Medical and Health Journal (EISSN. 2807-3541) is containing various articles/ manuscripts in the forms of research article, systematic reviews, case reports in the field of medicine focusing on basic medicine, clinical medicine, biomedical sciences, medical biotechnology, public health and nursing. Medical and Health Journal has been nationally accredited by the Ministry of Research and Technology/National Research and Innovation Agency of the Republic of Indonesia and is currently indexed in SINTA (Science and Technology Index) at SINTA 5 level. This journal is published by Universitas Jenderal Soedirman, Purwokerto, Indonesia.
Fakultas Kedokteran Universitas Jenderal Soedirman
Effect of Durian Rind Nanocellulose Addition on the Vickers Hardness of Self-Cure Acrylic Resin Fabricated By Spray-on Method
Self-cure acrylic resin is commonly used to fabricate orthodontic baseplates in removable appliances. However, it exhibits relatively low hardness, making it susceptible to wear and deformation under masticatory forces. The addition of reinforcing materials can enhance mechanical properties such as hardness. Nanocellulose derived from durian (Durio zibethinus Murr.) rind, an agricultural waste product, is a promising bio-based reinforcing material. This study aimed to determine the effect of durian rind nanocellulose addition on the Vickers hardness of self-cure acrylic resin fabricated using the spray-on method.This laboratory experimental study employed a posttest-only control group design. Durian rind nanocellulose was synthesized via acid hydrolysis and characterized using Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FTIR) to confirm morphology and functional groups before incorporation into the acrylic resin. The nanocellulose was dispersed in monomer using ultrasonic homogenization for 5 minutes to ensure uniform distribution, then applied to polymer powder using the spray-on method. Twenty-four samples were divided into three groups (n=8): 2% nanocellulose, 3% nanocellulose, and control (0% nanocellulose). The highest mean hardness value was found in the 2% nanocellulose group (30.77 ± 1.03 VHN), while the lowest was in the control group (26.90 ± 0.79 VHN). Data were normally distributed and homogeneous (Shapiro-Wilk and Levene tests). One-way ANOVA revealed significant differences among groups (p<0.05), with post hoc LSD tests confirming significant pairwise differences. This study concludes that durian rind nanocellulose addition significantly increases the Vickers hardness of self-cure acrylic resin fabricated by the spray-on method compared to the control group
The Effect Of Hydrogen Peroxide (H₂O₂) in Yoghurt (Lactobacillus bulgaricus and Streptococcus thermophilus) on Inhibiting the Growth of Streptococcus pyogenes
Yoghurt is a food product made from milk fermented with lactic acid bacteria (LAB), which provides various health benefits, including enhancing immunity through the production of lactic acid, hydrogen peroxide, diacetyl, and bacteriocins. Several studies have reported that LAB-fermented yoghurt can inhibit the growth of pathogenic bacteria. Streptococcus pyogenes is a gram-positive bacterium that forms chain like colonies, is small, round in shape, has a smooth surface, and produces grayish-white pigmentation on blood agar. S. pyogenes can cause respiratory infections such as pharyngitis, and skin infections such as impetigo, cellulitis, and erysipelas. This study aimed to investigate the role of hydrogen peroxide in yoghurt (L. bulgaricus and S. thermophilus) in inhibiting the growth of S. pyogenes. This was an experimental study using a post-test-only control group design. Bacterial colony counts were performed using a colony counter. A total of 60 samples were used, with three repetitions, two dilutions, and ten concentration groups (0%, 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%), with 0% serving as the control. Data were analyzed using the Kruskal-Wallis test, followed by the Spearman Rho test. The results showed that yoghurt inhibited the growth of S. pyogenes, and the 30% yoghurt concentration, containing 0.32 mmol/L hydrogen peroxide, was the minimum inhibitory concentration. Kruskal-Wallis analysis showed significant differences among groups (p<0.05), and the Spearman Rho test indicated a significant correlation (p<0.05) between the variables.
Prevalence of Hepatitis C in Hemodialysis Patients in Indonesia
Hepatitis C (HCV) is a blood-borne viral infection and a major cause of global morbidity and mortality. Indonesia is one of six countries contributing to 50% of the global HCV burden, with a prevalence of 0.5% in the general population. HCV infection is more frequently observed in patients with chronic kidney disease undergoing hemodialysis due to nosocomial transmission. This study employed a literature review method by searching articles published between 2015 and 2025 in Google Scholar, PubMed, and ProQuest, yielding 11 eligible studies. The analysis shows that the prevalence of HCV among hemodialysis patients in Indonesia ranges from 3.7% to 56.3%, with the highest rate reported at H. Adam Malik General Hospital Medan (56.3%) and the lowest at Banyu Bening Hospital Boyolali (3.7%). Most infected patients are male and over 45 years of age. These variations indicate that male sex and older age serve as risk factors for HCV infection in hemodialysis patients.
