematic review and meta-analysis of 10 RCTs. International Journal of Colorectal Disease, 37(11), 2263–2276. https://doi.org/10.1007/s00384-022-04261-0   Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with over 23% prevalence worldwide. It is divided into four subtypes: constipation-predominant IBS (IBS-C), diarrhea -predominant IBS (IBS-D), mixed IBS (IBS-M), and unclassified IBS (IBS-U). IBS-D, the most common subtype, is characterized by frequent diarrhea accompanied by abdominal distension or abdominal pain. It accounts for about one-third of total IBS cases and significantly affects patients' quality of life and contributes to the economic burden. The etiology and pathogenesis of IBS-D are still unclear, but studies suggest it is associated with dysbiosis of the gut microbiota, visceral hypersensitivity, stress, genetics, diet, and psychosocial factors. Current treatments include alosetron hydrochloride, selective M3 receptor antagonists, loxiglumide , somatostatin, oxytocin, tachykinin, antispasmodics, antimotility drugs, and anti-depressants. Probiotics, which can prevent recurrent pouchitis and Clostridioides difficile diarrhea , have been shown to be beneficial for IBS patients. SUPPORTING JOURNAL 2 SUPPORTING JOURNAL 1 MAIN JOURNAL SUPPORTING JOURNAL 3

3. The Power of PowerPoint - thepopp.com 3 The Power of PowerPoint - thepopp.com 3 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL SUPPORTING JOURNAL 2 Research question   Is probiotic therapy effective and safe for the treatment of IBS-D? Study design a systematic review and meta-analysis Time & setting This meta-analysis included the RCTs published between 2003 and 2021 with a total of 943 patients, including 483 in the intervention group and 460 in the control group. The sample sizes of included studies varied from 24 to 360 with the intervention duration ranging from 4 to 16 weeks. These studies were conducted in China (2/10), South Korea (2/10), the USA (2/10), Poland (2/10), Bangladesh (1/10), and Pakistan (1/10) Sample Eight electronic databases, namely PubMed, Web of Science,The Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang Data, were searched as well as gray literature as a supplementary search to identify and collect RCTs on probiotics therapy for IBS-D. all from the time of database inception to August 4, 2021, without restrictions in terms of publication type and language. MAIN JOURNAL SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3

4. The Power of PowerPoint - thepopp.com 4 The Power of PowerPoint - thepopp.com 4 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL SUPPORTING JOURNAL 2 Instrument Randomized controlled trials (RCTs) of probiotics therapy for the treatment of IBS-D were included and the quality was assessed using the risk of bias tool recommended by the Cochrane Handbook version 5.1.0.Meta-analysis was performed using RevMan 5.4 software. Procedure     Two researchers independently screened the literature and extracted the data. Any disagreement between them was resolved by consensus after discussion, or consultation with a third researcher. A pre-designed table was used to extract the data. The general data extracted from the studies were as follows: (a) basic characteristics, such as first author, publication year, study country, the sample size of the intervention and control groups, and duration of treatment; (b) general demographic characteristics, including age and gender; (c) T types and doses of probiotics; (d) primary and secondary outcomes as described in the inclusion criteria; and (e) risk of bias assessment. The assessment criteria included the following seven components: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other biases. The quality of evidence, relating to the specific outcomes, was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system. The summary of findings was tabularized, including five factors: risk of bias, inconsistency, imprecision, indirectness, and publication bias. The evidence certainty was classified as high, moderate, low, or very low. Statistical heterogeneity was analyzed for the included studies. MAIN JOURNAL SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3

5. The Power of PowerPoint - thepopp.com 5 The Power of PowerPoint - thepopp.com 5 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL SUPPORTING JOURNAL 2 Data analysis Meta-analysis was performed using RevMan 5.4 software. Statistical heterogeneity was analyzed for the included studies.The continuous data are generally presented as weighted mean differences (WMDs). However, in this study, the mean difference between the included studies was large; therefore, the standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used. The dichotomous data were expressed as relative risks (RRs) with 95% CIs. The statistical heterogeneity was evaluated using the I-square (I2) statistical test. In the case of significant heterogeneity(I2 > 50%, P < 0.05), the random effect model was adopted, and a fixed effect model was used for the studies having non-significant heterogeneity [44, 45]. In addition, the subgroup analyses based on the species and strains of probiotics were also performed. The sensitivity analyses were performed using RevMan 5.4 to check the stability of the results and determine the specific effects of omitting an individual study on the results. Finally, funnel plots were used to assess publication bias when the number of the included studies for an outcome was more than 10 . Results With very low certainty evidence, probiotics therapy could effectively improve the IBS-D symptoms in the IBS-D patients as compared to the placebo group. Combination probiotics might be more effective in improving IBS-D symptoms, abdominal pain, abdominal distension, and satisfaction with bowel habits; however, their effects on quality of life, stool frequency, and flatulence remain unclear. Therefore, high-quality RCTs are needed to further validate the effectiveness of confirmed strains for the treatment of IBS-D. Future studies should focus more on the different aspects of probiotics. MAIN JOURNAL SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3

