E-Jurnal Medika Udayana is a peer-reviewed scientific journal dedicated to publish good quality of research work in all areas of medical sciences. Scope of the journal includes: medicine, dentistry, nursing and allied health sciences, pharmacy, pathology, anatomy, pharmacology, toxicology, surgery and physiology.
CHARACTERISTICS AND LABORATORY EXAMINATION RESULTS IN PATIENTS WITH URINARY TRACT STONES AT PROF. DR. I.G.N.G. NGOERAH HOSPITAL DENPASAR
Urinary tract stone is multifactorial disease and laboratory examination helps to diagnose it. Research on characteristics and laboratory results is limited. This research aims to determine the characteristics and laboratory examination results of urinary tract stone patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar. It’s a descriptive cross-sectional study using secondary data from medical records of urinary tract stone patients at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from January 2021 to December 2022. The sampling technique used total sampling processed with SPSS with univariate analysis. The total sample is 182 with the majority aged ≥51 years (68.1%), male (72%), private employees (26.4%), no family history (97.8%), and without comorbidities. Urinalysis was dominated by yellow urine (73.1%), clear urine (58.8%), normal pH (95.6%), positive erythrocytes (+++) (56%), positive leukocytes (++++) (38.5%), positive bacteria (88.5%), negative nitrite (82.4%), and most crystal composition was calcium oxalate (64.28%). Blood examination dominated with normal erythrocytes (49.5%), decreased hemoglobin (63.2%), decreased hematocrit (59.9%), normal leukocytes (59.3%), and normal platelets (79.7%). Blood chemistry revealed elevated serum creatinine (59.9%), normal BUN (54.4%), and elevated uric acid (26.4%). The most common stone composition was uric acid (82.35%). In conclusion, urinary tract stones increased with age, dominated by males, private employees, no family history and comorbidities, normal urine color, turbidity, and pH, positive in erythrocytes, leukocytes, and urine bacteria, negative nitrite, calcium oxalate crystal composition, normal erythrocytes, decreased hemoglobin and hematocrit, normal leukocytes and platelets, normal BUN, increased serum creatinine and uric acid, and most stone composition is uric acid. Keywords: Characteristics, laboratory results, urinary tract stones
Hak Cipta (c) 2026 E-Jurnal Medika Udayana
DESCRIPTION OF BRCA I AND BRCA II GENETIC MUTATION TEST RESULTS ON SUSPICIOUS FAMILIAL BREAST CANCER IN BALI
Breast cancer is a disease in which abnormal cell growth occurs in the breast, abnormal cell growth in the breast occurs quickly and uncontrollably, and cell growth is irregular. This study aims to describe the results of BRCA I and BRCA II genetic mutation tests on suspected familial breast cancer in Bali.This research is descriptive research using observational research methods where the researcher only makes observations and describes without any intervention on the research subject. This research is in the form of a sample where this research was carried out by collecting secondary data from breast cancer patients based on the database in the surgical oncology division of Prof. dr. Hospital. I.G.N.G Ngoerah Denpasar for the 2020-2023 period. Patient data collected includes age, breast cancer subtype, pre/post menopause, family history of breast cancer(pedigree).The amount of data obtained was 10 patient samples. The results of the study showed an overview of the results of the BRCA I and BRCA II genetic mutation tests on suspicion of familial breast cancer, with the highest results in those aged 40-55 years, namely 6 people (60%), the breast cancer subtype showing that the most was luminal-A type as many as 3 people (30%), the most pre-menopausal patients were found, namely 8 people ( 80%), history of breast cancer in the family (pedigree) most often there is a relationship of cancer in the family, namely, 6 people (60%), mother, brother, sister (degree 1), and aunt (degree 2), and BRCA I test results and the majority of BRCA II were negative, namely 8 people (80%).
Ni Gusti Ayu Agung Manik Yuniawaty Wetan
Optimizing Schizophrenia Care: A Multi-Parameter Evaluation of Antipsychotic Prescribing Rationality
Schizophrenia is a chronic mental disorder that requires long-term antipsychotic pharmacotherapy with rational drug use to prevent relapse and improve patients’ quality of life. This study was a descriptive observational study with a retrospective approach aimed at evaluating the rationality of antipsychotic drug use in outpatient schizophrenia patients based on WHO criteria at Hospital X in the Tangerang region, Banten. The study sample consisted of 299 patients who met the inclusion and exclusion criteria, and the analysis was conducted using eight drug use indicators, including indication, patient, drug, dose, frequency, diagnosis, route of administration, and duration of therapy. The results showed that most patients were male (55%) and aged 26–35 years (31.8%), with paranoid schizophrenia as the dominant diagnosis (98%) and hallucinations as the main symptom (80%). Atypical antipsychotics were the main therapy, with risperidone 2 mg being the most frequently prescribed drug (30.6%), and polypharmacy was found in 59% of patients. The accuracy of drug use reached 100% for indication, diagnosis, route of administration, and duration of therapy, and was also high for drug selection (99%), patient (99.3%), and dose (97.7%), while frequency accuracy was lower (82.6%). Overall, antipsychotic use at Hospital X demonstrated a high level of rationality and was aligned with evidence-based practice principles; however, improvements are still needed in dosing frequency accuracy and stronger collaboration between psychiatrists and clinical pharmacists to minimize potential drug-related problems in patients receiving combination therapy.
KADAR THYROID STIMULATING HORMONE SERUM BERKORELASI POSITIF DENGAN DERAJAT KEPARAHAN MELASMA
Melasma merupakan hipermelanosis akuisita pada kulit yang sering terpapar matahari, terutama wajah. Patogenesisnya bersifat multifaktorial dan kompleks, dengan salah satu faktor resiko pencetus hormon tiroid. Peningkatan Thyroid Stimulating Hormone (TSH) dapat meningkatkan proses melanogenesis yang diduga melalui peningkatan Adenocorticotropic Hormone (ACTH). Studi cross sectional ini melibatkan 40 subyek melasma dan 10 subyek non melasma. Kadar TSH serum pada subyek melasma (median 2,0; IQR 5,1) secara signifikan lebih tinggi dibandingkan subyek non melasma (median 1,1; IQR 0,5; p=0,034). Penelitian ini menunjukkan terdapat korelasi bermakna positif sedang antara kadar TSH serum dengan derajat keparahan melasma, dengan tiap kenaikan 1 mIU/L TSH serum akan disertai peningkatan skor MASI sebesar 2,01. Derajat keparahan melasma dapat dipengaruhi oleh kadar TSH serum. (r = 0,441; p < 0,004; β =2,013; p=0,001; R2= 23,7%).
