JURNAL RISET KESEHATAN POLTEKKES DEPKES BANDUNG

The impact of the PLASI App on DPT and polio immunization visits for children 0–9 months

2025-02-06T09:06:31+08:00

Background: The World Health Organization (WHO), through the Immunization Agenda 2030, promotes digital innovation to improve vaccine coverage. Digital health interventions can enhance access to information and community participation, although disparities in technology access remain a challenge.

Objective: To determine the effect of the PLASI application (Immunization Information Service Provider) on visits for Diphtheria, Pertussis, Tetanus, and Polio immunizations in children.

Methods: PLASI, a digital application delivering immunization information through audio, visuals, and graphics, was evaluated using a quasi-experimental pretest–posttest control group design. The study involved 135 mothers with infants aged 0–9 months attending posyandu in Klari Village, Karawang (January–May 2024). Using purposive sampling, 80 respondents were selected and divided into intervention (PLASI users) and control (non-users) groups. Instruments included the PLASI application, pretest–posttest questionnaires assessing maternal knowledge, and immunization visit observation sheets.

Results: McNemar test showed significant increases in DPT (p=0.020) and polio (p=0.020) immunization visits among PLASI users compared to the control group. However, limited technology access and sudden schedule changes were identified as barriers.

Conclusion: The PLASI application is effective in improving immunization visits by enhancing access to information and community participation. Nevertheless, addressing existing barriers such as limited technology access and service constraints is necessary through targeted health education, stakeholder collaboration, and periodic evaluation. Strengthening these aspects will support the sustainability and adaptability of digital health interventions, particularly in areas with limited infrastructure.

Effectiveness of the rebozo technique with kazo in decreasing labor pain intensity and enhancing labor progression

2025-02-06T09:18:15+08:00

Background: Prolonged labor occurs due to prolonged labor pain, where the mother feels unable to endure the pain, leading to premature pushing before the cervix reaches full dilation. This condition posed a risk of cervical swelling and labor dystocia. The rebozo technique was a non-pharmacological method used to help manage pain during labor without medication.

Objective: This study aimed to analyze the effect of the rebozo technique using kazo cloth on pain intensity and labor progress at Zhafira Zarifa Clinic, Karawang Regency. Methods: This study employed a quasi-experimental design with a pretest–posttest two-group design approach. The study sample consisted of 60 multigravida mothers in the active phase of the first stage of labor, selected using accidental sampling. Inclusion criteria: multigravida mothers in labor, active phase cervical dilation of 4-7 cm, single fetus with occiput posterior presentation, uncomplicated pregnancy, and normal fetal heart rate. The experimental group (30 participants) received the rebozo technique using kazo, while the control group (30 participants) practiced breathing relaxation techniques. Pain intensity was measured using the Numerical Rating Scale (NRS), with a pain range of 7–10 as the sample criteria. Data analysis was conducted using the paired t-test in SPSS.

Results: The study found a significant effect of the rebozo technique using kazo on reducing pain intensity and accelerating labor progress, with a p<0.001.

Conclusion: This technique was proven effective in reducing pain and expediting labor. It was expected that this method could serve as an alternative for non-pharmacological pain management during labor.

The effectiveness of consuming Mosatabaf Cookies on blood pressure in hypertension patients within the Prolanis program

2025-05-23T06:54:03+08:00

Background: Hypertension is a major health problem with a continuously increasing prevalence and a high risk of serious complications. Its management involves not only pharmacological treatment but also nutritional interventions, such as increasing potassium and fiber intake. The use of local foods, such as mocaf and kepok bananas, in the form of Mosatabaf cookies, has the potential to serve as an alternative approach to help reduce blood pressure in individuals with hypertension.

Objective: This study aimed to see the effect of giving Mosatabaf cookies on blood pressure in pre-hypertensive patients.

Methods: The type of research used was a quasi-experiment to find a causal relationship between variables with a pretest and posttest design with two groups. The research was conducted for 7 days. The research sample was prolanlis patients suffering from hypertension at the Talang Ubi Health Center, totaling 60 people, consisting of 30 intervention groups and 30 control groups who had checked their blood pressure and nutritional intake. Samples were selected using purposive sampling.

Results: Based on statistical tests in the treatment group, the p-value of systolic 0.012 and diastolic 0.001 <0.005 with an average difference in systolic pressure reduction of 0.77 mmHg and diastolic 3.33 mmHg.

Conclusion: Based on these results, it can be concluded that there is an effect of giving Mosatabaf cookies on reducing systolic and diastolic blood pressure in Prolanis patients who experience hypertension.

Effectiveness of self-management intervention in community on management of type 2 diabetes mellitus: a systematic review

2025-08-29T04:05:56+08:00

Background: The rising global prevalence of type 2 diabetes mellitus (T2DM) highlights the urgent need for sustainable management strategies, such as community-based self-management interventions.

Objective: This systematic review aimed to evaluate the effectiveness of these interventions on diabetes control and quality of life among adults with T2DM.

Methods: Following PRISMA 2020 guidelines, seven Randomized Controlled Trials (RCTs) published between 2020 and 2024 were analyzed. These studies included 1,193 participants from diverse countries like the United States, Ghana, China, Nepal, and Taiwan. The interventions tested included digital education, programs led by community health workers (CHWs), and community-based cooking programs.

Results: Most studies reported improvements in HbA1c, self-care behaviors, and quality of life. The effectiveness varied depending on intervention duration, sample size, and socio-cultural context. Multicomponent interventions that combined education, social support, and community health worker (CHW) engagement produced the most consistent and positive outcomes.

Conclusion: Although these interventions show promise in improving glycemic control, self-care behaviors, and quality of life, the limited number of studies, heterogeneity of interventions, and methodological biases restrict the overall strength of the evidence. Therefore, further long-term randomized controlled trials (RCTs) in diverse settings, as well as cost-effectiveness evaluations, are needed before large-scale implementation.

Analytical sensitivity and specificity of the HNF1A gene primers using the qPCR method in the suspected patient with MODY3

2025-07-14T02:34:12+08:00

Background: Maturity onset diabetes of the young (MODY) is a rare monogenic type of diabetes, but it accounts for 1–5% of diabetes cases and typically presents before the age of 25. Among the 14 subtypes, MODY type 3 (MODY3) is the most common, particularly in Asian populations, and is associated with mutations in the hepatocyte nuclear factor 1 alpha (HNF1A) gene. Diagnosing MODY often presents challenges due to its varied clinical symptoms. Molecular testing based on qPCR offers a more accurate, relatively time-efficient, and cost-effective method for detecting HNF1A gene mutations.

Objective: This study aimed to validate the sensitivity and specificity of the primer for exon 4 of HNF1A in patients suspected of having MODY3 using qPCR with SYBR Green.

Methods: The samples included patients under 25 years old with a family history of diabetes mellitus, without obesity or ketoacidosis. Sensitivity was analyzed using probit regression based on amplification results from 10 DNA template dilutions with six replications. Analytical specificity was tested using a paired t-test against Plasmodium vivax spike DNA with three replications.

Results: The analytical sensitivity of the HNF1A exon 4 primer was 3.16 × 10⁻⁷ ng/µL. The specificity test showed a p-value < 0.05, indicating no significant difference between target DNA and spike DNA variations.

Conclusion: The HNF1A exon 4 primer demonstrated high sensitivity and good specificity, supporting its potential for qPCR-based detection of MODY as a preliminary validation.

Watching cartoons as an adolescent: the role of animated videos on aggression among high school students

2025-10-21T06:47:49+08:00

Background: Aggressive behavior among secondary school students, including bullying and acts of revenge, constitutes a significant public health concern, particularly in Indonesia. Despite various interventions implemented by schools and families, aggressive tendencies persist, with many adolescents continuing to engage in physical violence.

Objective: This study aimed to examine the effectiveness of animated video media in reducing aggressive behavior among secondary school students in Bandung City, Indonesia.