6. The Power of PowerPoint - thepopp.com 6 The Power of PowerPoint - thepopp.com 6 BAB 1 JOURNAL PRESENTATION SUPPORTING JOURNAL 1 REVIEW CRITICAL MAIN JOURNAL Whether study Revelation with practice at the time This? Yes , we think the research is relevant to the nursing practice and issues we raise . Because the condition of the digestive tract is not good and requires a balance of good bacteria . help is needed from probiotics given from hospital care . The administration of these probiotics helps in the treatment and improvement of the patient's digestive tract function . Whether study can be applied in case study setting the ? Yes can , in patients our management which has problem nursing diarrhea Where patient still having difficulty controlling fecal elimination . The good bacteria in probiotics help balance his digestive condition , thus reducing the frequency of diarrhea . SUPPORTING JOURNAL 2 SUPPORTING JOURNAL 3

7. The Power of PowerPoint - thepopp.com 7 The Power of PowerPoint - thepopp.com 7 BAB 1 JOURNAL PRESENTATION SUPPORTING JOURNAL 1 REVIEW CRITICAL MAIN JOURNAL How method application results study in article to the research setting at the time This? How to apply that is with method assisting patients in meeting their oral fluid intake by collaborating with probiotics . For example , lacto b or other types available in the hospital. What the benefits and risks that occur If results study applied in practice moment This? Benefits gained​ in application study This Already proven effective performed on patients with health conditions in critical or normal rooms for both adults and children as described in the supporting journal . Application study This No own risks , and proven safe in helping improve digestive conditions in patients . SUPPORTING JOURNAL 2 SUPPORTING JOURNAL 3

8. The Power of PowerPoint - thepopp.com 8 The Power of PowerPoint - thepopp.com 8 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL Citation Alsuwaylihi , A.S., & McCullough , F. (2023). The safety and efficacy of probiotic supplementation for critically ill adult patients : a systematic review and meta- analysis . Nutrition reviews , 81(3), 322–332. https://doi.org/10.1093/nutrit/nuac059   Background Poor nutritional and digestive conditions in patients can be a new health problem in patient care in hospitals . The stomach or gastrointestinal tract has an immunoregulatory role that is influenced by the immune system in the intestines . Certain health conditions cause changes in the microbiome in the digestive tract where good bacteria are lower than harmful bacteria . Changes in microbiome cause improvement gastrointestinal dysmotility , and this cause more Lots complications i. Probiotics are one form of assistance to stabilize the condition of the digestive tract in patients undergoing treatment in hospital. Research question   Are probiotics safe to help improve barrier function in the digestive tract ? Study design a systematic review and meta- analysis SUPPORTING JOURNAL 2 SUPPORTING JOURNAL 1 MAIN JOURNAL SUPPORTING JOURNAL 3

9. The Power of PowerPoint - thepopp.com 9 The Power of PowerPoint - thepopp.com 9 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL Time & setting The researchers do search comprehensive literature relevant using databases such as PubMed and the Cochrane Library, with focus on published studies​ between 2011 and 2020. Sample The researchers use Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for do search comprehensive to relevant studies . They​ look for two scientific databases , PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL), for trials controlled published randomized controlled trials (RCT) between 2011 and 2020. Search the includes related keywords​​ with sick patient​ critical and probiotics . Instrument The meta-analysis was conducted using Review Manager ( RevMan ) software Procedure     Review the includes trials​ randomized controlled trials (RCT) evaluating effect probiotics on results like mortality , ICU -acquired infections , and diarrhea in patients sick adult​ critical ( both those using ventilators and those not) using a ventilator). Study excluded If No use Language English , no report expected results , involving​ synbiotic or prebiotics , or No conducted in adult ICU patients . Data from selected studies​ extracted in a way systematically , with focus on results main related​ with efficacy and safety probiotics . This covers information about level infection , mortality , and incidence diarrhea . SUPPORTING JOURNAL 2 MAIN JOURNAL SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3

