e-ISSN: 2549-0265 Publisher: Masters Program in Public Health, Sebelas Maret University, Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Dr. Hendrastutik Apriningsih, dr., Sp.P (K), M.Kes Sebelas Maret University, Solo, Indonesia Description: Indonesian Journal of Medicine (IJM) is an international, open-access, and double-blind peer-reviewed journal, focusing on the publication of research evidence in the areas of biomedical science, clinical medicine, and community medicine. The journal began its publication on August 20, 2015, and was published online three times yearly. Due to the increasing demand for paper publication, beginning 2019 the journal is published quarterly (January, April, July, and October) with 12 articles in each issue. IJM provides a platform for health and medical researchers to publish high-quality medical research evidence from both developed and developing countries. It primarily publishes original research papers but also welcomes papers on systematic review/ meta-analysis, debate, and commentary. IJM recognizes the under-representation of medical issues impacting populations in the developing world in international journals. Therefore, the editors encourage authors from developing countries to submit and publish their research work in this journal. All papers published in IJM are freely available as downloadable PDF files. IJM is currently abstracted and indexed in DOAJ, CABI Global Health, <a href="https://scholar.google.com/citations?hl=en&user=osLJue8AAAAJ&view_op=list_works&citft=1&citft=2&citft=3&email_for_op=jurnals2ikm%40gmail.com&gmla=ABEO0Yosi57ZJQxiQZakIlrZZMHRVeUmviBwdbh0lzH43yrzKzPMUjXemetk742be-v_8vEdqM5T_3G3EqGJ179XBDV0o_hSbPoZwf5cIWbc4lRe7kFuPWjvflaGSlyGJQDhDo9yzNy4b0H9Pxig4N0YfukfZnHqlWqT_ZCWIewjQLoHPenaAsPXiv52uR7MFDfOJ2v9p3V-pEw_7aqKDrymFattIfDDThfRcw-6tYOSkj-SAg" target="_blank" rel="noopener">Google Scholar, CrossRef, SINTA, and GARUDA.We are making efforts to get it indexed in even broader international databases. This journal is accredited by the Ministry of Research, Technology, and Higher Education, Government of Indonesia, No. 21/E/KPT/2018, effective from July 9, 2018, to July 8, 2023.
Masters Program in Public Health, Sebelas Maret University
Plasma Serotonin Levels and Depression Scores in Informal Caregivers of Patients with Dementia and without Dementia: A Systematic Review
Background: Depression frequently affects informal caregivers, particularly those caring for dementia patients due to greater emotional and caregiving burdens. This study aims to compare depression levels and plasma serotonin concentrations between dementia and non-dementia caregivers. Subjects and Method: A systematic review was conducted using PRISMA guidelines. Articles were searched from PubMed, ScienceDirect, and Google Scholar between 2015–2024 using the keywords: dementia caregiver, non-dementia caregiver, depression, and serotonin. Nine primary observational studies met the inclusion criteria: full-text availability, adult informal caregivers, and quantitative measurement of depression and/or serotonin. Data were synthesized narratively. Results: Most studies demonstrated higher depression levels among dementia caregivers compared to non-dementia caregivers. Emotional distress, patient behavioral symptoms, and caregiving duration were identified as major contributing factors. One study showed lower plasma serotonin associated with higher depressive scores, supporting possible biological involvement. Conclusion: Dementia caregivers exhibit greater depressive symptoms than non-dementia caregivers, potentially linked to caregiving burden and serotonin imbalance. Early psychological screening and targeted support interventions are recommended.
