The Avicenna Medical Journal (AMedJ) is a peer-reviewed, open-access scholarly journal published biannually by the Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Indonesia. AMedJ publishes original research and reviews in biomedical sciences, clinical medicine, medical education, Islamic perspectives in medicine, and genetic as well as biomolecular studies. All manuscripts undergo a double-blind peer review with an average review time of eight weeks. Articles are published under a CC-BY-NC license, and an Article Processing Charge (APC) of IDR 400,000 applies to accepted manuscripts. ISSN: P-ISSN 2716-3628 | E-ISSN 2720-9563 DOI Prefix: 10.15408/avicenna Frequency: 2 issues per year Language: English Publisher: Faculty of Medicine, UIN Syarif Hidayatullah Jakarta Contact: amedj@apps.uinjkt.ac.id and amedj.fkuinjkt@gmail.com
Faculty of Medicine, UIN Syarif Hidayatullah Jakarta
Aggressiveness of Indonesia Triple Negative Breast Cancer Driven by Programmed Death Ligand-1 and Tumor Microenvironment
Background: Triple-negative breast cancer (TNBC) is one of the most aggressive breast cancer subtypes in Indonesia. The expression of PD-L1 1 and TME characteristics play essential roles in both immune system avoidance and medical treatment results. The Indonesian medical field lacks a comprehensive analysis of local TNBC research data because new studies continue to emerge. Methods: The research followed PRISMA guidelines and PECO framework for analysis. A total of 22 records were identified; 10 studies met eligibility, and 6 studies were included in the final synthesis. Results: The studies showed a wide range of PD-L1 expression in tumor cells, from 21% to 93.5%, depending on antibody clone (SP142, SP263, 22C3) and scoring threshold. The studies showed that most tumors had high-grade characteristics between 42% and 88% while displaying high proliferative rates with Ki-67 ≥20% in more than 80% of cases. The three most common metastasis locations in patients were the lungs, bones and then the brain. The survival rates of patients improved when their CD8/CD163 and CD4/FOXP3 ratios increased. The survival outcomes of patients worsened when their PD-L1 expression levels or mRNA expression increased. Conclusion: Indonesian TNBC shows aggressive pathological characteristics with variable PD-L1 expression and diverse tumor microenvironments. PD-L1 alone does not provide consistent prognostic value and is best interpreted together with immune-cell ratios and TIL density. Establishing standardized biomarker evaluation and adopting immune-based molecular classification could improve the precision of immunotherapy strategies in Indonesia. Keywords: Triple-negative breast cancer, PD-L1, tumor microenvironment, immune ratios, metastasis, Indonesia
Copyright (c) 2026 Dianidya Kumandang Sari, Rr. Ayu Fitri Hapsari , Devy Ariany, Deamon Sakaraga
Comparison of the Effectiveness of Ringer’s Lactate and 0.9% NaCl on Mortality in Adult Sepsis Patients: An Evidence-Based Case Report
Background: The selection of crystalloid fluid in sepsis resuscitation affects acid-base balance, organ perfusion, and mortality. 0.9% NaCl (normal saline, NS) is the standard fluid, but its high chloride content has the potential to cause physiological disturbances. In contrast, balanced crystalloids such as Ringer's Lactate (RL) have an electrolyte composition closer to physiological plasma and are thought to provide better clinical outcomes. Recent evidence suggests a possible role for RL in reducing mortality in patients with sepsis, although some studies report mixed results. This study aims to evaluate the effectiveness of Ringer's Lactate compared to 0.9% NaCl on mortality in adult patients with sepsis, using an evidence-based case report approach to inform fluid resuscitation decisions. Methods: A literature search was conducted in October 2025 through PubMed NCBI, Medline EBSCO, ScienceDirect, and Google Scholar. Four studies met the inclusion criteria (3 RCTs, 1 SR/MA of RCTs) and were subsequently screened according to the Centre for Evidence-Based Medicine (CEBM) guidelines for critical appraisal, relative to validity, relevance, and practicality to the clinical scenario. Results: Across the included studies, the direction of effect generally favored RL over NS with respect to mortality outcomes. However, effect estimates were reported using different measures, including risk ratios and hazard ratios, and not all observed differences reached statistical significance. Given methodological heterogeneity and identified risks of bias, quantitative pooling of results was not performed, and findings were interpreted qualitatively. Conclusion: The use of Ringer’s Lactate in adult patients with sepsis appears to be associated with a favorable direction of effect on mortality compared with 0.9 NaCl. Nevertheless, the certainty of this evidence is limited, and definitive conclusions regarding superiority cannot be drawn. Keywords: NaCl, balanced crystalloid, normal saline, mortality, Ringer’s lactate, sepsis
Copyright (c) 2026 Muhammad Rafif Ridwan, Faras Khairunnisa Ridwan, Muhammad Ijlal Ridwan, Surianty Susilo
Correlation between Preoperative Retinometry and Postoperative Cataract Vision with Phacoemulsification and Lens Implantation in Jakarta Hospital
Background: Cataracts, characterized by lens cloudiness, impair vision. Predicting visual outcomes after phacoemulsification with intraocular lens (IOL) implantation is crucial, and preoperative retinometry may be a valuable predictive tool. This study aimed to analyze this relationship. Methods: A cross-sectional analytical study was conducted using secondary data from 31 patients who underwent phacoemulsification with IOL at Jakarta Hospital (2020-2022). Patient characteristics (age, sex) were described. The correlation between preoperative retinometry measurements and postoperative visual acuity was analyzed using Spearman’s rank correlation test. Results: The cohort comprised 22 males and 9 females. Most male patients were aged 46–64, while most female patients were >65 years old. A statistically significant correlation was found between preoperative retinometry and postoperative visual acuity (p=0.005). The correlation strength was moderate (r=0.494), indicating that higher preoperative retinometry values predicted better postoperative visual acuity. Conclusion: Preoperative retinometry is a significant predictor of visual acuity following cataract surgery. This finding supports its clinical use for prognosticating surgical outcomes, demonstrating a direct, positive relationship between preoperative measurement and postoperative result. Keywords: Cataract, age, sex, retinometry, phacoemulsification, intraocular lens
