International Journal of Public Health Excellence (IJPHE)

Beyond BMI: The Synergistic Effect of Ultra-Processed Food Consumption and Sedentary Behavior on Gut Microbiota and Systemic Inflammation in Young Adults with Early Metabolic Syndrome – A Longitudinal Cohort Study

Mon, 08 Jun 2026 00:00:00 +0000

Background: Body mass index (BMI) inadequately captures metabolic risks driven by modern lifestyles, particularly the combination of ultra-processed food (UPF) intake and sedentary behavior. While each factor independently fosters low-grade systemic inflammation, their synergistic impact on the gut microbiota–inflammation axis in young adults with early metabolic syndrome (MetS) remains unexplored. Objective: This longitudinal cohort study examined the independent and synergistic effects of UPF consumption and sedentary behavior on gut microbiota composition and systemic inflammatory biomarkers in Indonesian young adults with early MetS over 12 months. Methods: We recruited 400 participants aged 20–30 years meeting 1–2 ATP III criteria for MetS. Dietary intake was assessed with a validated semi-quantitative FFQ with NOVA classification; sedentary time was measured via triaxial accelerometers. Gut microbiota was profiled using 16S rRNA sequencing (V3–V4 region), and hs-CRP, IL-6, and TNF-α were quantified at baseline and 12 months. Participants were stratified into four groups by median splits of UPF energy share (%kcal) and daily sedentary time. Generalized estimating equations tested synergistic interactions on inflammation, and mediation analyses evaluated microbiota diversity pathways. Results: The high-UPF/high-sedentary group exhibited the greatest increases in hs-CRP (+1.78 mg/L), IL-6 (+2.95 pg/mL), and TNF-α (+3.12 pg/mL), with a significant multiplicative interaction (p<0.001). Shannon diversity declined most sharply in the high-UPF/high-sedentary group (−0.32), paralleled by a rise in the Firmicutes/Bacteroidetes ratio (+0.47). Mediation analysis showed that 31.4% of the synergistic effect on hs-CRP was mediated by loss of diversity. Conclusion: Co-occurring high UPF consumption and sedentary behavior synergistically amplify systemic inflammation partly through gut dysbiosis in early MetS, underscoring the need to target both dietary and physical activity domains beyond BMI-centric strategies

Nursing Analysis of SEFT and PC6 Acupressure in Reducing Anxiety in Stemi Patients

Fitri Fitri, Zulmah Astuti, Ulfatul Muflihah, Dwi Widiyastuti — Sat, 13 Jun 2026 00:00:00 +0000

Anxiety is one of the most common psychological responses experienced by patients with ST-Elevation Myocardial Infarction (STEMI) during hospitalization in the Intensive Cardiac Care Unit (ICCU), which may affect physiological stability and the recovery process. Therefore, supportive non-pharmacological nursing interventions are needed to help manage anxiety. This study aimed to analyze nursing practice through the application of the Spiritual Emotional Freedom Technique (SEFT) and PC6/Neiguan acupressure on anxiety levels in patients with STEMI. A case analysis was conducted on two patients with STEMI in the ICCU using a nursing care approach. The first patient received standard care combined with SEFT and PC6/Neiguan acupressure interventions, while the second patient received standard care only. Anxiety levels were measured using the State–Trait Anxiety Inventory (STAI). The patient who received SEFT and PC6/Neiguan acupressure experienced a reduction in anxiety level from moderate anxiety to no anxiety, while the patient who received standard care only did not show any reduction in anxiety level and remained in the moderate anxiety category. The application of SEFT and PC6/Neiguan acupressure in nursing practice was associated with reduced anxiety levels in patients with STEMI and may serve as supportive nursing therapies within a holistic nursing care approach for cardiovascular patients

The Effect of a Mobile-Based Nutrition Education Module on Improving Feeding Practices and Nutritional Status of Children under Five in Urban Slums

Tue, 16 Jun 2026 00:00:00 +0000

Background: Inappropriate feeding practices and high malnutrition rates among children under five remain critical public health issues in urban slums, where access to nutrition information is limited. Mobile health (mHealth) interventions offer a promising platform for delivering nutrition education. Objective: This study aimed to evaluate the effect of a mobile-based nutrition education module on improving feeding practices and nutritional status of children aged 6–23 months in urban slums. Methods: A quasi-experimental pretest-posttest control group design was employed. A total of 120 mother-child pairs were purposively selected and allocated into an intervention group (receiving a 12-week mobile-based module, n=60) and a control group (receiving conventional lectures and leaflets, n=60). Feeding practices (minimum dietary diversity, meal frequency) were assessed using structured questionnaires, while nutritional status was measured through anthropometry (weight-for-age, height-for-age, weight-for-height z-scores). Data were analyzed using paired t-test, independent t-test, and ANCOVA (p<0.05). Results: The intervention group showed significantly greater improvements in feeding practice scores compared to controls (p<0.001). Moreover, stunting prevalence decreased from 32% to 18%, and wasting from 15% to 7% in the intervention group, with significantly better WAZ and HAZ z-scores than the control group (p<0.05). Conclusion: The mobile-based nutrition education module effectively improved maternal feeding practices and child nutritional status in urban slums. This innovation offers a scalable, low-cost solution for addressing childhood malnutrition in underserved populations.

