Medical Profession Journal of Lampung

Evaluation of High-Sensitivity CRP Levels as a Cardiovascular Risk Marker in Young Adults

Aldiano Rachmantiawan, Putu Ristyaning Ayu Sangging — Sat, 02 May 2026 00:00:00 +0000

Atherosclerosis and cardiovascular disease originate from chronic low grade inflammatory processes, making high sensitivity C reactive protein or hs CRP widely studied as a cardiovascular risk marker, including in young adults. This study is a narrative review of 16 articles published between 2019 and 2025 that examine hs CRP in young adults aged 18 to 45 years and its association with cardiometabolic risk factors, cardiovascular disease events, and clinical outcomes. The review findings indicate that in overweight or obese young adults, elevated hs CRP levels are associated with central obesity, atherogenic dyslipidemia, impaired fasting glucose, and higher blood pressure. In addition, irregular sleep patterns and short term variability in diastolic blood pressure are also linked to increased hs CRP levels, suggesting the presence of subclinical inflammation early in life. In older populations and in patients with established cardiovascular disease, high hs CRP levels are reported to predict cardiovascular disease incidence, carotid plaque formation, cardiometabolic multimorbidity, functional disability, and short term mortality. However, hs CRP is not associated with the progression of coronary artery calcification and demonstrates substantial intra individual variability. Overall, hs CRP has potential value as an additional marker to identify young adults at higher cardiovascular risk. Nevertheless, hs CRP is not sufficient as a single screening tool and should be interpreted alongside traditional cardiovascular risk factors and lifestyle patterns. Repeated measurements are recommended to improve risk assessment accuracy and to account for biological variability in hs CRP levels.

Comparison of Monotherapy, Dual Therapy, and Triple Combination Therapy in Patients with Primary Open-Angle Glaucoma at the Lampung Eye Center Hospital

Syalsa Zaiva, Nisa Karima — Sat, 02 May 2026 00:00:00 +0000

The eye is an essential sensory organ that delivers visual information to the brain. Glaucoma is a progressive optic neuropathy that can disrupt this process and lead to irreversible blindness. Primary open angle glaucoma is the most common type and is characterized by a gradual increase in intraocular pressure with minimal early symptoms. Glaucoma treatment is usually initiated with single drug therapy or monotherapy. If monotherapy is insufficient to control intraocular pressure, combination therapy using two or more medications is required, including double therapy and triple combination therapy. This study aimed to compare the effectiveness of monotherapy, double therapy, and triple combination therapy in reducing intraocular pressure in patients with primary open angle glaucoma at Lampung Eye Center Eye Hospital. An observational analytic method with a cross sectional design was used. Data on intraocular pressure and treatment regimens were obtained from medical records. Bivariate analysis was performed using the Kruskal Wallis test. The results showed that most subjects were male, with 23 patients or 53.5%, and the most common age group was 40 to 60 years, accounting for 41.9% of participants. Of the 43 patients included, 20.9% (9 patients) received monotherapy, 60.5% (26 patients) received double therapy, and 8 patients or 18.6% received triple combination therapy. Bivariate analysis demonstrated a statistically significant reduction in intraocular pressure in patients receiving triple combination therapy, with a p value less than 0.05. These findings indicate that triple combination therapy provides the most significant intraocular pressure reduction in patients with primary open angle glaucoma.

Mosquito Control Methods and Dengue Fever Disease: a Literature Review

Aulia Khairunnisa, Risti Graharti — Sat, 02 May 2026 00:00:00 +0000

Dengue Hemorrhagic Fever (DHF) is one of the vector-borne diseases that remains a public health challenge in Indonesia, characterized by high incidence rates, widespread vector distribution, and an increased risk of outbreaks in various endemic areas. The transmission of the dengue virus is greatly influenced by community behavior, residential environmental conditions, and the bioecology of the Aedes aegypti mosquito, which is able to breed in clean water puddles around homes. The dengue virus consists of four serotypes and can survive through vertical and horizontal transmission mechanisms, thereby strengthening the chain of transmission in the environment. On the other hand, vector control efforts using larvicides and chemical insecticides are still widely chosen by the community, even though improper use can cause insecticide resistance. This study aims to examine various methods of dengue vector control, including physical, mechanical, biological, chemical approaches, and the EcoHealth concept. The method used was a literature review of official guidelines, research articles, and the latest scientific publications on DHF and vector control. The results of the study show that physical control methods such as 3M Plus are the most effective and safest, while biological control through larval predators and environmentally friendly bacteria can reduce the larval population without causing negative ecological impacts. Chemical control still provides rapid effects, but must be used wisely to prevent resistance. The EcoHealth approach is considered more comprehensive because it involves environmental, social, cultural, and economic aspects of the community in sustainable control. In conclusion, optimal DHF control requires an evidence-based integrated strategy with cross-sector participation and the application of ecological principles to ensure long-term success in reducing disease incidence.

Comparison of Absolute Lymphocyte Count (ALC) Between Confirmed Patients and Probable Covid-19 Patients at Pesawaran Regional General Hospital Pesawaran

Denny Andika Kurniawan, Winda Trijayanthi Utama — Sat, 02 May 2026 00:00:00 +0000

Coronavirus Disease 2019 (COVID-19) is a broad group of viruses known to cause diseases with a diverse clinical spectrum, ranging from mild symptoms to severe disorders in humans. These viruses are zoonotic, meaning they can be transmitted from animals to humans, posing a major challenge in infection control efforts. In addition, variations in immune responses in each individual cause the clinical picture of Covid-19 to vary greatly, including changes in laboratory parameters such as absolute lymphocyte count (ALC). This study was conducted to analyze the differences in ALC values in patients with a confirmed diagnosis of Covid-19 compared to patients categorized as probable Covid-19 at the Pesawaran Regional General Hospital. The study design used an observational analytical method with a cross-sectional approach. Data processing and analysis were performed using an independent t-test to assess the difference in means between the two groups. The total sample consisted of 45 patients, namely 20 patients with confirmed Covid-19 and 25 patients with probable Covid-19. The results showed that the mean ALC value in the confirmed group was 1,241.5/µL, while in the probable group it reached 1,812.59/µL. These findings indicate a statistically significant difference between the mean ALC of the two groups, with a p-value of 0.0001. This difference also supports the findings of previous studies that lymphopenia is more commonly found in patients with verified Covid-19 infection. Thus, this study confirms that Covid-19 confirmation status is associated with changes in ALC, which can be a supporting clinical parameter in the evaluation and monitoring of patient conditions.