Copyright (c) 2026 Cyntia Rachmani Ferdyanti Kamal, Witri Ardini, Erfira Erfira, Hiro Putra Faisal, Nida Farida
Time-Dependent Secretion of IFN-γ, TNF-α, Perforin, and Granzyme-B in CTL-Conditioned Medium from Colorectal Cancer Patient
Background: Cytotoxic T lymphocytes (CTLs) are key effectors of adaptive immunity, exerting their functions through the release of pro-inflammatory cytokines and cytotoxic molecules. Conditioned medium (CM) derived from CTLs has emerged as a potential cell-free immunotherapeutic strategy; however, the temporal dynamics of its secreted mediators remain poorly defined. Methods: Human CTLs were isolated, activated, and cultured in vitro. CM was harvested at defined intervals (days 5, 10, and 15). Concentrations of interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), perforin, and granzyme-B were quantified by enzyme-linked immunosorbent assay (ELISA). Temporal secretion profiles were evaluated using ANOVA with post-hoc analysis. Results: IFN-γ and TNF-α exhibited peak secretion at day 5, followed by a decline at later time points. In contrast, perforin and granzyme-B increased progressively, reaching maximal levels at day 15. All four mediators demonstrated significant time-dependent variation (p < 0.05). Conclusion: CTL-derived CM displays distinct time-dependent secretion patterns, with cytokines predominating during early activation and cytotoxic molecules dominating later phases. These findings underscore the importance of optimizing CM collection timing to maximize its immunomodulatory and therapeutic potential, and provide a rationale for further translational development of CTL-CM in immunotherapy.
Balb/C Mice Optimization as Triple Negative Breast Cancer ModelWith 4T1 Cells and 4T1 Cells 3D Culture Inoculation Methods
Background: Triple Negative breast cancer (TNBC) is a subtype of breast cancer with negative expression of Progesterone Receptor (PR), Estrogen Receptor (ER), and Human Epidermal growth factor Receptor 2 (HER-2). Among other types of breast cancer, TNBC has a high rate of malignancy and recurrence, invasive, distant metastases, and resistance to conventional therapy. An optimal TNBC model is needed for drug discovery research in targeted therapy. However, optimizing the TNBC animal model by inoculating the 4T1 tumor cell line has a number of challenges and it is quite hard to be developed, especially in Indonesia. Methods: This quasi-experiment study used 28 Balb/c mice divided into four groups (7 mice respectively), group A (injected with basal medium), group B (injected with 4T1 cell), group C (injected with 4T1 cell + Geltrex), and group D (injected with 3D Culture 4T1 cell + Geltrex). After being injected, mice were followed up for 35 days. Once a week they had to be observed by measuring body weight and tumor volume. After 35 days, mice were sacrificed. Liver, lung, brain, and mammary gland were analyzed histopathologically with Hematoxylin-eosin (HE). Chi-square statistical analysis was done to compare intergroups. Results: Histopathologically, there was a group that found positive samples of Invasive Ductal Carcinoma (IDC)-like with a percentage of 28. 57% (2 out of 7), namely group C. Meanwhile, group B and D did not find any positive samples of TNBC, but in the mammary tissue, there was inflammation and epithelial hyperplasia. No distant metastases were found in the liver, lungs, and brain, however, there was inflammation in these secondary organs. Statistically, there was no significant difference between treatment groups with p-value = 0.41. Conclusion: The 4T1 cell inoculation method can produce IDC-like on HE with an incidence of 28.75% (2 of 7 individuals) in group C.
Social Support Build Resilience in Multidrug-Resistant Tuberculosis Patients: A Cross-Sectional Study in MDR-TB Patient Support Group
Background: Multidrug-resistant tuberculosis (MDR-TB) patient faces multi-dimensional challenges due to the physical factor, long-term treatment, negative stigma, and psychosocial challenge. Addressing these issues patient requires a resilience. The formation of resilience is influenced by both internal and external factors, including social support. This study purposed to assess the social support impact on resilience in MDR-TB patients. Methods: This study was an observational analytic study with cross sectional design. A total of 33 respondents with MDR-TB confirmed, a member of MDR-TB support group, and under treatment were involved. The social support level was measured using the ISEL-12 (Interpersonal Support Evaluation List) questionnaire, while the level of resilience was assessed using the CD-RISC-25 (Connor-Davidson Resilience Scale). Spearman correlation test in SPSS Ver 24.0 was used to examine the relationship between social support and resilience among patients with MDR-TB. Results: Majority of respondents (17 respondents, 51.6%) have good social support and 23 respondents (69.7%) exhibited a good level of resilience. The Spearman correlation test revealed a significant positive correlation between social support and resilience, with a p-value of 0.030 and a moderate strength correlation coefficient (r) of 0.378. Conclusion: This finding showed that good social support toward MDR-TB patients gives positive impact to patients’ resilience. Thus strengthens the system of social support in support group is important to decrease the psychosocial challenges and help to succeed the treatment.