Analysis of Household Air Pollution and Its Association with Acute Respiratory Infection Incidence in Women Living in Rural Agro-Industrial Areas

Tue, 16 Jun 2026 00:00:00 +0000

Introduction: Household air pollution (HAP) from solid fuel combustion remains a leading environmental health threat, yet its specific impact on women in rural agro-industrial areas, where agricultural residues are commonly used as cooking fuel, is poorly documented. This study aimed to measure HAP levels and determine their association with acute respiratory infection (ARI) incidence among women in these settings. Method: A cross-sectional study was conducted among 250 women from three rural villages in an agro-industrial region. Indoor PM2.5 and carbon monoxide (CO) concentrations were monitored over 24 hours using portable air samplers. Data on ARI symptoms (cough, fever, and difficulty breathing) and household fuel use were collected via validated questionnaires. Multivariate logistic regression was used to assess associations. Results: Mean 24-hour PM2.5 and CO levels were 285 µg/m³ and 7.2 ppm, respectively, both far exceeding WHO safety thresholds. Biomass fuel use dominated (78%), primarily agricultural waste. ARI prevalence reached 42%. After adjusting for confounders, elevated PM2.5 was significantly associated with ARI (AOR=2.8; 95% CI: 1.6–4.9), alongside biomass fuel use and prolonged cooking time. Discussion: The strong dose-response relationship suggests that chronic exposure to high particulate matter from agricultural residues directly compromises respiratory defenses. The synergistic effect of indoor smoke and poor ventilation likely exacerbates infection risk, highlighting a overlooked occupational-exposure pattern in agrarian communities. Conclusion: Urgent interventions particularly cleaner cookstove programs and kitchen design improvements are essential to reduce the substantial ARI burden among this vulnerable population.

Effectiveness of Neem Leaves (Azadirachta indica) on Traumatic Ulcer Healing: A Literature Review

Fri, 19 Jun 2026 00:00:00 +0000

Traumatic ulcer is the most common oral mucosal lesion encountered in dental practice, caused by mechanical, thermal, or chemical trauma. This condition causes significant pain and can impair patient quality of life. Neem leaves (Azadirachta indica) have long been used in traditional medicine as anti-inflammatory, antibacterial, and wound-healing agents. This literature review aims to examine scientific evidence on the effectiveness of neem leaves in healing traumatic ulcers through their pharmacological mechanisms. Literature searches were conducted through PubMed, Google Scholar, and Science Direct databases with keywords related to neem leaves, Azadirachta indica, traumatic ulcer, and oral mucosal wound healing. Articles meeting the inclusion criteria were critically reviewed. Active compounds in neem leaves including nimbin, nimbidin, azadirachtin, quercetin, and tannins have been proven to possess anti-inflammatory activity by inhibiting COX-2 and NF-κB pathways, as well as antibacterial activity against oral pathogenic bacteria. These compounds also accelerate fibroblast proliferation and collagen synthesis crucial in wound healing. Neem leaves have significant potential as a therapeutic agent in healing traumatic ulcers based on pharmacological evidence and preclinical studies. However, further randomized controlled clinical trials are needed to strengthen their clinical use

Systematic Literature Review : Potential of Kirinyuh Leaves ( Chromolaena Odorata ) As A Wound Treatment

Fri, 19 Jun 2026 00:00:00 +0000

A wound is damage to body tissue that can occur due to cuts, impacts, heat, infection, or chemicals. Wounds that are not properly treated can cause infection, inflammation, bleeding, and disruption of new tissue formation. One plant that has been widely studied is the kirinyuh leaf (Chromolaena odorata). This study used the Systematic Literature Review (SLR) method. Articles were searched through Google Scholar, PubMed, ScienceDirect, Semantic Scholar, Garuda, and Crossref for the period 2017-2025. The article selection process used the PRISMA flow through the stages of identification, screening, eligibility, and inclusion. The initial search results obtained 186 articles. After removing duplicate articles, screening titles and abstracts, and full-text examination, 41 final articles were obtained that met the analysis requirements. The articles analyzed consisted of laboratory experimental studies, in vivo, in vitro, literature reviews, systematic reviews, phytochemical analysis, and GC-MS or UPLC-MS analysis. The results showed that flavonoids were the compounds most frequently found in kirinyuh leaves and were most associated with accelerated wound healing. Kirinyuh leaves have been shown to accelerate wound closure, increase collagen formation, increase angiogenesis, repair fibroblasts, and inhibit the growth of bacteria such as Staphylococcus aureus, Escherichia coli, Salmonella typhi, MRSA, and ESBL. Burn wound research shows that N-hexane extract of kirinyuh leaves at a concentration of 30% provides a healing rate of 79% on the 21st day. Another study showed that a serum combination of kirinyuh essential oil and curcumin provides healing of diabetic wounds by 68.068%. The most commonly used dosage forms are gels, ointments, creams, serums, sprays, essential oils, and topical extracts.

The Effect of Knowledge and Attitude to Implement Dysmenorrhea Exercises on Reducing Pain Scale in Midwifery DIII Students at Paluta Husada Gunungtua

Umi Istiqomah — Sat, 20 Jun 2026 00:00:00 +0000

Adolescence is a phase of life between childhood and adulthood, from the age of 10 to 19 years. Adolescence is a unique stage of human development and is an important time to lay the foundation for good health. This study is a quantitative type with a pre-experimental design that uses the one group pretest-posttest design, because this study aims to compare the results of the pretest of the intervention group and the posttest of the intervention group. The sample in this study were 66 students of the D-III Midwifery Study Program level I and II of STIKes Paluta Husada. Knowledge behavior before carrying out dysmenorrhea exercises had knowledge mostly in the sufficient category and after carrying out dysmenorrhea exercises knowledge was good, and before carrying out dysmenorrhea exercises students had a negative attitude because they felt it would not affect them, but after carrying out the exercises there was a positive attitude. D-III Midwifery Study Program students at STIKes Paluta Husada Gunung Tua can play an active role in helping to reduce menstrual pain problems, especially in female students with dysmenorrhea exercises. As midwifery students, we are expected to implement our role as midwifery care providers by regularly conducting dysmenorrhea exercises to reduce and manage menstrual pain

The Influence of Accessibility Factors on The Success of Exclusive Breastfeeding in The Working Area of Portibi Public Health Center, North Padang Lawas Regency in 2026

Dina Herawati, Ica Fauziah Harahap — Sun, 21 Jun 2026 00:00:00 +0000

Breastfeeding is the best investment for biological survival and improving the health, social, and economic development of individuals and nations. Although the global breastfeeding initiation rate is relatively high, only about 40% of infants under 6 months of age receive exclusive breastfeeding, and 45% continue to receive breastfeeding until the age of 24 months (Fadlliyyah, 2019). This study is an observational study with a cross-sectional design that aims to analyze the influence of accessibility factors on the success of exclusive breastfeeding at the Portibi Community Health Center, North Padang Lawas Regency, in 2026. The study was conducted at the Portibi Community Health Center, North Padang Lawas Regency in 2026 with a total of 78 respondents. This study concluded that accessibility factors have a significant effect on the success of exclusive breastfeeding at the Portibi Community Health Center, North Padang Lawas Regency in 2026 (p-value = 0.05).