Secondary Spontaneous Pneumothorax in Recurrent Pulmonary Tuberculosis: A Case Report
Background: Secondary spontaneous pneumothorax is a potentially life threatening complication that may occur in patients with underlying pulmonary diseases, including pulmonary tuberculosis. In recurrent pulmonary tuberculosis, residual lung damage such as cavitation, fibrosis, and bullae increases the risk of alveolar rupture, leading to pneumothorax. Objective: To describe the clinical presentation, diagnostic findings, management, and outcome of a patient with secondary spontaneous pneumothorax associated with recurrent pulmonary tuberculosis. Case Presentation: A 21 year old male with a history of pulmonary tuberculosis two years prior presented to the emergency department with sudden onset shortness of breath and pleuritic chest pain. Physical examination and chest radiography revealed an avascular radiolucent area in the right lung, consistent with pneumothorax. A rapid molecular sputum test was positive for Mycobacterium tuberculosis. A diagnosis of right sided secondary spontaneous pneumothorax due to recurrent pulmonary tuberculosis was established. The patient underwent needle decompression followed by the placement of a water sealed drainage (WSD) system. Anti tuberculosis therapy was reinitiated according to the national treatment protocol. Results: Follow up chest radiographs demonstrated progressive lung re expansion, accompanied by significant clinical improvement. The patient’s condition stabilized, and no further complications were observed during hospitalization. Conclusion: Secondary spontaneous pneumothorax in patients with recurrent pulmonary tuberculosis represents an emergency condition that requires rapid diagnosis and appropriate management. The combination of WSD insertion and anti tuberculosis therapy proved effective in promoting lung re-expansion and improving clinical outcomes. Heightened clinical awareness of this complication is essential to improve prognosis in patients with recurrent pulmonary tuberculosis.
Advanced Nasopharyngeal Carcinoma with Intracranial Extension and Bilateral Cervical Lymphadenopathy: A Case Report
Background: Nasopharyngeal carcinoma (NPC) is an epithelial malignancy that is often found in Southeast Asia and is ranked sixth as the most common cancer in Indonesia. This disease is often diagnosed at an advanced stage due to nonspecific initial symptoms. Case Description: A 72-year-old man presented with chronic epistaxis, bilateral nasal obstruction, tinnitus, and bilateral neck node enlargement. Nasoendoscopy revealed a mass obscuring the fossa of Rosenmüller, while a contrast-enhanced CT scan revealed an infiltrative lesion in the nasopharynx extending to the skull base and intracranially with multiple cervical lymphadenopathy. Histopathology revealed nasopharyngeal nonkeratinizing squamous cell carcinoma, stage T4N3Mx. Management and Outcome: The patient was referred for concomitant chemoradiotherapy as standard therapy for advanced stage, with planned follow-up at an oncology center. Discussion: This case highlights the association between smoking and salted fish consumption with the occurrence of NPC and the challenges of early diagnosis due to symptoms resembling chronic rhinitis. Conclusion: Recognizing recurrent epistaxis and painless neck node enlargement is crucial for early detection of NPC. A multidisciplinary approach and integrated chemoradiotherapy play a significant role in improving patient prognosis.
Mental and Emotional Changes in the Elderly: A Literature Review
Emotional and mental changes in the elderly represent a psychological adaptation process that occurs with aging, encompassing shifts in thinking, emotional responses, and social interactions. A deeper understanding of this topic is essential for designing effective interventions aimed at improving the quality of life of older adults. Elderly individuals are vulnerable to experiencing issues such as excessive anxiety, profound sadness, loneliness, guilt, and decreased self-esteem. These conditions may be triggered by internal factors, including neurobiological changes and chronic stress, as well as external factors, such as age discrimination and social isolation. Such changes significantly impact various dimensions of the elderly’s quality of life, including physical, psychological, social, and spiritual aspects. Therefore, a holistic approach that involves the active role of the family in providing emotional and social support is crucial. Non-pharmacological interventions, such as cognitive behavioral therapy (CBT), meditation, and physical activity, have been proven effective in preventing and managing mental health problems in older adults and in promoting overall well-being.
Pediatric Submandibular Abscess: Diagnostic Challenges and Comprehensive Management – A Literature Review
Submandibular abscess in children is a rare deep neck space infection but can be fatal if diagnosis and management are delayed. Most cases (70–85%) originate from odontogenic infections of the mandibular molars, with Staphylococcus aureus and Streptococcus viridans as the predominant pathogens. This article reviews the etiology, early diagnosis, and management of pediatric submandibular abscesses based on recent literature (2020–2025) from Google Scholar, PubMed, and ScienceDirect. Anatomical and immunological differences in children lead to faster infection spread with nonspecific early symptoms; therefore, careful clinical examination and the use of CT scans or ultrasonography are crucial for early diagnosis. Management includes airway stabilization, culture-based broad-spectrum antibiotics, and timely surgical drainage. Multidisciplinary collaboration among dentists, ENT specialists, and pediatric anesthesiologists is essential to reduce morbidity and mortality. Prospective studies are needed to evaluate the effectiveness of minimally invasive approaches and current antibiotic resistance patterns in children. Early diagnosis, rational therapy, and interdisciplinary cooperation remain the key factors in achieving successful outcomes in pediatric submandibular abscess management.