Copyright (c) 2025 Putri Wulan Akbar, Lailia Nur Rachma, Zainabur Rahmah, Mohammad Iqbal Firdaus, Bryka Vian Nanggali
The Effect of Empathy on Patient Satisfaction in Hemodialysis Services: A SERVQUAL-Based Cross-Sectional Study
Background: Empathy is a fundamental aspect of healthcare service quality and plays a vital role in influencing patient satisfaction, especially in long-term, high-contact treatments such as hemodialysis. Despite its importance, limited research in Indonesia has specifically explored the impact of empathy on patient satisfaction in hemodialysis settings. This study aims to evaluate the effect of empathy on patient satisfaction among individuals receiving hemodialysis at Jakarta Hajj Hospital using the SERVQUAL framework. Methods: A quantitative, cross-sectional study was conducted at Jakarta Hajj Hospital between November and December 2022, involving 118 hemodialysis patients selected through consecutive sampling. Data were collected using a structured questionnaire adapted from the KKP-2017 and SERVQUAL instruments. Statistical analysis included descriptive statistics, followed by assumption tests (normality, linearity, and heteroscedasticity), and simple linear regression using SPSS version 26. Results: The mean empathy score was 3.47 ± 0.63. Simple linear regression indicated that empathy had a statistically significant effect on patient satisfaction (B = 0.701, SE = 0.084, 95% CI [0.535–0.868], β = 0.613, R² = 0.375, p < 0.001). The fitted model was: Patient Satisfaction = 13.24 + 0.701(Empathy). Conclusion: Empathy significantly contributes to patient satisfaction in hemodialysis services. Strengthening empathetic communication and patient-provider relationships may enhance service quality and overall patient experiences in chronic care environments.
A Comparative Study of Academic Performance in Myopic Students With and Without Vision Correction
Background: Vision is the primary way people get information and is crucial for the learning process. The World Health Organization (WHO) reports that 285 million people worldwide are visually impaired, with 42% of cases due to uncorrected refractive errors. School-age children are highly vulnerable to refractive errors, with myopia (nearsightedness) being the most common. A decrease in visual function due to myopia interferes with tasks requiring far vision, such as reading the blackboard, which can negatively impact academic performance. This study aims to compare the academic performance of patients with corrected and uncorrected myopia. Methods: This was a cross-sectional analytic study of 5th-grade elementary school students with myopia in Jakarta during 2023. Data collected included the students' average mid-semester exam scores and their myopia status, determined by visual acuity examinations. Results: Out of 106 respondents, 34% (36 people) had corrected myopia and 66% (70 people) had uncorrected myopia with 35 (33%) respondents having academic performance results below the passing grade. Bivariate analysis of the data using the Chi-square test yielded a p-value of 0.010 (p < 0.05). Conclusion: There is a significant relationship between academic performance results and the incidence of myopia.
Occupational Stress in Nurses at Hajj Hospital UIN Syarif Hidayatullah Jakarta: The Role of Conflict with Doctor and Death Exposure
Background: In the demanding healthcare environment, both nurses and doctors are at high risk of experiencing stress, with nurses being particularly vulnerable to various psychosocial hazards. This risk also applies to nurses at Hajj Hospital UIN Syarif Hidayatullah Jakarta, especially following organizational changes and nurse rationalization implemented since 2024. The aim is to identify contributing factors to occupational stress and inform interventions to improve nurses' well-being and the quality of healthcare services. Methods: A cross-sectional analytical study was conducted involving all 96 nurses at Hajj Hospital UIN Syarif Hidayatullah Jakarta. Data was collected using Expanded Nursing Stress Scale (ENSS) to asses hazard psychosocial and Workplace Stress Scale (WSS) to evaluate occupational stress levels through a Google Form. The study examined the association between conflict with doctors and lack of experience with End of life (independent variables) and the nurses' reported stress levels (dependent variable). Results: The study revealed a significant association between conflict with doctors and occupational stress (p=0.000), with nurses experiencing conflict being 6.13 times more likely to experience occupational stress (95% CI: 2.337-16.106). A significant relationship was also found between limited experience with End of life and occupational stress (p=0.017), with nurses having limited experience facing a 2.07-fold increased risk of occupational stress (95% CI: 1.188-3.612). Conclusion: The occupational stress experienced by nurses at Hajj Hospital UIN Syarif Hidayatullah Jakarta is significantly related to conflict with doctors and limited experience in managing End of life situations.
