Indonesian Journal of Global Health Research

Correlation of Blood Alcohol Levels with Gamma Glutamyl Transferase in Fiberglass Factory Workers

2025-03-18T21:48:46+00:00

Alcohol is an organic compound in liquid form, colorless, with a specific odor, flammable, volatile, and miscible with water in all proportions. Fiberglass factories are among the industries that use ethanol in the production process and for testing product compatibility. Ethanol exposure can occur through inhalation, dermal contact, and ingestion. Chronic alcohol exposure may lead to liver dysfunction and an increase in Gamma Glutamyl Transferase (GGT) levels in the blood. This research aimed to determine the correlation between blood alcohol levels and Gamma Glutamyl Transferase in fiberglass factory workers. The research method used was analytical observational with a cross-sectional approach, employing a purposive sampling technique. The study sample consisted of 30 fiberglass factory workers exposed to alcohol and meeting the inclusion criteria. Data collection was conducted by measuring blood alcohol levels and Gamma Glutamyl Transferase levels using the enzymatic photometric method. Data analysis was performed using statistical tests to determine the correlation between blood alcohol levels and Gamma Glutamyl Transferase levels. Plasma or blood serum from the workers was used as samples. The alcohol levels were found to be 100% within normal ranges, and Gamma Glutamyl Transferase levels were normal in 93% of cases. Statistical tests using SPSS and Spearman correlation analysis yielded a significance value of 0.600 (p > 0.05), indicating no significant relationship between blood alcohol levels and Gamma Glutamyl Transferase in fiberglass factory workers.

The Correlation between Blood Lead Levels and Smoking Habits among Retail Gasoline Sellers

2025-03-18T22:01:25+00:00

Heavy metal lead (Pb) is a type of metal that can negatively impact both the environment and human health. With a melting point of 327.5ºC, lead is a naturally occurring element in the Earth's crust. Lead can enter the human body through various means, including water, soil, and air. Inhalation is one of the primary routes of lead exposure. Lead levels in the body can be assessed through blood, bones, hair, and nails. Additionally, smoking habits can influence blood lead levels, as cigarette smoke contains small amounts of lead. This study aims to examine the relationship between blood lead levels and smoking habits among retail gasoline sellers. A descriptive-analytical research approach was employed, using a cross-sectional design and purposive sampling technique. The study subjects comprised retail gasoline sellers in Batu Ampar sub-district, Balikpapan City, who met the inclusion criteria. Blood samples were analyzed using the ICP-OES method at the Labkesda DKI Jakarta. Data analysis was conducted using the non-parametric Spearman test. The results from 20 respondents indicated no statistically significant relationship between blood lead levels and smoking habits among retail gasoline sellers in Batu Ampar sub-district, Balikpapan City (correlation value = 0.115, p-value = 0.628). The highest recorded blood lead level among daily smokers was 8.634 µg/dL, while the lowest was <0.228 µg/dL.

The Influence of Online Gaming Addiction on Depression in Adolescents

2025-04-21T04:22:12+00:00

Nowadays, there is a rapid increase of online games. In fact, Indonesia ranks as the 3rd highest online game users in the world. It is teenagers who become one of the biggest users of online games. An excessive online game playing can have an impact on mental health problems, including online gaming addiction, clinical distress, and even depression. Objective: The purpose of this study was to determine whether there is an effect of online gaming addiction on depression problems in adolescent online game users. Method: The type of research used is a quantitative method with Cross Sectional approach. The sample in the study amounted to 297 high school adolescents in Majene district, West Sulawesi. Determination of the sample used purposive sampling based on the inclusion and exclusion criteria set. Results: The results of this study showed that most adolescents experienced moderate online game addiction, namely 191 adolescents (64.3%) and most adolescents experienced moderate depression as many as 79 adolescents (26.6%). There was a significant relationship between online gaming addiction in adolescents with depression problems experienced by adolescents with p value < 0.05. Conclusions: Online game addiction in adolescents had a 3 times greater influence on depression problems in adolescents. Joint action was needed from schools, health institutions and families to overcome and to prevent the problem of online game addiction and depression in adolescents.

Determinant Factors of Medication Compliance in DM2 Patients: A Systematic Review

2025-06-07T02:45:38+00:00

Type 2 Diabetes Mellitus (DM2) is a chronic disease that requires high compliance in treatment to prevent complications. However, many DM2 patients are not compliant in undergoing drug therapy, which can hinder the effectiveness of treatment. Various factors have been identified as determinants of patient compliance, including demographic factors, knowledge, social support, and technology utilization.This study aims to analyze factors that influence medication adherence in DM2 patients based on a systematic review of several studies that have been conducted. The method used in writing this article is a literature review study with a systematic review method. The articles reviewed were obtained through searches on Google Scholar, Pubmed, Proquest, and ScienceDirect in the period 2015-2025 with the search keywords being Type 2 Diabetes Mellitus, Medication Compliance, Compliance Factors, Medication Supervisors . By using PRISMA, from 10,697 articles found, 10 journal articles were obtained to be reviewed. Based on the analysis of several studies, factors that have a significant influence on patient compliance in taking medication are the level of knowledge (p = 0.002), family support (p = 0.000; PR = 8.17 ) , and support from health workers (p = 0.000; PR = 6.10). Social Marketing, Frailty Syndrome and Age were also found to have a relationship with DM medication compliance. In addition, the use of technology such as medication reminder applications (PMO) has been shown to help improve patient compliance in undergoing DM2 therapy. Compliance of DM2 patients in undergoing drug therapy is influenced by various factors, including level of knowledge, social support, social marketing, age , frailty syndrome, and use of technology. Therefore, strategies to improve compliance must involve an educational approach, strengthening the role of families and health workers, and utilizing digital-based technology to increase the effectiveness of DM2 therapy.

Macronutrient Intake Among Multidrug-Resistant Tuberculosis Patients in Three Referral Hospitals in Indonesia

2025-06-07T05:24:09+00:00

Poor nutritional status, such as macro- and micronutrient deficiencies, might lead to worse clinical outcomes in multidrug-resistant tuberculosis (MDR-TB) patients. This study aimed to describe the macronutrient intake among MDR-TB patients and then compare those findings with the Indonesian recommended dietary allowance (RDA). A cross-sectional study of MDR-TB outpatients aged 18-65 years treated with the nine- or 18-month regimens at the end of the first month of treatment was conducted. Macronutrient intake data were obtained from a food consumption survey (24-hour food recall) of MDR-TB outpatients that was conducted by interviewing, recording, and then analyzing using NutriSurvey software, and compared with the RDA of the Ministry of Health of Indonesia. There were 63 outpatients with MDR-TB. The mean age was 38 (SD 12) years, and most of the patients were male (58.7%). Nutritional status based on BMI < 18,5 kg/m2 was observed in 43 patients (68.3%). According to the survey, after the end of the first month of MDR-TB treatment, the median (min–max) daily intake of energy was 1386.5 (519.4 – 2963.6) kcal per day, and the mean of protein was 49.6 (SD 23.0) grams per day. The median (min-max) daily intake of fat was 43.0 (1.1-170.6) grams per day, and the mean carbohydrate was 209.16 (87.9) grams per day. The proportions of energy, protein, fat, and carbohydrate deficiency were 85,7%, 68,8%, 74,6%, 90,5%, respectively. Macronutrient intake among MDR TB patients in this study was lower than the Indonesian recommended dietary allowance. These findings indicate that additional food intake and dietary counseling are needed in MDR-TB patients in Indonesia.

Application of Balloon Blowing Therapy with Pursed Lip Breathing Technique to Improve Oxygen Saturation in Children

2025-06-07T05:23:07+00:00

Respiratory issues are frequent in children and can lead to reduced oxygen levels. One non-medical approach that may be beneficial is Pursed Lip Breathing (PLB), which can enhance the exchange of oxygen and lower the respiratory rate. This research aimed to assess the effectiveness of balloon blowing therapy utilizing the PLB technique to improve oxygen saturation in children. A case study design with a nursing perspective was used, involving 11 children aged 4 to 8 years who were experiencing respiratory issues. The participants were selected using purposive sampling, focusing on children who met specific inclusion criteria. Data collection included measurements of respiratory rate (RR) and oxygen saturation (SpO₂) before and after the intervention, taken using a pulse oximeter. Paired t-tests and Pearson correlation were used for statistical analysis. The average respiratory rate reduced from 40.27 to 30.73 breaths per minute, while oxygen saturation increased from a range of 91–93% to 95–98%. The correlation coefficient between the pre- and post-intervention values was r = 0.823 (p = 0.002), indicating a strong and statistically significant relationship. These findings suggest that the intervention effectively decreased respiratory effort and enhanced oxygenation in children.Balloon blowing therapy with the PLB technique proves to be an effective, straightforward, and non-invasive method for improving respiratory function in children.

Cutaneous Polyarteritis Nodosa: A Case Report

2025-06-07T11:38:15+00:00

Cutaneous polyarteritis nodosa is a rare type of vasculitis that involves inflammation in small to medium-sized blood vessels, mainly targeting the skin. It affects people of all ages and significantly impacts both the skin and other organ systems. This case report aims to describe the clinical presentation, diagnostic approach, and therapeutic response. A 38-year-old man came with a two-week history of a red, non-itchy rash on both legs. A week before the rash appeared, patient experienced fever, sore throat, and stomach pain. His general condition was stable. Dermatological examination showed multiple palpable purpura on both legs, ranging from miliary to lenticular in size. Diascopy revealed non-blanching purpura, and dermoscopy showed a homogeneous pattern of multiple erythematous spots. Histopathology indicated a proliferation of blood vessels with enlarged endothelial cells, concluding with a diagnosis of polyarteritis nodosa. Patient was diagnosed with cutaneous polyarteritis nodosa and treated with methylprednisolone at 1 mg/kg/day, divided into three doses of 32 mg each, with tapering off every week. Clinical improvement was observed, and the skin lesions progressively resolved. This case highlights the importance of early recognition and corticosteroid therapy in the successful management of mild cutaneous polyarteritis nodosa.

Keywords: corticosteroid, cutaneous polyarteritis nodosa, vasculitis

Surgical Excision in the Management of Rhinophyma: A Case Report

2025-06-08T12:10:29+00:00

Rhinophyma is the most severe and disfiguring manifestation of phymatous rosacea, characterized by progressive hypertrophy of sebaceous glands and connective tissue on the nasal skin. It often leads to both aesthetic and functional impairment. Various treatment options are available, with surgical excision considered the most definitive for advanced cases. This case report aims to highlight the clinical presentation, diagnostic approach, and the effectiveness of surgical excision combined with electrocautery as a treatment modality for rhinophyma. We report a case of a 49-year-old male presenting with progressive nasal enlargement, nodularity with sharply demarcated borders, an irregular surface, and a firm, slightly compressible consistency. Clinical and histopathological examination confirmed the diagnosis of rhinophyma. The patient underwent surgical excision followed by electrocauterization. The procedure was well-tolerated without intraoperative or postoperative complications. Follow-up showed satisfactory cosmetic improvement and no signs of recurrence. The management of rhinophyma varies depending on disease severity. In advanced cases, surgical excision remains the treatment of choice. It provides immediate debulking of hypertrophic tissue and restoration of nasal contour. Combined with electrosurgical techniques, this method offers good cosmetic and functional outcomes, minimal scarring, and a low recurrence rate. It addresses both functional obstruction and cosmetic disfigurement, contributing to improved quality of life.

The Relationship Between Lipid Profile and HBA1C Levels in Type 2 Diabetes Melitus Patients

2025-06-08T17:49:26+00:00

Diabetes Mellitus is a chronic disease with high morbidity and mortality rates, requiring comprehensive and integrated management. Dyslipidemia is an important risk factor contributing to the occurrence of both microvascular and macrovascular complications in individuals with Diabetes Mellitus. Optimal control of HbA1c levels and lipid profiles is considered essential in reducing the risk of complications and improving patient outcomes. Therefore, monitoring and managing these parameters is a critical component of diabetes care to prevent further complications. This study aims to analyze relationship between lipid profile with HbA1c levels in Type 2 Diabetes Mellitus (T2DM) patients at Puskesmas in Samarinda. A cross-sectional study was conducted involving 1,482 patients with T2DM, selected through a total sampling technique. Data were obtained from secondary sources, specifically medical records. Bivariat analysis using the Chi-Square test was performed to evaluate the relationship between lipid profile and HbA1c levels. The analysis identified significant relationship between TG (p = <0,001 ; OR = 3,350; 95% CI:2,701-4,157), TC (p = <0,001; OR = 1,862; 95% CI: 1,486-2,334), HDL-C (p = 0,003; OR = 1,567; 95% CI: 1,169-2,100), and LDL-C (p = 0,013; OR = 1,310; 95% CI: 1,063-1,614). This study found a significant association between all components of the lipid profile and HbA1c levels among patients with type 2 diabetes mellitus (T2DM) in Samarinda. Levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were all significantly related to poor glycemic control. .

Raynaud’s Phenomenon in A Patient with Scleroderma: A Case Report

2025-06-08T18:08:40+00:00

Systemic sclerosis, or scleroderma, is a chronic autoimmune disorder characterized by fibrosis of the skin and internal organs, vasculopathy, and immune dysregulation. Raynaud’s phenomenon (RP), marked by episodic vasospasm of the digital arteries in response to cold exposure or emotional stress, is often one of the earliest and most common sign of SSc. Early diagnosis plays a crucial role in preventing and managing complications of RP, such as digital ulcers and tissue damage due to chronic circulatory impairment, as well as in reducing long-term disability. This case report aims to highlight pedal ulcers as a complication of RP scleroderma and to emphasize the importance of early intervention in preventing progressive tissue damage. The data was conducted through a comprehensive approach including history assessment, physical examinations, electronic medical record reviews, laboratory diagnostics, and imaging studies to ensure accurate diagnosis and effective interventions. We report a 26-year-old woman who presented with a six-month history of progressive skin thickening and hardening involving almost all of her body. The patient also experienced finger stiffness, flexion contractures, and limited mouth opening. Dermatological examination revealed sclerotic skin with hypopigmented and hyperpigmented patches forming a "salt-and-pepper" appearance across various body areas, along with microstomia and a beaked nose. The Modified Rodnan Skin Score (mRSS) was 34. A diagnosis of systemic sclerosis was established based on the American College of Rheumatology in collaboration with the European League Against Rheumatism (ACR/EULAR) criteria. The patient was lost to follow-up after the initial visit and later returned with toe necrosis and ulceration over the ankle area. Treatment included systemic corticosteroids combined with methotrexate, along with counseling to avoid cold exposure and manage stress. Raynaud’s phenomenon should be recognized as a critical early sign of scleroderma. Comprehensive early evaluation, including autoantibody testing, is essential for timely diagnosis and the prevention of severe vascular complications.

Factors Affecting Intradialytic Hypertension

2025-06-08T23:10:23+00:00

Intradialytic hypertension, defined as an increase in blood pressure during or immediately after hemodialysis which results in postdialysis hypertension, has long been recognized to complicate the hemodialysis procedure, yet it is often largely ignored. Intradialytic hypertension affects the quality of life of patients undergoing hemodialysis and reduces their survival and increases mortality in CKD patients on hemodialysis. Objective to identify other factors that influence the occurrence of intradialytic hypertension. We conducted a literature search through the ScienceDirect, Scopus, and PubMed databases. The keywords used are "blood pressure" AND "hypertension" AND "dialysis" AND "intradialytic hypertension" AND "factor." The method used to compile information in this article is a scoping review, covering the period from 2020 to 2025, with article screening guided by the PRISMA flow. The article search selection results from ScienceDirect (n=45), PubMed Database (n=74), and Scopus Database (n=50) show that 9 articles can be selected according to the criteria. Articles were selected that correlate with the theme, specifically those discussing factors influencing intradialytic hypertension. Sodium dialysate, intradialytic weigh gian, diabetes mellitus, malnutrition, endothelial dysfunction, duration of hemodialysis, injection of erythropoietin hormone, blood phosphorus, and zinc level, are some factor all affect intradialytic hypertension.

Analysis of Factors Related to the Incidence of Ventilator-Associated Pneumonia (VAP) in the Intensive Care Unit

2025-06-09T18:02:26+00:00

Ventilator-associated pneumonia (VAP) occurs in patients who have been on mechanical ventilation with an endotracheal tube (ETT) for at least 48 hours. This type of pneumonia typically arises as a result of nosocomial infections or Healthcare-Associated Infections (HAIs) and is commonly linked to the use of ventilators in hospital settings. This study was to identify the factors associated with the incidence of VAP among patients admitted to the Intensive Care Unit of Abdoel Wahab Sjahranie Hospital, Samarinda. Method: A cross-sectional study was conducted. The study population consisted of all patients who had undergone mechanical ventilation in the ICU without a prior history of pneumonia, totaling 118 respondents, using the HAIs bundle observation tool and direct observation. Chi-square and multiple logistic regression were used for statistical analysis, along with a predictive model. The results showed that the prevalence of VAP among respondents in the ICU was 5.9%. Factors significantly associated with the incidence of VAP included duration of ventilator use (p = 0.000), oral hygiene procedures (p = 0.000), head-of-bed elevation to 30–45° (p = 0.007), hand hygiene compliance (p = 0.015), and aseptic suctioning procedures (p = 0.043). The multivariate analysis identified duration of ventilator use ≥96 hours as the most dominant factor, with the highest Odds Ratio (OR = 13.975; 95% CI: 0.753–227.435). Duration of ventilator use was the most significant factor associated with an increased risk of VAP, with patients ventilated for ≥96 hours being 13 times more likely to develop VAP compared to those ventilated for <96 hours. Proper oral hygiene, appropriate head-of-bed elevation (30–45°), compliance with hand hygiene, and aseptic suctioning procedures were also found to be significantly associated with VAP incidence among ICU patients at Abdoel Wahab Sjahranie Hospital

The Relationship Between Self-Efficacy and Medication Adherence in Hypertension Patient

2025-06-09T12:13:02+00:00

Hypertension is a state of blood pressure above normal that has an impact on increasing morbidity and mortality rates. Hypertension generally makes sufferers have a low life expectancy and still choose to coexist with hypertension. In increasing life expectancy, hypertensive patients need high self-efficacy . A patient with high self-efficacy had twice the chance of showing better adherence to treatment when compared to patients with low self-efficacy. Objective to find out the relationship between self-efficacy and adherence to treatment for hypertension. This study is included in an observational analytical study with a cross sectional design approach. The subjects of this study were selected using a random sampling technique using 90 subjects who suffered from hypertension. The method used to measure self-efficacy was using the Medication Adherence Self-Efficacy Scale-Revision (MASES-R) and measuring medication adherence was using the Morisky Medication Adherence Scale -8 (MMAS-8). The validity test results showed that 8 questions were valid (r = 0.300), while the reliability test indicated that the MASES-R questionnaire (r = 0.990) and the MMAS-8 questionnaire (r = 0.674) were considered reliable. The results showed that there was a relationship between self-efficacy and treatment compliance in hypertensive patients at the Bambu Apus Health Center where P-Value = 0.01 = < (0.05) with a contingency coefficient value of 0.638 meaning that the strength between variables at a very strong level with the direction of a positive relationship. There is a relationship between self-efficacy and adherence to treatment for hypertension (P-Value < 0.05).

Multidimensional Impact of Overweight on Quality of Life of Children and Adolescents: A Scoping Review

2025-06-10T15:00:12+00:00

Overweight in adolescents is a global health issue that has shown a significant increase in recent decades. This condition has a multidimensional impact, particularly on the physical, psychological, social aspects, and overall quality of life of adolescents. Children and adolescents who are overweight often experience body shaming, social stigma, decreased self-esteem, and social isolation, all of which can contribute to a lower quality of life. Although numerous studies have explored the relationship between being overweight and quality of life, most have focused only on physical or psychological dimensions. Many of the existing studies examine just one or two aspects of quality of life and lack a comprehensive consideration of cultural factors, developmental age, and social interactions. Objective to comprehensively review the scientific literature that examines the impact of overweight on the quality of life among adolescents. This study employed a scoping review approach based on the PRISMA-ScR guidelines. Literature searches were conducted through three databases: Scopus, PubMed, and ScienceDirect, using the keywords "Overweight," "Adolescents," and "Quality of Life." The selected articles were published within the last three years (2023–2025) and met the inclusion criteria, including being written in English, open access, and relevant to the topic. A total of 15 articles were selected from an initial search result of 18,441 records. The article selection involved a multi-stage screening process, including title and abstract screening, full-text review, and assessment using inclusion and exclusion criteria. Each article was then analyzed thematically to identify patterns related to the impact of overweight on adolescents' quality of life. These studies employed qualitative and quantitative approaches, including multivariate analysis, logistic models, as well as mediation and moderation analyses. Most of the articles reported that overweight has a negative impact on adolescents’ quality of life, particularly in the physical, psychological, social, and academic functioning domains. Overweight in adolescents has a significant impact on various aspects of quality of life. These findings highlight the importance of developing multidimensional interventions that not only address physical aspects but also take into account psychosocial factors and the adolescent’s environment.

The Impact of Sanitation on Increasing the Risk of Stunting in Children Under Five: A Meta-Analysis

2025-06-12T19:19:55+00:00

Stunting among children remains a global public health issue, with as many as 149 milion children under the age of five affected worldwide. One of the contributing factors to stunting is poor sanitation. This research aims to estimate the extent to which poor sanitation contributes to the risk of stunting in children under five years old using a meta- analysis approach. study employed a systematic review and meta-analysis using the PICO framework (Population, Intervention, Controls/Comparisons, Outcome), defined as follows: Population: children under five years old; Intervention: poor sanitation; Comparison: good sanitation; Outcome: stunting. Articles were collected using PRISMA flow diagrams. A total of nine articles that met the quality standards were then included in the quantitative synthesis using meta-analysis. Articles were analysed using the Review Manager 5.3 application. The findings of this meta-analysis indicate a significant association between sanitation conditions and the risk of stunting in children under five. Children who live in environments with poor sanitation are 3.71 times more likely to experience stunting than those living in areas with good sanitation. Poor sanitation constitutes a major risk factor for stunting, which significantly impacts children's growth and development. Enhancing access to improved sanitation facilities and promoting good hygiene practices are priorities to prevent stunting, particularly in areas with high prevalence. These findings offer strong evidence to support the policymakers and other stakeholders in integrating sanitation- based interventions into public health programs to reduce the prevalance of stunting among children under five years of age.

Food Taboos and Prevention of Postpartum Anemia in the Karo Ethnic Community

2025-06-12T19:41:03+00:00

Postpartum anemia is a condition characterized by reduced hemoglobin levels in the blood, which diminishes the blood’s ability to optimally transport oxygen to meet the body’s physiological needs. Although a global health issue, this condition remains frequently overlooked and under-researched. This study aims to explore the perceptions, meanings, and values associated with cultural practices, such as food taboos, and their relationship to the occurrence of postpartum anemia in the Karo ethnic community. Using a qualitative approach, data were gathered through in-depth interviews with three postpartum mothers. The interviews were conducted over multiple sessions with each participant until responses became consistent. The findings revealed that specific food taboos are practiced during the postpartum period, which are culturally significant but may affect iron intake and risk worsening anemia. Postpartum mothers in the Karo ethnic community avoid consuming seafood and leafy vegetables with hairy surfaces. These foods are restricted due to the belief that they may cause itching. Food taboos among postpartum mothers in the Karo ethnic community can lead to micronutrient deficiencies, contributing to anemia. This highlights the need for health interventions that integrate cultural context and local wisdom.