The Relationship Between Post-Acne Scars and Quality of Life Among Medical Students of FK UNAND, Padang, Indonesia

Mon, 22 Jun 2026 00:00:00 +0000

Post-acne scars are a condition of skin layer damage due to the healing process of acne vulgaris, causing the skin to appear depressed. This condition disrupts facial aesthetics and may become permanent, thereby affecting the patient’s psychological condition and quality of life. This study aimed to determine the relationship between the severity of post-acne scars and the quality of life among medical students of FK UNAND, Padang, Indonesia. This study was an analytic observational study with a cross-sectional design conducted from June to December 2023. The population consisted of medical students of FK UNAND batch 2020–2022 who had acne scars. The total sample was 88 respondents selected using consecutive sampling. Data were collected using the Facial Acne Scar Quality of Life (FASQOL) questionnaire and Dysmorphic Concern Questionnaire (DCQ). Statistical analysis was performed using One-Way ANOVA and Fisher’s Exact Test. The results showed that most respondents were female and aged 21 years. The majority experienced mild acne scars (46.6%). The mean FASQOL score was 14.11. Most respondents felt disturbed by the presence of acne scars on their face. The DCQ results showed that 88.6% of respondents had no dysmorphic disorder features. There was no significant relationship between acne scar severity and quality of life (p=0.938) nor dysmorphic disorder (p=0.241). The study concluded that there was no relationship between the severity of post-acne scars and the quality of life among medical students of FK UNAND, Padang, Indonesia

Why do teens act impulsively? A psychoneuropsychiatry review of decision making

Tue, 23 Jun 2026 00:00:00 +0000

Adolescence is a crucial transitional phase characterized by the "Adolescent Health Paradox," a condition where adolescents are at their peak physical vitality yet experience increased morbidity and mortality rates due to high-risk behaviors. From a psychoneuropsychiatric perspective, this is caused by an imbalance in brain maturation between the limbic system and the prefrontal cortex. This literature review aims to provide a comprehensive understanding of the dynamics of adolescent brain development and its relationship with impulsive behavior and decision-making mechanisms. This study utilizes a literature review method by examining scientific articles from the Google Scholar, PubMed, and NCBI databases, as well as references from official institutions such as the WHO and the Ministry of Health of the Republic of Indonesia, primarily focusing on publications from the last ten years. The review indicates that adolescent impulsivity is a multidimensional construct involving "impulsive action" and "impulsive choice". Based on the Dual Systems Model, the limbic system (reward and emotion) develops more rapidly than the prefrontal cortex (executive control), leading adolescents to be more reactive and struggle with delaying gratification. Internal factors such as emotion regulation and resilience, as well as external factors like parental attachment and peer influence, significantly affect impulsivity levels. The clinical implications of this condition include an increased risk of mental disorders such as ADHD, Substance Use Disorder, and self-harm. Impulsive behavior in adolescents is a logical consequence of incomplete neurodevelopmental processes. Intensive guidance from parents and a supportive school environment are necessary to help adolescents develop self-control and healthy decision-making skills.

Analysis of Community Knowledge, Attitudes, and Experiences toward Preparedness for Initial Emergency Response in Karya Murni Village, Paguyaman District, Boalemo Regency

Ibrahim Suleman, Dewi Suryaningsi Hiola — Wed, 01 Jul 2026 00:00:00 +0000

Emergency conditions can occur suddenly in the community and require prompt and appropriate initial management before victims receive assistance from health professionals. Community preparedness is influenced by knowledge, attitudes, and experience in dealing with emergency conditions. This study aimed to analyze the relationship between community knowledge, attitudes, and experience and preparedness for initial emergency response in Karya Murni Village, Paguyaman District, Boalemo Regency. This study used a quantitative method with a correlational analytic design and a cross-sectional approach. The sample consisted of 50 respondents selected using purposive sampling. Data were collected using a questionnaire and analyzed through univariate and bivariate analyses using the Chi-square test. The results showed that most respondents had moderate knowledge (40.0%), positive attitudes (62.0%), no experience in dealing with emergencies (56.0%), and were categorized as prepared (56.0%). The statistical test results showed that knowledge, attitudes, and experience were associated with community preparedness for initial emergency response. The most dominant factor associated with preparedness was attitude. This study concludes that community preparedness for initial emergency response is associated with knowledge, attitudes, and experience. Therefore, health education, first-aid training, Basic Life Support simulations, and community empowerment are needed to improve community readiness to provide an initial response in emergency conditions.

The effectiveness of coping innovation interventions, reframing, and sleep hygiene in the adolescent aggregate of MTs Antasari Samarinda

Dini Andani Hasanah, Jumratul Amalia, Reza Wira Sanjaya, M. Bachtiar Safrudin — Wed, 01 Jul 2026 00:00:00 +0000

Adolescents are a vulnerable age group that often experience various mental health problems, such as stress, bullying, and sleep pattern disturbances influenced by academic demands, social pressure, and the use of digital technology. These conditions may trigger maladaptive coping, risky health behaviors, and decreased adaptive capacity among adolescents. Preliminary assessment at MTs Antasari Samarinda showed that some adolescents experienced moderate to high levels of stress, were at risk of bullying, and had sleep pattern disturbances with ineffective coping patterns. This study aims to analyze the effectiveness of innovative interventions involving coping strategies, reframing techniques, and sleep hygiene among adolescents at MTs Antasari Samarinda. The method used was a case study with a community nursing care approach that included assessment, diagnosis, planning, implementation, and evaluation. The assessment was conducted using several instruments, namely the Perceived Stress Scale (PSS-10), Bullying and Cyberbullying Scale for Adolescents (BCS-A), Brief-COPE, and Pittsburgh Sleep Quality Index (PSQI), along with interviews and observations.