Copyright (c) 2025 The Avicenna Medical Journal
The Impact of Neem Leaf Extract (Azadirachta indica) on renal hypoxia in Balb/C Mice Infected with Plasmodium berghei
Background: Millions of people die from malaria every year in tropical areas, making it a severe public health concern. Plasmodium, a genus of protozoa with several species, is the main cause of the disease. Humans contract malaria when bitten by female Anopheles sp. mosquitoes. Malaria is one of the world's deadliest diseases. The WHO's 2020 World Malaria Report indicates that there were 229 million cases of malaria globally in 2019, with 409,000 fatalities resulting from the disease. In nine Southeast Asian countries, malaria is endemic. After India, Indonesia is the second most endemic region. Transcription factors such as the HIF-1α protein are produced by hypoxic cells. Patients with malaria have a blockage of the cytoaderenal pathway. Hypoxia occurs due to vascular disorders that prevent oxygen flow to the kidney tissue. Antimalarial drugs are developed in response to the lethal consequences of hypoxia. Methods: BALB/c mice aged sixteen weeks were infected with the Plasmodium berghei ANKA strain. For six days, the neem leaf 96% ethanol extract was administered orally at doses of 8 mg, 12 mg, and 16 mg. As comparisons, negative, positive, and healthy controls were also included. The kidneys were isolated, and the mice were surgically removed on the seventh day. HIF-2α expression in kidney tissue, which was measured immunohistochemically using Abcam's anti-HIF-2α (H1α67) ChIP Grade antibody, was a characteristic of kidney hypoxia. One-way ANOVA, post-hoc LSD, and Pearson correlation tests were used to assess the hypotheses. Results: Treatment with neem leaf extract significantly decreased oxygen levels (p<0.000). The correlation test showed a very strong relationship between neem leaf extract and HIF-2α expression in the kidney (r=16.057). Conclusion: Twelve milligrams of neem leaf extract can reduce the risk of renal hypoxia. Keywords: Neem leaves, malaria, degree of parasitemia, hypoxia, Azadirachta indica
Copyright (c) 2026 Zainabur Rahmah, Tafakur Bagus Religious, Putri Wulan Akbar, Erryk Kosbandhono, Muhammad Amiruddin, Ach Nashichuddin
Can Spirituality Protect Medical Students from Psychological Distress? Evidence from a Descriptive-Analytical Study
Background: Heightened psychological distress is commonly reported among medical students due to academic pressure, multiple assessments, disrupted sleep, and a competitive learning environment. This study investigates the role of spirituality as a potential protective factor for mental health among first-year medical students. Methods: A descriptive-analytical design was employed, involving 115 students who completed a demographic questionnaire, the Daily Spiritual Experiences Scale (DSE), and the General Health Questionnaire-12 (GHQ-12). Results: A total of 92 valid responses were obtained, resulting in an 80% response rate. Respondents were predominantly female (n = 61, 66.3%), with most aged 18 years (n = 59, 64.1%). Regarding Qur’anic memorization, 43.5% had memorized only a few short chapters, 40.2% had memorized 1-5 juz, and 4.3% had memorized 26-30 juz. Mental health screening indicated that 46.7% had a positive mental state, while 53.3% were categorized as having a negative mental state. Notably, 80.4% of students (n = 74) reported limited levels of spirituality. Statistical analysis revealed a strong positive correlation between spirituality and mental health (r = 0.99; p = 0.00). Conclusion: These findings suggest that higher spiritual engagement may buffer psychological distress and that integrating spiritual approaches into medical education could help mitigate psychological distress in early training stages.
Distinguish Between Perforation or Coronary Cameral Fistula: A Rare Findings during Percutaneous Coronary Intervention
Introduction: Coronary cameral fistula (CCFs) is a connection between the coronary arteries and a chamber of the heart. Most of it is accidentally found on coronary angiography. This case report discusses a patient with symptoms in whom CCF was incidentally found on CAG. Case presentation: A 49-year-old male patient came to our hospital to undergo an elective standby coronary angiogram. No plaque was found in the LM and LCx; however, a chronic total occlusion (CTO) in the medial LAD was found, as well as 60% tubular stenosis in the proximal and 75% tubular stenosis in the distal RCA. Drug eluting stent was placed up to 20 atm in mid-distal LAD. However, we found contrast-dye extravasation that emptied directly into the heart chamber from the distal LAD. There’s no any signs of pericardial effusion from the bedside echo thus reinforcing the diagnosis of CCFs. Discussion: CCFs represent rare cardiovascular anomalies characterized by abnormal connections between coronary arteries and cardiac chambers or major vessels. Conclussion: Bedside echocardiography is a rapid modality to differentiate perforation from CCFs and can be performed intra-PCI. Management such as transcatheter closure or surgical ligation, can be performed with their own indications.
Body Image and Exercise Habits: A Study on UIN Jakarta Female Medical Students (2020-2022)
Background: Body image refers to an individual's perception of their physical appearance, which may influence self-confidence and exercise habits. During adolescence and early adulthood, significant physical and psychological changes often result in body dissatisfaction, potentially affecting patterns of physical activity. Exercise is a structured form of physical activity intended to promote health and maintain physical fitness. This study aimed to examine the relationship between body image and exercise habits among female medical students. Methods: A quantitative analytic study with a cross-sectional design was conducted involving 100 female medical students in the academic phase (class of 2020–2022) at the Faculty of Medicine, UIN Jakarta. Participants were selected using random sampling. Data on body image and exercise habits were collected using validated questionnaires and analyzed using the chi-square test. Results: The analysis revealed a statistically significant negative association between body image and exercise habits (p = 0.006; p < 0.05). Students with a negative body image were more likely to engage in frequent exercise compared to those with a positive body image. Conclusion: Body image significantly influences exercise habits among medical students. A better understanding of this relationship may support the development of health promotion strategies that foster consistent exercise routines without reinforcing negative body perceptions.
Characteristics of Dermatological and Venereological Diseases in Outpatients at Fatmawati Hospital From 2022 to 2024
Background: This research aimed to assess the characteristics and prevalence of dermatological and venereological diseases among outpatients at Fatmawati Hospital in Jakarta during the 2022-2024 period. Methods: A retrospective descriptive approach was employed, utilizing the total sampling method. Results: The findings reveal a consistent pattern in the ten most common diseases over the three-year period, including Dermatitis (31.22%), Morbus Hansen (17.03%), Psoriasis (11.70%), Acne Vulgaris (6.86%), Condyloma Acuminata (6.80%), Vitiligo (6.83%), Scabies (5.77%), Syphilis (5.17%), Tinea (4.73%), and Seborrheic Keratosis (3.87%). Conclusion: The research highlights the importance of Fatmawati Hospital as a key teaching institution for both general practitioners and specialists, due to the high number of dermatological and venereological cases observed during the research period. The presence of cases that could be managed at lower-level healthcare facilities also underscores the need for more effective referral systems.
