Contagion: Scientific Periodical Journal of Public Health and Coastal Health
Journal title CONTAGION: Scientific Periodical Journal of Public Health and Coastal Health Subject Health Sciences. Language English. ISSN 2685-0389 (online) Frequency Four times a year in January-March, April-June, July- September, and october- December. DOI Prefix 10.30829/contagion by Crossref Editor-in-chief Putra Apriadi Siregar, M.Kes (Scopus ID: 57485278200) Publisher Fakultas Kesehatan Masyarakat (FKM) UIN Sumatera Utara Citation Analysis Sinta2, Dimension, ASCI (Asian Science Citation Index), Google Scholar, Email contagion@uinsu.ac.id Contagion: Scientific Periodical Journal of Public Health and Coastal Health, a scientific periodical journal of public health published by the Public Health Study Program of the Faculty of Public Health at Universitas Islam Negeri Sumatera Utara Medan, Indonesia. These journals prioritize the collaboration of lecturers and students, with the scope of the discussion being about Public health, midwife, nursing, nutrition science, medicine, mental health, coastal public health, islamic and health sciences in islamic countries and developing countries. The journal is published four times a year in January-March, April-June, July- September, and october- December. Telp:+62895391495346||Email: contagion@uinsu.ac.id ||e-ISSN:2685-0389
Universitas Islam Negeri Sumatera Utara, Medan
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The Impact of Electronic Medical Records on Hospital Revenue from INA-CBGs Claims
Incorrect diagnosis and procedure coding are the major factors which lead to substantial reductions of claims in the INA-CBGs system. Studies have indicated reported losses of up to 23% due to this alone. This paper discusses whether Electronic Medical Records, hereafter referred to as EMRs, will mitigate such financial risks through improved documentation and coding quality. The study is a cross-sectional analysis based on 100 INA-CBGs inpatient claim documents, 50 with the use of EMRs and another 50 with the use of manual records, selected by simple random sampling technique. Five key variables have been related using the Chi-square test, multiple logistic regression analysis, and Structural Equation Modeling (SEM). Of all claims analyzed in this study, only 55% had complete medical information; diagnosis codes were accurate in 66% of them while accurate procedure codes accounted for just about 48%. Hospitals where EMRs are used had less revenue reduction at IDR 119,444,050 or -23.47%, compared to hospitals without EMRs which used manual records with a revenue reduction rate standing at IDR 272,422,069 or -47.92%. Of the claims analyzed, 55% had complete medical information, 66% had accurate diagnosis codes, and 48% had accurate procedure codes. Hospitals using EMRs experienced a smaller revenue reduction (IDR 119,444,050 or -23.47%) compared to those using manual records (IDR 272,422,069 or -47.92%). Diagnosis codes at accuracy (b = 3.595; p = 0.001), procedure codes at accuracy (b = 4.461; p < 0.001), documentation at completeness (b = 2.331; p < 0.001) and EMR use (b = 0.425; p < 0.001) were all significant factors with results of claims. EMRs significantly improve coding accuracy and reduce claim deductions, mitigating financial risk. Accelerating EMR adoption is recommended to strengthen hospital claim performance in the national health insurance system. Keyword: Electronic medical record; Diagnosis; Procedure; Hospital revenue; INA-CBGs
Copyright (c) 2025 Warsi Maryati, Anton Susanto http://creativecommons.org/licenses/by-sa/4.0
Effectiveness Test of Bay Leaf Ethanol Extract as Antihyperuricemia Invivo
The imbalance between high production and low excretion of uric acid in the body causes hyperuricemia, which can lead to gout. This disease is the second largest after stroke in Indonesia. Conventional therapy is not free from adverse effects. The tendency of society to go back to nature and the government's "Saintifikasi Jamu" program are efforts to explore safer alternative therapies. One of the plants that has the potential as an antihyperuricemia is bay leaves (Syzygium polyanthum Walp.). The purpose of this study is to optimize the use of scientifically based bay leaves as an antihyperuricemia agent. The research method used is experimental with a pre-posttest design . A total of 20 mice were divided into 5 test groups (induction, comparison, bay leaf extract group (EEDS) with doses of 100 mg/kgBW, 200 mg/kgBW, and 400 mg/kgBW. The effectiveness of antihyperuricemia was tested by inducing mice with 1% chicken liver juice and potassium oxonate. Uric acid levels were measured at T1, T7 and T14 days of the study using a Blood Uric Acid Meter. All groups of test extract doses showed effectiveness as agents to lower uric acid levels significantly compared to the induction group (p<0.05). The potential effectiveness of the antihyperuricemia extract showed an effect that was not statistically different from the comparison (allopurinol) (p>0.05) at all measurement points. The conclusion of this study shows that bay leaf ethanol extract has the potential as an antihyperuricemia agent, where a dose of 100 mg/kgBW showed the best effectiveness as an antihyperuricemia Keywords: Bay Leaves, Extract, Chicken Liver, Potassium Oxonate, Uric Acid
Copyright (c) 2025 Hilda S, Rosnike Merly Panjaitan, Nurul Hidayah http://creativecommons.org/licenses/by-sa/4.0
Developing a Social Learning-Based Educational Model to Improve Pregnancy and Baby Care Behavior in Adolescent Mothers
Adolescent pregnancy remains a serious public health issue, especially in developing countries. Many young mothers struggle because they lack the knowledge, emotional readiness, and support systems needed to maintain a healthy pregnancy and care for their babies. In Indonesia, these challenges are made worse by limited reproductive health education and the presence of social stigma. Padang, West Sumatra, faces similar concerns, with relatively high rates of adolescent pregnancy. The region's predominantly Muslim population and the Minangkabau culture; known for its strong emphasis on family and community values, play a significant role in shaping adolescent reproductive health behaviors. This study aims to design an educational model based on social learning theory to improve pregnancy and baby care practices among adolescent mothers in West Sumatra. A convergent mixed-methods design was used. Quantitative data came from structured questionnaires completed by 76 pregnant adolescents, while qualitative insights were gathered through interviews and focus group discussions with 11 informants, including adolescent husbands, family caregivers, midwives, and psychologists. The analysis showed that knowledge alone was not enough to encourage positive maternal behavior. Emotional readiness, stress management, family communication, and future planning were all significantly linked to better pregnancy care (p < 0.05). Qualitative findings further highlighted the importance of group-based training, interactive modules, accessible materials, and family involvement in strengthening adolescents' readiness and caregiving skills. The proposed educational model, grounded in social learning principles, offers a culturally sensitive and practical approach to empower adolescent mothers. If applied in community and clinical settings, it has the potential to improve maternal and child health outcomes and reduce the long-term risks associated with adolescent pregnancy Keywords: Adolescent pregnancy, educational model, social learning theory, maternal behavior, baby care
Copyright (c) 2025 dewi susanti, Muhammad Faisal, Elda Yusefni, Renidayati Renidayati http://creativecommons.org/licenses/by-sa/4.0
The Effect of Spiritual Care on Anxiety Level in Fracture Patients
Fractures are the most common physical injuries caused by accidents. The results Riskesdes (2018) show that in Indonesia, there are cases of fractures caused by traffic accidents, falls and sharp or blunt object trauma. Of the 45,987 falls that resulted in fractures, 1,775 people (3.8%) experienced fractures, of the 20,829 traffic accident cases that resulted in fractures. In every province in Indonesia, the most common fracture surgery in the extremities is in Bali with 3,065 cases, DKI Jakarta with 2,781 cases, while in North Sumatra there are 2,576 cases (Mongan & Solikhah, 2023). This study aims to see the effect of spiritual care on anxiety level in fracture patients at Sundari Hospital. This type of research is quasi-experimental with a pre test and post test design with control group. This research was carried out at Sundari Hospital from 11 April to 20 Mei 2025. The study population included 37 patients of fractures. The sampling technique is non-probability sampling. The number of samples in this study was 15 people for the control group and 15 people for the treatment group. The results of the study showed that there was a difference in the average anxiety level of fracture patients who were given spiritual care intervention compared to the group of patients who were not given intervention with p value = 0.000; 95% CI < alpha = 0.05 Keywords: Spiritual care, Anxiety level, Fracture