The interventions included training in problem-focused coping and emotion-focused coping, reframing techniques through structured counseling sessions, as well as education and implementation of sleep hygiene practices. The results showed an improvement in adolescents’ ability to manage emotions and solve problems adaptively, a reduction in bullying tendencies and negative thought patterns, and improved sleep quality after the intervention. These findings indicate that innovative coping, reframing, and sleep hygiene interventions are effective in improving adolescents’ mental health and adaptive behaviors, as well as supporting community nursing care practices in the school environment.

The Role of Active Compounds in Green Betel Leaf (Piper betle L.)as Antibacterial Agents in the Prevention of Dental Caries: A Literature Review

Thu, 16 Jul 2026 00:00:00 +0000

Dental caries remains one of the most prevalent oral health problems and is primarily associated with cariogenic bacteria, particularly Streptococcus mutans. Although chlorhexidine is considered the gold standard antibacterial agent, its potential side effects have encouraged the exploration of safer natural alternatives. This literature review aimed to analyze the role of active compounds in green betel leaf (Piper betle L.) as antibacterial agents in the prevention of dental caries. Literature was collected from electronic databases including Google Scholar, PubMed, ScienceDirect, Elsevier, and NCBI, with seven selected studies meeting the inclusion criteria. The findings showed that green betel leaf contains several bioactive compounds, including phenols, flavonoids, eugenol, hydroxychavicol, and allylpyrocatechol, which exhibit antibacterial activity through inhibition of bacterial growth, disruption of cell membranes, suppression of biofilm formation, and interference with bacterial cell wall synthesis. Green betel leaf also demonstrated effectiveness against other oral pathogens associated with caries. Although its antibacterial efficacy remains lower than chlorhexidine, green betel leaf shows strong potential as a natural and biocompatible alternative for dental caries prevention

Sociodemographic Factors as Predictors of Cutaneous Eruption Sites in Irritant Contact Dermatitis: An Analytic Study at Dr. Pirngadi Regional Public Hospital

Sun, 19 Jul 2026 00:00:00 +0000

Background: Irritant contact dermatitis (ICD) is a common skin disorder that may be influenced by various sociodemographic factors. These factors are suspected to contribute to the predilection sites of cutaneous eruptions in patients with ICD. Objective: This study aimed to determine the association between sociodemographic factors and the location of cutaneous eruptions in patients with irritant contact dermatitis at Dr. Pirngadi Regional Public Hospital.

Methods: This analytic observational study employed a cross-sectional design. A total of 56 ICD patients were included using a total sampling technique. The variables analyzed included sociodemographic characteristics (age, sex, and occupation) as independent variables and eruption sites as the dependent variable. Associations between categorical variables were analyzed using the Chi-square test with the likelihood ratio approach, while the strength of association was assessed using Cramer’s V coefficient. Results: The majority of respondents were female (37; 66.1%), while males accounted for 19 participants (33.9%). Based on occupation, most respondents were housewives (16; 28.6%) followed by civil servants (13; 23.2%). The most common eruption sites were the upper extremities (35.7%) and lower extremities (33.9%). Statistical analysis showed no significant association between age and eruption sites (p = 0.067) or between sex and eruption sites based on the Chi-square likelihood ratio test (p = 0.334; Cramer’s V = 0.243). In contrast, occupation demonstrated a statistically significant association with eruption sites (p = 0.038) with a moderate strength of association according to Cramer’s V (0.504). Conclusion: Occupation is a sociodemographic factor significantly associated with the location of cutaneous eruptions in patients with irritant contact dermatitis.

Effectiveness Use of the Jkn Mobile Application in Health Services at Gunung Tua General Hospital, North Padang Lawas

Tiasa Pohan, Mhd.Fadlillah Nasution, Johan Saputra — Mon, 20 Jul 2026 00:00:00 +0000

Advances in information technology sometimes require people to keep up with the times. Currently, the use of information and communication technology is crucial for businesses and organizations to win the competition. This study aims to analyze the effectiveness of the use of the JKN mobile application in healthcare services at Gunung Tua General Hospital. This research method uses a qualitative research method with a descriptive approach. Data collection was conducted through in-depth interviews, observation, and documentation with informants determined using a purposive sampling technique. The results show that the use of the JKN Mobile application has a positive impact on healthcare services, particularly in accelerating the registration process and reducing patient queues. This application is considered to help with time efficiency and increase user comfort. It is recommended that BPJS Kesehatan and the hospital increase socialization and education activities regarding the use of the JKN Mobile application, both through print and digital media, as well as direct patient assistance. In addition, improvements in the quality of technical services, including system and network stability, need to be continuously carried out. The hospital is also expected to provide special staff to assist patients who experience difficulties in using the application

The Relationship between Psychological Stress and the Menstrual Cycle in Eighth Grade Female Adolescents at SMP Negeri 3 Panyabungan Regency Mandailing Natal

