Homogeneity and the outcome of clinical trials: An appraisal of the outcome of recent clinical trials on endovascular intervention in acute ischemic stroke

Salat dhuha effect on oxidative stress in elderly women: A randomized controlled trial

Background

The aging process and a chronic sedentary lifestyle in the elderly as a result of physical restrictions during the COVID-19 pandemic, induces oxidative stress through oxygen supply and antioxidant activity imbalance which in turn induce degenerative diseases. Salat dhuha as a prayer and mind-body medicine which is practiced by the Muslim community can hopefully be a solution to decrease oxidative stress in the elderly.

Objective

To evaluate the acute physiological effects of salat dhuha on Glutathione Peroxidase activity (GPx) as an antioxidant and Malondialdehyde (MDA) as an oxidant in healthy elderly Muslim women population who have done salat dhuha regularly.

Method

A randomized controlled study was done on elderly women (aged 60-74 years old) who are treated in the North Sumatra Government's Nursing Home in Binjai and who routinely do 2 rakaat of salat dhuha every day. Several physical, clinical, and blood examinations were done pre and post-intervention. 101 elderly Muslim women in the nursing home were selected, 26 met the study criteria and were included in the study. The volunteers were randomized into 2 groups using lottery papers, the "2-rakaat salat dhuha group" (n = 13) and the "8-rakaat salat dhuha group" (n = 13). All volunteers did salat dhuha for at least 5 days per week for 6 weeks.

Result

24 elderly women completed the study, and one volunteer from each group dropped out. The characteristics of participants from both groups were homogenous. Results of the t-independent analysis showed that MDA concentrations in both groups in the pre and post-test were not significantly different (p > 0,05). Mann Whitney analysis showed that GPx on both groups in the pre and post-test were not significantly different (p > 0,05). Paired sample t-test analysis on the MDA concentrations pre and post-test in the 8-rakaat group showed a significant difference in MDA levels (p < 0,05). The 8-rakaat salat dhuha group showed that GPx activity increases as much as 8,9% and MDA levels decrease as much as 48,35 % after 6 weeks.

Conclusion

Salat dhuha promotes redox homeostasis and has the potential to prevent oxidative stress in elderly women.

Border Zones of Evidence: How Non-evidence Based Factors Influence Evidence Generation and Clinical Practice in Stroke Medicine

The interpretation of the results of clinical trials should be done by examining the finer prints of extraneous factors such as stopping rules, interim analysis, intricacies of patient selection, and the rationale of decisions that lead to non-prespecified termination. This can be done only by critical education in the art and science of interpretation of evidence emerging from clinical trials. The pioneering pivotal studies, namely, NINDS rtPA and ECASS III trials, hold disproportionate influence in determining the contours of the subsequent fate of clinical trials and treatment guidelines. It needs to be recognized that the pooling of studies using dissimilar trial designs, notwithstanding similar patient profiles, would undermine the positive signal emerging from the studies that have used better selection methodologies to homogenize the study population.