Identification of Cryptosporidium. Sp and Blastocystis. Sp

2025-06-14T01:46:59+00:00

Intestinal protozoan infection is still a major health problem in children, because children are most often in contact with soil as a source of infection and are a significant threat, but are often overlooked to public health until severe or chronic complications because many of them are usually asymptomatic or only manifest mild symptoms. The purpose of this study was to determine the incidence of Cryptosporidium sp, Blastocystis sp infections in school children in Pasir Sebelah, Padang City. This type of research is descriptive categorical, the sample is primary data with a sample size of 66 children using consecutive sampling techniques. Data were collected through direct interviews with caregivers and anthropometric measurements conducted by trained enumerators using standardized tools. This study was analyzed univariately and presented in the form of a frequency distribution table. This study obtained the results of intestinal protozoan infections in children found Cryptosporidium sp 42.4% added and Blastocyctis sp 31.8%. Intestinal protozoan infections were higher in the 7-10 year age group 51.5% and higher in girls 54.5%. The conclusion of this study was that the incidence of intestinal protozoan infections was quite high in children at Elementary School 23 Padang City. Conclusions: these children need special attention, and immediate treatment for infected children and counseling on education and prevention of diseases caused by intestinal protozoa.

Effectiveness of Peppermint Aromatherapy in Reducing the Incidence of PONV in Post-Anesthesia Bone Patients

2025-06-14T06:33:50+00:00

Post Operative Nausea and Vomiting (PONV) is a common complication after surgery with spinal anesthesia, with an incidence reaching 20–30%. PONV can prolong hospitalization, increase treatment costs, and reduce patient comfort. Peppermint aromatherapy is an effective, easy, and patient-accepted alternative to reduce PONV symptoms. Peppermint contains menthol which is carminative and antispasmodic, and can provide a relaxing effect through stimulation of the central nervous system. Objective to determine the effect of peppermint aromatherapy on the incidence of PONV in patients after spinal anesthesia. Method: This study was a quasi-experiment with a pre and post test design without control. Thirty post-spinal anesthesia patients were given peppermint aromatherapy, then PONV incidence was measured before and after the intervention using the Gordon scale. Data analysis used the Wilcoxon test. Results: Peppermint aromatherapy has been proven to be effective in reducing the incidence of PONV in patients after spinal anesthesia. Of the 30 respondents, the majority experienced nausea (73.3%) and vomiting (26.7%) before the intervention. After aromatherapy, 36.7% did not experience symptoms, and only 6.7% still vomited. The Wilcoxon test showed a significant difference (p = 0.000), indicating that peppermint aromatherapy was statistically effective in reducing PONV. Conclusions: Peppermint aromatherapy is effective in reducing the incidence of PONV in post-spinal anesthesia patients, as indicated by a decrease in nausea and vomiting symptoms after the intervention.

The Effectiveness of the Phase II Cardiac Rehabilitation Program on the Functional Capacity of the Heart and Quality of Life of Post-CABG Patients

2025-06-14T07:19:30+00:00

The Coronary Artery Bypass Graft (CABG) procedure is a form of surgical intervention carried out to treat coronary heart disease (CHD). Cardiac rehabilitation programs are training and education programs that aim to improve patients' heart health, especially after surgery. One of the goals of cardiac rehabilitation is to return patients to achieve optimal conditions, increase the functional capacity of the heart, and improve the quality of life. The purpose of the study was to test the effectiveness of the phase II cardiac rehabilitation program on increasing cardiac functional capacity and quality of life of post-CABG patients at H. Adam Malik Hospital Medan. The research design is a quasi-experimental one group pre-test and post-test design. The sampling technique is purposive sampling. The number of samples was 33 respondents. Data analysis was conducted using dependent t tests for heart rate (HR), systolic blood pressure, and diastole blood pressure. Data on respiratory rate (RR), METs, oxygen saturation (SpO2), and quality of life variables were used to test the wilcoxon. The results of the data analysis showed that there was no effect of the phase II cardiac rehabilitation program on HR and RR (p>0.05 value) because the majority of respondents took beta-blocker drugs. However, the results of statistical tests showed that there was an effect of the phase II cardiac rehabilitation program on systole and diastole blood pressure, METs, SpO2, and the quality of life of the respondents (p value <0.05). This study proves that the phase II cardiac rehabilitation program is effective in improving the functional capacity of the heart and the quality of life of post-CABG patients.

The Effectiviness of Aquatic Therapy as A Rehabilitation Innovation for Stroke Patients: Water as A Medium of Recovery-A Systematic Literature Review

2025-06-16T07:27:58+00:00

Stroke often causes long-term disabilities, significantly affecting motor and functional abilities. Rehabilitation interventions such as aquatic therapy, which utilize the properties of water to enhance movement and reduce pain, have gained increasing attention as innovative rehabilitation strategies. This systematic literature review aims to analyze and summarize the effectiveness of aquatic therapy as a rehabilitation innovation for improving functional recovery in stroke patients. A systematic search was conducted in three databases—PubMed, ScienceDirect, and Google Scholar—for articles published between January 2020 and January 2025. The keywords used in English included “aquatic therapy,” “stroke rehabilitation,” and “water-based therapy.” From the initial search, a total of 45 articles were identified. After screening titles and abstracts based on inclusion criteria (language, publication year, and open-access availability), 20 full-text articles were reviewed in detail. Following critical appraisal and relevance assessment to the research objectives, 10 articles were selected for final analysis. These articles were then synthesized to evaluate the effects of aquatic therapy on functional recovery, particularly focusing on gait and balance improvement in post-stroke patients. This review found 45 studies after identification. Most studies showed that aquatic therapy significantly improved balance, gait, muscle strength, and quality of life among stroke survivors. Additionally, resistance offered by water supports muscle strengthening without overstraining. However, variations in session duration, water temperature, and exercise intensity across studies suggest a need for standardized protocols. Aquatic therapy is an effective and innovative rehabilitation approach for stroke patients, particularly in enhancing motor recovery and quality of life. Future research should focus on standardized intervention protocols and long-term outcomes.

Atypical Localization of Pyogenic Granuloma on the Upper Lip: A Case Report

2025-06-19T10:37:46+00:00

Pyogenic granuloma is a benign vascular tumor that commonly arises following minor trauma, irritation, or hormonal influences. Although frequently found on the gingiva, hands, or face, localization on the upper lip is considered uncommon. This case report aims to describe the clinical presentation, diagnostic features, and therapeutic outcome of pyogenic granuloma in an unusual location. A 16-year-old girl presented with a two-month history of a red, painless nodule on the upper left lip. The lesion initially appeared as a wound that gradually enlarged and occasionally bled following minor trauma. The patient had been using orthodontic braces for the past four months. Dermatological examination revealed a solitary erythematous papule measuring 0.3 cm with a stalk and crust. Histopathological examination revealed slit-like proliferative blood vessels and inflammatory infiltrates, confirming the diagnosis of pyogenic granuloma. The lesion was treated by shave excision followed by electrocautery. Clinical improvement was observed, with complete resolution of the lesion at the 10-day follow-up. This case underscores the importance of clinical vigilance in recognizing pyogenic granuloma at atypical anatomical sites and demonstrates the effectiveness of shave excision combined with electrocautery as a treatment modality.

Comparison of the Effectiveness of Sbar and I-PASS Communication Methods in Nurse Handover: Literature Review

2025-06-19T11:04:49+00:00

Communication is a critical component in providing safe and high-quality nursing care. Various adverse events that occur in hospitals are mostly caused by communication errors between health workers. This literature review aims to analyze a systematic comparison of the effectiveness of the SBAR and I-PASS communication methods. Literature search methodology includes major electronic databases such as PubMed, Google Scholar with a publication time range of 2013-2023. A total of 1,008 articles were obtained from the initial search, after the screening process using the PRISMA flow diagram, 10 journals were obtained that met the criteria. Research results: Both SBAR and I-PASS methods were proven to be effective in increasing patient safety, with I-PASS showing slightly superior performance in reducing the risk of medical errors. Although both methods have a structural framework for information transfer, I-PASS shows better consistency and depth of information than SBAR. I-PASS shows superiority in handover process efficiency, with a more significant time reduction and increased communication completeness compared to SBAR. Conclusion: The I-PASS communication method is more recommended than SBAR in nursing handover practice because it has higher effectiveness in reducing the risk of medical errors and improving the quality of information transfer.

Implementation of Early Warning System (EWS) by Nurses in the Emergency Department and the Impact to Prevention Incident No Expected: Systematic Review

2025-06-22T13:36:32+00:00

The Emergency Department is a high-intensity clinical setting that manages critically ill patients who are highly susceptible to sudden clinical deterioration. Early detection through the implementation of the Early Warning System plays a crucial role in preventing unexpected adverse events, with nurses serving as the primary implementers of this system. This review aims to evaluate current evidence on the implementation of the Early Warning System by nurses in the Emergency Department and its impact on the prevention of unexpected adverse events. This study employed a systematic review approach by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines during the article selection process and using the 2023 edition of the Joanna Briggs Institute (JBI) Critical Appraisal Tool to assess the quality of included studies. Search for articles through the ScienceDirect, ProQuest, PubMed, BMJ Journal, and EBSCO databases from 2020 to 2025. and 10 articles were analyzed. The majority of studies reported that the use of the Early Warning System consistently enhances the early detection of patient deterioration, accelerates clinical response, improves triage accuracy, and assists in predicting the need for advanced care such as admission to intensive care units. Implementation by nurses was also associated with improved compliance in vital signs monitoring and a reduction in patient mortality.

Predicting Unfavorable Treatment Outcomes in Multi-Drug Resistance Tuberculosis Patients: A Retrospective Study in Jakarta, Indonesia

2025-06-21T02:10:55+00:00

Treatment of multidrug-resistant tuberculosis (MDR-TB) with a short-term regimen offers promise in terms of higher effectiveness and reduced therapy duration. However, treatment failure remains a major challenge in its implementation. This study aimed to identify predictive factors associated with unfavorable treatment outcome (UTO) among MDR-TB patients receiving the short-term regimen in DKI Jakarta Province from 2020 to 2022. Methods: A retrospective cohort study, using data from the National TB Information System (SITB). We retrieved all MDR-TB patients who started short-term treatment regimens at referral hospitals in DKI Jakarta Province in the period January 2020 to December 2022, totaling 166 patients. Each patient was followed for up to 11 months from the initiation of treatment, with final treatment outcomes collected through November 2023. Survival analysis using Cox proportional hazards regression was employed to assess the association between patient characteristics and time to UTO. Results: A total of 43.4% of patients is UTO. The cumulative probability of remaining free from UTO was 38% after day 400. Multivariate regression analysis showed that HIV-positive status (aHR = 2.98; 95% CI: 1.77–4.99) and comorbid diabetes mellitus (aHR = 1.92; 95% CI: 1.19–3.11) were significantly associated with an increased risk of UTO. Conclusion: UTO among MDR-TB patients on the short-term regimen remains high. HIV status and diabetes comorbidity are critical factors influencing treatment outcomes and should be prioritized in clinical management strategies for MDR-TB.

Obstetric Determinants of Postpartum Complications among Mothers in Indonesia: Evidence from the 2023 Indonesian Health Survey

2025-06-21T02:37:12+00:00

Postpartum complications remain a significant contributor to maternal morbidity and mortality in Indonesia, yet national data on their determinants remain limited. Understanding the role of obstetric factors in postpartum outcomes is essential for informing maternal health strategies, particularly in low- and middle-income settings where delays in risk detection and care are common. This study aims to analyze the association between obstetric factors and the occurrence of postpartum complications using data from the 2023 Indonesian Health Survey (SKI). This cross-sectional analysis utilized secondary data from the 2023 Indonesian Health Survey (SKI), involving women aged 15–54 years who delivered in the last five years. The dependent variable was postpartum complications, while independent variables included parity, place of delivery, mode of delivery, type of birth attendant, and pregnancy-related conditions. Descriptive statistics, Chi-Square tests, and multivariate logistic regression were used in the analysis. The results showed that primiparous women, those who delivered via cesarean section, gave birth in hospitals, were attended by doctors, and experienced complications during pregnancy were significantly more likely to report postpartum complications. These findings underscore the need for improved antenatal risk screening, enhanced referral systems, and targeted maternal health interventions to prevent adverse outcomes in the postpartum period in Indonesia.

A Study on the Changes in Seawater Quality Due to Dumping of Trenching Materials

2025-06-22T13:34:23+00:00

The dumping of trenching materials in offshore areas poses a potential risk to environmental quality and requires proper management to prevent disruption of ecosystem balance. Objective: This study aims to analyze changes in seawater quality, focusing on key parameters such as Total Suspended Solids (TSS), Dissolved Oxygen (DO), Ammonia (NH₃), Orthophosphate (PO₄-P), and Oil and Grease. Method: This study employed a quantitative descriptive research design aimed at assessing marine water quality. Primary data were collected through direct seawater sampling at three observation points in the coastal waters of Tanjung Jumlai, Penajam District, North Penajam Paser Regency. Seawater sampling was conducted using a Horizontal Water Sampler to ensure representative sample collection from each location.The collected samples were subsequently analyzed in a laboratory to determine the concentrations of five key water quality parameters. The results were then compared with baseline conditions and the marine water quality standards as stipulated in Government Regulation of the Republic of Indonesia No. 22 of 2021. Based on the laboratory results, the Marine Water Quality Index (IKAL) was calculated, and the water quality category was determined in accordance with the Minister of Environment and Forestry Regulation No. 27 of 2021.Results: "The analysis results showed an increase in TSS and ammonia levels, while DO slightly decreased after the dumping activity; however, these values remained below the quality standards. In contrast, orthophosphate and oil and grease levels increased beyond the permissible limits. Orthophosphate concentrations ranged from 0.020 to 0.030 mg/L, exceeding the quality standard of 0.015 mg/L, likely due to the release of nutrients contained in the sediments. Oil and grease concentrations reached 1.7 mg/L at all three observation sites, surpassing the standard of 1 mg/L, primarily due to vessel and heavy equipment operations during the dumping process. The rise in phosphorus and oil and grease levels serves as an early indicator of environmental pressure on marine waters and poses a risk of reducing aquatic biodiversity. Therefore, regular environmental quality monitoring is necessary to prevent more severe impacts. Although the Marine Water Quality Index decreased after the dumping activity, it remained within the range of 70–90, classified as 'good'.

Relationship Between Diet Patterns and Hypertension Levels in the Elderly

2025-06-22T14:33:08+00:00

Hypertension is a common health problem in the elderly population and is a significant risk factor for cardiovascular diseases. Dietary patterns are known to influence blood pressure control significantly, yet many elderly individuals continue to follow unhealthy eating habits that may exacerbate their condition. Objective: This study aims to determine the relationship between dietary patterns and hypertension levels in elderly individuals. Aims: This study aims to explore the relationship between dietary patterns and hypertension levels in the elderly and to analyze the distribution of hypertension based on age group and severity. Methods: This study used a quantitative approach with a cross-sectional observational analytical design. Data were collected from 45 elderly respondents through interviews using a structured dietary questionnaire and direct blood pressure measurement using a calibrated digital sphygmomanometer. Data analysis was conducted in two stages: univariate analysis to describe the characteristics of respondents and the distribution of hypertension, and bivariate analysis using the Chi-square test to assess the relationship between dietary patterns and hypertension levels. Results: The results showed that most respondents came from the 60-69 age group (88.89%), and the 70-79 age group (11.11%). Most respondents (57.8%) experienced stage I hypertension, while the rest (42.2%) experienced stage II hypertension. Bivariate analysis showed a significant relationship between diet and hypertension levels (p-value = 0.035). Respondents with a good diet tended to experience stage I hypertension (77.8%), while a poor diet was more dominant in stage II hypertension (78.9%). Conclusion: This study shows a significant relationship between diet and hypertension levels in the elderly in Bekasi City. The elderly with a good diet tend to experience stage I hypertension, while a poor diet correlates with stage II hypertension. These results indicate that diet plays an important role in the severity of hypertension in the elderly.

Chronic Rhinosinusitis with Dextra ET Sinistra Nasal Polyps

2025-06-22T14:52:51+00:00

Chronic rhinosinusitis with nasal polyps is a chronic inflammatory condition of the nasal mucosa and paranasal sinuses, characterized by bilateral polypoid tissue growth. This disease can significantly reduce quality of life due to persistent and recurrent symptoms. This report aims to describe a case of chronic rhinosinusitis with right and left nasal polyps, including risk factors, clinical features, supporting examination results, and patient management and follow-up. This study is a descriptive case report involving one patient with bilateral chronic nasal congestion, anosmia, and rhinorrhea that lasted more than 12 weeks. Data were collected through anamnesis, physical examination, nasoendoscopy, CT scan imaging, and patient medical records. Data analysis was performed qualitatively by describing the clinical course, supporting examination results, therapeutic interventions, and patient follow-up evaluation. The patient experienced significant improvement post-operatively with decreased symptoms, increased quality of life, and no polyp recurrence was found within 3 months after the procedure. Appropriate diagnosis and management of chronic rhinosinusitis with bilateral nasal polyps are essential to prevent complications and improve patient prognosis.

Model of Risk Factors Identification: A Qualitative Approach to Mitigate Pilot Errors in Indonesia

2025-06-25T06:58:49+00:00

Pilot errors accounts for 80% of accidents and 50% of serious incidents, thus identifying the risk factors is crucial to mitigation strategies. The research aimed to develop a model of pilot errors’ risk factors identification and mitigation by conducting a Focus Group Discussion (FGD) with stakeholders in Indonesia. This was a qualitative analysis by conducting hybrid FGD, divided into four groups of experts consisted of officials from the Directorate General Civil Aviation, human factors experts, active pilots and investigators from the National Transport Safety Committee, from 28 to 29 August 2024. The data was collected by transcribing verbatim transcript, then analysed using the Steps for Coding and Theorization and Content Validity Index. model was developed, consisted of pilots’ risk factors, divided into three themes, 16 sub-themes, grouped into internal and external factors, which can be identified by four activities and can be mitigated by three activities. The factors contributed to aviation safety are multifactorial and interrelated. The complexity of pilots’ risk factors involves a continuous assessment of identification and mitigation, emphasizes the adaptive collaboration among stakeholders. A significant contribution in aviation human factors data for the Safety Management System implementation in Indonesia.

Assessment Tools for Post-Stroke Discharge Readiness: A Literature Review

2025-06-25T10:45:34+00:00

Stroke survivors are at high risk of hospital readmission due to recurrent stroke, comorbidities, and inadequate discharge preparation. Readiness for hospital discharge plays a pivotal role in ensuring a safe transition of care and improving post-stroke outcomes. Evaluating patient and caregiver readiness for hospital discharge is essential to reduce the likelihood of readmission and optimize home care outcomes. This review aimed to identify, describe, and evaluate existing tools used to assess discharge readiness in post-stroke patients, and examine their effectiveness in supporting care transitions and preventing hospital readmissions.Methods: A systematic review was conducted in accordance with PRISMA guidelines. Four databases-PubMed, Science Direct, Clinical Key, and Google Scholar—were searched for relevant articles published between 2021 and 2025 using predefined keywords related to stroke, discharge readiness, transition of care, and readmission. After screening 202 initial records, 34 articles were selected for full-text review. Ten studies met the inclusion criteria and were then critically appraised using the Joanna Briggs Institute (JBI) checklist to assess methodological quality and risk of bias. The included studies were synthesized narratively based on study design, assessment tools used, psychometric properties, and their impact on discharge readiness and hospital readmission outcomes. The review identified several validated tools, including the Readiness for Hospital Discharge Scale (RHDS), the Preparedness Assessment for the Transition Home After Stroke (PATH-s), and the Caregiver Contribution to Self-Care Inventory (CC-SC-CII-v2). These tools varied in focus, population, and application context. While some showed strong psychometric properties and predictive power for readmission, others highlighted the need for caregiver inclusion and context-specific adaptation. However, inconsistencies in implementation, limited integration into clinical workflows, and lack of long-term outcome evaluations remain significant barriers. This review enhances understanding of discharge readiness assessment tools in post-stroke care and underscores their value in reducing readmissions and optimizing care transitions.

Peer-Based Interventions to Improve Self-Efficacy in Patients with Chronic Diseases

2025-06-25T14:07:31+00:00

Chronic diseases such as heart failure, diabetes, and hypertension require active patient involvement in self-management. Self-efficacy is a key factor that influences the success of self-management among individuals with chronic conditions. This article aims to synthesize current empirical evidence on the effectiveness of peer-based interventions in improving self-efficacy among patients with chronic diseases. This study employed a systematic review approach based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Literature was retrieved from PubMed, ScienceDirect, ProQuest, EBSCOhost, Wiley, and Google Scholar databases. The inclusion criteria were full-text articles in English, with designs such as randomized controlled trials, quasi-experiments, and pilot studies published between 2015 and 2025. Of the 635,062 8 articles identifie the inclusion criteria and were analyzed. The included articles were critically appraised using appropriate tools and independently reviewed for quality and relevance, with data systematically extracted and narratively synthesized due to methodological heterogeneity. All reviewed studies reported a significant increase in self-efficacy following peer-based interventions. These interventions were implemented in various formats, including group training, theory-based peer coaching (eg, Health Belief Model, Health Promotion Model), digital peer support, and nurse-facilitated peer programs. Some studies also demonstrate long-term effects and additional benefits such as improved quality of life, better stress management, and reduced stigma. Peer-based interventions are proven effective in enhancing self-efficacy among patients with chronic diseases and may serve as a complementary strategy in clinical practice and primary health care services.

The Effect of the Implementation of Family Functions with Self-Harm Behavior in Adolescents in the Digital Age

2025-06-26T08:16:37+00:00

The prevalence of self-harm behavior among adolescents has increased significantly. Research conducted by Muehlenkamp et al. (2012) shows that about 17-18% of adolescents worldwide report having committed self-harm at least once in their lives. Family has a huge influence on the psychological and emotional development of adolescents. The purpose of this study is to find out how the implementation of family functions affects self-harm behavior in adolescents. This study uses a quantitative method with a cross-sectional design. The researcher will examine how to carry out family functions and also how self-harm behavior is carried out by adolescents, then look at the relationship between these two things. Research Subject: Adolescents aged 12-18 years as many as 183 students with total sampling technique. Data were collected using the Family Assessment Device (FAD) instrument to assess family function and the Deliberate Self-Harm Inventory (DSHI) to measure the frequency and intensity of self-harm in adolescents. Data will be analyzed using the Chi square correlational statistical technique to see the relationship between family function and self-harm behavior. The results showed that family function in the good category was 61.7% while family function in the bad category was 38.3%. Self-harm behavior in adolescents 23.5%. Based on the Chi Square test, a p value of 0.048 was obtained, meaning that there is a significant relationship between the implementation of family functions and self-harm behavior in adolescents.

