Al Makki Health Informatics Journal is an open access scientific peer-review journal publishing. The Al Makki Health Informatics Journal's focus is on exchanging information relating to health informatics applied in industry, hospitals, government, and universities. All articles should include a validation of the idea presented, e.g. through case studies, experiments, or systematic comparisons with other approaches already in practice. Editor in Chief : Cucu Herawati ISSN: 3025-0501 (online) | 3025-6518 (Print) DOI: 10.57185 Frekuensi : Bi-monthly Indexing and Abstracting: Google Scholar, Garuda, Crossref, Dimension, Copernicus and others in progress Publication Guidelines: COPE Guidelines Publisher: Al-Makki Publisher collaborate with serkomi.com Editorial Team Cucu Herawati Editor in Chief Sekolah Tinggi Ilmu Kesehatan Cirebon, Indonesia [Scopus] [Sinta] [Google Scholar] Roby Setiadi Editorial Board Universitas Muhadi Setiabudi Brebes, Indonesia [Scopus ][Sinta] [Google Scholar] Advisory Board / Reviewers Dyah Suryani Editorial Board Universitas Ahmad Dahlan, Indonesia [Scopus] [Sinta] [Google Scholar] Prasojo Pribadi Editorial Board Universitas Muhammadiyah Magelang, Indonesia [Scopus] [Sinta] [Google Scholar]
The Effectiveness of Local Micro-Video-Based Education (Health Microclips) in Preventing Acute Respiratory Infections Among Families with Toddlers in the Service Area of the Molompar Community Health Center, Southeast Minahasa Regency
Acute Respiratory Infection (ARI) is one of the leading causes of morbidity and mortality among children under five years of age in Indonesia. This study aimed to examine the effectiveness of local micro-video-based education (Health Microclips) in preventing ARI among families with toddlers in the service area of Molompar Community Health Center, Southeast Minahasa Regency. A pre-experimental design using a one-group pretest–posttest approach was employed. A total of 162 respondents were selected using purposive sampling. Data were collected using validated questionnaires measuring knowledge, attitudes, and preventive practices related to ARI prevention. The intervention was delivered through local micro-videos distributed via WhatsApp. Data were analyzed using the Wilcoxon Signed-Rank Test. The results showed that the proportion of respondents with good knowledge increased from 32.1% to 79.6%, positive attitudes increased from 56.2% to 88.9%, and good preventive practices increased from 63.6% to 85.2%. The Wilcoxon test results showed a p-value of 0.000 (p < 0.05) for all variables. It was concluded that local micro-video-based education (Health Microclips) was effective in improving knowledge, attitudes, and preventive practices related to ARI prevention among families with toddlers.
Copyright (c) 2026 Al Makki Health Informatics Journal
Pengaruh Edukasi Dash (Dietary Approaches To Stop Hypertension) Terhadap Pencegahan Hipertensi Pada Ibu Hamil Trimester II Dan III Di Puskesmas Salewangeng Kabupaten Wajo
Hipertensi selama kehamilan memerlukan perhatian yang serius karena dapat menambah risiko terjadinya komplikasi seperti preeklampsia dan masalah dengan aliran darah ke plasenta. Salah satu langkah yang terbukti efektif dalam mencegah dan mengelola hipertensi selama kehamilan adalah penerapan pola makan DASH. (Dietary Approaches to Stop Hypertension). Tujuan dari studi ini adalah untuk memahami dampak pendidikan DASH dalam mencegah hipertensi pada wanita hamil. Jenis penelitiannya adalah menggunakan metode quasi eksperimen dengan non equivalent control group design. Penelitian ini dilakukan di Puskesmas Salewangeng, Kabupaten Wajo. Pendekatan yang diterapkan dalam penelitian ini adalah kuantitatif. Pengambilan sampel dilakukan dengan metode purposive sampling, menggunakan kriteria inklusi, dan untuk menganalisis data statistik diterapkan uji normalitas (Shapiro-Wilk) menggunakan SPSS versi 22. Uji bivariat menggunakan Paired Sample T-Test, Independent T-Test, Wilcoxon, dan Mann-Whitney. Hasil penelitian rata rata edukasi pengetahuan uji statistik menunjukkan nilai p sebesar 0,008 (p < 0,05). Perilaku penerapan p sebesar 0,017 (p < 0,05). Penurunan tekanan darah nilai p sebesar 0,426 (p > 0,05), sehingga dapat disimpulkan bahwa edukasi DASH berpengaruh signifikan terhadap peningkatan pengetahuan dan perilaku penerapan diet DASH pada ibu hamil, namun belum menunjukkan perbedaan yang signifikan secara statistik terhadap pencegahan hipertensi antar kelompok (p=0,426; p>0,05). Secara deskriptif, terdapat penurunan tekanan darah pada kelompok intervensi dari 138 mmHg menjadi 120 mmHg.
