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 Diabetic Gymnastics on Blood Glucose Levels in Diabetes Mellitus Patients at Patilanggio Public Health Center
Diabetes is a chronic metabolic disease that, if not managed properly, will increase the occurrence of complications. The risk of disease complications can be exacerbated by the non-compliance of DM patients in controlling blood sugar, so intervention is needed in controlling blood sugar in the form of diabetic gymnastics intervention. This research used a quantitative design with the Quasi Experiment method including a Pretest-Posttest Control Group design. The population was all people suffering from type II DM without complications, and the sampling technique used was the Simple Random Sampling technique with a total of 59 samples. The instrument consisted of the questionnaire and paired t-test, obtained a value of 0.043 (<0.05) in the intervention group, which means that there is an effect of diabetic gymnastics on reducing blood sugar levels during diabetes mellitus patients in the work area of the UPTD Puskesmas Patilanggio Subdistrict, Puhuwato Regency, and 0.161 (>0.05) in the control group which means there is no effect of it. Puskesmas can use this research in preventive efforts through diabetic gymnastics and as a source of information for patients to maintain diabetes control.
Relationship Between Results of The Gajah Mada Stroke Algorithm Assessment and Type of Stroke Based On Non Contrast Head CT-Scan Results at Wijayakusuma Purwokerto Hospital
Background: Stroke is a neurological deficit condition that often results in serious consequences dan requires rapid dan accurate diagnosis. Objective: This study aims to determine the relationship between the results of the Gajah Mada Stroke Algorithm assessment dan the type of stroke detected through non-contrast head CT scans at RST Wijayakusuma Purwokerto. Methodology: The research employed an observational approach, collecting data from 32 patients presenting with acute stroke symptoms from June to July 2024. Data were gathered through patient anamnesis, physical examinations, dan non-contrast head CT-scan results. Results: The findings indicate that ischemic stroke is the most prevalent type, accounting for 84.4% of cases based on non-contrast head CT scans. The Gajah Mada Stroke Algorithm also identified the majority of cases as ischemic stroke, with 59.4% of cases. Bivariate analysis using Fisher's Exact Test revealed a p-value of 0.006, demonstrating a significant relationship between the Gajah Mada Stroke Algorithm assessment dan CT-scan results. Conclusion: The Gajah Mada Stroke Algorithm has proven effeCTive in distinguishing between types of stroke. This study supports the use of the algorithm as a clinical diagnostic tool in stroke management.
Antioxidant and Anti-Inflammatory Activities of Kecombrang (Etlingera elatior) Extracts: A Systematic Literature Review
Kecombrang (Etlingera elatior) is a plant commonly used in traditional medicine and as a food seasoning by the Indonesian community. It contains various secondary metabolites such as saponins, tannins, alkaloids, steroids, flavonoids, and phenolic compounds, which are distributed from its rhizomes to its flowers. This literature review aims to provide a deeper understanding of the active compounds in kecombrang and their potential health benefits for humans. The study was conducted as a literature review using the PRISMA method, with data sources from four major databases: ScienceDirect, PubMed, Scopus, and Google Scholar. Findings from several studies involving rats as test subjects indicate that the active compounds in kecombrang exhibit antioxidant effects that protect cells from oxidative damage. Additionally, kecombrang extract demonstrates anti-inflammatory activity by directly inhibiting the enzymes COX and lipoxygenase, thereby reducing the biosynthesis of prostaglandins and leukotrienes.
Mothers’ Knowledge on Motor Development Stimulation in Toddlers at Puskesmas Kota Utara
Toddler age is considered part of the golden age, a crucial period for achieving optimal intellectual growth and development. During this stage, the rate of physical growth begins to slow, while motor development progresses significantly. Parental knowledge regarding developmental stimulation can influence the effectiveness of such stimulation. The purpose of this study was to describe mothers’ knowledge of motor development stimulation in toddler-aged children within the working area of Puskesmas Kota Utara. This research employed a quantitative method with a descriptive research design. The study population consisted of mothers with toddler-aged children. A total of 115 respondents were selected using a total sampling technique. The results showed that 73 respondents (63.5%) had a low level of knowledge, while 42 respondents (36.5%) demonstrated a good level of knowledge regarding motor development stimulation. It can be concluded that most mothers had limited knowledge, indicating the need for health professionals at the Public Health Center to provide health promotion interventions through educational activities aimed at improving maternal understanding of motor development stimulation.