10. The Power of PowerPoint - thepopp.com 10 The Power of PowerPoint - thepopp.com 10 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL Data analysis write use Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for extract data from studies elected . They analyze related results​ with ICU - acquired infections , incidents diarrhea , and levels death . Efficacy probiotics evaluated with compare incident ICU - acquired infections and outcomes other between group probiotics and control . Ratio risk and confidence interval counted For determine significance findings . Results Intervention of probiotic administration is a safe intervention in patient care . Prebiotic administration can reduce the incidence of infection and reduce the frequency of diarrhea . SUPPORTING JOURNAL 2 MAIN JOURNAL SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3

11. The Power of PowerPoint - thepopp.com 11 The Power of PowerPoint - thepopp.com 11 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL SUPPORTING JOURNAL 2 REVIEW CRITICAL SUPPORTING JOURNAL 1 Cititaion Huang, R., Xing, H. Y., Liu, H. J., Chen, Z. F., & Tang, B. B. (2021). Efficacy of probiotics in the treatment of acute diarrhea in children: a systematic review and meta-analysis of clinical trials. Translational Pediatrics, 10(12), 3248–3260. Background If acute diarrhea in children is not treated promptly and effectively, it can lead to severe dehydration and serious sequelae. Due to the imbalance of intestinal bacteria in children with acute diarrhea, the supplementation with probiotics is important, which can improve the intestinal microenvironment, promote immunity, and enhance resistance. This meta-analysis provides further evidence and discussion of the therapeutic effect of probiotics on acute diarrhea in children. Research Question   Is the use of probiotics effective in treating diarrhea  in children? SUPPORTING JOURNAL 3

12. The Power of PowerPoint - thepopp.com 12 The Power of PowerPoint - thepopp.com 12 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL SUPPORTING JOURNAL 2 REVIEW CRITICAL SUPPORTING JOURNAL 1 Study design The systematic review and meta-analysis Time and setting January 2010 to September 2020 Sample All participants were children over 6 months of age and under 10 years of age who had acute diarrhea. Children were included if the duration of diarrhea had lasted 3 days, the changes in stool frequency and consistency met the definition of acute diarrhea, there was thinning of stool consistency, and there were more than three watery stools within 24 hours. Children with malnutrition, bloody stools, meningitis, sepsis, or pneumonia infections were excluded, as well as those whose diarrhea was caused by antibiotic use or who had used antibiotics as the primary treatment. Instrumen Numerous randomized controlled trials (RCTs) SUPPORTING JOURNAL 3

13. The Power of PowerPoint - thepopp.com 13 The Power of PowerPoint - thepopp.com 13 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL SUPPORTING JOURNAL 2 REVIEW CRITICAL SUPPORTING JOURNAL 1 Procedure Studies were required to include a comparison of two groups of patients (experimental and control groups) where both groups of patients were given basic supportive treatment, such as oral rehydration solution and zinc supplementation, but the experimental group was additionally given probiotic additives, including single probiotics or combined probiotics and synbiotics. Data Anslysis Safety analysis None of the 12 included articles reported serious adverse effects that were significantly related to the intervention method. Sensitivity analysis The sensitivity analysis showed that the study results of 10 articles had similar distributions on both sides and good stability. Analysis of publication bias The funnel plot of the analysis of diarrhea rate indicators after 2 days of treatment showed that the left and right distributions of the six articles were asymmetric, suggesting that there may be publication bias, as shown. The results from the three subgroups showed that probiotics significantly reduced the duration of diarrhea symptoms in children. SUPPORTING JOURNAL 3

14. The Power of PowerPoint - thepopp.com 14 The Power of PowerPoint - thepopp.com 14 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL SUPPORTING JOURNAL 2 REVIEW CRITICAL SUPPORTING JOURNAL 1 Discussion In the treatment of acute diarrhea in children, the addition of probiotics can shorten the duration of diarrhea, increase treatment efficacy after 2 days of treatment, and shorten the length of hospital stay. However, because of possible publication bias in the current study, further high-quality RCT studies in clinical settings are needed to verify the current results and continue the exploration of this topic. Result Twelve articles with 744 patients were included in the study, and the overall quality of the articles was excellent. Meta-analysis showed that the duration of diarrhea in the probiotics group was shorter than that in the control group [standard mean difference (SMD) =−0.74, 95% CI: −1.11 to −0.37, Z=−3.935, P=0.000], the 2-day treatment efficacy for diarrhea in the probiotics group was greater than that in the control group [odds ratio (OR) =2.12, 95% CI: 1.47–3.05, Z=3.998, P=0.000], and the length of hospital stay in the probiotics group was shorter than that of the control group (SMD =−0.60, 95% CI: −0.74 to −0.47, Z=−8.781, P=0.000). In the subgroup analysis, combined probiotics shortened the duration of diarrhea compared with single probiotic use, and Lactobacillus reuteri and Saccharomyces boulardii had a better therapeutic effect than Lactobacillus rhamnosus or Lactobacillus acidophilus. SUPPORTING JOURNAL 3

