International Journal of Health and Pharmaceutical (IJHP)
International Journal of Health and Pharmaceutical (IJHP) e- ISSN : 2808-845X is a communication media and scientific publication in the health and pharmaceutical fields published by Inara Publisher. International Journal of Health and Pharmaceutical (IJHP) contains articles from research focusing on basic medicine, clinical medicine, epidemiology, preventive medicine (social medicine), pharmacy, and other medical fields. International Journal of Health and Pharmaceutical (IJHP) is published periodically four times a year (February, May, August and November).
The Effect of Healing Touch-Dhikr Therapy on Quality Sleep of Patients With Diabetes Mellitus on The Work Area Kaliwungu Health Center
Poor sleep quality is a common problem in patients with diabetes mellitus which can negatively impact metabolic control and reduce the patient's quality of life. Therefore, this study is important to find alternative non-pharmacological therapies to improve the sleep quality of diabetic patients. The main purpose of this study is to determine the effect of healing touch-dhikr therapy on the sleep quality of patients with diabetes mellitus in the Kaliwungu Health Center Working Area. This study uses a quantitative method, namely quasi experimental with a pretest-posttest with control group design. The sample consisted of 78 respondents who were selected through purposive sampling and divided into two groups: the intervention group (n = 39) and the control group (n = 39). The healing touch-dhikr intervention was given for seven days with a duration of 15–30 minutes per session. The data collection instrument used the Pittsburgh Sleep Quality Index (PSQI). Data analysis was carried out by dependent t-test and independent t-test test. The results showed a significant decrease in PSQI scores in both groups (p<0.001). The average sleep quality score of the intervention group decreased from 11.92 to 6.00 (difference of 5.92), while in the control group it decreased from 12.10 to 10.05 (difference of 2.05). Although both showed significant changes, the larger decline in the intervention group showed that healing touch–dhikr therapy was more clinically and statistically effective in improving the sleep quality of patients with diabetes mellitus. This is supported by an independent t-test showing a significant difference between the two groups (p< 0.001), which indicates the effectiveness of the intervention. Thus, it can be concluded that healing touch-dhikr therapy has a significant and clinically effective effect in improving the quality of sleep in patients with diabetes mellitus. This research supports the application of spiritual-based non-pharmacological interventions in nursing practice as a holistic approach that pays attention to the physical, psychological, and spiritual aspects of patients.
Copyright (c) 2026 Anggi Dita Puspita, Sukarmin, Diana Tri Lestari https://creativecommons.org/licenses/by-nc/4.0
The Effect of Knowledge Level About Chronic Kidney Disease On Psychological Well-Being of Chronic Kidney Disease Patients
Background:Chronic kidney disease has emerged as a leading cause of death and suffering in the 21st century. Hemodialysis is the most common renal replacement therapy for patients with chronic kidney disease. Hemodialysis patients experience physical and psychological distress. The psychological effects include increasedFatigue, anxiety, decreased quality of life, and increased risk of suicide are some of the factors contributing to this. Self-acceptance in patients can lead to the development of a new purpose in life, known as psychological well-being. One of the major problems contributing to hemodialysis failure is patient refusal, which is linked to low knowledge. This study aims to analyze the influence of knowledge levels about chronic kidney disease on psychological well-being in patients with chronic kidney disease. Method:This quantitative, observational, and analytical research method utilized a cross-sectional design. A population of 103 patients with chronic kidney disease undergoing hemodialysis in October 2023 served as the study subjects. The sampling technique used was total sampling. The Spearman rank test was also used by the researchers. The research instruments used were a questionnaire on the level of knowledge regarding chronic kidney disease and a questionnaire on the psychological well-being scale theory from Ryf.Results:A total of 89 respondents met the inclusion criteria. The Spearman rank test yielded a p-value of 0.000 and a correlation strength of +0.737, indicating a strong positive effect of knowledge on the psychological well-being of chronic kidney disease sufferers.Conclusion:The better the level of knowledge regarding chronic kidney disease, the greater the impact on improving the psychological well-being of chronic kidney disease sufferers.
Copyright (c) 2026 Dina Nahdiana, Merry Tiyas Anggraini, Susilo Budi Pratama, Muslimah Muslimah https://creativecommons.org/licenses/by-nc/4.0
Analysis of Food Taboo and Food Belief Compliance in Anemic Pregnant Women at Tuntang Community Health Center
Background: Anemia in pregnancy is defined as a hemoglobin concentration ≤ 11.0 g/dL. Inadequate diet can be caused by a culture of food taboo and food belief, this causes pregnant women to be at high risk of experiencing anemia. Objective: The aim of this study was to analyze the compliance of anemic pregnant women with food taboos and food beliefs. Methods: This research uses qualitative methods with an ethnological design. This research design was carried out using in-depth interviews. There were 9 research informants, namely 5 pregnant women with anemia and 4 additional informants. Audio recordings were transcribed and analyzed using thematic analysis.Results: The level of compliance of anemic pregnant women at the Tuntang health center towards the culture of food taboo and food disbelief is high. They tend to comply with input regarding intake from the family. Pregnant women who still adhere to this culture admit that they have followed this culture since their first pregnancy. Foods they avoid include goat meat, eggs and papaya leaves. Medical personnel play a role in providing education to pregnant women through routine examinations, classes for pregnant women, and providing additional food. Knowledge of anemic pregnant women at the Tuntang health center is quite good. Conclussion: Food taboo and food belief attitudes and habits are still adhered to due to family influence. They often get nutritional information through advice from medical personnel.
Copyright (c) 2026 Nabila Fahmi Hidayat, Risky Ika Riani, Yanuarita Tursinawati, Muslimah Muslimah https://creativecommons.org/licenses/by-nc/4.0
Characteristics of Procalcitonin Values and Absolute Neutrophil-Lymphocyte Ratio in Pneumonia Sepsis Patients in the Intensive Care Unit of a Hospital H. Adam Malik
.Sepsis pneumonia ranks among leading causes of global mortality, particularly in ICU settings, yet local biomarker profiles remain underexplored in resource-limited contexts like Indonesia. This study aimed to characterize procalcitonin (PCT) and absolute neutrophil-lymphocyte ratio (NLR) in ICU sepsis pneumonia patients at RSUP H. Adam Malik Medan (2023). Employing an observational analytic cross-sectional design, total sampling captured 132 patients meeting Sepsis-3 criteria (qSOFA ≥2, SOFA ≥2, age ≥18 years) with complete PCT/NLR data. Secondary data from medical records were analyzed using SPSS 25 via univariate descriptives and Spearman bivariate tests. Results revealed demographic dominance of males (61.37%) and age ≥60 years (40.15%), lymphopenia (94.70%), neutrophilia (90.90%), critical NLR (>17; 50%), and PCT predominantly in sepsis/infection range (0.5-2 ng/mL; 39.39%) followed by septic shock (>10 ng/mL; 29.55%). In conclusion, elevated NLR and PCT confirm severe inflammation patterns aligned with Sepsis-3, supporting biomarker-guided therapy to mitigate antibiotic overuse in Indonesian ICUs.
Copyright (c) 2026 Angela Yurika Purba, Syamsul Bihar, Bintang YM Sinaga https://creativecommons.org/licenses/by-nc/4.0
Optimizing Palliative Management For End-of-Life Elderly Patient With Non-Hodgkin Lymphoma : A Case Report
Diffuse Large B-Cell Lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma (NHL) in the elderly population. DLBCL is potentially curable with immunochemotherapy but becomes more difficult to cure as patients get older leading to poor prognosis. Palliative care is essential for patients with this condition to relieve their suffering and improve their quality of life. Treatment strategies of DLBCL in elderly patients remain a challenge for physicians and the patients. An 87-year-old male presented with difficulty swallowing for the past four months, worsened since last week. Throat pain, obstruction sensation, and confined to bed due to weakness. The patient has been diagnosed with DLBCL and refused chemotherapy. Dark-colored residue was observed in the nasogastric tube. There is an enlargement of right cervical lymph-node. His laboratory workup shows Hb 8,9mg/dL, histopathological of the oropharyngeal tissue showed Diffuse Large B-Cell Lymphoma, activated B-Cell subtype. Patient was treated through multidisciplinary approach to improve overall condition and his quality of life. The management of elderly patients with DLBCL requires multidisciplinary approach that considers patient preferences and quality of life. Elderly Prognostic Index are needed to evaluate patient condition, prognosis, and guide therapeutic decisions. Palliative therapy is an approach aimed at improving the quality of life of patients facing life-threatening illness through early identification and comprehensive management of pain, physical, psychosocial, and spiritual problems. Management of DLBCL in elderly patients requires balancing risks and benefits considering frailty, comorbidities, and overall functional status. Regardless of therapeutic choice, palliative and supportive care should be provided through a multidisciplinary approach to relieve suffering and preserve quality of life. Treatment decisions should be made involving the patient and their family, focusing on the ultimate goals of care in accordance to their wishes.
Copyright (c) 2026 Steven Jonathan, Devina Ravelia Tiffany Subroto, I Putu Bayu Triguna https://creativecommons.org/licenses/by-nc/4.0
Dysphagia Improvement Following Sublingual Nifedipine Administration in Long-Segment Esophageal Stricture: A Case Report
Dysphagia is a difficulty in swallowing either solid food or liquid. Esophageal stricture being one of the most common causes of dysphagia can be caused by inflammation, fibrosis, or neoplasia damaging the esophageal lumen. If left untreated, dysphagia can lead to malnutrition, aspiration, and decreased quality of life. Another common cause of dysphagia is esophageal motility disorder, an impairment in peristalsis of the esophageal. Calcium channel blockers such as nifedipine have been reported to improve dysphagia and may serve as alternative therapy while waiting for endoscopic intervention. A 27-year-old man presented with a two-month history of progressive dysphagia to solids, semisolids, and liquids, after an episode of hematemesis. Esophagogram showed esophageal stricture with impaired peristaltic. Contrast-enhanced CT result was suggestive of an intraluminal esophageal stricture. The patient was given sublingual nifedipine before meals as an alternative therapy while waiting for endoscopic intervention, and showed gradual sympomatic improvement. Dysphagia caused by long-segment esophageal stricture can be exacerbated by secondary motility disorder. While definitive treatment requires endoscopic intervention, sublingual nifedipine offered effective short-term symptomatic relief by reducing esophagogastric junction pressure and improving bolus transit through the narrowed lumen.