Copyright (c) 2026 Indonesian Journal of Medicine
Traditional Treatment Choices for Managing Dysmenorrhea Among Adolescent Girls: An Application of the Health Belief Model
Background: Dysmenorrhea is a common reproductive health problem among adolescent girls and often interferes with daily activities. Various management strategies are used to alleviate dysmenorrhea, including the use of traditional medicine. This study aimed to examine the influence of Health Belief Model (HBM) constructs on the choice of traditional medicine for reducing dysmenorrhea among adolescent girls. Subject and Methods: This quantitative study employed a cross-sectional design carried out in Boyolali Regency, Central Java, Indonesia. A total of 200 female adolescents were selected using stratified random sampling. Data were collected using a standardized questionnaire that had been tested for validity and reliability. Multivariate data analysis was conducted using path analysis to identify both direct and indirect effects among variables. Results: The selection of traditional medicine for dysmenorrhea management among adolescent girls was directly influenced by perceived benefits (b = 1.29; 95% CI= 0.61–1.97; p < 0.001) and perceived severity (b= −0.14; 95% CI= −0.71 to 0.43; p= 0.631). Meanwhile, perceived susceptibility (b= 0.81; 95% CI= 0.17–1.45; p= 0.013), perceived barriers (b= −1.53; 95% CI= −2.29 to −0.77; p < 0.001), cues to action (b= 1.44; 95% CI= 0.80–2.09; p < 0.001), and self-efficacy (b= −0.98; 95% CI= −1.61 to −0.34; p = 0.003) had indirect effects on the choice of traditional medicine. The resulting path model demonstrated good goodness-of-fit. Conclusion: Health Belief Model constructs can be effectively applied as a framework for understanding the selection of traditional medicine. HBM-based interventions that emphasize increasing perceived benefits and managing perceived barriers are recommended to support informed reproductive health decision-making among adolescents
Health Belief Model, traditional medicine, dysmenorrhea, adolescent girls
The Impact of Cognitive Impairment on Rehabilitation Outcomes among Geriatric Populations: A Systematic Review
Background: Cognitive impairment is a common issue in older adults and may significantly affect rehabilitation outcomes. Understanding the extent of its impact on medical rehabilitation is crucial for optimizing patient care and tailoring interventions for geriatric populations. Subjects and Method: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were performed using Google Scholar and PubMed to identify studies that examined the relationship between cognitive impairment and medical rehabilitation outcomes in the elderly. No restrictions were applied regarding publication dates or geographic regions, but only studies published in English were included. Out of 123 studies initially identified, 13 met the inclusion criteria, and 11 were included in the qualitative synthesis. Results: The analysis revealed that cognitive impairment negatively influenced rehabilitation outcomes in older adults. Patients with higher Mini-Mental State Examination (MMSE) scores demonstrated better functional recovery and greater improvements in rehabilitation. In contrast, those with significant cognitive impairment experienced reduced gains, highlighting a clear association between cognitive status and rehabilitation success. Conclusion: Cognitive impairment poses a substantial barrier to optimal rehabilitation outcomes among geriatric patients. These findings underscore the importance of incorporating cognitive assessment into rehabilitation planning and providing tailored interventions that address cognitive deficits. Enhancing rehabilitation strategies for individuals with cognitive impairment may improve functional recovery and overall quality of life in older populations.
Early vs. Late Initiation of Hemodialysis: Early Initiation as a Life-Saving Option in Stage III Leptospirosis Induced Acute Kidney Injury
Background: Leptospirosis is a zoonotic disease endemic in tropical regions with a high burden among low-income populations. Its clinical spectrum ranges from mild illness to severe Weil’s disease, which may involve multiple organs with common and severe complication is acute kidney injury (AKI) with no specific therapy exists. In this report, we describe how early hemodialysis may improve outcomes. Case Presentation: A 60-year-old man presented with a 10-day history of fever. He also reported calf pain and jaundice that had appeared one week prior to admission. Over the past week, the patient experienced decreased urinary frequency, with urine becoming more concentrated in color. Laboratory tests revealed thrombocytopenia, leukocytosis, elevated SGOT and SGPT levels, hyperbilirubinemia, and azotemia. Leptospira IgM was positive. Urinalysis demonstrated proteinuria and bilirubinuria. The patient’s Modified Faine’s Criteria score was 34, and his SOFA score was 11. Results: Patient was diagnosed with Weil's disease with AKI III complicated by sepsis. The furosemide stress test was administered to the patient but the results was not favorable therefore hemodialysis was initiated leading to an improvement in the patient’s condition. Conclusion: Early initiation of hemodialysis in patients with leptospirosis induced AKI provides favorable immediate outcome and prevents them from falling into uremic syndrome leading to mortality.