Factors Affecting Symptoms of Depression and Anxiety among Pregnant Women during COVID-19 Pandemic
Background: Changes in social life have a negative impact on mental health, leading to conditions such as depression and anxiety. Pregnant women are particularly vulnerable to mental health disorders, including depression and anxiety. This study aims to identify factors that influence symptoms of depression and anxiety in pregnant women during the COVID-19 pandemic. Methods: Analytic observational research was used in this study. Primary data were collected from November 1 to November 28, 2021. The data collected came from distributing paper questionnaires and online questionnaires at 7 Independent Midwifery Clinics. The measurement instruments used include Beck Anxiety Inventory (BAI), Fear of COVID-19 Scale (FCV-19S), and Beck Depression Inventory (BDI). Results: The results showed that out of 308 pregnant women in Palembang, 13.0% experienced mild depression symptoms, 5.2% experienced moderate depression symptoms, and 1.6% experienced severe depression symptoms. In addition, 41.9% of participants reported anxiety symptoms, which were categorized as mild to moderate anxiety (31.5%), moderate to severe anxiety (9.1%), and severe anxiety (1.3%). There was a significant association found in the bivariate analysis between depressive symptoms and the age maternal women, a significant association of anxiety and depression with abortion history, and a significant association of depressive symptoms and anxiety symptoms with fear related to COVID-19. Conclusions: Research reveals multiple relationships between maternal age and depressive symptoms; between an abortion history and anxiety symptoms; between fear of COVID-19 and the symptoms of depression and anxiety. Counselling in mental health is necessary, especially for pregnant women with high-risk of depression and anxiety.
The Differences of Adaptive and Maladaptive Coping Mechanisms on the Intensity of Maternal Pain in the First Stage of Labor
Background: Coping mechanisms play a crucial role in managing maternal pain during labor. Understanding the differences between adaptive and maladaptive coping strategies can help improve maternal care and pain management. The aim of this study was to determine the differences in the level of coping mechanisms and the intensity of pain in mothers during the first stage of labor. Methods: A cross-sectional study was conducted on 66 laboring mothers at PKU Muhammadiyah Delanggu Hospital. The intensity of pain was measured using the Visual Analog Scale (VAS), while coping mechanisms were assessed using the Brief COPE Questionnaire. Data analysis was performed using the Wilcoxon test with a significance level of p < 0.005. The results of the Wilcoxon test indicate a significant difference between adaptive and maladaptive coping mechanisms in relation to labor pain intensity (p < 0.005) (CI=95%). Among mothers with mild pain, 76.2% used adaptive coping mechanisms, whereas only 23.8% relied on maladaptive strategies. Similarly, in the moderate pain group, 78.8% used adaptive coping, while 21.2% used maladaptive coping. However, in the severe pain category, the majority (66.7%) used maladaptive coping mechanisms, whereas only 33.3% applied adaptive coping strategies. Results: The study confirms that adaptive coping mechanisms are associated with lower pain intensity during labor, while maladaptive strategies correlate with higher pain levels. Conclusion: These findings highlight the need for healthcare providers to educate and encourage expectant mothers to adopt effective coping strategies to improve maternal comfort and childbirth outcomes. Future research should explore interventions that enhance adaptive coping mechanisms in labor management.
Description of Sociodemography and Disease Distribution of Pilgrims through Wukuf Safari In The Hajj Period 1443H/2022M
Background: Hajj is wukuf at Arafah, which distinguishes it from Umrah.. The Indonesian government as the hajj organizer is obliged to facilitate wukuf safaris for pilgrims who have physical limitations or suffer from illness with assistive devices. Meanwhile, study on Hajj Health during Wukuf at Arafat and its relation to the condition of the pilgrims who carry out Safari Wukuf is still very limited. Therefore, this study aims to describe the disease and sociodemographic factors in Wukuf safari pilgrims during the 1443H/2022M Hajj period. Method : This study was carried out as a descriptive study using secondary data from 1443H/2022M Hajj pilgrims in the SISKOHATKES application. This research includes 138 pilgrims who participated in wukuf safari. The data is processed using descriptive analysis. The ethical clearance was obtained from the UIN Syarif Hidayatullah Jakarta Ethical Committee (Number No.B-022/F12/KEPK/TL.00/04/2023). Result : This study included 138 pilgrims from 12 embarkation points, with the majority coming from East Java (27 respondents) and West Java (25 respondents). The elderly (60-70 years) made up 59.4% of respondents, and those from the first batch (arrived in Medina to Mecca) made up 65.2%. All respondents have comorbidities, with cardiovascular illness (77.5%) and endocrine diseases (73.2%) being the most common. Cardiovascular illnesses are found to be the most prevalent among pilgrims in this study. Conclusion : The pilgrims who undergo Safari Wukuf are those who have a comorbid. Most diseases are caused by cardiovascular and endocrine disorders in the elderly congregation (60-70 years) and on the departure of the first wave.
Copyright (c) 2024 The Avicenna Medical Journal
The Effect of Duration of Use and Hygienity on Microbial Profile of Used Mask Surface Used by Children School in Jakarta
Background: Coronavirus Disease 2019 (COVID-19) is a respiratory infectious disease caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) virus. The main medium of transmission of COVID-19 is droplets from the respiratory tract. One way to prevent this is to wear a mask. In the context of good and correct mask use, the duration of mask use is one of the concerns, because a study shows that microbes in the form of potentially harmful bacteria and fungi can be found in the use of masks for a long duration. In addition, dental hygiene is also a factor in the development of microorganisms after wearing a mask. Children aged 0-18 years are vulnerable to contracting Covid-19, especially from family. However, until now there have been no studies conducted to identify the hygiene of masks used by children. The aims of this study is to determine the hygiene profile of masks used by school children by identifying the type, number of microbes and knowing the factors that affect the hygiene of the use of masks by elementary, junior high and high school age children. Methods: This study is a cross-sectional study by conducting interviews and collecting masks that have been worn by elementary school students in Jakarta. The surface of the face side mask was then swabbed and cultured on Nutrient Agar media. Data were analyzed using the Mann Whitney test. Results: The subjects in this study were 62 children with an age range of 7-13 years with the majority being female as many as 34 children (54.84%). This study found that there was no significant difference between the number of colonies based on tooth brushing activities before using a mask and the duration of mask use (p 0.396; p 0.268), while there was a significant difference with dental caries (p 0.041). In addition, there was a significant relationship between the presence of pathogens in the mask and the activity of brushing teeth before using the mask (p 0.027) with an OR value of 3.709 (95% CI 1.288- 10.685), meaning that respondents who did not brush their teeth before using the mask had a 3.709 times chance of having pathogens in the mask they used. Meanwhile, in terms of the presence of pathogens, there was no significant relationship between the presence of pathogens in the mask with dental caries and duration of mask use (p 0.166; p 0.516). The types of bacteria identified were dominated by non-pathogenic bacteria in humans, such as Staphylococcus epidermidis and Staphylococcus aureus. This could have occurred because it was affected by the pH of the skin surface which tends to be acidic, due to the free fatty acids contained in the skin. Conclusion: Dental and oral hygiene using masks is related to the presence of pathogenic microbes in the use of masks to prevent Covid-19 in children.
