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.
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
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.
Hak Cipta (c) 2026 E-Jurnal Medika Udayana
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
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
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%).
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 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.
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 RELATIONSHIP BETWEEN COMPLIANCE OF IRON-FOLIC ACID SUPPLEMENT TABLET CONSUMPTION WITH ANEMIA STATUS AMONG PREGNANT WOMEN AT KINTAMANI VI PRIMARY HEALTH CARE CENTER
Background: Anemia in pregnancy remains a common health problem that contributes to increased maternal and fetal morbidity and mortality. Preventive efforts have been implemented through the supplementation program of iron–folic acid tablets (Tablet Tambah Darah or TTD) recommended throughout pregnancy; however, its effectiveness depends greatly on compliance. Objective: To determine the association between compliance to iron-folic acid tablets consumption and anemia status among pregnant women in the working area of Puskesmas Kintamani VI. Methods: This was an analytical observational study with a cross-sectional design involving 75 third-trimester pregnant women who met the inclusion criteria and sampled using consecutive sampling. Compliance data were collected through interviews using a simplified Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire. Hemoglobin levels were obtained using a POCT (Point of Care Testing) device and medical records. Bivariate analysis was performed using the Chi-square test. Results: The results showed that 52% of respondents were classified as non-compliant. The proportion of pregnant women with anemia was 33.3% in the non-compliant group and 11.1% in compliant group. Bivariate analysis indicated a significant relationship between TTD compliance and anemia status (p-value=0.022; PR=0.33; 95% CI: 0.12–0.93). Other variables, including maternal age, education level, nutritional status, parity, micronutrient intake, sleep quality, hyperemesis gravidarum, income, occupation, and other medical factors, showed no significant association (p-value>0.05). Summary: Compliance to iron-folic acid tablets consumption serves as a protective factor against anemia. It is recommended that healthcare providers strengthen education, follow-up, and support strategies to improve adherence and help reduce anemia prevalence in pregnancy.
The Correlation between Bilirubin Levels and Birth Weight in Neonates with Neonatal Jaundice
Neonatal jaundice is a clinical condition caused by elevated bilirubin levels. Birth weight is often associated with the risk of neonatal jaundice due to liver function immaturity in low birth weight infants. However, research findings regarding the relationship between these two variables remain varied. This study aims to determine the relationship between total serum bilirubin levels and birth weight in neonates with neonatal jaundice at Ngoerah Hospital. This research is an observational analytic study with a cross-sectional approach using medical record data of patients who met the inclusion criteria at Ngoerah Hospital. Descriptive analysis results showed that the mean birth weight of the sample was 2,859.38 grams and the mean total bilirubin level was 17.77 mg/dL. The Spearman bivariate test results showed no significant relationship between birth weight and total bilirubin levels (p=0.222; r=0.198). Multivariate analysis also confirmed that birth weight was not a significant predictor (p=0.318) after controlling for gestational age and gender variables. There is no significant relationship between birth weight and total bilirubin levels in neonates with neonatal jaundice at Ngoerah Hospital. This result is likely influenced by the dominance of term infants in the sample and the presence of other, more dominant pathological factors.
Characteristics of patients with tinea capitis at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital from 2020 to 2024
Background: Tinea capitis is a dermatophyte infection of the scalp common in prepubertal children and can lead to alopecia. Retrospective studies are needed to describe the demographics, clinical profile, and treatment to improve prevention and management. Data for this study were obtained from patient medical records at RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar for the period 2020–2024. Objective: To determinan the characteristics of patients with tinea capitis at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital Denpasar for the period 2020-2024. Methods: This study was a descriptive observational cross-sectional study using medical record data of patients treated at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital Denpasar during 2020-2024. Based on the selection results according to the inclusion and exclusion criteria, 41 samples were analyzed. Results: Among the 41 samples analyzed, most of patients were 5-9 years old (57,4%). Cases were more frequent in females (58.5%) than males (41.5%). The most common clinical type was grey patch (21 cases; 51.2%). Wood’s lamp examination most often showed green fluorescence (29.3%); ectothrix spores were observed in 39.0% of cases. The most frequent dermoscopic finding was broken hair (17.1%). The predominant risk factor was pet ownership, present in 12 patients (29.3%). The dermatophyte Trichophyton rubrum had the highest isolation rate among dermatophytes (26.8%). Combination therapy with systemic and topical agents was administered to 40 patients (97.6%). Conclusion: The characteristics of patients with tinea capitis at RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar during 2020–2024 indicate the disease most commonly affects prepubertal children, is dominated by the grey patch clinical type, and Trichophyton rubrum is the most frequent causative agent. The majority of patients received combination therapy.