Quality of Life Among Older Adults Living with HIV: A Literature Review
Advances in antiretroviral therapy have extended the life expectancy of people living with HIV, leading to a growing population of older adults with this condition who face age-related biological decline alongside persistent psychosocial pressures that may reduce their quality of life. This review was conducted to describe the quality of life of older adults living with HIV and to examine the psychosocial factors influencing it based on research published in the past five years. A literature review approach was employed by searching several online databases and selecting studies published between 2019 and 2025 that focused on quality of life and psychosocial aspects among individuals aged 50 years and older living with HIV. Six studies met the inclusion criteria and show a consistent pattern indicating that the quality of life of older adults with HIV is shaped by psychosocial conditions such as stigma, depression, and limited social support, all of which contribute to diminished well-being. Conversely, protective factors such as resilience and community support play a crucial role in enhancing psychological health and improving overall quality of life. These findings highlight that the well-being of older adults living with HIV is strongly influenced by their psychosocial environment, and emphasize the need for interventions that strengthen social support and foster resilience to promote better quality of life within this population.
Management of Unilateral Hyperlactation in a Mother Exclusively Breastfeeding 7-Month-Old Infant: A Case Report
Background: Hyperlactation is a condition characterized by excessive breast milk production beyond the infant’s nutritional needs, which may lead to feeding difficulties and maternal discomfort. Unilateral hyperlactation is a rare condition and may result from idiopathic mechanisms, iatrogenic factors, or a combination of both. This case report describes the mechanism and successful management of unilateral hyperlactation occurring after contralateral breast abscess surgery. Case Report: A 24-year-old lactating mother presented with excessive milk production, breast pain, and recurrent ductal obstruction in the right breast. One month prior, she had undergone surgical drainage of a left breast abscess. Her 7-month-old infant experienced breastfeeding difficulties, green frothy stools, and excessive weight gain. The condition was diagnosed as a unilateral hyperlactation of idiopathic–iatrogenic hybrid, whereby reduced stimulation of the surgically treated left breast triggered compensatory overproduction in the right breast. A comprehensive management using Academy of Breastfeeding Medicine (ABM) protocol was implemented, including laid-back breastfeeding positioning, block feeding for 14 days, and oral pseudoephedrine 60 mg twice daily. Significant clinical improvement was observed, with reduced milk production to levels appropriate for the infant’s needs, resolution of maternal symptoms, and successful continuation of breastfeeding. Conclusion: Unilateral hyperlactation following breast surgery can be effectively managed using an ABM Protocol–based approach combining block feeding and pharmacological therapy, enabling successful continuation of breastfeeding.
Ileal Atresia in a Preterm Neonate Complicated by Necrotizing Enterocolitis: A Case Report
Background: Ileal atresia is a congenital intestinal obstruction that frequently affects premature neonates and is associated with high morbidity, particularly when complicated by necrotizing enterocolitis (NEC) and sepsis. Optimal outcomes depend not only on surgical intervention but also on comprehensive perioperative management by a multidisciplinary team, particularly neonatologists. Case Presentation: We report a male preterm neonate born at 32 weeks and 5 days of gestation with progressive abdominal distension, bilious gastric residue, and failure to pass meconium. Initial respiratory distress improved with non-invasive ventilation. However, gastrointestinal deterioration occurred on day four of life, with radiographic findings consistent with NEC stage III and pneumoperitoneum. Emergency laparotomy revealed ileal atresia, and staged surgical management was performed. Discussion: The pediatric or neonatal team played a crucial role in preoperative stabilization, including respiratory support, fluid and electrolyte correction, broad-spectrum antibiotics, and nutritional optimization. Postoperatively, close monitoring of respiratory status, infection control, gradual advancement of enteral nutrition, and growth assessment enabled recovery without major complications. Full oral feeding was achieved, and the patient was discharged in stable condition on day 27 of life. Conclusion: This case highlights the pivotal role of pediatricians or neonatologists in perioperative management of ileal atresia in premature neonates, emphasizing that meticulous supportive care significantly contributes to favorable surgical outcomes.