Weil’s disease, leptospirosis, early hemodialysis, outcome, uremic syndrome
Anti-inflammatory and Anti-infertility Effects of Ethanol Extract of Turmeric (Curcuma longa) in Male Wistar Rats with Type 2 Diabetes Mellitus Induced by Streptozotocin-Nicotinamide-High Fat Diet
Background: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder associated with chronic inflammation and male reproductive dysfunction. The ethanol extract of turmeric (Curcuma longa) has demonstrated potential as an alternative therapeutic agent due to its anti-inflammatory and reproductive restorative properties. This study aims to analyze the anti-inflammatory and anti-infertility effects of the ethanol extract of Curcuma longa in male Wistar rats with T2DM induced by a streptozotocin-nicotinamide-high fat diet (STZ-NA-HFD). Subjects and Method: Thirty male Wistar rats were randomized into six groups (n=5): normal control (K1), diabetic control (K2), positive control (T2DM + metformin 45 mg/kgBW, K3), and three treatment groups receiving Curcuma longa extract at doses of 50 mg/kgBW (K4), 100 mg/kgBW (K5), and 150 mg/kgBW (K6). Diabetes was induced with STZ (55 mg/kgBW) and nicotinamide (120 mg/kgBW). Blood glucose, IL-6, testosterone levels, sperm count, and sperm motility were evaluated after 21 days of treatment. Results: The turmeric extract significantly reduced blood glucose levels (p<0.001) and IL-6 concentrations from 574.06±68.99 to 214.06±78.71 ng/mL at a dose of 150 mg/kgBW (p<0.001). Normal sperm motility increased significantly at 150 mg/kgBW (20.0±2.55%) compared to the diabetic control (8.40±2.07%) (p=0.008). Conclusion: The ethanol extract of Curcuma longa demonstrated significant anti-inflammatory activity by reducing IL-6 levels and improving glycemic control. Its anti-infertility effect was reflected by enhanced sperm motility, particularly at the 150 mg/kgBW dose. These findings indicate that Curcuma longa possesses potential as an adjuvant therapy for the management of T2DM and its associated complications.
Type 2 diabetes mellitus, Curcuma longa, anti-inflammatory, fertility, interleukin-6, spermatogenesis
Copyright (c) 2025 Indonesian Journal of Medicine
Evaluation of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Diabetic Kidney Disease Patients: A Hospital-Based Cross-Sectional Analysis
Background: Diabetes mellitus represents a chronic metabolic disorder with globally increasing prevalence and is one of the leading causes of microvascular complications such as diabetic kidney disease (DKD). Chronic inflammation plays a crucial role in DKD pathogenesis, prompting exploration of simple inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This study aimed to determine the relationship between NLR and PLR values with the incidence of DKD. Subject and Methods: This cross-sectional study employed consecutive non-random sampling technique. The study population consisted of all patients visiting Cinta Kasih Tzu Chi Cengkareng Hospital from January to April 2025, totaling 128 respondents. Secondary data from medical records were analyzed using Chi-Square test to determine associations between NLR and PLR (categorized as high vs low) with diabetic kidney disease incidence. Statistical analysis employed Chi-Square test with significance set at p<0.050. Results: Among 128 respondents, 64 (50.00%) were diagnosed with diabetic kidney disease. High NLR group comprised 101 respondents (78.90%), with 50 (39.10%) having DKD. High PLR group totaled 32 respondents (25.00%), with 19 (14.80%) having DKD. NLR demonstrated no significant association with DKD incidence (PR= 0.96; CI95% 0.48 to 1.41; p=0.828). PLR also showed no significant association with DKD incidence (PR= 0.89; CI95% 0.52 to 1.53; p=0.552). Conclusion: Neither NLR nor PLR demonstrates a significant relationship with diabetic kidney disease incidence at Cinta Kasih Tzu Chi Cengkareng Hospital. These findings suggest that NLR and PLR cannot be used as standalone predictors for DKD and should be considered alongside other clinical parameters in comprehensive diabetes management protocols.
Health Belief Model Application in Bone Fracture Treatment-Seeking Behavior: Preferences for Traditional Bone-Setting Treatment versus Orthopedic Surgery
Background: Bone fractures are a significant public health issue, with 178 million new cases globally in 2019 and a prevalence of 5.5% in Indonesia. The Indonesian community tends to choose traditional treatment such as herbal medicine or surgical treatment for fractures, influenced by sociodemographic factors, culture, and individual perceptions. This study aims to analyze the Health Belief Model (HBM) factors that affect the choice of bonr fracture treatment services in the community. Subjects and Method: This cross-sectional study was conducted in Surakarta during April–May 2025, involving 200 participants, comprising 100 users of traditional bone-setting treatment and 100 users of orthopedic care. Data were collected using an online questionnaire covering demographic characteristics and HBM constructs. The data were analyzed using univariate methods, bivariate analysis with simple logistic regression, and multivariate analysis employing path analysis. Results: The decision to choose type bone fracture treatment care was directly influenced by perceived susceptibility (b = -2.30; 95% CI: -3.09 to -1.50; p < 0.00), benefits (b = 1.80; 95% CI: 0.89 to 2.72; p < 0.00), self-efficacy (b = 1.36; 95% CI: 0.51 to 2.22; p < 0.00), and action cues (b = 3.80; 95% CI: 1.70 to 5.90; p < 0.00), while the perception of barriers indirectly lowers self-efficacy (b = -0.65; 95% CI: -1.29 to -0.02; p < 0.04). Conclusion: The HBM constructs, especially perceived vulnerability, benefits, self-efficacy, and action cues, significantly influence the choice of treatment for fractures. Educational interventions are recommended to enhance the perception of the benefits of medical services and strengthen the self-efficacy of the community.