The Role of Patient Satisfaction in Mediating the Influence of Brand Image and Price on Inpatient Decision-Making (Non-JKN Patients): A Case Study

2025-06-26T08:31:12+00:00

Marketing is one of the core activities that must be undertaken by both goods and service companies, including hospitals. Various hospitals implement different strategies to enhance public trust in their services. This study aims to analyze and explain the mediating role of patient satisfaction in the relationship between brand image and price on inpatient decision-making among non-JKN patients. This study was a quantitative research employing a case study approach, conducted at Siloam Hospital Denpasar. The sample was choshen by purposive sampling. The total number of respondents was 100 non-JKN (non-national health insurance) inpatients. The research instrument used was a questionnaire measuring satisfaction related to brand image and decision-making among non-JKN patients. The analysis technique employed was Structural Equation Modeling (SEM) using the Partial Least Squares (PLS) approach. The R-square value for the influence of brand image and price on patient decision-making was 0.772, indicating a substantial effect (77.2%). This means that brand image and price influence patient decisions by 77.2%, while the remaining 22.8% is influenced by other variables. The R-square value for the influence of brand image and price on patient satisfaction was 0.636, also indicating a strong effect (63.6%), with the remaining 36.4% influenced by other factors. The findings indicate that brand image has a positive and significant influence on the decision-making of non-JKN inpatients at Siloam Hospital Denpasar.

Development of Health Promotion through Video Media to Increase Knowledge of Bullying Prevention in Adolescents

2025-06-26T08:48:23+00:00

Indonesia ranks fifth with the highest bullying cases, which is 41.1% of 78 countries. The negative effects that occur on the victim are experiencing psychological disorders, including low self-esteem. Therefore, there is a need for health education related to bullying through video media. This media is effective because it is able to attract attention through real visualizations and audio that supports the content of the material. The purpose of this study is to find out the difference in students' knowledge before and after the provision of health education through video media. This research method uses the Quasy experimental pre posttest one group design method. The population in this study is all students of SMK NU Ungaran aged 15-18 years, in March 2024 a total of 820 students. The technique used for sampling in this study is Proportionate random sampling. The sample in this study is 92 students. This research instrument used a bullying knowledge questionnaire consisting of 15 statements with a choice of true, wrong answers and low, medium, and high knowledge measurement results. Of the 15 statements in this knowledge questionnaire, validity has been tested and declared valid all with a value range of 0.576-0.904. The results of the reliability test are 0.874. Bivariate analysis used a simple t test dependent test. The results of the study were obtained Most of the students' knowledge before the intervention was low category as many as 52 respondents (56.5%), while the knowledge after the intervention was mostly in the high category of 55 respondents (59.8%). The results of the dependent t-test were obtained with a p-value of 0.000 which proves that there is a difference in knowledge before and after health education through video media.

Vulnerability Mapping of Dengue Hemorrhagic Fever (DHF) Cases in West Java Province in 2023

2025-06-28T13:06:54+00:00

Dengue Hemorrhagic Fever (DHF) is one of the public health problems that needs serious attention, because this disease contributes a high mortality rate. Dengue disease related to environmental conditions, climate, population density, and community behavior. West Java is the highest province of dengue cases in Indonesia in 2023 that has 19,328 cases with the number of deaths due to dengue reaching 134 people. This study aims to map the spread of the disease by describing the distribution of dengue cases and describing the level of vulnerability through risk factors from dengue. The method used in this study is descriptive research with a Geographic Information System (GIS) approach. The data used is secondary data from the official website of the Central Statistics Agency (BPS) of West Java Province. Data analysis was carried out using QuantumGIS (QGIS) version 3.40.4 which is open-source software. The scoring results of 27 districts and cities in West Java Province show that the priority areas in handling of dengue cases are Bogor City, Bekasi City, and Bogor Regency which are the areas with the highest level of vulnerability. This study is expected to provide an overview of the distribution of cases and the level of dengue vulnerability based on districts/cities in West Java Province, so that studies can be carried out on dengue disease prevention and control programs, especially in areas with the highest level of vulnerability.

The Impact of Stigma on the Mental Health of Adolescents with Tuberculosis: A Scoping Review

2025-06-29T10:43:22+00:00

Stigma toward adolescents with tuberculosis (TB) is a significant psychosocial issue that negatively affects their mental health. Adolescents are emotionally vulnerable, and the experience of stigma can exacerbate psychological distress and hinder treatment adherence. Objective: This study aims to review the scientific literature on the impact of stigma on the mental health of adolescents with tuberculosis and to identify the affected domains of mental well-being. Method: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Literature searches were performed in three major databases (Scopus, PubMed, and ScienceDirect) using the keywords “stigma,” “tuberculosis,” and “adolescent.” Articles were selected based on inclusion criteria: published between 2021 and 2025, written in english, open access, and directly relevant to the research, data extraction from the selected articles was conducted using a matrix format in microsoft word. The domains used for data extraction included the researcher’s name and year of publication, article title, research objectives, research methodology, research instruments, and key findings. Results: Out of 1,233 initially retrieved articles, 10 met the eligibility criteria and were analyzed. The synthesis of findings revealed that stigma has a detrimental impact on adolescent mental health, particularly in the forms of anxiety, depression, social withdrawal, and feelings of hopelessness. Stigma was also identified as a contributing factor to poor treatment adherence among adolescents with TB. Stigma significantly contributes to mental health challenges in adolescents diagnosed with tuberculosis. These findings highlight the urgent need for the development of multidisciplinary interventions that address psychosocial aspects to support treatment success and enhance the quality of life among adolescent TB patients.

Are Psychological Empowerment, Quality of Work Life, Organizational Commitment, and Job Satisfaction Necessary for Employee Performance in Manufacturing? Dual-Analysis SEM-PLS and NCA

2025-06-29T23:44:49+00:00

The manufacturing sector in Indonesia serves as a strategic economic pillar, significantly contributing to national growth. With a target to account for more than 20% of the Gross Domestic Product (GDP) by 2024. this sector not only drives economic development but also absorbs a substantial portion of the workforceThis study investigates the relationships between Psychological Empowerment, Quality of Work Life, Organizational Commitment, Job Satisfaction , and Employee Performance. Data from 287 Manufacturing employees in Kendal were analyzed using Structural Equation Modeling (SEM) with SmartPLS and Necessary Condition Analysis (NCA). The results show that Psychological Empowerment and Quality of Work Life significantly influence Organizational Commitment and Job Satisfaction. Both factors are also necessary conditions for these outcomes. Organizational Commitment and Quality of Work Life significantly impact Employee Performance, but Job Satisfaction does not directly affect performance in SEM. However, NCA identifies Job Satisfaction as a necessary condition for performance, emphasizing the dual importance of sufficient and necessary thresholds in Psychological Empowerment and Quality of Work Life. The study’s originality lies in combining SEM-PLS and NCA for a comprehensive analysis and exploring these relationships in an Indonesian manufacturing context. Practical implications include prioritizing employee empowerment, supportive work environments, and competitive compensation. Limitations involve the exclusion of other variables and affecting generalizability.

Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke: Factors Affecting Clinical Outcomes

2025-07-01T10:59:30+00:00

Stroke is one of the leading causes of disability and death worldwide. Thrombolytic therapy using intravenous recombinant tissue plasminogen activator (rt-PA) is the recommended treatment. However, functional outcomes vary due to various factors. Objective: The aim of this study was to analyze the factors affecting clinical outcomes of acute ischemic stroke patients treated with intravenous rt-PA. Method: This research was a retrospective study with a total sample of 52 acute ischemic stroke patients who received intravenous rt-PA therapy. The research variable data were collected from medical records, then statistically analyzed and correlated with patient clinical outcomes. Data from medical records were collected based on inclusion and exclusion criteria, then statistically analyzed using STATA 13. Univariate analysis is presented in a list of categories according to the research variables determined by percentage (standard error). Bivariate analysis was tested using simple logistic regression and multivariate analysis using multiple logistic regression. Results: The results of this study showed that patient clinical outcomes are not significantly impacted by risk factors (age, gender, prior stroke history, comorbidities), COVID-19 vaccination, onset and severity of stroke, HCTS onset, dosage, or onset therapy. The side effects of intravenous rt-PA have a significant impact on patient clinical outcomes, including therapy response and discharge condition (p = 0.008, p < 0.05, and p = 0.012, OR 34.073 (95% CI 2.165 – 536.147)), but do not affect the length of hospital stay. Conclusions: In considering the other factors, the study indicates that patients experiencing adverse effects from intravenous rt-PA have worse clinical outcomes.

Evaluation of Telemedicine Services in Outpatient Services at Hospital X, Jember District using the Human Organization Technology Method (Hot-Fit Model)

2025-07-01T13:18:39+00:00

The use of telemedicine as an information technology innovation in health services is one of the important strategies in improving quality services, especially in the era of digitalization of the health system. This study aims to capture patient perceptions and satisfaction with the use of telemedicine services at the X Hospital using the HOT-Fit Model approach. This study uses a quantitative method with a cross-sectional design and SmartPLS-based Structural Equation Modeling (SEM) analysis, involving 380 randomly selected respondents. Data was collected by filling out a questionnaire via Google Form. The results of the study indicate that there is a significant relationship between human, organizational, and technological variables on the net benefits or utilization of telemedicine. The technological factor has the most dominant influence both directly on utilization and indirectly through improving the quality of human resources and organizational support. These findings emphasize the importance of investing in technological infrastructure, increasing digital human resource literacy, and the role of organizations in supporting the successful implementation of telemedicine services.

Legal Accountability in the Delegation of Authority from Obstetricians to Midwives in Maternal and Child Hospitals

2025-07-02T05:15:06+00:00

According to Law No. 4 of 2019 concerning Midwifery, midwives are recognized as part of the health workforce, alongside physicians, who are authorized to provide medical services. In practice, midwives interact directly with both patients and other healthcare professionals during service delivery. In many instances, a delegation of authority from physicians, especially specialists, to midwives is necessary to ensure effective inter-professional collaboration. This study aims to know about legal accountability in the delegation of authority from obstetricians to midwives in maternal and child hospitals. The research employed a literature review design using a comprehensive strategy. Articles were sourced from international research journal databases accessed via the internet, specifically ScienceDirect, PubMed, and Google Scholar. All searches were conducted in May-June 2025, focusing on articles published between 2016 and 2024. The keywords used in this literature review were adapted from the Medical Subject Heading (MeSH) terms, including "legal accountability,” “the delegation of authority from obstetricians to midwives,” “maternal,” and “legal and policy aspects.” A total of 265 articles were identified, with 40 articles meeting the criteria and having full-text access, and 6 articles ultimately meeting the inclusion criteria. The findings of various juridical studies reveal two major themes concerning the delegation of authority from obstetrician-gynecologists to midwives within hospital settings: (1) the limitation of delegation authority, and (2) the lack of legal responsibility from both parties involved. The legal accountability involved in the delegation of authority from an obstetrician to a midwife encompasses three domains: civil liability, criminal liability, and administrative liability.

Postpartum Blues - Husband's Support for Primipara Birth: Scoping Review

2025-07-02T05:34:58+00:00

The process of childbirth causes several psychological changes in the mother, feelings of happiness, sadness and fear. These changes in feelings can occur in the first week after giving birth. Postpartum psychological changes called postpartum blues are more at risk of occurring in primitive mothers, where there is a change in the role of a mother. Husband's support greatly affects how psychological changes can cause postpartum blues problems especially in primitive mothers. The purpose of this literature review study was made to identify the husband's support for the incidence of baby blues in primipara mothers. The method used in this study is a socpong review and was systematically studied based on PRISMA flow cahart using Proquest, ScienceDirect, and Google Scholar databases with the keywords "husband support" and "primipara". With the inclusion criterion, research articles in 2017-2022 were found 871 articles using English, full text and in the form of articles. After scanning, 16 articles were obtained that matched the criteria and then a review was carried out. The results of the scoping review study showed that the husband's support for primipara mothers showed that mothers who received support from their husbands were less at risk of experiencing postpartum blue.

Effectiveness of Progressive Muscle Relaxation and Benson Spiritual Care on Reducing Fatigue in Patients with Type 2 Diabetes Mellitus

2025-07-02T06:25:53+00:00

Multifactorial fatigue syndrome is a symptom often felt by people with type 2 diabetes mellitus. Fatigue can prevent someone from doing daily activities that support glucose control. Progressive muscle relaxation and Bensonspiritual careis a combination of relaxation to reduce fatigue. This study was to determine the effectiveness of the combination of progressive muscle relaxation and Bensonspiritual careon fatigue in patients with type 2 diabetes mellitus. Research design using designQuasy Experimental pre test – post test control group designand techniquespurposive sampling. The sample of this study consisted of 2 groups, namely intervention and control, each with 24 respondents. The sampling technique used is purposive sampling. Fatigue was measured using the Indonesian Multidimensional Fatigue Inventory (IMFI-20). There was a decrease in fatigue with the combination of progressive muscle relaxation and Bensonspiritual care with the average fatigue value decreasing significantly (-59.5) compared to the control group (-16.8). The results of the independent t-test obtained ap value <0.001, there was a difference in the average fatigue (difference) between the intervention group and the control group. The study concluded that there was a combined effect of progressive muscle relaxation and Bensonspiritual care on reducing fatigue in patients with type 2 diabetes mellitus. Interventions can be developed as independent nursing interventions in patients with type 2 diabetes mellitus with fatigue.

The Impact of the Covid-19 Pandemic on Infectious Disease Control Regulations in Indonesia

2025-07-02T08:24:19+00:00

The COVID-19 pandemic exposed critical fragilities within Indonesia’s legal framework for infectious disease control, manifesting as regulatory fragmentation, overlapping jurisdictional authorities, and asymmetrical human rights protections particularly regarding compensation for vulnerable populations. This study analyses post-pandemic legal transformations, including Law No. 17 of 2023, which incorporates technological innovations yet retains significant gaps in constraining emergency powers and ensuring oversight mechanisms. Comparative analysis with Singapore, Hong Kong, and Thailand reveals divergent approaches to emergency authority delegation, legislative scrutiny, judicial review, and compensatory frameworks. This study utilises 15 primary legal sources. Additionally, 19 secondary legal materials, published between 2019 and the issuance of Presidential Decree of the Republic of Indonesia Number 17 of 2023 concerning the Declaration of the End of the Coronavirus Disease 2019 (COVID-19) Pandemic Status, are employed. Furthermore, five tertiary legal materials are used. These legal materials serve as the basis for examining the identified legal issues. The legal material analysis technique adopted in this study involves descriptive analysis, which includes expert opinions, conclusions, legal interpretations, and comparative legal analysis. The resurgence of COVID-19 in neighbouring states underscores the imperative for sustained preparedness. We recommend: (i) comprehensive statutory revisions; (ii) regulatory harmonisation; (iii) establishment of independent dispute-resolution mechanisms; (iv) enactment of robust health data protection legislation; and (v) enhanced surveillance and risk communication capacities. These reforms are fundamental to constructing a legally resilient, adaptive, and equitable system capable of mitigating future pandemic threats while balancing public health imperatives with constitutional safeguards.

Analysis of Risk Factors Influencing the Incidence of Diabetes Mellitus among Employees

2025-07-05T19:17:58+00:00

Diabetes Mellitus (DM) is a chronic metabolic disorder that remains a major public health concern globally. Its prevalence is influenced by various lifestyle and hereditary factors. This study aims to analyze the risk factors contributing to the incidence of DM among employees at Segiri Community Health Center. A retrospective case-control study was conducted using secondary data from health screenings and fitness assessments of Segiri Community Health Center employees in September 2023. From 50 staff members, 40 with complete records were included: 10 DM cases and 30 non-DM controls (1:3 ratio). Data included medical history, lifestyle behaviors, and anthropometric measurements. Analysis involved univariate and bivariate tests using cross-tabulation and Odds Ratio (OR). The most significant risk factor was abnormal Body Mass Index (BMI), as all DM cases had abnormal BMI values. Other influential factors included parental history of diabetes (OR = 18.0), personal history of hypertension (OR = 9.3), and parental history of hypertension (OR = 6.0). Additional contributing factors were low fruit and vegetable intake (OR = 4.0), excessive salt intake (OR = 1.63), and abnormal waist circumference (OR = 1.31). Smoking and alcohol consumption were not significantly associated with DM in this sample. Abnormal BMI and a family history of diabetes and hypertension significantly contribute to the incidence of DM. Targeted interventions focusing on these modifiable and non-modifiable risk factors are essential for effective workplace prevention strategies.

Initiation of the Development of a Bedside Handover Guideline in the Emergency Department of Hospital X

2025-07-03T19:40:00+00:00

Emergency Department (ER) services are highly complex and carry significant risks to patient safety. Effective communication during the handover process is critical to improving patient safety and care quality. Bedside handover is a strategic form of communication between healthcare workers, ensuring that vital patient information—such as vital signs and urgent care needs—is conveyed accurately and directly, with involvement from both patients and families. The ISBAR communication tool provides a clear structure that helps reduce the risk of miscommunication. Objective to develop a guideline that serves as a consistent reference for nurses in performing bedside handover, fostering a culture of safety and high-quality care at Hospital X. Method: This study used a case report approach with both qualitative and quantitative methods to examine the nursing service system at Hospital X. Data were collected through interviews, document reviews, observations, and questionnaires, and analyzed using the nursing management function approach: planning, organizing, directing, and controlling. Questionnaires were distributed to unit leaders, unit coordinators, and all staff nurses working in Room X, with a total of 48 respondents with total sampling. In the Unfreezing Phase, many ER nurses resisted the bedside handover method, perceiving it as time-consuming and burdensome. Observations revealed continued reliance on traditional handover methods. In the Changing Phase, a Plan of Action (POA) was developed, including drafting supervision guidelines, conducting socialization, and evaluating bedside handover implementation. In the Refreezing Phase, bedside handover was expected to become standard practice, though implementation was limited by time constraints. The implementation of bedside handover in the ER, guided by Lewin’s Change Theory and structured through ISBAR, is a strategic step to ensure care continuity and improve patient safety.

The Effect of Nurse Driven Protocol Implementation on the Incidents of Catheter Acquired Urinary Tract Infection in Geriatric Patients

2025-07-04T07:55:09+00:00

The aging process affects the immune system, making the elderly more vulnerable to bacterial and viral infections. Urinary tract infection (UTI) is the second most common infection among geriatric patients. UTIs caused by urinary catheter use, known as Catheter Acquired Urinary Tract Infections (CAUTI), are the leading cause of nosocomial infections, with 80% linked to catheter use. Preventing catheter use beyond 72 hours can reduce CAUTI incidence. The use of Nurse Driven Protocols (NDP) is one of the interventions recommended by the CDC to reduce catheter-related risk factors. This articles aiming to discuss the impact of NDP implementation on the incidence of CAUTI in geriatric patients. This study was conducted using the PRISMA checklist. Literature searches were conducted through several databases, including ProQuest. Science Direct, Scopus, and ClinicalKey Nursing, within the last five years (2020–2024). From 110 identified articles, five met the inclusion criteria, and two were analyzed in depth. The implementation of Nurse Driven Protocols (NDP) significantly reduced the incidence of CAUTI by ensuring catheters are only used when absolutely necessary and removed as soon as no longer indicated. Routine 24-hour assessments enable nurse to independently evaluate catheter use based on clear clinical criteri , such as the HOUDINI system. NDP empowers nurse to conduct independent evaluations and make decisions regarding catheter use, effectively preventing CAUTI and improving the quality of patient care.

Hazard Identification and Exposure Assessment for Wastewater Management Workers

2025-07-04T09:16:00+00:00

Sanitation workers in hospitals are at high risk of developing health disorders due to direct exposure to wastewater during the operation and maintenance of wastewater treatment plants (WWTP). This study aims to identify the types of health problems experienced by 33 sanitation personnel at Sentra Medika Cibinong Hospital and to analyze the contribution of wastewater treatment processes to these health risks using the Life Cycle Assessment (LCA) approach. Methods: This study employed a qualitative descriptive method using a Life Cycle Assessment (LCA) approach. From a total population of 33 individuals, the researcher selected all 33 as the study sample. Data were analyzed using both quantitative and qualitative approaches. Additionally, the Life Cycle Assessment (LCA) methodology was employed to identify environmental impacts and potential health risks arising from the hospital's wastewater management system. Results: The results showed that 87.9% of the workers reported health complaints, including skin irritation, respiratory symptoms (shortness of breath, coughing), dizziness, nausea, vomiting, and gastrointestinal disorders. The highest exposure occurred during chemical dosing, sludge pit cleaning, and wastewater sampling. The LCA results indicated that the aeration and disinfection stages contributed significantly to hazardous emissions such as hydrogen sulfide (H₂S), chlorine, and fine particulates, which can pose serious health risks. Conclusion: This study highlights the urgent need to improve occupational health protection through proper use of personal protective equipment (PPE), routine training, and redesigning WWTP systems to be more worker-friendly. LCA proved to be an effective tool in identifying health-related risk hotspots throughout the wastewater management cycle.

Analysis of the Relationship Between the Implementation of the Clinical Pathway for NSTEMI Disease and Service Variance

2025-07-04T15:14:44+00:00

This research was conducted to address the increasing number of NSTEMI (Non-ST Elevation Myocardial Infarction) cases, which represent a significant portion of heart attack patients (85%) according to the 2023 Ischemic Myocardial Infarction National Audit. The challenge for healthcare providers is to ensure optimal care for these patients. Clinical Pathways are structured guidelines designed to improve service quality, but despite a relatively high compliance rate (82%) for filling out Clinical Pathways at Taman Husada Bontang Hospital, there has been no clear analysis of how Clinical Pathway implementation benefits patient outcomes. Therefore, the study aims to evaluate the relationship between the implementation of Clinical Pathway and the quality of care provided to NSTEMI patients. The study aims to analyze the relationship between the implementation of the Clinical Pathway for NSTEMI patients and the quality of service at Taman Husada Bontang Hospital. Quantitative research method with a cross-sectional case study approach. The sample technique used is non-probability sampling; the number of samples is 50 Clinical Pathway forms from NSTEMI patients treated at the hospital during the 2022-2023 period. The Chi Square test on the service variance variable has a significant relationship with the implementation of Clinical Pathway, with a p value of 0.000 < 0.05, incomplete documentation resulting in a lack of information about the service variance provided with an OR value of 1.5. The conclusion is that the implementation of Clinical Pathway is significantly related to the quality of services, especially the variance of actions given to patients. To improve service quality, improvements are needed in documentation and regular evaluation of the implementation of the Clinical Pathway.

Thyroid Storm in A Patient with Graves’ Disease and Tubo-Ovarian Abscess: A Clinical Case Report

2025-07-04T21:46:48+00:00

Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, involving multi-organ dysfunction. This study aims to identify risk factors for thyroid storm and evaluate effective management strategies to reduce mortality. This study is a descriptive case report. Data were collected through patient interviews, physical examinations, and supporting tests at Wangaya Hospital. The data were analyzed qualitatively and presented in a narrative format based on case report guidelines. This paper reports the case of a 24-year-old female with a history of hyperthyroidism on methimazole and an intrauterine device (IUD) presented with abdominal pain that started in the epigastric region and migrated to the lower quadrants. She developed ocular prominence, vomiting, palpitations, generalized weakness, and non-bloody diarrhea. She also experienced persistent lower abdominal pain (pain score: 6/10), dysuria, and fever. A Burch-Wartofsky Point Scale (BWPS) score > 45 confirmed thyroid storm. She was admitted to the ICU and treated with propylthiouracil (PTU), hydrocortisone, digoxin, propranolol, and antibiotics for suspected infection. Her condition improved, and she was discharged after seven days. Thyroid storm is commonly triggered by Graves' disease. The diagnosis is clinical, based on BWPS or the Japanese Thyroid Association criteria, especially in patients with a history of hyperthyroidism and a precipitating factor. PTU is preferred due to its rapid onset and ability to inhibit the conversion of T4-to-T3. Successful management of thyroid storm requires prompt, comprehensive therapy to suppress thyroid hormone levels and treat triggering factors such as infection.