PROFILE OF OBESITY AND SMOKING AMONG PATIENTS WITH CORONARY HEART DISEASE AT THE CARDIOLOGY OUTPATIENT CLINIC OF RSD DR. H. SOEMARNO SOSROATMODJO
Background: Coronary heart disease (CHD) remains a major cause of morbidity and mortality in Indonesia and is closely associated with cardiometabolic risk factors such as obesity, smoking, hypertension, and diabetes mellitus. Describing the distribution of these risk factors in specific clinical settings is essential for risk stratification and targeted prevention. Objective: This study aims to describe the age profile and cardiometabolic risk factors, including obesity, smoking history, hypertension, and diabetes mellitus among CHD patients attending the Cardiology Clinic of RSD Dr. H. Soemarno Sosroatmodjo from January to June 2025. Methods: A retrospective descriptive cross-sectional study was conducted using secondary data from medical records, with total sampling of all eligible CHD patients who met the inclusion and exclusion criteria. Variables assessed were age groups, obesity based on body mass index, smoking history, hypertension defined according to standard clinical criteria, and diabetes mellitus. Data were analyzed using univariate methods and presented as frequencies and percentages. Results: Of 139 samples, 129 were eligible for analysis. Most patients were in the elderly age group. Obesity was present in (50.4%) of patients, predominantly class I obesity. Smoking history was identified in (89.9%) of patients. Hypertension and diabetes mellitus were also frequently identified as coexisting conditions, with (24.1%) of patients having established hypertension (grade 1 & 2) and (7.0%) diagnosed with diabetes mellitus. Conclusion: The high burden and coexistence of obesity and smoking among CHD patients highlight the importance of integrated cardiometabolic risk assessment and management in clinical practice.
FACTORS INFLUENCING THE PERFORMANCE OF LARVAE MONITORING OFFICERS (JUMANTIK) IN THE PREVENTION OF DENGUE HEMORRHAGIC FEVER IN THE WORKING AREA OF SOUTH KUTA PRIMARY HEALTH CENTER, BADUNG REGENCY
Background: Dengue Hemorrhagic Fever (DHF) remains a public health problem in Indonesia, including the service area of the South Kuta Primary Health Center, Badung Regency, Bali, where case numbers fluctuate annually. Prevention efforts are carried out through mosquito breeding site elimination (MBSE) with sustainable vector control. The success of MBSE largely depends on the role of larva monitoring cadres (jumantik). However, their performance varies and is influenced by individual and external factors such as age, length of service, knowledge, attitudes, training, work tools, supervision, and incentives. Objective: To determine the association between individual and external factors and the performance of larva monitoring cadres in the service area of the South Kuta Primary Health Center. Methods: This analytical observational study employed a cross-sectional design involving 56 larva monitoring cadres. Total sampling was applied, including all cadres who met the inclusion criteria. Data were collected using structured questionnaires and analyzed using univariate and bivariate analyses with the Chi-square test in SPSS. Results: Most cadres demonstrated good performance (57.9%). Length of service was significantly associated with cadre performance (p = 0.045), with cadres having a service duration of less than 84 months showing good performance in 73.1% of cases. Other variables, including age, knowledge, attitudes/motivation, training, work tools, supervision, and incentives, were not significantly associated with performance. Conclusion: Length of service was significantly associated with the performance of larva monitoring cadres. Although other factors were not statistically significant, the findings suggested that greater experience and better support tended to contribute to improved cadre performance in dengue prevention.