Hak Cipta (c) 2025 E-Jurnal Medika Udayana
CHARACTERISTICS OF COLON OBSTRUCTION AMONG PATIENTS WITH COLORECTAL CANCER IN PROF. DR. I.G.N.G. NGOERAH GENERAL HOSPITAL DENPASAR 2021-2022
Obstruksi usus besar (LBO) yang ditandai dengan penyumbatan lumen usus besar, dapat menyebabkan komplikasi berat seperti iskemia usus atau perforasi. Kanker kolorektal (KKR) merupakan masalah kesehatan yang signifikan secara global. Kasus LBO pada pasien KKR dikaitkan dengan prognosis pasien yang buruk. Walau demikian, banyak penelitian menunjukkan data dan temuan yang inkonsisten mengenai faktor risiko LBO pada KKR. Mengetahui karakteristik obstruksi kolon pada pasien kanker kolorektal obstruktif di RSUP Prof. dr. I.G.N.G Ngoerah Denpasar periode 2021-2022. Studi potong-lintang deskriptif dilakukan. Sampel terdiri dari 70 pasien yang memenuhi kriteria inklusi, dengan data yang dikumpulkan adalah faktor demografi, riwayat medis, dan presentasi klinis. Temuan mengungkapkan bahwa mayoritas demografi dari peserta penelitian merupakan laki-laki (71.4%), usia 50-69 tahun (67.1%), dan IMT ideal (52.9%). Berdasarkan presentasi klinis, mayoritas subjek (45.7%) memiliki stadium KKR TxNxM1 (stadium IV) tanpa adanya riwayat masalah gastrointestinal (52.9%). Sebagian besar pasien juga menunjukkan obstruksi parsial (71,4%), dengan lokasi di rektal sebagai lokasi yang paling umum (42.9%). Penelitian ini menunjukkan karakteristik demografi dan klinis dari LBO pada pasien dengan KKR obstruktif. Investigasi lebih lanjut diperlukan untuk mengeksplorasi faktor risiko tambahan, termasuk gaya hidup dan pola makan (diet), untuk meningkatkan strategi pencegahan dan manajemen klinis untuk populasi pasien ini.
IN VIVO STUDY OF THE POTENTIAL OF BELUNTAS LEAF (Pluchea indica) LOLOH AS AN ANTIHYPERCHOLESTEROLEMIA
Introduction: Non-Communicable Diseases (NCD) are the leading cause of death in Indonesia. One of the most prevalent NCDs is hypercholesterolemia. The most commonly used drug class is statins, which work by inhibiting HMG-CoA reductase; however, they carry side effects including myalgia, diabetes mellitus, and rhabdomyolysis. Traditional herbal medicine represents a potential alternative. According to the lontar usadha duwe griya, loloh of beluntas leaves is a traditional remedy used to treat conditions related to blood pressure disorders. This is supported by the phytochemical content of beluntas leaves, including flavonoids, alkaloids, and phenols, all of which have antihypercholesterolemic effects. Methods: This study used a true experimental design with a post-test only controlled group design involving 30 male Wistar rats divided into three groups: Group K (aquadest 5 ml/day/rat), Group KS (simvastatin 0.36 mg/day/rat), and Group P1 (loloh of beluntas leaves 4.5 g/day/rat). Data were analyzed using One-Way ANOVA. Results: One-Way ANOVA results for all variables showed p > 0.05, indicating no statistically significant difference. However, the findings may be clinically meaningful. Conclusion: Loloh of beluntas leaves (Pluchea indica) was not statistically significant but demonstrated potential clinical significance, except for the triglyceride variable.
Correlation Between Glomerular Filtration Rate and Serum Uric Acid/Creatinine Ratio in Pre-dialysis Chronic Kidney Disease Patients at Ngoerah Hospital Denpasar
Chronic kidney disease (CKD) is a structural and functional kidney abnormalities for over three months. Glomerular filtration rate (GFR) is an index to measure overall kidney function. Decreased renal excretory function leads to elevated serum uric acid and serum creatinine levels. The serum uric acid/creatinine ratio is recently recognized as an indicator of kidney function deterioration. The purpose of this study to determine the correlation between GFR and serum uric acid/creatinine ratio in pre-dialysis CKD patients at Ngoerah Hospital Denpasar. A cross-sectional analytical observational study was performed on 50 pre-dialysis CKD patients at Ngoerah Hospital Denpasar from 2022 to 2023, based on inclusion and exclusion criteria. The correlation between GFR and serum uric acid/creatinine ratio was assessed using Spearman's correlation test. The study participants were mostly male (68%), with a median age of 60.5 (21-79) years, and mostly in the stage G5 (74%). The median value of GFR was 16.85 (2.46-55.66) mL/min/1.73m2 and the median value serum uric acid/creatinine ratio was 2.29 (0.39-7.49) mg/dL. The results of the correlation analysis between the GFR and serum uric acid/creatinine ratio was found r = 0.832 (p = 0.000). This study conclude there was strong and significant positive correlation between GFR and serum uric acid/creatinine ratio.
CHANGES IN DIOPTRIC POWER OF GLASSES AMONG MYOPIC STUDENTS AT FK UDAYANA DURING ONLINE LEARNING 2020-2021
Myopia caused sufferers to have difficulty seeing distant objects. Glasses were a common modality used to correct myopia. The prevalence of myopia and the diopter power of myopic glasses in adolescents continued to increase since the COVID-19 pandemic. Several studies mentioned that adolescents experienced an increase of 0.9 D in 7 months after the pandemic, compared to 0.6 D per year before the pandemic. Given the growing concern over myopia among students during the COVID-19 pandemic, this study was essential to understand the changes in the diopter power of glasses in myopic students at Udayana University Faculty of Medicine (FK Unud) during online learning in 2020-2021. The aim of this study was to identify the factors that influenced changes in the diopter power of glasses in myopic students at FK Unud during online learning in 2020-2021. This was a descriptive quantitative study with a cross- sectional method, and data were collected using a questionnaire. The respondent characteristics were mostly 21 years old, female, engaged in outdoor activities for more than 3 hours, spent over 4 hours in front of digital screens, had sufficient room lighting, and sat upright while using their devices. Most respondents had mild myopia (<3 D) in both the right and left eyes before online learning. The most common increase in myopia diopter power after online learning was between 0.5–1 D in both eyes. It was found that risk factors for progressive myopia, such as outdoor activity, digital screen time, room lighting, and the position of reading digital devices, did not have a significant impact on changes in the diopter power of glasses in myopic students at FK Udayana during online learning in 2020-2021.