Copyright (c) 2025 Rina Rahmadani Sidabutar http://creativecommons.org/licenses/by-sa/4.0
Implementation Analysis of Medan City Regional Regulation No. 3 of 2014 on Smoke-Free Areas in Medan Baru District
The Medan City Government has enacted Regional Regulation No. 3 of 2014 concerning Smoke-Free Areas (SFA) to protect the public from exposure to tobacco smoke in public facilities. However, its implementation remains inconsistent across sectors and compliance remains low. This study aims to analyze the implementation of SFA regulations in Medan Baru District, Medan City, using William C. Edwards III's policy implementation framework, which focuses on communication, resources, disposition, and bureaucratic structure. Informants were determined purposively, representing implementers, supervisors, and policy targets. The SFA regulation has been socialized but not consistently. Limited human resources, insufficient budget, irregular monitoring, and the lack of SFA signage are weaknesses in implementing the SFA regulation. Policy implementers understand the policy objectives but remain weak in commitment. The bureaucratic structure, although the division of tasks between agencies is clear on paper, suffers from weak inter-agency coordination, SOP compliance, and law enforcement. Commitment from all parties is required to implement the SFA regulation in Medan City, as almost all sectors still have weaknesses in its implementation. Keywords: SFA Regulation, Policy Implementation, William C. Edwards III, Medan City
Copyright (c) 2025 Jasmen - Manurung http://creativecommons.org/licenses/by-sa/4.0
Activity Based Costing and Cost Recovery Rate of Ureteroscopy Under Indonesia's INA-CBGs Payment System
Universal Health Coverage (UHC) sustainability in Low-and Middle-Income Countries (LMICs) hinges on adequate Diagnosis-Related Group (DRG) tariffs, which frequently fail to cover the true cost of complex, high-technology procedures. This study aimed to estimate the actual unit cost of 360 Ureteroscopy (URS) encounters (January-December 2023) using Activity-Based Costing (ABC) and assess the resultant Cost Recovery Rate (CRR) under Indonesia's INA-CBGs payment system. A retrospective descriptive quantitative design cost analysis was performed at RSI Sultan Agung Semarang. The ABC unit cost ranged from IDR 9.322.737 (Class I) to IDR 8.322.737 (Class III). Compared to the INA-CBGs tariff, a significant and consistent deficit was found exclusively in Class III procedures, yielding the lowest CRR of 69%. The deficit was primarily driven by high expenditure on imported consumables and Operating Room time. Conclusion and Contribution: The INA-CBGs tariff is structurally inadequate for high-severity URS cases, threatening hospital financial sustainability. This study provides the first ABC micro-costing evidence linked to INA-CBGs for urological procedures, offering critical data to policymakers for a targeted tariff review and enabling hospital management to optimize key cost drivers Keywords: Diagnosis-Related Groups, Activity-Based Costing (ABC), Cost Recovery Rate (CRR), Ureteroscopy (URS), Universal Health Coverage (UHC), Unit Cost
Copyright (c) 2025 ARINA MANASIKANA http://creativecommons.org/licenses/by-sa/4.0
Successful Appendiceal Ureteral Substitution in a Rare Ureteric Involvement of Rhabdomyosarcoma in a Child - A Case Report
Ureteral Rhabdomyosarcoma (RMS) in children is a rare malignancy that may involve the ureter, leading to obstruction and hydronephrosis. Management requires a combination of oncologic therapy and individualized surgical planning, particularly when tumor resection results in extensive ureteral defects. This case report describes an 8-year-old girl with pelvic embryonal RMS involving the right distal ureter, previously treated with pelvic radiotherapy and VAD (vincristine, actinomycin, and doxorubicin) chemotherapy. Imaging showed tumor compression of the distal ureter with grade III hydronephrosis. Surgical resection necessitated en bloc distal ureterectomy, creating a 10-cm ureteral defect. Due to prior pelvic radiation and concerns regarding bladder fibrosis and metabolic complications from bowel interposition, ureteral substitution using the appendix was performed. Postoperative recovery was uneventful, with stable renal function, normal electrolyte balance, and no urinary leakage. Follow-up imaging at 6 months demonstrated a well-functioning appendiceal conduit and no residual tumor. This case illustrates that appendiceal ureteral substitution can be a safe and effective reconstructive option for long distal ureteral defects in pediatric RMS, particularly when prior radiation limits alternative techniques. Careful surgical technique and close follow-up remain essential to ensure optimal outcomes Keywords: Ureteral Substitution, Ureteral Reconstruction, Appendix, Embryonal Rhabdomyosarcoma
Copyright (c) 2025 Ali Ariyono, Indrawarman Soerohardjo, ahmad zulhan hendri http://creativecommons.org/licenses/by-sa/4.0
Determinant Risks of Adolescent Sex Behavior in Terjun Village
Adolescent sexual behavior is a complex issue that has a major impact on the health and well-being of young people worldwide. In today's internet era, it is shaped by many factors, including peer influence, family support, access to pornography, and reproductive health services. This study set out to examine the variables that influence adolescent sexual behavior. Using a cross-sectional design, researchers surveyed 170 adolescents in Terjun Village, selected through random sampling. Data were analyzed with the chi-square test to identify relationships between variables. The results showed that knowledge (p = 0.006), family support (p = 0.0005), and access to pornographic content (p = 0.0005) were significantly related to adolescent sexual behavior. In contrast, reproductive health services (p = 0.196) and peer influence (p = 0.440) did not show a significant relationship. These findings suggest that to help adolescents live healthier and more responsible sexual lives, efforts should focus on comprehensive sex education, strong family support, reproductive health promotion, and policy advocacy that reinforce these strategies Keywords: Adolescent, Sexual Behavior, Health, Risk
Copyright (c) 2025 Dhani Syahputra Bukit, Kintoko Rochadi, Alam Bakti Keloko http://creativecommons.org/licenses/by-sa/4.0
Quality of Life Among Informal Sector Workers in Relation to Working Hours, Income, and Social Support
The quality of life of informal sector workers is related to their work-life balance, job satisfaction, and health problems. Prevention of work accidents, occupational diseases, and welfare improvement are regulated in the occupational health and safety management system. The purpose of analyzing their quality of life. A cross-sectional design was conducted for this research, from May to August 2025 on online platform drivers. Accidental techniques and establishing inclusion criteria were used to determine the research sample. The instrument used was a questionnaire that had met validity and reliability standards. Multivariate regression was used for data analysis. The results of the study found that their quality of life was related to income, social support, and working hours, stated at a p value <0.001. Of the three variables related to quality of life, working hours/week showed a negative relationship with a B value of -0.231, while the other two variables were positive. The higher the number of hours worked by online platform workers per week, the lower their quality of life. In contrast to income, the t value = 5.576 and p = 0.000 means that income is correlated 5 times with quality of life. High income means their quality of life is 5 times better. Social support was proven to be significantly related to quality of life with a p value of 0.000 and t value of 12.038. Positive social support was associated with 12 times better quality of life for workers Keywords: ISO 45001, Long Working Hours, Platform work, Quality of Life, Total worker health
Copyright (c) 2025 Nuraini Nuraini http://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Health Education Using Web-Based Family Planning Information Media "Life Care" in Improving Acceptors' Knowledge