Identification of Factors Associated with Low Back Pain among Online Motorcycle Taxi Drivers in Denpasar
Background: Low back pain (LBP) is a musculoskeletal complaint widely experienced worldwide, including among online motorcycle taxi drivers. Several factors related to LBP include sex, age, body mass index (BMI), length of work, sitting posture, sitting duration, and smoking. Low back pain can reduce the productivity of online motorcycle taxi drivers. Therefore, this study aimed to identify the factors related to LBP among online motorcycle taxi drivers in Denpasar. Methods: An analytical observational design with a cross-sectional approach and a purposive sampling technique. Participants were online motorcycle taxi drivers who met the inclusion and exclusion criteria. Data were collected using structured questionnaires and anthropometric measurements and were analyzed using univariate analysis, the chi-square test, and Fisher’s exact test, with a significance level of p < 0.05. Results: The prevalence of low back pain was 68.1% (47 respondents). Statistical analysis demonstrated significant associations between BMI ≥ 23 kg/m² (p = 0.040), sitting duration ≥ 9 hours/day (p = 0.015), and non-ergonomic sitting posture (p = 0.033) with LBP. Meanwhile, sex (p = 1.000), age (p = 1.000), length of work (p = 0.860), and smoking (p = 0.296) were not significantly associated with LBP. Conclusions: Sitting duration, sitting posture, and BMI were significantly associated with low back pain among online motorcycle taxi drivers in Denpasar.
CHARACTERISTICS OF DRY EYE SYNDROME AMONG TOURISTS ENGAGING IN WATER SPORTS AT BEACH TOURISM DESTINATIONS
Dry Eye Syndrome (DES) is a common ocular disorder that can be triggered by various factors, including sociodemographic characteristics, extreme environmental conditions, and exposure to seawater during water sports activities. This study aimed to identify the characteristics of DES among tourists engaging in water sports at beach tourism destinations based on sex, age, location, duration and type of activity, ultraviolet (UV) index, environmental temperature, and use of eye protection. This study employed a prospective observational descriptive analytic design and involved 65 tourists. Data were collected using an initial research questionnaire and the Ocular Surface Disease Index (OSDI). The results showed that most respondents were classified as normal (76.9%), followed by mild (20%) and moderate (3.1%) DES, with no severe cases identified. Females demonstrated a higher proportion of DES compared to males, and respondents aged ≥30 years showed a greater tendency toward DES than those aged <30 years. Longer activity duration (≥60 minutes), participation at watersport facilities, primary water sports, UV index ≥5, higher environmental temperature, and absence of eye protection were associated with an increased risk of DES, although these associations were not statistically significant (p > 0.05). Furthermore, the incidence of DES increased proportionally with the accumulation of risk factors, with a statistically significant association between the number of concurrent risk factors and DES occurrence (p = 0.011), highlighting the multifactorial nature of DES.
The Relationship Between Emotional Intelligence and Academic Achievement of Medical Students at Udayana University
Emotional intelligence combines aspects of interpersonal interaction that can improve individual performance and awareness for successful academic development. This quantitative analytical study with a cross-sectional approach aimed to determine the relationship between emotional intelligence and academic achievement among medical students at Udayana University. The sample included 171 students from the 2022 cohort selected via total sampling. Emotional intelligence was measured using the SSEIT questionnaire covering emotion regulation, appraisal, utilization, and social skills, while academic achievement was determined by the 5th-semester GPA. Data were analyzed using the Kolmogorov-Smirnov test and Spearman's correlation. The results indicated an average emotional intelligence score of 116.55 ± 14.13, with 79.5% of respondents falling into the “With Honors” GPA category. Spearman's correlation showed no significant relationship between emotional intelligence and academic achievement (rs = 0.128, p = 0.094). Furthermore, no significant relationships were found in the specific sub-domains of emotion regulation, assessment, utilization, or social skills. In conclusion, there is no significant relationship between emotional intelligence and academic achievement in this group. Therefore, further research involving medical students from various batches is recommended to obtain a more comprehensive picture.