Carpal Tunnel Syndrome Risk: Impact of Work Duration on Farmers
Farmers, as an informal work group, are at high risk of occupational diseases, including Carpal Tunnel Syndrome (CTS). This study analyzes the relationship between work duration and suspected CTS incidence among farmers in Linggasari Village, Kembaran District, Banyumas Regency.An observational study was conducted on 72 farmers using interview methods, physical examinations, and CTS provocation tests. Data were analyzed bivariately using Chi-Square statistical testing. Of 72 respondents, 26 (36.11%) were suspected of having CTS, with 16 (61.54%) having work duration exceeding 52,320 hours. Among 46 respondents not suspected of CTS, 13 (28.26%) had work duration less than 52,230 hours. Statistical analysis revealed a p-value of 0.006 (p < 0.05), indicating a significant relationship between work duration and suspected CTS incidence. A statistically significant correlation exists between work duration and suspected CTS among farmers.
Relationship Between History of Exclusive Breastfeeding and the Incidence of Stunting in Toddlers
Stunting is a condition in which the height or length of a toddler is lower than it should be based on age, which is caused by long-term malnutrition, especially in the first 1000 days of life (HPK). The purpose of this study was to determine the relationship between the history of exclusive breastfeeding and the incidence of stunting in toddlers. The researcher used the Purposive Sampling Technique. The samples in this study were mothers and toddlers aged 2-5 years who had been registered at the Tilango Health Center, Gorontalo Regency, totaling 92 samples. The results of the study using the Chi-square test obtained ap value of 0.038 (p <0.05), which showed that the variable history of exclusive breastfeeding had a significant relationship with the incidence of stunting in toddlers aged 2-5 years at the Tilango Health Center, Gorontalo Regency. The Health Center is expected to be able to carry out routine monitoring of children at risk of stunting, with special attention to exclusive breastfeeding.
Gender Differences in Scabies Risk Factors at Darul ‘Ulum Islamic Boarding School, Cilacap
Background: The global prevalence of scabies remains high, with approximately 300 million cases reported annually. Despite educational and behavioral interventions implemented in Islamic boarding schools, case reduction has been insignificant. Gender-related risk factors for scabies require further investigation. Objective: This study aimed to determine the differences in scabies risk factors between males and females at A.P.I Darul ‘Ulum Islamic Boarding School, Cilacap. Methods: An observational analytic study with a cross-sectional approach was conducted on 37 students selected through total sampling from February to March 2024. Data were collected using questionnaires and physical examinations and analyzed using Fisher's exact test. Results: Scabies was identified in 10.8% of the respondents (4 out of 37), all of whom were males. Most respondents exhibited poor personal hygiene (73.0%) and normal nutritional status (56.8%). Significant differences were found in scabies incidence based on gender (p=0.036), knowledge level (p<0.001), and nutritional status (p=0.003). However, personal hygiene did not show a significant correlation with scabies incidence (p=0.557). Male respondents with underweight nutritional status and low knowledge levels had a higher risk of scabies (40%). Conclusion: There were differences in scabies risk factors between males and females at A.P.I Darul ‘Ulum Islamic Boarding School, Cilacap.
The Effect of LEGO Play Therapy on Reducing Anxiety of Hospitalized Preeschool Children
Anxiety in children during hospitalization presents a significant barrier to effective care. When hospitalized, children often exhibit a range of distress behaviors such as aggression, crying, biting, and kicking. Children are individuals with unique thought patterns and environmental understandings. The familiar routines and parental presence at home are absent in the hospital setting, which poses a stark contrast especially for preschool-aged children. This study aimed to assess the impact of LEGO play therapy on reducing anxiety in preschool children hospitalized I the pediatric ward of RSUD Toto Kabila. This quantitative research employed a quasi-experimental design with a one-group pre-post test approach involving a single group of respondents receiving LEGO play therapy. The study included 33 respondents selected through accidental sampling, utilizing questionnaires as the research instrument. Statistical analysis was cocducted using the non-parametric Wilcoxon test. The findings revealed (p-value <0.05) 0.000, meaning LEGO play therapy reduces anxiety in preschool children during hospitalization, with LEGO play therapy as a non-pharmacological intervention to alleviate anxiety in hospitalized children. It is recommended that nursing practioners incorporate this therapy into pediatric care to help reduce anxiety associated with hospitalization.
Caught in the Crossfire: Doctors’ Battle with Emotional Strain and Resource Shortages (Lesson Learned from Covid-19 Pandemic)
Healthcare professionals, particularly doctors, navigate a delicate balance between empathy and emotional resilience, a challenge that became more pronounced during the COVID-19 pandemic. This study explores the experiences of doctors in managing empathy while coping with burnout, compassion fatigue, and resource scarcity. Through in-depth interviews with general practitioners and specialists, four key themes emerged: the emotional impact of patient conditions on doctors, the heightened burnout caused by excessive workloads, the distress of resource shortages, and the struggle to maintain professionalism despite emotional strain. Findings highlight the dual nature of empathy—while essential for patient care, it also contributes to emotional exhaustion. The study underscores the urgent need for systemic support, including psychological interventions and institutional strategies, to sustain healthcare professionals' well-being and ensure compassionate yet sustainable medical practice.