Copyright (c) 2026 Steven Jonathan, I Putu Bayu Triguna, Gde Giri Prathiwindya, I Made Suma Wirawan https://creativecommons.org/licenses/by-nc/4.0
Cultural Nursing Competence Among Graduate Nurses From Selected University in Indonesia: Findings From The Nurses Cultural Competence Scale
Cultural diversity in Indonesia poses significant challenges and opportunities in nursing practice. Nurses are required to provide culturally sensitive care to meet patients’ diverse cultural values, beliefs, and practices. Cultural care competence is therefore essential as a foundation for effective and patient-centered nursing care. However, evidence related to cultural competence among graduate nurses in Indonesia remains limited. This study employed a quantitative, descriptive, and analytical design with a cross-sectional approach. A total of 292 nurses who graduated from a selected University in Indonesia participated in the study using purposive sampling. Data were collected between March and April 2024 using the Nurses' Cultural Competence Scale (NCCS), which consists of 41 items covering four dimensions: cultural awareness, cultural knowledge, cultural sensitivity, and cultural skills. The data were analyzed using univariate descriptive statistics. The findings showed that 51.4% of respondents had a high level of cultural competence. Most participants were female (80.1%), with a mean age of 23.89 years and a mean working experience of 23.21 months. High levels were observed across all NCCS dimensions, including cultural awareness (54.1%), cultural knowledge (56.2%), cultural sensitivity (51%), and cultural skills (54.5%). The dominance of high cultural competence suggests that nurses possess adequate readiness to deliver culturally sensitive nursing care. Demographic characteristics such as age, gender, educational background, and early clinical exposure may have contributed to the development of cultural competence among respondents. The study demonstrates that nurses who graduated from a selected university generally exhibit good cultural care competence, which is crucial for providing responsive and culturally appropriate nursing care.
Copyright (c) 2026 Rafaelino Raditya A. N, Jesshica Wahyuningrum, Febi Muliani Ranawijaya, Juhdeliena Juhdeliena, Agustina Saputri https://creativecommons.org/licenses/by-nc/4.0
Assessment of Medical Record Documentation and SOAP Completeness in Outpatient Services at a Primary Health Facility
Medical records are essential for clinical decision-making, continuity of care, legal compliance, and accreditation. Despite their importance, incomplete documentation remains a significant challenge in primary health care, particularly in settings that rely on manual record-keeping. This study assessed the completeness of outpatient medical records at the general polyclinic of Klinik UIN Syarif Hidayatullah Jakarta and examined patterns in outpatient service utilisation, including patient demographics, insurance coverage, and referral trends. A mixed-methods design was employed, integrating quantitative analysis of 399 outpatient medical records from January to February 2024 with qualitative data from observations and interviews. The quantitative component evaluated the completeness of SOAP documentation, patient demographics, service utilisation, and referral rates. The qualitative component investigated workflow challenges, clinician perspectives, and factors influencing documentation quality. In January, 201 outpatient visits were recorded, and in February, 198 visits occurred. Each month, more than 64% of patients were female. BPJS beneficiaries accounted for 842% of all visits, indicating they were the predominant users of the service. Referrals increased from 21 in January to 41 in February, for a total of 62. SOAP documentation was largely complete in January but declined in February, with most omissions found in the Assessment and Objective sections. Fourteen incomplete SOAP components were identified over two months, with 12 occurring in February. Although service utilisation remained stable, documentation quality varied substantially. The frequent incompleteness of the Objective and Assessment components underscores the need for improved workflow organisation, enhanced clinician training, and the adoption of electronic medical records. Regular audits and standardisation of SOAP documentation are recommended to strengthen compliance and support accreditation.
Copyright (c) 2026 Erwin Hermawan, Erfira Erfira https://creativecommons.org/licenses/by-nc/4.0
Factors Associated with Rabies Antibody Titers in Dogs in Mapanget District, Manado City
Rabies remains a highly fatal zoonotic disease and continues to pose a substantial public health challenge in Indonesia, including in Manado City. Mapanget District hosts a considerable dog population, yet empirical data on herd immunity based on rabies antibody titers are scarce. This study aimed to evaluate the determinants associated with rabies antibody titers among dogs in Mapanget District, Manado City. A cross-sectional study was conducted involving 97 dogs selected through purposive sampling. Serum samples were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) to classify antibody titers as protective (≥0.5 IU/mL) or non-protective (<0.5 IU/mL). Statistical analyzes included Fisher's Exact Test and multivariable logistic regression to assess associations between host factors and antibody titer status. Only 8.2% of dogs exhibited protective antibody titers, whereas 91.8% demonstrated non-protective levels. Vaccination status showed a highly significant association with antibody titers (p < 0.001). Vaccinated dogs were markedly more likely to achieve protective titers compared to unvaccinated dogs (OR = 35.71; 95% CI: 3.888–328.026). No significant associations were observed for dog type, age, or sex (p > 0.05). The findings underscore a critically low level of immunity within the dog population in Mapanget District, primarily attributable to insufficient vaccination coverage. Vaccination emerged as the predominant factor influencing the development of protective antibody titers. Strengthening routines and mass vaccination programs, coupled with systematic serological monitoring, are imperative to achieve adequate herd immunity and to advance rabies elimination strategies in the region.
Copyright (c) 2026 Dimitris Rosalin Hutasoit, Billy Johnson Kepel, Jeanette Iren Christy Manoppo https://creativecommons.org/licenses/by-nc/4.0
The Effects of Neuromuscular Electrical Stimulation (NMES) on Muscle Mass, Muscle Strength, and Functional Ability in The Elderly: A Literature Review
Sarcopenia is characterized by a loss of muscle in the elderly population with correlative muscle function loss and decreased mobility and independence, and it is associated with increased metabolic and cardiovascular risk. Physical activity is the foundation for prevention and treatment, yet numerous older people are unable to exercise sufficiently due to acute or chronic illnesses, neurological diseases, pain, anxiety, fear of falling, or demotivation. Neuromuscular electrical stimulation (NMES) might be the alternative or add-on treatment as it elicits muscle contractions with very little voluntary demand. This review examined the impact of NMES on muscle mass/size, muscle strength, functional capacity, and plausible mechanisms in elderly subjects. This study used a literature review from PubMed and ScienceDirect, identifying 108 records and including 38 eligible studies on NMES in older adults, with findings synthesized descriptively due to heterogeneity in protocols and outcomes. Overall, NMES was frequently reported to increase or at least maintain muscle mass or size, often in the quadriceps, and to reduce disuse atrophy during immobilization or critical illness, including ICU and acute heart failure settings, particularly when combined with early rehabilitation. Several studies also reported improvements in maximal isometric strength and functional outcomes such as mobility, balance, and gait. Proposed mechanisms include activation of anabolic signaling (IGF-1/PI3K/mTOR), enhanced regeneration markers, and reduced catabolic gene expression (FOXO1A, MSTN, MAFbx, MuRF1), without clear increases in oxidative stress in some studies. NMES appears promising, but standardized dosing and outcomes are needed
Copyright (c) 2026 Kadek Dwi Wira Sanjaya, I Ketut Gede Agus Budi Wirawan https://creativecommons.org/licenses/by-nc/4.0
The Relationship of Fiber Supplements and Cholesterol Levels in Hypercholesterolemia Patients at The Pati II Health Center in 2025
The phenomenon of hypercholesterolemia has become problematic both in the world and in Indonesia because high cholesterol levels (hypercholesterolemia) are the main risk factor for non-communicable diseases (NCDs) and have implications for an increase in mortality due to hypercholesterolemia, which is 73%. Hypercholesterolemia is closely related to risk factors such as age, gender, diet, smoking, lack of physical activity, BMI, and other related clinical conditions such as triglycerides, obesity, diabetes mellitus, and hypertension. The purpose of the study was to determine the relationship between fiber supplements and cholesterol levels in hypercholesterolemia patients at the Pati II Health Center in 2025. This research method is a correlation analytical research with a cross sectional approach. A sample was taken from a part of the research population with a sample of 56 respondents with a sampling formula using the slovin formula and the sampling criteria used was purposive sampling. The measuring tools used are observation sheets and GCU Easy Touch tools. The data analysis used univariate and bivariate analysis with a spearman rank correlation test with a significant value of a=0.05. The results showed that as many as 29 (51.8%) respondents consumed fiber supplements. High cholesterol levels were 22 (39.3%) of respondents. The results of the study concluded that there was a relationship between fiber supplements and cholesterol levels in patients at the Pati II Health Center in 2025 with a p value of 0.001.
Copyright (c) 2026 Risa Wulandari, Dewi Hartinah, Diana Tri Lestari https://creativecommons.org/licenses/by-nc/4.0
Learning Motivation among University Students in Tangerang Regency: A Descriptive Quantitative Study
Background: Learning motivation plays a crucial role in students’ academic success, engagement, and persistence, particularly within higher education environments that demand high levels of cognitive, emotional, and behavioural involvement. Motivated students are more likely to actively participate in learning activities, apply effective learning strategies, and maintain resilience when facing academic challenges. Understanding students’ learning motivation is therefore essential for higher education institutions in designing supportive academic environments and evidence-based educational strategies.Objective: This study aimed to describe the level of learning motivation among university students in Tangerang Regency, Indonesia. Methods: A descriptive quantitative research design was employed in this study. A total of 395 university students were recruited using purposive sampling based on predefined inclusion criteria. Data were collected between January and April 2025 using a validated learning motivation questionnaire that measured intrinsic and extrinsic motivation dimensions. The questionnaire was distributed online via Google Forms to ensure accessibility and efficiency. Data were analysed using univariate statistical analysis and are presented in the form of frequencies, percentages, means, and standard deviations. Results: The findings showed that most students (52.41%) demonstrated a high level of learning motivation. The descriptive analysis further indicated relatively high mean scores for both intrinsic and extrinsic motivation, suggesting that students’ learning motivation was supported by both internal factors, such as personal interest and self-development, and external factors, including academic environment and institutional support. Conclusion: University students in Tangerang Regency generally exhibit high learning motivation. These findings highlight the importance of maintaining and strengthening supportive academic environments to sustain students’ motivation and enhance academic engagement in higher education.