Mon, 20 Jul 2026 00:00:00 +0000

The menstrual cycle is the time from the first day of menstruation until the next menstrual cycle, while the length of the menstrual cycle is the distance from the start date of the previous menstruation to the start of the next menstrual cycle. A woman's menstrual cycle is usually 21-35 days, only 10-15% of women have a cycle of 28 days, 3-5 days and some have 7-8 days. Stress is an individual's response to changes in a threatening situation, This can be seen as a personal reaction to external events or demands such as doing tasks or internal states of mind such as worry. Stress tends to increase when unable to cope with unpleasant situations faced by a person. The population in this study was 47 people. The sample in this study used a Total Sampling sampling technique, namely a sampling technique where the sample size is the same as the population. The type of research used in this study is descriptive analytic with the Cross sectional method. The results of this study indicate that the p value = 0.050 (p = 0.05), so it is concluded that Ho is rejected and Ha is accepted. It is recommended for female students to continue to understand how to manage stress and reproductive health and to be able to carry out activities that are expected to reduce stress levels and seek information related to stress management and reproductive health

Challenges and Opportunities for Innovation in Implementing Electronic Medical Record (EMR) at Indonesia First-level Army Health Facilities

Anna Triwijayati, Dea Amelia Aditya Winata, Seno Aji Wahyono — Mon, 20 Jul 2026 00:00:00 +0000

This study aims to explore the challenges, efficiency, and innovation opportunities with the implementation of Electronic Medical Records (EMR) at Indonesia first-level army health facilities specifically Air Defense Artillery Center Clinic (Pusdikarhanud). This research adopted a qualitative approach using a case study method through semi-structured interviews with nine informants, consisting of seven clinic staff and two patients. In addition, participatory observation allowed the researcher to comprehend the subjective meanings behind individual actions and social interactions in the context of EMR usage. The findings indicate that the EMR implementation at the Pusdikarhanud Clinic faced several challenges related to technology infrastructure, staff training, data security and privacy, as well as integration with other systems. However, EMR implementation also brings efficiencies in coordination and collaboration among service units, clinic operations, and the enhancement of healthcare service quality. Furthermore, various innovation opportunities are identified, such as improving technology infrastructure, developing additional features in EMR, and integrating with other healthcare service systems. Theoretical implications of this study are the importance of systems-based approaches in health management and the potential of EMR as a tool to enhance efficiency and healthcare service quality. The practical implications include recommendations for the Pusdikarhanud Clinic to improve technology infrastructure, staff training, data security, and system integration, as well as policy recommendations for the government in standardizing EMR implementation, providing financial support, and developing technology infrastructure. Therefore, this study provides valuable insights for healthcare practitioners, policymakers, and researchers in understanding the challenges and opportunities of EMR implementation in health management transformation.

Analysis Of The Impact Of Health Services And Facilities On The Decline In Patient Visits At Sangkunur Community Health Center

Normayanti Rambe, Lisna Khairani Nasution, Susi Febriani Yusuf — Mon, 20 Jul 2026 00:00:00 +0000

The use of Puskesmas as a center for basic health services in the community is still minimal. The results of the North Sumatra Provincial Susenas in 2021 where the population who treated the road was recorded at 17.47% in utilizing the Auxiliary Puskesmas / Puskesmas. The study aims to analyze the effect of health worker services, facilities, and infrastructure on the decrease in community patient visits (non-PBI) of the Sangkunur Health Center. The type of research used is analytical quantitative research with the Explanatory Research type, with a sample of all patients aged ≥ 17 years, who went to the Sangkunur Health Center, with a Non-PBI category of 243 people. The Statistical Test used is the chi-square test and linear logistic regression. The results showed that there was an influence of health services on the decrease in patient visits to the Sangkunur Health Center with a p-value = 0.000. The conclusion is that the poor service of health workers resulted in respondents decreasing visits at the Sangkunur Health Center.

The Relationship Between Maternal Knowledge and Stunting Prevention Practices Among Children at Alisah Clinic in 2026

Ermita Silvana Putri, Eni Monaliska Sihombing — Wed, 22 Jul 2026 00:00:00 +0000

Stunting is a health issue that is currently a major concern, particularly in Indonesia. Stunting is a condition in which a child experiences growth impairment, resulting in shorter stature. Low levels of maternal knowledge influence mothers’ behavior in providing balanced nutrition to their children. This study aims to analyze the relationship between maternal knowledge and preventive measures against stunting in children at the Alisah Clinic in 2026. This study is an analytical survey using a cross-sectional approach. The study population consisted of mothers with children under 5 years of age at Alisah Clinic. The sample comprised 40 participants selected using accidental sampling. The results showed that of the 40 respondents with children under 5 years of age, the majority 23 respondents (57.5%) had knowledge categorized as “inadequate,” while a minority 8 respondents (20.0%) had knowledge categorized as “good.” Of the 40 respondents with children under 5 years of age, the majority 29 respondents (72.5%) did not take preventive measures, while a minority 11 respondents (27.5%) did. Of the 40 respondents regarding stunting prevention who have children under 5 years of age, the majority 22 respondents (55.0%) did not take any preventive measures, while a minority 18 respondents (45.0%) did. There is a relationship between mothers’ actions and the prevention of stunting in children. At a 95% confidence level with α = 0.005%, the two-tailed significance value (sig) was 0.00 < 0.05. The conclusion of this study is that there is a relationship between mothers’ knowledge and preventive measures against stunting in children at the Alisah Clinic in 2026. It is recommended that mothers further improve their knowledge regarding the prevention of stunting in children through educational sessions or other sources of information.

The Effect of Pelvic Rocking with a Birth Ball on the Progress of Labor During the Active Phase of the First Stage of Labor

Nining Sulistyowati, Ani Mulyandari — Wed, 22 Jul 2026 00:00:00 +0000

Prolonged labor can lead to increased morbidity and mortality rates in both mothers and infants. Therefore, measures must be taken to prevent prolonged labor, one of which is the use of the nonpharmacological “Pelvic Rocking” technique with a birth ball, which can facilitate labor progress and accelerate the process. This study aims to analyze the effects of pelvic rocking using a birth ball on labor progression during the active phase of the first stage of labor. The method applied in this study is a quasi-experimental design with a posttest-only control group. The study population consisted of all mothers in labor at the TPMB in Tanjungpinang City, with a sample size of 34 mothers in the active phase of the first stage of labor, divided into two groups (intervention and control). Consecutive sampling was used, while data analysis was performed using the Mann-Whitney U test. The findings of this study indicate that the pelvic rocking method using a birth ball did not have a significant effect on the progress of labor during the active phase of the first stage of labor, with a p-value of 0.086 (>0.05). Based on these results, it can be concluded that the pelvic rocking method using a birth ball can serve as an effective strategy to accelerate the labor process, provided that supporting factors are taken into account.