I Gusti Ngurah Agung Krisna Widiantara Bagus Putra
TUBECTOMY TRENDS IN MATERNITY MOTHERS WITH CESAREAN SECTION AT UDAYANA II HOSPITAL DENPASAR
Tubectomy is one of the permanent contraceptive methods that plays an important role in supporting family planning and reproductive health programs. However, its use is relatively lower than other long-term contraceptive methods. The purpose of this study is to analyze the trend of tubectomy incidence in hospitals. This study uses a quantitative descriptive design with a retrospective approach. Data was taken from the medical records of patients who underwent tubectomy at Udayana II Hospital Denpasar for the 2021–2025 period. The study sample included maternity mothers with cesarean section with inclusion criteria being a tubectomy and complete medical records. The variables analyzed included the number of cases per year, demographic characteristics of patients such as age, education level, occupation, place of residence and length of treatment. Tubectomy data and patient characteristics were measured based on the information stated in the patient's medical record. The analysis was carried out descriptively using the distribution of frequency and annual trends. The incidence of tubectomy in maternity mothers with cesarean section at Udayana II Hospital Denpasar showed a relatively stable trend throughout the study period. The majority of tubectomy procedures are performed on mothers with characteristics of age over 35 years old, have a secondary education, have a job, are Hindu, live in Denpasar City, have non-militery status, and undergo treatment for about three days. These findings make an important contribution to efforts to improve the quality and efficiency of tubectomy services in maternal mothers. Therefore, the results of the study recommend the need to strengthen the quality of services by considering sociodemographic factors, as well as ensuring the availability of access to tubectomy procedures as part of reproductive health services.
RISK FACTOR ANALYSIS OF OBSTRUCTIVE SLEEP APNEA AND ANXIETY AMONG PATIENTS WITH PULMONARY TUBERCULOSIS AT IBNU SINA HOSPITAL, MAKASSAR
Pulmonary Tuberculosis (TB) is a global health problem that is often accompanied by comorbidities such as Obstructive Sleep Apnea (OSA) and anxiety disorders, which can worsen quality of life and treatment adherence. This study aims to analyze the risk factors of OSA and anxiety, as well as the relationship between the two in pulmonary TB patients at Ibnu Sina Hospital, Makassar.This study employed an observational analytic design with a cross-sectional approach. The sample consisted of 85 pulmonary TB patients selected using a total sampling technique. Data were collected using the STOP-BANG questionnaire to assess the risk of OSA and the GAD-7 questionnaire to measure anxiety levels. Data analysis was conducted using univariate and bivariate methods, with the Chi-Square test at a significance level of p<0.05 using SPSS version 25.0. The majority of respondents were male (51.8%) and belonged to the adult age group (69.4%). The study found proportions of OSA and anxiety among pulmonary TB patients. The analysis showed a significant relationship between age and sex with the incidence of OSA and anxiety. Furthermore, there was a significant association between OSA and anxiety in pulmonary TB patients (p<0.05).There is a significant relationship between OSA and anxiety in pulmonary TB patients. Age and sex are important risk factors; therefore, a comprehensive approach is needed in the management of TB patients. Keywords : Pulmonary tuberculosis, obstructive sleep apnea, anxiety, risk factors, GAD-7
FREQUENCY DISTRIBUTION OF NON-HODGKIN LYMPHOMA AT THE ANATOMICAL PATHOLOGY LABORATORY, RSUP DR. M. DJAMIL,PADANG, 2020–2023
Malignant lymphoma is a hematological malignancy that affects the body's diffuse lymphatic system. This will occur when white blood cells do not grow normally. Lymphoma can affect areas of the lymphatic system as well as other organs throughout the body, clinically manifesting as nodal or extranodal involvement characterized by enlargement or lumps. Malignant lymphoma is divided into Hodgkin's lymphoma and non-Hodgkin's lymphoma. The frequency of non-Hodgkin's lymphoma is more common than Hodgkin's lymphoma. This study aims to determine the frequency distribution of non-Hodgkin's malignant lymphoma in the Anatomical Pathology Laboratory of RSUP. Dr. M. Djamil Padang in 2020-2023. ​This descriptive observational study employed a total sampling technique from medical records to examine all non-Hodgkin lymphoma patients from 2020 to 2023 who met the inclusion criteria, totaling 211 samples.The results indicate a male predominance (66.8%), with the most common age group being > 60 years (33.6%), and a majority located in nodal areas (52.6%). The primary clinical manifestation reported by most patients was enlargement (72.5%), and the most prevalent histopathological type was big cell (35.1%). ​In conclusion of this study is that cases of non-Hodgkin's malignant lymphoma at the Anatomical Pathology Laboratory of RSUP. Dr. M. Djamil Padang in 2020-2023 found that the peak occurred at the age of >60 years, more male than female, the most nodal location, the most clinical manifestations of lumps and large cell histopathology type. Therefore, education and early detection of malignant lymphoma cases are needed.