Health Belief Model, fractures, limb amputation, bone surgery, health behavior
Guttate Psoriasis Flare Following the Third Dose of mRNA COVID-19 Vaccine in a 36-Year-Old Male: A Case Report
Background: Psoriasis is a chronic, immune-mediated skin disease known to flare in response to various environmental and immunologic triggers, including infections, stress, medications, and vaccinations. With the global rollout of COVID-19 vaccines, rare instances of psoriatic eruptions have been reported. This study aimed to report the case of guttate psoriasis flare following the third dose of mRNA COVID-19 vaccine in a 36-year-old male. Case Presentation: We report the case of a 36-year-old male with a history of guttate psoriasis that occurred seven years prior, which resolved spontaneously without recurrence. The patient had remained disease-free until five days after receiving a third (booster) dose of an mRNA COVID-19 vaccine, when he developed a sudden, widespread eruption of erythematous, drop-like papules and small plaques, predominantly involving the trunk and extremities. Initial management with topical corticosteroids yielded minimal response. Skin biopsy revealed histopathological features consistent with psoriasis. The patient was subsequently started on low-dose methotrexate, result­ing in significant clinical improvement within four weeks. Conclusion: This case highlights the possibility that mRNA COVID-19 vaccination may, in rare cases, trigger guttate psoriasis even in individuals with a remote history of the disease and prolonged remission. While vaccination remains a crucial public health intervention, healthcare providers should remain aware of potential cutaneous adverse events and provide prompt, individualized management to maintain both optimal patient care and public vaccine confidence.
Factors Influencing Events Dysfunction Cognitive Post Operation on Patient Elderly: Systematic Review
Background: : Improvements in global life expectancy have led to a significant increase in the elderly population, which in turn results in a growing number of elderly patients undergoing surgery. This condition raises the risk of postoperative complications, such as postoperative cognitive dysfunction (POCD). POCD can reduce quality of life, prolong the length of hospital stay, and increase mortality. This study aims to identify and synthesize the factors that influence the occurrence of POCD in elderly patients. Subjects and Method: This study is a Systematic review with PICO. The article used in research were obtained from several databased including Google Scolar, Scopus, and PubMed Keywords to find articles are "postoperative cognitive dysfunction," "elderly patients," and "geriatrics". This articles used are failing to directly discuss risk factors for postoperative cognitive dysfunction in elderly patients, or identified as opinion pieces, conference abstracts without full text, or narrative reviews, will be excluded. Articles were selected using PRISMA flow diagram. Results: a total 8 articles reviewed in Systematic Review showed that The incidence of POCD in the elderly shows significant variation between studies, ranging from 8.33% to 37.7% . Risk factors that have been consistently identified as having a significant influence on the incidence of POCD include advancing age, low level of education, number of comorbidities, high ASA score, long duration of anesthesia, intraoperative hypotension, history of cerebral infarction, and low oxygen saturation at induction. The use of certain anesthetic agents such as sevoflurane and midazolam has also been shown to increase the risk of POCD. Instead, use dexmedetomidine preoperative, analgesia preemptive and the combination of general anesthesia with epidural block were identified as protective factors. Conclusion: The main risk factors advanced age, education level, comorbidities, and type and duration of anesthesia.
Older Adults Exhibit a Nine-Fold Increased Risk of Type 2 Diabetes Mellitus: Evidence from a Hospital-Based Cross-Sectional Analysis
Background: Type 2 diabetes mellitus represents a significant global health burden with increasing prevalence worldwide. Age and gender are recognized as important demographic risk factors influencing diabetes incidence. This study aimed to determine the relationship between age and gender with the incidence rate of type 2 diabetes mellitus at Bhayangkara Pusdik Brimob Watukosek Hospital. Subjects and Method: This cross-sectional study conducted at internal medicine polyclinic, Bhayangkara Pusdik Brimob Watukosek Hospital, Pasuruan, East Java, Indonesia, from October 2020 to May 2021. Study subjects of 250 patients were selected using total sampling technique. Secondary data from medical records were analyzed using odds ratio calculations to determine associations between age (categorized as high-risk ≥45 years vs low-risk <45 years) and gender with type 2 diabetes mellitus incidence. Data were analyzed using a multiple logistic regression. Results: Among 250 respondents, 140 (56.00%) were diagnosed with type 2 diabetes mellitus. High-risk age group comprised 136 respondents (54.40%), with 107 (76.40%) having diabetes. Female respondents totaled 148 (59.20%), with 80 (57.10%) having diabetes. Age demonstrated significant association with diabetes incidence (OR= 9.06; 95% CI= 5.15 to 15.93; p<0.001), indicating that high-risk age individuals were nine times more likely to develop diabetes compared to low-risk age individuals. Gender showed no significant association with diabetes incidence (OR= 0.82; 95% CI= 0.48 to 1.41; p=0.475). Conclusion: Age has a significant relationship with type 2 diabetes mellitus, while gender shows no significant association.