The Impact of High Dose Ozone Therapy on Hematological and Biochemical Profiles : An Observational Study
Background: Ozone therapy, namely High Dose Ozone Therapy (HDO), has become a versatile medical treatment in several clinical settings. Although it is becoming more well acknowledged, there is still a lack of extensive evidence about the impact of this on hematological and biochemical indicators. This study seeks to address this void by examining the consequences of this phenomenon in a clinical environment. Method: An observational study was done, which followed a structured approach, comprising a total of 100 patients who were selected from the SMC Clinic. Hematological and biochemical indices were evaluated before and after ozone therapy sessions to analyze blood parameters. Two blood samples were obtained at two specific time points: prior to the commencement of the ozone therapy (T0) and after the therapy was finished (T1). Results: Substantial alterations were noted in both hematological and biochemical parameters after the therapy. The hematological changes observed in this study showed a substantial rise in the red blood cell count (p=0.009), hemoglobin levels (p=0.004), and hematocrit (p=0.039), along with a decrease in erythrocyte sedimentation rate (ESR) (p=0.020). Notable biochemical changes were observed, including significant modifications in total plasma protein (TPP) (p=0.008) and lactate levels (p=0.001). Furthermore, there was a noteworthy decrease (p<0.05) in the levels of malondialdehyde (MDA), which is a marker for oxidative stress. Conclusion: HDO exerts a regulatory influence on crucial hematological, biochemical, and oxidative stress factors. These findings indicate that HDO may have therapeutic benefits for treating chronic disorders and cancer. It can improve blood parameters and reduce oxidative stress. The decrease in markers of oxidative stress, such as MDA, suggests a potential reduction in the likelihood of problems associated with oxidative damage in chronic diseases. Nevertheless, additional research is required to validate these findings, investigate their wider therapeutic implications, and comprehend the long-term consequences and safety of HDO therapy.
Reduction in Depressive Symptoms in Patients with Breast Cancer Following Cognitive Behavioral Psychotherapy Intervention
Background: Breast cancer, a malignancy in breast tissue has the highest prevalence among women globally. Around 50% breast cancer patients have experienced depression caused by the illness and its treatments, which is alarming due to its effects on the treatment effectiveness and recovery. This study is performed to know the effects of cognitive behavioral therapy in decreasing depressive symptoms in breast cancer patients. Methods: The researchers followed a structured and systematic approach sourced from seven databases: ScienceDirect, ResearchGate, PubMed, Google Scholar, Biomed Central, Taylor & Francis Online, and Pharmacophore. The keywords used in this study were “Breast cancer” AND “Cognitive Behavioral Therapy” AND “Depression”. The initial search yielded 1.190 journals. After applying the inclusion and exclusion criteria, 11 journals were found that met criteria. The search was limited to randomized controlled trials, assessed using the JBI critical appraisal for risk of bias. Results: The result shows positive outcomes in breast cancer patients with depression comorbidity following the implementation of cognitive behavioral therapy intervention. These positive changes include enhanced problem-solving skills in relation to psychosocial and emotional aspects, improved adaptability to various situations, and decreasing depressive symptoms. Conclusion: Cognitive behavioral therapy is effective in decreasing depressive symptoms in breast cancer patients
Juridical Analysis of Health Services for Elderly Hajj Pilgrims
Indonesia with the largest Muslim population causes the number of Muslims who registered to leave for the holy land to increase, including the number of elderly pilgrims in 1444 H/2023 M as many as 10,166 people from a total quota of 221,000 pilgrims. The Indonesian Ministry of Religious Affairs issued several special policies related to elderly pilgrims. The program is outlined in the "Elderly Friendly Hajj Guide" which consists of several important things in providing services to elderly pilgrims both at the time of departure, while in the holy land, and when returning to the homeland. This research uses a descriptive qualitative approach and secondary data, in the form of normative research through literature studies consisting of laws and regulations, books, journals, and presentation papers. Regulations related to elderly pilgrims have been stated in Law No. 8 of 2019 on the Implementation of Hajj and Umrah. However, existing laws and regulations have not specifically regulated services for elderly pilgrims, so special regulations are needed that regulate elderly pilgrims including elderly Hajj health services. The Indonesian Ministry of Health in supporting the Elderly Friendly Hajj policy seeks to improve health services to pilgrims, especially to elderly pilgrims. Policy changes related to health istithaah are needed to reduce the risk of morbidity and mortality of elderly pilgrims along with the increasing number of elderly pilgrims in the coming year.