THE RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND THE OCCURRENCE OF PRIMARY DYSMENORRHEA AMONG UNDERGRADUATE MEDICAL STUDENTS AT UDAYANA UNIVERSITY
Primary dysmenorrhea is menstrual pain in the lower abdomen originating from the uterus without accompanying complications or organic abnormalities. Primary dysmenorrhea most commonly occurred in late adolescence, particularly among women aged 18–24 years, which corresponds to the typical age of university students. Primary dysmenorrhea was influenced by several factors, one of which was nutritional status. Aiming to evaluate the link between nutritional status and primary dysmenorrhea, this research focused on female students within the Undergraduate Medical Program at Udayana University. Focusing on female medical students at Udayana University, this cross-sectional study analyzed the link between nutritional status and primary dysmenorrhea. Data were gathered through non-probability accidental sampling to determine the association between the independent variable (nutritional status) and the dependent variable (primary dysmenorrhea severity). The study involved 111 respondents, with a prevalence of primary dysmenorrhea of 92,8% and proportion of severe primary dysmenorrhea of 25%. Severe primary dysmenorrhea was more frequently experienced by respondents with overweight nutritional status compared to those with underweight and normal nutritional status (p=0,058). In addition, severe primary dysmenorrhea was more common among respondents with high stress levels (p=0,456). Therefore, it was concluded that there was no significant relationship between nutritional status or stress level and the severity of primary dysmenorrhea among undergraduate medical students at Udayana University.
PREVALENCE AND RISK FACTORS FOR SLEEP QUALITY DISORDERS IN PENCAK SILAT ATHLETES BULELENG REGENCY
The quality of sleep-in athletes contributes to athletic performance, injury risk, recovery time, cardiovascular endurance and anaerobic strength. Pencak silat athletes also have a risk of having poor sleep quality, in connection with the intensity of training and academic stress in athletes who are students. However, specific data on the prevalence and risk factors for sleep quality disorders in athletes are still limited. This study is aimed at determining the quality of sleep and factors related to pencak silat athletes. A cross-sectional study conducted on pencak silat athletes in Buleleng Regency in June-August 2025. A total of 32 pencak silat athletes participated in this research, who were selected using the total sampling method. The criteria for sample inclusion set include being willing to be the subject of the research, and signing the informed consent, being present at the data collection, being able to fill out the questionnaire completely and participating in the data collection until the end. The exclusion criteria in this study are athletes in poor physical and mental health, who are diagnosed by a doctor, and have moved their domicile outside Buleleng. Sleep quality data were collected by the interview method using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. As many as 59.4% of pencak silat athletes have good sleep quality. Early wake-up time, the use of sleep medications, the presence of sleep disorders and sleep efficiency are factors related to the quality of athletes' sleep (p <0.05). Therefore, it can be concluded that the sleep quality of pencak silat athletes is quite good. So, it is recommended to increase adequate sleep time supervision between 8-10 hours per day, avoid the use of sleeping pills and overcome sleep disorders in athletes to maintain athlete performance.
FACTORS ASSOCIATED WITH OBESITY AMONG STUDENTS AT SMA NEGERI 1 PENEBEL, TABANAN
Background: Adolescent obesity has become an increasing public health challenge, with long-term impacts on quality of life and an elevated risk of degenerative diseases. The urgency to address this condition continues to grow due to its rising prevalence and the potential for adverse health outcomes in adulthood. This study aimed to determine the prevalence of obesity and analyze factors associated with obesity among students at SMA Negeri 1 Penebel, Tabanan. Methods: This study employed an analytical observational design with a cross-sectional approach involving 140 respondents. Data were collected through anthropometric measurements and self-administered questionnaires assessing genetic factors, sex, physical activity level, and sleep duration. Data analysis was conducted using the Chi-square test, Fisher’s Exact Test, and multivariate logistic regression analysis. Results: The prevalence of obesity among students at SMA Negeri 1 Penebel, Tabanan was 37.1%. Bivariate analysis demonstrated significant associations between genetic factors (p = 0.006) and sleep duration (p = 0.013) with obesity. In contrast, sex (p = 0.073) and physical activity level (p = 0.824) were not significantly associated with obesity status. Multivariate analysis indicated that genetic factors were the strongest independent predictor of obesity among students (p = 0.031). Conclusion: Genetic factors and sleep duration were significantly associated with obesity, with genetic factors identified as the most dominant predictor. The high prevalence of obesity underscores the importance of preventive health interventions focusing on modifiable risk factors, particularly among students with a genetic predisposition.