Methods: This pre-experimental study involved 208 secondary school students in Bandung City, Indonesia. Participants were assigned to either an intervention group (n = 104) or a control group (n = 104). The intervention group viewed a 30-minute animated educational video each day for seven consecutive days, focusing on understanding and managing aggression. Levels of aggression were assessed using the Buss–Perry Aggression Questionnaire through pre-test and post-test evaluations.

Results: The findings revealed a statistically significant reduction in aggression levels among participants in the intervention group (p < 0.001), whereas the control group exhibited no significant change (p = 0.648). Hostility and retaliatory thoughts were more prevalent among younger adolescents. Regression analysis identified age, physical aggression, and anger as significant predictors of total aggression.

Conclusion: The study underscores the potential of animated educational media as an engaging and developmentally appropriate intervention for preventing aggressive behavior in the digital era. The integration of multimedia-based learning into school health programs aimed at improving emotional regulation and conflict resolution skills may serve as an effective strategy to mitigate aggression among adolescents.

Analysis of lead and cadmium contamination content in meti shells (Batissa violacea von Lammarck, 1818) from the La'a River, Petasia Village, Central Sulawesi

2025-09-09T09:09:04+08:00

Background: The meti clam (Batissa violacea L. von Lamarck, 1818) is a freshwater bivalve of significant ecological and economic importance, functioning as a natural filter feeder in aquatic ecosystems. However, increasing domestic and anthropogenic activities have contributed to heavy metal contamination in its habitat, posing potential health risks to consumers.

Objective: This study aimed to determine the concentrations of lead (Pb) and cadmium (Cd) in meti clams as a preliminary assessment of environmental quality and food safety in the La’a River.

Methods: A quantitative descriptive design supported by laboratory analysis was employed. Samples were purposively collected from three sites—upstream, residential, and downstream—each consisting of 30 edible clams with a minimum shell length of 4 cm. Following wet digestion, meat and shell samples were analyzed for Pb and Cd using Atomic Absorption Spectrophotometry (AAS).

Results: The highest Pb level in meat was found downstream (0.2495 mg/kg), while the highest Cd level was upstream (0.2133 mg/kg). In shells, the highest Pb and Cd levels were detected in residential areas (34.5528 mg/kg and 3.3753 mg/kg). All metal concentrations in edible tissues were below the BPOM limit (1.0 mg/kg), indicating safety for consumption. However, high accumulation in shells indicates environmental stress.

Conclusion: Meti clams remain safe for consumption, but elevated heavy metals in shells reflect environmental pollution. Continuous monitoring and pollution control are needed, and shells may serve as bioindicators of contamination.

Nutritional knowledge as a determinant of dietary patterns based on the balanced nutrition guidelines among junior high school students

2025-09-14T22:58:43+08:00

Background: Unhealthy dietary patterns are a risk factor contributing to the increasing global health burden and are associated with health problems in adolescents, such as obesity and nutrient deficiencies. Many adolescents still have dietary patterns that do not comply with the recommended portions in the Balanced Nutrition Guidelines.

Objective: This study aimed to identify factors associated with dietary patterns based on the balanced nutrition guidelines among junior high school students in a public school in Pandeglang Regency.

Methods: This was a quantitative study using a cross-sectional design. The respondents consisted of 7th and 8th-grade students, with a total of 161 participants. Dietary patterns were assessed using a Semiquantitative Food Frequency Questionnaire (SFFQ) through interviews. Nutritional status was measured using a microtoise and a digital scale. Additionally, respondents completed questionnaires covering demographic characteristics, body image, nutrition knowledge, peer influence, and parental influence. Data were analyzed using univariate analysis, bivariate analysis with the chi-square test, and multivariate analysis with multiple logistic regression.

Results: The results showed that factors associated with adolescents' dietary patterns were nutrition knowledge and parental role (p<0.05). The most dominant factor associated with dietary patterns was nutrition knowledge, with an odds ratio (OR) of 3.11;95% CI(1.26–7.67).

Conclusions: Schools are expected to provide health education that emphasizes the importance of a nutritious and balanced diet, while also building good communication and collaboration with parents. In addition, the role of families needs to be strengthened in providing nutritious and balanced foods at home to support healthy dietary patterns among adolescents.

Factors related to public support for the WINGKO (Wolbachia Ing Kota Semarang) program

2025-10-23T02:36:40+08:00

Background: Dengue fever (DF) remains a persistent public health threat in Semarang City, with 404 reported cases in 2023. To address this issue, the WINGKO Program (Wolbachia ing Kota Semarang) was launched in 2023 as a vector control initiative involving the release of Aedes aegypti mosquitoes inoculated with Wolbachia bacteria.

Objective: This study aimed to analyze the factors associated with public support for the WINGKO program.

Methods: A cross-sectional study was conducted among 80 residents of RW 2, Meteseh Village, Tembalang District, using a structured questionnaire and purposive sampling technique. Data were analyzed using the Chi-Square test and Pearson correlation to determine the factors influencing community support for the WINGKO Program.

Results: The results showed that residents who had lived in Semarang for more than five years were more likely to support the program (OR 3.590, 95% CI 1.247–10.330, p = 0.015). Participants with higher education levels were three times more likely to support the program (OR 3.626, p = 0.006). A history of dengue infection (OR 2.878, p = 0.035) and prior involvement as a Wolbachia Foster Parent (OTA) (OR 3.093, p = 0.044) were also significantly associated with higher program support. In contrast, variables such as gender and household size were not significantly related to support for the program.

Conclusion: This research highlights the importance of targeted community engagement strategies that consider educational and experiential factors to strengthen public acceptance.

Effect of mangosteen peel powder substitution on the antioxidant activity and sensory properties of green tea

2025-09-22T04:05:46+08:00

Background: Mangosteen peel powder tea is a natural beverage with a unique taste and aroma, containing xanthones and rich in antioxidants that can help regulate blood glucose levels in type II diabetes mellitus.

Objective: This study aimed to determine the effect of mangosteen peel powder substitution on the organoleptic properties and antioxidant activity of green tea.

Methods: The research design was an experimental study using a Completely Randomized Design (CRD) non-factorial, consisting of three treatments: A (mangosteen peel:green tea 50%:50%), B (60%:40%), and C (70%:30%), each with three replications. The tested parameters included acceptability (color, taste, and aroma) through a hedonic test by 30 trained panelists at the Food Laboratory, Nutrition Department, Poltekkes Kemenkes Aceh, and antioxidant activity using the DPPH (2,2-diphenyl-1-picryhydrazil) method at the Instrument and Chemistry Research Laboratory, Faculty of Mathematics and Natural Sciences, Syiah Kuala University. Data were analyzed using ANOVA and continued with Duncan’s test at a 95% confidence level.

Results: The results showed that the highest scores for color and taste were obtained in treatment A, while aroma was highest in treatment C, categorized as “slightly liked.” The highest antioxidant activity was also found in treatment C with an IC₅₀ value of 4.42 µg/ml, classified as potent.

Conclusion: It was concluded that mangosteen peel substitution had no significant effect on color and taste but significantly affected aroma and antioxidant activity of green tea. Further In vivo studies are needed to evaluate its antidiabetic effectiveness.

A comparative study of IPE-based podcasts and guidebooks on disaster preparedness behavior

2025-10-21T04:12:05+08:00

Background: Disaster preparedness is a key competency for health students in disaster-prone countries like Indonesia. Effective educational media that support interprofessional learning are needed. Podcasts offer an innovative approach that can be integrated into Interprofessional Education Collaborative Practice (IPE-CP).

Objective: To analyze differences in knowledge and attitudes toward disaster prevention between students receiving podcast-based education and those using a handbook.

Methods: A quantitative quasi-experimental design was used. The experimental group (Padang) received podcast interventions, while the control group (Bandung) used the Guidelines for Health Crisis Management in Disasters (PKKB) handbook. A total of 200 respondents were included in the experimental group, and 100 in the control group (1:2 ratio). Data were collected using validated questionnaires and analyzed using the Mann–Whitney test.