The Description of Hip and Waist Ratio of Breast Cancer Patients at RSUP Prof. Dr. I G.N.G. Ngoerah
Background: Breast cancer is a type of cancer that grows and develops in the breast due to cells that grow abnormally. Statistically, it is showed that obesity is a risk factor for breast cancer, where the hip and waist ratio is closely related to obesity in humans. Objective: To determine hip and waist ratio of breast cancer patients at RSUP Prof. Dr. I G.N.G. Ngoerah. Method: This research is descriptive observational with a cross-sectional type. The data was collected by recording the hip and waist ratio of breast cancer patients treated at the Surgical Oncology Polyclinic at RSUP Prof. Dr. I G.N.G. Ngoerah in April – June 2023 with a target of 30 samples. Research results: Breast cancer patients are dominated by those aged ≥40 years (80%), with the most common breast cancer subtype being Luminal A (27%), the highest frequency of chemotherapy being once (57%), body mass index tends to be normal (70%), and the hip and waist rasio being low-risk (73%). Conclusion: The description of the hip and waist ratio of breast cancer patients at RSUP Prof. Dr. I G.N.G. Ngoerah is low-risk (<0.85) in 22 samples (73%) and high-risk (≥0.85) in 8 samples (27%).
dr. Putu Anda Tusta Adiputra, S.Ked, Sp.B(K)Onk
THE RELATIONSHIP BETWEEN OBESITY AND THE INCIDENT OF LATERAL INGUINAL HERNIA AND MEDIAL INGUINAL HERNIA IN ELDERLY MEN AT THE CENTRAL GENERAL HOSPITAL PROF. DR. I.G.N.G. NGOERAH DENPASAR
Inguinal hernia is a hernia that often found in elderly men. As many as 75% of hernia cases are inguinal hernia patients, 40% of patients aged 45-74 years, and 47% aged over 75 years. Elderly patients who experience inguinal hernias have a high risk of morbidity related to the postoperative healing process. Obesity is excessive or abnormal fat accumulation which causes a risk of health problems. Several studies say that the incidence of inguinal hernias is lower in obese patients than in normal weight. However, there is also research says that obesity has a significant relationship with the incidence of inguinal hernias. Obesity is a risk factor for inguinal hernias. This research aims to determine the relationship between obesity and the incidence of lateral inguinal hernias and medial inguinal hernias in elderly men at Hospital Prof. Dr. I.G.N.G Ngoerah Denpasar. This study used an analytic observational design with a retrospective approach on 49 secondary data obtained from medical records using a total sampling method that met inclusion and exclusion criteria. Data were processed using Microsoft Excel and SPSS. The statistical test results show p = 0,624 which means there is no significant relationship between obesity and lateral inguinal hernias and medial inguinal hernias in elderly men.
ADJUVANT CHEMOTHERAPY RESPONSE ON STAGE IB3, IIA2, AND IIB CERVICAL CANCER PATIENT AT PROF. DR. I.G.N.G NGOERAH GENERAL HOSPITAL IN 2021-2022
Cervical cancer has become attention and health problem due to increased number of case and death. There are various type of cervical cancer treatments. In Prof. Dr. I.G.N.G. Ngoerah General Hospital, neoadjuvant chemotherapy is used to reduce tumor size before surgery is performed on IB3, IIA2, IIB stage cervical cancer due to limited radiotherapy device. This study aims to investigate neoadjuvant chemotherapy response on IB3, IIA2, IIB stage cervical cancer. Data of patient characteristic and chemotherapy response were collected from patient medical record. The data was processed using univariate analysis. The IB3 stage has highest successful response proportion (70%), followed by IIA2 stage (64,3%), then IIB (54%). Elderly patients (> 50 years old) have worse response compared to young patients (< 50 years old). Based on age, the highest percentage of complete chemotherapy responses was in the age range of 40-49 years (17%). Based on the parity group, the lowest parity group had the highest complete chemotherapy response (14%). There were 41% of patients with a poor response in the SCC group and 43% of patients with a poor response in the non-SCC group. When viewed from the degree of differentiation, the group with a good degree of differentiation has the highest percentage of complete responses (29%). The group with the largest tumor size which is above 7 cm had the highest percentage of poor chemotherapy response (67%).
Gastroprotective Activity of Clove (Syzygium Aromaticum) in Anti-Tuberculosis Drug-Induced Rats By Enhancing Gastric Foveolar Cell Granules
The standard first line anti-tuberculosis drug (ATD) therapy includes a combination of four drugs, namely isoniazid, rifampicin, ethambutol, and pyrazinamide. However, these combination drug therapies often cause gastrointestinal adverse effects. Clove (Syzygium aromaticum) contains eugenol as its main component, which has gastroprotective activity to prevent those adverse effects. The purpose of this study is to prove gastroprotective activity of clove by increasing gastric foveolar granules. Experimental rats were treated for 21 days. Treatment groups were treated with ethanolic extract of clove 200, 400, and 800 mg/kg in ATD-induced rats. The positive control group only received ATD 350 mg/kg, and the normal control group received no treatment. After 21 days, the rats were sacrificed and the pylorus section of the stomach stained with hematoxylin-eosin (HE) and were examined under light microscope. The examination showed that administration of ATD in positive control group reduced the amount of gastric foveolar granule compared to the normal control group which received no treatment (P<0,05) and clove ethanolic extract in any doses significantly increase the amount of gastric foveolar granules compared to the positive control group (P<0,05). Terapi obat anti-tuberkulosis (OAT) standar lini pertama mencakup kombinasi empat obat, yaitu isoniazid, rifampisin, etambutol, dan pirazinamid. Namun, terapi kombinasi ini seringkali menimbulkan efek samping gastrointestinal. Cengkih (Syzygium aromaticum) mengandung eugenol sebagai komponen utamanya yang memiliki aktivitas gastroprotektif untuk mencegah efek samping tersebut. Tujuan penelitian ini adalah untuk membuktikan aktivitas gastroprotektif cengkih dalam meningkatkan granul pada sel foveolar lambung. Tikus percobaan diberi perlakuan selama 21 hari. Kelompok perlakuan diberi ekstrak etanol cengkih 200, 400, dan 800 mg/kg dan diinduksi OAT. Kelompok kontrol positif hanya mendapat OAT 350 mg/kg, dan kelompok kontrol normal tidak mendapat perlakuan apapun. Setelah 21 hari, tikus diterminasi dan bagian pilorus lambung dilakukan perwarnaan dengan hematoxylin-eosin (HE) dan dilihat di bawah mikroskop cahaya. Hasil analisis menunjukkan bahwa pemberian ATD pada kelompok kontrol positif menurunkan jumlah granul pada sel foveolar lambung dibandingkan dengan kelompok kontrol normal yang tidak mendapat perlakuan apapun (P<0,05) dan ekstrak etanol cengkih pada dosis berapapun secara signifikan meningkatkan jumlah granul pada sel foveolar lambung dibandingkan dengan kelompok kontrol positif (P<0,05).