One approach to strengthening the quality of human resources is to ensure that individuals have access to reliable reproductive health information, particularly by improving knowledge about contraception through innovative digital platforms. This study examined the effectiveness of digital health education delivered through the “LIFE CARE” platform in enhancing reproductive health knowledge related to contraceptive methods among current contraceptive users. The observation was carried out at the Karya Wanita Community Health Centre in Pekanbaru City from January to July 2024, involving 77 participants selected purposively from a total of 220 contraceptive users. A one-group pretest-posttest design was applied, and knowledge scores were analyzed using the Wilcoxon test with SPSS version 25 software. Results demonstrated a significant increase in knowledge after the intervention, with median scores rising from 75 (SD = 14.27) before the intervention to 95 (SD = 6.10) post-intervention (p < 0.001). These findings confirm that web-based educational interventions are effective in enhancing contraceptive knowledge and highlight their potential to strengthen family planning services and digital health education strategies at the primary healthcare level. Keywords: Digital Health Promotion, Web-Based Education, Family Planning, Contraceptive Knowledge, Reproductive Health
Copyright (c) 2025 roza Asnel, Salsabila Oktoviani, Tengku Hartian SN, Mailiza Cahyani, Dewinny Septalia Dale http://creativecommons.org/licenses/by-sa/4.0
The Effect of Self-Efficacy Training on Nursing Students' Anxiety in Facing The National Objective Structured Clinical Examination (Osce) in Medan City
The National Objective Structured Clinical Examination (OSCE) is a key graduation requirement for nursing students, but its implementation often triggers anxiety. This anxiety can lower self-confidence, harm academic performance, and in severe cases, even lead to depression. One effective way to address this challenge is through self-efficacy training, helping students build belief in their ability to complete tasks successfully. Strong self-efficacy fosters motivation, effort, and perseverance, which are essential when preparing for OSCE. This study used a quasi-experimental, one-group pretest-posttest design. Training was delivered in eight sessions, each lasting 60 minutes. The population included all nursing students at Prima Indonesia University, Medan, and a sample of 40 students was selected using total sampling. Anxiety levels were measured with the Hamilton Anxiety Rating Scale (HARS), and data were analyzed using a paired sample T-test. The results showed that self-efficacy training significantly reduced students' anxiety in facing the national OSCE (p = 0.001) Keywords: Self-efficacy, Anxiety, Nursing Students, National OSCE
Copyright (c) 2025 Basri basri, Afeus Halawa http://creativecommons.org/licenses/by-sa/4.0
Distribution Pattern Environmental Sanitation Analysis and Diarrhea with Stunting Incidence in Toddlers in Karo Regency North Sumatra Province
Stunting is a national problem because its increasing prevalence and impact can increase less competitive human resources, affect work productivity, increase the risk of overweight and obesity, and trigger metabolic syndrome. Environmental factors such as sanitation and hygiene, drinking water sources, drinking water quality, and toilet ownership are indirect factors causing stunting. This study aims to analyze the distribution of stunting incidence and environmental sanitation factors causing stunting in Karo Regency, North Sumatra, Indonesia. A case-control design was conducted on 246 toddlers with a 1:1 ratio. The distribution pattern of stunting incidence and the relationship between patient characteristics and environmental risk factors were studied using a Geographic Information System. Data on clean and healthy living behavior were collected using a questionnaire, and microbiological laboratory tests measured water quality. Spatial analysis used an average nearest-neighbor overlay. The relationship between characteristics and risk factors with stunting incidence was analyzed using chi-square and logistic regression. The average nearest neighbor analysis showed a nearest neighbor index of 0.19 (<1) (Z score -16.72, p-value 0.01). Regression analysis was carried out using GeoDa software (p-value 0.76). There was a relationship between clean water quality, clean and healthy lifestyles (PHBS), and diarrhea (p-value <0.05) and stunting. Family latrines, waste disposal facilities, and wastewater drainage (p-value >0.05) were not associated with stunting. Case distribution tended to be clustered, and no association was found between population density and stunting. This study's findings provide new insights that health promotion to prevent stunting should not only focus on nutritional fulfillment but also on clean and healthy living behaviors and water quality Keywords: Stunting, sanitation, diarrhea, Karo regency, clean water, waste
Copyright (c) 2025 Jernita Sinaga, Risnawati Tanjung, Restu Auliani, Deli Syaputri http://creativecommons.org/licenses/by-sa/4.0
Analysis of Factors Influencing the Performance of Specialist Doctors at RSI PKU Muhammadiyah Pekajangan
This study aims to analyze the influence of work environment, remuneration, and work motivation on the performance of specialist doctors at RSI PKU Muhammadiyah Pekajangan. This study employed a mixed-methods sequential explanatory design, beginning with a quantitative correlational study of 32 specialist physicians at PKU Muhammadiyah Islamic Hospital in Pekajangan, followed by a qualitative case study with five purposively selected physicians. Work environment, remuneration, work motivation, and performance were measured using a validated and reliable Likert-scale questionnaire; quantitative data were analyzed using descriptive statistics and Pearson correlation, while qualitative data were analyzed using the Miles and Huberman model to deepen the interpretation of the findings. The results of the quantitative analysis showed that the work environment (p = 0.000), remuneration (p = 0.027), and motivation (p = 0.000) significantly influenced the performance of doctors. Qualitative findings revealed that the performance of specialist doctors at RSI PKU Muhammadiyah Pekajangan was influenced by three main factors, namely individual factors (work motivation), organizational factors (remuneration), and work environment factors. Therefore, hospital management is recommended to strengthen a supportive work environment, improve transparency and fairness in the remuneration system, and provide continuous professional development and motivational programs to sustainably enhance specialist physicians' performance. Keywords: Doctor Performance, Work Environment, Remuneration, Work Motivation, Islamic Hospitals
Copyright (c) 2025 Frans Saputra, Sri Sundari http://creativecommons.org/licenses/by-sa/4.0
Therapeutic Effect of Curcumin on Hepatic iNOS Expression in a Rat (Rattus norvegicus) Preeclampsia Model
Preeclampsia is a pregnancy-specific disorder characterized by hypertension after 20 weeks of gestation and multisystem involvement, including hepatic dysfunction. Amplified oxidative stress and systemic inflammation contribute to liver damage, partly through the stimulation of inducible nitric oxide synthase (iNOS). Curcumin, a polyphenol derived from Curcuma longa, possesses strong antioxidant and anti-inflammatory properties and has been reported to inhibit iNOS expression in various disease models. The objective of this study was to evaluate the effect of curcumin on hepatic iNOS protein expression in a rat model of preeclampsia. A true experimental post-test-only control group design was employed. Twenty-five pregnant Wistar rats were randomly assigned to five groups: negative control, positive control (L-NAME-induced preeclampsia), and three treatment groups receiving curcumin at 30, 50, or 100 mg/kg body weight alongside L-NAME. Preeclampsia was induced by intraperitoneal administration of L-NAME (125 mg/kg body weight) from gestational day 13 to 19, during which curcumin was administered orally. Liver tissues were collected and subjected to immunohistochemical analysis to quantify iNOS expression. One-way ANOVA with post hoc testing (p < 0.05) revealed significant differences among groups. Quantitative ImageJ analysis iNOS expression (% positive area) showed: 5.06 (negative control), 77.00 (positive control), 64.34 (P1), 33.67 (P2), and 19.78 (P3), indicating a dose-dependent reduction in iNOS expression. Curcumin at 100 mg/kg body weight produced the most pronounced decrease in hepatic iNOS expression in preeclampsia-induced rats. These findings demonstrate that curcumin exerts hepatoprotective effects through the downregulation of iNOS in preeclamptic liver tissue and suggest its potential as an adjunctive therapeutic or preventive strategy for mitigating hepatic inflammation in preeclampsia. Further investigation in advanced preclinical and clinical studies is warranted. Keywords: Curcumin, iNOS, Oxidative stress, Hepatic Inflammation, Preeclampsia.