EFFECT OF PURPLE CABBAGE (BRASSICA OLERACEA VAR. CAPITATA L.) EXTRACT ONSERUM SGPT LEVELS IN MALE WISTAR RATS TREATED WITH A HIGH-FAT DIET AND CCL₄
Non-alcoholic fatty liver disease (NAFLD) represents a growing global health concern and is marked by progressive liver injury, which partly mediated by oxidative stress. Purple cabbage (Brassica oleracea var. capitata L.) contains high levels of anthocyanins, bioactive compounds recognized for their potential protective effects on the liver. This study aimed to assess the effect of purple cabbage extract serum glutamic pyruvic transaminase (SGPT) levels in male Wistar rats exposed to a high-fat diet and carbon tetrachloride (CCl₄). Methods: This experimental investigation utilized 24 male Wistar rats that were randomly assigned to four groups (n = 6). The negative control group (P0) received a high-fat diet in combination with CCl₄ induction. The intervention groups were administered purple cabbage extract at dose of 100 mg/kg BW (P1), 200 mg/kg BW (P2), and 400 mg/kg BW (P3) for six consecutive weeks alongside the same induction protocol. SGPT levels were analyzed at the completion of the treatment period. Results: The negative control group (P0) exhibited the highest mean SGPT concentration (74.52 ± 11.451 U/L). Administration of purple cabbage extract resulted in a dose-related decline in SGPT levels, with mean values of 57.90 U/L (P1), 47.78 U/L (P2), and 38.56 U/L (P3). Statistically significant reductions were observed in the P2 (p = 0.006) and P3 (p = 0.002) groups, whereas the decrease in P1 did not reach significance (p = 0.055). Conclusion: Purple cabbage extract exerted a dose-dependent hepatoprotective effect, as demonstrated by reductions in SGPT concentrations in Wistar rats with liver injury induced by a high-fat diet and CCl₄ exposure.
Luh Komang Wiranindra Patni Mulyana Utami
LOW DENSITY LIPOPROTEIN (LDL) LEVELS, AGE, AND SEX AS RISK FACTORS FOR CORONARY HEART DISEASE INCIDENTS AT NGOERAH HOSPITAL
Coronary heart disease (CHD) is the foremost cause of mortality in Indonesia and is closely related to atherosclerosis due to increased levels of low density lipoprotein (LDL). The risk of CHD increases with age and is generally higher in male than in female, especially before menopause. Therefore, this study sought to assess the role of LDL, age, and sex as risk factors for CHD at Ngoerah Hospital. A case-control study of 34 case and 34 control patients (2022–2024) was conducted using consecutive sampling from medical records. To identify risk factors for CHD, bivariate analysis was conducted using the Chi-square test, followed by multivariate analysis using multiple logistic regression. Among the 68 patients analyzed, the majority (41 patients, 60.3%) had high LDL levels. The sample characteristics were predominantly male (44 patients, 64.7%) and of older age (42 patients, 61.8%). Multivariate analysis revealed that patients with high LDL levels showed a 7.4-fold greater likelihood of developing CHD relative to those with low LDL levels (AOR = 7.4; CI 95% : 2.22–24.75; p = 0.001). Male patients was also significantly associated with CHD, with approximately 5.78 times higher odds compared to females (AOR = 5.78; CI 95% : 1.67–19.97; p = 0.006). Age did not show a significant relationship with CHD (p = 0.65).