Study on the Prevalence of Low Back Pain based on Age and Gender in Indonesian Hajj Pilgrims: Period 1438 – 1443 H
Background: Musculoskeletal pain is a common complaint in men and women with a wide age range and in all sociocultural groups. Low back pain significantly contributes to the overall burden of musculoskeletal conditions. In 2020, low back pain (LBP) affected 619 million people globally and it is estimated that the number of cases will increase to 843 million cases by 2050, driven largely by population expansion and ageing.1 Hajj is a series of worship with high demands on physical strength, and musculoskeletal pain experienced by the pilgrims will significantly affect the worship and the pilgrims' classification of health, known as health istithaah. Objective: This study aims to determine the prevalence of low back pain incidence based on the age and gender of Indonesian pilgrims in periods 1438-1443 H. Methods: This descriptive study with a cross-sectional design used secondary data from Health Information System for Indonesian Hajj Pilgrims (SISKOHATKES) with a period of Hajj from 1438 H until 1443 H. Results: This study showed that the prevalence of Indonesian pilgrims in 1438-1443 H diagnosed with low back pain in Saudi Arabia based on age group was highest at 46 years and over each year. However, the prevalence of female sex was not consistently higher than male in 1438-1443 H. The percentage of the male sex (0.020%) was higher than the female sex (0.016%) in 1438 H, and the female sex was consistently higher than the male sex in 1439 – 1440 H, while in 1443 H, the male and female sexes had the same proportion. Conclusion: Indonesian pilgrims aged 46 years and over with a diagnosis of low back pain have a higher prevalence in each year of examination, and female and male pilgrims do not consistently have a higher prevalence value in the period 1439 - 1443 H
Analysis of Food consumed by Indonesian Moslem Hajj Pilgrims: Complete and Incomplete Nutrition
Background.The Mabrur hajj is the goal of carrying out hajj. Hajj pilgrims during the hajj journey are expected to have physical readiness besides financial and security. Health problems while in Mecca such as: congested congregation, population diversity, climate, and far from health facilities arises the possibility of various infections and non-infections. One of the physical readings is through the consumption of nutrients during the Hajj pilgrimage. This study analyzes the understanding of nutritional needs for health during the pilgrimage journey of Indonesia Methods. The design of this study was conducted descriptively observing a quantitative approach by filling out a questionnaire. The number of respondents who filled out the questionnaire reached 231 people with the following profiles: 66% women; 71% of the productive age is 25-50 years. Results:There are 71% of respondents consuming food with incomplete nutritional composition at every meal. However, most of the nutritional composition consumed and needed has been fulfilled. There are only a few types of fruit that are less liked because they are not accustomed to the tongue of the pilgrims. There are 55% pilgrims who prepare their own supplements and medicines Conclusion: This shows the awareness of pilgrims to the need for macronutrients and micronutrients during the pilgrimage. It is necessary to educate the benefits of nutrition need to be done to reduce immunity, energy needs, physical health and religious approaches.
Age of children contributes to potential drug interaction at nine primary health cares
Introduction: Adverse drug reaction including drug interaction should be prevented early in children’s patients since children are vulnerable subjects due to their biological development process. Our study aimed to identify the potential drug interaction in children’s patients from nine primary health cares (PHC) at Tangerang. Methods: This study was done with an analytical cross-sectional approach at nine PHC. All children patients from age 1 to 18 years old were recruited for two weeks study. All prescriptions were analyzed and categorized for potential drug interactions. Results: We identified 19 mild and moderate but not serious potential drug interactions from 791 prescriptions (2%). The most common mild potential drug interaction is paracetamol and domperidone as well as mefenamic acid and dexamethasone for moderate potential drug interaction. Number of drugs and gender did not significantly correlate to potential drug interactions, but age did (p=0.04). Discussion: We identified that age correlated significantly to potential drug interactions. In brief, the older the patients, the higher the possibility for the drug interactions, thus physicians should be more aware in prescribing drugs to older children’s patients.
Correlation Between Duration of Using Silicone Oil Tamponade and Increased Intraocular Pressure
Background: Silicone oil is an artificial liquid that functions as a tamponade agent in vitreoretinal surgery. One disadvantage of using silicone oil is that it needs advanced procedures for oil evacuation because it is not absorbed spontaneously by the retina. This evacuation is recommended as soon as the retina heals to prevent complications such as pupil block and glaucoma secondary to silicone oil (SO) emulsification and causing increased intraocular pressure (IOP). The recommended time for SO evacuation is the first 3-6 months after surgery. The aims of this study is to determine the relationship between increased IOP and duration of use of tamponade SO. Methods: This study used a cross-sectional design by taking secondary data on retinal detachment history patients who underwent silicone oil evacuation at KMJA Hospital Jakarta from January 2019 to November 2021. Results: Respondents were 39 patients with an age range of 23-69 years and 71,8% were male. The average duration of use of SO is 9 months. In weeks 3-4 after the SO evacuation, data on the number of eyes with high IOP have obtained from as many as 9 eyes and 6 of them had used tamponade SO for more than 6 months with a p-value of 0.153. Conclusion: There was no significant association between the duration of SO tamponade use and increased IOP after SO evacuation.
Overview of the Functions of Ginger Rhizome (Zingiber officinale Roscoe), Black Cumin (Nigella sativa), and Pasak Bumi (Eurycoma longifolia Jack) in Male Infertility
Background: More than 186 million individuals worldwide from Southeast Asian and African nations are affected by infertility, a common health issue, specifically among men. In Indonesia, the use of "jamu" or herbal preparations derived from a diverse variety of herbal sources remains a widely practiced therapeutic approach. Furthermore, the Research and Development Center of the Indonesian Ministry of Health conducted extensive investigations between 2012 and 2018, including 204 distinct plant species used as stimulants and fertility enhancers. Among the species extensively used by ethnic traditional healers are pasak bumi (Eurycoma longifolia Jack), Pimpinella alpina Kds or Pimpinella pruatjan Molk (purwoceng), ginger rhizome (Zingiber officinale Roscoe), and black cumin (Nigella sativa). Methods: This study was compiled as an overview of ten original articles from PubMed and Google Scholar using keywords related to the effects of ginger rhizome, black cumin, and pasak bumi on male infertility. Results: The three plants were useful for improving sperm parameters by antioxidant activity, and increasing the production of reproductive hormones. Conclusion:These plants had a potential role in treating and protecting male infertility by the antioxidant activities.
