BACKGROUND: Musical artwork using Balinese flutes made from bamboo (timing buluh) by Agus Teja Sentosa, S.Sn is a combination of music played with flute as the main instrument which contains certain components resembling music therapy such as in western classical music by Antonio Lucio Vivaldi. AIM: This study aims to determine the improvement of cognitive function and increase in serum dopamine in the elderly after listening to music with Balinese flute as the main instrument. METHOD: The current study allocated 18 subjects in the control group listened to western classical music by Antonio Lucio Vivaldi, while 18 subjects in the intervention group listened to western classical music and music from Balinese flute as the main instrument by Agus Teja Sentosa, S.Sn. MoCA-Ina assessment and examination of serum dopamine levels were carried out initially and 21 days after listening to music intervention. RESULTS: The mean increase in cognitive function score was higher in the intervention group (5.22; p < 0.001) than in the control group (4.67; p < 0.001), this increase was not statistically significant with a value of p = 0.562 (p > 0.005). The mean increase in dopamine levels in the control group (3.60) was greater than in the treatment group (3.56), but the mean increase was not statistically significant (p = 0.085). CONCLUSION: There was a significant relationship between listening to the main instrumental Balinese flute music and the improvement of cognitive function, especially in the memory domain in all study subjects, but the mean increase in cognitive function and serum dopamine level did not reach statistical significance.

Background Migraine is a primary headache with a prevalence of 12–20% in the world. Approximately 38% sufferers were indicated for prophylactic therapy, but only a small proportion (3–13%) received prophylactic therapy. The role of melatonin in migraine is to protect the brain against toxins through anti-free radical activity, inhibition of the release of inflammatory factors and neurotransmitters. Results This review uses the PRISMA protocol and uses source from Pubmed. A total of 142 articles were found according to the search strategy. 5 articles were collected with a randomized-controlled trial design that matched the inclusion criteria. Of the 5 articles, there were only 2 articles that proved significant where melatonin gave better results compared to placebo in migraine sufferers, especially in the frequency of attacks, duration, and reduction in the use of other analgesics. Based on the dose and duration of melatonin administration, although most use a dose of 3 mg melatonin with a duration of 2–3 months, this still needs to be investigated further because the available data are not sufficient. In addition, the use of melatonin before going to bed at night is said to be better because it is associated with the majority of side effects that occur, namely sleepiness. Conclusion Studies on melatonin and migraine with a randomized-controlled trial design are still limited so there is not enough evidence to support the administration of melatonin as a treatment for migraine sufferers, including the safety and side effects, especially for a long period of time.

BackgroundStudies show that wearing personal protective equipment (PPE) for long periods of time can lead to discomfort such as headaches, which could affect the performance of healthcare workers. The aim of this study was to determine the prevalence and risk factors of headaches related to PPE in healthcare workers at a COVID-19 referral hospital. MethodsA cross-sectional study was conducted involving 174 healthcare workers in a COVID-19 referral hospital in Bali. We conducted interviews using a questionnaire that consisted of three main parts: characteristics of the subjects, PPE usage, and PPE-associated headaches. A multiple logistic regression was used to analyze the data. ResultsThe analysis results showed that the PPE-associated headaches had a prevalence of 63.8% and were gradual in onset, pressure-like in quality (46%), and mild in intensity (80.1%). PPE level III-associated headache was the most common type. The majority of the participants had headaches up to 6 hours after using the protective gear, but improving within 15-30 minutes of removal and/or after pharmacotherapy. A Chi-squared analysis showed a statistically significant association between duration of PPE use, working units, and PPE levels (p<0.05). A logistic regression analysis found a significant relationship between PPE level and headache occurrence (OR=4.826;95%CI: 2.433-9.572; p<0.001). ConclusionThe frequency of PPE-associated headache was high and the PPE level was a risk factor of headache among healthcare workers. Better strategies are needed to reduce the duration of PPE exposure so that the work performance and quality of life of healthcare workers are not significantly affected.

BACKGROUND: Studies have shown the effects of music toward improved cognitive function due to changes in molecular production and signaling through increased messenger secretion, including hormones, neurotransmitters, and growth factor proteins. Most of the studies used Western classical music as an intervention. AIM: We would like to investigate whether traditional Balinese flute musical composition entitled can improve cognitive function as well as brain-derived neurotrophic factor (BDNF) and interleukin (IL)-6 levels, on par with the Western classical composition. METHODS: This was a prospective intervention trial involving 40 participants recruited from Primary Health Clinic 2 in West Denpasar, Bali, and divided into two groups. Participants were asked to listen to either “Morning Happiness” by Mr. Agus Teja Sentosa, S. Sn (treatment), or Vivaldi’s composition of “Spring” (control group) for 20 min each day for 21 days. Cognitive evaluation was performed using Montreal Cognitive Assessment (MoCA)-INA and blood sample was withdrawn during the 1st day for BDNF and IL-6 levels measurement. All statistical analyses were conducted using IBM SPSS Statistics 20. RESULTS: There was a significant difference between initial and endpoint MoCA-INA test results among treatment and control group (p < 0.001), but there was no significant difference between control and treatment (p = 1.00). BDNF levels differed significantly between initial and endpoint BDNF levels among control group (p < 0.001), but did not differ significantly between control and treatment groups (p = 0.534). There was no significant difference between initial and endpoint IL-6 levels between the control group, but there was a close to statistical difference between of initial and endpoint IL-6 levels among the treatment group (p = 0.052). There was a significant difference in the memory domain between the control and treatment groups (p = 0.01) as measured using MoCA-INA questionnaire. CONCLUSION: Balinese traditional flute composition was proven to be non-inferior when compared with Western classical composition as it improved mainly memory domain accompanied by increasing BDNF and decreased IL-6 levels.