Age, gender, cross-sectional study, type 2 diabetes mellitus
Effect of Hydroxypropyl Methylcellulose Concentration Variations as a Gelling Agent on the Physical Quality of Hydrogel Formulations Containing Ethanol Extract of Impatiens balsamina L. Herb
Background: Impatiens balsamina L. herb is known to possess anti-inflammatory and antioxidant activities, making it a promising candidate for development as an active ingredient in topical formulations. Hydrogels are considered an ideal delivery system for topical wound treat­ment due to their ability to provide controlled drug release, with hydroxypropyl methyl­cellulose (HPMC) commonly employed as a stable gelling agent. This study aimed to evaluate the effect of varying HPMC concentrations on the physical quality of hydrogel formulations containing ethanol extract of Impatiens balsamina L. herb. Subjects and Method: This was an experimental study. Hydrogel formulations were prepared with varying concentrations of hydroxypropyl methylcellulose (HPMC) at 1%, 2%, and 3% as the gelling agent. Each formulation was evaluated for physical quality parameters, including organo­leptic properties, homogeneity, spreadability, adhesiveness, and pH value, following standard topical formulation testing procedures. Results: The evaluation results showed that all formulations exhibited good homogeneity and pH values within the safe range for skin application. Increasing HPMC concentration did not visually affect the color of the formulations; however, it influenced the formulation consistency, decreased spreadability, and increased adhesiveness. Conclusion: Variations in HPMC concentration in hydrogel formulations containing ethanol extract of Impatiens balsamina L. herb significantly affected the physical quality parameters, particularly consistency, spreadability, and adhesiveness. The formulation with 2% HPMC concen­tration demonstrated the most optimal physical characteristics for topical application.
impatiens balsamina L. herb, hydrogel, hydroxypropyl methylcellulose
Antidiabetic and Anti-inflammatory Effects of Peperomia pellucida Leaf Extract: Modulation of Blood Glucose, IL-1β, and Pancreatic Histopathology in STZ-Induced Diabetic Rats
Background: Diabetes mellitus (DM) is a significant global health challenge with a rapidly increasing prevalence. Although synthetic antidiabetic drugs remain the standard treatment, long-term use often leads to adverse side effects, prompting exploration of natural alternatives. This study investigated the therapeutic potential of ethanol extract of Peperomia pellucida (L.) Kunth leaves in diabetes management through comprehensive assessment of glycemic control, inflammatory marker (IL-1β), and pancreatic tissue histopathology. Subjects and Method: Thirty male Wistar rats were randomized into five groups (n=6): normal control, negative control (STZ-induced), positive control (STZ+metformin 50 mg/kg BW), and two treatment groups receiving Peperomia pellucida extract at doses of 40 mg/kg BW and 80 mg/kg BW, respectively. After 7 days of treatment, blood glucose levels, serum IL-1β concentrations, and pancreatic histopathology were evaluated. Phytochemical screening was conducted to identify bioactive compounds in the extract. Results: Phytochemical analysis confirmed the presence of alkaloids, flavonoids, tannins, saponins, and phenolics. Blood glucose measurements showed significant intergroup differences on day 0 (p<0.001) and day 7 (p<0.001). The 80 mg/kg BW extract group showed a reduction in blood glucose from day 0 (Mean=312.83; SD=40.92) to day 7 (Mean=281.00; SD=34.86). IL-1β serum analysis revealed significant differences among groups (p<0.001), with lower IL-1β levels observed in extract-treated groups compared to the negative control. Histopathological examination demonstrated improved pancreatic tissue structure in extract-treated groups, especially at higher doses. Conclusion: Ethanol extract of Peperomia pellucida (L.) Kunth leaves exhibits promising antidiabetic and anti-inflammatory properties in STZ-induced diabetic rats, as evidenced by reduced blood glucose, decreased IL-1β levels, and improved pancreatic histology. These findings suggest that Peperomia pellucida (L.) Kunth is a potential candidate for the development of natural therapies for diabetes management.