15. The Power of PowerPoint - thepopp.com 15 The Power of PowerPoint - thepopp.com 15 BAB 1 JOURNAL PRESENTATION REVIEW CRITICAL Citation Arif , R.N.A., Mardhiyah , A., & Mediani , H.S. (2023). Effectiveness of Probiotic Yogurt on Diarrhea Incidence in Pre-School Children. Jurnal Obsesi : Jurnal Pendidikan Anak Usia Dini, 7(2), 1934–1948.https://doi.org/10.31004/OBSESI.V7I2.4221 Background Diarrhea is the second most common disease in children. Most of the treatment of diarrhea only focuses on treating dehydration, but reducing frequency of diarrhea is not yet clear. So one of the complementary therapies is to use probiotic yogurt. SUPPORTING JOURNAL 2 SUPPORTING JOURNAL 1 SUPPORTING JOURNAL 3 MAIN JOURNAL Research Question Is probiotic yogurt effective for acute diarrhea in children?

16. The Power of PowerPoint - thepopp.com 16 The Power of PowerPoint - thepopp.com 16 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL REVIEW CRITICAL SUPPORTING JOURNAL 1 Study design The systematic review Sample The research sample was pediatric patients under 12 years of age experiencing acute diarrhea, the interventions provided were administration of probiotic bacterial strains and yogurt, articles written in English and full text. The results of the literature search determined 10 articles. There were 8 articles found which stated that giving probiotic bacteria and yogurt containing probiotics and plain yogurt (non-probiotics) was able to reduce the frequency, duration and prevention of diarrhea in children. Instrumen This study uses a systematic literature review method and uses the PRISMA (Preferred Reporting Items for Systematic Review and Meta Analyses) guidelines. Article search strategy through databases, namely PubMed, CINAHL, EBSCO and ScienceDirect. SUPPORTING JOURNAL 3 SUPPORTING JOURNAL 2

17. The Power of PowerPoint - thepopp.com 17 The Power of PowerPoint - thepopp.com 17 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL REVIEW CRITICAL SUPPORTING JOURNAL 1 Procedure To determine the eligibility of an article to be reviewed systematically, the PICOS format is needed to determine the inclusion criteria and exclusion criteria in the article. To reduce the risk of bias in this review, a critical appraisal was carried out using the Joanna Briggs Institute (JBI) Critical Appraisal guide to assess and analyze the quality of the article methodology that has been obtained in each article that has been qualified based on the inclusion criteria, in addition, a journal ranking check was carried out based on the Scopus index through Schimago journal rankings to ensure that the included articles are Scopus indexed articles. Critical Appraisal was carried out by author 1 and author 2 to determine the quality of the article. Data Anslysis Based on the results of a review conducted on 10 articles, it was found that 8 articles stated that giving probiotic bacteria or yogurt containing probiotics and regular yogurt (non-probiotic) can reduce the frequency, duration and prevent diarrhea in children. SUPPORTING JOURNAL 3 SUPPORTING JOURNAL 2

18. The Power of PowerPoint - thepopp.com 18 The Power of PowerPoint - thepopp.com 18 BAB 1 JOURNAL PRESENTATION MAIN JOURNAL REVIEW CRITICAL SUPPORTING JOURNAL 1 Discussion The results of this systematic review still have variations in research results, although overall there are more research results stating that giving probiotics and probiotic yogurt is effective in reducing the frequency, duration of diarrhea and length of hospitalization, but it really depends on the type of probiotic used, whether it needs to be combined or just a single probiotic and what is the right dose to provide effectiveness in treating children with acute diarrhea. The results of this systematic review also found that probiotic yogurt and probiotics do not have any side effects on children with diarrhea. Result The conclusion of this study found that the use of probiotics with a combination of multi-strain probiotics, as well as single probiotics with certain doses, especially the bacteria Saccharomyces boulardii and Lactobaclus rhamnosus can help reduce the frequency and duration of diarrhea. SUPPORTING JOURNAL 3 SUPPORTING JOURNAL 2