Factors Influencing Compliance with the Use of Personal Protective Equipment (PPE) Among Healthcare Workers: A Literature Review

Kurnia Ningrum, Risti Graharti, TA Larasati — Sat, 02 May 2026 00:00:00 +0000

Abstract

The use of Personal Protective Equipment (PPE) is a key component of infection prevention and control in healthcare facilities. Compliance among healthcare workers determines the effectiveness of protection against biological, chemical, and physical hazards in the workplace. However, PPE compliance remains a challenge in many healthcare settings. This literature review aims to identify factors influencing PPE compliance among healthcare workers based on recent studies. The review was conducted using Google Scholar, PubMed, and ScienceDirect databases with the keywords “personal protective equipment,” “compliance,” and “healthcare workers.” Articles published between 2015 and 2025 were included. Of the 62 articles identified, 13 met the inclusion criteria and were analyzed in depth. The analysis focused on synthesizing findings related to individual, organizational, and work environment factors affecting PPE compliance. The results show that individual factors such as knowledge, attitude, risk perception, and work experience significantly influence compliance behavior. Organizational factors, including PPE availability, institutional policies, supervision, safety culture, and continuous training, also play an important role in shaping compliance. In addition, work environment factors such as workload, comfort of PPE, and physical conditions of care areas contribute to compliance levels. Understanding these factors is essential for improving patient and healthcare worker safety through comprehensive intervention strategies. Improving education, strengthening institutional policies, and ensuring adequate PPE supply systems are expected to enhance compliance. In Indonesia, integrated studies examining factors influencing PPE compliance remain limited, highlighting the need for further research to support policy development and occupational safety practices for healthcare workers.

Case Report: The Use of MRI in the Diagnosis of Acute Post-Traumatic Vertebral Compression Fracture

Frecilia Afrida, Ricky Ramadhian — Sat, 02 May 2026 00:00:00 +0000

Vertebral compression fracture (VCF) is a common spinal injury, particularly among the elderly population with underlying osteoporosis. This condition may lead to severe pain, functional limitation, spinal deformity, and increased morbidity and mortality if not accurately diagnosed and managed. A comprehensive clinical and radiological approach is essential to establish the diagnosis and to differentiate acute traumatic fractures from chronic or pathological vertebral fractures. Magnetic resonance imaging (MRI) plays a crucial role in the evaluation of vertebral compression fractures due to its superior ability to assess soft tissues, spinal cord involvement, and bone marrow edema, which is a key indicator of acute injury. This case report describes a 68-year-old male with a known history of osteoporosis who presented to the emergency department following a fall from a height. The patient complained of severe lumbar pain and limited mobility without neurological deficits. MRI examination revealed an acute vertebral compression fracture characterized by bone marrow edema, with no evidence of paraspinal soft tissue involvement or spinal cord compression. These findings confirmed the diagnosis of an acute post-traumatic VCF in an osteoporotic patient. This case highlights the pivotal role of MRI in determining fracture acuity, evaluating spinal stability, detecting potential complications, and guiding appropriate management strategies. The appropriate utilization of MRI may improve diagnostic accuracy, facilitate timely intervention, and ultimately enhance clinical outcomes in patients with vertebral compression fractures.

Case Report : A 48-Year-Old Male with Cervical Herniated Nucleus Pulposus

Sat, 02 May 2026 00:00:00 +0000

Cervical herniated nucleus pulposus is a common cause of neck pain, radicular pain, and neurological deficits resulting from compression of cervical nerve roots by intervertebral disc pathology. The incidence of cervical radiculopathy peaks in the fourth and fifth decades of life and is closely associated with degenerative disc changes. This report presents the case of a 48 year old male who complained of chronic neck pain radiating to the upper back and right upper extremity, accompanied by paresthesia, restricted cervical range of motion, and weakness during right arm elevation. The symptoms had persisted for one year and progressively worsened over the last two months, with no history of trauma. The patient also reported intermittent burning sensations that improved with rest. These clinical features were consistent with cervical radiculopathy caused by progressive cervical disc herniation. Magnetic resonance imaging of the cervical spine in sagittal sections revealed disc protrusion at the C5 C6 level causing anterior spinal canal compression, as well as mild disc protrusion at C6 C7 with narrowing of the anterior subarachnoid space. Thoracic spine MRI showed no significant abnormalities. Initial management consisted of conservative therapy using non steroidal anti inflammatory drugs and gabapentin to address inflammatory and neuropathic pain components. Due to persistent symptoms and motor weakness, surgical intervention with percutaneous endoscopic cervical discectomy was planned. A thorough understanding of cervical spine anatomy, disc herniation pathophysiology, clinical manifestations, and imaging findings is essential for accurate diagnosis and appropriate treatment selection to prevent symptom progression and deterioration of patient quality of life.

The Diference Between Knowledge of Diabetes Mellitus with Blood Sugar Levels In Type 2 Diabetes Patiens

Samintola Dolok Saribu, Winda Trijayanthi Utama — Sat, 02 May 2026 00:00:00 +0000

Diabetes mellitus (DM) is a degenerative disease characterized by elevated blood sugar levels or hyperglycemia. The incidence of DM continues to increase every year, influenced by various factors such as suboptimal recovery, the need for continuous consumption of antidiabetic drugs, uncontrolled blood sugar levels, and low patient knowledge about the disease. This condition can worsen complications and reduce the quality of life of patients. This study was conducted to determine the difference in the level of knowledge about diabetes mellitus with blood sugar levels in type 2 diabetes mellitus patients at Dr. H. Abdul Moeloek Regional General Hospital in Lampung Province. This study used a descriptive method with a cross-sectional study design. Sampling was conducted using non-probability sampling, specifically consecutive sampling, with instruments in the form of questionnaires to measure knowledge levels and random blood sugar level tests. Data were analyzed using the chi-square test to see the relationship between variables. A total of 35 respondents participated in this study, with 11.4% in the good knowledge category, 14.3% in the adequate category, and 74.3% in the poor category. The average blood sugar level of the respondents was 285 mg/dL. The statistical test results showed a p-value of 0.003, indicating a significant difference between the level of knowledge about diabetes mellitus and fasting blood sugar levels. Thus, this study concluded that the level of patient knowledge has a significant relationship with fasting blood sugar levels in type 2 DM patients.