The Relationship Between Husband Support and Antenatal Care Visits Among Pregnant Women in the Third Trimester at PMB Nelly in Padangsidimpuan In 2024

Tue, 30 Jun 2026 00:00:00 +0000

Prenatal care, or prenatal checkups at the nearest medical facility, can evaluate the health of pregnant women.Husband's support is one element that influences the frequency of prenatal care visits. Matemal mortality can be avoided with more prenatal care visits. This study aims to determine the relationship between prenatal care visits and husband's support among third-trimester pregnant women at PMB Nelly, Padangsidimpuan City in 2024. This study used a cross-sectional and quantitative approach. A total of 32 people were selected using an accidental sampling method. The results showed that the majority of husbands (18 people) did not provide assistance, and the mejority (20 people, or 62.5%) did not attend scheduled prenatal care appointments. A significant correlation between husband's support and prenatal care visits among third-trimester pregnant women was found using the chi-square test, which produced a p-value of 0.006. Conclusion: Among third-trimester egnant women, there is a relationship between prenatal care visits and husband's support. Recommendation: Husbands can help their wives to continue with prenatal care by increasing their involvement, and pregnant women should understand the importance of completing all planned ANC examinations as decided by health professionals.

Exploring Pregnant Women's Experiences with RNN-Based Chatbot for Reproductive Health Education at Primary Health Centers: A Qualitative Phenomenological Study

Thu, 23 Jul 2026 00:00:00 +0000

Background: Inadequate reproductive health knowledge among pregnant women contributes to high maternal morbidity in Indonesia. Digital health promotion, particularly through recurrent neural network (RNN)-based chatbots, offers accessible and personalized health education. However, qualitative evidence on how such chatbots shape knowledge and experience remains scarce. Objective: This study aimed to explore pregnant women's experiences in acquiring reproductive health knowledge through RNN-based chatbot health promotion media at primary health centers, focusing on the depth and meaning of perceived knowledge change. Methods: A qualitative study with an interpretive phenomenological approach was conducted involving 24 pregnant women from two Puskesmas in Padangsidimpuan, Indonesia. Participants used the "Bunda Cerdas" chatbot based on LSTM architecture for two weeks. Data were collected through semi-structured in-depth interviews and analyzed using Braun and Clarke's thematic analysis. Trustworthiness was ensured through triangulation and member checking. Results: Six main themes emerged: (1) integrated thematic understanding, (2) convenient access to trusted information, (3) engaging and human-like interaction, (4) empowerment in health decision-making, (5) transformative knowledge retention, and (6) technical-social barriers. Participants reported a shift from fragmented to comprehensive knowledge, particularly in recognizing danger signs, nutritional needs, and birth preparedness. The conversational memory and contextual replies of the RNN chatbot fostered a sense of reliable companionship. Conclusion: RNN-based chatbot media substantively enriched pregnant women's reproductive health knowledge through personalized, dialogic learning. Its integration into primary care services can complement standard antenatal education, addressing knowledge gaps while respecting local cultural context. Further mixed-methods research is recommended to quantify outcomes and ensure sustainable implementation.

Airway Obstruction: A Comprehensive Literature Review on Etiology, Pathophysiology, and Clinical Management

Diska Aprisa Lestari, Rika Yolanda Putri, Baiq Rizqika, Muhammad Sultan — Fri, 24 Jul 2026 00:00:00 +0000

Airway obstruction represents a critical medical condition characterized by narrowing or complete blockage of the respiratory passages, leading to impaired ventilation and potentially life-threatening complications. This comprehensive literature review examines the multifaceted aspects of airway obstruction, encompassing its definition, classification, epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and management strategies. Airway obstruction can be categorized based on duration (acute vs. chronic), anatomical location (upper vs. lower respiratory tract), and severity (partial vs. complete obstruction). The global burden of this condition is substantial, with chronic obstructive pulmonary disease (COPD) affecting approximately 391.9 million individuals worldwide, asthma impacting 262 million people, and acute lower respiratory infections contributing significantly to morbidity and mortality, particularly in pediatric populations. The pathophysiology involves complex interactions between anatomical factors, inflammatory responses, smooth muscle dysfunction, and structural remodeling. Clinical presentation varies according to obstruction location and severity, ranging from wheezing and stridor to respiratory failure and cardiac arrest. Diagnostic evaluation requires systematic physical examination, careful history taking, and appropriate imaging modalities including radiography, CT scanning, MRI, and bronchoscopy. Management strategies encompass both pharmacological interventions (bronchodilators, corticosteroids, epinephrine, antibiotics) and non-pharmacological approaches (chest physiotherapy, breathing exercises, positional therapy). Early recognition and prompt intervention remain paramount in preventing fatal complications. This review synthesizes current evidence to provide a comprehensive understanding of airway obstruction, emphasizing the importance of timely diagnosis and individualized management approaches