Analysis Factor Which Relate With Complaint Musculoskeletal disorders (MSDs) At the Asahan Regency Education Office Employees
Background: One of the major occupational health problems that can arise due to ergonomic risk is musculoskeletal disorders (MSDs). Office workers are among those most susceptible to chronic musculoskeletal health issues. This study aimed to identify factors associated with MSDs among employees of the Asahan District Education Office. Subjects and Method: This study was conducted at the Asahan District Education Office from December to January 2025. A descriptive quantitative analysis using a cross-sectional design was applied. The total population was 71 employees, and total sampling was used. Data were analyzed statistically using the Chi-square test. Results: There were significant associations between age (Mean=1.86; SD=0.350; p=0.004), work duration (Mean=1.65; SD=0.481; p=0.001), BMI (Mean=1.46; SD=0.502; p=0.001), and exercise habits (Mean=1.35; SD=0.481; p=0.001) with MSD complaints. However, gender (Mean=1.39; SD=0.492; p=0.683) was not significantly associated with MSDs. Conclusion: Four factors were significantly associated with MSD complaints. These findings can serve as a reference for institutions to improve ergonomic intervention and prevention efforts, such as mandating employees to participate in morning exercise activities every Friday.
Giant Cell Tumor of the Metacarpal and Its Intervention to Preserve Joint Function: A Case Report
Background: Giant cell tumor (GCT) is one of the most common benign bone tumors, but it has a high recurrence rate and is aggressive. It can occur elsewhere, but frequently in the distal femur and proximal tibia. The goal of treatment is to remove the tumor cells and maintain the metacarpophalangeal function. Various modalities exist to remove the tumor cells from curettage, wide excision, radical excision, or amputation. Reconstruction following the removal of tumor cells also varied by using graft, bone cement, prosthesis, or arthrodesis. There are no definitive guidelines to determine which modalities are the best, especially in unusual sites. In this case report, we present an unusual site of GCT in the second metacarpal, and clinical outcomes after the 1-year final follow-up were nearly normal. Case Presentation: A 22-year-old female presented to the hospital with a history of a lump and intermittent pain in the right hand for 2 years. Physical examination and radiograph suspected an unusual site of GCT and no cartilage involvement. A core biopsy was taken, and a GCT was confirmed. Wide excision, preserving the native joint of the metacarpal, and reconstruction using autologous non-vascularized fibular graft with the help of K-wire and adjuvant of hydrogen peroxide. Results: Constant improvement of clinical outcomes post-operatively with Michigan Hand Outcomes Questionnaire (MHQ) score was nearly normal, and there was no sign of recurrence at 6-month follow-up. Conclusion: Our report suggests that wide excision and reconstruction by fibular struts with a preserved native metacarpal joint, followed by hydrogen peroxide as an adjuvant and K-wire as a fixator, could be used as a combination therapy with good results.
Effect of Preoperating Maltodextrin 12.5% Carbohydrate Drink on High Sensitive C Reactive Protein Levels Post-Brachytherapy
Background: Brachytherapy is radiation therapy that will cause inflammation and tissue damage that leads to inflammation, characterized by the release of pro-inflammatory cytokines, including hs-CRP levels in the plasma. Preoperative administration of glucose solution is known to reduce the increase in cortisol, and is thought to reduce postoperative hs-CRP levels. So far there has been no research that specifically examines the effect of preoperative carbohydrate administration on hs-CRP values after brachytherapy. This study aims to determine the effect of preoperative carbohydrate administration on post-brachytherapy hs-CRP values. Subjects and Method: This study was designed a double-blind randomized controlled trial was conducted at the Radiotherapy Unit of Dr. Moewardi General Hospital, Surakarta, from April to September 2022. Sixty-four cervical cancer patients with ASA physical status I or II undergoing brachytherapy under general anesthesia were recruited using consecutive sampling. Participants were randomly assigned into two groups: an intervention group receiving 12.5% maltodextrin solution and a control group receiving mineral water. The independent variable was preoperative carbohydrate administration, and the dependent variable was hs-CRP level measured 2 hours before and 4 hours after brachytherapy. Data were analyzed using paired t-test Results: Post-brachytherapy hs-CRP levels were significantly lower in the treatment group (mean = 2.565 ± 2.0 mg/dL) compared to the control group (mean = 3.69 ± 2.58 mg/dL; p = 0.019). Both groups showed significant increases in hs-CRP from pre- to postoperative values (p < 0.001). The change in hs-CRP (Δhs-CRP) was also significantly lower in the treatment group (p = 0.025). Conclusion: The administration of maltodextrin was able to significantly reduce post-brachytherapy hs-CRP levels compared to placebo.