A 45 Year Old Female Patient with Cornea Ulcers Cum Hypopyon Oculi Dextra: A Case Report

Aulia Ghina Sabilla, Muhammad Maulana — Sat, 02 May 2026 00:00:00 +0000

The cornea is a transparent, avascular layer located at the front of the eye, primarily functioning to protect the eyeball. It consists of five distinct layers: the epithelium, Bowman's membrane, stroma, Descemet's membrane, and endothelium. The corneal epithelium plays a crucial role as a barrier against infection. Damage to the epithelial layer allows external substances to penetrate the underlying tissues, potentially leading to a corneal ulcer. A corneal ulcer is a pathological condition characterized by a lesion or defect in the corneal epithelium, resulting from a loss of tissue integrity and accompanied by an inflammatory infiltrate. This condition can affect the cornea from the epithelium to the stroma and constitutes an ophthalmic emergency that can severely threaten vision. Corneal ulcers are frequently associated with hypopyon, which is an inflammatory reaction in the anterior chamber of the eye, visible as a white layer that settles at the bottom of the chamber due to gravity. In this case report, a 45-year-old woman presented with a red right eye and decreased visual acuity that had persisted for one month. The patient reported a history of ocular trauma from being struck by grass while pulling weeds. Ophthalmological examination revealed a visual acuity of 1/300 in the right eye (OD), bulbar conjunctival injection, hyperemia of the fornix and palpebral conjunctiva, positive ciliary injection, a cloudy cornea with a distinct, excavated central lesion measuring 9 mm x 7 mm, and hypopyon occupying the lower one-third (1/3) of the anterior chamber. Visual acuity in the left eye (OS) was 6/6, and the anterior segment of the OS was within normal limits. The management provided included medicamentous therapy, non-medicamentous therapy, and a plan for operative intervention. The medicamentous regimen for the right eye consisted of topical Moxifloxacin 0.5% hourly, Natamycin 5% every 3 hours, Atropine Sulfate 1% every 8 hours, Sodium Potassium Chloride every 4 hours, and systemic therapy with Ciprofloxacin tablets 2x500 mg and Ketoconazole tablets 3x200 mg.

The Role of Erythrocyte Sedimentation Rate in the Evaluation of Chronic Inflammatory Diseases

Faraztya Purnama Sari, Putu Ristyaning Ayu Sangging, Risti Graharti — Sat, 02 May 2026 00:00:00 +0000

Chronic inflammation is a persistent immune response resulting from continuous inflammatory stimuli, such as chronic infections, autoimmune diseases, and metabolic disorders, and plays a significant role in the pathogenesis of various chronic diseases. Continuous evaluation of inflammatory activity requires laboratory parameters that are easily accessible and capable of reflecting long-term inflammatory processes. The erythrocyte sedimentation rate (ESR) is a non-specific hematological test that remains widely used in clinical practice to assess systemic inflammation. Elevated ESR values occur as a result of changes in acute-phase proteins, particularly fibrinogen and immunoglobulins, which promote erythrocyte aggregation and accelerate the sedimentation process. This review article aims to discuss the role of ESR in the evaluation of chronic inflammatory diseases, including the mechanisms underlying ESR elevation, its advantages, limitations, and comparison with other inflammatory biomarkers. ESR has advantages in representing stable chronic inflammation, its simplicity, and relatively low cost; however, it also has limitations, including low specificity and a slow response to changes in inflammatory activity. Therefore, ESR should be interpreted comprehensively in conjunction with clinical evaluation and other inflammatory biomarkers to support optimal management of chronic inflammatory diseases.

Low Back Pain Among Rubber Farmers: A Literature Review

Redi Bintang Pratama, Muhammad Aditya Utomo, Winda Trijayanthi Utama — Sat, 02 May 2026 00:00:00 +0000

Low Back Pain (LBP) is one of the most common musculoskeletal disorders experienced by agricultural workers, including rubber farmers, due to heavy physical demands, repetitive activities, and non-ergonomic work postures. The high prevalence of LBP among rubber farmers has the potential to reduce work productivity, increase the risk of disability, and negatively impact quality of life. This study aims to review the literature related to the incidence, prevalence, risk factors, and prevention and management efforts for Low Back Pain in rubber farmers. The method used is a literature review by searching for scientific articles through the Google Scholar, PubMed, ScienceDirect, and Garuda databases. The articles included were original studies in Indonesian and English published in the last ten years and discussed LBP in rubber farmers or agricultural workers with similar work characteristics. The results of the study showed that the prevalence of LBP among rubber farmers was relatively high, ranging from 33% to more than 70%. The main risk factors include heavy workloads, non-ergonomic work postures, repetitive work activities, prolonged standing or bending, and working without ergonomic training. Individual factors such as age, length of service, body mass index, and smoking habits also contribute to an increased risk of LBP. Recommended LBP prevention and management efforts include applying ergonomic principles at work, regulating work and rest times, occupational health education, stretching and back muscle strengthening exercises, and controlling individual risk factors. The conclusion of this literature review indicates that LBP among rubber farmers is a multifactorial occupational health problem that requires ergonomic interventions and continuous occupational health promotion.

Risk Factors and Complications of Uncontrolled Hypertension in Indonesia: Literature Review

Nabila Puspitasari, Ade Yonata, Suryadi Islami — Sat, 02 May 2026 00:00:00 +0000

Uncontrolled hypertension is one of the major public health problems in Indonesia and contributes substantially to increased morbidity and mortality related to cardiovascular disease and target organ damage. This condition occurs when blood pressure remains above the recommended target despite the use of antihypertensive therapy. This article aims to review and analyze risk factors and complications associated with uncontrolled hypertension in the Indonesian population. The study applied a literature review design with article searches conducted through the Google Scholar and Garuda databases in accordance with the PRISMA 2020 guidelines. Following the selection process, twelve articles met the inclusion criteria and were analyzed descriptively. The review results indicate that the dominant risk factors for uncontrolled hypertension include older age, obesity, diabetes mellitus, dyslipidemia, employment status, low educational level, poor medication adherence, excessive salt intake, physical inactivity, smoking, and psychological stress. The most frequently reported complications were stroke, chronic kidney disease, heart failure, myocardial infarction, and hypertensive retinopathy. These findings demonstrate that uncontrolled hypertension in Indonesia remains a serious challenge that requires integrated control strategies through early detection, optimization of therapy, improvement of patient adherence, and strengthening of promotive and preventive interventions based on primary health care services and community involvement.