Copyright (c) 2026 Veronica Paula, Davoino Konyorah, Wanda G J Atafani, Yinti Werlina Boymau, Edson Kasenda https://creativecommons.org/licenses/by-nc/4.0
The Influence of Non-Clinical Factors (Age, Location, and Non-Medical Costs) on Patient Satisfaction and Loyalty at The Outpatient Polyclinic of The Manado City Dental and Oral Hospital
Patient satisfaction and loyalty are influenced not only by clinical factors but also by non-clinical factors, especially in the context of dental and oral health services supported by the National Health Insurance system. Three non-clinical factors that are strongly suspected of influencing patient satisfaction are age, non-medical costs, and location. Purpose. This study aims toanalyzing the direct and indirect influence between age, non-medical costs, and location on patient loyalty through patient satisfactionat the outpatient clinic of the Manado City Dental and Oral HospitalMethods. This study is a quantitative study with an analytical observational approach and uses a cross-sectional design, which was conducted in October - December 2025. The study sample consisted of 128 respondents consisting of respondents ≥ 18 years. Data were collected through questionnaires, then analyzed using univariate, bivariate, and multivariate analysis. Results.The results show that there is a direct effect of age and non-medical costs on patient satisfaction (p = 0.001), there is a direct effect of age on patient loyalty (p = 0.001), there is a direct effect of patient satisfaction on patient loyalty (p = 0.001), there is a direct effect of age on patient loyalty through patient satisfaction (p = 0.001) and there is a direct effect of non-medical costs on patient loyalty through patient satisfaction (p = 0.036). Meanwhile, there is no direct effect of location on patient satisfaction and loyalty (p = 0.976 and 0.436), there is no direct effect of non-medical costs on patient loyalty (p = 0.058), and there is no effect of location on patient loyalty through patient satisfaction (p = 0.979).ConclusionPatient satisfaction is a full mediator between non-medical costs and loyalty, and a partial mediator between age and loyalty.
Copyright (c) 2026 Sysilia M. N. Karinda, Windy M.V. Wariki, Aaltje E. Manampiring https://creativecommons.org/licenses/by-nc/4.0
Effectiveness of Tuberculosis Surveillance System in Remote Areas Through A Mixed-Methods Approach: A Case Study in Kabawo District, Muna Regency
Tuberculosis (TB) remains a public health problem, especially in remote areas with limited resources and access to health services. The effectiveness of the TB surveillance system is crucial for successful disease control. This study aimed to assess the effectiveness of the TB surveillance system in Kabawo District, Muna Regency, using a mixed-methods approach. This study employed a mixed-methods design with a concurrent triangulation strategy. Quantitative data were analyzed univariately using SPSS to assess the components of the surveillance system, while qualitative data were obtained through in-depth interviews and analyzed descriptively. The quantitative analysis showed that the availability and capacity of human resources had an average score of 3.28, the TB case reporting system 3.83, the TB treatment success process 3.52, and the availability of facilities and infrastructure 2.89. The TB case detection process had an average score of 0.87. The overall effectiveness of the TB surveillance system was categorized as effective with an average score of 0.85. Qualitative findings revealed barriers such as social stigma, trust in traditional medicine, and limited geographic access that impacted the implementation of TB surveillance. The TB surveillance system in Kabawo District is considered effective, but still requires strengthening in the aspects of active case detection, utilization of facilities and infrastructure, as well as socio-cultural and geographic access-based interventions to increase effectiveness in a sustainable manner.
Copyright (c) 2026 Tri Rahmatiani Gani, Windy Mariane Virenia Wariki, Grace Debbie Kandou https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Clinical Nurse Career Path and The Implementation of Public Service Interaction Behavior at Dr. Rehatta Hospital, Central Java Province
The quality of nursing services in hospitals is a crucial factor that affects public satisfaction and trust. Issues related to service complaints in Jepara underline the importance of nurse professionalism, one of which is developed through a career level system. This study aims to analyze the relationship between the career path of clinical nurses and the implementation of public service interaction behavior at dr. Rehatta Hospital, Central Java Province. This quantitative research uses a correlation design with a cross-sectional approach. The study population was 106 clinical nurses, with a sample of 84 nurses selected through stratified random sampling techniques. Data was collected using a questionnaire referring to Permenkes No. 33 of 2019, then analyzed univariately to describe the characteristics of respondents and bivariate with the Spearman Rank Correlation Test. The results of the study showed that the majority of respondents had public service interaction behavior in the "Good" category (70.2%). The correlation test showed a correlation coefficient value (r) of 0.638 with a p-value of 0.000. These results prove that there is a very significant, strong, and positive relationship between the career path of clinical nurses and the implementation of public service interaction behavior. The higher the career level of a nurse, the better her interaction behavior. Therefore, the career level system has proven to be effective as an instrument to improve the quality of nursing services.
Copyright (c) 2026 Buchori Setyoaji Prayodya, Indanah, Sri Siska Mardiana, Andy Sofyan Prasetyo https://creativecommons.org/licenses/by-nc/4.0
Factors Associated With The Empathetic of Staff at The Central Laboratory Installation of M. Djamil Hospital Padang
Empathy is a crucial component for healthcare professionals to build relationships with patients and improve the quality of care. However, it is often overlooked among laboratory personnel who tend to focus more on technical aspects. Individual and organizational factors are suspected to contribute to decreased empathy among laboratory staff. This study aimed to identify the factors associated with empathy among staff at the Central Laboratory Installation of M. Djamil Hospital Padang. This study employed a Mixed Method design using a Concurrent Embedded model involving 53 laboratory staff. Data were collected through questionnaires, in-depth interviews, observations, and document reviews. Quantitative data were analyzed using chi-square tests and logistic regression, with statistical significance set at p < 0.05. The results showed that the majority of respondents were aged 30–42 years (52.8%), female (77.4%), held a diploma degree (81.1%), had ≥5 years of work experience (84.9%), and had low empathy levels (56.6%). There were significant associations between age (p=0.043), education level (p=0.042), organizational support (p=0.005), workload (p=0.003), work stress (p=0.045), and work motivation (p=0.023) with empathy levels. Meanwhile, gender, length of service, and seminar/training attendance were not significantly associated with empathy. Multivariate analysis revealed that organizational support, workload, and work stress were the key factors associated with empathy, with organizational support emerging as the most dominant factor (p=0.004). Qualitative data supported these findings, indicating that high workload, lack of organizational support, and performance pressure were major barriers to demonstrating empathy toward patients. In conclusion, laboratory staff empathy is influenced by age, education, organizational support, workload, job stress, and work motivation, with organizational support being the most dominant factor.
Copyright (c) 2026 Annisa Safitri, Zelly Dia Rofinda, Nelmi Silvia https://creativecommons.org/licenses/by-nc/4.0
Pyoderma Gangrenosum in an Elderly Woman: Case Report
Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that presents with rapidly progressive, painful ulcers and may be diagnostically challenging because it mimics infection, vasculitis, and other ulcerative dermatoses. This report describes an 88-year-old Minang woman who presented with multiple enlarging, painful ulcers on both lower legs and thighs over six months, with significant functional limitation requiring wheelchair use. Dermatological examination showed multiple ulcers with granulation to necrotic bases, irregular margins, and undermined edges, with surrounding erythema and hyperpigmentation. Laboratory evaluation demonstrated mild anaemia with otherwise unremarkable results, while Gram staining showed no bacteria. Dermoscopy revealed irregular ulcer borders with yellow-brown crusting on an erythematous background. Histopathology supported ulcerative PG by demonstrating epidermal hyperplasia with acantholysis, inflammatory cell infiltration including polymorphonuclear leukocytes and lymphocytes, mixed dermal infiltrate, and evidence of vascular destruction. The patient was treated with systemic methylprednisolone alongside topical wound care (saline compresses, topical antibiotics, and topical corticosteroids), resulting in reduced pain and lesion improvement at two-week follow-up with no new ulcers. This case highlights the importance of recognising characteristic clinical features, excluding infection, and using histopathology to support diagnosis, particularly in elderly patients where disease burden and complications may be greater and management must prioritise gentle wound care and avoidance of trauma.
Copyright (c) 2026 Rina Gustia, Hersa Firda Kartika, Mutia Sari https://creativecommons.org/licenses/by-nc/4.0
The Role of Social Media in Digital Marketing Communication For Healthy Behaviour
The aim of this research is to analyze the communication challenges in the Social Media in Digital Marketing Communication (DMC) era, and understanding generation millenial for healthy digital behaviour. This research is a literature review. Data collection using documentation from Google Scholar. Data analysis using Systematic Literature Review (SLR). Communication challenges in the current digital era, especially in interacting with generation Millenial, is a very wide expansion of the communication field through various digital platforms, such as social media, instant messaging, and online content. Generation Millenial (GM) has unique characteristics that influence the way they communicate, such as a preference for short messages, images and videos that are effective in conveying messages. Understanding and adapting your communication style to them is important for building strong and effective relationships. In addition, it must be acknowledged that generation millenial has a high level of technological awareness, which can raise privacy and security issues that must be managed wisely in an effort to establish successful communication with this generation.