Comparative Antibacterial Effects of Honey Bee Propolis on Gram Negative Bacteria Escherichia coli and Gram Positive Bacteria Staphylococcus aureus
Antimicrobial resistance in pathogens such as Escherichia coli and Staphylococcus aureus poses an urgent global health challenge. Honeybee propolis is known for its promising antibacterial potential.This study aimed to compare the antibacterial effectiveness of propolis against E. coli (Gram-negative) and S. aureus (Gram-positive) using the in vitro disk diffusion method. Propolis was tested at concentrations of 6.25%, 12.5%, 25%, 50%, and 100% against both bacterial species. Disk diffusion assays were conducted on Mueller Hinton Agar, and inhibition zones were measured using a vernier caliper. Data were analyzed using one-way ANOVA. The results showed the Inhibition zone diameters increased with higher propolis concentrations. At 100% concentration, S. aureus showed a 15 mm inhibition zone, while E. coli showed only 7 mm. One-way ANOVA indicated significant differences (p < 0.05) in both bacteria. These findings indicate that propolis exhibits antibacterial activity against both S. aureus and E. coli, with greater effectiveness against Gram-positive S. aureus. These findings support the potential use of propolis as a natural antibacterial agent, particularly for Gram-positive infections.
The Relationship of Knowledge of Prepuberty Adolescent Girls and Readiness for Menarche
Menarche is the first menstruation which usually occurs between the ages of ten and sixteen years or at the beginning of adolescence in the middle of puberty before entering the reproductive period. The aim of this research was to determine the relationship between prepubertal adolescent girls' knowledge and readiness to face menarche at SDN 7 Tabongo, Gorontalo Regency. The research method uses quantitative research using an analytical research design with a crosssectional approach. The population in this study were all prepubertal teenage girls in grades IV, V, and VI at SDN 7 Tabongo, Gorontalo Regency who had not experienced menstruation. Sampling in this research used a total sampling technique. The number of samples used was 41 samples. The results of the research using the chi-square test obtained a p-value of 0.000 (<0.05), meaning that there is a relationship between knowledge and readiness for menarche in young women at SDN 7 Tabongo, Gorontalo Regency. Where good knowledge can certainly increase readiness in facing menarche. It is hoped that this research can provide input for nurse practitioners in providing education about readiness for menarche.
Mitral and Tricuspid Valve Regurgitation as a Subclinical Manifestation of Rheumatic Heart Disease: A Pediatric Case Report
Background: Rheumatic heart disease (RHD) accounts for approximately 15.6 million cases globally, with 282,000 new cases and 471,000 episodes of acute rheumatic fever (ARF) annually, predominantly affecting children aged 5–15 years in the Pacific region. In 2015, the incidence in Indonesia reached 1.18 million cases, mostly among children and young adults. RHD results from valvular damage due to an autoimmune inflammatory response to Group A Streptococcus (GAS) infection. It primarily affects the mitral valve (75%), aortic valve (25%), and rarely the tricuspid valve. ARF typically precedes RHD, marked by valvular abnormalities. Initial symptoms include sore throat, progressing in 2–4 weeks to fever and clinical signs such as polyarthralgia, polyarthritis, chorea, and erythema marginatum. Complications may include infective endocarditis, heart failure, stroke, and atrial fibrillation. The World Heart Federation recommends prophylactic administration of Benzathine benzylpenicillin G (BPG) every 3–4 weeks to prevent recurrent streptococcal infections. Case Report: An 8-year-old boy presented with left-sided chest pain described as pressure-like and non-radiating, along with fatigue, nausea, and joint pain for four days. He had a history of recurrent pharyngitis beginning a year earlier. A positive Anti-Streptolysin O (ASTO) test was previously recorded. Due to persistent joint pain and chest discomfort, the patient was referred to a tertiary hospital and hospitalized for four days. Physical examination showed a body weight of 20.5 kg, height 119 cm, with no murmur or tachycardia, but arthritis and erythema marginatum were observed. Laboratory findings indicated leukocytosis (14,110/mm³), and echocardiography revealed mild mitral and tricuspid regurgitation consistent with RHD. He was treated with intramuscular BPG (600,000 IU) and oral aspirin. The patient continues monthly outpatient follow-ups for BPG injections. Conclusion: RHD remains a significant contributor to childhood morbidity and mortality. This case highlights an atypical subclinical presentation without murmur, identified through echocardiography showing dual mild valvular insufficiency. Treatment included BPG and aspirin.