Peritonsillar Abscess

Fri, 24 Jul 2026 00:00:00 +0000

Peritonsillar abscess (PTA) is the most common deep neck space infection, predominantly affecting adolescents and young adults. This condition represents a suppurative complication of acute tonsillitis or pharyngitis, characterized by pus accumulation between the tonsillar capsule and the superior pharyngeal constrictor muscle. Despite advances in antibiotic therapy, PTA remains a significant clinical entity with potential for life-threatening complications if inadequately managed. This article provides a comprehensive overview of peritonsillar abscess, encompassing its etiology, epidemiology, pathophysiology, clinical manifestations, diagnostic approaches, and evidence-based management strategies. This study employed a qualitative comprehensive literature review method. Data were collected through systematic searching of electronic databases including PubMed, Scopus, and Google Scholar for articles published between 2010 and 2024. Additionally, retrospective data from Sanglah General Hospital Denpasar (2010–2017) were analyzed to provide Indonesian epidemiological context. The annual incidence of PTA approximates 30 cases per 100,000 population, with peak incidence in individuals aged 15–40 years. The condition is predominantly polymicrobial, with Group A Streptococcus recovered from approximately 20% of cases. Analysis of 38 Indonesian patients revealed male predominance (65.78%), mean age of 38.76 years, and Streptococcus viridans as the most commonly isolated organism (63.16%). Clinical presentation is characterized by unilateral sore throat, trismus, muffled "hot potato" voice, and uvular deviation. Diagnosis is primarily clinical, with needle aspiration serving as the gold standard. Management comprises prompt antibiotic therapy combined with surgical drainage. Peritonsillar abscess requires early recognition and appropriate intervention to prevent complications. A multimodal approach incorporating clinical assessment, imaging when indicated, and timely surgical drainage with targeted antibiotic therapy yields favorable outcomes.

Diphteria

Sat, 25 Jul 2026 00:00:00 +0000

Diphtheria remains a significant public health threat in Indonesia despite decades of immunization programs. The country has witnessed a resurgence of cases, with outbreaks repeatedly occurring in provinces with low vaccination coverage. While quantitative surveillance data exist, little is known about the underlying socio-behavioral and health system factors that perpetuate transmission. This qualitative study aimed to comprehensively explore the barriers to diphtheria prevention and control from the perspectives of multiple stakeholders. Using a descriptive exploratory design, in-depth interviews and focus group discussions were conducted with 60 participants, including healthcare workers, parents, community leaders, and district health officials, across three high-incidence districts. Data were analyzed thematically using Braun and Clarke’s framework. Four overarching themes emerged: (1) pervasive immunization gaps driven by vaccine hesitancy and access deficits; (2) fragmented health system capacity, particularly in surveillance and case management; (3) deeply rooted socio-cultural beliefs and misinformation; and (4) weak intersectoral coordination during outbreak response. Participants vividly described how religious objections, fear of adverse events, geographic remoteness, and inadequate logistics chain interact to sustain outbreaks. The findings highlight that diphtheria resurgence is a multifactorial phenomenon requiring integrated interventions. Strengthening routine immunization through community engagement, enhancing diagnostic capacity, and establishing culturally sensitive communication strategies are critical. This study provides essential evidence for policy refinement toward achieving diphtheria elimination in Indonesia

Analysis of the Relationship between Hemodynamic Status, Age, and Body Mass Index on Postural Balance in Patients with a History of Chronic Disease

Sat, 25 Jul 2026 00:00:00 +0000

Background: Postural balance is a crucial motor component in maintaining functional stability. A decline in postural control performance significantly increases the risk of falls, particularly among populations with chronic comorbidities and degenerative conditions.Objective: This study aims to analyze the functional health profile and examine the correlation between hemodynamic status, age, and Body Mass Index (BMI) toward postural balance performance in patients with a history of chronic diseases.Methods: This quantitative study used a cross-sectional design utilizing secondary data from a community health screening initiative (n = 13). Parameters evaluated included demographic characteristics (age and sex), hemodynamic status (systolic/diastolic blood pressure and heart rate), anthropometry (BMI), and functional postural balance score (P. Balance). Data were analyzed using descriptive statistics and Pearson correlation coefficients (r) via Python programming. Results: The majority of respondents were female (92.3%) with a mean age of 53.15 \pm 13.02 years old. The average functional balance score of the subjects was 2.23 \pm 0.60. Correlation analysis revealed that Systolic Blood Pressure (SBP) demonstrated the strongest moderate negative correlation with functional balance performance (r = -0.45). Conversely, age (r = -0.16) and BMI (r = 0.11) exhibited weak correlations with the subjects' postural stability.Conclusion: Hemodynamic status, particularly systolic blood pressure, carries a more substantial functional relationship with postural control stability compared to age and anthropometric factors among populations with chronic comorbidities. Future community health interventions are recommended to prioritize hypertension management combined with targeted balance strategy training.

The Effect of Administering Ethanol Extract of Rambutan Leaves (Nephelium Lappaceum L.) on Accelerating The Healing of Excision Wounds In Male White Mice (Rattus Norvegicus)

Patimah Simamora — Thu, 06 Aug 2026 00:00:00 +0000

Excisional wounds are wounds in which the skin surface and underlying layers are broken to varying depths but the wound edges are regular and are caused by accidental events such as accidents, trauma, or exposure to pressure, heat, sunburn, or chemicals. Rambutan leaves (Nephelium lappaceum L.) are known to contain secondary metabolite compounds, especially flavonoids and tannins, which have the potential to accelerate the healing of excisional wounds through antioxidant, anti-inflammatory, and astringent activities. This study aims to determine the effect of administering rambutan leaf ethanol extract on accelerating the healing of excisional wounds in male white rats (Rattus norvegicus) and to determine the most effective concentration. The parameters observed include the percentage of wound healing and epithelialization time. Data were analyzed using the One-Way ANOVA test with a 95% confidence level. The results of phytochemical screening showed that rambutan leaf ethanol extract contains flavonoids and tannins. The percentage of wound healing on the 14th day in the 20%, 25%, 30%, positive control, and negative control concentration groups was 87%, 90%, 95.45%, 93.10%, and 86%, respectively. The results of statistical analysis showed that there were significant differences between the treatment groups. On the 4th day, the F value was 4.842 with p = 0.007, on the 9th day, the F value was 6.524 with p = 0.002, and on the 14th day, the F value was 8.720 with p <0.000 (p <0.05). The concentration of 30% rambutan leaf ethanol extract provided the best wound healing activity with a healing percentage of 95.45% on the 14th day with a significant value of 0.000 (p<0.05) and the fastest epithelialization time was a concentration of 30% on the 6th day with a significant value of 0.018 (p<0.05) compared to other groups.