Paraspinal Abscess Secondary to Spondylodiscitis: A Rare Presentation with Progressive Neurological Deficits and Systemic Infection
Background: Spondylodiscitis is a rare but serious spinal infection that may result in neuro-logical and systemic complications, especially when associated with paraspinal abscess formation. This case highlights its clinical severity and the importance of early intervention. This study aims to highlight the clinical importance and potential severity of spondylodiscitis, particularly when complicated by paraspinal abscess formation. Case Presentation: A patient presented with progressive lower back pain, bilateral lower limb weakness, and systemic symptoms including fever and night sweats. Laboratory tests revealed hypoalbuminemia, leukocytosis, and anemia. MRI imaging identified a paraspinal abscess at the L3–L5 levels, resulting in lumbar canal stenosis and worsening neurological deficits. Emergency surgical intervention was undertaken, consisting of abscess drainage, laminectomy for neural decompression, and posterior spinal stabilization. Intraoperative findings included a substantial purulent collection, necessitating extensive debridement. Postoperatively, the patient demonstra¬ted clinical improvement with ongoing antibiotic therapy, nutritional support, and rehabilitation. Discussion: Spondylodiscitis with paraspinal abscess is a diagnostic challenge due to its insidious onset and non-specific presentation. Delayed recognition increases the risk of severe neurological impairment and systemic sepsis. MRI is the gold standard for early detection, while micro¬biological confirmation is crucial for targeted treatment. A multidisciplinary approach is essential. Surgical intervention is indicated for progressive neurological deficits, extensive abscess formation, or spinal instability, with timely antibiotic therapy playing a critical role in infection control. Conclusion: This case illustrates the importance of early diagnosis and timely surgical manage-ment in spondylodiscitis with paraspinal abscess. Multimodal treatment improves outcomes and helps prevent long-term disability.
The Social Face of Stigma: A Meta-Analysis of Gender, Support, and Living Environment in HIV/AIDS Perception
Background: The stigma of society towards ODHA itself is influenced by various factors, where there are three factors that can be used as a benchmark, namely gender, place of residence, and social support. This study aims to estimate the magnitude of the influence of gender, social support and housing on the perception of stigma in people with HIV/AIDS, based on the results of a number of previous primary studies. Subject and Method: This study is a meta-analysis and systematic review study, with PICO, Population: ODHA patients (People with HIV/AIDS), Intervention: Women, low social support and village dwelling, Comparison: men, high social support and urban dwelling, Ooucome: HIV/AIDS stigma. Primary study searches used electronic databases: PUBMED, BMC, Scopus and Scient Direct published from 2012 to 2022. The keywords used are "people living with HIV" AND "gender" AND "social support" AND "residence" AND "perceived stigma HIV, cross-sectional"". There are 9 English fulltext arithmetic with effect size using adjusted odds ratio from 2012 to 2022. Articles selected with PRISMA Flow and analyzed using RevMan 5.3. Result: This meta-analysis was conducted on 9 primary studies from India and Ethiopia with a sample = 14,191 HIV/AIDS patients. This study showed that the risk of stigma perception increased with female sex (aOR=1.35, CI 95%=0.75 to 2.46; p=0.320; I²=91%) and rural housing (aOR=1.49; CI 95%=0.89 to 2.47; p=0.130), but it is not statistically significant. The risk of stigma perception decreased with high social support (aOR=0.53; CI 95%=0.32 to 0.90; p=0.020), and the results are statistically significant. Conclusion: The risk of stigma perception increases with female gender, rural housing and high social support.