Synthesizing The Evidence: TP53 Mutations as a Prognostic and Predictive Biomarker in Breast Cancer
The journey to personalize breast cancer therapy increasingly navigates the complex landscape of somatic TP53 mutations, the most frequent genetic drivers of this disease. Moving beyond a simple prognostic badge, we now understand these mutations create a spectrum of clinical behaviors, deeply influenced by their specific functional impact and, critically, by their genetic companions. A systematic literature review was conducted across three major electronic databases: ScienceDirect, ProQuest, and Scopus. The search was restricted to peer-reviewed journal articles published in English between 2021 and 2024 to ensure the inclusion of recent evidence. The confluence of TP53 and PIK3CA mutations stands out as a devastating synergy that heralds a tumor phenotype with profound resistance to common chemotherapy regimens, especially taxanes, and the direst survival outcomes. This genetic context also subtly reshapes responses to HER2-targeted drugs, revealing that TP53's influence is both powerful and context-dependent. A more nuanced profiling, one that accounts for these critical genetic interactions, is no longer a future aspiration but a present necessity. These findings collectively advocate for the integration of comprehensive molecular profiling, including nuanced TP53 and PIK3CA assessment, into clinical decision-making.
Basic Immunization Status and Incidence of Measles Among Toddlers in Working Area of Limboto Public Health Center, Gorontalo Regency
Measles (campak) is a contagious disease that remains a health problem among toddlers and contributes to high morbidity and mortality rates in children. Globally, measles cases increased from 170,000 cases in 2022 to over 320,000 cases in 2023, with deaths occurring mainly in children who did not receive complete immunization. This condition indicates that basic immunization plays an important role in measles prevention. In Gorontalo Province, measles and rubella cases are still found in several districts/cities, with Gorontalo Regency having the highest number of cases. One of the preventive efforts is the provision of complete basic immunization to enhance immunity against the disease. This study aimed to determine the relationship between basic immunization status and the incidence of measles in toddlers in the working area of Limboto Health Center, Gorontalo Regency.This study was a quantitative study with an analytic observational design using a cross-sectional approach. The study population consisted of all toddlers in the working area of Limboto Health Center, Gorontalo Regency, with a total sample of 60 toddlers taken using a total sampling technique. The research instrument used a checklist sheet. Data analysis was conducted univariately and bivariately using the Chi-Square test. The study results showed that there was a relationship between basic immunization status and the incidence of measles in toddlers (p-value < 0.05). The conclusion of this study is that there is a relationship between basic immunization status and the incidence of measles in toddlers. Therefore, it is recommended that healthcare workers increase education for parents and improve complete basic immunization coverage as a preventive measure against measles in toddlers.
Overview of Adherence Diet Management in Type 2 Diabetes Mellitus Patients at Kabila Public Health Center
Diet is a crucial part of managing type 2 diabetes mellitus. One way to achieve this is by following the 3J (Type, Amount, and Schedule) of dietary management. Dietary adherence remains variable, even though patients receive regular education through the PROLANIS program. Dietary non-compliance can result in uncontrolled blood glucose levels and an increased risk of chronic complications. This study aims to describe the 3J diet management compliance in type 2 Diabetes Mellitus patients at the Kabila Community Health Center. This study used a descriptive quantitative design. The research variable was 3J diet management compliance. The population was 289 type 2 DM patients, and a sample of 75 respondents selected using accidental sampling techniques. The instrument used was a 3J diet compliance questionnaire. Data were analyzed univariately using frequency distribution to describe the level of respondent compliance. The results of the study based on indicators, compliance with the type of diet showed that 45 respondents (60.0%) were non-compliant, the number of calories showed that 41 respondents (54.7%) were non-compliant, while the meal schedule showed that 47 respondents (62.7%) were compliant. These findings illustrate that most patients still experience difficulties in managing the type and amount of food, even though they have been quite good at complying with the meal schedule. The Community Health Center is advised to conduct monitoring activities and further research is suggested to develop peer tutoring-based intervention methods.
Phytochemical Characterization of the Chloroform Extract of Foeniculum vulgare Mill. Leaves with Implications for Antiparasitic Agent Development
The development of antiparasitic agents derived from natural products continues to receive considerable attention due to increasing resistance and limitations of conventional therapies. This study aimed to examine the phytochemical profile of the chloroform extract of fennel leaves (F. vulgare Mill.) as a basis for antiparasitic agent development. The extract was obtained using a maceration method and analyzed using thin layer chromatography. Qualitative analysis was conducted based on the observation of visible spots after spraying with appropriate visualization reagents, while supporting analysis was performed based on the calculation of retention factor values for the detected spots. The results revealed the presence of several major groups of secondary metabolites, including flavonoids, terpenoids, alkaloids, and phenolic compounds, as indicated by specific color changes and retention factor values. The diversity of these metabolites suggests the possible involvement of multiple biochemical pathways related to antiparasitic mechanisms. Overall, the phytochemical profile of the chloroform extract of fennel leaves provides important preliminary data to support further research on natural product–based antiparasitic agents.