Effectiveness of Atraumatic Tooth Extraction in Minimizing Trauma and Pain: A Case Report
Background: The atraumatic tooth extraction technique aims to minimize tissue trauma and pain, thereby promoting optimal healing and supporting the success of future prosthetic rehabilitation. Objective: This case report aims to describe the application of atraumatic tooth extraction techniques in various tooth extraction indications and to evaluate their clinical outcomes. Methods: The technique was applied to four patients with different extraction indications. The procedure was performed using optimal anesthesia, specialized instruments such as luxating elevators and atraumatic forceps, as well as root sectioning when necessary. Results: All patients reported minimal pain during and after the procedure, requiring only a single dose of mild analgesics. Soft tissue healing occurred more rapidly than with conventional extractions, with one-week evaluations showing that the wounds were almost completely closed. No significant complications were observed, except for one case of mild emphysema, which resolved within five days. Conclusion: Atraumatic tooth extraction techniques are effective in reducing tissue trauma, accelerating healing, and preserving the supporting tooth structures. This technique can be recommended as the primary choice for various extraction cases, particularly for patients scheduled for prosthetic rehabilitation or implant placement.
The Correlation Between Physical Activity Levels With Salivary Cortisol Levels on Medical Students, at Jenderal Soedirman University
Medical students generally have low levels of physical activity. Medical students also experience more severe stressors than students in other study programs. Salivary cortisol levels can reflect a person's stress level. This study aims to determine the correlation between physical activity levels and salivary cortisol levels in medical students at Jenderal Soedirman University. This study was conducted on 50 medical students at Jenderal Soedirman University aged 18–25 years. The study subjects were selected using purposive sampling. Physical activity levels were measured using the International Physical Activity Questionnaire-Long Form (IPAQ-LF), and saliva cortisol levels were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The correlation test used was Pearson's correlation test with a significance level of p<0.05. The results showed that the average physical activity level and saliva cortisol levels of the respondents were 1334.31±552.10 MET-minutes/week and 9.76±2.97 ng/mL. Bivariate analysis showed a p-value of 0.507, indicating that there was no correlation between physical activity levels and saliva cortisol levels among medical students at Jenderal Soedirman University.
The Effectiveness of FAST Method Education in Early Stroke Detection Efforts for Hypertensive Patients at Pa’betengang Community Health Center, Bantaeng
Stroke is a major complication of hypertension that leads to disability and death; however, knowledge among hypertensive patients regarding the early signs of stroke remains low. This study aimed to evaluate the effectiveness of the FAST (Face, Arm, Speech, Time) educational method in improving early stroke detection skills among hypertensive patients. A one-group pre-experimental pre-post design was used involving 60 hypertensive patients at the Pa’betengang Community Health Center, Bantaeng Regency. The education was delivered in two sessions using visual media and interactive simulations. Knowledge was measured using a questionnaire administered before and after the intervention. The results showed an increase in the average knowledge score from 10.63 (SD ±2.85) to 17.18 (SD ±1.96) after the intervention, with a statistically significant difference (p < 0.001). The FAST method of education was proven effective in enhancing early stroke detection abilities among hypertensive patients. This intervention is recommended as an educational strategy in promotive programs within primary healthcare services.
PCI Revascularization Strategies in Patients with Acute Myocardial Infarction and Multivessel Disease
Background: The incidence of Acute Myocardial Infarction (AMI) accompanied by Multivessel Disease (MVD) has increased annually, necessitating appropriate revascularization strategies to minimize clinical risks. Objective: This study aimed to evaluate various revascularization strategies using Percutaneous Coronary Intervention (PCI) that can be applied in patients with AMI and MVD. Methods: A systematic review was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method. The keywords used were (“Revascularization" AND "Multivessel Disease" AND "Acute Coronary Syndrome”) OR (“Revascularization" AND "Multivessel Disease" AND "Acute Myocardial Infarction”). Articles were collected based on inclusion criteria: original articles, published in English, and published between 2020 and 2025. Results: A total of 1,263 articles were found in the initial search. Of these, 169 were excluded due to duplication, 1,069 due to irrelevant PICO criteria, and 6 due to limited access. From the remaining 19 articles, it was found that revascularization strategies could be classified based on the number of vessels treated (culprit-only, incomplete, and complete revascularization) and the timing of the intervention (immediate and staged revascularization). Conclusion: No single strategy was superior in all contexts. The choice of revascularization strategy should be individualized based on each patient’s clinical status and coronary anatomy to optimize outcomes.