Results: The mean knowledge score was higher in the podcast group (14.32) than in the handbook group (12.65) (p<0.05). However, no significant difference was found in attitude scores between the podcast group (66.78) and the handbook group (66.25) (p>0.05).

Conclusion: Podcasts were effective in improving knowledge but not attitudes. Podcast-based education integrated with IPE-CP principles showed greater effectiveness than handbook-based learning in enhancing students’ disaster preparedness knowledge.

The effect of guided imagery therapy on anxiety in chronic kidney failure patients undergoing hemodialysis: a quasi-experimental study

2025-10-31T04:07:42+08:00

Background: Patients undergoing hemodialysis often experience high levels of anxiety, which negatively impacts their quality of life and adherence to treatment. Guided imagery therapy, as a mind-body relaxation technique, can reduce anxiety.

Objective: This study aimed to evaluate the effectiveness of guided imagery therapy in reducing anxiety in patients with chronic kidney disease undergoing hemodialysis.

Methods: This study used a quasi-experimental design with a control group. A total of 32 patients were recruited and randomly divided into the intervention group (n=16), who received guided imagery therapy for three times a week for one week, and the control group (n=16), who received standard care. The level of anxiety was measured using the State-Trait Anxiety Inventory (STAI) before and after the intervention. Descriptive statistics were used to analyze participant characteristics, and paired t-tests were used to evaluate changes in anxiety scores.

Results: The research results showed that the pre-test data of both groups indicate a high level of anxiety. The average anxiety score in the intervention group before the intervention was 56.20, and after the intervention was 41.13. The average anxiety score in the control group before the intervention was 45.88, and after the intervention was 44.56. Bivariate results showed a significant decrease in anxiety scores after the intervention in the intervention group compared to the control group (p<0.05).

Conclusion: Guided imagery therapy can significantly reduce anxiety levels in patients undergoing hemodialysis. This technique can be easily integrated into routine hemodialysis care as a complementary approach to enhance patients' psychological well-being.

Early mobilization and wound care after knee arthrodesis for tibial chondrosarcoma: a case report

2026-01-13T15:04:55+08:00

Background: Proximal tibial chondrosarcoma is a malignant bone tumor requiring wide resection and often causing challenges in wound management and lower-limb functional recovery. In resource-limited healthcare settings, knee arthrodesis remains an important limb-salvage procedure when endoprosthesis reconstruction is unavailable. However, evidence regarding nursing-based postoperative wound care and early mobilization remains limited.

Objective: This case report describes the implementation of an evidence-based nursing approach integrating early mobilization with objective monitoring of wound healing and functional outcomes following knee arthrodesis.

Case: A 40-year-old male with grade 2 proximal tibial chondrosarcoma underwent wide resection followed by knee arthrodesis using plate–screw fixation and bone cement. Postoperatively, the patient experienced massive bleeding resulting in anemia, leucocytosis, severe lower-limb muscle weakness, restricted mobility, and partial functional dependence.

Intervention and Outcomes: Daily nursing assessments were conducted using the Bates–Jensen Wound Assessment Tool (BWAT) and the Modified Iowa Level of Assistance Scale (mILOA). Early mobilization was initiated on postoperative day two. Over 19 days, BWAT scores improved from 24 to 13 without wound dehiscence, accompanied by increased functional mobility and reduced dependence from partial assistance to minimal assistance.

Conclusion: Early mobilization combined with BWAT- and mILOA-based monitoring may provide a safe, practical, and sustainable nursing strategy to support wound healing and functional recovery after knee arthrodesis in resource-limited settings.

Respiratory viruses detection using the FilmArray Panel

2025-07-21T01:24:15+08:00

Background: Respiratory infections, including pneumonia, are a leading cause of global mortality. These infections can be caused by various pathogens, including typical and atypical bacteria, as well as viruses, fungi, and parasites. Rapid and accurate diagnosis is crucial, especially in cases requiring intensive care, to ensure timely and appropriate treatment.

Objective: This research aimed to obtain an overview of the application of the FilmArray method, a nested multiplex pcr base method, in determining the diagnosis and management of respiratory tract infections.

Methods: This study was a cross-sectional study with a descriptive analytic design on patients with respiratory tract infections. The study was conducted from April to June 2022 at the Biomolecular Laboratory, Laboratory Installation of RSPI Prof. Dr. Sulianti Saroso.

Results: Of the 72 patients examined, 27 (37.5%) tested positive for one of the viruses, while 45 (62.5%) tested positive for neither viruses nor bacteria. Among the positive patients, the most commonly detected virus was human rhinovirus/enterovirus (48%), followed by SARS-CoV-2 (48%), and human metapneumovirus (4%). No atypical bacteria or a double infection of virus and bacteria were detected.

Conclusion: This research indicates that molecular-based methods using the FilmArray respiratory panel can be used for the rapid and accurate detection of respiratory tract infection cases, especially those caused by respiratory viruses and atypical bacteria.

Literature review: development of Balanced Counseling Strategy media as a tool to assist in making decisions about family planning after childbirth

2024-12-04T07:02:38+08:00

Background: Total fertility rate (TFR) affects population growth and may increase maternal and infant mortality if not controlled through effective family planning programs, particularly postpartum family planning. Balanced Counseling Strategy (BCS) is a practical, interactive, and client-centered counseling approach designed to improve contraceptive decision-making and client participation.

Objective: This study aimed to review the effectiveness of Balanced Counseling Strategy media as a tool for postpartum family planning decision-making.

Methods: This study used a literature review design. Articles were obtained from electronic databases using the keyword “Balanced Counseling Strategy.” Inclusion criteria included full-text articles published between 2019–2024, employing quantitative, qualitative, or mixed-method designs, and conducted by researchers in the health field. A total of 10 national and international journal articles met the inclusion criteria and were analyzed.

Results: The reviewed studies showed that Balanced Counseling Strategy media was effective in supporting postpartum family planning decision-making. BCS helped prospective family planning acceptors select contraceptive methods according to their needs and preferences, increased client participation, and improved the effectiveness of counseling services.

Conclusion: Balanced Counseling Strategy media is effective as a counseling tool for postpartum family planning decision-making. Its use supports appropriate contraceptive selection and enhances the quality of postpartum family planning counseling.

The role of parental knowledge and iodized salt utilization in the incidence of stunting

2025-12-09T10:46:22+08:00

Background: Stunting is a condition of growth failure in toddlers due to chronic malnutrition and repeated infections, characterized by a child's height being below -2 standard deviations. The impact of stunting is not only visible in the child's physical appearance, but also in brain development and cognitive abilities. One cause that is often not recognized but has a major influence on child growth is iodine deficiency. This problem can actually be prevented by using iodized salt in daily food.

Objective: This article aimed to explain the role of parental knowledge and the use of iodized salt on the incidence of stunting in children.

Methods: This study used a quantitative correlation research method with a cross-sectional approach, sampling 63 of 181 infants and toddlers. The study location was in Sidorejo Village, Bandongan, Magelang. This questionnaire contained the characteristics of respondents consisting of name, age, gender, and results of measurements of height, weight, and height of children, as well as questions about iodine use. Data analysis used Chi-Square (X2) and Lambda Test.

Results: The results showed a significant relationship between parental knowledge and stunting (ρ = 0.005; r = 0.549), and a significant relationship between the use of iodized salt and stunting, with a Prevalence Odds Ratio (POR) of 18.27.

Conclusion: This means that parents who do not use iodized salt have a greater chance of having stunted children than mothers who do.

The impact of resistance training on bone mineral density in postmenopausal women with osteopenia and osteoporosis: a review

2026-01-20T14:53:34+08:00

Background: Osteopenia and osteoporosis are common in postmenopausal women and increase fracture risk. Resistance training may positively influence bone mineral density (BMD), but optimal and safe recommendations based on FITT principles and the mechanisms underlying its effects remain uncertain.

Objective: To identify effective and safe resistance training regimens for postmenopausal women with osteopenia and osteoporosis and to clarify the mechanisms underlying its effects on BMD.