Beyond Survival: Multisystem Life-Threatening Illness in an Infant with Congenital Heart Disease and Sepsis
Introduction: Congenital malformations are a leading cause of infant disability and mortality. Congenital infections, particularly cytomegalovirus (CMV) and Toxoplasma gondii, are associated with structural abnormalities of multiple organ systems, including congenital heart disease (CHD). In utero infection may disrupt cardiac organogenesis, increasing the risk of heart failure. Infants with CHD are also highly susceptible to sepsis, frequently requiring pediatric intensive care. Managing life-threatening conditions in infants presents significant clinical challenges, including complex therapeutic decisions, drug dosing, and multidisciplinary care. Case Report: A 1-month-old male infant presented with poor feeding and lethargy. He had been previously diagnosed with failure to thrive and CHD consisting of atrial septal defect (ASD) and ventricular septal defect (VSD). Further evaluation revealed heart failure (Ross III), congenital CMV and toxoplasmosis infections, sepsis, bronchopneumonia, prolonged jaundice, and hydrocele dextra. The patient required PICU admission for 6 days followed by 7 days of inpatient care. Clinical improvement was achieved following comprehensive medical management, and the patient was discharged in stable condition. Conclusion: Congenital infections may play a critical role in the development and clinical severity of CHD, contributing to heart failure and increased susceptibility to sepsis. Early recognition and integrated multidisciplinary management are essential to improve outcomes in infants with multiple life-threatening conditions, emphasizing care that extends beyond survival toward functional recovery..
Acute Toxicity Test of Tamarillo Fruit Ethanol Extract (Solanum betaceum Cav.) on the Levels of Liver Transaminase Enzymes in Male Wistar Rats
Indonesians traditionally utilize tamarillo for its various health benefits. However, the lipophilic compounds it contains have the potential to cause hepatotoxicity and increase transaminase enzymes, namely SGPT and SGOT enzymes. The study aimed to test the toxicity of tamarillo ethanol extract acutely on SGPT and SGOT levels in male Wistar white rats. The study used a post-test only experimental design with a control group design. Fifteen rats were randomly divided into five treatment groups. Group K1 as a control was given distilled water, group K2 was given paracetamol 2.5 g/kgBW, while groups K3, K4, and K5 were each given tamarillo ethanol extract in single doses of 200, 400, and 600 mg/kgBW. After 24 hours, rat blood serum samples were taken through the orbital sinus to measure SGPT and SGOT levels using the UV test method. The results showed that the average SGPT levels increased in the K2 group by 295.34±13.31 U/L and K5 by 93.67±19.03 U/L. Meanwhile, the average SGOT levels increased in the K2 group by 874±25.06 U/L, K4 by 164.67±7.57 U/L and K5 by 213.34±13.50 U/L. The One-Way ANOVA test showed a significance value of p=0.000 in the K2 and K5 groups for SGPT, while SGOT in the K2, K4 and K5 groups. Administration of tamarillo ethanol extract can cause liver damage at doses of 400 mg/kgBW and 600 mg/kgBW.
Characteristics of Presbycusis Patients at RSUD Prof. Dr. Margono Soekarjo Purwokerto
Presbycusis is a progressive sensorineural hearing loss commonly affecting the elderly and significantly reducing quality of life. RSUD Prof. Dr. Margono Soekarjo Purwokerto, as a referral hospital, treats a large number of elderly patients, making characterization of presbycusis patients essential. This study aimed to describe the characteristics of presbycusis patients based on age, sex, occupation, comorbidities, and degree of hearing loss. A descriptive quantitative study with a retrospective approach was conducted using total sampling of presbycusis patients at the ENT outpatient clinic from 2022 to 2024. A total of 81 patients met the inclusion criteria. Most patients were male and aged 61–74 years. The most common occupation was farmer, and hypertension was the most frequent comorbidity. Hearing loss was generally bilateral with moderate to moderately severe degree.
Exclusive Breastfeeding and the Risk of Complicated Pneumonia in Toddlers: A Literature Review
Pneumonia is a leading cause of morbidity and mortality in children under five worldwide. The World Health Organization (WHO, 2019) reports that pneumonia accounts for approximately 14% of all infant deaths, with more than 740,000 deaths per year. In Indonesia, the prevalence of pneumonia in infants remains high, including in West Nusa Tenggara Province, which recorded 32,128 cases in 2023, with 4,183 cases in West Lombok Regency. One protective factor believed to reduce the risk of pneumonia is exclusive breastfeeding during the first six months of life. Breast milk contains various immunological components such as secretory immunoglobulin A (sIgA), lactoferrin, lysozyme, and oligosaccharides, which play a role in protecting against lower respiratory tract infections (Lyons et al., 2020; Moraes-Pinto et al., 2021). This literature review was compiled using a narrative literature review method using relevant national and international sources, including journals from PubMed, ScienceDirect, and official WHO and UNICEF reports. The literature reviewed was published between 2015 and 2024, focusing on the relationship between exclusive breastfeeding and the incidence of pneumonia in toddlers. The analysis was conducted descriptively and thematically, reflecting the content of previous studies. Based on the study results, exclusive breastfeeding has been shown to have a significant protective effect against the incidence of pneumonia. Infants who are not exclusively breastfed have a two to five times higher risk of developing lower respiratory tract infections (Popovsky, E.Y. and Florin, T.A., 2021). A global study by Victora et al. (2016) found that exclusive breastfeeding reduces the risk of severe pneumonia by up to 64% and has the potential to prevent 820,000 child deaths annually. However, the incidence of complicated pneumonia is also influenced by other factors such as nutritional status, basic immunizations, exposure to cigarette smoke, and home environmental conditions (Dean & Florin, 2018; Saunders, 2017). Exclusive breastfeeding plays a crucial role in preventing pneumonia in toddlers through immunological mechanisms and protection of the respiratory mucosa. However, because pneumonia is a multifactorial disease, the effectiveness of exclusive breastfeeding needs to be supported by improved nutritional status, immunization coverage, and environmental improvements. Comprehensive promotive and preventive efforts are needed to reduce the incidence of pneumonia and its complications in the community.
