Introduction Smoking is one of the most important causes of mortality and morbidity in the world, as it is related to the risk factor and etiology of respiratory-tract diseases. Long-term smoking causes both structural and functional damage in the respiratory airways, leading to changes in nasal mucociliary clearance (NMC). Objectives The aim of the present study was to look systematically into the current literature and carefully collect and analyze results to explore NMC in smokers. Data Synthesis Two independent reviewers conducted a literature search on some Electronic database: Pubmed, Medline, Ebsco, Springer Link, Science Direct, Scopus, and Proquest searching for articles fulfilling the inclusion and exclusion criteria. The lead author independently assessed the risk of bias of each of the included studies and discussed their assessments with the other two authors to achieve consensus. Of the 1,654 articles identified in the database search, 16 met the criteria for this review. Most of the articles (15 out of 16) showed the impairment of NMC in smokers. Conclusion The present systematic review suggests that there is an impairment of NMC in smokers. The impairment is not only observed in cigarette smoking, but also in passive smoking, bidi smoking, electronic smoking, and hookah smoking. The impairment of NMC in chronic exposure to smoking is caused by the ciliotoxic effect, hypersecretion and viscoelastic change of mucous, airway surface liquid depletion, increased oxidative stress, and deteriorations in the inflammatory and immune systems.

Introduction:Critical patients are patients who potentially get reversible dysfunction in one or more life-threatening organs and require care in the Intensive Care Unit (ICU). Methods: The objective of this research is to analyse the physical function-tardive dyskinesia in critical patients with sedation in the ICU. The design of this research is cross-sectional. The population is all of the critical patients in the ICU of the Baptist Hospital in Kediri. The purposive sample population was 41 respondents based on the inclusion and exclusion criteria. The variables are 'giving the sedation' and 'physical functiontardive dyskinesia'. The data was collected using a Motor Activity Assessment, and the Sedation Scale for Critically Ill Patients and Tardive Dyskinesia Screening. Results: The results showed that giving sedation can slow physical function in the form of motor activity; the response of noxious stimuli (7.3%), response to touch or calling name (19.5%) and an increasing score of agitation and co-operative (4.9%). Symptoms of tardive dyskinesia increased after sedation in the form of tongue protrusion (4.9%), lip-smacking, puckering and pursing (2.4%), and rapid movements of the arms and legs. The administration of sedation in the first 24-hours in ICU patients affects the physical function of the critical patients (p = 0.005). Conclusions: Giving sedation affects the patients' physical functions. Therefore, the prevention of the effects of sedation and treatment during ICU is needed in order to avoid a decrease in the physical function of critical patients.

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Background Chronic occupational exposure in textile workers lowers the pulmonary function and levels of sinonasal IgA. A Nephrolepis exaltata herbal mask can protect the respiratory tract. This study aims to understand the effect of this herbal mask on the IgA levels and pulmonary function in textile workers. Thirty employees were selected for this study. Methods The pre- and post-test randomized experimental control trials were conducted in a garment industry of Bawen, Semarang, Indonesia. The subjects that qualified to participate (n = 30) fulfilled the inclusion criteria i.e., 20–35 years old, healthy, and willing to be a research subject; and exclusion criteria i.e., having history of alcohol consumption, smoking, history of liver disease, autoimmune disease, cancer, pulmonary and heart disease and/or being pregnant. The subjects were then divided randomly into control group (n = 15), who used regular mask that was rewashed and changed every month for eight weeks, and treatment group (n = 15), who used Nephrolepis exaltata mask that was changed every two days for eight weeks. Pulmonary function tests were carried out using MIR Spirolab III before and after the experiment. IgA levels were measured by nasal wash method using ELISA. Results IgA levels of the treatment group before and after usage of mask were significantly different (p<0.001) compared to the control group. There were significant difference in FVC of the control group, but no significant difference was observed for FEV1 (p = 0.507) and PEF (p = 0.001). In the treatment group, all three parameters showed significant differences [FVC (p = 0.038), FEV1 (p = 0.004), and PEF (p = 0.001)]. The means of ΔFVC, ΔFEV1, and ΔPEF were significantly (p<0.05) higher in the treatment group with OR = 5.1 for higher IgA levels. Conclusions The herbal mask is better in increasing IgA and improving the pulmonary function compared to the regular mask.