Methods: A systematic search was conducted in PubMed, Scopus, ScienceDirect, Cochrane, and Europe PMC up to September 2, 2025. Inclusion criteria were randomized controlled trials and quasi-experimental studies evaluating resistance training effects on BMD in postmenopausal women with osteopenia or osteoporosis, published between 2015-2025, with full-texts in English. Critical appraisal used the CEBM Oxford Critical Appraisal Tools for Therapy Study.

Results: From 111 articles identified, seven met the inclusion criteria. Resistance training improved BMD through mechanical stimulation of bone formation, with site-specific and dose–response effects. Moderate to high-intensity training (60% to >80% 1-RM), targeting wrist, trunk, hip, and lower limbs, performed 2–3 times weekly for 30–60 minutes over at least six months, produced greater BMD improvements at the lumbar spine and femoral neck compared to lower intensity, with no adverse events reported. Low to moderate intensity remained beneficial, particularly with higher frequency or longer duration.

Conclusion: Moderate to high-intensity resistance training is safe and most effective to increase BMD in postmenopausal women with osteopenia and osteoporosis. Professional supervision, gradual load progression, and individualized adjustments are essential to optimize outcome and ensure safety.

Good Family Support Will Reduce Stress Levels In Type 2 Diabetes Patients

2025-01-23T04:49:09+08:00

Background: Patients with type 2 diabetes mellitus often experience stress as a consequence of the lifestyle changes required to manage this chronic condition. Family involvement and support play a crucial role in helping patients adapt and in reducing the levels of stress they experience.

Objective: This study aimed to evaluate the relationship between the level of family support and the level of stress among patients with type 2 diabetes mellitus who were hospitalized in one of the hospitals in Bali.

Methods: The study employed a correlational design with a cross-sectional approach. A total of 66 respondents were selected using a total sampling method from the inpatient ward. Data were collected using a family support questionnaire and the Depression Anxiety Stress Scale (DASS). Data analysis was conducted using the Spearman Rank correlation test.

Results: The findings indicated that the majority of patients received good family support (47%) and experienced low levels of stress (59.1%). Further analysis revealed a significant relationship between family support and stress levels (p = 0.000; Rs = -0.401).

Conclusion: The greater family support is associated with lower levels of stress among patients. Therefore, interventions to strengthen the role of family support are highly recommended, including providing education to families about their supportive role, assistance in disease management, and reinforcement of psychosocial aspects through effective communication and active family involvement in patient care.

Effect of ALBI score on NT-proBNP and diastolic dysfunction in Child-Pugh C cirrhosis

2025-08-26T04:11:59+08:00

Background: The Albumin–Bilirubin (ALBI) score and N-Terminal pro b-type natriuretic peptide (NT-proBNP) are important parameters for detecting asymptomatic left ventricular dysfunction and predicting prognosis in heart failure. Hepatic cirrhosis classified as Child-Pugh C indicates severe liver damage with high risk of cardiovascular complications, including diastolic dysfunction.

Objective: To analyze the effect of the ALBI score on NT-proBNP levels and the degree of diastolic dysfunction in patients with Child-Pugh C hepatic cirrhosis.

Methods: This observational analytic study with a cross-sectional approach involved 54 patients with Child-Pugh C hepatic cirrhosis receiving outpatient and inpatient care at Dr. Moewardi General Hospital, Surakarta. Samples were selected using consecutive sampling and divided into control group (ALBI Grades I–II,n=27) and an intervention group (ALBI Grade III, n=27). NT-proBNP levels were measured using the enzyme immunoassay method, while diastolic function was assessed by echocardiography using E/A ratio, E/e′, deceleration time (DT), tricuspid regurgitation (TR) velocity, and left atrial volume index (LAVI).

Results: The mean NT-proBNP level in the intervention group was significantly higher than in the control group (1926 ± 468 pg/mL vs.1184 ± 351 pg/mL; p=0.032). However, no significant difference was found in the degree of diastolic dysfunction between groups (p=0.234). Grade II diastolic dysfunction occurred in 48.1% of patients with ALBI Grade III and 37.0% with ALBI Grades I–II.

Conclusion: The ALBI score significantly affects NT-proBNP levels but not the degree of diastolic dysfunction. Combined assessment of ALBI and NT-proBNP may support early detection of cardiac dysfunction in advanced hepatic cirrhosis.

Association Between Anti-Dengue IgM/IgG Serological Profile Results and the Severity of Dengue Infection

2026-02-02T17:26:31+08:00

Background: Dengue infection is a disease caused by the Dengue virus, which is transmitted by Aedes mosquito vectors and can cause Dengue fever (DF) and even Dengue shock syndrome (DSS).

Objective: The aim of this study was to determine the relationship between serological profiles and the severity of Dengue.

Methods: Variations in IgM and IgG serological profiles distinguish between primary infection (predominantly increased IgM) and secondary infection (decreased IgM and rapid increase in IgG), which are associated with differences in clinical manifestations and the severity of Dengue infection. This retrospective analytical descriptive study was conducted at KRMT Wongsonegoro Hospital with 160 dengue patient samples (period 2021-2022) selected by simple random sampling, followed by data analysis using the Chi-Square and Fisher Exact tests.

Results: The results showed a significant association between anti-Dengue serological tests and severity, with IgM (+), IgG (+), and the combination of IgM (+) IgG (+) each having a p-value <0.05. Patients with IgM (+) had a 4 times higher risk of severe dengue, while IgG (+) increased the risk up to 7 times, and the combination of IgM (+) IgG (+) increased the risk 5 times.

Conclusion: These results confirm that serological profiles can serve as early predictive indicators of severity, thereby supporting early triage and appropriate treatment for high-risk patients.

Analysis of Creatinin Phospokinase (CPK) enzyme activity for determining te cut off duration of antipsychotic drug therapy

2025-12-31T12:42:27+08:00

Background: Schizophrenia is a mental disorder affecting thoughts, emotions, and behavior. Antipsychotic therapy is the main treatment; however, it may cause neurological side effects, including Neuroleptic Malignant Syndrome (NMS). Creatine Phosphokinase (CPK) is commonly used as a biomarker for detecting NMS.

Objective: To evaluate the relationship between the duration of antipsychotic therapy and CPK enzyme activity and to determine the cut-off value of therapy duration associated with increased CPK levels in patients with schizophrenia.

Methods: This cross-sectional study used secondary data from 43 schizophrenia patients treated at the West Java Provincial Mental Hospital between January and September 2024. Samples were selected using purposive sampling. Inclusion criteria were patients receiving single or combination antipsychotic therapy, while patients with heart disease or muscle disorders were excluded. Spearman correlation analysis was used to assess the relationship between therapy duration and CPK activity, and Receiver Operating Characteristic (ROC) analysis was performed to determine the cut-off value.

Results: No significant relationship was found between the duration of antipsychotic therapy and CPK enzyme activity (p = 0.311). ROC analysis identified a therapy duration cut-off at 19–20 days, although its predictive value was weak (Asymp. Sig = 0.237).

Conclusion: There was no significant relationship between the duration of antipsychotic therapy and CPK enzyme activity in patients with schizophrenia. Although a therapy duration cut-off of 19–20 days was identified, further studies with larger samples are needed.

Ergonomics and mental workload with office syndrome symptoms at Health Vocational College X

2025-11-12T10:27:32+08:00

Background: Office Syndrome refers to musculoskeletal complaints caused by static work postures, prolonged work duration, and non-ergonomic work facilities. Previous studies have shown that poor posture, inadequate workstation design, prolonged computer use, and high mental workload contribute to musculoskeletal disorders (MSDs). However, studies examining the combined influence of ergonomic factors and mental workload among lecturers and educational staff at health vocational colleges remain limited.

Objective: Analyze the influence of ergonomic factors and mental workload on the incidence of Office Syndrome in lecturers and educational staff at health vocational colleges.

