Objective: This study is conducted to determine the protective effects of physical exercise and ascorbic acid on increasing blood glucose (BG) levels and islet pancreatic area in high-carbohydrate (HC) diet rats. Methods: A total of 20 rats were divided into four groups: Control group which was a HC and treatment groups which were HC plus exercise (HCEx), HC plus ascorbic acid (HCAs), and HCEx and ascorbic acid (HCExAs). The duration of treatment was 9 weeks. Swimming to exercise held 6 times a week and ascorbic acid dose was 9 mg. Results: It showed that the smallest body weight was HCEx group. BG difference (before and after treatment = BG diff) had a significant difference (p=0.021) among groups, and the lowest level of BG diff was HCEx group. HCAs had the biggest BG diff. However, there was no significantly difference among groups on islet pancreatic area, but HC group had the largest area. Conclusion: This study suggests that a combination of exercise and ascorbic acid on HC diet subject may regulate BG level compared to the exercise or ascorbic acid alone. However, they do not influence pancreatic islet area.

Introduction: Smoking has been reported as one of tuberculosis (TB) risk factor. The association between smoking and TB has been proven in multiple studies, but little known about the association between smoking degree and sputum smear positive. Methods: An analytic observational study using cross-sectional design. Data of patients with pulmonary TB conducted at DOTS (Directly Observed Treatment Short course)/MDR (Multi Drug Resistance) outpatient and inpatient ward in Dr Soetomo General Hospital Surabaya from January to October 2018. The degree of smoking was measured using Brinkman Index (BI). The odds ratio (OR) and 95% confidence intervals (CI) were also estimated.Results: There were 94 patients with pulmonary TB, 56 non-smoker and 38 smoker. Light smoking (P = 0,120, OR = 0.200, 95% CI: 0.022-1.823), moderate smoking (P=0.377, OR = 1.667, 95% CI: 0.533-5.209), heavy smoking (P=0.076, OR= 0.333, 95% CI: 0.96-1.160). Moderate smoking compared to heavy smoking as a control (P=0.33, OR = 5.000, 95% CI=1.096-22.820). Conclusion: There’s no significant correlation between smoking habits and sputum smear positive, but the present study evidenced the patients with smoking habits had greater chance to get sputum smear positive than non-smokers. Patient with moderate smoking compared to heavy smoking had greater chance to get sputum smear positive.

Background Social restrictions due to the COVID-19 pandemic have shifted most learning methods into online courses, especially for medical skills education. However, the effects of online courses on medical skill education amongst medical students are still arguable. The study aims to analyse medical students’ knowledge, attitude, practice and satisfaction towards medical skills between online and offline courses. Method We performed a case–control study conducted among 533 medical students with online (as a case group, n = 288) and offline courses (as a control group, n = 245). We evaluated three fundamental medical skills, including history taking [HT], lung physical examination [LPE], and heart physical examination [HPE]. We tested the knowledge and skills among students through theory and practical examinations. Students’ attitudes and satisfaction were assessed using a validated questionnaire. Results The scores for knowledge and practical skills among the online group were significantly higher ( p = 0.016, p = 0.004, respectively). In comparison, the scores for the students’ attitudes and satisfaction were substantially lower ( p = 0.000, p = 0.003, respectively) compared to the control group. Most of the students in both groups passed the exam (case vs. control = 81.94%; 83.27%, respectively). Males were the only factor associated with a higher rate of passing the examination (OR 0.42, 95% CI [0.27–0.67], p = 0.000). Conclusions Online learning could be an alternative approach on improving student’s knowledge and practice towards medical skill especially amidst COVID-19 pandemic, however further consideration on student’s attitude and satisfaction are mandatory to achieve appropriate competence as future general practitioner.