Iron Given, Iron Denied: Neonatal Hematologic Alterations in Obese Pregnancies Despite Universal Supplementation
Background: Maternal obesity, a pro-inflammatory state now highly prevalent among women of reproductive age in Indonesia, may undermine the effectiveness of antenatal iron supplementation. Neonatal iron deficiency remains a public health concern, with maternal inflammation potentially disrupting fetal iron transfer. Objective: To investigate the association between maternal third-trimester Body Mass Index (BMI) and neonatal hematologic and iron parameters, within the context of standardized antenatal iron supplementation. Methods: This hospital-based cross-sectional study in Central Java, Indonesia, enrolled 84 full-term neonates whose mothers received iron supplementation. Subjects were stratified by maternal BMI into non-obese (<25 kg/m²) and obese (≥25 kg/m²) groups. Cord blood was analyzed for hematologic indices (hemoglobin, Mean Corpuscular Volume [MCV], Mentzer Index) and iron biomarkers (ferritin and hepcidin). Results: Neonates from obese pregnancies exhibited significantly higher MCV (103.4 ± 5.1 fL vs. 100.1 ± 4.9 fL, p=0.004) and Mentzer Index (21.8 ± 4.7 vs. 21.3 ± 2.9, p=0.040) compared to the non-obese group. These findings suggest macrocytic shifts and possible ineffective erythropoiesis. No significant differences were observed in hemoglobin, ferritin, or hepcidin levels between groups. Conclusion: Maternal obesity during late pregnancy is associated with altered neonatal hematologic profiles, despite standardized iron supplementation. These results underscore a potential inflammation-mediated disruption in placental iron transfer and erythropoiesis, reinforcing the need for tailored antenatal strategies that incorporate maternal metabolic screening and functional hematologic monitoring for atrisk infants.
Mortality Analysis in Neonates with Gastroschisis: A Retrospective Study at Dr. Sardjito General Hospital, Yogyakarta (2007–2012)
Background: Gastroschisis is a congenital abdominal wall defect that poses a significant risk of morbidity and mortality in neonates, particularly in low- and middle-income settings. Despite advances in neonatal care and surgical techniques, survival outcomes remain variable and influenced by multiple clinical factors. Objective: To analyze the clinical and laboratory factors associated with mortality among neonates with gastroschisis treated at Dr. Sardjito General Hospital, Yogyakarta, Indonesia, between 2007 and 2012. Methods: This was a retrospective observational study involving 35 neonates diagnosed with gastroschisis. Data were collected from medical records, including birth weight, gestational age, timing of surgery, hemoglobin and platelet levels, albumin status, bowel necrosis, sepsis status, and anatomical characteristics of the abdominal wall defect. Univariate and multivariate logistic regression analyses were performed to identify significant predictors of mortality. Results: The overall mortality rate was high. Sepsis was found to be the only independent predictor of mortality (p = 0.037; OR 14.29; 95% CI: 1.179–173.261). Other factors significantly associated with mortality in univariate analysis included low birth weight (p = 0.043), small defect-to-bowel disproportion (p = 0.020), and postoperative hemoglobin <13 g/dL (p = 0.019). Postoperative thrombocytopenia and bowel necrosis showed a strong trend toward higher mortality but did not reach statistical significance. Gestational age, albumin levels, and timing of surgery were not significantly associated with mortality. Conclusion: Sepsis remains the most critical factor associated with mortality in neonates with gastroschisis. Early infection control, optimal perioperative hematologic management, and timely surgical intervention are essential to improve survival outcomes. These findings highlight the need for standardized protocols and further prospective studies to reduce mortality in this vulnerable population.
Histopathology of Rat (Rattus norvegicus) Lungs in Several Drowning Condition in Freshwater
Background: Drowning remains a significant cause of mortality, with complex pathophysiological mechanisms that are often challenging to diagnose. Histopathological examination of the lung is one of the tests that supports the diagnosis of the cause of death and manner of death in drowning cases. Objective: This study aims to analyze the histopathological features of rat lungs drowned in freshwater under conscious, unconscious, and post-mortem conditions. Methods: A descriptive experimental study by dividing the rats into three conditions; conscious, unconscious and post-mortem drowning. The lung tissues collected from the drowned rats, processed, stained with hematoxylin eosin and observed under the microscope. The results stated in descriptive form and scores. Results: In Group 1, alveolar edema (score 2), hemorrhage (score 4), inflammatory cell infiltration (score 2.2), and alveolar thickening (score 2.4) were observed. Group 2 exhibited a similar histopathological pattern to Group 1. Group 3 showed mild alveolar edema (score 1), massive hemorrhage (score 4), extensive inflammatory cell infiltration (score 4), and severe alveolar thickening (score 3). Conclusion: Histopathology of lung tissue of rats that drowned alive showed moderate alveolar edema, massive hemorrhage, moderate inflammatory cell infiltration and moderate alveolar thickening. Rats that drowned unconsciously showed moderate alveolar edema, massive hemorrhage, moderate inflammatory cell infiltration and moderate alveolar thickening. Rats that drowned after death showed minimal alveolar edema, massive hemorrhage, massive inflammatory cell infiltration and severe alveolar thickening.