Comparison of Conventional and Modern Extraction Methods on the Antibacterial Activity of Natural Products

Aisyah Ramadhani Paduan Ratu, Syazili Mustofa, Giska Tri Putri, Hendri Busman — Sat, 02 May 2026 00:00:00 +0000

Indonesia memiliki keanekaragaman hayati yang kaya, dan banyak spesies tumbuhan yang dapat dimanfaatkan sebagai agen antibakteri. Pemilihan metode ekstraksi diduga memengaruhi efektivitas antibakteri. Artikel ini bertujuan untuk membandingkan efektivitas metode ekstraksi konvensional dan modern dalam menghasilkan hasil optimal dan aktivitas antibakteri. Studi ini dilakukan dengan menggunakan pendekatan tinjauan sistematis. Penelaahan literatur menghasilkan 27 studi yang memenuhi kriteria inklusi. Metode konvensional yang paling umum diterapkan meliputi maserasi dan sokletasi, sedangkan teknik modern yang diidentifikasi meliputi ekstraksi berbantuan gelombang mikro (MAE), ekstraksi berbantuan ultrasonik (UAE), dan ekstraksi fluida superkritis (SFE). Bukti yang ditinjau menunjukkan bahwa metode ekstraksi modern mampu menghasilkan hasil yang lebih tinggi dalam durasi yang lebih singkat dibandingkan dengan teknik konvensional. Lebih lanjut, aktivitas antibakteri tertinggi juga dilaporkan pada ekstrak yang dihasilkan melalui metode modern. Meskipun demikian, beberapa studi menunjukkan bahwa metode konvensional masih dapat menghasilkan aktivitas antibakteri yang kompetitif, tergantung pada pilihan pelarut dan karakteristik fitokimia bahan tanaman. Secara keseluruhan, metode ekstraksi modern menawarkan peningkatan efisiensi dan potensi untuk meningkatkan aktivitas antibakteri, namun pemilihan metode yang ideal harus mempertimbangkan sifat bahan baku, senyawa target, dan aplikasi yang dimaksud.

The Effectiveness of Herbal Plant Based Topical Preparations on Incision Wound Healing in In Vivo Studies: A Narrative Review

Rijal Rahman Hakim, Syazili Mustofa, Giska Tri Putri, Hendri Busman — Sat, 02 May 2026 00:00:00 +0000

Incision wounds are injuries that result in the disruption of skin tissue continuity and are at risk of infection as well as delayed healing if not managed optimally. Standard treatment often uses chemical antiseptics which risk causing irritation and resistance side effects. Indonesia has a wealth of herbal plants that have the potential to be effective wound healing alternatives. To evaluate the effectiveness of herbal-based topical preparations on incision wound healing in in vivo studies of white rats (Rattus norvegicus). This study is a narrative review conducted by searching for experimental scientific articles (True Experimental) published between 2020–2025. Inclusion criteria included in vivo studies on white rats with incision wound models, using herbal topical preparations (gels, ointments, creams), and comparing them with positive controls (standard drugs) and negative controls. Nine selected articles were analyzed descriptively. The review results showed that plants such as Papaya Stem, Jatropha curcas Leaves, Jatropha multifida Leaves, Lantana camara, Stenochlaena palustris, Shallots, Allium chinense, Lime Peel, and Taro showed significant wound healing activity. Topical preparations with optimal extract concentrations were able to match the healing speed of standard drugs and improve histopathological parameters (collagen and fibroblasts). Based on the literature review, herbal-based topical preparations are proven effective in accelerating incision wound healing in rat models and have the potential to be developed as phytopharmaceuticals.

Orbital Apex Syndrome in an Uncontrolled Diabetes Mellitus Patient: Case Report

Astriani Rahayu, Olivia Putri Chairunnisa, Muhammad Yusran — Sat, 02 May 2026 00:00:00 +0000

Orbital Apex Syndrome (OAS) is a rare and severe neurological condition characterized by dysfunction of multiple cranial nerves, including II, III, IV, V1, and VI, which can rapidly progress and lead to permanent vision loss. This report describes a case of a 63-year-old male with uncontrolled diabetes mellitus, hypertension, and gout arthritis who presented with left periorbital pain, swelling, redness, followed by vision loss and ophthalmoplegia. Clinical examination revealed no light perception, severe ptosis, proptosis, reduced corneal sensation, and a relative afferent pupillary defect in the left eye. Laboratory findings showed leukocytosis and markedly elevated HbA1c levels. Brain computed tomography demonstrated opacification of the left ethmoid and sphenoid sinuses with enhancement at the left orbital apex, supporting the diagnosis of OAS secondary to bacterial sinusitis. Despite prompt clinical evaluation and planned further imaging, the patient’s systemic condition rapidly deteriorated, leading to multi-organ failure and death before neurological improvement could be achieved. This case highlights the aggressive course of OAS in immunocompromised individuals, particularly those with poorly controlled diabetes. Inflammation and edema at the orbital apex can cause compression of multiple cranial nerves, resulting in visual impairment, ophthalmoplegia, and sensory deficits. Early recognition of symptoms, rapid diagnosis, and immediate multidisciplinary management, including targeted antimicrobial therapy and strict glycemic control, are essential to prevent irreversible complications and improve outcomes. OAS secondary to sinusitis should be strongly considered in patients presenting with painful ophthalmoplegia and visual loss, especially in those with significant metabolic comorbidities.