CORRELATION BETWEEN NEUTROPHIL-TO-LYMPHOCYTE RATIO (NLR), PLATELET-TO-LYMPHOCYTE RATIO (PLR), AND SYSTEMIC IMMUNE INFLAMMATION INDEX (SII) WITH PLACENTA ACCRETA SPECTRUM (PAS)
Background: Placenta accreta spectrum (PAS) is a severe obstetric complication characterized by abnormal placental invasion into the myometrium due to defects in the decidual layer. This condition is associated with massive postpartum hemorrhage and increased maternal morbidity and mortality. Early identification of PAS remains challenging. Systemic inflammatory biomarkers derived from routine blood tests, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), have been proposed as potential predictors of abnormal placentation. Objective: This study aimed to analyze the relationship between NLR, PLR, and SII and the occurrence of placenta accreta spectrum and to evaluate their predictive accuracy for PAS. Methods: This study used an analytic observational design conducted at H. Adam Malik General Hospital and affiliated hospitals. The study included pregnant women with placenta previa who underwent delivery and histopathological evaluation. Demographic characteristics, obstetric history, and laboratory parameters including neutrophil count, lymphocyte count, platelet count, NLR, PLR, and SII were collected. The diagnosis of PAS was confirmed based on histopathological findings. Statistical analysis was performed to determine differences between PAS and non-PAS groups and to evaluate the predictive performance of NLR, PLR, and SII using receiver operating characteristic (ROC) curve analysis. Results: Significant differences were found in laboratory inflammatory parameters between PAS and non-PAS groups. Higher values of neutrophils, NLR, PLR, and SII were observed in patients with PAS compared to those without PAS. ROC curve analysis demonstrated that NLR, PLR, and SII had diagnostic value in predicting PAS, with SII showing the highest predictive performance among the evaluated indices. These findings indicate that increased systemic inflammatory activity is associated with abnormal placental invasion. Conclusion: NLR, PLR, and SII are significantly associated with placenta accreta spectrum. These hematological indices derived from routine blood tests may serve as simple and accessible biomarkers for predicting PAS and may assist clinicians in early identification and management planning for high-risk pregnancies.
BRAIN RESUSCITATION IN SEVERE HEAD INJURY AT SANGLAH CENTRAL GENERAL
Head trauma is a serious problem worldwide and causes morbidity and mortality at a young age. The increase in the number of severe head injuries continues to occur along with the number of accidents. This study aimed to examine the characteristics of brain resuscitation in patients with a severe head injury. Descriptive research with cross-sectional research method and the data obtained as many as 35. Data processing using SPSS and displayed in a distribution table according to the variables. This study found that patients with severe head injuries were most often at the age of >45 years, namely 18 people (51.4%), and male sex was more common than women as many as 24 people (68.6%). The most common GCS was found with GCS 3-5 as many as 21 people (60%). The brain resuscitation regimen in patients with a severe head injury was given crystalloid solution (0.9% NaCl, Ringer's lactate) in 35 people (100%), mannitol 20% in 22 people (62.9%), and phenytoin in 33 people (94.3%). The GOS value of all patients with severe head injury with a GOS value of 1 or died (100%). Most deaths from severe head injury patients were in the first <48 hours as many as 27 people (77.1%)
HUBUNGAN STRES AKADEMIK DENGAN TENSION TYPE HEADACHE PADA MAHASISWA PROGRAM STUDI SARJANA KEDOKTERAN UNIVERSITAS UDAYANA
Tensionntypeeheadachee(TTH) merupakan bentuk nyeri kepala primer yang paling sering diderita semua kelompok usia di seluruh dunia. Literatur menunjukkan bahwa stres merupakan pemicu utama dari serangan nyeri kepala. Tercatat sekitar 80% mahasiswa di seluruh dunia mengalami stres, baik setelah ujian, pembuatan karya ilmiah, maupun pembuatan tugas lainnya. Penelitiannini merupakannpenelitian observasional analitikkdengan rancangannstudiccross-sectional yang bertujuan untuk menilai hubungan antara stres akademik dengan TTH. Populasi penelitianIni merupakan mahasiswa Program Studi Sarjana Kedokteran, Fakultass Kedokterann Universitass Udayana angkatan 2018, 2019, dan 2020. Data dikumpulkan secara online dengan mengisi kuesioner student-life stress inventory (SSI) untuk menilai tingkat stres akademik dan diagnosis TTH dinilai berdasarkan kriteria diagnosis menurut International Headache Society (2018). Data hasil penelitian dianalisis dengan ujicchi-square untuk mengetahui hubungan tingkat stressakademikkdengan TTH. Sampel penelitian berjumlah 181 responden dengan 131 diantaranya mengalami TTH. Kejadian TTH lebih banyak ditemukan pada responden dengan stres sedang-berat yakni 94 (71,8%), sementara pada stres ringan sebanyak 37 (60,7%). Hasil uji analisis hubungan antara tingkat stres akademik dengan TTH menggunakan uji chi-square didapatkan p-value sebesar 0,012. Berdasarkan hasil penelitian ini dapat disimpulkan bahwa terdapat hubungan yang signifikan antara tingkat stres akademik dengan TTH pada mahasiswaaProgrammStudi Sarjana KedokterannUniversitas Udayana. Kata kunci : TTH, stres akademik, nyeri kepala. ABSTRACT Tension typehheadachee(TTH) is the most commonnform of primary headacheeaffecting all age groups worldwide. Literature showed that stress was a significant trigger of headache attacks. It has been recorded that around 80% of students worldwide have experienced stress after exams, writing scientific papers, and making other assignments. Thissstudy was anaanalytic observationalsstudy with accross-sectional study designnto assess the relationshippbetween academicsstress and TTH in medical students of Udayana University. The population of this study were medical students of Udayana University, batch 2018, 2019, and 2020. Data collection was taken online by filling out a student-life stress inventory (SSI) questionnaire to assess academic stress levels. In contrast, TTH diagnosis was assessed based on the diagnostic criteria according to the International Headache Society (2018). Data analysisswas performed using thecchi-square test to determine the relationship between academic stress levels and TTH. There were 181 respondents, with 131 of them were experiencing TTH. The incidencesof TTH was more found in respondents with moderate-severe stress, namely 94 (71,8%), while in mild stress were 37 (60,7%). The chi-square analysis test about the relationship between academic stress levels and TTH obtained a p-value of 0.012. Therefore, this study concluded alssignificant relationshippbetween academic stress and TTH in medical students of Udayana University. Keywords : TTH, academic stress, headache.