Development of a Color Doppler Phantom Based on SimuGel Gelatin as an Innovative Simulation Medium for Laboratory Practicum in the Ultrasonography Course
Ultrasonography, particularly Doppler ultrasound, requires adequate practical skills to ensure accurate examination and interpretation of blood flow characteristics. However, student training is often limited by restricted patient availability, safety considerations, and insufficient opportunities for repeated practice. Simulation media, such as phantoms, provide a controlled and safe learning environment; however, commercial Doppler phantoms remain relatively expensive and less accessible for educational institutions. This study aimed to develop a SimuGel gelatin-based Color Doppler phantom as an innovative simulation medium for laboratory practice in ultrasonography courses. This study employed a Research and Development (R&D) method using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. The phantom was developed using SimuGel gelatin, glycerin, distilled water, psyllium husk, preservatives, acrylic components, and an aquarium pump-based flow system. Product feasibility was evaluated by three experts, while practicality testing involved 30 students. Data were collected through observation, questionnaires, interviews, and product trials, then analyzed descriptively using a Likert scale. The results showed that expert validation categorized the phantom as feasible, with assessment scores ranging from 2.67 to 4.00. Student evaluations indicated a very feasible category, with an average score of 3.70. The phantom successfully generated Color Doppler visualization, supported training in Doppler ultrasound parameters, and improved students’ understanding of ultrasound examination procedures. However, the continuous flow system limited the simulation of physiological pulsatile blood flow characteristics. In conclusion, the SimuGel-based Color Doppler phantom was a feasible, practical, and affordable learning medium for Doppler ultrasound education, although further improvements are required to enhance the realism of the simulated blood flow.
The Role of Counseling on the Utilization of Family Medicinal Plants as Traditional Herbal Remedies on the Knowledge Level of the Community in Datarajan Village
The use of medicinal plants as traditional remedies offers synergistic effects, in which combinations of several plant species can enhance treatment effectiveness. Indonesia possesses the second-largest biodiversity in the world, with approximately 25,000–30,000 plant species, of which around 7,500 have been identified as having medicinal potential; however, only approximately 1,200 species are utilized as traditional medicines. This study aimed to determine the level of community knowledge and examine the effect of counseling on knowledge regarding the utilization of Tanaman Obat Keluarga (TOGA) as traditional herbal remedies. The study employed a quasi-experimental method with a non-equivalent control group design. The results showed that among 120 respondents in the intervention group, the majority demonstrated a good level of knowledge, with 71 respondents (59%) categorized as having good knowledge. The Mann–Whitney test results indicated a p-value of 0.000, demonstrating a significant difference between groups. This study concluded that community knowledge was categorized as good and that counseling had a significant effect on the knowledge level of the community in Datarajan Village, Ulu Belu District, Tanggamus Regency, regarding the utilization of Tanaman Obat Keluarga (TOGA) as traditional herbal remedies.
Coaching and Capacity Building Interventions for One Health Workforce in Southeast Asia: A Scoping Review
The One Health approach emphasizes the interconnectedness of human, animal, and ecosystem health, advocating for cross-sector collaboration to combat zoonotic threats. Despite policy advances in Southeast Asia, little is known about coaching and capacity-building efforts for the region's One Health workforce. This review aimed to map such interventions, examine their methods and target groups, assess outcomes, and identify gaps. Using the Arksey and O'Malley framework and PRISMA-ScR reporting, a search across seven databases and gray literature from 2000- 2025 was conducted. Studies included addressed multiple sectors in Southeast Asia and described or evaluated coaching or capacity-building. Two reviewers screened records with a Cohen’s kappa of 0.86. Twenty-nine studies met inclusion criteria; Thailand (27.6%) and Indonesia (24.1%) were most represented. Group training predominated (34.5%), and only one study employed executive coaching. Outcomes clustered at Kirkpatrick Levels 1–2, with 20.7% reaching Level 4. Environmental health professionals and five ASEAN countries remained absent from the evidence base. Coaching efforts remain regionally limited, modality-restricted, and outcomes shallow; gaps include executive coaching, organizational consulting, and environmental health inclusion. Future initiatives should combine personalized coaching with organizational strategies, emphasizing longitudinal research and coverage of ASEAN countries.