Web-Based Triage Analysis (Triage Go) on Speed and Accuracy of Service

2025-07-04T22:17:11+00:00

The increasing number of visits to the ER requires nurses and ER staff to move quickly in assessing the condition and sorting patients based on their severity. This is to determine the priority of patient management. The administrative process for registration often takes a long time so that nurses still use paper to perform initial triage on patients. In this digital era, technology-based solutions are becoming increasingly relevant, especially with the increasing use of digital platforms worldwide. Method: Article search using electronic databases such as Pubmed, Science direct, and Google Scholar. The search for articles used were articles published in 2019-2024, using the keywords "Triage" AND "Web Triage" AND "Speed" OR "Accuracy" OR "ER Service". Results: Based on 10 articles obtained, it was found that the use of Web-based Triage is one of the implementations of innovation that can be applied to improve the quality of service time in the ER. Analysis of web-based Triage (TRIAGE GO) can influence the speed and accuracy of service in the ER of Cilacap Regional Hospital. Conclusion: Web-based triage system as the best solution to optimize services in Emergency Installation.

Implementation of Betty Neuman's Systems Theory in Hospital Nursing Practice: A Systematic Review

2025-07-04T22:36:14+00:00

Betty Neuman's system theory offers a holistic nursing approach that focuses on strengthening the patient's line of defense through the identification and management of stressors at the primary, secondary, and tertiary levels. Although this model has been widely applied in clinical practice, the consistency and effectiveness of its implementation in hospitals still require thorough evaluation. This study aims to systematically review empirical evidence on the application of Betty Neuman's theory in the field of nursing in hospitals. The method used in writing this article is a literature study with a systematic review method. The articles reviewed were obtained through searches on Google Scholar, Sematic Scholar, Proquest, and ScienceDirect in the period 2015-2025 with the search keywords implementation, nursing, hospital, betty neuman system Using PRISMA, from 946 articles found, 10 journal articles were obtained for review. A total of 10 articles were synthesized based on the findings of the effectiveness of implementing Betty Neuman's theory in nursing practice in hospitals, including Environmental Factors, Client System, Stressors, Lines of Defense and Resistance, Three Levels of Prevention, and Recovery. The results of the study indicate that the implementation of this theory is effective in strengthening the patient's defense system, reducing anxiety levels, and accelerating recovery in various conditions such as stroke, cancer, heart failure, and pre-operative anxiety. This model facilitates a multidimensional approach that includes the physiological, psychological, social, and spiritual aspects of the patient, while emphasizing the role of nurses as stressor managers and holistic recovery facilitators. However, practice in the field is still often limited to physical interventions only, so that the full potential of the theory has not been optimally utilized.

The Role of Discipline in Forming the Performance of the Doctor in Responsibility for Service (DPJP): Systematic Review

2025-07-04T23:05:26+00:00

Optimal healthcare in hospitals relies heavily on the discipline and work quality of health professionals, crucial factors for patient experience and facility reputation, as supported by Indonesian regulations like Law No. 17 of 2023. The Doctor in Charge of Services (DPJP) plays a central role in coordinating patient care and upholding discipline within the medical team. Previous studies confirm the significant impact of work discipline on hospital employee performance. However, factors like poor communication between doctors and patients, identified as a primary cause of disciplinary violations by the Indonesian Medical Discipline Honor Council (MKDKI), also affect service quality. Challenges in Indonesia, such as resource scarcity and high workload, add complexity to the relationship between DPJP discipline and performance.Objective : This study regularly reviews literature from 2021-2025 to explore the role of discipline in shaping DPJP performance, identifying influencing factors and research gaps, aiming to enhance healthcare quality in Indonesia through optimizing DPJP roles.Method : A systematic review, conducted following the PRISMA framework, identified 20 articles out of an initial 1,348 that met the pre-defined inclusion criteria. These articles, published between 2021 and 2025, were retrieved from IJHPM, PubMed, ResearchGate, ScienceDirect, and Springer, with a specific focus on discipline and healthcare professional performance. The PEO framework guided the article search and selection process.Results : Discipline in healthcare management and professional learning positively influences efficiency, effectiveness, and competence. While compensation can boost discipline and performance, unrealistic targets and poor communication can hinder it. Systemic issues also affect discipline and performance.Conclusions : Discipline is vital for DPJP performance and overall healthcare quality, alongside communication and management effectiveness. Optimizing the DPJP role through improved discipline is crucial for enhancing healthcare in Indonesia.

The The Role of Nurses in Managing Anxiety Levels of Patients with HIV/AIDS: A Phenomenological Study

2025-08-11T11:55:48+00:00

This study aims to explore the role of nurses in managing anxiety levels in patients with HIV/AIDS: Phenomenological Study in Papua Province. The method used is an exploratory phenomenology approach , data collection with in-depth interviews , determination of participants in this study is purposive sampling . Participants in this study were nurses who treat patients with HIV/AIDS, with the number of participants in this study as many as 3 participants. The results of the study obtained 3 themes, namely anxiety, support from those closest to them, the experience of health workers in providing services. The conclusion of the results of the study obtained 3 themes, namely anxiety, support from family and the experience of health workers. Statements from participants based on the experience of health workers in handling patients with HIV/AIDS that special attention is needed for HIV/AIDS sufferers, especially in terms of carrying out control and consuming drugs.

Correlation Between Lead Levels and Percentage of Basophilic Stippling in the Blood of Silver Men

2025-07-06T13:36:29+00:00

The phenomenon of silver men has become increasingly prevalent in recent years. The direct application of metallic paint to the body and the nature of their activities are major factors contributing to potential lead expsure. Elevated blood lead levels can disrupt hematopoiesis, leading to various blood abnormalities, including the presence of basophilic stippling. Basophilic stippling is a distinctive marker indicative of heavy metal toxicity, particularly lead poisoning. This study aims to examine the correlation between blood lead levels and the presence of basophilic stippling in the blood of silver men in Purbalingga Regency and Purwokerto Sub-district. This study employed an observational analytical design with a cross-sectional approach. The research sample consisted of blood specimens from 14 silver men, selected using accidental sampling. Blood samples (3 mL) were collected from the respondents arms into EDTA tubes. Blood lead levels were analyzed using Atomic Absorption Spectrophotometry (AAS), while basophilic stippling was examined through Giemsa-stained blood smears observed under a microscope. The collected data were analyzed using Pearsons correlation test. The Pearson correlation test yielded a p-value of 0.045 (p 0.05) and a correlation coefficient of 0.542, indicating a strong positive correlation. There is a strong correlation between blood lead levels andthe presence of basophilic stippling in silver men. An increase in blood lead levels is accompanied by the occurrence of basophilic stippling, highlighting the potential toxic effects of lead exposure in this population.

Nutritional Status Assessment Based on BMI-Age and Metabolic Syndrome Status among Adolescents

2025-07-29T08:58:56+00:00

Adolescents are in a transitional phase that often involves changes in dietary habits and lifestyle, which can significantly affect their nutritional status and increase the risk of metabolic syndrome. This study aimed to identify the nutritional status based on Body Mass Index-for-Age (BMI/A) and metabolic syndrome status among adolescents in Semarang Regency. A quantitative descriptive survey with a cross-sectional approach was conducted at SMA Negeri 1 Pabelan, Semarang Regency, from March to July 2024. A total of 86 students aged 16–18 years were selected using random sampling. Data collection included anthropometric measurements (height, weight, waist circumference) to assess nutritional status and blood tests for glucose, uric acid, and cholesterol levels to identify potential metabolic syndrome. Data analysis was conducted using quantitative descriptions. The results showed that 11.6% of respondents were undernourished and 8.1% were obese. The prevalence of pre-metabolic syndrome was higher among female students (33.7%) compared to male students (16.3%), while metabolic syndrome was more common among males (27.9%) than females (18.6%). In conclusion, most adolescents had a good nutritional status; however, the presence of undernutrition and obesity indicates a risk of metabolic syndrome. Continuous health monitoring and education regarding balanced nutrition and healthy lifestyles are essential to prevent adolescent metabolic disturbances.

The Relationship between Smoking and Physical Activity with Cognitive Impairment among the Elderly

2025-07-06T22:16:53+00:00

The rising number of elderly individuals presents challenges, especially concerning their health and well-being. Without proper intervention, these issues can escalate into more complex problems, including cognitive impairment. To minimize the risk of cognitive impairment that can lead to dementia, it's crucial to reduce risk factors like quitting smoking and engaging in regular physical activity. This study aimed to explore the relationship between smoking, physical activity, and cognitive impairment in the elderly. A retrospective research method was employed, utilizing simple random sampling. The study included 142 elderly participants who met the inclusion criteria. To assess cognitive levels, the Mini Mental State Examination (MMSE) was used. This instrument demonstrated strong validity and reliability, with a Cronbach's Alpha of α=0.827. For measuring physical activity, the Physical Activities Scale For the Elderly (PASE) instrument was utilized, also showing good validity and reliability with a Cronbach's Alpha of α=0.768. Data analysis was conducted using the chi-square statistical test, which revealed a significant relationship between smoking, physical activity, and cognitive impairment in the elderly (p < 0.05). The research findings indicated that the majority of respondents (57.04%) experienced mild cognitive impairment. Additionally, 54.23% of respondents had a history of smoking, and 65.49% exhibited poor physical activity.

A Systematic Literature Review: PvK12 and PfK13 Gene Mutations as Markers of Resistance to Artemisin

2025-07-06T22:54:01+00:00

P. falciparum and P. vivax are among the most dangerous types of plasmodium , as they cause morbidity and mortality. Long-term use of Anti-Malaria Drugs (OAM) causes resistance. The purpose of this study was to determine the mutation of the pvk12 and pfk13 genes as a marker of resistance to artemisinin . This study used a systematic review method that was compiled based on the Preferred Reporting Items for Systematic Reviews and Meta Analyzes (PRISMA). The article search used five databases, namely PubMed, Google Scholar, BMC, Portal Garuda and the National Library (Perpusnas) of Indonesia. The keywords and boolean operators used in the literature search were "artemisinin", "resistance", "mutation", "gen", "plasmodium falciparum", "kelch 12", "kelch 13", "PvK12" PfK13" The inclusion criteria for this study were articles published at least in 2018 (the last 5 years). The exclusion criteria were paid articles, textbooks , articles systematic literature review , articles that use languages other than English and Indonesian. The results of a systematic review use 688 articles and finished of 10 articles showed that 8 articles found that there were no mutations in the pvk12 and pfk13 genes as markers of resistance to artemisinin and 2 articles found that there were mutations in the pvk12 and pfk13 genes as markers of resistance to artemisinin.

The Effect of Physical Exercise on Cognitive Impairment in Patients with Diabetes Mellitus

2025-07-07T00:02:33+00:00

Diabetes mellitus has been proven to be associated with cognitive decline and an increased risk of dementia. Exercise, both physical activity and brain training, as a non-pharmacological intervention, has the potential to improve cognitive function. Objective to investigate the effect of physical activity on cognitive impairment in patients with diabetes mellitus. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method was used to select articles. The JBI critical appraisal checklist was used for quality assessment. Articles were searched through PubMed, Medline, and ScienceDirect databases from 2014 to 2024, using full-text articles. Out of 507 articles identified, 13 articles were included in the review, selected through a screening process based on predefined inclusion and exclusion criteria, and all demonstrated that physical activity, cognitive training, combined training, and training with lifestyle modifications can improve cognitive function in patients with type 2 diabetes mellitus. Exercise programs such as aerobic exercise, combined training, or other more specific exercises have been proven to improve cognitive function and metabolic indicators in patients with diabetes mellitus, such as HbA1c levels and insulin resistance. However, the majority of study participants were older adults.

Clinical Features and Histopathologic Examination in Supporting The Diagnosis of Exfoliative Dermatitis Suspected Caused by Captopril in Child : A case report

2025-07-11T09:25:14+00:00

Exfoliative dermatitis (ED) is defined as diffuse erythema and scaling of the skin involving more than 90% of the total body skin surface area. It is a reaction pattern and cutaneous manifestation of a myriad of underlying ailments, including psoriasis and eczema, or a reaction to the consumption of certain drugs. Though some experts believe it does not pose a significant risk of death, erythroderma is a potentially life-threatening condition that requires proper diagnosis, identification of underlying etiology, and management. Several factors have been implicated as triggers for erythroderma and can be grouped into several general categories, including preexisting dermatoses, drugs, and malignancies. Drugs Involved in ED, one of the drugs that cause it is cardiac drugs such as captopril. Captopril, an angiotensin-converting enzyme (ACE) inhibitors containing a sulfhydryl group and has occasionally been implicated in complex immunological diseases, this chemical group has been considered the culprit of allergic reactions to captopril. Histopathologic examination is important to exclude differential diagnosis. Management of ED involves combining symptomatic relief with addressing the underlying etiology and potential systemic complications. In patient hospitalization is required in acute cases.

Analysis of Factors Associated with the Incidence of Dengue Hemorrhagic Fever (DBD)

2025-07-11T10:06:44+00:00

Dengue fever is still a public health problem worldwide, especially in tropical and subtropical regions. Data from around the world shows that Asia ranks first in the number of Dengue Fever sufferers each year. The purpose of this study was to determine the factors that affect the incidence of Dengue Fever (DHF) in the work area of BLUD Puskesmas Sangatta Utara, Kecamatan Sangatta Utara, Kabupaten Kutai Timur. This study used a case-control design, with 115 positive cases of DHF and 115 control cases in the work area of BLUD Puskesmas Sangatta Utara, East Kutai Regency, making a total of 230 samples. The data collection techniques included a preparation stage (obtaining research permits and conducting a preliminary study), followed by an implementation stage (collecting respondent data, sorting samples according to criteria into two groups, filling out questionnaires, and collecting research instruments). This study found a significant association with the incidence of DHF in the following variables: knowledge (p < 0.001) OR 0.061, daytime activity (p < 0.001) OR 2.878, mosquito nest eradication efforts (p < 0.001) OR 0.118, and the habit of hanging used clothes in the house (p < 0.001) OR 8.576. It can be concluded that the habit of hanging used clothes in the house is the most dominant variable associated with the incidence of DHF in the work area of BLUD Puskesmas Sangatta Utara (Odds Ratio Exp(β) = 89.297).

Analysis of Risk Factors for Chronic Kidney Failure

2025-07-11T10:31:57+00:00

The background of this study focused on the increasing incidence of chronic renal failure at Kudungga Sangatta Hospital, East Kutai Regency, which is a serious concern in an effort to improve the quality of public health services. The general objective was to analyze the risk factors of chronic renal failure in Kudungga Sangatta Hospital, East Kutai Regency. This type of research is an analytic observational research with case control design or case control study. The non-random sampling method is purposive sampling as many as 140 people, as for data collection techniques, namely, the preparation stage (preparing a research permit, and conducting a preliminary study), after that there is an implementation stage (collecting respondent data, sorting samples according to sample criteria in two sample groups, filling out questionnaire data, and collecting research instruments). The data analysis techniques in the study were editing, coding, shorting, data entry, and data cleaning. Age was significantly associated with the incidence of acute renal failure (P < 0.001). Family history of hypertension is significantly associated with the incidence of acute renal failure (P < 0.001, OR = 69.750). Family history of diabetes mellitus was not significantly associated with the incidence of acute renal failure (P = 0.806). Taking Analgesic and NSAID drugs were not significantly associated with the incidence of acute renal failure (P > 0.05). The conclusion is that there is a relationship between age and family history of hypertension with the incidence of chronic renal failure and there is no relationship between family history of diabetes mellitus, and using analgesic drugs and NSAIDs is not significantly related to the incidence of acute renal failure at Kudungga Sangatta Hospital, East Kutai Regency.

Risk Factors for Musculoskeletal Disorders (MSDS) in Hip Workers at Food Agents

2025-07-15T11:22:35+00:00

Musculoskeletal Disorders (MSDs) are one of the most common occupational health problems, especially among workers who do heavy physical work, such as porters. This study aims to identify risk factors for MSDs in porters at grocery agents in Prabumulih City, South Sumatra, using a cross-sectional study design. This study involved seven main variables, namely work posture, age, nutritional status, length of service, workload, smoking habits, and exercise habits. The research method used was a quantitative approach with a cross-sectional design, with a sample of 73 respondents selected by simple random sampling. The instruments used in this study included a characteristic questionnaire, Nordic Body Map (NBM), Quick Exposure Checklist (QEC), and Cardiovascular Load (%CVL) measurements. Data analysis was carried out univariately and bivariately using the Chi-Square test. The results showed a significant relationship between work posture (p=0.003), age (p=0.045), nutritional status (p=0.004), length of service (p=0.002), workload (p=0.001), and exercise habits (p=0.014) with MSDs complaints. Meanwhile, smoking habits (p=0.072) did not show a significant relationship with MSDs complaints. Based on these findings, it can be concluded that ergonomic factors and worker characteristics play an important role in the emergence of MSDs complaints.

The Effectiveness of Autogenic Relaxation on Sleep Quality and Fatigue Levels in Cancer Patients Undergoing Chemotherapy

2025-07-14T06:18:12+00:00

Fatigue and sleep disturbances are two common symptoms experienced by cancer patients undergoing chemotherapy. These conditions negatively impact quality of life and the effectiveness of treatment. One promising non-pharmacological approach is autogenic relaxation, a relaxation technique that combines self-suggestion, controlled breathing, and focused attention on bodily sensations to achieve physical and mental calmness. This study aims to evaluate the effectiveness of autogenic relaxation in improving sleep quality and reducing fatigue levels in cancer patients undergoing chemotherapy. The study employed a quasi-experimental design with a pretest–posttest and control group. A total of 30 patients were divided into two groups: intervention (n = 15) and control (n = 15). The sampling technique used was purposive sampling. The intervention was conducted for two weeks, twice a day, using an audio guide. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and fatigue was assessed using the Fatigue Assessment Scale (FAS). The intervention group showed a decrease in mean PSQI scores from 11.2 to 8.1 (p = 0.017) and FAS scores from 34.5 to 28.3 (p = 0.031). Data analysis was performed using the Shapiro–Wilk normality test, followed by the Wilcoxon test for analysis within groups, and the Mann–Whitney test for between groups. The control group did not show any significant changes. These results indicate that autogenic relaxation stimulates a physiological relaxation response that contributes to improved sleep and reduced fatigue. Autogenic relaxation is an effective and applicable non-pharmacological supportive intervention for cancer patients during chemotherapy.

How Effective Diabetic Foot Care is in Preventing Ulcers: Literature Review

2025-07-14T07:46:21+00:00

Diabetic foot ulcers are a serious complication of diabetes that can lead to severe infections and even amputation. Proper foot care is a key prevention strategy, although the effectiveness of interventions varies in practice. Objective: This study analyzes the effectiveness of foot care interventions in preventing ulcers in diabetic patients through a systematic literature review. A Systematic Literature Review was conducted following the PRISMA guidelines and the PICO approach (Population: type II diabetes patients; Intervention: foot care interventions; Comparison: standard education or no specific intervention; Outcome: prevention of foot ulcers). Article searches were conducted using the PubMed and Google Scholar databases from 2020 to 2025 using the keywords: diabetic foot care, foot ulcer prevention, and foot care education. The initial search yielded 268 articles, comprising 212 articles from Google Scholar and 56 articles from PubMed. Further screening was conducted by reading the titles and abstracts, removing duplicates and irrelevant articles, leaving 98 articles. During the eligibility stage, the full texts were thoroughly read and selected based on the established criteria, ultimately yielding 10 articles that met the criteria for further analysis. The methodological quality of the articles was assessed using the JBI Critical Appraisal Tools. A review of 10 articles showed that various interventions, including behavior-based education and technology models, were effective in improving foot care and significantly reducing the risk of ulcers (p < 0.05) across all studies.

Accuracy of Hemoglobin Measurement using the SD Biosensor Standard G6PD Analyzer as Point-of-Care in Pediatric Populations in Malaria-Endemic Regions

2025-07-15T20:03:50+00:00

Background: Malaria remains a significant public health concern, particularly in endemic regions, is frequently associated with anemia in children. Accurate hemoglobin measurement is crucial for diagnosing anemia, especially in resource-limited settings. This study compares the accuracy of SD Biosensor Standard G6PD Analyzer with Hemocue HB301 System for hemoglobin measurement among children in malaria-endemic areas.

Objective: To determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), pretest odds, post-test odds, and overall accuracy of the SD Biosensor Standard G6PD Analyzer compared to the Hemocue HB301 System.

Method: This cross-sectional diagnostic study involved 325 children aged 6-18 years in Kualuh Leidong District. Secondary data were obtained from a previous study conducted in August 2024, using a total sampling technique.

Result: The mean hemoglobin level measured by SD Biosensor Standard G6PD Analyzer (14,22±2,21 mg/dL) was higher than that measured by Hemocue HB301 System (13,45±1,63 mg/dL), with significant difference (p=0,001). The prevalence of anemia detected by SD Biosensor and Hemocue was 12,3% and 11,4%, respectively. The SD Biosensor Standard G6PD Analyzer demonstrated a sensitivity of 70,27%, specificity of 95,14%, PPV of 65%, NPV of 96,14% and an overall accuracy of 92,31%.

Conclusion: The SD Biosensor Standard G6PD Analyzer exhibited relatively low sensitivity but high specificity compared to Hemocue HB301 System in measuring hemoglobin levels among children in malaria-endemic areas. Further research is needed to compare both devices against the gold-standard automated hematology analyzer and to identify the factors influencing measurement accuracy.

Keywords: Anemia, Hemocue HB301 System, Hemoglobin, Malaria, SD Biosensor Standard G6PD Analyzer

The Effect of Self-Care Behavior on Blood Glucose Control Levels Among Patients with Type II Diabetes Mellitus

2025-07-16T03:28:10+00:00

Diabetes mellitus is characterized by elevated blood glucose levels above normal, with random blood glucose levels ≥ 200 mg/dl and fasting blood glucose levels ≥ 126 mg/dl. This study employed a quantitative research method with a quasi-experimental design and an equivalent control group design approach. The study utilized power analysis with consecutive sampling techniques. Data collection techniques involved distributing questionnaires to 74 diabetes mellitus patients in the Onolalu Health Center Working Area, South Nias District. Data analysis techniques used independent t-test statistical analysis and presented in the form of a T-test table. The results of the study indicate that there is an influence of self-care behavior on blood sugar control levels in type II diabetes mellitus patients in the Onolalu Health Center Working Area, South Nias Regency, with a Sig. (2-tailed) of 0.024 < 0.05. Therefore, in the independent sample t-test, it can be concluded that the null hypothesis (HO) is rejected and the alternative hypothesis (Ha) is accepted. Thus, it can be concluded that there is a significant (statistically significant) difference between the average blood sugar levels of type II diabetes mellitus patients in the intervention group and the control group.