A Social Aspect and Stigma in Children With Epilepsy : A Literature Review

Amti Miftakhur Rizki, Roro Rukmi Windi Perdani, Linda Septiani, Anggi Setiorini — Sat, 02 May 2026 00:00:00 +0000

Epilepsy in children not only results in neurological impairments but also carries a significant psychosocial burden, with social stigma emerging as a major challenge affecting quality of life. This literature review aims to explore the forms of stigma, social impacts, contributing factors, and strategies to mitigate stigma in children with epilepsy by analyzing published research. The literature search was conducted through PubMed, Google Scholar, and Scopus, focusing on articles published between 2020 until 2025. Findings from the review indicate that stigma is experienced by approximately one-third of children and adolescents with epilepsy (34%–35.6%), showing consistent patterns across countries such as Tiongkok, Uganda, and Turki. Stigma is significantly correlated with increased psychological distress and reduced self-esteem. Factors such as lack of formal education (62% stigma rate in Uganda), low family income, and higher seizure frequency were found to exacerbate stigma levels. The impact of stigma also extends to parents, contributing to health fatalism the belief that health outcomes are predetermined and cannot be changed. However, physical activity has been identified as a mediating factor that can reduce the negative psychological consequences of stigma. Overall, stigma represents a universal issue that adversely affects the mental health of children with epilepsy and their families. A holistic approach combining seizure control with psychosocial interventions including public education, school-based support, and promotion of physical activity is essential to combat stigma and improve quality of life.

Burn Wound: Epidemiology, Pathophysiology, and Factors That Accelerate Healing

Muhamad Djamil Alviando Arja, Syazili Mustofa — Sat, 02 May 2026 00:00:00 +0000

Burn injuries are a type of injury that can be life-threatening and cause extensive tissue damage, requiring proper treatment to prevent complications and accelerate healing. The healing process of burn injuries involves complex biological mechanisms that are influenced by various factors, including inflammatory mediators, immune cells, and tissue components. This study aims to examine the epidemiology of burns, explain the pathophysiological process, and identify factors that can accelerate healing. The research method used is a literature review by searching scientific articles from PubMed, ScienceDirect, Google Scholar, and the Cochrane Library using keywords related to burn injury, pathophysiology, wound healing, and healing factors. The review results show that burns are more common in the productive age group, with the most common causes being fire, hot water, and electric current. The pathophysiology of burns includes the phases of hemostasis, inflammation, proliferation, and remodeling, all of which are influenced by the complex interaction of various cellular and molecular mediators. Several factors have been proven to accelerate wound healing, such as the active compounds in tobacco (flavonoids, tannins, saponins, and alkaloids), adequate nutrition, proper wound care management, and the patient's overall health condition. Understanding the epidemiology, pathophysiology, and healing factors of burn wounds is crucial for improving patient management quality and can serve as the basis for developing more effective and safer therapies.

Personal Hygiene in The Prevention of Soil-Transmitted Helminth Infections

Sat, 02 May 2026 00:00:00 +0000

Soil-transmitted helminth (STH) infection is a disease caused by intestinal nematode worms transmitted through contaminated soil. The STH species that most commonly infect humans include Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. STH infection remains a global public health problem and is estimated to affect more than 1.5 billion people worldwide, particularly in developing countries with tropical and subtropical climates and inadequate sanitation conditions. Among school-aged children, STH infection is one of the most frequently encountered forms of helminthiasis due to suboptimal hygiene-related behaviors. This infection can lead to various adverse health outcomes, including impaired nutrient absorption, poor nutritional status, reduced learning ability, and delays in children’s growth and development. This literature review aims to provide an overview of the role of personal hygiene, including handwashing with soap, nail hygiene, and the use of footwear, in preventing STH infection among children. The findings indicate that the prevalence of STH infection among children with poor personal hygiene ranges from 24% to more than 80% in several endemic areas. Children who do not wash their hands with soap are reported to have a 6–9 times higher risk of infection compared to those who practice good hygiene. Poor nail hygiene and not wearing footwear are also associated with an increased risk of infection. This literature review emphasizes that personal hygiene plays a crucial role in preventing STH infection and reinfection among children and should be strengthened as part of school-based promotive and preventive strategies.

Intestinal Protozoan Infections in Elementary School Children in Indonesia: A Narrative Review of Knowledge and Risk Factors

Sat, 02 May 2026 00:00:00 +0000

Intestinal protozoan infections are a prevalent public health problem among primary school children in Indonesia, contributing significantly to acute and chronic diarrhoea, malnutrition, and anaemia, which ultimately reduce cognitive performance and learning ability. This literature review aims to identify patterns of knowledge, hygiene behaviour, and environmental and socio-economic factors that serve as key risk predictors for intestinal protozoan infections in this population. Various cohort and cross-sectional studies in Indonesia highlight Giardia duodenalis, Entamoeba histolytica/dispar, and Blastocystis spp. as the dominant pathogens, with the highest prevalence in areas with poor sanitation, limited access to clean water, and high population density. Behavioural factors include a lack of consistency in handwashing with soap (HWS), nail hygiene, and healthy snacking habits, despite the widespread implementation of health education interventions. Multivariate analysis of the literature review indicates a synergistic interaction between low hygiene knowledge and inconsistent practices, coupled with suboptimal environmental sanitation, limited potable water infrastructure, and low socioeconomic status as key determinants. Overall, these findings emphasise the need for a multidimensional intervention approach that integrates behaviour-based education, improved sanitation infrastructure, and socio-economic support to reduce the burden of intestinal protozoan infections in primary school children in Indonesia. Further prospective research is needed to validate causality and evaluate the effectiveness of interventions.

Subacute Subdural Hematoma with Delayed Onset After Mild Head Trauma in a Young Patient: a Case Report

Anggela Anggela, Frecilia Afrida, Fitriyani Fitriyani — Sat, 02 May 2026 00:00:00 +0000

Subdural hematoma (SDH) is a neurological disorder characterized by the accumulation of blood beneath the dura mater. Its incidence ranges from 1.7 to 20.6 cases per 100,000 population annually, with a higher prevalence observed in the elderly. Known risk factors associated with SDH include traumatic brain injury such as traffic accidents, advanced age, alcohol consumption, anticoagulant use, and various medical conditions such as epilepsy, hemophilia, hydrocephalus, cerebral aneurysm, and malignancies. A 19-year-old female patient, Ms. ZA, presented to the Emergency Department of Abdul Moeloek Regional General Hospital (RSUDAM) with complaints of persistent headaches radiating to the posterior neck region, which significantly interfered with daily activities. The patient had a history of a traffic accident two weeks prior to admission. According to her family, she lost consciousness for approximately two hours and experienced hematemesis following the incident. There were no reported symptoms of limb weakness, epistaxis, otorrhagia, or seizures. On physical and neurological examination, no abnormalities were identified. However, a cranial CT scan revealed a subacute subdural hematoma in the left frontoparietal region with a thickness of 0.47 cm. The patient was managed conservatively with both pharmacological and planned surgical interventions. Medical therapy included intravenous Mannitol titration dose, Paracetamol 3x750 mg, Ranitidine 2x1 ampoule, along with oral supplementation of vitamin B12 and folic acid, each administered twice daily. Surgical management involved a planned burr hole drainage procedure by the attending neurosurgeon.