THE ASSOCIATION BETWEEN PARENTING STYLE AND SOCIAL MEDIA USE INTENSITY WITH THE RISK OF EATING DISORDERS AMONG FEMALE ADOLESCENTS AT SMPN 3 MAKASSAR IN 2026
Background : Eating disorders among female adolescents represent a significant mental health concern influenced by various psychosocial factors, including parenting style and the social media use intensity. Unsupportive parenting and exposure to idealized body standards on social media are believed to contribute to an increased risk of eating disorders. This study aimed to analyze the association between parenting style and social media use intensity with the risk of eating disorders among female adolescents at SMPN 3 Makassar. Methods : This study employed an observational analytic design with a cross-sectional approach involving 265 respondents selected through purposive sampling technique. Parenting style was assessed using the Parental Authority Questionnaire–Short Version (PAQ-SV), social media use intensity was measured using the Social Networking Time Use Scale (SONTUS), and the risk of eating disorders was assessed using the Eating Attitudes Test-26 (EAT-26). Data were analyzed using the chi-square test and binary logistic regression. Results : The bivariate analysis showed significant associations between parenting style and the risk of eating disorders (p = 0.020), as well as between social media use intensity and the risk of eating disorders (p = 0.008). Multivariate analysis showed that permissive parenting (OR = 2.309; 95% CI = 1.021–5.221; p = 0.044) and very high social media use intensity (OR = 6.369; 95% CI = 1.743–23.269; p = 0.005) were the most dominant factors associated with an increased risk of eating disorders. Conclusion : Therefore, family-based preventive approaches are needed, including the promotion of authoritative parenting and education on controlled social media use, to reduce the risk of eating disorders among female adolescents.
THE EFFECT OF BRAND IMAGE AND SERVICE QUALITY ON PATIENT SATISFACTION AND ITS IMPACT ON PATIENT LOYALTY AT MANGUSADA BALI HOSPITAL
This study aims to analyze the effect of brand image and service quality on patient satisfaction and its impact on patient loyalty at Mangusada Hospital, Bali. This research employed a quantitative method using a survey approach involving hospital patients. Data were analyzed using path analysis to examine both direct and indirect effects among variables. The results indicate that brand image and service quality have a positive and significant effect on patient satisfaction. Patient satisfaction also significantly influences patient loyalty. Furthermore, brand image and service quality indirectly affect patient loyalty through patient satisfaction as a mediating variable. Simultaneously, these variables contribute significantly to improving patient loyalty.
THE ASSOCIATION OF ADHERENCE WITH ANTIEPILEPSY DRUG CONSUMPTION ON SEIZURE CONTROL IN EPILEPSY PATIENTS AT THE NEUROLOGY POLYCLINIC OF REGIONAL PUBLIC HOSPITAL SANJIWANI
Epilepsy is the most common neurological disease in the world. Treatment with antiepileptic drugs (AEDs) is important to achieve optimal quality of life. Non-adherence with medication consumption is known to contribute to increased mortality and morbidity rates in epilepsy patients due to uncontrolled seizures. This study aims to determine the association between drug consumption adherence and seizure control in epilepsy patients at the Neurology Policlinic at Sanjiwani Regional Hospital. This research is a cross-sectional analytical study. The sampling technique used was consecutive sampling with a measuring instrument in the form of the MMAS- 8 questionnaire. Statistical tests carried out included univariate analysis, chi-square, and binary logistic regression. The results of the study found that the majority of participants had uncontrolled seizures (57.8%) and high level of medication adherence (50%). In the chi-square analysis, a significant association was obtained between drug consumption adherence and participants’ seizure control. In addition, adherence to medication consumption had a dominant influence compared to other variables in binary logistic regression analysis (p=0,017; AOR=12,83, CI 95% 1,57-104,51). This study concludes there is a significant association between adherence to OAE consumption and seizure control. Patients who have low adherence have a 12,83 times greater chance of experiencing uncontrolled seizures than medium-high adherence. However, this result lacks precision seen from the wide confidence interval value.
THE RELATIONSHIP BETWEEN A HISTORY OF PRETERM BIRTH AND THE PREVALENCE OF INTELLECTUAL DISABILITY AMONG CHILDREN AT SPECIAL SCHOOLS IN MAKASSAR CITYKOTA MAKASSAR
Background: Intellectual disability is a neurocognitive developmental disorder that can be influenced by various perinatal factors, one of which is a history of preterm birth. Preterm birth risks disrupting the maturation of brain structure and function, thus impacting a child's intellectual abilities. This study aimed to analyze the relationship between a history of preterm birth and intellectual disability among children attending Special Schools in Makassar City. Methods: This study employed an analytical observational cross-sectional design and was conducted from December 2025 to January 2026 at SLB Negeri 1 Makassar City and SLB C Yayasan Pembina Pendidikan Luar Biasa (YPPLB) Makassar City. A total of 82 respondents were selected using purposive sampling. Birth history was obtained through interviews with parents, while the level of intellectual disability was obtained from school documents. Analysis was performed using the Chi-Square test. Results: Most respondents had no history of preterm birth (76.8%), while the majority of children had moderate intellectual disabilities (39.0%). Chi-square analysis demonstrated a significant relationship between a history of preterm birth and the prevalence of intellectual disability in children (p=0.019). Conclusion: A history of preterm birth is significantly associated with the prevalence of intellectual disability in children at special schools in Makassar City. This finding highlights the importance of addressing perinatal factors as part of early detection and prevention efforts for developmental disorders.