Nursing Assessment in Intensive Care Unit: A Systematic Review

2025-07-16T17:12:31+00:00

Nursing assessment in critical patients in the ICU is a complex process that is essential for supporting standard interventions to improve the safety and quality of nursing care. This study aims to identify and analyze various literature related to nursing assessments and nursing care based on ICU service standards. A total of 293 articles were initially identified from various databases: 52 from PubMed, 145 from ScienceDirect, 83 from Google Scholar, 10 from Scopus, and 3 from ProQuest. After removing 85 duplicate articles, 208 articles remained. The screening process based on title identification, further reduced 55 articles. Subsequent abstract screening yielded 31 articles. Finally, a full text review of these articles resulted in 10 articles selected for inclusion. The literature review found that pre-arrival assessments help prepare for patient care needs before ICU arrival. Quick checklist based assessments can quickly and systematically identify early critical conditions in patients. Comprehensive assessments, using an integrated and ongoing patient assessment format, combined with progress notes and sophisticated monitoring tools, can enhance the efficiency of patient care. The conclusion is that implementing Nursing Assessment through a systematic approach to ICU services significantly contributes to optimizing the quality and safety of critical patient care.

The Relationship between Spiritual Well-Being and Social Interaction with the Resilience of Male Prisoner

2025-07-17T09:23:11+00:00

The problem of low resilience among male correctional inmates still often occurs, such as withdrawing, tending to be offended, aggressive, easily involved in riots and attempting suicide. Male inmates are required to have good social interaction skills to be able to adapt to the prison environment and to have good spiritual well-being to prevent negative behavior from occurring. The aim of this research is to determine the relationship between spiritual well-being and social interaction with the resilience of male inmates in one of the prisons in Central Java. The research was conducted in December 2023, research design usingcross-sectional with the multiple linear regression analysis method on a population of 399 male WBP, the sampling technique used wassimple random samplingon a sample of 200 male WBPs analyzed using the testproduct moment. Data collection using questionnaires spiritual well-being scale (SWBS), social interaction, And resilience scale which first carried out validity and reliability tests on 70 WBP and was declared valid and pass the ethics test. The research show that there is a meaningful and significant relationship between spiritual well-being and social interaction on resilience, while the regression coefficient shows that spiritual well-being and social interaction have an influence on resilience of 7.6% apart from being influenced by other factors.

Molecular Biomarkers in Pneumonia: Therapeutic Potential of Traditional Plant Medicine

2025-07-17T13:08:46+00:00

Pneumonia causes 2.56 million global deaths annually, with current therapies limited by antimicrobial resistance and adverse effects. Traditional medicinal plants offer multi-target potential through anti-inflammatory, antioxidant, and immunomodulatory mechanisms. This review synthesizes knowledge on molecular biomarkers in pneumonia pathogenesis and evaluates therapeutic potential of medicinal plants, particularly Coleus amboinicus. A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science covering publications from January 2000 to June 2025. Inclusion criteria encompassed studies investigating molecular biomarkers, pneumonia therapeutic pathways, or medicinal plants with respiratory therapeutic properties. Narrative synthesis was employed due to study heterogeneity. Of 1,247 articles identified, 10 studies met inclusion criteria and were utilized in the analysis. Key inflammatory biomarkers included IL-6, TNF-α, and IL-1β, increasing from 5.05 mg/dL (controls) to 25.30 mg/dL in bacterial pneumonia. Neutrophil extracellular trap (NET) formation emerged as a central mechanism (47.36% of protein targets). Coleus amboinicus demonstrated 139 bioactive compounds with broad-spectrum antimicrobial activity and antioxidant properties (DPPH EC₅₀ 32.67-152.8 µg/mL). Traditional medicinal plants, particularly Coleus amboinicus, modulate key molecular pathways in pneumonia through sophisticated multi-target mechanisms, supporting integration of biomarker-guided approaches in contemporary respiratory care.

Patient Satisfaction and Associated Factors among Patients of Dental Profession Students, Indonesia: A Cross Sectional Study

2025-07-17T13:27:40+00:00

Patient satisfaction regarding oral health services is defined as the difference between the patient's view of the services they receive and their expectations of these services. Communication is one of the factors that contribute to increasing the level of patient satisfaction. Meanwhile, communication problems are often a patient complaint as 35%-40% of patients are not satisfied when consulting with a doctor. Analyzing the relationship between patient satisfaction and the provision of communication, information, and education carried out by dental profession students at the Dental and Oral Hospital of Muhammadiyah University, Semarang. Method: This type of research is observational with cross sectional design. The population is 101 consisting of dental professional student patients. The sampling technique uses accidental sampling. The independent variables are the provision of IEC, age, gender, and level of professional students and the dependent variable is patient satisfaction. The questionnaire to measure patient satisfaction and the provision of IEC was taken from previous studies and has been proofread. Validity testing was conducted using expert judgment, with heterotrait-monotrait (HTMT) ratios below 0.9, and the reliability test using Cronbach's alpha yielded a result of 0.7. Ethical approval has been obtained and data collection involves informed consent and questionnaire interviews. Data analysis was carried out with univariate and bivariate using rank spearman correlation and Chi-square. There is a relationship between the provision of IEC with patient satisfaction (p = 0.000). there is no relationship between age (p = 0.840), gender (p = 1.000) and the level of professional students (0.260) with patient satisfaction. the results of patient satisfaction at RSGM Unimus assessed by patients have very satisfactory results. Maintaining and improving patient satisfaction is needed by RSGM to achieve maximum service quality. There is a relationship between the provision of communication, information, and education with patient satisfaction.

Self-Medication Practices in Remote, Border, and Island Areas: A Literature Review

2025-07-18T02:47:27+00:00

Health is defined as a state of physical, mental, and social well-being that enables every individual to lead a socially and economically productive life. One of the initial efforts in treatment is the practice of self-medication. Self-medication is the independent use of medication without supervision or direct consultation with a health professional, with the aim of addressing health complaints experienced. The purpose of this study was to examine the description and risk factors of self-medication in Indonesia and globally. This research method is a descriptive observational study using a literature review design, with the following databases: Wiley Online Library, PubMed, and ScienceDirect From 2021 to 2025, a total of 25 articles were reviewed. The search strategy for articles in Wiley Online Library, PubMed, Google Scholar, and ScienceDirect used four keywords: "Self-medication"; "Drugs"; "Remote Areas"; and Risk Factors." Search results that met the criteria were then subjected to article analysis. Self-medication is common in various parts of the world, especially in areas with limited access to healthcare. This practice is increasingly prevalent in Indonesia, particularly in remote areas such as border and coastal areas. These areas face numerous challenges, including difficult-to-reach locations, limited healthcare facilities, and a shortage of medical personnel. These conditions encourage people to self-medicate without the supervision of healthcare professionals. This self-medication practice carries significant potential risks, such as inappropriate medication use, which can lead to increased drug resistance and other health problems. Therefore, it is crucial to understand the factors influencing self-medication in remote areas to effectively mitigate its negative effects.

Analysis of Risky Sexual Behavior in the Drug user Population

2025-07-18T05:52:10+00:00

Drug abuse is one of the serious public health problems in Indonesia, especially because it can increase risky sexual behavior for HIV/AIDS transmission. Transmission of HIV can occur not only through the use of injection needles but also through unsafe sexual contact (not using condoms) with fellow injecting drug users or between injecting drug users and FSWs. This study aims to analyze risky sexual behavior in the drug user population at the Palembang City Drug Rehabilitation Center Foundation. This study is a descriptive analytical study with a cross-sectional design. The research instrument used a questionnaire based on the 2023 Integrated Biological and Behavioral Survey (STBP) of the Indonesian Ministry of Health 7. The study sample consisted of 130 people, selected based on the study's inclusion criteria. The majority of respondents were male (100%), age >29 years (63.8%), senior high school (67.7%), unmarried (60.8%), and had a permanent residence (96.2%). Then, the age of first using drugs was 15-19 years (55.4%), with a duration of use >5 years (63.8%), and they did not use injectable drugs (94.6%). From sexual behavior, 56.9% had had sex (vaginal), 28.5% with a permanent female partner, 13.8% with a paid woman. The analysis showed a significant relationship between age, marital status, age of first drug use, and knowledge of HIV/AIDS risk behavior. In contrast, education, current residence status, selling or buying sex, duration of drug use, injection drug use and attitudes were not significantly related. Education efforts and prevention programs need to be more focused on factors that have been proven to have an influence.

Do Not Forget the Diseases Apart from Covid-19! Its High Morbidity Illness: Evidence from Indonesia and The Philippines

2025-07-18T08:13:43+00:00

Along with the Coronavirus Diseases (or called “COVID-19”) pandemic, most of the world’s population is affected by global endemic diseases that have been around for a long period of time, so it can affect the additional burden on a country's healthcare system such Indonesia and the Philippines as case study. Therefore, this article aims to evaluate the rate of endemic disease and COVID-19, as well as to review the healthcare system and resources in Indonesia and the Philippines. We conducted a specific analysis based on official health documents by the government and previous literature; also, news portals were conducted. Our findings note that is a shift in the contribution of the healthcare system in Indonesia and the Philippines due to relatively high surveillance of the spread of COVID-19, as a consequence in the centralization of health budgets and resources for the prevention of COVID-19 disease as opposed to endemic diseases. Indeed, some endemic disease morbidity is reported to be higher than the COVID-19 pandemic. In the end, Indonesia and the Philippines are faced with the unexpected, where it has been proven that endemic diseases still exist during the COVID-19 pandemic and future healthcare spending

The Impact of Moringa Leaf Capsule Supplementation on Weight Change in Adolescent Girls Who Drop Out of School Aged 12–18 Years

2025-07-21T01:11:52+00:00

Complex health issues require collaboration from various healthcare professions. One key aspect of preparing a healthy generation is nutritional status. Moringa leaves (Moringa oleifera), known as the “miracle tree,” are rich in essential nutrients such as vitamins, proteins, iron, carbohydrates, fats, minerals, and amino acids. This study aimed to evaluate the impact of Moringa leaf extract capsules on weight gain among adolescent girls who dropped out of school in North Polongbangkeng District, Takalar Regency, South Sulawesi. This true experimental study used a Randomized Controlled Double Blind Pre-Posttest design. A total of 30 school dropouts aged 12–18 years were selected using simple random sampling, then randomly assigned into an intervention group (15 received Moringa capsules, 2×1 daily, 1000 mg/capsule) and a control group (15 received iron tablets with the same dose). Data were analyzed using the Paired T-Test and Mann-Whitney U test. The intervention group showed a significant weight increase from 41.82 kg to 42.42 kg (p < 0.05), while the control group showed no significant change. There was a significant difference between groups (p = 0.001). Moringa leaf extract significantly improved weight gain among adolescent girls who dropped out of school.

Analysis of Determinants of Bullying Tendencies among Urban and Rural Adolescents

2025-07-27T13:38:51+00:00

Bullying is a serious issue that threatens adolescent mental health and shows a high prevalence in Indonesia. This behavior is influenced by various internal and external factors, yet few studies have comprehensively compared bullying tendencies between adolescents in urban and rural settings. Objective: This study aims to analyze the main determinants influencing bullying tendencies among adolescents aged 12–15 years and to examine interregional differences. A quantitative approach with a cross-sectional design was used. A total of 167 students were selected through cluster random sampling from SMP Negeri 1 Banda Aceh and MTsN 6 Montasik. Data were analyzed using logistic regression and multinomial logistic regression tests. The results showed that parenting style, gender, and self-esteem were significantly associated with bullying tendencies. Authoritarian parenting showed the highest influence (Odds Ratio [OR] = 13.78; p = 0.001), followed by permissive parenting (OR = 6.15; p = 0.043), and self-esteem (OR = 8.81; p = 0.001). Gender also contributed, with males having a higher tendency to engage in bullying than females (OR = 2.54; p = 0.085). In contrast, ethnicity, socioeconomic status, nutritional status (BMI), social skills and popularity, and academic achievement showed no statistically significant associations. The study also found that students in MTsN 6 Montasik (rural area) had higher bullying behavior (25.61%) compared to those in SMP Negeri 1 Banda Aceh (urban area) at 12.94%. These findings affirm the importance of appropriate parenting, healthy self-esteem, and sensitivity to gender differences as key elements in bullying prevention efforts.

Blood Pressure Control Efforts in Hypertension Patients: An Exploratory Study

2025-07-22T09:10:09+00:00

Non-communicable diseases (NCDs), especially hypertension, are the leading cause of premature death worldwide, with a high prevalence in low- and middle-income countries. In Indonesia, hypertension poses a major health challenge, particularly in coastal areas where diets are high in sodium. This study aims to explore the efforts made by individuals with hypertension in managing their blood pressure. A qualitative study with a case study approach was conducted in Kluet Selatan, South Aceh, in November 2024. Data were collected through in-depth interviews and focus group discussions (FGDs) involving 12 participants, including hypertension patients, family members, health workers, and community leaders. Data were recorded, transcribed verbatim, and analyzed using thematic analysis to identify patterns and key themes related to hypertension management. The results revealed that patients had initiated dietary changes, increased physical activity, and practiced stress management. However, they encountered challenges such as financial limitations, ingrained eating habits, and restricted access to health facilities. Family involvement and the use of traditional remedies were found to support hypertension control. Despite these efforts, persistent social, cultural, and economic barriers hinder sustainable behavior change. Limited health education and lack of access to specialized care also affect long-term hypertension management in this setting.

Narrative Review: The Impact of Progress Test Examinations on Cummulative Grade Point Average (GPA) Among Medical Faculty Students

2025-07-22T07:07:01+00:00

The Progress Test (PT) is a standardized assessment tool used in medical education to evaluate cumulative knowledge and predict academic achievement, including Grade Point Average (GPA). This narrative review aims to examine the relationship between PT scores and the GPA of medical students. The literature search was conducted across PubMed, Embase, and manual sources, yielding 101 articles. After applying inclusion and exclusion criteria, 44 full-text articles with free access were reviewed, and 10 articles were selected for in-depth analysis. The selected studies discuss the impact of PT on learning strategies, knowledge retention, academic stress, and GPA outcomes. Most studies (9 out of 10) reported a positive correlation between PT scores and GPA, indicating that PTs can reflect students' cognitive development and academic readiness. However, factors such as test structure, learning approaches, and students’ understanding of PT purpose may influence its effectiveness. Overall, this review supports the role of PT as a formative and summative tool in assessing and enhancing academic performance.

Analysis of Activity Based Costing (ABC) Calculations in Services Hemodialysis at the Kudungga Regional Hospital Dialysis Unit

2025-07-22T09:04:09+00:00

Hemodialysis is a kidney replacement therapy where blood from outside the body is filtered by a machine. The provision of hemodialysis services currently still uses the old rates and is considered not to provide profits for hospitals, so good calculations are needed as a form of efficiency in financing hemodialysis procedures in hospitals, especially in the JKN era. Hospitals will receive comprehensive information on shopping costs, unit cost calculations and action suggestions in accordance with applicable rates. The study was carried out with the aim of finding out the unit cost rates for hemodialysis services in the Kudungga Regional Hospital Dialysis Unit using the Activity Based Costing (ABC) method and comparing them with INA-CBGs rates and hospital rates. This research uses a descriptive and quantitative approach. Unit costs for dialysis units and cost analysis using the Activity Based Costing (ABC) method approach are the main subjects of this research. This research is based on all financial balance data for hemodialysis services at the Kudungga Regional Hospital Dialysis Unit. The unit cost of hemodialysis can be determined by tracing the costs related to the hemodialysis cost center as a production center and other elements that support this action. The data will be grouped into fixed costs, semi-variable costs and variable costs, then included in direct costs, indirect costs, overhead and unit cost calculations using the Activity Based Costing (ABC) method. The research results show that the unit cost calculation for hemodialysis based on the Activity Based Costing (ABC) method is IDR 1,397,627.79. Meanwhile, the Kudungga Regional Hospital rate is only IDR 1,258,300, the hospital rate only meets 90.03% of the unit cost using the ABC method. Meanwhile, when compared with the INA-CBGs tariff, which is IDR 921,300, the INA-CBGs tariff only meets 65.92% of the unit cost using the ABC method. Things that influence are direct costs, indirect costs and the number of hemodialysis procedures.

Serum Electrolyte and Blood Lipid Profile in Stroke Patients

2025-07-27T13:49:54+00:00

Stroke is a leading cause of death and disability worldwide, including in Indonesia. While vascular factors are the primary cause, metabolic components such as serum electrolytes and blood lipids also play a significant role in the onset and progression of stroke. Imbalances in sodium, potassium, and chloride, as well as abnormalities in cholesterol and triglyceride levels, can influence both stroke risk and prognosis. Understanding these biochemical profiles in stroke patients is essential for improving clinical outcomes. This study aims to analyze the profile of serum electrolytes and blood lipids in stroke patients treated at Dr. Chasbullah Abdulmajid Hospital, Bekasi City, during the period December 2024 to March 2025. Stroke is one of the leading causes of morbidity and mortality worldwide, which is known to occur due to vascular factors. Metabolic factors such as serum electrolytes and blood lipids can play an important role in the pathogenesis and prognosis of stroke. Using a descriptive design, patient medical record data were collected and analyzed, which were then processed univariately, with a focus on serum electrolyte profiles, including sodium, potassium, and chloride, as well as blood lipid profiles, such as total cholesterol, LDL, and HDL. The results showed that the characteristics of stroke patients treated at Dr. Chasbullah Abdulmajid Hospital, Bekasi City, during the period from December 2024 to March 2025, differed only by gender, with 46 patients (50.5%) being male and 45 patients (49.5%) being female. The most common comorbid history in stroke patients was hypertension, totaling 53 people (58.3%), followed by diabetes mellitus, totaling 26 (28.6%). The largest electrolyte imbalance disorder was hypokalemia in 43 people (47.3%), followed by hyponatremia in 35 people (38.5%) and hyperchloremia in 23 people (25.3%). The majority of patients had low HDL levels, with 46 people (50.5%), 27 people (29.7%) having increased triglyceride levels, and 20 people (22.0%) having quite high cholesterol levels. These findings are expected to provide important insights for clinical management and prevention of stroke in the future.

Analysis of Outpatient Waiting Time Determinants in Hospitals Based on the Donabedian Framework

2025-07-23T03:59:27+00:00

Waiting time is one of the indicators in evaluating the quality of outpatient services in hospitals. Long waiting times are often the main complaint of patients and have the potential to reduce satisfaction and effectiveness of services. This article aims to review the available literature on patient waiting times and identify factors that contribute to waiting times for outpatient services. The method used is a Systematic Literature Review using the Preferred Reporting Items for Systematic Reviews (PRISMA) flow by collecting articles from the Google Scholar and PubMed databases published between 2019 and 2024 with the keywords " outpatient", "waiting time" and "hospital", as well as in Indonesian: "waktu tunggu, perawatan jalan" and "poliklinik". Based on the analysis results, 20 articles were selected from the 130 articles selected that met the inclusion criteria and were subsequently analysed and classified using the Donabedian theoretical framework, which consists of three components: structure, process, and outcome. The analysis results indicate that structural factors, such as limited medical personnel, inadequate infrastructure, and inefficient queuing systems, are the primary causes. In the process aspect, doctor delays, lengthy administrative processes, and a lack of service system integration also contribute to lengthening waiting times. Meanwhile, outcome factors are closely related to patient perceptions and satisfaction levels. The study's conclusions suggest that improving outpatient wait times necessitates a comprehensive approach that encompasses enhancing service structure, process efficiency, and prioritising patient outcomes.

The Impact of Aerobic Exercise and Cognitive Stimulation on Cognitive Function in the Elderly

2025-07-23T04:41:35+00:00

The world's population, including Indonesia, is currently undergoing an aging process, characterized by an increase in the number and proportion of elderly individuals. The aging process leads to changes in physical health, sleep patterns, psychosocial well-being, and cognitive function in the elderly. Cognitive impairment poses a serious problem for older adults due to its physical, psychological, social, and economic impacts. Effective interventions can provide holistic support to elderly individuals with cognitive impairment, helping them to live better and more meaningful lives. This research aims to analyze the influence of aerobic exercise and cognitive stimulation on the improvement of cognitive function in the elderly. The research method used was an experimental study with a one-group pretest-posttest design. The sample was selected using a purposive sampling technique. The study sample consisted of 34 elderly individuals who met the inclusion criteria. The research instrument used the Mini Mental State Examination (MMSE) to measure the cognitive level of the elderly participant. Data were processed using SPSS and analyzed using the Wilcoxon Signed Rank Test.The results of the Wilcoxon signed-rank test showed that the average score of cognitive function experienced a significant increase between before and after the intervention, with a p-value of 0.000. Based on the findings of this study, aerobic exercise and cognitive stimulation have a positive influence on the improvement of cognitive function in the elderly.

Marked Clinical Improvement of Psoriasis Vulgaris with Methotrexate: A Case Report with 75% PASI Reduction

2025-07-23T17:01:52+00:00

Psoriasis is an immune-mediated chronic, recurrent, systemic inflammatory disease induced by the combination of hereditary and environmental factors. The etiology of this disease involves many factors, including genetics, immunology, and the environment. Clinically, psoriasis vulgaris is characterized by the presence of reddish plaques with thick, symmetrically distributed squama mainly in the predilection areas. In moderate to severe cases, systemic therapy such as phototherapy, systemic anti-inflammatory agents, or biologic treatments is required, with topical therapy serving as an adjunct. Methotrexate is one of the effective systemic treatment options for severe psoriasis, either as monotherapy or in combination regimens. This case report aims to demonstrate the clinical efficacy of methotrexate in the management of moderate-to-severe psoriasis vulgaris. We report a case of a 37-year-old male presenting with scaly reddish skin thickening accompanied by itching all over the body. Clinical and histopathological examination confirmed the diagnosis of Psoriasis Vulgaris and treated with methotrexate. After a period of regular weekly methotrexate administration and monitoring, the patient achieved a 75% reduction in the Psoriasis Area and Severity Index (PASI), indicating significant therapeutic response. This case highlights the efficacy of methotrexate as a cost-effective and accessible treatment option for achieving substantial disease control in psoriasis vulgaris.

Calculation Rational Rates Based on Unit Costs Compared to Kudungga Hospital Surgical Instalation Rates

2025-07-24T05:57:16+00:00

Hospitals that have carried out unit cost calculations can find out how much they are spending, so that the hospital can know if waste occurs. This is because the costs incurred by one hospital will be different from those incurred by another hospital, even though the hospital is in the same type of hospital. Apart from that, the results of unit cost calculations can also be used as a basis for decision making to improve hospital quality and quality. The aim of this research is to calculate rational rates for types of surgery using the multiple distribution method, then compare them with hospital rates for general surgery rates at the Central Surgical Installation of Kudungga Sangatta Regional Hospital. This study is a comparative descriptive quantitative analytical study to compare the rational rates of types of operations (special, special, major, major, and medium cito operations) in the general surgery group during the period of 2023 with the rates of general surgery operations at the Central Surgery Installation of Kudungga Sangatta Regional Hospital with a sample population of all 340 patients using BPJS insurance who received general surgery operations. The results of the research show that the rational rates obtained for special CITO operations are IDR 14,094,633, special operations IDR 12,383,431, large CITO operations IDR 5,262,904, large operations IDR 6,775,203, and medium operations IDR 3,858,857. Rational rates are higher than hospital rates, except for major CITO surgery rates. Therefore, when determining hospital rates, it is necessary to consider unit cost analysis so that hospital operational costs can be efficiently spent.