In Silico Analysis of Moringa oleifera Leaf Phytochemicals as Potential DNA Gyrase Inhibitor in Salmonella typhi
Salmonella typhi is an infectious bacterium leading to typhoid fever, that is increasing in cases worldwide each year. Due to the resistance to antibiotics, the discovery of safer and efficacious drugs remains important. This study evaluates the potential interaction of M. oleifera phytochemical compounds against DNA gyrase of Salmonella typhi using an in silico molecular docking approach. Ligand’s phytochemicals were retrieved from the PubChem database, while the three-dimensional structure of DNA Gyrase subunit A and subunit B were obtained from the Protein Data Bank (PDB ID: 5ZJT and 6J90). Molecular docking was done using PyRx software and BIOVIA Discovery Studio as visualization software. Phytochemical compounds that had higher predictive binding affinity to DNA gyrase subunit A were Naringenin (∆G=-7.9 kcal/mol), 6-Prenylnaringenin (∆G=-8.1 kcal/mol), 6-Methoxypodophyllotoxin (∆G=-7.9 kcal/mol). Brefeldin A- DNA gyrase subunit A complex had the same binding affinity to ciprofloxacin (∆G=-7.7 kcal/mol). Phytochemical compounds that had higher predictive binding affinity to DNA gyrase subunit B were Naringenin (∆G=-8.9 kcal/mol), 6-Prenylnaringenin (∆G=-8.8 kcal/mol), 3',4'-Dimethoxy-7-hydroxyflavone (∆G=-8.6 kcal/mol), Sinapoyl malate (∆G=-7.8 kcal/mol), and Sinapoyl malate-4'-methyl ester (∆G=-8.3 kcal/mol). These findings suggest that phytochemical compounds from M. oleifera leaves may act as potential DNA gyrase inhibitors. However, further in vitro and in vivo validation is required to confirm its antibacterial activity.
The Relationship Between Stress Levels and Disease Perception in DM-TB Comorbid Patients in Gorontalo City
Diabetes mellitus (DM) and tuberculosis (TB) are chronic diseases that remain major public health problems and frequently occur concurrently as DM–TB comorbidity. This condition not only worsens patients’ physical status but also affects psychological aspects, particularly stress levels and illness perception. Patients living with two chronic diseases simultaneously tend to experience stress due to long-term treatment burdens, complications, and demands for therapeutic adherence. High stress levels may influence how patients perceive their illness, reduce motivation, and shape negative illness perceptions, which can ultimately hinder optimal disease management. This study aims to analyze the relationship between stress level and illness perception among patients with DM–TB comorbidity in Gorontalo City. This study employed a quantitative, cross-sectional design. The sample consisted of patients with DM–TB comorbidity undergoing treatment at several community health centers in Gorontalo City. Stress level was measured using the Perceived Stress Scale (PSS), while illness perception was assessed using the Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using statistical tests to determine the relationship between stress level and illness perception. The results showed that most patients experienced moderate to high stress levels and tended to have negative illness perceptions. Statistical analysis indicated a significant relationship between stress level and illness perception among patients with DM–TB comorbidity. The higher the patients’ stress levels, the more negative their perception of the illness. It can be concluded that psychological aspects play an essential role in the management of patients with DM–TB comorbidity; therefore, health interventions should integrate clinical and psychosocial approaches to improve treatment adherence and patients' quality of life.