Copyright (c) 2026 Erlina Puspitaloka Mahadewi, Astrid Chrisafi, Ritta Setiati, Dwi Nurmawaty, Elistia Elistia, Dina Sudarmika, Sam Salomon https://creativecommons.org/licenses/by-nc/4.0
Mortality Prediction in ICU Patients on Mechanical Ventilation at RSUD Pasar Minggu
Although effective in saving lives, mechanical ventilation also carries the risks of serious complications. This study aimed to identify predictor factors for mortality in patients on mechanical ventilators in the ICU. Methods: This retrospective cohort study analyzed medical records from 424 patients, were obtained through simple random sampling from 614 patients meeting the inclusion and exclusion criteria. Data analysis was conducted using IBM SPSS Statistics version 22. Bivariate analysis was conducted using the chi-square test to identify associations between independent variables and mortality, followed by multivariate analysis using logistic regression to determine significant predictors of mortality. Result : The mortality rate was 51%. Multivariate analysis identified nine mortality factors. ICU admission from inpatient ward (RR=2.688), GCS (RR=2.674), respiratory failure (RR=18.187), ROSC (RR=6.754), septic shock (RR=3.885), renal failure (RR=2.024), and reintubation (RR=2.257) were found to increase the risk of mortality, while length of ICU stay (RR=0.323) and length of ventilator use (RR=0.313) were identified as protective factor. On the other hand, variables such as age, gender, pneumonia, stroke, and tracheostomy did not have a real influence on mortality in this study.Conclusion: ICU admission from inpatient ward, GCS, respiratory failure, ROSC, septic shock, renal failure, and reintubation were found to be predictors of mortality in patients with mechanical ventilator in ICU.
Copyright (c) 2026 Sitti Umniyatul Azkiyah, Lili Indriawati, Anna Sunita https://creativecommons.org/licenses/by-nc/4.0
The Relationship of Knowledge, Attitudes, and Scalp Care Behaviors to The Risk of Seborrheic Dermatitis in The Class of 2023 and 2024 Students of The Faculty of Medicine, Al-Azhar Islamic University In 2025
Background: Seborrheic dermatitis is a chronic inflammatory skin disease in areas rich in sebaceous glands, especially the scalp, which is influenced by the growth of Malassezia sp and risk factors such as knowledge, attitudes, and scalp care behavior. Objective: To determine the relationship between knowledge, attitudes, and scalp care behavior on the risk of seborrheic dermatitis in the 2023 and 2024 intakes of students at the Faculty of Medicine, Al-Azhar Islamic University in 2025. Methods: This study was a quantitative cross-sectional study with a purposive sampling design. Data were collected through questionnaires and clinical examinations, then analyzed bivariately using the Chi-square test with a significance level of p-value <0.05. Results: Most respondents were at risk of developing seborrheic dermatitis (67.5%). The Chi-square test results showed no relationship between scalp care knowledge and the risk of seborrheic dermatitis (p-value = 1.000; PR = 0.977), while attitudes (p-value = 0.000; PR = 0.257) and scalp care behavior (p-value = 0.000; PR = 0.075) were significantly related and acted as protective factors. Conclusion: There is no relationship between the level of knowledge of scalp care and the risk of seborrheic dermatitis, but attitudes and behavior of scalp care are significantly related to the incidence of seborrheic dermatitis in students of the Faculty of Medicine, Al-Azhar Islamic University.
Copyright (c) 2026 Jannatul Ulya, Lysa Mariam, Rusmiatik https://creativecommons.org/licenses/by-nc/4.0
Benson's Effect of Relaxation With Murotal Surah Ar-Rahman Against Emergencies in Hypertensive Patients At The Jati Health Center
Hypertension is a chronic disease that is often accompanied by psychological problems in the form of anxiety. Uncontrolled anxiety can worsen the condition of hypertensive patients. One of the nonpharmacological efforts that can be made to lower anxiety levels is Benson Relaxation combined with the Qur'anic murottal. This study aims to determine the effect of Benson Relaxation with murottal on anxiety levels in hypertensive patients. This study uses a quasi experiment design with a pretest and posttest with control group approach. The research sample amounted to 42 respondents who were divided into intervention groups and control groups, each as many as 21 respondents, with purposive sampling techniques. Anxiety levels are measured using the Hamilton Anxiety Rating Scale (HARS). The research instrument showed that the item correlation value ranged from 0.529–0.727 and Cronbach's Alpha value was 0.756. The data were analyzed using the Wilcoxon test. The results showed that in the intervention group there was a decrease in anxiety levels, with the median value before the intervention being 17.00 and after the intervention being 12.00, and the value p = 0.000 (p < 0.05), which means that there is a significant difference. Meanwhile, in the control group, there was no significant difference in anxiety levels, with the median value before treatment being 20.00 and 20.00 after treatment, and the p value = 0.058 (p > 0.05). Benson relaxation with murottal is effective in lowering anxiety levels in hypertensive patients and can be recommended as a non-pharmacological supportive therapy in nursing services. L,l,
Copyright (c) 2026 Tri Widiyati, Sukarmin Sukarmin, Diana Tri Lestari https://creativecommons.org/licenses/by-nc/4.0
Effectiveness Extract Temulawak (Curcuma zanthorrhiza) as an Insecticide Against Kutu Rambut (Pediculus humanus capitis)
Temulawak (Curcuma zanthorrhiza) contains secondary metabolite compounds that allow this plant to be used as an alternative insecticide. Several secondary metabolite compounds of temulawak, namely phenols, terpenoids, flavonoids, saponins, alkaloids and tannins have insecticidal properties against head lice. This study aims to study the effectiveness of administering temulawak extract against kutu rambut (Pediculus humanus capitis). This study is experimental, namely in the form of administering temulawak extract to head lice. The extract used was divided into 4 concentrations, namely 0% (K0), 7% (P1), 9% (P2) and 11% (P3). The results of the One Way ANOVA analysis showed a significant difference in the average percentage of kutu rambut deaths between the control group and the treatment group with a value (p = 0.001 <α (0.05)). The Bonferroni post hoc test revealed a significant difference in the average percentage of kutu rambut deaths between group K0 and group P1 (p=0.028), between group P2 and group P3 (p=0.045), between group P1 and group P3 (p=0.002), and between group P2 and group P3 (p=0.048). However, there was no significant difference in the average percentage of kutu rambut deaths between group P1 and group P2 (p=0.185). This is considered effective as an insecticide against kutu rambut at concentrations of 9% and 11%, as the average percentage of kutu rambut deaths at the 9% concentration was 50-60%, and at the 11% concentration the average number of kutu rambut deaths was 80-90%.
Copyright (c) 2026 Rosi Esa Gustina, Visna Septiandari https://creativecommons.org/licenses/by-nc/4.0
Clinical Profile and Outcome of Dilated Cardiomyopathy Children in Banten District Hospital: Retrospective Data of Limited Resources
Pediatric dilated cardiomyopathy (DCM) is a rare and serious disorder, characterized by left or bilateral ventricular dilatation with impaired systolic function, often leading to heart failure. This retrospective study, conducted at Banten District Hospital in Indonesia, aimed to explore the clinical profile, outcomes, and associated factors in pediatric DCM patients from June 2022 to October 2025. A total of 35 children aged 27 days to 18 years were included. Common comorbidities included rheumatic heart disease, congenital heart disease, tuberculosis, myocarditis, and anemia. The study found a significant relationship between malnutrition and adverse outcomes, with 85.7% of patients surviving, while 14.3% died. The most common ejection fraction (EF) score was moderately reduced (30-40%). These findings underline the importance of addressing underlying comorbid conditions such as rheumatic heart disease and nutritional deficiencies. The study calls for a comprehensive approach to managing pediatric DCM, including early detection and treatment of comorbidities, to improve survival outcomes in resource-limited environments.
Copyright (c) 2026 Amalia Ghanita Herdiana, E.S. Zul Febrianti https://creativecommons.org/licenses/by-nc/4.0
Self-efficacy among Nursing Students in Online Learning: A Cross-sectional Study in Banten
An increasingly important part of nursing education is online learning. Students' self-efficacy, or their confidence in their capacity to complete academic assignments, is a key factor in determining their level of engagement, performance, and flexibility in digital settings. Recent research suggests that among nursing students, self-efficacy is positively correlated with academic achievement, learning engagement, and preparedness for e-learning. The study aimed to characterize the degree of self-efficacy among online learning nursing students. This study applied a cross-sectional, descriptive design with 295 undergraduate nursing students at one private university in West Indonesia. The method employed was total sampling. A 14-item Likert-type questionnaire based on Bandura's dimensions (level, strength, and generality) was used to gauge self-efficacy. The instrument demonstrated good internal consistency (Cronbach's α = 0.944) following verification in a pilot test. Google Forms was used to gather data online between February and March of 2021. The findings revealed 23.7% of students demonstrated high self‑efficacy, whereas 53.2% of students have moderate self-efficacy and 23.1% of respondents found low self-efficacy. Nursing students who have high self-efficacy expressed more confidence in their ability to manage online tasks, finish projects, and handle technical challenges. These results are consistent with new research showing that technology readiness, online learning satisfaction, device accessibility, and structured pedagogical approaches all boost online learning self-efficacy. In general, nursing students showed moderate levels of self-efficacy when learning online. Learning outcomes can be maximized by enhancing self-efficacy through improved learning design, increased technical assistance, and readiness-building initiatives.
Copyright (c) 2026 Hohi Hoschinthya Lobo Djingi, Indah Pratiwi Pomali, Vamy Pellondou, Riama Marlyn Sihombing, Komilie Situmorang https://creativecommons.org/licenses/by-nc/4.0
Dyspepsia in Early Pregnancy as a Result of Hormonal and Functional Changes: A Case Report
Introduction: Dyspepsia is a common gastrointestinal complaint in early pregnancy, generally associated with hormonal and functional changes. This condition may reduce quality of life, affect maternal nutritional status, and present a diagnostic challenge in differentiating it from other conditions such as hyperemesis gravidarum or gastrointestinal infection. Case Report: A 27-year-old woman, G1P0A0, at 10 weeks of gestation, presented with nausea and vomiting more than two times per day, accompanied by epigastric discomfort and bloating after meals. Physical examination revealed epigastric tenderness without signs of severe dehydration. Laboratory tests showed normal hemoglobin, mildly elevated leukocytes, slightly decreased potassium, and the presence of bacteria and leukocytes in urine. Result: A working diagnosis of dyspepsia in early pregnancy was established after ruling out hyperemesis gravidarum and gastroenteritis. The patient was treated with Ringer’s lactate infusion, intravenous ondansetron, antacids, and vitamin B complex supplementation, which led to improvement of symptoms. Conclusion: Dyspepsia during pregnancy is a common complaint with both hormonal and functional etiologies. Diagnosis requires thorough history-taking and exclusion of important differential diagnoses. Management should prioritize lifestyle modification and supportive therapy, with safe pharmacotherapy during pregnancy when necessary
Copyright (c) 2026 Abitmer Gultom https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Body Mass Index, Work Period and Smoking With Low Back Pain Complaints Among Ironworkers in Babakan Village, Mataram City in 2025
Background: Low Back Pain (LBP) is a common musculoskeletal disorder among informal sector workers, including blacksmith workers, due to heavy physical workloads and non-ergonomic working postures. Individual factors such as Body Mass Index (BMI), length of employment, and smoking habits are suspected to increase the risk of LBP. Methods: This was an observational analytic study with a cross-sectional design. A total of 51 blacksmith workers were selected using purposive sampling based on inclusion and exclusion criteria. Data were collected through anthropometric measurements, the Nordic Body Map questionnaire, and a smoking habits questionnaire. Data analysis was performed using univariate and bivariate analyses with the Chi-Square test at a significance level of α = 0.05. Results: A significant association was found between BMI and low back pain complaints (p = 0.001; PR = 7,073; 95% CI: 1,090–45,883). Length of employment was also significantly associated with low back pain complaints (p = 0.004; PR = 3,850; 95% CI: 1.081–13.708). However, smoking habits were not significantly associated with low back pain complaints (p-value = 0.154; 95% CI: 1.039–2.338; PR: 1.558). Conclusion: Body Mass Index and length of employment are significantly associated with low back pain complaints among blacksmith workers, while smoking habits show no significant association. Preventive efforts should focus on weight control and regulation of work duration and workload.