Complete Rectal Prolapse in a Patient with Suspected Benign Prostatic Hyperplasia: a Case Report

Jannah Fatinah Zhohiroh, Yusmaidi Fathurrahman — Sat, 02 May 2026 00:00:00 +0000

Rectal prolapse is a condition characterized by the protrusion of the full thickness of the rectal wall through the anus due to weakness of the pelvic floor supporting structures, which is chronic and progressive in nature. Repeated increases in intra-abdominal pressure, such as in chronic constipation and lower urinary tract disorders, play a role in its pathogenesis. We report a case of a 55-year-old male presenting with a protruding anal mass that could not be manually reduced for 8 hours prior to admission, with a history of progressively worsening prolapse over approximately ±10 years. Complaint accompanied by chronic constipation, with hard, infrequent bowel movements and habitual excessive straining during defecation and lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH). Physical examination revealed a cylindrical prolapsed mass with a central orifice, characteristic of complete rectal prolapse. No signs of acute complications or significant systemic abnormalities were found on supporting investigations. The patient underwent surgical management with suture rectopexy as the definitive treatment combined with the Thiersch procedure. This combined approach was selected due to the long-standing, large prolapse and the suspected sphincter weakness, aiming to provide anatomical stabilization along with additional mechanical support to reduce the risk of recurrence. Postoperatively, the patient showed clinical improvement without complications. This case highlights the importance of identifying factors that increase intra-abdominal pressure and considering combined surgical approaches in managing complete rectal prolapse to achieve optimal clinical outcomes.

Analysis of Predictive Factors for Improved Glycemic Control in Patients with Type 2 Diabetes Mellitus at Abdul Moeloek Hospital, Lampung Province, January–December 2022

Sat, 02 May 2026 00:00:00 +0000

The 2018 Basic Health Research report indicated that prevalence of Diabetes Mellitus (DM) in Indonesia increased to 8,3%. This rise was accompanied by an increase in obesity prevalence, a major risk factor for DM, from 14,8% in 20113 to 21,8% in 2018. These findings suggest that the number of individuals with DM in Indonesia is substantial and continues to grow annually. Data from Bandar Lampung City in 2021 showed that out of 6,467,624 individuals aged ≥15 years, approximately 198,046 (3%) were diagnosed with DM. This study aimed to analyze the association between predictive factors and glycemic control among patients with type 2 diabetes mellitus at Abdul Moeloek Hospital, Lampung Province, during January-December 2022. This research employed an observational study with a cross-sectional design. Secondary data were obtained from medical records of both inpatient and outpatient type 2 diabetes mellitus patients. Data analysis was performed using the Chi-Square test, with the Mann-Whitney test as an alternative. The result demonstrated significant associations between age at diagnosis (p=0,006), duration of Diabetes (p=0,012), body mass index (p=0,016), and comorbidities (p=0,020) with glycemic control. In conclusion, age at diagnosis, duration of disease, body mass index, and comorbid conditions were significantly associated with glycemic control among patients with type 2 diabetes mellitus receiving oral antidiabetic drugs and insulin therapy at Abdul Moeloek Hospital, Lampung Province, during January-December 2022.

The Role of Health Education in Preventing Non-Communicable Diseases in the Community: a Literature Review

Sekar Feni Widiyastuti, Azelia Nusadewiarti — Sat, 02 May 2026 00:00:00 +0000

A Non-communicable diseases (NCDs) are the leading cause of global morbidity and mortality, accounting for approximately 71% of all deaths annually, including among the productive-age population. In Indonesia, the prevalence of NCDs such as hypertension, diabetes mellitus, and cardiovascular diseases continues to show a significant upward trend. The main risk factors for NCDs include unhealthy behaviors such as smoking, unhealthy dietary patterns, physical inactivity, and alcohol consumption. From a clinical perspective, controlling these risk factors through behavioral modification is a key strategy to reduce the incidence, progression, and complications of NCDs. Health education plays a crucial role in improving health literacy, including an individual’s ability to understand medical and numerical information related to their health condition. Improved health literacy is associated with better treatment adherence, improved control of clinical parameters such as blood pressure and blood glucose levels, and a reduced risk of long-term complications. Various forms of educational interventions, including healthcare-based services, community-based programs, and digital health technologies, have been proven effective in promoting healthy lifestyle behaviors. However, their implementation still faces several challenges, including low levels of health literacy, sociocultural influences, limited access to information, and suboptimal health system support. Therefore, comprehensive, sustainable, and context-based educational strategies are needed to enhance the effectiveness of both prevention and clinical management of NCDs.

Depressive-Type Schizoaffective Disorder in a Young Adult Woman: Challenges in Diagnosis and Management, A Case Report

Muhammad Akmal Ghani, Tendry Septa, Risti Graharti — Sat, 02 May 2026 00:00:00 +0000

Depressive-type schizoaffective disorder (F25.1) is a psychiatric disorder characterized by the coexistence of psychotic symptoms typical of schizophrenia and prominent depressive symptoms within the same episode of illness. This disorder is thought to involve dysregulation of multiple neurotransmitter systems, particularly dopamine and serotonin, which contribute to the simultaneous manifestation of psychotic and affective symptoms. Establishing the diagnosis remains challenging due to its overlapping clinical features with schizophrenia and major depressive disorder with psychotic features. This case report describes a 26-year-old woman who presented to the Psychiatric Outpatient Clinic of Lampung Provincial Mental Hospital with complaints of talking to herself, auditory hallucinations consisting of voices commenting on her daily activities, insomnia, anxiety, feelings of worthlessness, and suicidal ideation that emerged during the course of her illness. The symptoms developed following psychosocial stressors, including family conflicts and economic difficulties. Mental status examination revealed hypotymic mood, blunted affect, circumstantial thought process, and a history of persistent auditory hallucinations, while cognitive function, orientation, and memory remained intact. Based on psychiatric assessment and the diagnostic criteria of the Indonesian Classification of Mental Disorders (PPDGJ-III), the patient was diagnosed with depressive-type schizoaffective disorder (F25.1). The diagnosis was established due to the simultaneous presence of schizophrenic and depressive symptoms within the same episode of illness. Differential diagnoses considered included paranoid schizophrenia and severe depressive episode with psychotic symptoms. The patient received pharmacological treatment consisting of risperidone, trihexyphenidyl, fluoxetine, lithium carbonate, and clobazam, accompanied by psychoeducation and supportive psychotherapy. Clinical improvement in psychotic symptoms and overall functioning was observed following treatment. Depressive-type schizoaffective disorder requires comprehensive clinical evaluation to distinguish it from other psychotic and affective disorders and necessitates a multidisciplinary approach combining pharmacological and psychosocial interventions to improve patient outcomes.