Copyright (c) 2025 Desy Aulina Sururi, Mutiara Putri Nanda Rizki, Bambang Rahardjo, Novida Ariani http://creativecommons.org/licenses/by-sa/4.0
Bladder Rhabdomyosarcoma in Adolescents at a Tertiary Centre in Indonesia: A Case Series with Focus on Age-Specific Treatment Response and Diagnostic Challenges
Bladder rhabdomyosarcoma (RMS) is a rare type of soft tissue cancer in adolescents, and it often shows up with vague urinary symptoms that can be easy to miss. Compared to younger children, teenagers tend to respond less well to treatment and have lower survival rates, even when given equally intensive therapies. This difference seems to come from both biology and the challenges of diagnosis. We saw two adolescent male patients, aged 17 and 21, who came in with blood in the urine. Imaging with ultrasound and contrast CT scans revealed solid bladder masses with clear hyperenhancement (delta HU 37-38). Pathology and immunohistochemistry (desmin, myogenin, MyoD1) confirmed embryonal RMS, one conventional type and one botryoid variant. Both were staged as pT2bN0M0. Each patient underwent partial cystectomy after an initial TURBT. Neither received chemotherapy. Case 1 had a laparoscopic partial cystectomy in February 2023, while Case 2 had surgery three years earlier. Both were followed closely with cystoscopy every 3-6 months. At 30 and 36 months post-surgery, respectively, both remain disease-free, with normal bladder function and no need for catheters. These cases show that adolescents with localized bladder RMS can do well when the tumor is completely removed, even without chemotherapy. CT hyperenhancement helps raise suspicion, while immunohistochemistry confirms the diagnosis. Partial cystectomy not only achieves complete resection but also preserves bladder function. Ongoing surveillance is critical, and age-specific treatment strategies, focused on surgery plus careful follow-up, deserve further study for this group. Keywords: Rhabdomyosarcoma, Bladder Tumour, Adolescent, Age-Specific Treatment, Diagnostic Delay, Bladder Preservation, Partial Cystectom
Copyright (c) 2025 Andhyka Brillian Kharisma http://creativecommons.org/licenses/by-sa/4.0
Peer Educators in Religious Moderation and Mental Resilience through Strengthening Religious: Moderation Writing Classes
This community service program addressed the need to strengthen religious moderation and mental resilience among students (santri) in Indonesia's diverse socio-religious context. Implemented at Pesantren Ulumul Qur'an, the initiative designed and evaluated an empowerment model that integrated two core components: the training of peer educators and the facilitation of a religious moderation writing class. The primary objective was to enhance the santri's knowledge, attitudes, and practical skills related to religious moderation and emotional management through a participatory, peer-based learning approach. The methods involved a series of structured activities, including training workshops, mentoring sessions, and facilitated writing and peer-review discussions, engaging a total of 31 santri. Data collected through pre- and post-program questionnaires revealed significant positive outcomes. The results showed marked improvements in several key areas: santri participation in writing activities increased, the consistent use of credible references in their writing rose from 25.8% to 38.7%, the practice of outlining arguments before writing grew from 38.7% to 67.7%, and the application of polite and inclusive language became more prevalent. Furthermore, the santri exhibited a strong consensus in supporting democratic values, interfaith cooperation (96.8%), and the protection of minority rights (96.8%). In conclusion, this service program effectively demonstrates that a model combining peer education and critical literacy through writing is a powerful tool for fostering a generation of santri who are not only knowledgeable and resilient but also active promoters of moderation and harmony in society. Keywords: Religious Moderation, Peer Educator, Writing Class, Santri, Community Empowerment.
Copyright (c) 2025 Budiman Budiman, San Putra, Prima Yanti Siregar, Putra Apriadi Siregar, Bagus Rahmadi, Zahrani Nabila, Faiza Adinda, Putri Safira http://creativecommons.org/licenses/by-sa/4.0
Reduction of VEGF Levels by Phaleria macrocarpa Flavonoids in an Endometriosis Mouse (Mus musculus) Model
Endometriosis occurs when endometrial-like cells proliferate at ectopic sites outside the uterus. The advancement of endometriotic lesions is strongly influenced by VEGF, as it stimulates the formation of new blood vessels. In contrast, flavonoids derived from Phaleria macrocarpa extract possess inhibitory effects on both pro-inflammatory signaling molecules and pro-angiogenic pathways. This study investigated the effects of flavonoids from Phaleria macrocarpa extract on VEGF levels in the peritoneal fluid of endometriosis mouse models. This research employed a post-test-only control group experimental design. A total of thirty mice (Mus musculus) were assigned to six groups: a healthy control group, an untreated endometriosis group, and four endometriosis groups receiving isolated flavonoids from Phaleria macrocarpa extract at doses of 3.75, 7.5, 15, and 30 mg/mouse/day (n=5). Peritoneal fluid samples were collected from all groups to examine VEGF levels using ELISA. The results were expressed as mean ± SD and subsequently evaluated using a one-way ANOVA with LSD post-hoc test at a significance level of p-value < 0.05. Flavonoids at the dose of 30 mg/day significantly decreased the VEGF levels compared to the group of endometriosis mouse models (p-value=0.001). Flavonoids decreased VEGF levels as an angiogenic factor in peritoneal fluid, which may play a role in the proliferation of endometriosis tissue. Keywords: Flavonoid, Phaleria macrocarpa, VEGF, Endometriosis
Copyright (c) 2025 Amina Diarsy http://creativecommons.org/licenses/by-sa/4.0
Predictive Models and Tools for Early Detection of Stunting in Children: A Systematic Review
Child stunting remains a critical public health challenge globally, with early detection essential for preventing irreversible developmental consequences. This review uniquely synthesizes predictive and measurement tools for early stunting detection across multiple low- and middle-income countries, addressing the gap in systematic evaluation of their diagnostic performance. Following PRISMA 2020 guidelines, we systematically searched PubMed, ProQuest, Emerald, and Springer databases for studies published between 2019-2024. We used the SPIDER method to define this study's inclusion, and eligible studies included those developing or validating predictive models and diagnostic tools for stunting detection in children aged 0-19 years. The articles included in this assessment use different methodologies conduct a critical appraisal to determine the quality of the articles using the instrument tool from Joana Briggs Institute (JBI). Thirteen studies met the inclusion criteria, identifying four primary tool categories clinical scoring systems, omposite anthropometric indices, diagnostic charts and machine learning models. The MEIRU chart demonstrated superior diagnostic accuracy (sensitivity 97.6%, specificity 96.3%, kappa 0.93) compared to traditional WHO methods. Clinical scores exhibited moderate performance with sensitivity ranging from 61.9% to 90.0%. Common predictors across models included maternal education, birth weight, child age, gender, and socioeconomic status. Predictive models and measurement tools are valuable for the early detection of stunting, enabling timely and targeted interventions to reduce its long-term impact on child health and development. Keywords: Anthropometry, Diagnostic accuracy, Early detection, Prediction models, Risk factors