THE RELATIONSHIP BETWEEN A HISTORY OF DIABETES MELLITUS AND ABORTUS WITH THE INCIDENCE OF POSTPARTUM HEMORRHAGE AT ANANDA MOM AND CHILD HOSPITAL OF MAKASSAR IN 2022-2024a Makassar Tahun 2022-2024
Background: Postpartum hemorrhage is a major cause of maternal mortality worldwide, contributing to more than one-fifth of maternal deaths. This study aimed to analyze the association between a history of diabetes mellitus and a history of abortion with the incidence of postpartum hemorrhage, and to identify the most strongly associated factor at Ananda Mother and Child Hospital of Makassar, during 2022 to 2024. Methods: This study employed a case control design with a 1:1 ratio between case and control groups. A total of 132 patients were selected using purposive sampling. Data were obtained from medical records of patients who delivered at Ananda Mother and Child Hospital from 2022 to 2024. Data analysis was conducted using the Chi-square test for bivariate analysis and logistic regression for multivariate analysis. Results: A history of diabetes mellitus was significantly associated with postpartum hemorrhage (p = 0.013; OR = 4.559; 95% CI = 1.424–14.593). Similarly, a history of abortion was also significantly associated with postpartum hemorrhage (p = 0.012; OR = 2.713; 95% CI = 1.303–5.647). Multivariate analysis showed that a history of diabetes mellitus was the most dominant factor associated with postpartum hemorrhage (OR = 5.742; 95% CI = 1.729–19.070; p = 0.004). Conclusion: Pregnant women are advised to undergo regular antenatal care, adopt a healthy lifestyle, and adhere to healthcare providers’ recommendations throughout pregnancy and delivery to reduce the risk of postpartum hemorrhage.
USE OF ANTICOAGULANTS IN COVID-19 PATIENTS AS A PREVENTIVE EFFORT FOR HEART FAILURE MORTALITY
Background: Thrombosis and hypercoagulable states are complications that can arise in COVID-19 and heart failure patients. This occurs due to a cytokine reaction, leading to the activation and increase of coagulation factors. This condition can lead to complications such as DVT, VTE, and PE, which will increase the severity and mortality of the patient's disease. Anticoagulants are one of the effective therapies to prevent and treat various types of thromboembolic diseases. Heparin and enoxaparin are commonly used anticoagulants in hospitals. Objective: This study aimed to determine whether the use of anticoagulants was associated with the mortality rate in COVID-19 patients diagnosed with heart failure. Methods: This study was conducted using a cross-sectional analytic design. The sample consisted of 71 patients, including 51 who used enoxaparin, 15 who used heparin, and 5 who used a combination of both. After the data was obtained, it was then processed and presented in tabular form. Results: While initial findings suggested that enoxaparin use was associated with lower mortality rates compared to heparin or a combination of both, subsequent analysis revealed no statistically significant difference in mortality rates among patients receiving enoxaparin, heparin, or a combination (p-value = 0,191). Conclusion: There was no significant difference in mortality rates between patients given enoxaparin, heparin, or a combination.
PHARMACOTHERAPY PROFILE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN ELDERLY PATIENTS AT RSUP PROF DR. I.G.N.G NGOERAH DURING THE PERIOD OF JANUARY 2023 – DECEMBER 2023
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a global health issue that is often undiagnosed, particularly among the elderly. Furthermore, elderly patients with comorbidities may receive multiple and varied therapies to address their conditions, which can lead to complex polypharmacy. Therefore, research is needed to describe pharmacotherapy profile of COPD in elderly patients. Objective: To describe the pharmacotherapy profile of COPD in elderly patients at Prof. dr. I.G.N.G Ngoerah Hospital. Methods: This study employs a descriptive quantitative method with a cross-sectional approach, with samples taken retrospectively from the medical records of elderly COPD patients at Prof. dr. I.G.N.G Ngoerah Hospital in 2023, according to inclusion and exclusion criteria. Data was collected via Google Forms and analyzed using Microsoft Excel. Results: The most used COPD therapy regimen is the LABA-ICS combination, specifically the combination of salmeterol and fluticasone propionate (54.2%) followed by the combination of budesonide and formoterol fumarate (26.5%). Supportive therapy commonly administered to patients, include mucolytic agents such as N-acetylcysteine (61.4%) and ambroxol (22.8%). The most common comorbidity diagnosed among COPD elderly patient was cardiovascular disease (54.3%), with most patients receiving beta-blocker medications that have the potential to cause drug interactions with β2-agonists. Conclusion: The use of dual LABA-ICS combinations with additional symptomatic therapy in the form of mucolytics such as N-acetylcysteine and ambroxol is the most common choice for controller therapy for outpatient elderly COPD patients at Prof. dr. I.G.N.G Ngoerah Hospital.
THE RELATIONSHIP BETWEEN BODY MASS INDEX AND DEGREE OF DYSMENORRHEA AMONG ADOLESCENT GIRLS AT SMAN 8 GOWA IN 2025
Background: Dysmenorrhea is menstrual pain commonly experienced by adolescent girls and may interfere with learning activities, concentration, and quality of life. This study aimed to analyze the relationship between body mass index (BMI) and the degree of dysmenorrhea among adolescent girls at SMAN 8 Gowa. Methods: This observational analytic study used a cross-sectional design and was conducted from October to November 2025. A total of 301 female students aged 15-19 years were selected by purposive sampling from 647 students after meeting the inclusion and exclusion criteria. BMI was calculated from measured weight and height, while dysmenorrhea severity was assessed using the Visual Analog Scale (VAS). Data were analyzed using the Chi-square test with SPSS version 29. Results: Most respondents were underweight (44.9%). The most common degree of dysmenorrhea was moderate (41.5%), followed by severe (36.9%) and mild (21.6%). Severe dysmenorrhea was most frequent among underweight respondents (45.2%). The Chi-square test showed a significant association between BMI and dysmenorrhea severity (p=0.021). Conclusion: Body mass index was significantly associated with the degree of dysmenorrhea among adolescent girls at SMAN 8 Gowa; underweight adolescents tended to experience more severe dysmenorrhea.