Methods: The study used a quantitative cross-sectional approach with 88 respondents purposively. Data were collected using an ergonomic questionnaire, NASA-TLX, and Office Syndrome questionnaire. Validity test shows that r count>r table (0.361) and Cronbach's Alpha reliability test>0.7.

Results: The Somers' test showed a significant relationship between ergonomics and Office Syndrome (p=0.032) as well as mental workload and Office Syndrome (p= 0.007). Ordinal logistic regression analysis shows that ergonomics (p=0.030) and mental workload (p=0.019) have a significant effect on the level of office syndrome.

Conclusion: Ergonomic factors and mental workload have a significant effect on office syndrome complaints. Interventions are needed in the form of improving the ergonomic work environment and managing mental workload to reduce the risk of physical complaints in the higher education environment.

Melasma and prolonged oral contraceptive use: a community-based retrospective cohort study

2025-12-16T12:09:25+08:00

Background: Melasma is a common skin disorder often influenced by hormonal factors such as estrogen and progesterone. Combined oral contraceptives (COCs), which contain both hormones, are widely used in Indonesia and may contribute to melasma, especially among long-term users.

Objective: This study aimed to examine the association between prolonged COC use and melasma among women in Lamongan Regency, Indonesia.

Methods: Using a retrospective cohort design, 20 reproductive-aged women were selected through purposive sampling. Data were collected via structured interviews and clinical observation, and analyzed using the Chi-square test.

Results: Results showed that 55% of participants developed melasma, with a significant association between COC use duration and melasma occurrence (p = 0.024). Women who used combined oral contraceptives for ≥3 years showed a trend toward higher odds of developing melasma compared to those who used COCs for <3 years (OR = 8.0; p= 0.024.

Conclusion: These findings underscore the need for integrating dermatological considerations into contraceptive counseling, particularly in primary healthcare facilities.

Factors associated with patient safety management activities among clinical nurses

2026-02-26T09:42:20+08:00

Background: Nurses play a critical role in preventing patient safety incidents through the implementation of patient safety management activities. However, evidence on the individual and organizational factors related to these activities among clinical nurses in Indonesian hospitals remains limited.

Objective: This study aimed to identify factors associated with patient safety management activities among clinical nurses.

Methods: This cross-sectional study was conducted in three hospitals in Malang Raya, East Java, Indonesia, involving 225 nurses recruited using proportional quota sampling. Data were collected using the Nurse Professional Competence Scale, the Practice Environment Scale of the Nursing Work Index, the Safety Motivation Tool, and the Safety Care Activity Scale. Data analysis included descriptive statistics, bivariate analysis (Mann-Whitney test, Kruskal-Wallis test, and Spearman correlation), and multiple linear regression.

Results: The final regression model indicated that motivation (β = 0.762, p < 0.001) and work environment (β = 0.161, p < 0.001) were significantly associated with patient safety management activities, explaining 68.9% of the variance.

Conclusion: These findings highlight the importance of nurse motivation and supportive work environments in strengthening patient safety practices, while providing empirical evidence on the combined role of individual and organizational factors in Indonesian hospital settings.

Development of interactive virtual book media on anemia prevention in female adolescents in junior high school

2026-02-27T10:03:50+08:00

Background: Anemia remains a significant public health problem among adolescent girls and can negatively affect learning ability, concentration, and productivity. The rapid advancement of digital technology highlights the need for innovative and engaging educational media to improve anemia prevention efforts. However, limited studies have focused on developing interactive digital learning tools tailored to adolescent needs.

Objective: This study aimed to develop an interactive virtual book as a digital educational media for anemia prevention among adolescent girls.

Methods: This study used a Research and Development (R&D) approach with the 4D model, consisting of define, design, and develop stages. The define stage included needs analysis through interviews and literature review. The design stage involved creating storyboards, navigation structures, and interface designs. The development stage included media production, expert validation, and limited user testing. The study participants were 30 seventh-grade female students of SMPN 26 Bandung selected using purposive sampling. Data were collected through validation sheets and questionnaires, and analyzed descriptively.

Results: The validation results showed that the media achieved a feasibility score of 100% from the material expert and 85% from the media expert, both categorized as highly feasible. The limited trial showed an average score of 75.58% across aspects of comprehension, usability, attractiveness, motivation, and learning interest, indicating that the media is feasible for use.

Conclusion: The interactive virtual book developed in this study meets feasibility standards and is appropriate as a digital educational medium for anemia prevention among adolescent girls, with potential to enhance engagement and learning outcomes.

Effectiveness of veragreens gel with cabbage (Brassica oleracea) extract and aloe vera in wound healing and anti-inflammatory activity in vivo

2025-09-10T05:11:10+08:00

Background: A common issue faced by breastfeeding mothers is nipple cracks and breast engorgement, which can hinder the breastfeeding process and reduce the frequency of breastfeeding. Traditional remedies, such as direct breast milk application or cabbage leaf compresses, are often considered impractical.

Objective: This study aimed to evaluate the effectiveness of Veragreens, a topical gel formulated with a combination of cabbage leaf extract (15%) and aloe vera (25%), in accelerating wound healing and reducing inflammation in vivo using mice (Mus musculus).

Methods: This experimental study involved three treatment groups: a negative control, a positive control (Flamar/aloe vera gel), and a treatment group using Veragreens. Phytochemical tests showed that cabbage extract contains flavonoids with anti-inflammatory properties, while aloe vera contains mannose-6-phosphate, which supports tissue regeneration.

Results: The results demonstrated that Veragreens accelerated wound healing, as indicated by faster wound closure and hair regrowth by day 7. Anti-inflammatory testing revealed a significant reduction in inflammation volume (p < 0.001) in the Veragreens groups, although slightly slower than the positive control. No significant differences were observed in overall effectiveness between the Veragreens and positive control groups.

Conclusion: Veragreens has the potential to serve as a safe and effective topical solution for simultaneously treating nipple cracks and breast engorgement, making it a promising natural care product for breastfeeding mothers.

Factors associated with taste satisfaction in Hajj catering meals and their implications for health

2026-05-08T09:23:15+08:00

Background: Large-scale Hajj catering requires efficiency without compromising taste quality. The use of ready-to-use spice paste improves efficiency and consistency but may affect sensory quality. Taste satisfaction is also influenced by food handlers’ perception and experience.

Objective: This study aimed to analyze factors associated with taste satisfaction in Hajj catering, including the use of ready-to-use spice paste, perceived importance of its use, and work experience of food handlers.

Methods: A cross-sectional design with a quantitative approach supported by qualitative data was used. Data were collected through questionnaires from 31 catering staff selected by purposive sampling and semi-structured interviews. Analysis was performed using Fisher’s Exact test and Odds Ratio (OR) (α=0.05).

Results: The use of ready-to-use spice paste and the perceived importance of its use were significantly associated with taste satisfaction (p<0.05). Perceived importance of spice paste use showed the strongest association with taste satisfaction (OR=9.90; 95% CI: 1.80–54.00). Work experience was not significantly associated with taste satisfaction (p>0.05). Most respondents reported moderate satisfaction with meal taste. Qualitative findings showed that chefs performed flavor fine-tuning to maintain sensory quality despite the use of ready-to-use spice paste.

Conclusion: Taste satisfaction in Hajj catering meals is influenced by technical and perceptual factors related to spice paste use. Maintaining sensory quality through flavor adjustment remains important to support food acceptance. Further studies using direct health indicators are needed to confirm the health implications.

Lavandula angustifolia aromatherapy to accelerate the duration of labor

2025-10-21T01:38:02+08:00

Background: Prolonged labor is one of the causes of maternal and neonatal mortality. Lavandula angustifolia aromatherapy has the potential to increase labor duration.

Objective: This study aimed to analyze the effect of Lavandula angustifolia aromatherapy on the duration of the first stage of active labor.

Methods: This type of research was quantitative with a posttest-only design with a control group, using simple random sampling. The study was conducted from May to July 2023 at Kediri City Hospital with a sample size of 60 participants giving birth in the active phase at Kediri City Hospital, with an intervention group of n = 30 and a control group of n = 30. In the intervention group, respondents were given Lavandula angustifolia aromatherapy through inhalation during the active phase of labor, accompanied by standard care according to hospital procedures. In the control group, respondents only received standard care. Duration assessment was carried out from 4-10 cm dilation.