Evaluation of Medication Planning Management Using ABC-VEN Analysis at Hospital X Purwokerto
Background: Pharmaceutical expenditures represent a significant portion of hospital budgets, underscoring the need for efficient inventory management to ensure medicine availability and avoid financial losses. Objective: This study aimed to evaluate the medication planning and procurement process at Hospital X using the ABC-VEN matrix to classify drugs by cost and clinical importance. Methods: A retrospective, descriptive study was conducted using procurement and planning records from January to December 2024. Results: ABC analysis revealed that 10.9% of drugs (category A) accounted for 70.13% of total spending, while 21.8% (category B) contributed 20.15%, and 67.18% (category C) represented only 9.72%. VEN classification identified 15.6% of drugs as vital, 74.22% as essential, and 10.16% as non-essential. The integrated ABC-VEN analysis categorized 20 items as Priority (P), 95 as Main (U), and 13 as Supplementary (T). Conclusion: The ABC-VEN approach effectively identified priority medicines, enhanced planning efficiency, and supported rational resource utilization in hospital pharmaceutical management.
Biopotency of Ethanol Extract of Rasamala (Altingia excelsa) Leaves as a Botanical Insecticide Against Aedes aegypti Mosquitoes
Aedes aegypti is the primary vector of dengue hemorrhagic fever (DHF), which remains a major public health concern in Indonesia. Continuous use of synthetic insecticides has led to the emergence of resistance and adverse environmental impacts. This study aimed to evaluate the biopotential of ethanol extract from Altingia excelsa (rasamala) leaves as a botanical insecticide against Aedes aegypti mosquitoes. The experiment was conducted by exposing female Aedes aegypti mosquitoes aged 3–5 days to vapor from rasamala leaf extract at threeconcentrations (25%, 50%, and 75%) using an electric liquid vaporizer device. Mortality percentages were recorded at 8, 16, and 24 hours and subsequently analyzed using statistical and probit methods. The results demonstrated that rasamala leaf extract possesses insecticidal activity. However, the LC₅₀ value of 182% indicated low efficacy, as it exceeded the highest concentration tested. Moreover, the LT₅₀ value could not be reliably determined within the observed time frame. These findings suggest that while Altingia excelsa extract exhibits insecticidal potential, further optimization of its formulation or an increase in concentration is required to achieve greater effectiveness.
The Effect of Positive Affirmations on Children's Anxiety Levels during Hospitalization at RSUD Dr. M.M. Dunda Limboto
Anxiety is a response to unpleasant situations and is commonly experienced daily, particularly by children. One approach to addressing anxiety is through the use of positive affirmations. This study aims to analyze the effect of positive affirmations on children's anxiety levels during hospitalization at RSUD Dr. M.M. Dunda Limboto. This quantitative study utilized a quasi-experimental design with a non-equivalent control group approach. The sampling technique employed was incidental sampling, with a population of 177 respondents and a sample size of 38 respondents, including 19 in the intervention group and 19 in the control group. The instruments used in this research were a Standard Operating Procedure (SOP) for positive affirmations and the Visual Analog Scale for Anxiety (VAS-A) observation sheet. Non-parametric Wilcoxon testing was used for data analysis within the same group. The p-value for the intervention group was 0.000, indicating a significant change in anxiety levels before and after receiving positive affirmation intervention. In contrast, the p-value for the control group was 0.157, indicating no significant change in anxiety levels before and after the intervention. For data analysis between the two unpaired groups, an independent t-test was conducted, yielding a p-value of 0.001, indicating a significant difference in anxiety levels between the intervention group (receiving affirmations) and the control group (without affirmations) during hospitalization at RSUD Dr. M.M. Dunda Limboto. The study concludes that positive affirmations significantly affect children's anxiety levels during hospitalization at RSUD Dr. M.M. Dunda Limboto. Therefore, this study may serve as valuable information and input for RSUD Dr. M.M. Dunda Limboto to enhance the quality of hospital services and incorporate positive affirmations as an effort to reduce the impact of hospitalization on pediatric patients.