Copyright (c) 2026 Aqilatunisa, I Wayan Tunjung, Henry Pebruanto, Deny Sutrisna Wiatma https://creativecommons.org/licenses/by-nc/4.0
The Effects of Creatine snd Protein Supplements on Cystatin C and Serum Creatinine Levels Among Male Weight Training Enthusiasts Aged 20-35 Years in Surabaya Gymnasiums
Protein and creatine supplementation is commonly used to enhance resistance training performance. Long-term and high-dose intake may influence renal function through renal hyperfiltration that affect glomerular filtration rate (GFR). This study aimed to examine the association between protein and creatine supplementation and renal function assessed by estimated glomerular filtration rate (through cystatin c and creatine serum), among male resistance training practitioners in Surabaya. A quantitative analytical comparative study with a cross-sectional design was conducted. The study population consisted of males aged 20–35 years who actively engaged in resistance training. Participants were classified into supplement users and non-users. Serum cystatin C and creatinine levels were measured using an automated clinical chemistry analyzer and eGFR values were calculated using CKD-EPI equations (2012 and 2021). Statistical analyses were performed to compare eGFR values between groups. Data normality was assessed using the Shapiro–Wilk test, and between-group comparisons were conducted using independent sample t-tests. Normal data distribution was confirmed (p > 0.05). Across all CKD-EPI equations, the non-supplement group consistently demonstrated higher mean eGFR values compared with the supplement group. The magnitude of these differences was small, with Cohen’s d values ranging from 0.265 to 0.278, indicating minimal practical significance. Independent sample t-tests revealed no statistically significant differences in eGFR between supplement users and non-users using CKD-EPI 2021 (p = 0.309), CKD-EPI 2012 with race coefficient (p = 0.285), or CKD-EPI 2012 without race coefficient (p = 0.292).
Copyright (c) 2026 Winata Yantono Widarto, Rahajoe Imam Santoso, Raden Roro Shinta Arisanti, William Sayogo, Antonius Yansen Suryadarma https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Caffeine Consumption and The Incidence of Depression, Anxiety and Stress in Online Motorcycle Taxi Workers in Mataram City
Mental health problems such as depression, anxiety, and stress are increasingly experienced by informal sector workers, including online motorcycle taxi drivers. Long working hours and high work pressure encourage high caffeine consumption to maintain alertness, which may affect mental health. This study aimed to determine the relationship between caffeine consumption and the incidence of depression, anxiety, and stress among online motorcycle taxi workers in Mataram City. This study was an observational analytic study with a cross-sectional design involving 109 online motorcycle taxi workers selected using purposive sampling. Data were analyzed using univariate and bivariate analysis with the Spearman Rho test. The results showed that most respondents had very high caffeine consumption. Depression levels were generally normal, while anxiety and stress showed moderate to high prevalence. There was no significant relationship between caffeine consumption and depression (r = 0.090; p = 0.351). However, caffeine consumption showed a significant positive relationship with anxiety (r = 0.280; p = 0.003) and stress (r = 0.523; p = 0.000). In conclusion, high caffeine consumption is associated with increased anxiety and stress, but not with depression among online motorcycle taxi workers in Mataram City.
Copyright (c) 2026 Nurul Inayah Tajuddin Putri, Lusiana Wahyu Ratna Wijayanti, Iing Iing, Nisia Putri Rinayu https://creativecommons.org/licenses/by-nc/4.0
Antibacterial Activity Test of a Combination of Ethanol Extract of Bidara Leaf (ziziphus mauritiana) and Betel Leaf (Piper betle L) Against Staphylococcus aureus in Vitro
Infections caused by Staphylococcus aureus remain a global health problem, particularly due to increasing antibiotic resistance that limits the effectiveness of conventional therapy. This condition encourages the development of alternative antibacterial agents based on natural materials. Bidara leaves (Ziziphus mauritiana) and betel leaves (Piper betle L.) are known to have antibacterial activity, however the potential of their combination against Staphylococcus aureus has not been widely studied. This study aims to evaluate the antibacterial activity of a combination of ethanol extracts of bidara leaves and betel leaves against the growth of Staphylococcus aureus with three variations of concentration ratios, namely 100%:0%, 50%:50%, and 0%:100%. There are also 2 control groups, namely a positive control using the antibiotic Clindamycin and a negative control using 10% DMSO. The study used a true experimental design with a post-test only control group design and was conducted using an inhibition zone test with the disc diffusion method. In addition, phytochemical screening tests were carried out to identify active compounds in each extract. The results of phytochemical screening of bidara leaf extract, betel leaf extract, and their combination showed positive results containing secondary metabolites in the form of alkaloids, flavonoids, tannins, terpenoids, and phenols. The results showed that the average diameter of the inhibition zones formed were group 1 (100%:0%) 25.6 mm, group 2 (50%:50%) 19.4 mm, and group 3 (0%:100%) 26.2 mm. The Mann-Whitney test showed significant differences between groups (P=0.000), however further tests showed that there were no significant differences between the treatment groups. In conclusion, the combination of bidara leaf (Ziziphus mauritiana) and betel leaf (Piper betle L.) extracts has antibacterial activity against Staphylococcus aureus, but does not show a synergistic effect and is not more effective than single extracts.
Copyright (c) 2026 Azka Nadya Robbani, I Putu Dedy Arjita, Deny Sutrisna Wiatma, Ety Retno Setyowati https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Basic Immunization Completeness and The Growth and Development of Children Aged 11-24 Months at Srikandi Husada Clinic, Kudus Regency
Children who have completed a complete series of basic immunizations are more likely to have optimal growth status and development in accordance with their age stages, when juxtaposed with children who have not completed the basic immunizations. This phenomenon can be explained by the fact that basic immunization contributes to building the immune system which further allows children to absorb nutrients properly and prevent diseases so that growth and development in children can occur optimally. This study aims to investigate the relationship between basic immunization completeness and the growth and development of children aged 11-24 months. This study uses an analytical observational research design with a cross sectional approach. All children aged 11-24 months at Srikandi Husada Clinic, Kudus Regency involved a population selected as a sample through purposive sampling techniques. The data was analyzed using the Spearman Rho test. The results showed that out of 59 children, 31 children received complete basic immunization and 28 children did not receive complete basic immunization. The percentage of growth increased by 55.9%, the percentage of growth did not increase by 44.1% while the percentage of development in accordance was 54.2%, doubtful by 27.1% and deviation by 18.6%. The results of the analysis indicated that the completeness of basic immunization was related to the growth of children with a p-value of 0.014<0.05 and an r value of 0.319. Meanwhile, in the aspect of child development, a p-value of 0.000<0.05 was obtained with an r value of 0.494 which indicates that the completeness of basic immunization is related to child development. So, it can be concluded that there is a relationship between the completeness of basic immunization and the growth and development of children aged 11-24 months at the Srikandi Husada Clinic, Kudus Regency.
Copyright (c) 2026 Erra Ardika, Ika Tristanti, Diah Andriani Kusumastuti https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Levels of Knowledge, Perception, and Attitude With Cervical Cancer Prevention Behavior Through Hpv Vaccination Among Female Medical Students of The Faculty of Medicine, Islamic University of Al-Azhar
Background: Cervical cancer is a women's reproductive health problem that can be prevented through Human Papillomavirus (HPV) vaccination. However, HPV vaccination coverage among young age groups, including female medical students, remains relatively low despite their health education background. Knowledge, perceptions, and attitudes are believed to play a role in shaping health-related behaviors. Objective: To analyze the relationship between the level of knowledge, perceptions, and attitudes with cervical cancer prevention behavior through HPV vaccination among female medical students at Al-Azhar Islamic University Methods: This study used a quantitative cross-sectional design. A total of 75 female medical students were selected using proportionate stratified random sampling. Data were collected through a structured questionnaire and analyzed using the Chi-square test with a significance level of p-value < 0.05. Results: The majority of respondents had good knowledge, positive perceptions, and favorable attitudes toward cervical cancer and HPV vaccination. However, most respondents had not received the HPV vaccine (85.3%). Statistical analysis showed no significant association between knowledge (p = 1.000), perception (p = 0.056), or attitude (p = 1.000) and cervical cancer prevention behavior through HPV vaccination. Conclusion: Good levels of knowledge, perception, and attitude were not significantly associated with cervical cancer prevention behavior through HPV vaccination among female medical students.