Results: The results were tested using a t-test, showing that the average duration of labor in the intervention group VS the control group was m = 292.50 (13,975) minutes versus m = 374.70 (16,572) minutes with a p value of 0.000.

Conclusion: The results of this study indicate that the duration of the first stage of active labor in the intervention group was shorter than that of the control group after administration of Lavandula Angustifolia Aromatherapy. This study can be a recommendation for midwives to provide Lavandula Angustifolia Aromatherapy as a safe and effective intervention in accelerating the duration of labor.

The effect of health education on the anxiety level of families with mentally retarded children

2026-01-30T12:11:57+08:00

Background: Limited intellectual abilities in children with mental retardation have an impact on low learning ability and difficulty in adapting to social demands. This causes anxiety in the family of a mentally retarded child due to fears for the condition and future of the child.

Objective: This study aimed to analyze the effect of health education on the level of anxiety in families with mentally retarded children in State Special Needs School Bangkinang Kota.

Methods: This quantitative study employed a quasi-experimental design without a control group. The research was conducted at State Special Needs School Bangkinang Kota on May 6, 2024. The population consisted of 64 families with children with intellectual disabilities. A purposive sampling technique was used, with 25% of the population selected as participants, resulting in a total sample of 16 respondents. Anxiety levels were assessed using the Hamilton Anxiety Rating Scale (HARS).

Results: Based on the Paired Sample T-test test showed that there were differences in anxiety levels before and after health education with a p value of 0.000.

Conclusion: This means that there is an influence of health education on the level of anxiety of families with mentally retarded children in State Special Needs School Bangkinang Kota. The school is expected to provide health education to families about mental retardation.

Analysis of accessibility factors and community support for the success of the syphilis screening program for pregnant women

2026-02-18T12:23:22+08:00

Background: Syphilis screening during pregnancy is a critical strategy to prevent adverse outcomes for mothers and newborns. However, in rural areas, the success of screening programs is often influenced by structural barriers and poorly addressed social support systems.

Objective: This study aimed to analyze the determinants of successful syphilis screening among pregnant women in Pakong District, Pamekasan, with an emphasis on service accessibility and community support.

Methods: This study employed a sequential explanatory mixed methods design. The study population was all pregnant women in the Pakong Community Health Center (Puskesmas) working area from January to December 2024, with a sample of 1,552 respondents drawn using total population sampling. The quantitative phase used a cross-sectional approach analyzed using binary (bivariate and multivariate) logistic regression. The qualitative phase involved in-depth interviews with pregnant women, midwives, and laboratory staff. Thematic analysis was conducted to explain the quantitative findings.

Results: Qualitative results indicated that service accessibility and community support were the main determinants of successful screening. Qualitative findings revealed that service accessibility and community support were determinants of successful syphilis screening in rural settings.

Conclusion: Strengthening physical access, ensuring the continuity of laboratory services, empowering community cadres, increasing family involvement, and reducing stigma are crucial to increasing the effectiveness and sustainability of syphilis screening programs.

Medication adherence, clinical outcome and quality of life in dyslipidemia patients: a cross-sectional study

2026-01-12T10:26:52+08:00

Background: Dyslipidemia is a disease that requires long - term drug therapy. High in medication adherence is necessary to achieve the good clinical outcome and quality of life.

Objective: This study aimed to provide medication adherence, clinical outcome, and quality of life in dyslipidemia patients and assess the influencing factors.

Methods: This study used a cross - sectional design conducted at Universitas Indonesia Hospital. Morisky Medication Adherance Scale-8 (MMAS-8) questionnaire and EQ-5D-5L questionnaire were used to assess patient’s medication adherence and quality of life. Statistical analysis was carried out using the Chi – Square test with confidence interval of 95%. This study involved 81 dyslipidemia patients in the period from September 15^th to October 14^th 2025.

Results: This study showed that 64.2% of patients had high medication adherence. A total of 88.9% of dyslipidemia patients had controlled total cholesterol levels, and 90.1% had a good quality of life. Gender, age, education, comorbidities, number of medications, and duration of therapy did not affect medication adherence, clinical outcomes, or quality of life among dyslipidemia patients. However, duration of therapy was found to be associated with the quality of life of dyslipidemia patients (p=0.049).

Conclusion: Most dyslipidemia patients had high medication adherence, controlled total cholesterol levels, and a good quality of life. Duration of therapy was associated with the quality of life of dyslipidemia patients.

Herbal therapeutics for preventing postoperative peritoneal adhesions: a mechanistic review of preclinical evidence

2026-04-02T09:15:22+08:00

Background: Postoperative peritoneal adhesions remain a common complication of abdominal and pelvic surgery and may cause bowel obstruction, infertility, chronic pain, and difficult reoperation.

Objective: This review synthesized evidence on herbal therapeutics for adhesion prevention.

Methods: A comprehensive search of PubMed, Scopus, and Google Scholar for 2015-2025 publications used keywords related to postoperative adhesions and herbal therapy. English-language full-text in animal experimental studies with peritoneal adhesion induction and herbal interventions were included; non-herbal interventions, duplicate reports, non-postoperative adhesions, abstracts only, non-English papers, and retracted articles were excluded.

Results: A total of 169 records were identified, and after duplicate removal, title and abstract screening, and full-text eligibility assessment, 29 studies were included in the qualitative review. Curcumin consistently reduced inflammatory signaling, oxidative stress, collagen deposition, and adhesion scores through NF-kB modulation and antioxidant effects. Ginger and gingerol lowered TNF-α, IL-6, TGF-β1, VEGF, and malondialdehyde, indicating anti-inflammatory, antifibrotic, and anti-angiogenic activity. Rosmarinus officinalis reduced cytokines, oxidative markers, and TGF-β1 in rat models. Bletilla striata, frankincense, and polyherbal formulas showed additional wound-healing, anti-inflammatory, and pro-fibrinolytic effects.

Conclusion: Herbal therapeutics appear promising as adjunctive strategies for preventing postoperative adhesions; however, the evidence remains heterogeneous and is dominated by animal and in vitro studies. Standardized formulations, safety evaluation, and well-designed clinical trials are needed before wider clinical application.

Relationship of knowledge and attitude toward the practice of oral health among expectant mothers

2026-04-13T10:51:44+08:00

Background: Oral health during pregnancy is a critical component of maternal and fetal well-being; however, it is often overlooked due to a lack of knowledge and attitude to maintain the wellness of oral health among expectant mothers.

Objective: to assess the relationship between knowledge and attitude with oral health care practices among pregnant women in Made Community Health Centre, Surabaya.

Methods: A descriptive cross-sectional study involving 300 pregnant women selected through purposive sampling. Data were collected using a validated structured questionnaire, and Spearman’s rank correlation analysis was applied to evaluate the relationships between variables.

Results: The majority of participants fell within the 26–35 age bracket (50%) and were in their third trimester (53%). The statistical analysis revealed a significant positive correlation between knowledge and oral health practice (r_s = 0.382; p < 0.001). Furthermore, a moderate and significant correlation was found between attitude and practice (r_s = 0.445; p < 0.001). While the participants demonstrated generally adequate knowledge and positive attitudes, specific preventive practices—such as the use of dental floss and regular dental visits—remained suboptimal. The findings confirm that both knowledge and attitude are significant determinants of oral health behaviours, with attitude showing a slightly stronger association with practice.

Conclusion: To bridge the gap between knowing and doing, continuous oral health education integrated into antenatal care services is essential. Strategies should focus on fostering positive attitudes to encourage consistent oral hygiene practices among expectant mothers.

Health belief model: enhancing farmers’ awareness of healthy lifestyle practices in the agricultural sector

2025-10-21T03:46:38+08:00

Background: Agriculture is one of the primary sectors in Indonesia and is considered highly vulnerable to occupational accidents. Farmers are frequently exposed to various physical and chemical hazards that may lead to occupational injuries and work-related illnesses.