Copyright (c) 2025 Nurannisa Nurannisa, Titih Huriah http://creativecommons.org/licenses/by-sa/4.0
Relationship between Clinicopathological Features and Expression of COX-2 among Colorectal Cancer Patients: A Prospective Observational Study
Colorectal cancer (CRC) is the third most common cancer globally and a leading cause of cancer-related mortality. Cyclooxygenase-2 (COX-2) plays a critical role in CRC pathogenesis by promoting inflammation, tumor proliferation, and metastasis. COX-2 inhibitors, such as NSAIDs, have shown potential in reducing CRC progression. However, the relationship between COX-2 expression and clinicopathological features remains controversial. This study aims to assess the correlation between COX-2 expression and clinicopathological characteristics in CRC patients in Indonesia. A prospective observational study was conducted on 81 CRC patients at a tertiary hospital in West Java, Indonesia, from January to June 2024. COX-2 expression was quantified using qPCR from tumor tissue samples. Clinicopathological data, including age, sex, tumor grade, stage, and complications, were collected and analyzed. Among the 81 participants, 81.5% were over 50 years old. Low-grade adenocarcinoma was the most prevalent histopathological type (73%), followed by high-grade adenocarcinoma (11%) and mucinous adenocarcinoma (11%). The majority of cases were in regional or early stages (74%), while 26% were in late stages. Higher COX-2 expression was more frequent in males, rectal tumors, high- grade adenocarcinomas, advanced stages, and metastatic cases. Although no statistically significant association was found, a trend toward increased COX-2 expression in advanced CRC was observed. No significant association was found between COX-2 expression and clinicopathologic characteristics of CRC. However, higher COX-2 expression may be associated with advanced disease. Keyword: Clinicopathological features, Colorectal cancer, Cyclooxygenase-2, Inflammation, Metastasis
Copyright (c) 2026 Mohamad Romdhoni, Kiki Lukman, Reno Rudiman, Andriana Purnama, Bambang Am Am Setya Sulthana Degrees, Tommy Ruchimat, Alma Wijaya, Yunia Sribudiani Degrees, Prapanca Nugraha http://creativecommons.org/licenses/by-sa/4.0
Effects of Online Prenatal Yoga on Anxiety Level and Quality of Life Among Third Trimester Pregnant Women in North Cikarang District
The third trimester of pregnancy, is a vulnerable period for anxiety due to physical changes, sleep disturbances, hormonal shifts, and concerns about childbirth. According to statistics from the WHO, up to 10% of pregnant women and 13% of postpartum women suffer from mental health problems, among which the prevalence of prenatal anxiety is as high as 15%. These conditions may impair maternal and fetal health and reduce quality of life. Prenatal yoga, especially movements targeting the psoas muscle, has been proposed to alleviate stress and anxiety. This study aimed to examine the effects of prenatal yoga on anxiety levels and quality of life among women in the later stages of pregnancy in North Cikarang District. A total of 64 participants took part in this quasi-experimental study. They were allocated into two groups based on health centers: an intervention group (n=32), which received eight online prenatal yoga sessions, and a control group (n=32), which continued routine antenatal care. To assess the impact of the intervention, anxiety levels were evaluated both before and after the treatment using the “Perinatal Anxiety Screening Scale (PASS)”, and quality of life was measured using the “World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF)”. Data analysis was performed using the Wilcoxon and Mann-Whitney statistical tests. The findings revealed a significant decrease in anxiety levels among participants in the intervention group compared to those in the control group (p < 0.001). Furthermore, participants who engaged in prenatal yoga experienced notable enhancements in their quality of life, encompassing physical, psychological, social, and environmental aspects (p < 0.001). Overall, the study concludes that prenatal yoga serves as an effective approach to alleviating anxiety and enhancing the overall quality of life for women in the later stages of pregnancy in North Cikarang District Keywords: Anxiety, Third-Trimester Pregnancy, Quality of Life, Pregnant Women, Online Prenatal Yoga
Copyright (c) 2026 Bambang Amelia Fajriati Urbaningrum http://creativecommons.org/licenses/by-sa/4.0
Strengthening Self-Efficacy in Personal Hygiene Among Children of Indonesian Migrant Workers in Malaysia
Children of migrant workers often face limited access to basic services and health education, which can negatively affect their personal hygiene practices. This community engagement initiative aimed to enhance self-efficacy and improve hygiene knowledge and behaviors among migrant children through simple, enjoyable, and contextually relevant approaches. The program was implemented at Sanggar Belajar Negeri Sembilan, Malaysia, in July 2025, involving a total sample of 30 children aged 7-13 years. The intervention combined interactive lectures, demonstrations of the seven-step of proper handwashing, or what is commonly known as CTPS or Cuci Tangan Pakai Sabun, and toothbrushing techniques, as through a modified educational board game based on Snakes and Ladders. Monitoring was conducted descriptively through baseline and final observations, along with informal oral questioning (without formal questionnaires) to assess changes in knowledge, attitudes, participation, and signs of self-efficacy. The results indicated meaningful practical improvements: over 80% of participants could identify 3-5 correct hygiene practices; children showed increased confidence in demonstrating the seven CTPS steps and expressed commitment to brushing their teeth at least twice daily; and high levels of active participation were observed (≥25 children engaged in discussions, Q&A, and games until the end of the session). The program was well received by both participants and facilitators, suggesting that a combination of brief lectures, simulation, and gamification is practically effective for promoting hygiene in migrant community contexts Keywords: Personal Hygiene, Migrant Children, Indonesia, Self-Efficacy, Malaysia
Copyright (c) 2026 Nofi Susanti, Aulia Annisa, Putra Apriadi Siregar, Prima Yanti Siregar, Apriliani Apriliani, Rani Suraya, Muhammad Rezebri, Hafsah Hafsah http://creativecommons.org/licenses/by-sa/4.0
Immunohistochemical Profile of Er, Pr, Her2, and Ki-67 In Breast Cancer Patients
Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide, with hormonal factors playing a critical role in tumor development and progression. This study aims to describe the immunohistochemical profile of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 in breast cancer patients at MRCCC Siloam Semanggi Hospital in 2022. A retrospective descriptive study was conducted using a total sampling of anatomical pathology archives, comprising 316 breast cancer cases. The most common age group was 40-49 years. ER positivity was observed in 229 patients (72.5%), while PR positivity was found in 183 patients (57.9%). HER2 overexpression (3+) was identified in 75 patients (23.7%); cases with equivocal HER2 (2+) required confirmation by in situ hybridization. High proliferative activity, indicated by Ki-67 ≥20%, was present in 262 patients (82.9%). These findings indicate a predominance of hormone receptor-positive tumors with high proliferative indices, highlighting the importance of immunohistochemical profiling in guiding prognosis assessment, therapeutic decision-making, and selection of targeted and systemic treatments in breast cancer management. Keywords: Breast Cancer, Immunohistochemistry, Estrogen Receptor (ER), HER2, Ki-67
Copyright (c) 2026 Marliana Nurprilinda, Erida Manalu, Tiroy Sari B. Simanjuntak, Reinhard Christovel Andreas http://creativecommons.org/licenses/by-sa/4.0
Patterns and Appropriateness of Antihypertensive Use in Preeclampsia: A Retrospective Study at a Jakarta Tertiary Hospital (2022-2024)
Preeclampsia (PE) complicates approximately 2-8% of pregnancies worldwide and remains a leading cause of maternal and perinatal morbidity and mortality, contributing to more than 50,000 maternal deaths and nearly 500,000 neonatal deaths annually. Appropriate antihypertensive therapy is essential to prevent disease progression and adverse outcomes. This non-experimental, cross-sectional, retrospective study was conducted at the Indonesian Christian University Hospital from August to December 2024. All medical records of patients with preeclampsia during the study period were included using total sampling (N = 52). Variables included patient characteristics, type of antihypertensive therapy, and appropriateness of drug use. Appropriateness was evaluated using the 4Ts criteria (appropriate indication, appropriate drug, appropriate dose, and appropriate patient) based on the POGI 2016 guideline. Data were analyzed as proportions with 95% confidence intervals (CI), and associations between preeclampsia severity and antihypertensive patterns were explored descriptively. Most patients were aged >35 years (50%), in the third trimester of pregnancy (94.2%), and diagnosed with mild preeclampsia (80.8%). In mild preeclampsia, nifedipine monotherapy was the most frequently prescribed antihypertensive (92.9%; 95% CI: approximately 80-99%). In severe preeclampsia, nifedipine monotherapy was used in 50% of cases (95% CI: approximately 19-81%), whereas nifedipine-methyldopa combination therapy accounted for 40% (95% CI: approximately 13-74%). Evaluation of antihypertensive use showed 100% appropriateness for indication, drug selection, dose, and patient suitability, indicating entirely rational use in accordance with guidelines. Antihypertensive prescribing patterns for preeclampsia in this hospital largely adhered to clinical guidelines, with nifedipine as the mainstay therapy for both mild and severe cases. These findings support the effectiveness of guideline-based pharmacotherapy for the management of preeclampsia and highlight the need for further multicenter studies to evaluate clinical outcomes and long-term maternal-fetal safety. . Keywords: Preeclampsia, Antihypertensive Agents, Nifedipine, Drug Utilization, Pregnancy, Guideline Adherence.
Copyright (c) 2026 Abitmer Gultom, Hertina Silaban, Yohanes Baptistuta Paser http://creativecommons.org/licenses/by-sa/4.0
Family Behaviour In The Prevention of Pulmonary Tuberculosis Transmission Among Children
Introduction: Tuberculosis (TB) remains a critical public health priority in Indonesia, with household contacts of patients, particularly children, constituting a high-risk group for infection. The family unit plays a pivotal yet complex role in either mitigating or facilitating transmission within domestic settings. Objective: This study aimed to compare the knowledge, attitudes, and preventive practices (KAP) related to TB between families with and without household TB contacts in Medan, Indonesia. Methods: A comparative cross-sectional study was conducted across eight public health centers in Medan. A total of 100 family respondents (50 with child household TB contacts and 50 without) were recruited. Data on sociodemographics and TB-related KAP were collected via a validated, structured questionnaire and analyzed using Chi-square tests in SPSS 22.0. Results: A stark, inverse distribution was observed. Families with household TB contacts demonstrated significantly poorer knowledge (94.0% poor vs. 6.0% good), less positive attitudes (66.0% good vs. 86.0% good), and markedly inferior preventive practices (12.0% good vs. 93.0% good) compared to families without contacts (p=0.027, p=0.019, and p=0.007, respectively). Conclusions: The study reveals a critical paradox: families at the highest risk of transmission possess the lowest KAP levels for prevention. This indicates a profound failure of current TB contact investigation and education paradigms to effectively penetrate high-risk households. Urgent recalibration of national TB control strategies is needed to implement intensive, household-centered behavioral interventions to break the chain of intra-familial transmission. Keywords: Tuberculosis; Knowledge, Attitudes, Practice; Household Contacts; Health Education; Indonesia.
Copyright (c) 2026 Tri Makmur, Fazidah Aguslina Siregar http://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Sialang Honey in Burn Healing Through the Expression of Vascular Endothelial Growth Factor (VEGF) in Rattus norvegicus
Full-thickness burns require rapid revascularization to prevent tissue necrosis and support the healing process. Sialang honey, a wild multifloral honey from Indonesia, has traditionally been used for wound care, but its specific mechanism in modulating angiogenesis remains poorly understood. This study aimed to evaluate the effectiveness of Sialang honey on the expression of Vascular Endothelial Growth Factor (VEGF) in a mouse model with full-thickness burns. A true experimental study with a post-test only control group design was conducted using 27 male Wistar rats (Rattus norvegicus). Full-thickness burns were induced and treated daily for 14 days. Rats were randomly divided into three groups: Negative Control (0.9% NaCl), Treatment (Topical Sialang Honey), and Positive Control (1% Silver Sulfadiazine). Skin tissue was collected on days 5, 7, and 14. VEGF expression was detected using immunohistochemical (IHC) staining and measured via H-Score. Data were analyzed using One-Way ANOVA and Post-Hoc LSD Test (p<0.05). Treatment with Sialang Honey significantly increased VEGF expression compared to the negative control group. Peak expression occurred on day 7 (mean difference vs. control: p=0.000), indicating strong angiogenesis during the proliferation phase. Notably, VEGF levels in the honey group decreased significantly on day 14 (p<0.05), mimicking the physiological transition to the remodeling phase. The honey group showed a superior angiogenic response compared to Silver Sulfadiazine on day 7. Sialang honey effectively accelerated burn wound healing by modulating VEGF expression promoting an initial surge in angiogenesis followed by a physiological decline. These findings support the potential of Sialang honey as an effective topical agent for burn management. Keywords: Sialang Honey, Vascular Endothelial Growth Factor (VEGF), Angiogenesis.