Copyright (c) 2026 Kadek Ayu Adelia Kristiani Putri, I Putu Dedy Arjita, Hilda Santosa, Muhammad Ashabul Kahfi Mathar https://creativecommons.org/licenses/by-nc/4.0
Digital Marketing Strategies for Healthy Behaviour in Communities and Society
This study aims to appraise the effectiveness of health creation through social media in encouraging healthy actions among adolescents in the health community. The discussion covers two main aspects the urgency of health creation through social media for these adolescents, the effectiveness, and challenges faced in its perpetration. The urgency of health creation through social media is grounded on the high use of digital platforms among adolescents, making it a implicit tool for propagating health information. Social media allows presto and wide access to educational content, improves health knowledge, and encourages active participation by adolescents in maintaining their health. The study results indicate that health creation through social media is effective in adding health knowledge and motivating changes in healthy hygiene actions. still, several challenges need to be addressed, similar as the spread of inaccurate information, limited access and digital knowledge, and issues of sequestration and data security within the community. The study concludes that despite these challenges, social media has great eventuality as an effective health creation tool for adolescents with applicable digital marketing. Applicable strategies are demanded to address these challenges, including digital knowledge education and the development of regulations to insure information delicacy. farther exploration is recommended to explore the combination of social media with face-to-face interventions, to enhance the effectiveness and strategies of health creation in healthy life actions.
Copyright (c) 2026 Erlina Puspitaloka Mahadewi, Elistia Elistia, Ayu Larasati, Dina Sudarmika, Sam Salomon, Arman Harahap https://creativecommons.org/licenses/by-nc/4.0
Eco-Social Strengthening, Assertive, and Effective Communication, in Gen Z Poverty Alleviation at The JPC Foundation Through The RPJ
This study aims to capture the patterns of economic strengthening of the people of Jakarta, especially Central Jakarta, around the JPC foundation office in Indonesia. In order to alleviate poverty due to economic and social aspects, and through an approach by engaging the community and related communities, to synergize in achieving goals. The method used in this writing is a descriptive method. While the design used in this writing is a library studies design, where the author conducts a search for literature and then conducts a review. The synergy of poverty alleviation strategies has been formulated into five categories, namely: (1) institutional aspects of poverty alleviation; (2) policies and budgeting of programs for poverty alleviation; (3) human resources (4) data and information regarding poverty, and (5) monitoring and evaluation (monev) systems for poverty alleviation policies and programs. Implications are a form of mapping the synergy of poverty alleviation with patterns that involve the community and communities, so that goals can be achieved in a structured and systematic manner, especially for Generation Z.
Copyright (c) 2026 Erlina Puspitaloka Mahadewi, Mohamad Reza Hilmy, Intan Silviana Mustikawati, Samudro Seto, Ayu Larasati, Arnastya Iswara Sanantagraha https://creativecommons.org/licenses/by-nc/4.0
Overview of Patient Satisfaction with Information Services and Drug Availability in The Pharmacy Institution of Ibnu Sina Hospital, Makassar
Pharmacy services are a crucial aspect of healthcare systems, directly influencing patient satisfaction levels. At Ibnu Sina Hospital in Makassar, two key factors affecting patient satisfaction are drug information services and drug availability. Patient satisfaction with these services serves as an indicator of the quality of pharmacy care provided. This study aims to analyze patient satisfaction with drug information services and drug availability at the Pharmacy Department of Ibnu Sina Hospital, Makassar. The study employed a descriptive observational design with a cross-sectional approach. Data were collected using a Likert-scale questionnaire administered to 100 randomly selected respondents. The results showed that patient satisfaction with drug information services ranged from satisfied to very satisfied across all dimensions studied. Empathy received the highest score (84.2%), followed by responsiveness (80.3%) and assurance (82.2%), indicating that patients felt personally cared for and confident in the competence of the pharmacists. Medication availability received a score of 86.5%, indicating that the majority of patients were satisfied with the availability of medications at this hospital. Overall, the results of this study suggest that pharmacy services at Ibnu Sina Hospital, Makassar, have met patient expectations, both in terms of clear and accurate drug information and adequate drug availability. This study recommends that the hospital continue to improve the quality of communication between pharmacists and patients and ensure optimal drug availability to further enhance patient satisfaction.
Copyright (c) 2026 Ismi Azis, Dahliah Dahliah, Nur Fadhillah Khalid, Syamsu Rijal, Iin Widya Ningsi https://creativecommons.org/licenses/by-nc/4.0
The Relationship between Hypertension History, Smoking Degree, and Ultraviolet (UV) Exposure to The Incidence of Seniilis Cataracts at Praya Regional General Hospital
Background: Senile cataract is the leading cause of blindness and remains a significant public health problem, particularly among the elderly population. This condition is multifactorial and influenced by various risk factors, including a history of hypertension, smoking intensity, and exposure to ultraviolet (UV) radiation. This study aimed to analyze the association between a history of hypertension, smoking intensity, and ultraviolet (UV) radiation exposure with the occurrence of senile cataract at Praya Regional General Hospital. Methods: This study employed an analytical observational design with a cross-sectional approach. The study subjects consisted of patients with senile cataract and non-cataract patients who met the inclusion and exclusion criteria. Data were collected through interviews, questionnaires, and medical records. Statistical analysis was performed using the chi-square test and Fisher's exact test with a significance level of 0.05. Results: The characteristics of the respondents were predominantly female, with 44 individuals (53.7%), and the largest age group was 60–69 years, comprising 39 individuals (47.6%). In terms of occupation, most respondents were farmers, totaling 37 individuals (45.1%), followed by housewives with 30 individuals (36.6%). The analysis showed that a history of hypertension was significantly associated with the occurrence of senile cataract (p = 0.007). Meanwhile, smoking intensity (p = 0.316) and ultraviolet (UV) radiation exposure (p = 1.000) were not significantly associated with the occurrence of senile cataract. Conclusion: A history of hypertension is a risk factor associated with senile cataract, whereas smoking intensity and ultraviolet radiation exposure were not proven to have a significant association. Continuous screening and health education efforts are needed to control modifiable risk factors in order to reduce the incidence of senile cataract.
Copyright (c) 2026 Khaidir Imam Paqih, Sri Subekti, Sahrun, Dian Rahadianti https://creativecommons.org/licenses/by-nc/4.0
The Influence of Social Media Marketing Strategies on Consumer Repurchase Intention of Gluten-Free Food Products
This study aims to analyze the influence of Social Media Marketing on Repurchase Intention by including Brand Love and Brand Loyalty as mediating variables in consumers of gluten-free Rq Cookies products. The phenomenon of the emergence of public awareness of a healthy lifestyle has encouraged the development of various gluten-free products in Indonesia, including those produced by the MSME Rq Cookies. To understand consumer behavior, this study uses a quantitative method through a survey of 152 respondents who have purchased Rq Cookies products and actively follow brand activities on social media such as Instagram and TikTok. Data analysis uses the SEM-PLS software. The results show that Social Media Marketing has a positive and significant influence on Brand Love, Brand Loyalty, and Repurchase Intention. However, Brand Love does not have a significant influence on Repurchase Intention and does not act as a mediator in the relationship between Social Media Marketing and Repurchase Intention. In contrast, Brand Loyalty is proven to have a significant influence on Repurchase Intention and is able to mediate the relationship. These findings indicate that loyalty plays a stronger role than emotional aspects in the context of repeat purchases of gluten-free products. The managerial implication is that Rq Cookies needs to strengthen its social media strategy by focusing on increasing brand loyalty through consistent, informative content that highlights the quality and health value of gluten-free products, including developing a community of consumers who care about a healthy lifestyle.
Copyright (c) 2026 Muhammad Rifqi Fadhlurrahman, Erlina Puspitaloka Mahadewi https://creativecommons.org/licenses/by-nc/4.0
Implementation of The Five Pillars Diabetes Education on Knowledge and Self-Care Behavior Among Patients With Type 2 Diabetes
Type 2 diabetes mellitus (T2DM) management requires effective self-care, which can be strengthened through structured education. The Five Pillars of Diabetes Self-Care including nutrition, physical activity, medication adherence, blood glucose monitoring, and foot care provide a comprehensive framework for patient with T2DM. This study evaluated the effects of an educational program based on these five pillars on the knowledge and self-care behaviors of patients with T2DM. A quasi-experimental one-group pretest–posttest design was used. A total of 24 patients with T2DM from the Jalan Emas Community Health Center in Tangerang were recruited using accidental sampling. The intervention consisted of four weekly interactive educational sessions that covered all five pillars. Valid and reliable instruments (the Five Pillars Knowledge Questionnaire and the Summary of Diabetes Self-Care Activities/ SDSCA) were used for data collection. Data were analyzed using the Wilcoxon Signed-Rank Test. Post-intervention analysis showed significant improvements in knowledge related to nutrition management (p = 0.023), blood glucose monitoring (p = 0.008), and foot care (p = 0.003). Overall self-care behavior also increased significantly (p = 0.001). However, no significant improvements were observed in knowledge related to physical activity (p = 0.317) and antidiabetic medication (p = 0.053). The Five Pillars Diabetes Education program was effective in improving key areas of knowledge and self-care behavior among patients with T2DM. These findings support the adoption of structured, comprehensive, and practical educational interventions, while also emphasizing the need for more targeted strategies to enhance physical activity engagement and medication adherence.
Copyright (c) 2026 Fiolenty Sitorus, Putri Valerie Gaudiosa Noija , Wulan Patricia Nikita Pusung, Renova O. Br. Sibuea https://creativecommons.org/licenses/by-nc/4.0
The Role of Healthcare Access and Maternal Posyandu Adherence on Stunting Incidence on Maratua Island
Stunting persists as a public health crisis on Maratua Island, Berau Regency, where geographical isolation hinders maternal healthcare access and Posyandu adherence, contributing to high toddler stunting rates despite national efforts targeting below 14% prevalence by 2025. This study aimed to analyze the relationship between maternal healthcare access, Posyandu adherence, and stunting incidence among toddlers. Employing a quantitative descriptive correlational design, it targeted a total population of 54 stunted toddlers from 2025 Puskesmas records using total sampling. Data were collected via structured Likert-scale questionnaires (validity r > 0.268; Cronbach's α > 0.70) combined with anthropometric records, analyzed univariately for characteristics and bivariately via Spearman correlation (SPSS v23) due to non-normal data. Results showed all respondents stunted (mostly mild; 75.9% short stature), with no significant healthcare access correlation (p=0.077) but strong Posyandu adherence link (p=0.000). In conclusion, enhancing maternal Posyandu compliance through targeted island interventions offers greater stunting reduction impact than access improvements alone.