Objective: To evaluate the application of the Health Belief Model (HBM) in improving farmers’ awareness of the importance of adopting a healthy lifestyle to reduce the risk of occupational accidents in the agricultural sector.

Methods: This study used a quantitative approach with a cross-sectional design. A purposive sampling technique was used to recruit farmer groups from the Pandalungan region (Lumajang, Jember, and Probolinggo Regencies). A total of 155 respondents participated in the study. Data were collected using a Likert-scale questionnaire based on the Health Belief Model, which had been tested for validity and reliability (Cronbach’s Alpha = 0.789). Descriptive statistical analysis was conducted to describe farmers’ awareness of a healthy lifestyle.

Results: The results showed that the highest scores were found in the self-efficacy (11.54) and cues to action (11.22) components, indicating that respondents had strong confidence and motivation to adopt healthy behaviors. However, the scores for perceived severity (8.59) and perceived susceptibility (8.85) were relatively lower, suggesting a limited perception of occupational accident risks among farmers.

Conclusion: The HBM-based approach in agricultural settings demonstrated improvements in preventive behaviors and healthy lifestyle practices among farmers. Nevertheless, health education interventions emphasizing the perception of occupational accident risks remain necessary to further enhance occupational safety awareness.

Effect of a mechanical ventilation system (exhaust fan) integrated with chlorination on reducing bacterial colonies in dental treatment rooms

2026-02-12T17:20:09+08:00

Background: Microbial air contamination (bioaerosols) in dental treatment rooms poses a significant risk for the transmission of Healthcare-Associated Infections, particularly during aerosol-generating procedures. Limited studies have evaluated integrated ventilation and disinfection systems to control airborne bacteria.

Objective: This study aimed to evaluate the effectiveness of a mechanical ventilation system (exhaust fan) integrated with calcium hypochlorite disinfection in reducing airborne bacterial colonies.

Methods: A quasi-experimental study with a pretest–posttest design was conducted under four conditions: P1 (before ventilation), P2 (after ventilation), P3 (outlet without disinfection), and P4 (outlet with calcium hypochlorite). Air sampling was performed using the settle plate method with five Nutrient Agar plates exposed for 15 minutes at a height of one meter. The exhaust fan was operated for one hour prior to sampling. Each condition was repeated 15 times. Bacterial colonies were quantified and converted into CFU/m³ using the Omeliansky formula.

Results: The baseline bacterial concentration was 211.04 CFU/m³. Ventilation significantly reduced bacterial colonies to 100.63 CFU/m³ (p = 0.015). No significant difference was observed between indoor and outlet air (p = 0.297). The addition of calcium hypochlorite significantly reduced bacterial colonies to 16.07 CFU/m³ (p < 0.001).

Conclusion: Mechanical ventilation reduces airborne bacterial load, and integration with calcium hypochlorite disinfection effectively minimizes microbial contamination before air is released into the environment.

Impact of obstetric history and pregnancy intervals on postpartum anemia and lactation process: a cross-sectional analysis

2026-01-28T14:37:05+08:00

Background: High Maternal Mortality Rate in Indonesia is linked to postpartum anemia. This study addresses the high prevalence of postpartum anemia (>35%) in Kerek Health Center, Tuban.

Objective: This study aimed to analyze the influence of predictor factors (history of Postpartum Hemorrhage/PPH and pregnancy interval/PI) on Anemia Incidence, as well as the influence of lactation practices (Early Initiation of Breastfeeding/EIBF and history of lactation onset) on Lactation Process.

Methods: A cross-sectional approach was conducted from September 2025 to December 2025. Data analysis was performed using JASP (0.18). The study population comprised all postpartum mothers in the Health Center’s working area, with 200 respondents selected using the total sampling technique. Independent variables included PPH history, PI, EIBF history, and late onset of lactation. The dependent variables were the incidence of anemia and breast milk production.

Results: A significant association was established between a history of PPH and the incidence of anemia (p=0.001), where a history of PPH increased the risk of anemia 5.006 times (OR=5.006). An ideal PI (≥2 years) was identified as a significant and dominant protective factor against anemia (OR=0.297, p=0.001). Regarding the lactation aspect, EIBF history had a significant association (OR=5.631, p=0.001). Conversely, a history of late onset of lactation was also significant to lactation failure (OR=0.165, p=0.001).

Conclusion: Delivery history has a significant influence on the incidence of anemia and the success of lactation. Practically, these findings suggest that healthcare providers should prioritize early screening for high-risk mothers during prenatal care and intensify lactation support programs.

Effectiveness of school-based peer education on knowledge, attitudes, and behavior of diabetes mellitus prevention among adolescents

2026-03-04T11:19:32+08:00

Background: Diabetes Mellitus (DM) has become a global health concern with a rapidly increasing prevalence, including among adolescents. Early prevention efforts are essential and can be implemented through school-based peer education approaches.

Objective: To determine the effectiveness of school-based peer education on knowledge, attitudes, and behaviors related to diabetes mellitus prevention among adolescents.

Methods: A quasi-experimental design with a pretest and posttest control group was employed. The sample consisted of 90 adolescents, divided equally into the intervention and control groups (45 participants each). The intervention group received peer education through four weekly sessions, each lasting 60 minutes, while the control group did not receive any intervention. Data were collected using validated and reliable questionnaires assessing knowledge, attitudes, and behaviors related to diabetes mellitus prevention. The analysis employed the Mann-Whitney U test, the Wilcoxon signed-rank test, the independent t-test, and the paired t-test.

Results: The intervention group exhibited a considerably greater increase in knowledge scores compared to the control group (p=0.001). Attitude scores improved in the intervention group but declined in the control group, with a statistically significant difference (p = 0.005). Despite a marginally bigger improvement in behavior scores within the intervention group, the difference lacked statistical significance (p=0.802).

Conclusion: School-based peer education improved adolescents’ knowledge and attitudes toward diabetes mellitus prevention but did not significantly influence preventive behaviors. Therefore, sustainable educational interventions that are integrated into school programs and support from various stakeholders

The role of monsoon dynamics in PM2.5 concentration during the 2023–2024 El Niño event in Southeast Asia: a public health concern

2026-03-16T17:06:02+08:00

Background: El Niño and positive Indian Ocean Dipole (IOD) events can disrupt monsoon circulation and increase air pollution exposure in Southeast Asia, particularly PM2.5, which poses significant public health risks.

Objective: This study aimed to analyze PM2.5 exposure during the 2023–2024 El Niño period and assess its potential public health risks in Southeast Asia.

Methods: Daily PM2.5 concentrations in major Southeast Asian capitals during the 2023–2024 El Niño period were analyzed to evaluate temporal variability, exceedances of WHO and national standards, and potential transboundary pollution using Spearman correlation analysis.

Results: Jakarta and Hanoi showed the highest daily median PM2.5 concentrations, exceeding 100 µg/m3. However, exceedances of WHO and national air quality standards occurred in almost all ASEAN capitals. Strong positive correlations were observed between Yangon and Vientiane (r = 0.753, p < 0.01), Vientiane and Bangkok (r = 0.695, p < 0.01), and Yangon and Bangkok (r = 0.670, p < 0.01), likely due to shared continental and monsoonal influences. In contrast, weaker correlations were found among maritime cities such as Jakarta, Singapore, and Kuala Lumpur because of variable sea–land circulation and tropical convection. Elevated PM2.5 concentrations during El Niño may increase respiratory and cardiovascular health risks.

Conclusion: PM2.5 concentrations during the 2023–2024 El Niño period exceeded WHO and national standards in most Southeast Asian capitals, highlighting the need for cross-border mitigation strategies and integrated early warning systems to protect public health.