Copyright (c) 2026 Syamsul Rizal, Mirnasari Amirsyah, Budiman Budiman, Khairan Khairan http://creativecommons.org/licenses/by-sa/4.0
The Effect of Curcumin on 5-Lipoxygenase (5-LO) Levels in the Hearts of Wistar Rats (Rattus norvegicus) as a Preeclampsia Model
Excessive activation of the 5-lipoxygenase (5-LO) pathway plays a pivotal role in promoting inflammation and endothelial dysfunction, thereby aggravating cardiovascular complications in preeclampsia. Curcumin, a natural polyphenolic compound with well-established anti-inflammatory and antioxidant properties, has been suggested to suppress 5-LO activity. This study aimed to evaluate the effect of curcumin administration on cardiac 5-LO levels in pregnant Wistar rats with an L-NAME?induced preeclampsia model. A true experimental post-test?only control group design was conducted using 25 pregnant Wistar rats divided into five groups, consisting of a negative control, a positive control receiving L-NAME, and three treatment groups administered curcumin at doses of 30, 50, or 100 mg/kg body weight alongside L-NAME. Preeclampsia was induced by L-NAME administration at a dose of 125 mg/kg body weight from gestational day 13 to 19, while curcumin was given orally during the same period. Cardiac 5-LO levels were measured from serum samples using enzyme-linked immunosorbent assay (ELISA) and analyzed using one-way ANOVA followed by Tukey?s post hoc test with a significance level of p < 0.05. The results showed a marked elevation of cardiac 5-LO levels in the positive control group compared to the negative control. Curcumin administration significantly reduced 5-LO levels at all tested doses, with the most pronounced effect observed at 100 mg/kg body weight. Furthermore, a very strong negative correlation was identified between curcumin dose and cardiac 5-LO levels (r = −0.871), indicating a clear dose-dependent response. These findings demonstrate that curcumin effectively suppresses cardiac 5-LO levels in a dose-dependent manner in a preeclampsia rat model and highlight its potential clinical relevance as a natural adjunct therapy for mitigating cardiovascular inflammation and endothelial dysfunction associated with preeclampsia Keywords: Curcumin, 5-Lipoxygenase, Inflammation, Heart, Preeclampsia
Copyright (c) 2026 Berliana Noviasih Pertiwi, Lina Zafirah Sukaji, Bambang Rahardjo, Linda Ratna Wati http://creativecommons.org/licenses/by-sa/4.0
Determinants of Relapse Among Schizophrenia Patients in West Kalimantan: A Cross-sectional Study
Relapse can affect functional impairment, rehospitalization, readmission, and long-term disability among schizophrenia patients. Although several factors, such as medication adherence, internalized stigma, and family support, are recognized as determining factors, there is still limited evidence from the Indonesian context, especially in West Kalimantan. This study aimed to evaluate the factors associated with relapse among schizophrenia patients. A quantitative, cross-sectional design was conducted at a mental hospital in West Kalimantan. A total of 63 patients and their families participated in this study, selected using a consecutive sampling technique. The MMAS-8, ISMI-9, and family support questionnaires were used to collect the data; patients completed the MMAS-8 and ISMI-9 questionnaires directly, whereas their families completed the family support questionnaire using a Google Form. The patients' medical reports were used to identify the relapse rate. Data were analyzed using Fisher's exact test and multivariate logistic regression.? Fisher's exact test showed that medication adherence was significantly associated with relapse (p = 0.02, p < 0.05), while internalized stigma and family support were not associated (p = 0.21; p = 0.12, p > 0.05). Medication adherence was the strongest factor associated with relapse, with an Adjusted Odds Ratio (AOR) of 2.091. This finding suggests that schizophrenia patients with a low level of medication adherence were over two times more likely to experience a lifetime relapse compared to those with a higher level of medication adherence ? Keywords: ?Family Support, Internalized Stigma, Medication Adherence, Relapse, Schizophrenia
Copyright (c) 2026 Wahyu Kirana, Dewin Safitri, Yunita Dwi Anggreini http://creativecommons.org/licenses/by-sa/4.0
The Association Between the Infection Prevention and Control (IPC) Committee's Performance and Compliance With the Use of Personal Protective Equipment (PPE) in Sembiring Hospital
Hospitals play a critical role in preventing nosocomial infections, and the use of personal protective equipment (PPE) is a key strategy for protecting healthcare workers and preventing pathogen transmission. This cross-sectional quantitative study aimed to assess the influence of the Infection Prevention and Control (IPC) Committee's performance on PPE compliance at Sembiring Hospital. A total of 57 healthcare workers participated and were surveyed using structured questionnaires. Data were analysed using univariate, bivariate (Chi-square) and multivariate (logistic regression) methods. All IPC performance indicators, surveillance, supervision, policy and procedure development, training, education effectiveness, participation and collaboration, and PPE availability, were significantly associated with PPE compliance. Multivariate analysis showed that education effectiveness had a significant effect on compliance (p = 0.002; Exp(B) = 16.655; 95% CI: 2.707?90.543). These findings suggest that strengthening the IPC Committee's role in delivering effective education is essential to improve PPE compliance among healthcare workers. For policy and practice, hospitals should prioritise continuous IPC training programmes and institutionalise periodic competency assessments to enhance adherence to PPE protocols and safeguard both staff and patients Keywords: IPC Committee, PPE Compliance, Infection Prevention, Hospital Policy
Copyright (c) 2026 Alprindo Sembiring Meliala, Efrata Efrata, Friska Ernita Sitorus, Hariati Hariati, Rostiodertina Girsang, Zuliawati Zuliawati, Jekson Martiar Siahaan http://creativecommons.org/licenses/by-sa/4.0
The Effect of Ladder Drill and Zig-Zag Run Exercises and Motivation on Crescent Kick Performance in Young Athletes: A Health and Fitness Perspective
This study tackles the issue of enhancing athletic performance in Pencak Silat, particularly in the execution of the crescent kick, a technique that demands agility, strength, and coordination. It is known that physical conditioning and motivation can affect how well an athlete performs. Nevertheless, limited research investigates the impact of training methodologies and motivational levels on martial arts performance. To examine this, a quasi-experimental design was utilized, testing two physical training methods (Ladder Drill and Zig-Zag Run) and two motivation levels (high and low) on 40 athletes (20 male and 20 female) from the IKSPI Kera Sakti club. The study employed a 2x2 factorial design, utilizing crescent kick ability as the dependent variable and motivation as a moderating variable. The results showed that the main effects of training methods and motivation levels on crescent kick ability were not statistically significant (p >0.05). However, the overall model explained 92% of the variance in performance (Adjusted R? = 0.905), which shows that both physical training and motivation had a strong effect on performance. Tests for normality and homogeneity of variance showed that the assumptions for parametric analysis were met, which made sure that the results were reliable. This study emphasizes that the amalgamation of physical conditioning and psychological support not only improves athletic performance but also fosters the physical and mental well-being of adolescents, thereby advancing overarching objectives in health promotion. To get the best results in sports and long-term health, you need to look at all of these factors together. Subsequent research ought to incorporate larger sample sizes and longitudinal methodologies to investigate the enduring effects of such interventions on youth development ? Keyword: Pencak Silat, Crescent Kick, Physical Conditioning, Motivation, Ladder Drill, Zig-Zag Run
Copyright (c) 2026 Iqlal Kahfi, Aldo Naza Putra, Bafirman Bafirman, Ahmad Chaeroni http://creativecommons.org/licenses/by-sa/4.0
Therapeutic Potential of Phaleria Macrocarpa Flavonoid Extract Regulating Rantes in Endometriosis