Copyright (c) 2026 Nurul Fhadillah. Z, Rusdi Rusdi, Ainur Rachman https://creativecommons.org/licenses/by-nc/4.0
Rainfall Intensity - Dengue Fever Incidents Relationship During Rainy Season in Bantul Regency, Yogyakarta, Indonesia
Dengue Hemorrhagic Fever (DHF) is a disease caused by dengue virus (DENV) infection. Dengue fever is spread through the bite of the female Aedes aegypti mosquito. Rainfall intensity plays a role in creating a suitable environment for vectors, thus potentially increasing the number of DHF cases. Rainfall intensity is not the same throughout the rainy season. This study aims to determine the relationship between rainfall intensity and DHF incidence at the beginning, middle, and end of the rainy season in Bantul Regency. This study is an observational analytical study with a cross-sectional design. Monthly rainfall and DHF incidence data per sub-district from 2019-2023 were obtained from the Climate Agency of Yogyakarta Province and the Bantul Regency Health Office, respectively. The results of the Spearman rank test showed a positive correlation between rainfall and DHF incidence in the middle (p = 0.005) and end (p = 0.000) of the rainy season, but no correlation at the beginning of the rainy season (p = 0.181). Thus, the control of dengue fever must be increased from the beginning of the rainy season, considering the tendency of a lag effect and the significance of rainfall with dengue fever at the peak and end of the rainy season.
Copyright (c) 2026 Muhammad Ganang Garnida, Tri Wulandari Kesetyaningsih https://creativecommons.org/licenses/by-nc/4.0
The Effect of Benson Relaxation Therapy and Murotal Surah Ar-Rahman on Anxiety in Patients With Diabetes Mellitus in The area of The Holy Ghost Sanctuary
Diabetes mellitus is a chronic disease that often causes psychological stress, one of which is anxiety. Anxiety in people with diabetes can worsen health conditions and hinder the healing process. Non-pharmacological therapies such as benson relaxation therapy and Surah Ar-Rahman's murotal therapy are suspected to have the potential to lower anxiety levels based on several previous study results. The purpose of this study is to determine the effect of benzon and murottal therapy on the anxiety level of patients with diabetes mellitus. This study uses a quasi-experimental design with a pre test and post test control group design approach in one intervention group. There were 52 respondents, of which each group would get 26 respondents who were selected through purposive sampling techniques. Benson and murotal therapy interventions were given for 7 consecutive days with a duration of 10-15 minutes. Anxiety levels were measured before and after the intervention using the Depression Anxiety and Stress Scale questionnaire with a total of 21 questions. The results and discussion were obtained based on the Sapiro Wilk test and the T-test with the Paired Samples Test. The results of the analysis showed that the relaxation therapy of benson and murotal Surah Ar-Rahman had a significant effect on the anxiety level of Diabetes Mellitus patients in the Kaliwungu Health Center area, with a p-value of 0.001 (p<0.05). Meanwhile, the results of the comparison of the intervention group and the control group were with a p-value of >0.0001. The results of this study strengthen the theory that relaxation and spirituality-based nonpharmacological interventions are able to influence psychological responses, particularly in lowering anxiety levels.
Copyright (c) 2026 Indah Listiyana Putri, Sukarmin, Heny Siswanti https://creativecommons.org/licenses/by-nc/4.0
Relationship Between Exclusive Breastfeeding and Birth Weight (BBL) to The Incidence of Respiratory Tract Diseases in Children at PKU Gamping Hospital
Background: Exclusive breastfeeding during the first six months plays an important role in fulfilling nutritional needs and strengthening children's immunity against infections. However, exclusive breastfeeding coverage in Indonesia remains below the national target. Infants with abnormal birth weight are also more susceptible to infections, including respiratory tract diseases. Objective: To analyze the relationship between exclusive breastfeeding and birth weight with respiratory tract diseases among children at PKU Gamping Hospital. Methods: This analytical observational study used a cross-sectional design involving children aged 18 months to 5 years who visited the pediatric clinic of PKU Gamping Hospital from May to July 2025. A total of 86 children were selected using purposive sampling. Data were collected through questionnaires and analyzed using the chi-square test with a significance level of p<0.05. Results: Among 86 children, 53.5% were male and 46.5% female. Exclusive breastfeeding was significantly associated with respiratory diseases in children (p=0.017), while birth weight showed no significant association (p=0.202). Conclusion: Exclusive breastfeeding is significantly associated with respiratory diseases in children, whereas birth weight is not significantly associated.
Copyright (c) 2026 Gina Puspita, Kalya Hasana https://creativecommons.org/licenses/by-nc/4.0
The Effect of Moderate Intensity Swimming Exercise on Antioxidant Enzyme Activity Levels in Adults
This study aimed to investigate the effect of moderate intensity swimming exercise on the activity levels of antioxidant enzymes in adults. To achieve this, a literature review was conducted, analyzing data from multiple studies examining the impact of regular swimming on antioxidant markers such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). The studies included in the review varied in terms of participant demographics, exercise protocols, and measurement techniques. The findings consistently showed that moderate intensity swimming exercise significantly enhances the activity of key antioxidant enzymes, indicating an improved oxidative stress response. This suggests that engaging in regular moderate intensity swimming can be a beneficial strategy for bolstering the body's antioxidant defenses, potentially contributing to better overall health and reduced risk of oxidative stress-related diseases.
Copyright (c) 2026 Jihan Nadhila Diamanda, Nila Wahyuni, Agus Eka Darwinata https://creativecommons.org/licenses/by-nc/4.0
Analysis of Maternal Characteristics, Knowledge, and Attitude Factors Associated with the Coverage of K6 Antenatal Visits at Parung Panjang Health Center
Background: Antenatal care (ANC) is a critical component of maternal health services aimed at improving maternal outcomes and reducing the risk of pregnancy-related complications. The Indonesian government has established a minimum standard of six antenatal visits (K6) to ensure optimal monitoring of pregnancy. However, the coverage of K6 visits at the primary healthcare level has not fully met the expected targets. Maternal characteristics, including demographic and behavioral factors, are considered important determinants influencing adherence to antenatal visits. Objective: This study aimed to analyze maternal characteristics, knowledge, and attitudes, as well as their association with the coverage of K6 antenatal visits in the working area of Parung Panjang Health Center in 2025. Methods: This study employed a quantitative analytic design with a cross-sectional approach. The sample consisted of 154 pregnant women selected using a total sampling technique. The dependent variable was K6 antenatal visit coverage (complete vs. incomplete). Independent variables included maternal age, educational level, employment status, parity, level of knowledge, and attitudes toward antenatal care. Data were collected using a structured questionnaire and verified through antenatal visit records in the Maternal and Child Health (MCH) handbook. Data analysis was conducted using univariate analysis to describe respondent characteristics, bivariate analysis with chi-square tests, and multivariate analysis using multiple logistic regression with a significance level of 5%. Results: More than half of the respondents (53.9%) had not completed the recommended K6 antenatal visits. Univariate analysis showed that the majority of mothers had low educational attainment and insufficient levels of knowledge and supportive attitudes toward antenatal care. Bivariate analysis revealed that maternal education, knowledge, and attitudes were significantly associated with K6 visit coverage (p<0.05). Multivariate analysis indicated that maternal attitude was the most dominant factor associated with complete K6 visits after controlling for other maternal characteristics. Conclusion: The coverage of K6 antenatal visits in the study area remains low and is influenced by maternal characteristics, particularly education, knowledge, and attitude. Maternal attitude is the dominant factor associated with the completeness of K6 antenatal visits. Strengthening health education and fostering positive attitudes toward antenatal care services need to be enhanced to improve pregnant women’s adherence to antenatal visits
Copyright (c) 2026 Susanti Susanti, Yeny Sulistyowati, Zarfiel Tahal, Ismail Sangadji https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Body Mass Index (BMI), Gender and Hypertension With The Incidence of Knee Osteoarthritis at North Lombok Regency Hospital
Osteoarthritis (OA) of the knee is a degenerative joint disease that often occurs in old age and is one of the main causes of pain and limited mobility. The incidence of knee OA is influenced by various risk factors, including body mass index (BMI), gender, and hypertension, but the results of studies related to these factors still show differences in findings. In North Lombok Regency, data on risk factors for knee OA is still limited. This study aims to analyze the relationship between BMI, gender, and hypertension with the incidence of knee osteoarthritis at North Lombok Regency Hospital. This study uses an analytical observational design with a case control approach. The case group consists of 54 patients who were diagnosed with knee osteoarthritis and underwent treatment at the North Lombok Regency Hospital in the period of July 2024-July 2025. The control group consisted of 54 people who were patients of the Internal Medicine Polyclinic of the North Lombok Regency Hospital in August 2025 who did not suffer from knee osteoarthritis. Sampling of the control group was carried out using purposive sampling techniques based on inclusion and exclusion criteria. Data were obtained from the patient's medical records and analyzed using univariate and bivariate analyses to assess the relationship between independent variables and the incidence of knee OA. he results of this study are expected to show the relationship between BMI, gender, and hypertension with the occurrence of knee osteoarthritis, and to support prevention and treatment efforts for knee osteoarthritis at North Lombok Regency Hospital.
Copyright (c) 2026 Muhammad Aron Baihaqi, Rohmania Setiarini, Henry Pebruanto, Deny Sutrisna Wiatma https://creativecommons.org/licenses/by-nc/4.0
Fetal Macrosomia with Suboptimal Antenatal Care: A Case Report
Background: Fetal macrosomia is associated with increased maternal and neonatal morbidity. Early detection relies on adequate Antenatal Care (ANC), including appropriate metabolic screening and serial fetal growth assessment. Suboptimal ANC may delay the recognition of maternal risk factors and fetal overgrowth, particularly in high-risk pregnancies. Case presentation: We reported a case of a 46-year-old Indonesian multiparous woman with obesity who was referred from the Community Health Centre (CHC) to a secondary hospital due to post-term pregnancy, suspected fetal macrosomia, and advanced maternal age. Despite multiple ANC visits, random blood glucose testing was not documented during Integrated Antenatal Care at the CHC, the primary healthcare level. Progressive excessive maternal weight gain and marked increases in fundal height were observed during the second and third trimesters without further metabolic evaluation. An elective caesarean section was performed at 40+4 weeks of gestation, delivering a male neonate weighing 5,295 g. Post-operative evaluation revealed maternal prediabetic status, while the neonate required monitoring due to macrosomia but remained clinically stable. Conclusion: This case highlights the consequences of suboptimal antenatal screening and surveillance in high-risk pregnancies. Failure to perform a timely metabolic assessment and respond to clinical indicators of excessive fetal growth may contribute to the delayed diagnosis of fetal macrosomia. Strengthening the quality and completeness of integrated antenatal care, particularly at the primary healthcare level, is essential to improve early detection and prevent adverse maternal dan neonatal outcomes.