Effect of Level 1 Progressive Mobilization Therapy on Oxygen Saturation in Patients Diagnosed with Respiratory Failure in ICU of Prof. Dr. H. Aloei Saboe Hospital, Gorontalo City
Level 1 progressive mobilization therapy is a non-pharmacological therapy using a complementary approach that can affect oxygen saturation. The purpose of this study was to determine the effect of level 1 progressive mobilization therapy on oxygen saturation in patients diagnosed with respiratory failure in the ICU of Prof. Dr. H. Aloei Saboe Regional Hospital, Gorontalo City. This study is a quantitative study with a quasi-experimental design using a one-group pre-post test design approach . which only involved one treatment group, namely the group of patients diagnosed with respiratory failure who were given level 1 progressive mobilization therapy intervention. The study population was 51 patients with an accidental sampling technique with a sample size of 45 patients. This research instrument used the SOP for level 1 progressive mobilization and an oxygen saturation observation sheet. Data analysis used the Wilcoxont-test. The results of the study obtained a p-value of 0.000 (α <0.05) meaning that there was an effect of level 1 progressive mobilization therapy on oxygen saturation in patients with respiratory failure at Prof. Dr. H. Aloei Saboe Regional Hospital, Gorontalo City. Level 1 progressive mobilization plays a crucial role in improving respiratory function, accelerating recovery, and maintaining the body's overall physiological balance. This research is expected to serve as a reference for providing nursing care, particularly level 1 progressive mobilization exercises for patients diagnosed with respiratory failure, as an effort to prevent decreased oxygen saturation.
Molecular Mechanisms and Clinical Effects of Medicinal Plants in Modulating Oxidative Stress: A Systematic Review from Athletic Performance to Vital Organ Protection
Oxidative stress constitutes a major pathophysiological mechanism in conditions ranging from exercise-induced muscle fatigue to chronic organ damage including diabetic nephropathy and ischemic stroke. Medicinal plants offer therapeutic potential through bioactive compounds that modulate cellular defense pathways. This systematic review evaluated the molecular mechanisms and clinical efficacy of medicinal plants (Kaempferia galanga, Nigella sativa, Panax ginseng, and other herbal formulations) in managing oxidative stress across diverse health contexts. A comprehensive literature search was conducted using reputable databases. Studies measuring oxidative stress biomarkers (MDA, SOD) and cellular signaling pathways (Nrf2, NF-κB, PI3K/AKT) were included. Results showed that N. sativa and K. galanga supplementation in athletes significantly reduced MDA levels and inflammatory cytokines (IL-6), accelerating post-exercise recovery. Bioactive compounds including Ginsenoside Ro and Kaempferide demonstrated organ-protective effects through Nrf2/HO-1 activation, autophagy promotion, and mitochondrial protection in ocular and renal tissues. These findings indicate that medicinal plants exert cytoprotective effects by activating endogenous antioxidant systems. The therapeutic spectrum spanning athletic performance enhancement to chronic organ protection underscores the translational potential of herbal interventions as promising antioxidant agents.
Description of Uremic Pruritus in Chronic Kidney Failure Patients Undergoing Hemodialysis at Prof. Dr. Aloei Saboe Regional General Hospital
Chronic kidney disease (CKD) is a global health problem with a steadily increasing prevalence, particularly among patients undergoing hemodialysis. One of the most frequently reported complaints is uremic pruritus, defined as a chronic itching sensation that significantly affects patients' quality of life. This study aimed to describe the characteristics of uremic pruritus in patients with chronic kidney disease undergoing hemodialysis at RSUD (Regional General Hospital) Prof. Dr. Aloei Saboe, Gorontalo City. This study employed a descriptive quantitative design using a total sampling technique involving 42 CKD patients undergoing hemodialysis who presented with uremic pruritus. Data were collected using a demographic questionnaire and the 5D Itch Scale instrument. The results showed that 3 respondents (7%) experienced mild pruritus, 24 respondents (57%) experienced moderate pruritus, and 15 respondents (36%) experienced severe pruritus. The findings indicate that uremic pruritus remains a predominant clinical problem among CKD patients undergoing hemodialysis. Consequently, increased attention to assessment and management is necessary to improve patients' quality of life
Association Between Lumbar Vertebral MRI Findings and Neuropathic Pain in Patients With Low Back Pain at Prof. Dr. Margono Soekarjo General Hospital
Background: Low back pain (LBP) is a common musculoskeletal condition that may be accompanied by neuropathic pain due to irritation or compression of lumbar neural structures, often associated with structural abnormalities detected on MRI. Objective: This study aimed to assess the association between lumbar MRI findings and neuropathic pain in patients with LBP at Prof. Dr. Margono Soekarjo General Hospital. Methods: An analytical observational study with a cross-sectional design was conducted involving 68 patients, using lumbar MRI data and neuropathic pain screening with the ID Pain questionnaire. Associations were analyzed using Chi-square tests and multivariate logistic regression with a significance level of p < 0.05. Results: The most frequent MRI findings are herniated nucleus pulposus (85.3%), spinal stenosis (57.4%), spondylosis (38.2%), and spondylolisthesis (19.1%), while neuropathic pain is identified in 66.2% of patients. Significant associations are observed between neuropathic pain and all MRI findings, with lumbar spinal stenosis identified as the strongest predictor. Conclusion: Lumbar MRI abnormalities are significantly associated with neuropathic pain in patients with LBP, and spinal stenosis represents the most influential factor, emphasizing the importance of radiological evaluation in the management of LBP with neuropathic components.