Endometriosis is a long-term inflammatory disease that affects women of childbearing age. It is caused by endometrial tissue growing in places other than the uterus. RANTES (Regulated on Activation, Normal T Cell Expressed and Secreted) and other important inflammatory mediators are very important in making the inflammatory responses related to this disorder worse. The aim of this study was to evaluate the impact of the ethanolic extract of flavonoids derived from the fruit of Phaleria macrocarpa (Mahkota Dewa) on RANTES levels in a rat model of endometriosis. Thirty female rats were divided into six groups: one healthy control group, one endometriosis control group, and four treatment groups that received doses of 3.75, 7.5, 15, and 30 mg/rat/day of the extract, respectively. The endometriosis model was established by transplanting myometrial and endometrial tissues from a patient with adenomyosis into the peritoneal cavity of immunosuppressed rats. Once the model was set up, the rats got the extract every day for 15 days in a row. We used the ELISA method to measure RANTES levels and histological and immunohistochemical analyses to look at ERβ expression. The results showed that the endometriosis control group (K+) had the highest levels of RANTES (64.05 ? 1.86 pg/mL). Surprisingly, the group that got 30 mg/rat/day (P4) had the biggest drop in RANTES levels (45.95 ? 1.07 pg/mL). Moreover, an upregulation of ERβ expression was observed in rats with induced endometriosis, evidenced by intensified brown staining, succeeded by a dose-dependent reduction, signifying modulation of estrogenic activity. In summary, the administration of the ethanolic flavonoid extract from Phaleria macrocarpa significantly reduced RANTES levels in rats with endometriosis, underscoring its potential as an alternative treatment for managing inflammation related to endometriosis. ? Keyword: Keywords: Phaleria macrocarpa, flavonoid, endometriosis, RANTES
Copyright (c) 2026 Fany Hardiati Amalia, Amina Diarsy, Sutrisno Sutrisno, Safrina Dewi Ratnaningrum http://creativecommons.org/licenses/by-sa/4.0
Utilization of the National Health Insurance Healthy Indonesia Card (JKN KIS) in Negeri Liang, Central Maluku Regency
The National Health Insurance Healthy Indonesia Card (JKN KIS) is Indonesia?s primary system for achieving Universal Health Coverage. Although many people nationwide are enrolled, use remains limited in rural areas such as Negeri Liang in Central Maluku. This study explores factors affecting JKN KIS utilization by assessing residents? knowledge, access to information, attitudes, and social influences within rural communities. A cross-sectional survey of 189 residents from Liang Village used a structured questionnaire focusing on four latent constructs. Data analysis employed Partial Least Squares?Structural Equation Modeling (PLS-SEM) in SmartPLS, with 5,000 bootstrapped resamples (two-tailed) to evaluate reliability, validity, and predictive relevance through loadings, AVE, CR, HTMT, R?, f?, and 95% confidence intervals. Results show that knowledge (β = 0.308, 95% CI: 0.182?0.442; f?= 0.147), access to information (β= 0.251, 95% CI: 0.118?0.389; f?= 0.104), and attitude (β= 0.357, 95% CI: 0.217?0.497; f?= 0.187) significantly and positively influence JKN KIS use, with attitude being the most impactful factor. Social influences, however, were not significant (β= 0.051, p= 0.388; f?= 0.004), indicating a limited direct effect. The structural model exhibits moderate explanatory power (R?= 0.482). In conclusion, participation in JKN KIS in rural areas is mainly driven by internal cognitive and emotional factors, rather than social influences. To boost engagement, strategies should focus on enhancing public knowledge, improving access to trustworthy information, and fostering positive attitudes. Policy recommendation: primary healthcare centers should prioritize attitude-oriented education and counseling, emphasizing financial protection and service benefits, with the aim of at least a 15% increase in valid JKN KIS claims within one year. ? Keywords: Health Insurance Utilization, Knowledge, Information Access, Attitude, Social Factors?
Copyright (c) 2026 hans sammy salakory http://creativecommons.org/licenses/by-sa/4.0
Analysis of Factors Influencing Exclusive Breastfeeding Practices in Kramat Gajah Village, Deli Serdang
Exclusive breastfeeding (EBF) is the optimal method of feeding infants from birth to six months without providing any additional food or drink. Exclusive breastfeeding is influenced by maternal age, knowledge, education level, andemployment status, household income, and support from healthcare workers. This study aims to analyze the association among maternal age, knowledge, education, employment status, household income, and healthcare worker support with the practice of exclusive breastfeeding. A quantitative, descriptive study with a cross-sectional approach was implemented in Kramat Gajah Village. The study population consists of breastfeeding mothers with infants aged 0-6 months, selected through total sampling. Independent variables are maternal age, education level, household income, employment status, maternal knowledge, and healthcare worker support, while the dependent variable is exclusive breastfeeding. Data were gathered through a structured questionnaire, and statistical analysis was carried out using the Chi-square test. A total of 65 breastfeeding mothers participated in the study. The majority of respondents exclusively breastfed their infants (75.4%), were aged 20-35 years (78.46%), had an education level of junior or senior high school (84.62%), had a household income greater than or equal to the regional minimum wage (≥ IDR 3,255,572; 53.84%), were unemployed (83.1%), and received support from healthcare workers (84.6%). The Chi-square test results revealed significant associations between exclusive breastfeeding practices and maternal knowledge (p=0.003), education (p=0.049), and employment status (p=0.011). In contrast, no significant associations were found between exclusive breastfeeding and maternal age (p=0.118), household income (p=0.424), or healthcare worker support (p=0.220). Therefore, maternal knowledge, education level, and employment status significantly influence exclusive breastfeeding practices in Kramat Gajah Village, whereas maternal age, household income, and healthcare worker support do not show significant associations Keywords: Exclusive Breastfeeding, Determinants, Maternal Knowledge, Maternal Education, Breastfeeding Practices
Copyright (c) 2025 Emi Inayah Sari Siregar, Tinah Tinah, Abdul Hairuddin Angkat http://creativecommons.org/licenses/by-sa/4.0
Toxicity Assessment of Ethanol Extract from Castanopsis Costata (Blume.) A. DC Leaves on the Microscopic Structure of White Rat Kidneys
Castanopsis Costata (Blume.) A. DC. leaves are traditionally used for medicinal purposes and are known to be rich in bioactive compounds such as flavonoids, tannins, and alkaloids. However, scientific validation regarding their safety profile remains limited. This study aimed to evaluate the acute toxicity effects of ethanol extract from Castanopsis Costata leaves on the renal histopathology of white rats (Rattus norvegicus). The study used a pretest and posttest in the experimental design method. Twenty-five male rats were randomly assigned into five groups and orally administered the ethanol extract at doses of 5, 50, 300, 2000, and 5000 mg/kg body weight for seven consecutive days. On the eighth day, the rats were euthanized, and kidney tissues were collected for microscopic examination. Data normality and homogeneity were assessed before conducting one-way ANOVA followed by Tukey's HSD post hoc test. Histopathological evaluation revealed no significant morphological alterations in renal tissues across all treatment groups. Statistical analysis confirmed that the data were normally distributed and homogeneous (p > 0.05). One-way ANOVA indicated no significant nephrotoxic effects associated with extract administration across the tested doses (p = 0.023). The ethanol extract of Castanopsis Costata leaves exhibited no observable renal toxicity at doses up to 5000 mg/kg body weight in white rats, suggesting its potential safety for further pharmacological exploration. Future studies should assess sub chronic and chronic toxicity to establish a more comprehensive safety profile Keywords: Castanopsis Costata, Ethanol Extract, Renal Histopathology, Acute Toxicity, White Rats
Copyright (c) 2025 Pratiwi Rukmana Nasution, Zulfikri Zulfikri http://creativecommons.org/licenses/by-sa/4.0