Copyright (c) 2026 Alfun Dhiya An, Indrahany Alwiandono, Asri Nur Maulidya, Restu Maharany Arumningtyas https://creativecommons.org/licenses/by-nc/4.0
The Effect of Healing Touch and Dhikr Therapy on Reducing Blood Pressure in Hypertensive Patients at The Jati Health Center
Hypertension is one of the chronic health problems that is at risk of causing cardiovascular complications if not managed optimally. In addition to pharmacological therapy, a nonpharmacological approach is needed as a complementary therapy to help lower blood pressure. This study aims to determine the effect of healing touch and dhikr therapy on reducing blood pressure in hypertensive patients. This study used a quasi-experimental design with a pretest-posttest design with a control group. The number of respondents was 46 hypertensive patients who were divided into intervention groups and control groups. The intervention group was given a combination of healing touch and dhikr therapy, while the control group only received standard therapy. Analysis of blood pressure differences before and after intervention in the intervention group was conducted using the Wilcoxon test for systolic blood pressure and the paired t-test for diastolic blood pressure. In the control group, the analysis was carried out using the Wilcoxon test. The comparison of blood pressure drops between groups was analyzed using the Mann–Whitney test. The results showed that systolic and diastolic blood pressure in the intervention group experienced a statistically significant decrease (p < 0.001). The decrease in blood pressure in the intervention group was greater than in the control group, and the difference was statistically significant (p < 0.001). It can be concluded that the combination of healing touch therapy and dhikr is effective as a complementary therapy in lowering blood pressure in hypertensive patients.
Copyright (c) 2026 Amanda Putri Nabilla, Sukarmin, Tri Suwarto https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Health Belief and Self Acceptance and Self Management Behavior in Pulmonary Tuberculosis Clients in The Work Area of The Japan Kudus Health Center
The study discusses pulmonary tuberculosis as a chronic infectious disease that is still a global health problem, with Indonesia ranking third in the world. The increase in tuberculosis cases is influenced by drug resistance, limited access to health services, and poor environmental hygiene conditions. Kudus Regency, especially the work area of the Japanese Health Center, is an area with a relatively high number of tuberculosis cases. This disease not only has an impact on the physical condition, but also affects the mental and social aspects of the patient, so that self-management skills are an important factor in the success of treatment. The Health Belief Model explains that an individual's perception of susceptibility, disease severity, benefits, and barriers to health measures plays a role in shaping health behavior. In addition, good self-acceptance can improve treatment adherence and coping ability of patients. Self-management includes medication adherence, symptom management, and lifestyle changes influenced by social support, education level, and understanding of disease. This study used a correlational design with a cross sectional approach and involved 53 respondents who were selected through purposive sampling techniques. The research instruments include the Health Belief Model questionnaire, self acceptance, and self-management. Data analysis was carried out univariate and bivariate using the chi square test. The results showed that most of the respondents had a high health belief of 79.2 percent and a high self-acceptance of 75.5 percent. The majority of respondents' self-management was in the good category, namely 94.3 percent. The bivariate test showed a significant relationship between health belief and self-management with a p value of 0.044 and an odds ratio of 9.111. In addition, there was a significant relationship between self acceptance and self-management with a p value of 0.02 and an odds ratio of 1.193. The conclusion of this study shows that health belief and self acceptance are meaningfully related to the self-management behavior of tuberculosis clients, so education and psychosocial support need to be improved on an ongoing basis.
Copyright (c) 2026 Arda Aulia Chusna, Dewi Hartinah, Muhamad Jauhar https://creativecommons.org/licenses/by-nc/4.0
Nasal Malignant Peripheral Nerve Sheath Tumor Resembling Cavernous Hemangioma: A Case Report
Background: Malignant peripheral nerve sheath tumor (MPNST) is a malignant, locally invasive tumor that originates from Schwann cells in the peripheral nerves, and has a high probability of metastasize. It accounts for 5-10% of all soft tissue sarcomas and has an incidence of 0.001% in the general population. Because of its rarity and lack of specificity, little is known about its imaging features, and reports on the nasal region are uncommon. Case Report: A 43-year-old woman with symptoms of nosebleed from her right nostril and had a tampon inserted for 4 days, but the bleeding persisted. No history of trauma. Physical examination is inconclusive. CT Angiography (CTA) shows a hypervascular mass in the right nasal cavity extending into the ethmoidal sinus, suggesting a cavernous hemangioma. The patient underwent mass extirpation surgery. Histopathological and histochemical examination of the removed tissue revealed a malignant peripheral nerve sheath tumor. The patient then underwent radiotherapy. An MRI evaluation revealed no residual tumor. Discussion: Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma. This tumor can be aggressive by infiltrating the surrounding tissue, including bone structures, in contrast to hemangiomas. Computed tomography is useful for locating the tumor, identifying infiltration, and planning treatment. Because this reported case was believed to be in the early phases of the illness, the lesion found in CTA has regular margins and well-defined boundaries, thus it is more appropriate for cavernous hemangioma. As a multi-parameter modality, MRI can provide a wealth of information on characterizing various components in tumors, thus is used for further investigation and post-treatment evaluation. Conclusion: Because of the overlapping radiographic features, distinguishing MPNST from other more prevalent tumors, such as cavernous hemangioma, is challenging. It is important for radiologists to consider MPNST as a differential diagnosis of masses in the nasal cavity.
Copyright (c) 2026 Mohammad Rizki Pratama, Nur Hayati, Herwinda Octavia https://creativecommons.org/licenses/by-nc/4.0
The Relationship Between Marriage Age, Parity, and Hormonal Contraceptive Use With Cervical Cancer Incidence at NTB Provincial Hospital
Background: Cervical cancer is the most common health problem affecting the female reproductive system. It is caused by infection with the Human Papillomavirus (HPV). The most common risk factors for cervical cancer are age at marriage, parity, and use of hormonal contraceptives. Objective: To analyze the relationship between age at marriage, parity, and hormonal contraceptive use with cervical cancer incidence at the NTB Provincial General Hospital. Methods: This quantitative study used a case-control design. The sampling technique used purposive sampling with a sample size of 110 samples. Data were taken from medical records at the NTB Provincial Hospital. Data were analyzed using the Chi-square test with a significance limit of p-value <0.05.Results: It was found that most of the respondents married at the age of ≥20 years, as many as 69 (62.7%), had parity ≤3 times as many as 80 (72.7%), and used hormonal contraception as many as 58 (52.7%). The Chi-square test showed a significant relationship between age at marriage (p-value = 0.002; OR = 3,997; 95% CI = 1.742-9.170), parity (p-value = 0.005; OR = 3,917; 95% CI = 1.555-9.863), and use of hormonal contraception (p-value <0.001; OR = 4.618; 95% CI = 2.066-10.327) with the incidence of cervical cancer. Conclusion: Age at marriage, parity, and use of hormonal contraception were significantly associated with the incidence of cervical cancer at the NTB Provincial Hospital.
Copyright (c) 2026 Ni Luh Made Candra Wati, Hilda Santosa, I Gede Angga Adnyana, Adib Ahmad Shammakh https://creativecommons.org/licenses/by-nc/4.0
Effects of Inclisiran on Systemic Inflammatory Biomarkers: A Systematic Review
Background: Inclisiran is a novel small interfering RNA (siRNA) therapy that specifically targets proprotein convertase subtilisin/kexin type 9 (PCSK9), thereby introducing an innovative method for the regulation of lipid levels. The implications of this intervention regarding systemic inflammatory biomarkers necessitate comprehensive investigation. Objective: To thoroughly evaluate how inclisiran influences inflammatory markers, especially high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), among a group of people identified with hypercholesterolemia or atherosclerotic cardiovascular disease. Methods: A thorough systematic literature review was performed in accordance with the PRISMA 2020 guidelines. A meticulous search was undertaken across three databases (Scopus, ScienceDirect, PubMed) encompassing the timeframe from January 2017 to December 2025. Two independent reviewers engaged in the processes of filtering, extracting information, and quality evaluation by using the Cochrane RoB 2.0 tool, specifically crafted for randomized controlled trials (RCTs). Results: Out of an initial cohort of 304 records, 11 studies met the predetermined inclusion criteria, encompassing 4 noteworthy phase 2-3 randomized controlled trials (RCTs) (ORION-1, -9, -10, -11). Inclisiran revealed considerable reductions in LDL-C concentrations (varying from 47.9% to 52.6%), while demonstrating neutral effects on hs-CRP levels, which encompassed non-significant increases when compared to placebo (for example, from 3.5% to 8.5%). No investigations have provided data pertaining to IL-6 or TNF-α. All RCTs evaluated demonstrated a significantly low propensity for bias. Conclusions: Current empirical research indicates that inclisiran does not significantly influence systemic hs-CRP levels and lacks comprehensive data regarding other essential inflammatory biomarkers. The enhancements noted in cardiovascular wellness tied to this medication seem to be chiefly dictated by major declines in LDL-C concentrations, instead of variations in overall inflammation. Upcoming research on heart health results must incorporate a wide selection of inflammatory indicators to fully explain the complicated impacts of inclisiran.
Copyright (c) 2026 Warham Warham, Nurul Fitriani Andi Padri, Wiking Zeth, Annisa Istiqamah Ahmad, Asdwiyenti Miftahulresty Aksi, Azhim Asshiddiq Suhardi Andi Ara https://creativecommons.org/licenses/by-nc/4.0