Expectative Management of a Late-Diagnosis Twin Reversed Arterial Perfusion Sequences (TRAPS) - A Rare Case Report
Twin Reversed Arterial Perfusion Sequence (TRAPS) is a rare and severe complication unique to monochorionic twin pregnancies, characterized by retrograde perfusion of a nonviable acardiac twin by a structurally normal pump twin. Management of TRAPS diagnosed in late gestation remains controversial due to limited interventional options and an unpredictable clinical course. While early fetal intervention is generally recommended, evidence supporting expectant management in late-diagnosed cases, particularly in resource-limited settings, remains scarce. We report a 31-year-old gravida 2, para 1 woman with a monochorionic diamniotic twin pregnancy complicated by TRAPS, who was referred to a maternal–fetal medicine clinic at 29–30 weeks of gestation. Given stable pump twin hemodynamics, late gestational age, and unavailability of fetal therapy, expectant management with intensive ultrasound surveillance was pursued. At 32 weeks, signs of evolving cardiac compromise prompted delivery by cesarean section. The pump twin survived with prematurity-related complications and was discharged in stable condition. This case highlights that expectant management may be a reasonable option in carefully selected late-diagnosed TRAPS cases when fetal therapy is unavailable, provided that close surveillance and timely delivery are ensured.
Indicators of Mothers’ Knowledge Regarding Completeness of Basic Imunization for Children Aged 0-24 Months in Kota Tengah Public Health Centre, Gorontalo
Immunization is a crucial preventive measure to protect children from infectious diseases. A significant decline in coverage is often influenced by the role of mothers as the primary decision-makers in children's health.This study aimed to describe maternal knowledge indicators and their relationship with the completeness of basic immunization for children aged 0-24 months. Utilizing a quantitative design with a cross-sectional approach, the study was conducted on 42 respondents in the Kota Tengah Public Health Center work area, selected through accidental sampling. Data were collected using knowledge questionnaires and Maternal and Child Health (MCH) books, and then analyzed descriptively and using the Chi-square test. The results show that while the majority of mothers understand the definition of immunization, approximately one-third of respondents still have misconceptions regarding the types, benefits, and schedules of vaccinations. Statistical tests reveal a significant relationship between the level of maternal knowledge and immunization completeness (p=0.001), where mothers with better knowledge tend to be more compliant in completing their children's immunization status. In conclusion, maternal knowledge is a vital determinant in the success of immunization programs. More comprehensive health education strategies and continuous guidance for parents are highly necessary to raise awareness and ensure optimal child health protection at the public health center level.
The Relationship Between Peer Group Support and Snack Choosing Behavior Among School-Aged Children at Limboto 1 Public Elementary School
School-age children, aged 6 to 12, are at a crucial developmental stage, where school experiences are a key aspect of their lives. Children's snack selection behavior is influenced by two factors: personal factors such as knowledge and habits, and environmental factors such as the role of family, peers (peer group), and school conditions. Peer group support is a form of social support provided by individuals within friendships to help and strengthen each other. This study aims to determine the relationship between peer group support and snack choice behavior among school-aged children at Limboto 1 Public Elementary School. This study used probability sampling, a technique that provides an equal opportunity for each member of the population to be selected as a sample. The method used in this study was proportionate stratified random sampling, a sampling technique used when the population has non-homogeneous members and is divided into strata with varying numbers. The results above indicate a relationship between peer group support and snack choice behavior among school-aged children. This was confirmed by statistical testing using Chi Square, which yielded a p-value of 0.009 <α = 0.05.
The Role of Rumination in University Students’ Mental Health: A Mediation Analysis of Depression and Anxiety
This study examined the relationship between rumination and mental health among university students by testing the mediating roles of depression and anxiety. Rumination refers to a repetitive and passive focus on negative experiences and emotions that may influence psychological functioning. A quantitative correlational design was employed. A total of 113 students completed the Ruminative Response Scale (RRS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ-12). Parallel mediation analysis indicated that rumination significantly predicted depression (β = .6197, p < .001) and anxiety (β = .5830, p < .001). Depression significantly predicted mental health (β = .2893, p = .025), whereas anxiety was not a significant predictor (β = .1186, p = .343). The direct effect of rumination on mental health was not significant (β = −.0940, p = .427), nor was the total effect (β = .1544, p = .098). However, the indirect effect through depression was significant (β = .1793, p = .031; 95% CI [.00464, .0957]), whereas the indirect path through anxiety was not significant (β = .0692, p = .347). These findings indicate that depression fully mediates the relationship between rumination and mental health. Thus, the influence of rumination on students’ mental health primarily operates through increased depressive symptoms.