The Relationship between Endothelial Dysfunction and Preeclampsia with Severe Features

Angelie Cahya Putri, Nurul Islamy, Anisa Nuraisa Jausal, Suharmanto Suharmanto — Sat, 02 May 2026 00:00:00 +0000

Preeclampsia with severe features is a major pregnancy complication contributing substantially to maternal and perinatal morbidity and mortality worldwide. This condition primarily arises from impaired placentation that leads to placental hypoperfusion and the release of anti-angiogenic factors such as sFlt-1 and soluble endoglin, which suppress pro-angiogenic activity of VEGF and PlGF, ultimately triggering systemic endothelial dysfunction. This review aims to analyze the relationship between endothelial dysfunction and the pathophysiological mechanisms of severe preeclampsia through current scientific literature. A narrative literature review was conducted, examining clinical and molecular studies related to angiogenesis, oxidative stress, inflammation, and biomarkers influencing disease progression. The findings indicate that angiogenic imbalance, increased oxidative stress, inflammatory activation, and hemodynamic alterations are key drivers of endothelial injury, resulting in hypertension, proteinuria, edema, and multi-organ involvement. Additionally, the sFlt-1/PlGF ratio is identified as a strong predictor of disease severity and progression toward severe preeclampsia. The discussion highlights that deeper understanding of endothelial mechanisms provides promising pathways for developing early screening tools and targeted therapeutic strategies. Thus, endothelial dysfunction represents a central component in the pathogenesis of severe preeclampsia and remains critical for improving detection and clinical management.

Case Report: Radiological Features of Cardiomegaly in A Patient with Type 2 Diabetes Mellitus

Dinda Ananto Prameswari, Ricky Ramadhian — Sat, 02 May 2026 00:00:00 +0000

Cardiomegaly is a condition characterized by enlargement of the heart that is often detected only after clinical symptoms develop. Type 2 diabetes mellitus is recognized as a major contributor to cardiovascular disease, including structural and functional cardiac abnormalities. This case report aims to describe the radiological findings of cardiomegaly in a patient with type 2 diabetes mellitus. A 44-year-old male presented with dyspnea that worsened during physical activity. Physical examination revealed a blood pressure of 176/88 mmHg, peripheral edema, and a cardiac murmur. Laboratory investigations showed hyperglycemia, normocytic normochromic anemia, and mild renal dysfunction. An anteroposterior (AP) chest radiograph demonstrated bilateral reticular opacities suggestive of interstitial pulmonary edema, widening of the right peritracheal stripe line suspicious for a vascular etiology, and cardiomegaly. Electrocardiography revealed evidence of left ventricular hypertrophy. The patient was diagnosed with type 2 diabetes mellitus, congestive heart failure (CHF), and normocytic normochromic anemia. Chronic hyperglycemia in diabetes mellitus may increase the production of reactive oxygen species (ROS), leading to oxidative stress, inflammation, myocardial hypertrophy, fibrosis, and cardiac remodeling, all of which contribute to the development of cardiomegaly and heart failure. Coexisting hypertension and chronic anemia may further aggravate these pathological processes. In this case, measurement of the cardiothoracic ratio (CTR) showed a value greater than 0.5, supporting the diagnosis of cardiomegaly. Chest radiography remains a useful initial screening modality for detecting cardiac enlargement in patients with type 2 diabetes mellitus.

A Case Report: Type 2 Diabetes Melitus, Hypertension, and Diabetic Neuropathy in A Geriatric Patient

Tazkia Vidini Caya, Nanda Fitri Wardani — Sat, 02 May 2026 00:00:00 +0000

Type 2 diabetes mellitus (T2DM) and hypertension are common chronic diseases among older adults and are associated with microvascular complications such as diabetic neuropathy. Comprehensive management is essential to prevent disease progression and improve patients' quality of life. This case report aims to describe the implementation of a holistic approach in managing a geriatric patient with T2DM, hypertension, and diabetic neuropathy at the primary healthcare level. Data were obtained through history taking, physical examination, laboratory findings, and follow-up evaluation. A 62-year-old woman presented with tingling and pain in both feet that had progressively worsened over the previous three months, accompanied by intermittent headaches. Clinical evaluation revealed a blood pressure of 160/95 mmHg, fasting blood glucose of 162 mg/dL, random blood glucose of 348 mg/dL, diminished patellar and Achilles reflexes, and a Douleur Neuropathique 4 (DN4) score of 5. The patient was diagnosed with T2DM, stage II hypertension, and diabetic neuropathy. Management included pharmacological treatment with metformin, amlodipine, and gabapentin, along with education regarding medication adherence, dietary modification, physical activity, and family support. Follow-up after 14 days demonstrated improvement in neuropathic symptoms, reduction of blood pressure to 137/90 mmHg, decreased fasting blood glucose to 149 mg/dL, improved treatment adherence, and healthier lifestyle behaviors. This case highlights that a holistic approach integrating medical therapy, health education, lifestyle modification, and family involvement can contribute to better clinical outcomes and risk factor control in geriatric patients with chronic diseases.