Molecular Docking Analysis of Sesquiterpenes Hydrocarbons from Merauke Agarwood (Aquilaria malaccensis) Targeting Penicillin-Binding Proteins in Acinetobacter baumanni

2026-02-20T15:43:29+08:00

Background: Acinetobacter baumannii is a critical nosocomial pathogen associated with a high level of antibiotic resistance, necessitating the exploration of alternative antibacterial candidates from natural sources. Merauke agarwood (Aquilaria malaccensis) essential oil contains various sesquiterpenes; however, molecular-level evidence targeting A. baumannii penicillin-binding proteins (PBPs) remains limited.

Objective: This study evaluated the interactions of selected sesquiterpene hydrocarbons, γ-cadinene, kessane, and α-gurjunene, from Merauke agarwood using an in silico approach.

Methods: Drug-likeness and ADMET properties were predicted using ADMETLab 3.0, while potential biological activities were assessed with PASS Online. Molecular docking was performed against A. baumannii PBP1a (3UE3) and PBP3 (3UDF) using CB-Dock2, followed by protein–ligand interaction analysis with PLIP.

Results: All compounds complied with Lipinski’s rule and showed moderate quantitative estimates of drug-likeness, although high lipophilicity and plasma protein binding were predicted. Docking analysis revealed moderate binding affinities toward both PBPs (−6.2 to −6.7 kcal/mol) and identified conserved hydrophobic interaction regions involving recurrent amino acid residues within each protein. PASS predictions indicated higher probabilities of antibacterial-related activity than inactivity for all ligands

Conclusions: These sesquiterpene hydrocarbons from agarwood form stable interactions with A. baumannii PBPs, providing a structural basis for lead scaffolds in structure-based screening. Further studies on oxygenated derivatives, formulation strategies, and experimental validation are recommended. These sesquiterpene hydrocarbons from agarwood form stable interactions with A. baumannii PBPs, providing a structural basis for lead scaffolds in structure-based screening. Further studies on oxygenated derivatives, formulation strategies, and experimental validation are recommended.

Effects of fermented red rice (Oryza sativa) and black rice (Oryza sativa L. indica) on blood pressure in pregnant women with preeclampsia

2026-02-26T09:14:27+08:00

Background: Preeclampsia is a hypertensive disorder of pregnancy for approximately 75% of direct maternal deaths. Early detection and promoting healthier nutritional alternatives are strategies to mitigate its risks. Fermented red rice and black rice may serve as dietary interventions due to bioactive compounds such as lovastatin that may support maternal health in preeclampsia.

Objective: To compare and analyze the effect of fermented red rice and black rice on the blood pressure of pregnant women with preeclampsia. A true experimental research design with randomized pretest-posttest control-group design.

Methods: The study conducted from August-September 2025, involved 60 pregnant women with preeclampsia in the working area of Cikalongwetan Regional Hospital. Participants were randomly assigned to three groups, a fermented red rice, a fermented black rice, and a control receiving mineral water. Each group received 5mL of their intervention twice daily for four weeks. Data were analyzed using Paired Sample t-test and One Way ANOVA.

Results: The results after four-week intervention showed significant differences in blood pressure reduction among the groups. Fermented red rice showed the most decrease, with mean reduction of 22.5 mmHg in systolic blood pressure and 12.5 mmHg in diastolic blood pressure. Fermented black rice also showed reduction, averaging 14.5 mmHg (systolic) and 11.5 mmHg (diastolic). The One-Way ANOVA confirmed a statistically significant difference, the mean post intervention systolic (p=0.025) and diastolic (p=0.007) blood pressure among the groups.

Conclusion: The reduction in blood pressure was greater fermented red rice group compared to fermented black rice group.non- pharmacological pain management during labor.

Physical environmental factors and the occurrence of pneumonia among under-five children in developing Asian countries: a scoping review

2026-04-06T16:48:10+08:00

Background: Pneumonia remains one of the leading causes of morbidity and mortality among children under five in developing countries and is suspected to be associated with household physical environmental factors that have not been comprehensively examined in an integrated manner.

Objective: This study aimed to map the scientific evidence on physical environmental factors associated with pneumonia among children under five in developing countries in Asia using a scoping review approach based on the PRISMA-ScR guidelines.

Methods: Literature searches were conducted in the Scopus, PubMed, and Google Scholar databases from 2015 to 2025, with inclusion criteria focusing on primary research articles addressing children under five and physical environmental factors. A total of ten articles were included and analyzed descriptively.

Results: The findings indicate that the most consistently associated household physical environmental factors with pneumonia among children under five include indoor air pollution from biomass fuels, inadequate household ventilation, overcrowding, and exposure to harmful gases such as carbon monoxide. In addition, poor natural lighting and high humidity were also reported to contribute to an increased risk of pneumonia. It was also found that immunization status and socioeconomic conditions influence the incidence of pneumonia.

Conclusion: These findings indicate that pneumonia among children under five is a multifactorial isease influenced not only by household environmental conditions, but also by biological and socioeconomic factors. Overall, household physical environmental factors remain important determinants of pneumonia among children under five, although their impact may vary depending on contextual and supporting factors

Correlation between neutrophil-to-lymphocyte ratio and molecular test Ct category in patients with drug-resistant tuberculosis

2026-04-30T15:20:58+08:00

Background: Drug-resistant tuberculosis remains a clinical and public health challenge. The neutrophil-to-lymphocyte ratio (NLR) reflects systemic inflammation, whereas the cycle threshold (Ct) category from Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) Ultra reflects semiquantitative molecular bacillary load. Evidence linking both parameters in drug-resistant tuberculosis remains limited.

Objective: To analyze the correlation between blood NLR and molecular test Ct category in patients with drug-resistant tuberculosis.

Methods: This analytic observational study with a cross-sectional design was conducted at Dr. H. A. Rotinsulu Lung Hospital, Bandung, from January to November 2024. Twenty-nine adult patients with drug-resistant tuberculosis who had complete hematology and Xpert MTB/RIF Ultra results were selected using purposive sampling. NLR was calculated from differential leukocyte counts. Ct was grouped into high, medium, and low categories. Data were analyzed using descriptive statistics, Spearman correlation, and the Kruskal-Wallis test.

Results: Of 29 patients, 19(66%) were male, and 22(76%) of the whole sample had elevated NLR. Ct categories consisted of high in 15 patients, medium in 3 patients, and low in 11 patients. Mean NLR was 6.76 in the high Ct group, 3.50 in the medium group, and 5.49 in the low group. Spearman analysis showed a very weak and non-significant positive correlation between NLR and Ct category (r=0.101; p=0.300). The Kruskal-Wallis test also showed no significant NLR difference across Ct categories (H=1.667; p=0.435).

Conclusion: NLR was not significantly correlated with Ct category and did not differ significantly across Ct groups. NLR should be interpreted as an adjunct inflammatory marker, not as a substitute for molecular bacteriological assessment in drug-resistant tuberculosis.

The association of depression and fatigue with sleep disturbances in people living with HIV (PLWH): a systematic review

2026-05-13T11:48:55+08:00

Background: HIV remains a global health problem. Sleep disturbances, depression, and fatigue are among the most common problems experienced by people living with HIV. Although these problems frequently occur together, comprehensive research regarding the association between depression and sleep disturbances as well as fatigue and sleep disturbances remains limited.

Objective: This systematic review aimed to investigate the relationship between depression and fatigue and sleep disturbances in people living with HIV.

Methods: A systematic literature review was conducted across four databases PubMed, Scopus, ScientDirect and Sage covering publications from January 2016 to April 2026, following the PRISMA 2020 guidelines. Thirteen eligible studies were reviewed . Methodological quality was evaluated using the JBI Critical Appraisal Tool.

Results: A total of 13 studies were included in this systematic review. Most studies showed that depression was significantly associated with sleep disturbances among people living with HIV (PLWH), including poorer sleep quality, shorter sleep duration, and lower sleep efficiency. Fatigue was also associated with sleep disturbances, particularly insomnia and daytime sleepiness

Conclusion: Depression and fatigue are important factors associated with sleep disturbances among PLWH. These findings highlight the need for comprehensive assessment and management of sleep and psychological problems in HIV care.