The Effect of Using a Health Chatbot for Diabetes Consultation on Patient Satisfaction and Lifestyle Management
This study aims to analyze the effect of health chatbot usage on patient satisfaction and lifestyle management in type 2 diabetes patients. The background of the study is based on the increasing prevalence of diabetes in Indonesia and the limited medical personnel, which cause patients to not always receive continuous support. Health chatbots are seen as an innovative solution based on artificial intelligence (AI) that can provide information, education, and reminders interactively. The research method used a quantitative approach with an explanatory survey design involving 220 respondents with type 2 diabetes in urban areas of Indonesia. Data were collected through a Likert-scale-based questionnaire, semi-structured interviews, and observations of patient interactions in digital health communities. Analysis was performed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to test the relationship between variables. The results showed that chatbot usage had a significant positive effect on patient satisfaction (β=0.338, p<0.001) and lifestyle management (β=0.206, p<0.01). Patient satisfaction also significantly influenced lifestyle management (β=0.285, p<0.001) and partially mediated the effect of chatbots on lifestyle (β=0.097, 95% CI [0.043–0.165]). These findings confirm that health chatbots have the potential to become an integral part of digital healthcare services, although their impact on patient physical activity is still limited.
Patient Experience with Side Effects of Chemotherapy Drugs in Hospital Oncology Installations
Cancer is one of the leading causes of death in the world, with an ever-increasing incidence. Based on GLOBOCAN 2022 data, more than 20 million new cases of cancer and 9.7 million deaths were recorded globally, with a projected increase of up to 28.4 million cases by 2040. This study aims to explore and describe the subjective experience of patients in dealing with chemotherapy side effects in the Oncology Installation of Hospital X. The method used is a qualitative research with a descriptive phenomenological design, involving 15 patients who meet the inclusion criteria. Data were collected through in-depth interviews, participatory observations, and semi-structured questionnaires. The results showed that nausea and vomiting were the most common side effects (93%, severity score 7.8), followed by fatigue (87%, 8.2) and hair loss (80%, 6.5). Family support has been shown to affect patients' ability to manage symptoms, while limited pre-chemotherapy education and the number of clinical pharmacists are barriers to treatment. In conclusion, the treatment of chemotherapy patients requires a holistic approach based on patient-centered care that integrates physical, psychological, and social aspects, as well as strengthening education and clinical pharmacy services to improve the patient's quality of life during therapy.
Copyright (c) 2025 Al Makki Health Informatics Journal
Diabetes Mellitus Patients' Experiences in Managing Diet during the COVID-19 Pandemic
The COVID-19 pandemic has brought significant changes in people's lives, especially for patients with chronic diseases such as Diabetes Mellitus (DM). Consistent diet management is an important component of DM control, but the pandemic situation presents new challenges. This study aims to explore the experiences of DM patients in managing their diet during the COVID-19 pandemic. The research uses a qualitative approach with a phenomenological design. Data were collected through in-depth interviews, questionnaires, and observations of seven purposively selected type 2 DM patients. The results of the study showed that the majority of patients had difficulty maintaining a regular diet due to limited access to healthy food, psychological pressure, and changes in daily routines. Family support helps maintain dietary discipline, while nutritional counseling services have been very limited during the pandemic. The average score of the questionnaire showed low consistency in the consumption of vegetables and fruits, as well as the low frequency of nutritional consultations. Observations of the home environment also show the dominance of instant food and a lack of healthy meal planning. In conclusion, the pandemic exacerbated the dietary management challenges in DM patients. Community-based interventions, sustainable nutrition education, and family involvement are needed to support effective management of DM in times of crisis.