Understanding Depression in Daily Practice

Dana Rizki Adilla Sitepu, Deasy Hendrianti, Haznur Ikhwan, Hervina — Thu, 13 Aug 2026 00:00:00 +0000

Depression represents a significant global health challenge, characterized as an abnormal condition arising from an individual's inability to adapt to specific circumstances or events, consequently affecting physical, psychological, and social functioning. According to the American Psychiatric Association (APA, 2013), depressive disorders are classified into two main categories: Major Depressive Disorder (MDD), marked by loss of interest or pleasure in daily activities lasting at least two weeks without manic episodes, and Dysthymic Disorder, a milder but chronic condition persisting for approximately two years. This article employs a comprehensive literature review methodology, systematically examining scholarly journals, scientific articles, websites, and textbooks to explore the characteristics, risk factors, and manifestations of depression across various populations. The findings reveal distinct patterns in specific demographic groups, including pregnant and postpartum women, adolescents, and the elderly, each presenting unique clinical features and predisposing factors. Depression results from a complex interplay of biological, psychological, and social factors, manifesting through characteristic physical, psychological, and social symptoms. The condition often leads to feelings of hopelessness, low self-esteem, persistent pressure, and negative thought patterns that may culminate in suicidal ideation. Early recognition and appropriate intervention are crucial for preventing adverse outcomes across all age groups and populations

Inaccuracies in Paper-Based Medical Record Information: An Exploratory Qualitative Case Study at Putri Hijau Hospital

Wed, 02 Sep 2026 00:00:00 +0000

Paper-based medical records are vulnerable to incomplete, delayed, and inconsistent information, which may hinder data use in care delivery. This study explored medical record information inaccuracies, perceived contributing factors, perceived impacts, and prevention efforts at Rumah Sakit Tk II 01.05.01 Putri Hijau Kesdam I/BB Medan, in 2018. An exploratory qualitative case study used in-depth interviews with four purposively selected informants: a specialist physician, an inpatient ward nurse, a medical records officer, and an inpatient ward general practitioner. Each informant participated in one interview session, totaling 211 minutes. Transcripts were analyzed thematically; analytical decisions were traceable through an audit trail, member checking, and comparison of cross-professional perspectives. Analysis generated 13 substantive codes grouped into four themes. Documentation supported routine care but was not consistently complete or timely. Inaccuracies were perceived to relate to documentation awareness, workflow, service workload, and record verification; they could potentially disrupt continuity of clinical information, administrative processes, data functions, and quality. Prevention requires standard operating procedures, standardized formats, checklists, evaluation, feedback, and cross-professional accountability. The findings offer lessons for improving paper-based documentation and electronic medical record governance during digital transformation, without estimating the prevalence of inaccuracies or overall hospital quality in the single institutional case examined here.

Relationship between Body Mass Index and Backpack Load with Shoulder Pain Complaints among First-Grade Junior High School Students

I Komang Adi Putra Yasa, I Gusti Ngurah Mayun, I Putu Astrawan — Thu, 10 Sep 2026 00:00:00 +0000

Shoulder pain is one of the most common musculoskeletal complaints among school-aged adolescents and has the potential to interfere with learning activities and daily functioning. This complaint is thought to be influenced by various factors, including Body Mass Index (BMI) and the use of overweight backpacks, which may increase mechanical stress on the shoulder structures. This study aimed to determine the relationship between BMI and backpack load with shoulder pain complaints among first-grade students at SMP Negeri 5 Abiansemal, Badung, Bali. This study employed a quantitative analytical observational method with a cross-sectional design. The sample consisted of 78 students selected using a purposive sampling technique. BMI data were obtained through measurements of body weight and height, backpack load was measured using a digital scale, and shoulder pain complaints were assessed using the Visual Analogue Scale (VAS). Data were analyzed using the Chi-Square test with a significance level of p < 0.05. The results showed no significant relationship between BMI and shoulder pain complaints (p = 0.532), whereas a significant relationship was found between backpack load and shoulder pain complaints (p < 0.001), indicating that heavier backpack loads are associated with a higher risk of shoulder pain. Backpack load management is recommended as a strategy to prevent musculoskeletal complaints among students.

The Relationship Between Sleep Quality and Cognitive Function and Activities of Daily Living in the Elderly in Banjar Denkayu Delodan, Werdi Bhuwana Village, Mengwi District, Badung Regency

Komang Agus Krisnayana, I Ketut Arya Yoga Krismantara, Ratih Wulansari Manuaba — Wed, 16 Sep 2026 00:00:00 +0000

Sleep quality disorders are frequently experienced by the elderly due to degenerative processes, potentially impairing brain recovery, memory consolidation, concentration, and cognitive function. Persistent sleep disturbances may reduce energy, balance, and physical capacity, affecting independence in activities of daily living (ADL). This study aimed to analyze the relationship between sleep quality and cognitive function and activities of daily living among the elderly in Banjar Denkayu Delodan, Werdi Bhuwana Village, Mengwi District, Badung Regency. This descriptive correlational study employed a cross-sectional approach involving 50 elderly participants selected through simple random sampling. Instruments included the Pittsburgh Sleep Quality Index (PSQI), the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina), and the Katz Index. Data were analyzed using the non-parametric Somers' d test. The majority of participants (82%, n=41) had poor sleep quality. Cognitive impairment was observed in 44% with mild impairment and 26% with moderate impairment, while 44% exhibited moderate dependence in ADL. Somers' d test revealed a strong, significant positive relationship between sleep quality and cognitive function (r=0.653; p=0.001), and a significant moderate negative relationship between sleep quality and ADL (r=-0.412; p=0.026). Significant relationships exist between sleep quality and both cognitive function and independence in activities of daily living among the elderly in Banjar Denkayu Delodan.