Analysis of Factors Affecting Job Satisfaction and Performance of Specialist Doctors

2025-07-24T07:12:48+00:00

There are many patient complaints regarding the performance of specialists at Kudungga Hospital. This is shown in accordance with the results of patient satisfaction surveys conducted in 2020 and 2021. From the satisfaction survey, it was concluded that the patient's complaint was the behavior of doctors who often arrived late so that the polyclinic schedule was not on time. The purpose of this study is to analyze factors related to job satisfaction and performance of specialist doctors at Kudungga Regional Hospital, East Kutai Regency.The type of research used is observational with a cross sectional design, namely a study that explores information about the phenomenon of work dissatisfaction of Specialist Doctors at Kudungga Sangatta Hospital and then analyzes the dynamics of the correlation between phenomena, between the independent variable and the dependent variable can be how far the influence between the independent variable on the dependent variable. The population and sample in this study were 30 specialist doctors who actively worked at the Kudungga Sangatta Regional General Hospital. Data collection was carried out by distributing questionnaires and collecting secondary data in the form of OPPE specialist doctors and And data analysis was carried out using univariate and bivariate analysis using the Spearman Rank test. There is a relationship between work environment conditions and promotion opportunities with job satisfaction of Specialist Doctors. Based on the results of data analysis and discussion, it can be concluded that factors related to specialist doctor job satisfaction consist of work environment conditions and promotion opportunities. The variable most closely related to specialist doctor job satisfaction is work environment conditions, which has an R value of 0.689 (a strong correlation).

Dietary Patterns are Related to the Incidence of Anemia in Adolescent Girls

2025-07-24T10:02:53+00:00

Anemia in adolescent girls is a significant public health problem, especially in developing countries like Indonesia. This study aims to analyze the relationship between dietary patterns and the incidence of anemia in adolescent girls in Bogor Regency. The population in this study were adolescent girls aged 11–13 years who were selected through simple cluster sampling technique. Data were collected using a structured questionnaire and hemoglobin level measurements to determine anemia status. The instrument used was a dietary questionnaire with a validity test (r count = 0.23901 <0.36 1) and the reliability of the dietary questionnaire Cronbach's alpha value = 0.8346 (>0.6). Data analysis was performed using chi-square statistical tests and logistic regression. Adolescents with poor dietary patterns were the most likely to experience anemia, amounting to 125 adolescents or 42%. The chi-square test obtained a p-value = 0.001 (p <0.05), meaning there is a relationship between dietary patterns and the incidence of anemia in adolescent girls in Bogor Regency in 2025. Adolescents with knowledge of balanced diets tend to have a lower risk of experiencing anemia.

Dilemmatic of Management of Wound Care of Diabetic for Risk Amputation in Rural Areas: A Case Report

2025-07-24T11:21:16+00:00

Diabetic wounds are one of the most challenging complications faced by individuals with diabetes. These wounds not only pose serious physical threats, such as infection and limb loss, but also cause significant psychological distress. One ethical dilemma commonly encountered in diabetic wound care involves decision-making about treatment options, especially when patients request amputation due to pain or economic burden, while healthcare providers aim to preserve the limb through advanced wound care techniques. This situation requires careful consideration of both medical and ethical aspects to ensure patient-centered care. The objective of wound care in such cases is not only physical healing but also improving the patient’s psychological well-being. When care is holistic and empathetic, patients are more likely to engage in treatment positively and without fear, especially during painful procedures such as dressing changes. This case highlights a 55-year-old man with a 20-year history of uncontrolled diabetes and a chronic, infected wound on his right leg. The patient's initial desire for amputation was addressed through a multidisciplinary approach using the TIME method Tissue management, Inflammation control, Moisture balance, and Epithelial advancement. The structured, ethical, and compassionate care helped the patient reconsider amputation, demonstrating that rural nurses and health teams can resolve ethical dilemmas and support better patient outcomes.

Corelation Between Uric Acid and Neutrophil Lymphocyte Ratio (NLR) in Controlled and Uncontrolled Type 2 Diabetes Mellitus

2025-07-24T14:19:38+00:00

Type 2 diabetes mellitus (DM) is a metabolic disease characterized by chronic hyperglycemia, often linked to metabolic complications and inflammatory conditions. Uric acid and Neutrophil-Lymphocyte Ratio (NLR) are biomarkers of inflammation and oxidative stress in this condition. This study aims to examine the relationship between uric acid and NLR in controlled and uncontrolled type 2 DM patients. Using an analytical observational design with a cross-sectional approach and consecutive sampling, 112 subjects were divided into controlled (HbA1c < 7%) and uncontrolled (HbA1c ≥ 7%) groups. Data were collected from RSUP H. Adam Malik Medan through laboratory tests for whole blood, uric acid, and HbA1c levels. Pearson or Spearman correlation tests were used to assess relationships between variables with a significance level of p < 0.05. Significant demographic differences were found between groups, with higher uric acid and HbA1c levels in the uncontrolled DM group. Positive correlations were observed between uric acid and NLR, as well as uric acid and HbA1c, in both groups. Additionally, a strong positive association between HbA1c and NLR was found in both groups. Uric acid, NLR, and HbA1c are correlated in both controlled and uncontrolled type 2 diabetes mellitus.

Impact of Top Management Decision on Hospital Risk Management: A Scoping Review

2025-07-25T17:33:41+00:00

Top management decisions play a crucial role in shaping hospital risk management. Effective leadership, resource allocation, and a strong safety culture are essential to minimize risks and improve healthcare quality. This study aims to explore the impact of top management decisions on hospital risk management and to identify key factors that influence the success of patient safety programs. This scoping review followed the PRISMA framework. Articles were systematically searched from PubMed, Scopus, and Google Scholar, focusing on publications from 2005 to 2025. Keywords included hospital risk management, top management, decision making. Ten relevant articles were selected and analyzed thematically to identify key patterns related to leadership decisions in hospital risk management. The study found that top management influences hospital risk management through leadership support, resource allocation, communication, safety culture development, and staff training. However, challenges such as limited resources, inadequate staffing, and underreporting of incidents remain. Top management is crucial in ensuring hospital safety through strong leadership, clear communication, sufficient resources, and ongoing staff training to enhance patient safety and risk management. Overcoming organizational barriers is essential for sustaining long-term safety improvements.

Effectiveness of Turmeric Decoke on Breast Milk Production for Postpartum Mothers

2025-07-25T18:00:36+00:00

Every mother can breastfeed, but there are obstacles that hinder breastfeeding. Low exclusive breastfeeding rates can be influenced by several other factors such as socio-cultural, psychological, physical, health workers, knowledge, and family/community organization support. Compounds in turmeric are useful as a stimulus to facilitate the release of breast milk from the body so that breast milk will be quickly produced by the body through the performance of the hormone prolactin. The general objective of this study was to determine the effectiveness of turmeric decoction on breast milk production in postpartum mothers at PMB Sari Meryandi. This research method used Quasi-Experimental with a one-group pretest-posttest research design. Sampling was carried out using an accidental sampling technique with a total of 15 respondents.The sampling technique used was a questionnaire and an interview as the instrument. The population of this study was postpartum mothers on days 3-5 who were exclusively breastfeeding and experiencing irregular milk production. This study was conducted for 7 consecutive days by giving 100 grams of boiled turmeric water, followed by 200cc of water, to their babies, and drinking it either cold or warm. Smooth breastfeeding was categorized as having an average milk production of >50cc/24 hours.The data analysis used was the Wilcoxon test (data with non-normal distribution). The results of the univariate analysis showed an average knowledge level in the intervention group. The results of the 2-tailed Sig value <0.05, which means there is a significant difference in the pre-test and post-test values after the administration of turmeric boiled water in the intervention group.

Effectiveness of Coping Through Audio Visual Education of J. Watson's Caring Concept Model on Reducing Anxiety Pre Percutaneous Coronary Intervention (PCI) of Cad Patients in the Hospital

2025-07-25T19:09:09+00:00

Coronary Heart Disease (CHD) is the leading cause of death globally, including in Indonesia. One of the procedures to treat CHD is Percutaneous Coronary Intervention (PCI), but this action often causes significant anxiety in patients. Unmanaged anxiety can worsen the physical and mental condition of patients. This study aims to analyze the effectiveness of audio-visual education based on the Caring Jean Watson concept in reducing anxiety in pre-PCI patients at Dr. Loekmonohadi Hospital, Kudus. The study design was a quasi-experiment with a "nonequivalent control group design", involving 40 patients divided into two groups: intervention (Watson's audio-visual caring education) and control (conventional education). Anxiety levels were measured using the Hospital Anxiety and Depression Scale (HADS) before and after the intervention. The data obtained before being analyzed was tested using the Shapiro-Wilk test to ensure that the data was normally distributed, then a parametric paired T-test was carried out to see the difference in anxiety between before and after being given education. The results showed a significant decrease in anxiety in the intervention group, where 45% of patients reached normal anxiety levels and only 10% still experienced severe anxiety. In contrast, in the control group, 70% of patients remained at severe anxiety levels. The paired T-test statistical test produced a p-value of 0.000 (p < 0.05 ), indicating a significant difference before and after education. Caring-based audio-visual education has been shown to be effective in reducing pre-PCI patient anxiety.

Effectiveness of Management Strategy of Implementation of Stunting Program: Case Study

2025-07-26T05:20:06+00:00

Stunting remains a significant public health challenge in Indonesia, with multifactorial causes including maternal nutrition, inadequate infant feeding practices, and poor sanitation. Effective implementation management of stunting programs is key to addressing this issue sustainably. This study aimed to analyze the effectiveness of management strategies in implementing stunting reduction programs in Tempeh Subdistrict, Lumajang Regency, focusing on process and outcome indicators. The qualitative approach employed a purposive sampling method, consisting of six informants divided into primary informants and triangulation informants. These included health office staff, community health center officers, and mothers of stunted children. Data were collected through interviews and document reviews, then analyzed using interactive data condensation, presentation, and conclusion drawing. The study found that the SIDERA program (Stimulation, Early Detection Friendly to Children) empowered PAUD teachers in early detection and parental education on nutrition, which contributed to reduced wasting and underweight prevalence, indicators closely linked to future stunting. Effective cross-sectoral synergy among health centers, local governments, educational institutions, and community health volunteers facilitated program implementation. However, challenges remain in timely training delivery and strategic targeting of interventions to the most affected communities. Effective management strategies that emphasize comprehensive understanding of programs, accurate targeting, timeliness, achievement of objectives, and tangible changes in community behavior are crucial for stunting prevention efforts. Strengthening coordination and optimizing training schedules for key stakeholders such as PAUD teachers can further improve program outcomes.

Implementation of the BPJS Health Referral Program in Indonesia: Literature Review

2025-07-26T07:53:12+00:00

BPJS Health's Reverse Referral Program (PRB) is an initiative designed to ensure continuity of care for patients with chronic diseases by coordinating between primary healthcare facilities (FKTP) and partner pharmacies. This article aims to review the available literature on the effectiveness of PRB drugs, the flow of referral services, drug availability, and the role of partner pharmacies in supporting program implementation. The method used was a Systematic Literature Review using the Preferred Reporting Items for Systematic Reviews (PRISMA) flow by collecting articles from the Science Direct, Pubmed and Google Scholar databases published between 2019 and 2024 with the keywords "BPJS Referral Program", "Referral Drug Effectiveness", "PRB Drug Availability", and "BPJS Partner Pharmacies". From the initial search results, 39 articles were found (3 articles from ScienceDirect, 11 articles from PubMed, and 25 articles from Google Scholar). Based on the analysis conducted, 6 articles were double-published, 5 articles were incomplete, and 8 articles were not relevant to the topic. Then, after selection, 20 articles were identified as meeting the inclusion criteria. The results of the analysis showed that PRB helps improve patient compliance in chronic disease management and reduces the burden on referral hospitals. However, challenges faced include limited drug distribution, logistical constraints, and suboptimal coordination. This review concludes that technology-based solutions and increased regulatory capacity are needed to ensure the overall effectiveness of this program.

Analysis of Factors Affecting Antiretroviral Adherence in HIV/AIDS Patients

2025-07-26T22:59:14+00:00

Human Immunodeficiency Virus (HIV) remains a major global public health issue, with antiretroviral (ARV) therapy playing a critical role in its management. Adherence to ARV therapy is essential to suppress viral load, prevent drug resistance, and improve the quality of life of people living with HIV/AIDS (PLWHA). However, cases of non-adherence persist. At RSUD A. Wahab Sjahranie, a referral hospital in East Kalimantan, 16% of patients have been found to be non-adherent to their ARV medication. Ensuring adherence is vital to avoid complications and prevent HIV transmission. This study aims to identify and analyze the factors influencing ARV adherence among HIV/AIDS patients at the Anyelir Outpatient Clinic, RSUD A.W. Sjahranie, Samarinda. This study employed a quantitative analytical approach with a cross-sectional design. It involved 106 HIV/AIDS patients who were actively receiving antiretroviral therapy (ART). The independent variables included knowledge, self-efficacy, duration of therapy, side effects, family support, social support, and healthcare staff attitude. Data were collected using a structured questionnaire administered directly to respondents and supported by secondary data from medical records. A total sampling technique was applied, and data were analyzed using chi-square tests and logistic regression at a 95% significance level. A total of 85.8% of respondents were classified as adherent to ARV treatment. Bivariate analysis showed that knowledge (p = 0.019), family support (p = 0.018), social support (p = 0.011), healthcare staff attitude (p = 0.006), and self-efficacy (p = 0.002) were significantly associated with ARV adherence. Multivariate analysis identified family support (OR = 4.275), healthcare staff attitude (OR = 6.834), and self-efficacy (OR = 20.241) as the most influential factors. Knowledge, side effects, family support, social support, healthcare staff attitude, and self-efficacy are significant determinants of ARV adherence among PLWHA. Among these, self-efficacy emerged as the most dominant factor.

Neutrophil-To-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Predictors of Mortality in Chronic Kidney Disease Patients Undergoing Hemodialysis

2025-07-26T23:00:33+00:00

Chronic Kidney Disease (CKD) is associated with high mortality, especially among patients undergoing hemodialysis (HD). Inflammation markers such as the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) have been linked to mortality prediction. This study aims to evaluate the role of NLR and PLR as mortality predictors in CKD patients undergoing HD at H. Adam Malik Hospital, Medan. This retrospective study analyzed CKD patients receiving HD from January to December 2023, aged 18-60 years, and undergoing routine HD for at least 3 months. Excluded were those with comorbidities, immunosuppressant use, or incomplete records. Data on demographics, laboratory values (including NLR and PLR), and mortality outcomes were collected. ROC curve and logistic regression analysis were used. Out of 108 patients, 35 (32.4%) died. The median NLR was significantly higher in the mortality group (7.89 vs. 3.41, p < 0.001), while PLR showed no significant difference. ROC analysis revealed NLR's moderate accuracy (AUC = 73.3%, cut-off = 5). Multivariate analysis identified coronary artery disease history, age, and creatinine levels as significant mortality factors. NLR is a moderate predictor of mortality in CKD patients undergoing HD, while PLR is not.

The Calm Before the Storm: Wellens Syndrome Revisited

2025-07-27T11:41:29+00:00

Wellens syndrome is a characteristic electrocardiographic pattern indicating a critical stenosis of the left anterior descending (LAD) coronary artery and is a warning sign for an impending anterior myocardial infarction. Early recognition is crucial, as this pattern typically appears when the patient is pain-free and cardiac biomarkers are standard, which can potentially mislead clinicians. This case report aims to highlight the importance of recognizing the pattern of Wellens Syndrome through the clinical description of patient Mr. A, a 61-year-old male with hypertension and chronic kidney disease who presented with chest pain that has subsided. We present a 61-year-old Melanesian man with a history of hypertension and stage 3 chronic kidney disease, who had recent anginal chest pain that resolved upon evaluation. On examination, blood pressure was 154/80 mmHg, heart rate 78/min, respiratory rate 20/min, temperature 36.7°C, oxygen saturation 99% on room air, and minimal pitting oedema in both legs. The ECG obtained showed biphasic T waves in leads V2–V4 with the patient feels no chest pain at all, consistent with a type A Wellens pattern. Troponin T was negative (< 40 ng/L), and no ST elevation or pathologic Q waves were observed. Chest X-ray showed cardiomegaly. Coronary angiography revealed a critical stenosis in the proximal LAD. The patient underwent percutaneous coronary intervention with stent placement to the proximal LAD. Wellens syndrome represents a “pre-infarction” state that should be identified to prompt urgent revascularization before extensive myocardial infarction occurs. This case underscores the importance of recognizing Wellens syndrome as “the calm before the storm” and avoiding conservative management that could lead to adverse outcomes.

Nutritional Status Profile of Women of Reproductive Age Based on Anthropometric Indicators

2025-08-01T05:37:34+00:00

Nutritional status reflects the balance between nutritional needs and intake, which is crucial for the health of women of reproductive age, as it directly affects reproductive function, pregnancy, and overall family well-being. This study aimed to accurately assess their nutritional status using anthropometric indicators as an initial step to prevent metabolic disease risks in women of reproductive age. This was a descriptive study with a cross-sectional design conducted from November 2024 to January 2025. The population consisted of all women of reproductive age (WRA) with total of 45 respondents were selected using purposive sampling. Data were collected through direct observation using a checklist that included demographic characteristics and anthropometric measurements. The data were analyzed univariately and classified based on WHO standards to determine categories of undernutrition, normal, overweight, and central obesity. Results were presented in tables, charts, and descriptive narratives. Most women of reproductive age (WRA) were in the productive age range of 21–35 years, with the majority having a senior high school education and working as employees or laborers. Nutritional status, based on BMI and MUAC, was predominantly in the normal category; however, waist circumference and waist-to-hip ratio (WHR) measurements indicated a high prevalence of central obesity among the WRA. All respondents had a WHR ≥ 0.85, indicating a high risk of non-communicable diseases such as hypertension and type 2 diabetes. This study assessed the nutritional status of women of reproductive age using anthropometric indicators such as BMI, MUAC, waist circumference, and WHR. While most had normal nutritional status, there was a high prevalence of central obesity, which poses a risk for non-communicable diseases like hypertension and diabetes.

Combination of Subcision, Microneedling, and Platelet-Rich Plasma Therapy in Patient with Grade Four Atrophic Acne Scars

2025-08-01T05:26:12+00:00

Atrophic acne scars affect up to 75% of patients with a history of acne and are often associated with significant psychosocial distress. These scars are classified into three main types: ice pick, rolling, and boxcar. A multimodal therapeutic approach is often required for effective management, particularly in severe cases. This report presents a case of a 40-year-old married woman with a 10-year history of inflammatory acne lesions that progressed into grade 4 atrophic scars. The acne was suspected to be triggered by injectable contraceptive use, which contains progestins with androgenic activity. The patient frequently picked at her acne, leading to deep scarring predominantly on both cheeks. Based on clinical evaluation, dermoscopy, and skin analyzer assessment, the patient underwent a series of treatments combining subcision, microneedling, and platelet-rich plasma (PRP) therapy. Following treatment, the Self-Assessment of Clinical Acne-Related Scars (SCARS) score improved from 22 to 14, while the Facial Acne Scar Quality of Life (FASQoL) score improved from 32 to 16. This case highlights the effectiveness of a combination approach in remodeling scar tissue and improving quality of life in patients with severe atrophic acne scars. A tailored, comprehensive treatment plan is essential for optimal outcomes.

An Overview of Diabetes Mellitus Patients

2025-08-09T06:58:15+00:00

Dietary compliance among patients with type 2 diabetes mellitus (T2DM) is a crucial aspect of disease management, yet many patients in rural areas, including the Pengarayan Health Center service area in Ogan Komering Ilir Regency, still exhibit low adherence. Several factors such as knowledge, education level, family support, and healthcare worker involvement are suspected to influence this behavior. Objective to provide an overview of the levels of knowledge, family support, healthcare worker support, and dietary compliance among T2DM patients in the working area of Pengarayan Health Center, Tanjung Lubuk Subdistrict. This was a quantitative descriptive study using a cross-sectional design. Total sampling was applied to 125 T2DM patients registered in the health center area. Data were collected using validated and reliable questionnaires measuring knowledge, family support, healthcare worker support, and dietary compliance. The study found that 63.2% of patients had low knowledge, 51.2% received good family support, and 64.0% reported support from health workers. Dietary compliance was found in 50.4% of respondents. Educational attainment showed a strong relationship with compliance, where those with higher education levels were more adherent to dietary recommendations. Knowledge level and family support play a vital role in dietary compliance among T2DM patients. Strengthening education and involving family and healthcare professionals more actively could significantly improve adherence to dietary guidelines and better disease control outcomes.

Behavior Related to the Success of Pulmonary TB Treatment

2025-08-13T09:32:02+00:00

Pulmonary Tuberculosis (TB) is an infectious disease caused by Mycobacterium Tuberculosis, this disease becomes a public health problem, especially if there is a break in treatment which has an impact on TB drug resistance. The purpose of this study is to see the correlation or relationship of determinant factors that influence the success of pulmonary tuberculosis treatment. The type of research is Observational Analytical with a Cross Sectional approach. Data collection uses questionnaires, observations and interviews. The population is 158 and the sample is 91 respondents with cluster sampling. The study was conducted in Parigi Moutong Regency during February-June 2025. Of the 91 respondents who were 94.5% compliant with taking medication, 75.8% had good Family Support, 75.8% had Drug Supervisor (PMO) Support and 83.5% had Health Worker Support, the results of the chi square test showed a relationship between medication adherence and the success of Pulmonary TB Treatment p = 0.000 <0.05, there was a relationship between family support and the success of Pulmonary TB Treatment p = 0.001 <0.05, there was a relationship between support (PMO) and the success of Pulmonary TB Treatment p = 0.001 <0.05 and there was a relationship between Health Worker support and the success of Pulmonary TB Treatment p = 0.000 <0.005. Conclusion There is a relationship between behavior (medication adherence, family support, PMO support and health worker support) and the success of pulmonary TB treatment.

The Relationship Between Spraying Frequency and Incidence of Anemia in Farmers

2025-08-13T12:14:06+00:00

Various types of pesticides commonly used by farmers and the public include insecticides, fungicides, and herbicides. Excessive pesticide use in agricultural settings can lead to adverse health effects, one of which is anemia. This study aimed to analyze the relationship between pesticide spraying frequency and the incidence of anemia among horticultural farmers in Gisting District, Tanggamus Regency, in 2025. A quantitative, case-control design was employed. The study was conducted in Gisting District, Tanggamus Regency, Lampung Province, from August 2024 to January 2025. The study population consisted of 41 anemic farmers with hemoglobin levels below 13 g/dL, and 41 non-anemic farmers as the control group. Purposive sampling was used, with the case group comprising anemic farmers and the control group including non-anemic respondents. The independent variable was spraying frequency, and the dependent variable was anemia. Data on spraying frequency were collected via questionnaire, while anemia was assessed through laboratory analysis. Data analysis included univariate and bivariate methods, with the Chi-Square test applied for inferential statistics. Results showed that the majority of farmers in the case group (73.2%) sprayed pesticides more than twice per week, whereas 53.7% of the control group sprayed less than twice per week. The analysis yielded a p-value of 0.024, indicating a significant association between spraying frequency and anemia incidence. The odds ratio (OR) of 3.158 (95% CI: 1.253–7.957).

Systematic review: The Effect of Non-pharmacological Interventions on Reducing Pain During the First Stage of Labor

2025-08-14T07:13:52+00:00

Labor pain is one of the main problems experienced by mothers during the birth process. Pain management can be done with pharmacological and non-pharmacological methods. Non-pharmacological approaches are considered safer and more effective because they have minimal side effects. This systematic review aims to analyze the effect of non-pharmacological interventions such as music therapy, endorphin massage, effleurage massage, deep back massage, and a combination of therapies on reducing pain in the first stage of labor. The review method uses a systematic review using PRISMA For Systematic Review, which is obtained from the Google Scholar, Proquest, Pubmed databases. The review results obtained 18 of the 369 articles selected from 2018-2025. The keywords used are non-pharmacological therapy, labor pain, music therapy, massage therapy. Labor pain is grouped into 1 theme, namely non-pharmacological therapy. This study involved 18 relevant articles. The results showed that all interventions were effective in reducing labor pain (p <0.05). Combinations of therapies such as music and aromatherapy provided a more significant effect.