Pediatric Atypical Progressive Acute Kidney Injury In Indonesia
Background: In the last few months of the 2022, there has been an increase in pediatric acute kidney injury cases with high mortality in Indonesia. Atypical progressive acute kidney injury (AKI) described as duration of the development of the disease into end stage stadium occured rapidly and abruptly result in high mortality indicates more than 50% despite received dialysis treatment. The cases were dominated by previously healthy toddlers age less than five years old without comorbidities. This review presents necessary informations related to etiology, diagnosis and management of atypical progressive AKI. This review also discuss about the etiology although the spesific causes are still widely studied as well as reports of new events on the causes of AKI. Methods: Systematic review of studies about atypical progressive acute kidney injury, the situation that is occurring at the moment in Indonesia. Results: There are spesific operational definition for diagnosing atypical progressive AKI in children including initial symptoms cover for infection symptoms of respiratory tract and gastrointestinal system and none history of previously kidney injury which also found both hyperinflamation or hypercoagulation signs. Most children were previously health children. Spesific cause are still unknown but some children were found positive for viral and bacterial infection, SARS COV-2 antybody and also ethylene glycol intoxication as reported cases in Gambia by WHO. Conclusion: When compared to the pediatric community AKI in general, certain variations were discovered in the atypical pogressive type of AKI, known patient features, initial symptoms, and etiology.
atypical progressive acute kidney injury
Relationship Risk Factors and Hemiparesis Prevalence in Ischemic Stroke at Medical Rehabilitation Fatmawati General Hospital 2022
Background: A stroke is a brain dysfunction in the form of nerve insufficiency caused by a disruption of blood flow to part of the brain. Stroke is divided into two types, namely ischemic and hemorrhagic type. Ischemic stroke or non-hemorrhagic stroke is an acute disease whose time of onset of symptoms determines the patient's survival prognosis. It will often cause cerebral infarction. The government of the Republic of Indonesia found that stroke patients, especially ischemic strokes in Indonesia, were still predominantly male, with a rate of 50,1%. This problem could be due to a more carefree lifestyle and a heavier workload. The stroke rate is very high and has increased dramatically, especially in patients >50 years of age. Methods: This study is a cross-sectional observational study. The study sample was obtained by a consecutive sampling of up to 105 study data samples taken from the medical record data. Data analysis was performed using univariate and bivariate analyses with Chi-Square tests. Results: Based on a sample of 105 patients, with an age range between 60-70 years old the following results Relationship of Prevalence of Hemiparesis in Ischemic Stroke Patients by Gender to Blood Pressure (P=0,312), Age (P=0,591) and Nutritional Status (P=0,760). Conclusion: No statistically significant relationship was found between stroke risk factors in blood pressure, age, and nutritional status with hemiparesis rates in geriatric ischemic stroke patients at the Medical Rehabilitation Clinic in Fatmawati Central General Hospital, Jakarta.
Using machine learning and texture analysis to predict significant and nonsignificant prostate lesions
Introduction: Prostate cancer is a well-recognized medical problem accounting for the most diagnosed type of cancer in men. The importance of early detection and its improved survival rate have motivated research on the best cancer detection method. Consequently, computer-aided diagnosis was introduced; however, more datasets are needed, and more testing and trials are required to reach a feasible and reliable diagnostic method. In this study, we use MRI T2 WI and ADC-map sequences to build a classifier to differentiate between clinically significant and insignificant prostate lesions. Material and Methods: Haralick’s first and second order statistical features were extracted from pathologically proven prostate lesions found in The Cancer Imaging Archive open data source. We used the WEKA platform for data analysis, including 152 lesions divided into 70% training set and 30% testing set. Results: The proposed classifier showed sensitivity, specificity, F-measure, and AUROC of 82.6%, 87%, 84.4%, and 92.6%, respectively. Conclusions: The proposed classifier does not require a high-end computer, outperforms many previous classifiers, and has the potential to discriminate clinically significant from insignificant prostate lesions.
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Comparison of Intraocular Pressure Before and After Silicone Oil Evacuation with Retinal Detachment History in Jakarta Hospital
Background: Retinal disorders are the fourth most common cause of blindness in Indonesia and one of them is retinal detachment. Vitrectomy with silicone oil (SO) tamponade is a popular technique for treating it. As a complication of using SO, intraocular pressure (IOP) can increase and usually returns to normal after evacuation of SO. However, in some conditions, such as emulsifying SO, can cause IOP to remain high even after SO evacuation has been carried out. Objective: To determine the comparison of intraocular pressure before and after evacuation of silicone oil in patients with a history of retinal detachment. Method: This study is a cross sectional with analytical reasearch. Secondary data was taken from the medical records of patients with a history of retinal detachment who underwent silicone oil evacuation performed at KMJA Jakarta Hospital. Result: 39 Respondents aged 23-69 years and 82% are male. The average length of use of SO is 9 months. It was found that the IOP decreased which was not significant in weeks 1-2 after evacuation of SO (p value 0.098) and also the increase in IOP was not significant in weeks 3-4 after evacuation of SO (p value 0.184). Conclusion: There is no significant difference in intraocular pressure before and after evacuation of silicone oil in patients with a history of retinal detachment
Patients with a history of retinal detachment