Recurrent Diabetic Foot Ulcer in an Elderly Patient with Chronic Non-Adherence and Coastal Environmental Risk : A Family Medicine Case Report

Lely Sustantine Totalia, R. Wianti Soeryani, Novendy Novendy — Sat, 02 May 2026 00:00:00 +0000

Recurrent diabetic foot ulcer is a major chronic complication of type 2 diabetes mellitus that contributes to increased
morbidity, amputation rates, and reduced quality of life, particularly among older adults. Ulcer recurrence is influenced not only by clinical factors but also by medication adherence, psychosocial conditions, family support, and environmental
circumstances. This case report aims to describe the application of a family medicine approach in managing recurrent diabetic foot ulcer in an elderly patient with multimorbidity and socioeconomic limitations. Mr. S, a 74-year-old man with a five-year history of type 2 diabetes mellitus, hypertension, peripheral neuropathy, and previous foot debridement, presented with a plantar ulcer on the left foot caused by a wooden splinter from the floor of his stilt house. Clinical evaluation revealed a 3 × 2 cm ulcer with moderate infection, HbA1c of 10.2%, poor medication adherence, high diabetes distress, and risk of malnutrition. Holistic assessment identified internal factors including poor glycemic control, chronic non-adherence, and diabetic neuropathy, as well as external factors such as a hazardous coastal home environment, an elderly caregiver, and limited family income. Management was carried out using patient-centered care, family-focused care, and communityoriented care through wound debridement, insulin therapy, antibiotics, intensive diabetic foot care education, medication adherence improvement strategies, home environmental modification, and home visits. Four-week follow-up demonstrated clinical improvement, with ulcer size decreasing to 1.5 × 1 cm, healthy granulation tissue formation, improved medication adherence, and better foot care practices. A comprehensive family medicine approach may improve clinical outcomes and help prevent recurrent diabetic foot ulcers among vulnerable older adults.

Intestinal Protozoa as A Risk Factor For Malnutrition in School-Age Children: Literature Review

Husaini Gustiar, Linda Septiani, Betta Kurniawan, Jhons Fatriadi Suwandi — Sat, 02 May 2026 00:00:00 +0000

Intestinal protozoal infection is an important health problem among elementary school children, especially in areas with poor sanitation and high population density. Protozoa such as Giardia lamblia, Entamoeba histolytica, Cryptosporidium spp., and Blastocystis hominis can disrupt nutrient absorption, trigger chronic diarrhea, alter gut microbiota composition, and induce mucosal inflammation, which directly affects children’s nutritional status. This literature review aims to analyze the role of protozoal infections as risk factors for malnutrition by examining publications from 2020 to 2025 indexed in PubMed, Google Scholar, and ScienceDirect. The method involved selecting articles based on inclusion criteria, methodological quality, and relevance to nutritional status variables. The analysis showed that the prevalence of protozoal infections in children ranged from 3.2 percent to 62.5 percent, with wide geographic variation. Giardia lamblia was associated with stunting, with odds ratios ranging from 1.8 to 2.4. Cryptosporidium spp. contributed to wasting through recurrent chronic diarrhea. Entamoeba histolytica was related to underweight conditions. Blastocystis hominis played a role in mild nutritional deficits through subclinical inflammation and disruption of microbial balance. Behavioral factors such as lack of handwashing with soap, consumption of untreated water, fecal-oral exposure, and prolonged residence in high-risk environments increased the likelihood of malnutrition. This review concludes that intestinal protozoal infections significantly contribute to malnutrition among elementary school children through impaired absorption, chronic diarrhea, mucosal inflammation, and persistent digestive dysfunction.

Utilization of Digital Imaging in Healthcare: A Literature Review

Mohamad Idris, Linda Septiani — Sat, 02 May 2026 00:00:00 +0000

The development of digital technology has driven significant transformation in healthcare, particularly through the utilization of digital imaging. The application of digital imaging in healthcare includes disease diagnosis, radiological analysis, early disease detection, identification of herbal medicinal plants, patient monitoring, telemedicine, and the development of Artificial Intelligence (AI)-based healthcare systems to enhance the accuracy and efficiency of medical services. This study examined the utilization of digital imaging in healthcare based on various relevant studies. The method used in this study was a literature review conducted by collecting and analyzing national and international scientific articles related to digital image processing in healthcare. The results of the literature review indicate that digital imaging plays an important role in improving the effectiveness of diagnosis, medical analysis, and telemedicine services. Artificial Intelligence (AI) technologies, particularly deep learning and Convolutional Neural Networks (CNN), have demonstrated high accuracy in medical image processing, while image compression technology improves the efficiency of medical data transmission. However, its implementation still faces several challenges, including limitations in technological infrastructure, image quality, internet connectivity, and patient data security. Therefore, the development of digital imaging technology in healthcare needs to be continuously improved to support a more optimal healthcare system.

Keywords: artificial intelligence, digital imaging, medical diagnosis, healthcare, technology

Potential of Indonesian Medicinal Plants as Candidates for Supportive Therapy in Dengue Hemorrhagic Fever

Terza Aflika Happy, Linda Septiani, Risti Graharti, Femmy Andrifianie — Sat, 02 May 2026 00:00:00 +0000

Dengue Hemorrhagic Fever (DHF) remains a major public health problem in Indonesia, with high morbidity and mortality rates. Since the current management of DHF is primarily supportive, identifying effective complementary therapies has become an important research priority. Indonesia possesses extraordinary biodiversity, including numerous medicinal plants rich in bioactive secondary metabolites with potential therapeutic properties. This study aimed to review the potential of Indonesian medicinal plants as candidates for supportive therapy in DHF based on available scientific evidence. A literature review was conducted by analyzing national and international publications related to medicinal plants and dengue infection. The findings indicate that several Indonesian medicinal plants, including Phyllanthus niruri L., Psidium guajava, Carica papaya L., and Ipomoea batatas, demonstrate promising potential as supportive therapies for DHF. Their therapeutic effects are mainly attributed to bioactive compounds such as flavonoids, quercetin, saponins, tannins, alkaloids, and polyphenols, which exhibit antiviral, anti-inflammatory, antioxidant, and immunomodulatory activities. These compounds may also promote thrombopoiesis by stimulating granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-3, thereby contributing to platelet recovery. In addition, they help reduce oxidative stress, suppress excessive pro-inflammatory cytokine production, and preserve vascular endothelial integrity, potentially preventing disease progression and plasma leakage. Overall, Indonesian medicinal plants represent promising candidates for complementary supportive therapy in DHF. Nevertheless, further preclinical investigations and well-designed clinical trials are required to confirm their efficacy, safety, optimal dosage, and mechanisms of action before they can be recommended for routine clinical practice.