The Effect of Animated Videos on Teeth Brushing on School Children's Knowledge of Maintaining Dental and Oral Health”

2025-08-14T07:57:27+00:00

Dental caries remains a common health problem among children in many countries, including Indonesia, with a fairly high incidence rate. According to data from Riskesdas (2018), 81.5% of children aged 3-4 years in Indonesia suffer from dental caries. Lack of knowledge and poor oral hygiene practices can increase the risk of dental health problems. Educational media in the form of animated videos are considered effective because they stimulate visual and auditory senses, thereby aiding children's understanding. This study aims to evaluate the effect of an animated video on proper toothbrushing techniques on students' knowledge levels at SDN Bontoramba 1 Makassar. It is hoped that the implementation of such media can enhance children's awareness and knowledge about oral and dental care, thereby positively impacting their quality of life. This study aims to determine children's level of knowledge about dental and oral health care before receiving education through animated videos, then analyze changes in knowledge after the education, and assess the effect of animated videos on children's motivation to maintain dental and oral health. The research used a quasi-experimental design with a pre-post test approach, This study involved 36 elementary school students, consisting of 16 girls and 20 boys. The respondents were assessed before watching the educational animation video and then reassessed after the educational intervention through the video. Based on the McNemar test analysis, 29 students who initially had poor knowledge improved to good after watching the animated educational videos, and no students showed a decline from good to poor. The statistical test results showed a significance value of p < 0.001, which is less than the criterion limit of 0.05 There was a significant difference between the results before and after the intervention. These findings indicate that the use of animated educational videos has a significant effect on improving students' knowledge of how to brush their teeth to maintain dental and oral health.

Scooping Review: The Effectiveness of Physical Training Based on Child Health Models for Obese Adolescents

2025-08-14T08:36:39+00:00

Adolescent obesity is a global public health concern that affects both physical health and psychosocial well-being. Integrative interventions that combine physical training with psychosocial support, such as the Child Healthcare Model, are increasingly being used to address this issue holistically. This study aims to explore the effectiveness of physical training based on the Child Healthcare Model on weight loss and body image among obese adolescents through a scoping review guided by the PRISMA framework. This study aims to assess the effectiveness of physical exercise based on the Child Healthcare Model in reducing weight and improving body image in obese adolescents. It is hoped that the results of this study will provide a deeper nunderstanding of the role of structured physical exercise in supporting obese adolescents to achiev their ideal weight and form a more positive body image. A comprehensive literature search was conducted using PubMed, Scopus, ScienceDirect, and Google Scholar databases for relevant studies published between 2019 and 2024. The search focused on studies involving adolescents aged 12–18 years with obesity who underwent physical training programs integrated with the Child Healthcare Model. Study selection followed the PRISMA-ScR flow diagram, and data were extracted and synthesized narratively. Out of 187 initial articles, 23 met the inclusion criteria. Most studies reported that physical training combined with the Child Healthcare Model—through nutritional education, psychological support, and family involvement—resulted in average weight loss of 3–5% over 12 weeks and significantly improved body image as measured by validated scales. Family and professional involvement were key factors in enhancing participant motivation and outcomes. Physical training based on the Child Healthcare Model is effective in reducing body weight and improving body image among adolescents with obesity. These findings support the implementation of holistic, family-centered interventions in adolescent obesity programs.

The Effect of Progressive Muscle Relaxation on Blood Sugar Levels in Patients with Type 2 Diabetes Mellitus

2025-08-18T13:48:20+00:00

One of the most complex chronic diseases is diabetes, which requires ongoing medical care aimed at reducing multifactorial risks beyond glycaemic control. Diabetes and stress are interrelated, where stress results in increased cortisol production, cortisol itself inhibits the work of insulin, this triggers an increase in blood sugar levels. One of the ways to control blood sugar levels by providing non-pharmacological therapy is to provide music therapy, relaxation and guided imagery. Progressive Muscle Relaxation (PMR) is one of the relaxations that can be applied to patients with diabetes mellitus. This relaxation technique can speed up the body's metabolism by physiologically increasing blood flow. This study aims to determine the effect of progressive muscle relaxation on blood sugar levels in patients with type 2 diabetes mellitus. This research is a quasi-experimental. The research design used is nonrandomised pretest - posttest with control group design. The research sample was divided into two groups, the intervention group and the control group. Blood sugar level measurements were carried out in the intervention group twice, namely before (pretest) and after (posttest) being given progressive relaxation therapy, while the control group did not receive any actions. The population in this study were patients with type 2 diabetes mellitus at Dr Moewardi Surakarta Hospital. Data analysis using the parametric paired t-test because the data is normally distributed. The blood sugar level in the control group before the relaxation intervention was an average of 237.90 mg/dl and after the relaxation intervention was an average of 218.57 mg/dl. The average blood sugar level in the control group before relaxation was 238.10 mg/dl and after relaxation was 231.43 mg/dl. The p-value for the intervention group based on the paired sample t-test statistic is 0.000 (p < 0.05) with an average decrease in blood sugar level of 19.33 mg/dl. These results indicate that progressive muscle relaxation exercises have an effect on changes in blood sugar levels in patients with type 2 diabetes mellitus. Based on the above description, it can be concluded that progressive muscle relaxation has an effect on changes in blood sugar levels in patients with type 2 diabetes mellitus.

Unpreparedness in Self-Management: A Description of Self-Management of Type II Diabetes Mellitus Patients in Health Facilities

2025-08-19T15:59:57+00:00

Type 2 diabetes mellitus is a metabolic disorder caused by hyperglycemia. If uncontrolled, it can be fatal. Therefore, effective self-management and self-control activities are necessary for sufferers. Self-management includes behaviors related to diet, exercise physique, monitoring sugar blood And maintenance foot. This study aims to identify self-management on patient DM type 2 in Internal Medicine Polyclinic, Sekarwangi Regional Hospital. This study used a quantitative descriptive method with a survey approach. The instrument used to measure diabetes self-management was the DSMQ (Diabetes Self-Management Questionnaire) questionnaire adapted into Indonesian. The sample size of this study was 120 type 2 DM patients, using a quota sampling method, in accordance with established inclusion and exclusion criteria. Data analysis used in this study was descriptive univariate analysis. This study shows that the characteristics of respondents were on average 53 years old, had suffered from DM for around 4 years, 61.6% were female, 44.1% had secondary education, 65% were married, 80.8% were employed, 73.3% had no family history of the disease, and 74.1% of respondents had never attended DM education . Analysis score s elf-management shared into three category that is Good Enough And bad, The results of this study showed that respondents who performed self-management were fair (42.5%), good (29.1%), and poor (28.3). The average subscales were fair glucose management, adequate dietary control, poor physical activity, and poor health services. This indicates that most respondents have not performed self-management effectively. It is important for nurses to facilitate proper self-management for DM patients and implement specific programs for DM patients.

The Effect of Healing Touch Therapy on Anxiety: Systematic Literature Review

2025-08-19T16:40:55+00:00

Patient anxiety that is not handled properly can have an impact on the patient's deterioration in health status and quality of life. One of the therapies that can be applied is to overcome patients' anxiety disorders with touch healing therapy. . One therapy that can be applied to address anxiety disorders in patients with anxiety disorders is healing touch therapy. The purpose of this literature review was to determine the effect of healing touch therapy on anxiety. This literature review was conducted through a search of publications in Google Scholar, Somantic Scholar Proquest, and PubMed between 2019 and 2025 using the PRISMA method. The keywords used were "Healing Touch" OR "Therapeutic Touch" AND Anxiety OR "Anxiety Disorders". The search for related articles from seven sources met the inclusion criteria, the results of the search for articles from several sources obtained 170 articles, of which only 6 articles met the criteria. The conclusion was that healing touch therapy has an effect on patient anxiety. Healing touch therapy is an intervention that can be implemented or carried out by nurses to help reduce patient anxiety levels.

The Effectiveness of Diabetes Self-Management Education (DSME) on the Self-Care of Patients with Diabetic Foot Ulcers

2025-08-31T12:39:58+00:00

Diabetic foot ulcers are one of the chronic complications of diabetes mellitus (DM) that can lead to serious infections and even amputation. Poor self-care ability is a major risk factor in the development of chronic wounds among DM patients. The Diabetes Self-Management Education (DSME) intervention has been considered effective in improving patients’ self-management abilities; however, contextual evidence in Indonesia remains limited. This study aimed to evaluate the effectiveness of DSME intervention in improving self-care abilities among patients with diabetic foot ulcers at RSUD Banjarmasin. The study employed a quasi-experimental design using a one group pre-test and post-test approach. A total of 30 patients were selected using total sampling. The DSME intervention was delivered over seven consecutive days through a structured, face-to-face educational approach. Self-care ability was measured using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire before and after the intervention. Data were analyzed using a paired sample t-test. Prior to the intervention, the majority of respondents (70%) were categorized as having poor self-care. After the intervention, 80% of respondents were categorized as having good self-care. The paired sample t-test showed a significant difference in self-care scores before and after the DSME intervention (p < 0.001). The DSME intervention was effective in enhancing self-care abilities among patients with diabetic foot ulcers.

Association Between Glycaemic Control and Cardiac Function in Children with Diabetes Mellitus

2025-08-31T13:47:04+00:00

The prevalence of Diabetes Mellitus (DM) among children and adolescents has been progressively increasing, with Type 1 DM constituting the majority of cases. Cardiovascular disease (CVD) is a major long-term complication, yet early cardiac involvement remains poorly understood in this population. This study aimed to assess the association between glycaemic control and cardiac function in paediatric patients with DM. A cross-sectional observational study was conducted involving 30 children with type 1 or type 2 DM at H. Adam Malik General Hospital, Medan. Glycaemic control was assessed using HbA1c levels. Cardiac function was evaluated using electrocardiography (ECG) and echocardiographic parameters, including ejection fraction (EF), fractional shortening (FS), tricuspid annular plane systolic excursion (TAPSE), and E/A ratio. Data were analysed using Chi-Square and Mann-Withney Test. Most subjects (90%) had poor glycaemic control (HbA1c ≥7%). Cardiac dysfunction (reduced EF <55%) was identified in 16.7% of patients. However, no statistically significant associations were found between cardiac function and HbA1c, duration of diagnosis, blood pressure, or body mass index (BMI) (p>0.05). There was no significant relationship was found between glycaemic control and cardiac function, highlighting the need for more sensitive diagnostic tools and long-term follow-up to detect subclinical cardiovascular complications.

Evaluation of the Provision of Direct Observation of Procedural Skills (DOPS) on Physical Examination Skills and Water Seal Drainage (WSD) Treatment in Nursing Students

2025-09-01T03:55:14+00:00

In improving student performance, clinical practice is needed, but before students practice in the field, mental preparation, knowledge and skills are needed, all of which we can find out by evaluating each student. Direct Observation of Procedural Skills (DOPS) is an evaluation method designed to address these gaps. The application of DOPS in health education in Indonesia is still relatively new and has not been widely integrated into the curriculum. However, the need for a more effective learning method is increasingly urgent, especially in the areas of procedural skills such as physical examination and WSD treatment. This study aims to determine the provision of the DOPS method to improve the skills of physical examination and WSD care in 4th semester nursing students at Aisyah Pringsewu University. This study used a quantitative approach with a quasy experimental design. This research design uses a One Group Pre-Post Test Without Control Group Design approach. The sample amounted to 32 respondents selected through the total sampling technique. Data were collected using the Standard Operating Procedure (SOP) with an independent t test. Results Show that the paired sample t-test above, known sig value. (2-tailed) is 0.001 <0.05, then Ho is rejected and Ha is accepted. So it can be concluded that there is a difference in the value of DOPS on physical examination skills and WSD Care. It is concluded that there is a significant difference between the control group and the intervention group before and after DOPS on physical examination skills and WSD.

Nipple Dermatitis as a Localized Manifestation of Atopic Dermatitis: A Case Report

2025-09-02T01:56:12+00:00

Nipple dermatitis is an inflammatory skin condition affecting the areolar and nipple region, most commonly associated with atopic dermatitis (AD). It presents significant diagnostic challenges due to its overlapping features with other conditions such as irritant contact dermatitis, allergic contact dermatitis, Paget’s disease, and cutaneous . This case report aims to present the diagnostic approach and management of nipple dermatitis in an adolescent patient, highlighting its clinical relevance and differential diagnosis.This case report discusses a 16-year-old female presenting with bilateral nipple dermatitis, initially suspected to have malignancy. Comprehensive evaluation including cytology, ultrasonography, and KOH examination ruled out malignancy and fungal infection. A working diagnosis of nipple dermatitis secondary to atopic dermatitis was established. The patient responded well to topical corticosteroids, emollients, antihistamines, and supportive care. This case highlights the importance of accurate clinical assessment and individualized treatment in managing nipple dermatitis, particularly in adolescents. Early identification and appropriate intervention can prevent chronicity and improve patient quality of life.

Empowering Primiparous Mothers Through Kegel Exercise: A Strategy to Enhance Sexual Self Efficacy During the Post Partum Period

2025-09-02T11:22:32+00:00

The postpartum period is a critical phase marked by significant physical and psychological changes, particularly for primiparous mothers who are experiencing childbirth for the first time. One of the common challenges encountered during this period is a decrease in sexual self-efficacy, defined as the individual's confidence in engaging in a healthy and satisfying sexual life. This study aimed to examine the effect of Kegel exercise education on improving sexual self-efficacy among primiparous women. A quasi-experimental design with a pretest-posttest control group approach was employed. The intervention consisted of structured Kegel education delivered through sequential stages: situational analysis, problem identification, planning, and implementation. The study sample consisted of 34 primiparous mothers from the Lerep Public Health Center working area, divided equally into intervention and control groups using purposive sampling. Respondents in the intervention group were those who received Kegel exercise education, while the control group consisted of those who did not receive any intervention. Univariate analysis was conducted using central tendency, while bivariate analysis was performed using the Man Whitney, which showed a p-value of 0.01 < α (0.05). The results demonstrated a statistically significant improvement in the sexual self-efficacy of the intervention group compared to the control group. It can be concluded that Kegel exercise education is an effective and empowering strategy to support the recovery of sexual function and improve the quality of life in primiparous women during the postpartum period.

The Effectiveness of Interactive Video Education Compared to Cadre Approach on Postpartum Mothers' Behavior in Umbilical Cord Care

2025-09-02T13:17:27+00:00

Umbilical cord infection significantly contributes to neonatal morbidity and mortality in border areas, with risky traditional care practices still commonly performed in Sanggau Regency. Objective: This study aimed to compare the effectiveness of interactive video education with health cadre approach in improving umbilical cord care behavior. The research design used an open-label randomized controlled trial with subjects of third-trimester pregnant women with gestational age more than thirty-seven weeks. Samples were taken using total sampling with forty-three initial respondents, then dropout occurred resulting in forty-two respondents divided into video group twenty-one people and cadre group twenty-two people. Before randomization, stratification was performed based on education and parity using simple random sampling with Excel RAND function. The video group received education through validated interactive videos, while the cadre group received lectures and demonstrations. Assessment was conducted on knowledge, attitudes, and practices using valid and reliable structured instruments from postpartum until umbilical cord separation. Data were analyzed using Mann-Whitney U, chi-square, and multiple logistic regression. Interactive video was significantly more effective in improving knowledge with odds ratio thirteen point six times greater, but no significant difference for attitudes and practices. Multivariate analysis showed education variables had significant effect with prediction accuracy of eighty-one percent. No single method was superior for all behavioral aspects, so combining both methods could be an optimal strategy to comprehensively improve umbilical cord care behavior Interactive video was more effective in improving knowledge, while the cadre-based approach had a stronger influence on shaping attitudes and practices, although the results were not statistically significant.

The Application of Art Therapy in Patients with Hallucinations: A Literature Review

2025-09-05T11:20:36+00:00

Art Therapy is one of the non-pharmacological therapies in counseling which can be used to reduce anxiety and manage emotions such as stress, depression, and self-doubt. The forms of art therapy activities are very varied covering construction painting, collage, print making and drawing. To determine the application of art therapy in hallucination patients. This article uses a literature review searched through the Google Scholar and pubmed database, with the keywords Art therapy, Hallucinations, drawing and painting, which are limited from 2021-2025. The strategy used by the researchers in searching and selecting the articles is the PICO framework. For this study we searched and found the titles and abstracts of 286 pieces of literature on Google Scholar and pubmed. Then, the 8 core articles were selected based on the inclusion criteria of art therapy application hallucination patients with hallucination. The literature review provides evidence supporting the application of art therapy in hallucination patients.

Spatial Autocorrelation Between Poverty Factors and Exclusive Breastfeeding Intake with Stunting in West Java Province at 2018 - 2020

2025-09-06T00:26:52+00:00

Stunting is a condition of growth failure in toddlers that leads to reduced productivity and susceptibility to degenerative diseases. The prevalence of stunting in West Java Province was the highest on the island of Java in 2018-2020. The objective of this study was to analyze the distribution map and spatial autocorrelation for stunting prevalence in West Java Province, with considering the spatial effects. The present study employed an ecological design with a spatial approach. The research data was obtained from Open Data Jabar, which is freely accessible via the website. The analysis was conducted using GeoDa software. The results indicate an increase in the areas demonstrating spatial effects between stunting and breastfeeding each year (2018–2020). Concurrently, the spatial implications of poverty on stunting necessitate further examination in the western region of West Java Province, particularly in Sumedang, Tasikmalaya, and Indramayu.

The Relationship Between Lipid Profile and the Incidence of Relapsing Nephrotic Syndrome in Children

2025-09-06T00:37:34+00:00

Nephrotic syndrome (NS) is one of the most common chronic kidney diseases in children, characterized by massive proteinuria, hypoalbuminemia, edema, and dyslipidemia. Relapse occurs in most cases and contributes to worsening the disease course. Dyslipidemia is suspected to influence relapse risk, but the specific relationship between lipid profile and relapsing NS remains unclear. Objective to analyze the association between total cholesterol, triglycerides, LDL, and HDL levels with relapse incidence in children with nephrotic syndrome. A retrospective study was conducted on 66 children aged 2–18 years with NS treated at H. Adam Malik General Hospital, Medan, in 2024. Subjects were divided into relapsing (n=54) and non-relapsing (n=12) groups. Data were obtained from medical records and analyzed using the Mann-Whitney test and Spearman correlation. Triglyceride (p=0.007), LDL (p=0.013), and HDL (p<0.001) levels differed significantly between the relapsing and non-relapsing groups. Total cholesterol showed no significant difference (p=0.164). The mean albumin level was significantly lower in the relapsing group (2.9 g/dL vs. 4.1 g/dL; p<0.001). A significant negative correlation was found between albumin and triglyceride levels (r=-0.326; p=0.008). Triglyceride, LDL, and HDL levels are significantly associated with relapse in pediatric nephrotic syndrome. Hypoalbuminemia is also an important risk factor. Lipid profile evaluation can serve as a useful indicator in monitoring and managing relapses.

The Effect of Calf Raise Exercise on Heart Rate, Oxygen Saturation, and Blood Pressure in Anesthesiology Nursing Students

2025-09-06T01:05:55+00:00

Physical exercise is a body activity that is carried out in a planned, structured and repetitive manner with the aim of improving or maintaining physical fitness and overall health. The busyness experienced by students in terms of theoretical and practical learning makes students do less physical exercise, and this can have implications for decreased muscle flexibility and the risk of muscle injury. Lack of physical exercise has a significant impact on the cardiovascular system, especially on heart rate (HR), oxygen saturation (SpO2), and blood pressure (BP). The purpose of this study was to determine the effect of the calf raise exercise on heart rate, oxygen saturation and blood pressure. This research method is using a pre-experimental with a pre-post one-group design. This research method is using a pre-experimental with a pre-post one-group design. The number of samples in this study was 170. Using the total sampling technique by using inclusion we’re resting HR less than 100 x/min and BP within normal limits, namely systolic less than 120 mmHg and diastolic less than 110 mmHg, the statistical test in this study was the Friedman test. The mean results after the calf raise training for heart rate were 93.47±8.65, oxygen saturation 98.27±1.26, systolic blood pressure 120.28±10.97, and diastolic blood pressure 79.97±7.25. The conclusion of this research is that there are differences in heart rate variables, oxygen saturation, blood pressure at six measurement time points with a p-value of 0.000 each.

Life Support Vs Life Cost: Ethical Conflicts in Critical Care Decision Making-A Case Report

2025-09-06T03:01:01+00:00

This case study describe patient receiving treatment in the ICU requested leave against medical advice (LAMA) due to financial limitation regarding hospital bills. This situation presents an ethical dilemma, as the patient requires emergency surgery and mechanical ventilation, making it unfeasible to discontinue the procedure. This study aims to highlight the strategic role of ICU nurses in mediating discharge requests, while upholding patient safety and respecting the family's values and decisions. A man after a traffic accident with a diagnosis of multiple skull fractures and Epidural Hematom (EDH). The patient’s family has provided written informed consent for this case report.This case has been documented in accordance with the CARE Case Report Guidelines. Following the nurse communicated with the case manager and a family conference was held with the medical team, the family decided to agree to surgery on the patient and the costs would be discussed with the extended family. Nurses not only play an active role as coordinators or mediators in providing patient care but also must identify potential financial resources available to the patient's family. This is done to prioritize the patient's interests.

The Combination of Deep Breathing, Isometricity, and Religious Prayer on Reducing Blood Pressure in Elderly Parents with Hypertension

2025-09-06T05:31:25+00:00

Hypertension treatment therapy needs to be supported by non-pharmacological therapy because it has fewer side effects, one of which is exercise, but so far it has not been widely done by hypertension sufferers. The study was to analyze the effect of the combination of NADA ISME RELIGI (deep breathing, isometrics and religious prayers) on reducing blood pressure in elderly with hypertension. A quasi-experimental study with a pretest-posttest with a control group design was used in 66 elderlies with hypertension recruited using purposive sampling. The research variables were the combination of NADA ISME RELIGI and blood pressure. Data analysis using paired sample t-test and independent t-test. The results of inferential testing showed that in the intervention group the pre and post-test values of blood pressure were p = 0.000 (p <0.05), so it can be concluded that the combination intervention of RELIGIOUS NADA ISME has a significant effect on blood pressure in hypertension sufferers. The combination of RELIGIOUS NADA ISME (Deep Breathing, Isometric and Religious Prayer) can reduce blood pressure in the elderly with hypertension, as evidenced by the results of research in the intervention group showing a decrease in blood pressure.