Association Between Prematurity and Neonatal Sepsis: A Case–Control Study at a Tertiary Referral Hospital in Indonesia
Background: Neonatal sepsis remains a leading cause of morbidity and mortality in newborns, particularly among preterm infants whose immature organ systems and immune defenses increase their vulnerability to infection. Evidence on the association between prematurity and neonatal sepsis remains variable across settings, highlighting the need for context-specific research. Objective: To examine the association between prematurity and the occurrence of neonatal sepsis at a tertiary referral hospital in Indonesia. Methods: A hospital-based analytic observational study with an unmatched case–control design was conducted at Margono Soekarjo Regional Hospital, Central Java, Indonesia, from June to November 2024. Medical records of neonates admitted in 2023 were reviewed. Cases were neonates diagnosed with sepsis, while controls had no sepsis diagnosis. A total of 136 neonates were selected using simple random sampling, with 68 cases and 68 controls. Data were analyzed using Chi-square tests and odds ratios (OR) with 95% confidence intervals (CI). Results: Preterm birth was more frequent among cases (64.7%) compared to controls (32.4%). The majority of sepsis cases were moderate-to-late preterm (41.2%) and predominantly late-onset (86.8%). Bivariable analysis demonstrated a significant association between prematurity and neonatal sepsis (χ² = 14.248, p < 0.001), with an OR of 3.833 (95% CI: 1.883–7.805), indicating that preterm neonates had nearly four times higher risk of developing sepsis than term neonates. Conclusion: Prematurity is a significant risk factor for neonatal sepsis, particularly late-onset cases, in this tertiary care setting. These findings highlight the urgent need for targeted infection prevention strategies and enhanced clinical monitoring for preterm infants in neonatal intensive care units.
Effectiveness of Pneumococcal Conjugate Vaccine in Reducing Childhood Pneumonia: A Comprehensive Literature Review
Background: Pneumonia remains the leading cause of morbidity and mortality among children under five worldwide, with Streptococcus pneumoniae and Haemophilus influenzae identified as the most common etiological agents. The high disease burden, particularly in low- and middle-income countries, underscores the urgent need for effective prevention strategies. The Pneumococcal Conjugate Vaccine (PCV) has demonstrated substantial impact in reducing pneumonia incidence and invasive pneumococcal disease globally, and has been included in Indonesia’s national routine immunization program since 2022. Objective: This literature review aims to synthesize current evidence on the effectiveness of PCV in reducing childhood pneumonia morbidity and mortality, evaluate its safety profile, and discuss implications for immunization policy and program implementation in Indonesia and globally. Methods: A narrative literature review was conducted using data from peer-reviewed journals, WHO reports, and national health surveys published between 2010 and 2025. Databases searched included PubMed, Scopus, and Google Scholar, using keywords “pneumococcal conjugate vaccine,” “effectiveness,” “childhood pneumonia,” and “immunization program.” Studies meeting inclusion criteria—randomized controlled trials, cohort studies, case-control studies, and meta-analyses—were analyzed and synthesized. Results: Evidence from multiple countries, including the United States, France, Israel, South Africa, Argentina, and Indonesia, consistently demonstrates significant reductions in pneumonia hospitalizations, invasive pneumococcal disease incidence, and mortality among children following PCV introduction. PCV-13 and PCV-15 have shown broad serotype coverage and sustained impact. Co-administration of PCV with other routine vaccines has been proven safe, with no increase in adverse events following immunization (AEFI). Conclusion: PCV is an effective and safe intervention for reducing the burden of childhood pneumonia and invasive pneumococcal disease. Nationwide implementation in Indonesia has the potential to substantially decrease pneumonia-related mortality in children under five. Continuous surveillance, serotype monitoring, and program evaluation are essential to maximize vaccine benefits and inform future immunization policies.
Relationship Between Diabetes Distress and Self Management on Type 2 Diabetes Mellitus Patients in Sumbang District Banyumas
Background: Diabetes distress is a form of anxiety, worry, fear, and perceived threat related to the struggles experienced by individuals living with diabetes mellitus. The presence of diabetes distress is associated with reduced self-care (self-management). Diabetes mellitus self-management refers to a series of actions taken by individuals to manage their medical condition, including dietary regulation, physical activity management, regular and consistent intake of diabetes medication, blood glucose monitoring, and routine foot care. Objective: This study aims to determine the relationship between diabetes distress and self- management in patients with type 2 diabetes mellitus in Sumbang District, Banyumas. Method: This research uses an analytical observational study with a cross sectional approach. The sampling technique used was a total sampling of 55 people. Data analysis using the chi-square test. Research Results: The results of the research showed that self-management of type 2 DM patients was mostly in the sufficient category, namely 25 people (45.5%) and diabetes distress of type 2 DM patients is in the mild category, namely 35 people (63.6%). There is a relationship between diabetes distress and self-management in type 2 diabetes mellitus patients in Sumbang District, Banyumas (p = 0.000). Conclusion: Diabetes distress is related to self-management in type 2 diabetes mellitus patients.