DEMOGRAPHIC ANALYSIS OF ELBOW FRACTURE PATIENTS AT RSUP PROF. DR. I.G.N.G. NGOERAH
Fraktur sekitar siku adalah cedera muskuloskeletal yang umum ditemukan di instalasi gawat darurat, terutama akibat trauma langsung maupun tidak langsung pada ekstremitas atas. Kompleksitas anatomi sendi siku, yang melibatkan artikulasi humeroulnaris, humeroradialis, dan radioulnaris proksimal, membuat fraktur pada area ini rentan menyebabkan gangguan fungsi jika tidak ditangani dengan tepat. Penelitian deskriptif retrospektif ini menganalisis kasus fraktur siku di RSUP Prof. Dr. I.G.N.G. Ngoerah pada periode November 2024 hingga Oktober 2025. Penelitian ini berfokus pada demografi pasien, jenis fraktur (terbuka/tertutup), penyebab, dan strategi penanganan. Sebanyak 51 rekam medis pasien dimasukkan, dengan mayoritas pasien laki-laki (51%) dan dalam rentang usia 15-64 tahun (84,3%). Sebagian besar fraktur adalah fraktur tertutup (86,3%), sementara fraktur terbuka terjadi pada 13,7%. Penyebab fraktur sebagian besar tidak diketahui (88,2%), diikuti oleh kecelakaan lalu lintas (11,8%). Lokasi fraktur yang paling sering ditemukan adalah olekranon, interkondiler humerus, dan kepala radius. Sebagian besar pasien (80,4%) menjalani fiksasi terbuka dan internal (ORIF) menggunakan plate dan screw. Temuan ini menyoroti pentingnya penanganan trauma yang tepat waktu dan akurat, terutama untuk fraktur yang memerlukan intervensi bedah. Penelitian ini juga menekankan perlunya protokol standar di instalasi gawat darurat untuk meningkatkan hasil pasien dengan fraktur siku. Penelitian lanjutan disarankan untuk menilai hasil fungsional jangka panjang dan memperbaiki strategi pengobatan.
IDENTIFICATION OF Streptococcus suis BACTERIA ON LAWAR PLEK SOLD IN GIANYAR REGENCY IN 2025
Streptococcus suis is a zoonotic pathogen found in pigs. These bacteria can causes of meningitis and can lead to various other diseases in humans. In 2023, Gianyar Regency recorded the highest number of suspected Meningitis Streptococcus suis cases in Bali. The habit of the Balinese in consuming traditional foods made of raw pork meat and blood is suspected to be the cause of the increase in Streptococcus suis infection. One of the Balinese traditional foods made of raw pork meat and blood is lawar plek. This study aimed to identify Streptococcus suis contamination in lawar plek sold in Gianyar Regency. The study used a cross-sectional design with purposive sampling as the method for determining the number of samples. A total of 28 lawar plek samples were collected from four sellers in each sub-district of Gianyar Regency. Bacterial identification was performed through isolation on blood agar plate, gram staining, catalase testing, and Polymerase Chain Reaction testing. Data analysis was conducted descriptively to determine the number of samples contaminated with Streptococcus suis. Isolation on blood agar plate showed colonies that were grayish white, coccus with flat edges and a convex surface, and measuring 1–4 mm in size. Microscopic observation showed coccus gram-positive bacteria in 22 samples (78.6%) and gram-positive bacilli in 6 samples (21.4%). The catalase test showed positive results in 18 samples (81.8%) and negative results in 4 samples (18.2%). Polymerase Chain Reaction testing of four samples showed negative results. Based on the identification results, it can be concluded that no Streptococcus suis contamination was found in lawar plek samples collected from sellers in Gianyar Regency.
QUALITY-OF-LIFE OF ELDERLY NATIONAL HEALTH INSURANCE PARTICIPANTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS IN DENPASAR
Elderly individuals are at a high risk of suffering from chronic diseases, especially hypertension and type 2 diabetes mellitus (DM type 2). Chronic diseases were often accompanied by multimorbidity and require long-term treatment. This led to a decline in the quality - of -l ife among the elderly. This research aimed to understand the quality-of-life among elderly individuals with hypertension and DM type 2 who are participants of BPJS Kesehatan and reside in the city of Denpasar. The study used a cross-sectional descriptive design, conducted from January to August 2023. A total of 49 elderly individuals (age ≥60 years) from 4 community health centers in Denpasar were selected as respondents using consecutive sampling. Data were collected through interviews using a questionnaire. The collected data include d respondent characteristics and the level of quality-of-life based on the SF-36 questionnaire. Based on the data analysis, the majority of respondents suffer red from hypertension (51.0%) for a duration of 2-5 years (44.9%), with one accompanying disease (48.9%), mainly heart disease (48.9%). In terms of physical and mental aspects, elderly individuals with hypertension and/or DM type 2 had good quality-of-life . Individuals with hypertension/DM had better physical functional abilities compared to mental functional abilities, with poor social functioning. Conversely, elderly individuals with more than one chronic disease generally had a lower quality-of-life , with better mental functional abilities compared to physical functional abilities. Therefore, policymakers were encouraged to maintain efforts to improve the quality-of-life , such as through exercise or health promotion programs (Prolanis), and develop health programs focused on mitigating the impact of multimorbidity at both individual and community levels. Keywords :
The Association Between Knowledge Level and Attitudes of Women of Reproductive Age With Cervical Cancer Prevention in Kuta Selatan District
Background: Cervical cancer remains a major, yet largely preventable, public health problem among women. Prevention strategies including HPV vaccination are available, but implementation of cervical cancer preventive measures in the community remains suboptimal. Objective: This study aimed to examine the association between levels of knowledge and attitudes and the adoption of cervical cancer preventive practices among women of reproductive age in Kuta Selatan Subdistrict. Methods: An analytic observational study with a cross-sectional design was conducted. Seventy-three respondents were enrolled using a nonprobability (non-random) sampling technique. Data were collected via a structured questionnaire previously utilized in earlier studies. Data analysis comprised univariate and bivariate assessments, with bivariate associations tested using Pearson’s chi-square at a 95% confidence level (α = 0.05). Results: Descriptive analysis indicated that respondents exhibited varying categories of knowledge and attitudes; however, the majority had not undertaken cervical cancer preventive measures optimally. Bivariate analysis revealed no significant association between knowledge level and preventive actions (p = 0.680). Similarly, no significant relationship was observed between attitude and preventive practices (p = 0.859). Conclusion: Neither knowledge nor attitude showed a significant association with cervical cancer preventive practices among women of reproductive age in Kuta Selatan Subdistrict. These findings suggest the need for more comprehensive promotive and preventive interventions that address additional determinants to improve preventive behaviour.