The Application of the Health Belief Model in the Selection of Acupuncture Therapy for Low Back Pain Patients
Background: Low back pain (LBP) is one of the health problems experienced by 50–80% of adults. LBP affects individual, physical, social, and psychological aspects. Individuals suffering from LBP require comprehensive treatment to ensure the success of therapy. The study aims to determine the patient's perception of the choice of LBP therapy using the Health Belief Model theory. Subjects and Method: This research was conducted using a cross-sectional study conducted in Surakarta, from September to October 2024. A total of 200 acupuncture patients and physiotherapy patients were selected using fixed disease sampling. The independent variables were vulnerability perception, severity perception, benefit perception, obstacle perception, cues to action perception, self-efficacy. The bound variable is the choice of therapy. The data using questionnaires were analyzed using multiple logistic regression. Results: Perceived susceptibility was less likely to use acupuncture therapy (OR= 0.51; 95% CI= 0.14 to 1.79; p=0.293). Perceived severity was more likely to use acupuncture therapy (OR=3.99; 95% CI= 1.17 to 13.54; p= 0.027). Perceived benefits were more likely to use acupuncture therapy (OR=43.90; 95% CI= 9.45 to 203.99; p<0.001). Perceived barriers were less likely to use acupuncture therapy (OR=0.03; 95% CI p< 0.01 to 0.20; p< 0.001). Cues to action were more likely to use acupuncture therapy (OR=7.10; 95% CI p= 2.20 to 22.91; p< 0.001). High self-efficacy has a greater likelihood of using acupuncture therapy (OR=142.49; 95% CI= 14.17 to 1432.86; p<0.001). Conclusion: The Health Belief Model for the selection of acupuncture therapy increased with the perception of severity, perception of benefits, action signals, and self-efficacy. The choice of acupuncture therapy decreased with a high perception of resistance. Perception of vulnerability was statistically not significantly associated with therapy selection. The independent variables in the model were able to explain the variation in therapy selection (acupuncture vs physiotherapy) by 68.69%.
Impact of Dental Restoration and Extraction Treatments on Oral Health–Related Quality of Life (OHRQoL)
Background: Cavities or dental caries is one of the most common diseases as the main cause of pain in the oral cavity which can have a significant impact on quality of life. Cavities have several treatment modalities available such as restoration and tooth extraction. These treatment options not only affect the patient's clinical condition, but can also affect the psychological, social, and functional aspects reflected in the Oral Health Related Quality of Life (OHRQoL). The study aimed to determine the effect of restoration treatment and tooth extraction on Oral Health Related Quality of Life (OHRQoL). Subjects and Method: This research was conducted in December 2024 with a total of 200 samples in Surakarta, This study uses a quantitative design with a cross-sectional approach. Data were collected from patients who had undergone restoration treatment and/or tooth extraction on cavities. Dependent variables are in the form of Oral Health Related Quality of Life (OHRQoL) and independent variables in the form of restorative treatments, tooth extraction, age and gender. Data were analyzed by double linear regression. Results: Multiple linear regression analysis showed a significant negative association between the type of dental treatment and OHRQoL. Patients who underwent tooth extraction had OHRQoL scores that were 26.89 units lower than those who received restorative treatment (b = -26.89; 95% CI = -29.39 to -24.39; p < 0.001). No significant association was found between age or sex and OHRQoL. Conclusion: Dental restoration treatments have a significant influence on improving Oral Health Related Quality of Life (OHRQoL), while tooth extraction shows a positive but insignificant relationship. Age and sex variables had no statistical effect on OHRQoL.
Cavities, restoration, extraction, oral health, quality of life
Ultrasonography Findings of Rare Form Deep Vulvar Hemangioma: A Case Report
Background: Hemangiomas are the most common vascular tumors in infants and children, they typically appear after birth, grow rapidly, and then gradually involute. Early diagnosis is crucial, but the clinical presentation of hemangiomas can resemble other vascular anomalies, necessi­tating the use of imaging studies like ultrasonography (US) in order to establish accurate diag­nosis. This study aims to present the ultrasonographic characteristics of a rare case of vulvar hemangioma, with the objective of aiding in its differentiation from other vulvar vascular malformations. Case Presentation: A 9-year-old girl presented with a painless vulvar mass that had been enlarging over 3 months. Physical examination revealed a 3 x 2.5 x 1.5 cm, well-defined, skin-colored, non-tender, and immobile mass. Greyscale ultrasonography showed a septated cystic lesion with internal echoes. Doppler ultrasonography showed low flow vascular patterns, suggestive of a hemangioma. Surgical excision was performed, and histopathology confirmed the diagnosis of a hemangioma Results: Although vulvar hemangioma is rare, it can mimic other vascular anomalies, making imaging essential for accurate diagnosis and management. Ultrasonography, as a inexpensive and non-invasive imaging modality, plays a crucial role in differentiating hemangiomas from other vascular malformations. Conclusion: Hemangioma is a form of vascular mass and the most common one, at early phase the clinical presentation might resemble other vascular anomalies. Thereby diagnostic modalities such as ultrasonography might be able to help to establish the diagnosis
ultrasonography, vulvar hemangioma,vascular tumors