The Relationship Between Leadership Style, Job Satisfaction, and Work Environment with Nurse Performance in the Inpatient Ward

2025-09-06T07:27:20+00:00

Nurse performance refers to the execution of tasks, responsibilities, and authority in the best possible manner to achieve hospital goals in providing nursing services. In Indonesia, many hospitals have nurse performance levels below the ideal target of 75% of the available workforce. Objective to analyze the relationship between leadership style, job satisfaction, and work environment with nurse performance in the inpatient ward at Universitas Kristen Indonesia General Hospital. This quantitative study uses a cross-sectional design with a sample of 72 nurses, selected through total sampling. The research instruments include questionnaires on leadership style, job satisfaction, and work environment. Data were analyzed using the Chi-Square statistical test. 59.7% of nurses had moderate performance levels. 61.1% rated leadership style as moderate. 61.1% of nurses reported moderate job satisfaction. 68.1% assessed the work environment as moderate. Bivariate analysis showed a significant relationship between: Leadership style and nurse performance (p-value = 0.001); Job satisfaction and nurse performance (p-value = 0.001); Work environment and nurse performance (p-value = 0.001). There is a significant relationship between leadership style, job satisfaction, and work environment with nurse performance in the inpatient ward of Universitas Kristen Indonesia General Hospital.

Analyzing Waste in Emergency Radiology Services through A Lean Management Approach: A Literature Review

2025-09-08T10:32:49+00:00

Hospitals play a strategic role in supporting promotive, preventive, curative, and rehabilitative health efforts. The Emergency Department (ED) and Radiology Unit are critical services that directly affect the speed and accuracy of diagnosis, especially in emergency cases. This study aims to evaluate the efficiency of these two units using a Lean Management approach. A systematic literature review was conducted through databases including Scopus, PubMed, and Google Scholar using the keywords “emergency department,” “radiology,” and “lean management.” Inclusion criteria consisted of English- and Indonesian-language articles published between 2015 and 2024. Article selection followed the PRISMA guidelines. A total of 250 records were initially identified, with 10 high-quality articles ultimately meeting all inclusion and quality appraisal criteria for analysis. Findings indicate that Lean Management effectively identifies process waste, particularly prolonged patient waiting times and delays in radiology reporting. Techniques such as Value Stream Mapping and Root Cause Analysis were found to streamline workflows and reduce non-productive time. The implementation of Lean Management significantly enhances the efficiency of radiology services in emergency settings by optimizing processes and minimizing waste. Continuous outcome monitoring, regular training, multidisciplinary collaboration, and information technology integration are essential to ensure sustainable and system-wide improvements.

The Effect of Antenatal Diaphragmatic Breathing Exercise in Preventing Decreased Uterine Contractions in Caesarean Section Patients

2025-09-08T12:04:58+00:00

The number of sectio caesarea (sc) deliveries has increased, the main side effect of sc is bleeding caused by inadequate contractions. Understanding the risk of atony management is very important starting from antenatal care, various education is given to mothers including doing aerobic exercises including diphragmatic breathing as a prevention of uterine atony. The aim of this study was to see the effect of antenatal diaphgramatic breathing (dbe) exercise on preventing a decrease in uterine contractions in CS patients. This research method used a quasi-experimental posttest nonequivalent design with control group design, the sample in this study were 3rd trimester pregnant women who were at risk of being elective, totaling 56 people by using incidental sampling techniques, using the uterine contraction observation sheet instrument, data analysis used the chi square test. The results of the study showed that there was a significant effect of antenatal dbe implementation on preventing a decrease in intraoperative uterine contractions after the placenta came out. However, there was no effect of antenatal dbe on preventing uterine contractions 1-2 postoperative sc.

Relationship Between Clean and Healthy Living Behavior and the Incidence of Stunting in Toddlers

2025-09-12T11:49:43+00:00

Stunting is a condition of a short body based on the height-for-age index. Clean and healthy living behavior is an important behavior that can prevent stunting. The purpose of the study was to determine the relationship between clean and healthy living behavior and the incidence of stunting in toddlers at the Koto Panjang Ikua Koto Health Center. This study is an observational study with a cross sectional approach, he sampling technique used was proportional sampling with 82 respondents. Data were collected using a microtoise, the maternal and child health book and a questionnaire. The data were analyzed using chi-square and logistic regression test. The results showed a relationship between weighing toddlers and the incidence of stunting (p=0,003), exclusive breastfeeding is related to the incidence of stunting (p=0,009), the habit of washing hands with soap is related to the incidence of stunting (p=0,039), the use of healthy latrines is related to the incidence of stunting (p=0,017), eradication of mosquito larvae is related to the incidence of stunting (p=0,032). The results of the multivariate analysis showed that weighing toddlers had the most dominant relationship with the incidence of stunting (OR:6,376). Concluded that clean and healthy living behavior is significantly associated with the incidence of stunting.

Advances in Gene-Based Therapies for Leber Congenital Amaurosis: A Review of Clinical Trials

2025-09-12T20:04:56+00:00

Leber congenital amaurosis (LCA) is characterized by early-onset significant vision loss in infancy. Conventional therapeutic strategies offered limited benefits, thus escalating the focus on research into gene-based therapies. This review aimed to explore the clinical trials focusing on gene-based therapies for LCA. This literature review identified clinical trials on gene-based therapies for LCA registered on ClinicalTrials.gov using the keyword “Leber congenital amaurosis OR LCA,” with no restriction on year of registration. Trials not involving gene therapy were excluded. For each eligible trial, the corresponding National Clinical Trial (NCT) number was used to search the PubMed database for peer-reviewed publications, and grey literature was sourced when no publications were available. Extracted data included patient inclusion criteria, sample size, intervention dosage, safety profiles, adverse events, and efficacy outcomes. Numerous gene-based therapies for LCA have been reported, especially those targeting mutations in RPE65, CEP290, GUCY2D, AIPL1, and LCA5. Adeno-associated virus (AAV)-mediated gene replacement therapies, CRISPR/Cas9 gene editing, and antisense oligonucleotides (AONs) have been reported to deliver promising outcomes for LCA. Luxturna (voretigene neparvovec) has been FDA-approved for RPE65-LCA, while trials on emerging therapies like EDIT-101 and sepofarsen hold therapeutic promise for CEP290-LCA. The review underscores emerging strategies in gene therapy that lay the foundation for tailored, mutation-specific treatments. Several challenges remain in optimizing delivery vectors, preserving long-term efficacy, and minimizing adverse events.

Effect of FSMP on Weight Gain in Severely Underweight and Stunted Under-Five Patients

2025-09-13T01:52:31+00:00

Severely underweight in children under five, particularly severely underweight and stunting, remains a major public health issue with long-term impacts on human resource quality. One of the recommended interventions is the provision of Food for Special Medical Purposes (FSMP) in healthcare facilities. This study aimed to determine the effect of the program on weight gain among underweight and stunted under-five patients in the Sakura Inpatient Ward of Bekasi Regional General Hospital. This was a true experimental study with a one-group pretest-post-test design. The sample was obtained through total sampling of all under-five patients aged 0–36 months with severely underweight and stunting who were hospitalized in the Sakura Inpatient Ward from January 2024 to June 2025, totalling 71 patients. Data were analyzed using paired t-tests with a significance level of 5% (α = 0.05). There was an increase in the average body weight among severely underweight children from 5.31 kg to 5.63 kg (Δ = 0.32 kg; p < 0.001), and among those with both severely underweight and stunting from 4.97 kg to 5.34 kg (Δ = 0.37 kg; p < 0.001). The provision of program significantly increased body weight in under-five children with severely underweight, as well as those with combined severely underweight and stunting.

Relationship Between Dried Amnion Sheet and Dry Powdered Amnion with Changes in Wound Area in Acute Wounds

2025-09-13T02:18:42+00:00

Dried sheet amnion has long been used as a wound treatment that provides better results than standard general care. In addition to dried amnion sheet, dry powdered amnion preparations have begun to be used for wound care. This study aims to evaluate the effectiveness of dry powdered amnion compared to dried amnion sheets in wound healing, and to compare both treatments with standard acute wound care. Sixty-three healthy Wistar rats were randomly divided into three groups: dried amnion sheet treatment group, dry powdered amnion treatment group, and standard wet wound care control group. The research procedure began with the administration of anesthesia using penthotal at a dose of 10mg/kgBW intramuscularly. The backs of the rats were shaved and a 2x1cm wound was designed using a GOAL razor blade after disinfection with 10% betadine solution and 1:30 savlon. Wounds were made on the backs of the rats, and treatments were given according to the group. The wound area was evaluated at time points 6 hours after treatment, day 2 and day 5. Statistical analysis was performed to compare the effectiveness of the treatments. Both treatments with dry powdered amnion and dried amnion sheets significantly reduced the wound area compared to the control group. However, treatment with dried amnion sheets showed higher efficacy in reducing wound area compared to treatment with dry powdered amnion. Statistical analysis confirmed significant differences in wound area reduction between groups. Dry powdered amnion and dried amnion sheets were effective in reducing wound area compared to standard wet wound care. Treatment with dried amnion sheets showed greater efficacy than treatment with dry powdered amnion.

Bilateral Achilles Tendon Rupture Following A Fall from Height: Case Report

2025-09-14T07:53:34+00:00

Achilles tendon rupture is an injury characterized by partial or complete disruption of the Achilles tendon, commonly caused by trauma or a sudden change in foot position. This condition accounts for approximately 20% of all major tendon ruptures. This study aims to present and analyze a rare case of bilateral Achilles tendon rupture, emphasizing the clinical presentation, diagnostic challenges, and management considerations. Men are at 2–12 times higher risk than women, with the incidence increasing between the ages of 40 and 59 years. Diagnosis is established through history taking, physical examination, and imaging modalities such as ultrasonography or MRI. We report a case of a 53-year-old male who presented with pain and swelling in both posterior ankles for the past three months, following a fall from a height of approximately four meters. The patient experienced limited mobility and required a walking aid. Physical examination revealed bilateral edema, a palpable defect in the Achilles tendon, tenderness, a positive Thompson test, and weakness of plantar flexion. MRI confirmed bilateral Achilles tendon rupture. The patient had previously undergone conservative management, including the application of an ankle strap and administration of nonsteroidal anti-inflammatory drugs, with no improvement. Bilateral Achilles tendon rupture is a rare condition, typically resulting from high-energy trauma. Delayed diagnosis and treatment may increase the risk of complications and long-term disability. Management options include conservative or surgical approaches, selected based on patient age, extent of rupture, and activity level. Bilateral Achilles tendon rupture following a fall from height is an uncommon case, highlighting the importance of prompt diagnosis and appropriate treatment to prevent permanent functional impairment.

Varicella Presentation in Adult: A Case Report

2025-09-13T03:31:31+00:00

Varicella is a disease caused by the varicella-zoster virus (VZV), a herpesvirus specific to humans. It is highly contagious but preventable through vaccination. It is usually diagnosed clinically and is often self-limiting. However, complications can include pneumonia, neurological, hematologic, ocular, renal, hepatic conditions, as well as sepsis, and secondary infections that can be fatal. Effective antiviral therapy has reduced associated morbidity and mortality. To report a case of varicella with bronchopneumonia in an adult patient. A 58-year-old male presented with persistent vesicular eruptions on the face, chest, back, and extremities. He was admitted to the emergency room and referred to dermatology. He had no history of prior varicella or vaccination. He was diagnosed with varicella with pneumonia and treated with acyclovir, cetirizine, paracetamol, and fusidic acid cream. Data were obtained through anamnesis, physical examination, and relevant supporting investigations, then qualitatively analyzed by correlating clinical findings and investigation results to confirm the diagnosis, evaluate treatment response, and construct the case narrative. Adult varicella is up to 25 times more severe than in children. The virus is transmitted via the respiratory tract with an incubation period of 10–21 days. Physical stress and disruption of circadian rhythms may impair immune response. Lesions typically start on the face and scalp and spread to the body. A This case highlights a presentation of adult varicella with systemic involvement. Early antiviral treatment can improve prognosis.

Healthcare Financing for Bone Marrow Transplants: A Scoping Review

2025-09-13T13:05:13+00:00

Bone marrow transplantation (BMT) is a life-saving procedure for haematological malignancies and other severe blood disorders. It is need resource-intensive treatment with significant financial implications. The cost of BMT varies across different countries and healthcare systems, influenced by factors such as treatment protocols, hospital infrastructure, medication expenses, and post-transplant care. Understanding the financial aspects of BMT is crucial for improving accessibility and ensuring sustainable healthcare service. Objective to analyse the cost of BMT across different regions, identify sources of financing, and explore financial challenges and potential solutions for patients undergoing BMT. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases from 2001 - 2025. MeSH Terms using ((haematology malignancy OR leukaemia OR acute leukaemia OR acute myeloid leukaemia OR acute lymphoblastic leukaemia OR myeloma OR lymphoma OR thalassemia) AND (bone marrow transplantation OR stem cell transplantation OR haematopoetic stem cell transplantation OR hematopoietic stem cell transplantation OR allogeneic transplantation ) AND (OR costing OR payer)). Data were extracted on total BMT costs, cost components, sources of financing, and financial challenges associated with the procedure. The analysis followed the Cochrane Handbook for Systematic Reviews of Interventions. Out of 528 initially screened studies, 19 articles met the inclusion criteria. The cost of BMT varied significantly by country, with developed nations reporting higher costs than developing countries. The primary cost components included hospital and treatment expenses, medications, and follow-up care. Financing sources varied across regions, including private health insurance, government-funded healthcare programs, non-profit organisations, fundraising efforts, and out-of-pocket payments. Many patients in low- and middle-income countries face financial barriers due to limited insurance coverage and high out-of-pocket expenses. BMT remains a costly procedure with significant financial challenges, particularly in regions with limited healthcare funding.

The Effect of Local Anesthesia on Dermatological Actions on Patient Comfort

2025-09-13T14:33:22+00:00

Local anesthesia is commonly used in a variety of dermatological procedures to reduce pain and improve patient comfort. However, some side effects can occur, including burning sensations, nausea, vomiting, dizziness, blurred vision, and even impaired consciousness. This study aimed to evaluate the effect of local anesthesia on patient comfort during dermatological procedures. The study was conducted at an aesthetic clinic in Semarang from 7 to 9 February, involving 20 patients (2 men and 18 women). This study uses a quantitative descriptive study with a cross-sectional approach to assess patient comfort and side effects after local anesthesia in dermatologic procedures. Patients aged 18 and older who consent will be recruited consecutively. Researchers will using observation checklist and vital sign chart to collect demographic and clinical data, observe and record specific side effects such as feeling hot/sore, nausea, vomiting, dizziness, blurred vision, impaired consciousness, and fainting during and up to 30 minutes after the procedure, and monitor vital signs before and after the procedure. The results showed that 16 out of 20 patients reported no complaints after the procedure. Three patients experienced a burning sensation, while one patient experienced nausea and vomiting. None of the patients reported dizziness, blurred vision, loss of consciousness, or fainting. In conclusion, local anesthesia provides a high level of comfort for patients with minimal side effects. Therefore, it remains a safe and effective option for dermatological procedures, although monitoring individual responses remains important.

Pregnant Women's Preparedness in Facing Earthquakes Disaster Risk

2025-09-13T23:50:52+00:00

Earthquake disasters can pose many challenges for pregnant women, namely a lack of access to prenatal care and emergency medical services needed. In emergency disaster conditions, what must be of special concern to pregnant women is the safety and well-being of the baby in their womb. This study aims to determine how prepared pregnant women are in facing the risk of earthquake disasters. This study employs a qualitative phenomenological research approach. The phenomenological approach in qualitative research focuses on the essence of life experiences or phenomena that can be observed or experienced by people from different perspectives. This study involved 5 pregnant women. Data collection techniques were carried out using semi-structured interviews. The instrument used was an interview guide for pregnant women's preparedness to face earthquake disasters. The data analysis used is Colaizi analysis. There are 4 themes, namely the highest risk is earthquakes, pregnant women as a vulnerable group, the preparedness of pregnant women, and being prepared for childbirth. The good preparedness of these pregnant women demonstrates that they are aware of the high-risk area for earthquake disasters and are ready for whatever may happen, including childbirth in disaster conditions.

Evaluation of the Implementation of an Inpatient Electronic Medical Record System Using the Delone and Mclean

2025-09-15T06:40:34+00:00

Background: Sumber Waras Hospital is committed to enhancing the quality of healthcare services through the implementation of an Electronic Medical Record (EMR) system. EMR is an essential tool for managing patient health data to improve service efficiency and effectiveness. However, its implementation still encounters various challenges, such as limited user training, interoperability issues, and inconsistent data quality. Therefore, this study aims to evaluate the success of the inpatient EMR system implementation at Sumber Waras Hospital using the Delone and McLean model approach. Research Methods: This research applied a descriptive quantitative method with a cross-sectional design. The study population consisted of 344 healthcare personnel, with a total of 77 respondents selected using the Slovin formula at a 10% margin of error. Result: The evaluation showed that system quality was categorized as moderate with an average score of 2.86. Information quality was also in the moderate category with a score of 3.15, followed by service quality at 3.14. System use was categorized as moderate with a score of 3.47, user satisfaction was categorized as good with a score of 3.50, and net benefits were categorized as moderate with a score of 3.30. Conclusion: The implementation of the inpatient EMR system at Sumber Waras Hospital is generally running quite well, although improvements are still required, particularly in system quality, information quality, and service quality aspects. The evaluation results are expected to serve as a reference for system improvements and user training efforts to enhance the overall quality of healthcare services. Keywords: Electronic Medical Records, Information System Evaluation, Delone and Mclean Bibliography: 43 (2017-2024).

Delayed Union in Pediatric Bennett’s Fracture Treated with Open Reduction and Internal Fixation Using Kirschner Wire: A Case Report

2025-09-17T18:48:12+00:00

Bennett’s fracture is a fracture-subluxation of the thumb carpometacarpal joint, occasionally seen in pediatric patients. Despite the frequency of metacarpal fractures, limited data exist on outcomes and complications in children. Optimal surgical treatment remains unclear. This case report aims to describe a rare instance of delayed union in a pediatric Bennett’s fracture treated with Kirschner wire fixation and to contribute to the limited evidence guiding its management. This is a descriptive case report. Data were collected through clinical examination, surgical records, and serial imaging, and were analyzed descriptively to assess healing progression and function. A 14-year-old boy presented three weeks post-injury with persistent thumb pain after a karate trauma. Imaging confirmed a Bennett’s fracture. He underwent open reduction and internal fixation (ORIF) using Kirschner wires. Although initial recovery was uneventful, delayed union was noted at three months, requiring prolonged observation. Complete union occurred at five months, with good functional outcome. Delayed union can occur in pediatric Bennett’s fractures, even with stable fixation. This report emphasizes the need for accurate reduction, extended monitoring, and further documentation to inform pediatric surgical protocols.

The Effect of Using the Elsimil Application on the Readiness of Prospective Brides and Grooms in Stunting Mitigation Efforts

2025-09-14T07:05:22+00:00

Reproductive health is a crucial aspect of preparing for a healthy married life. Sometimes, prospective brides and grooms don't realize the importance of maintaining their health before pregnancy. This lack of knowledge can increase the risk of stunting. Accessing health education and support through mobile apps is an effective way. One application developed by the BKKBN for health screening of prospective brides and grooms is the ‘Elsimil’ (Electronics Ready for Marriage and Pregnancy). The purpose of study was to determine the effectiveness of the use of the ‘Elsimil’ on the readiness of prospective brides and grooms. The type of research is Quasi-experiment with One group pre-posttest design. The sample was taken using a Purposive sampling with a sample size of 36 people. Data collection of health behaviour of prospective brides and grooms using questionnaires to measure the level of knowledge and attitudes of prospective brides and grooms regarding pre-marital health screening as well as observation sheets for monitoring the health of prospective brides and grooms. Data analysis using the Wilcoxon test. The results of this statistical analysis indicate that there is an effect of the use of the ‘Elsimil’ application on the readiness of prospective brides and grooms in stunting mitigation efforts, with the results obtaining a p-value of 0.000.

Mothers’ Lived Experiences in Preventing Toddler Diarrhea Using Local Wisdom Poda Na Lima: A Phenomenological Study

2025-09-26T06:09:47+00:00

Diarrhea remains one of the leading causes of morbidity and mortality among children under five in Indonesia. Prevention efforts based on local wisdom, such as Poda Na Lima, a traditional life philosophy of the Batak Angkola community, hold significant potential as a promotive and preventive approach to child health. This study aims to explore the experiences of mothers of children under five in implementing Poda Na Lima as a preventive measure against diarrhea in their children. A qualitative approach with a phenomenological method was employed. Participants were selected using purposive sampling, with the number determined by the principle of data saturation, resulting in a total of ten participants. Data were collected through in-depth interviews guided by a semi-structured interview protocol developed based on the five principles of Poda Na Lima. Thematic analysis was used to analyze the data. The findings of the study revealed five themes: maintaining cleanliness of the heart, maintaining personal hygiene, maintaining cleanliness of clothing, maintaining cleanliness of the home, and maintaining cleanliness of the yard. Mothers of young children perceive Poda Na Lima not merely as a traditional custom, but also as a guide for daily healthy living. Personal, family, and environmental hygiene practices are considered key to diarrhea prevention.

Implementation of Clinical Pharmacy Services for Inpatients with Improvement Strategies Based on SWOT Analysis

2025-09-14T08:59:04+00:00

Pharmaceutical Service Standards in Hospitals are regulated in the Regulation of the Minister of Health of the Republic of Indonesia Number 72 of 2016 on the management of pharmaceutical preparations, medical devices, and consumable medical materials as well as clinical pharmacy services in carrying out pharmaceutical service duties in hospitals. This study aims to evaluate the implementation of clinical pharmacy services in inpatients Hospital X in Surakarta and propose improvement strategies through SWOT analysis. The research method used is quantitative descriptive with a retrospective design. Samples were obtained by purposive sampling technique with pharmacist respondents who were directly responsible for clinical pharmacy services to and inpatient patients. The data analysis used was a validity and reliability test and improvement strategies using SWOT analysis. The results of the study show that clinical pharmacy activities are relatively good except for monitoring drug levels in the blood which have not yet been implemented. It is concluded that the implementation of clinical pharmacy services in inpatients at Hospital X is classified as a good category with a percentage (74%) and is in accordance with PMK No. 72 of 2016 except the unimplemented drug therapy level monitoring. The results of the SWOT analysis of IFAS with a positive result of 0.95 and a positive effas of 0.48 so that the position of the hospital's pharmaceutical installation is in quadrant I so that the right strategy is an aggressive strategy.

Antioxidant Activity Ethanolic Extract of Kalakai Leaf (Stenochlaena Palustris (BURM.F) Bedd) From Central Kalimantan by DPPH Method

2025-10-08T07:05:17+00:00

The diseases triggered by free radicals in Indonesia are increasing. Free radicals can be neutralized by antioxidants. The main sources of antioxidants are plants or fruits. Kalakai (Stenochlaena palustris (Burm.f.) Bedd.) is one of the typical plants of Kalimantan known for its medicinal properties. The leaves of Kalakai contain compounds such as flavonoids, phenols, tannins, alkaloids, and saponins, which have antioxidant abilities. This research aims to determine the antioxidant activity of Kalakai leaf extract from Central Kalimantan against DPPH free radicals based on the IC50 value. Antioxidant activity was measured using the DPPH method and analyzed using UV-Vis spectrophotometry at a wavelength of 516.6 nm. The results showed that Kalakai leaf extract had moderate antioxidant activity with an IC50 value of 241.547 ppm, while vitamin C as a positive control had strong activity with an IC50 of 10.031 ppm. These findings indicate that Kalakai leaves, although less potent than vitamin C, may serve as a promising natural antioxidant source. The conclusions is kalakai leaf extract exhibits moderate antioxidant activity and holds potential for further development in natural antioxidant applications.