Psoriasis Vulgaris Complicated by Secondary Tinea Pedis Infection: A Case Report
Background: The coexistence of psoriasis vulgaris and tinea pedis presents significant diagnostic challenges due to similar clinical presentations. Chronic topical corticosteroid therapy may predispose psoriatic patients to secondary fungal infections through local immunosuppression. Case report: A 34-year-old female presented with a one-year history of erythematous, scaly, thickened lesions on bilateral feet extending above ankles, knees, elbows, and inguinal areas. Initial psoriasis vulgaris diagnosis led to treatment with topical desoximetasone 0.25% twice daily and oral cetirizine once 10mg daily. While other body sites improved significantly, bilateral foot lesions showed minimal response. Skin biopsy revealed characteristic psoriatic features including parakeratosis, Munro microabscesses, and epidermal acanthosis. Lactophenol cotton blue staining demonstrated septate hyphae with conidia consistent with Trichophyton species, confirming concurrent tinea pedis. Treatment was modified to fluconazole 150 mg weekly, topical ketoconazole 2% twice daily, and temporary corticosteroid discontinuation, resulting in significant improvement of foot lesions after three weeks.Summary: This case demonstrates the importance of comprehensive diagnostic evaluation when standard psoriasis treatment fails where the differential treatment response across anatomical sites served as a crucial indicator for further investigation emphasizing systematic approaches incorporating histopathological and microbiological examinations..
Microrna Profile of Plasma Exosomes by Nanostrings in Early Onset Compared Late Onset Preeclampsia: Preliminary Study
Research on miRNA biomarkers in preeclampsia as part of screening, diagnosis, and prognosis has been widely conducted, but the results show contradictory results and vary based on the type of preeclampsia. This study aims to compare the profile of plasma exosome miRNA in early onset compared late onset as a preliminary study to identify the miRNA profile of preeclampsia patients in Indonesia. The study was conducted at Margono Hospital,Indonesia using plasma exosomes samples of three patients with early-onset preeclampsia and three patients with late-onset preeclampsia and processed with NanoStrings. KEGG was used to identify preeclampsia pathophysiological pathways by bioinformatic analysis of DIANA-miRPath v3.0 and microT-CDS v5.0. The results showed that the characteristics of parity, hemoglobin, systolic and diastolic blood pressure, proteinuria and BMI did not differ between EOPE and LOPE. Significantly different variables were the age of the EOPE (28 ± 5.29) vs LOPE (38.67 ± 2.06 mmHg), pregnancy weight gain (10.0 vs 15.33), and fetal weight in EOPE (1550 ± 132 g) vs LOPE (2693 ± 716 g). The results showed that the 24 miRNAs differed significantly. The three highest expression miRNAs in the EOPE group were miR-196b-5p, miR-190a-5p, and miR-515-3p. In contrast, the three lowest expression miRNAs are miR-3179, miR-181a-5p, and miR-15b-5p. Pathway analysis of the upregulated miRNA involved the ErbB signalling pathway, Proteoglycan in cancer, and Lysin degradation. Downregulated miRNA targets involved in the HIPPO signalling pathway, fatty acid biosynthesis, and TGF-β signalling pathway. Conclusions: The preliminary study results indicated significant differences in miRNA expression, suggesting that EOPE is influenced by aggressive cellular signaling and metabolic dysregulation, while LOPE is more linked to the disruption of growth-inhibiting pathways and fatty acid metabolism. These unique miRNAs establish a robust foundation for subsequent validation studies utilizing bigger samples as a prospective biomarker panel.
Platelet-to-Lymphocyte Ratio as a Prognostic Biomarker for Overall Survival in Glioma Patients: A Retrospective Cohort Study in Yogyakarta, Indonesia
Background: Glioma is the most common primary brain tumor in adults, with a generally poor prognosis despite advances in treatment. Inflammation plays a role in tumor initiation, progression, and invasion. The platelet-to-lymphocyte ratio (PLR) is a minimally invasive, cost-effective biomarker that may predict overall survival (OS) in glioma patients. Objective: This Study aims to evaluate the association between pre-treatment PLR and overall survival in patients with glioma. Methods: This retrospective cohort study included glioma patients treated at Dr. Sardjito General Hospital and affiliated hospitals in Yogyakarta between 2017–2022. PLR was calculated from pre-treatment complete blood counts. The optimal cut-off value was determined via ROC curve analysis. Kaplan–Meier survival analysis and Cox proportional hazards regression were performed to evaluate associations between PLR and OS, adjusting for age, sex, tumor grade, size, location, surgery type, and Karnofsky Performance Status (KPS). Results: A total of 149 patients were included (median age: 48 years; 57.7% male; 69.1% high-grade glioma). The optimal PLR cut-off was 236.77 (AUC = 0.591; sensitivity = 42.9%; specificity = 77.8%). Median OS was 14.1 months for PLR < 236.77 versus 5.8 months for PLR ≥ 236.77. High PLR was associated with increased mortality risk (HR = 2.18; 95% CI: 1.37–3.45).nConclusion: Elevated pre-treatment PLR is independently associated with shorter OS in glioma patients. PLR may serve as a simple, inexpensive prognostic biomarker in clinical practice, particularly in resource-limited settings.