Health Informatics-Based Telecounseling Innovation in Mental Health Services
Arjadi, R., Kusumawardhani, S. J., Purnomo, N., & Bockting, C. L. (2023). Benefits and challenges in implementing online mental health consultation in Indonesia: Survey in practitioners. Jurnal Psikologi Ulayat: Indonesian Journal of Indigenous Psychology, 10(2), 284–299. DTO Kemenkes RI. (2024). Reflecting the mental health situation in Indonesia with SATUSEHAT. Medium. https://medium.com/@dtokemkes/reflecting-mental-health-situation-in-indonesia-with-satusehat Geraldina, A. M., Suen, M. W., & Suanrueang, P. (2023). Online mental health services during COVID-19 pandemic in Indonesia: Challenges from psychologist perspective. PLoS ONE, 18(6), e0285490. https://doi.org/10.1371/journal.pone.0285490 Lim, C. T., & Fuchs, C. (2024). Integrated digital mental health care: A vision for addressing population mental health needs. International Journal of General Medicine, 17, 359-365. https://doi.org/10.2147/IJGM.S449474 Munira, L., Liamputtong, P., & Viwattanakulvanid, P. (2023). Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study. Belitung Nursing Journal, 9(2), 110-117. https://doi.org/10.33546/bnj.2521 Ospina-Pinillos, L., et al. (2025). Co-designing, developing, and testing a mental health platform for young people using a participatory design methodology in Colombia: Mixed methods study. JMIR Human Factors, 12(1), e66558. https://doi.org/10.2196/66558 Saptandari, E. W. (2020). Covid-19 and mental health: The growing need of telecounseling in Indonesia. Buletin Psikologi, 28(2), 99-112. https://doi.org/10.22146/buletinpsikologi.59542 Thakkar, A., Gupta, A., & De Sousa, A. (2024). Artificial intelligence in positive mental health: A narrative review. Frontiers in Digital Health, 6, 1280235. https://doi.org/10.3389/fdgth.2024.1280235 Torous, J., Linardon, J., Goldberg, S. B., et al. (2025). The evolving field of digital mental health: Current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality. World Psychiatry, 24(2), 156-174. https://doi.org/10.1002/wps.21299 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. Creswell, J. W., & Clark, V. L. P. (2018). Designing and conducting mixed methods research (3rd ed.). Sage Publications. Moran, N., & O'Brien, N. (2022). System Usability Scale benchmarking for digital health apps: Meta-analysis. JMIR mHealth and uHealth, 10(8), e37290. Skivington, K., Matthews, L., Simpson, S. A., et al. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374, n2061. Sousa, V. D., & Rojjanasrirat, W. (2011). Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research. Journal of Evaluation in Clinical Practice, 17(2), 268-274. Bangor, A., Kortum, P., & Miller, J. (2009). Determining what individual SUS scores mean: Adding an adjective rating scale. Journal of Usability Studies, 4(3), 114-123. Berardi, C., Hine, M., Bélanger, F., & Bhatikar, S. (2024). Barriers and facilitators to the implementation of digital technologies in mental healthcare systems: A qualitative systematic review. BMC Health Services Research, 24, 243. Chen, Y., Wang, L., & Zhang, H. (2024). Effectiveness of telemedicine on common mental disorders: An umbrella review and meta-meta-analysis. Computers in Human Behavior, 157, 108236. Cuijpers, P., Karyotaki, E., de Wit, L., & Ebert, D. D. (2019). The effects of fifteen evidence-supported therapies for adult depression: A meta-analytic review. Psychotherapy Research, 30(3), 279-293. DTO Kemenkes RI. (2024). Reflecting mental health situation in Indonesia with SATUSEHAT. Medium. https://medium.com/@dtokemkes Fischer-Grote, L., Fössing, V., Aigner, M., Fehrmann, E., & Boeckle, M. (2024). Effectiveness of online and remote interventions for mental health in children, adolescents, and young adults after the onset of the COVID-19 pandemic: Systematic review and meta-analysis. JMIR Mental Health, 11, e46637. Greenwood, H., Krzyzaniak, N., Peiris, R., et al. (2022). Telehealth versus face-to-face psychotherapy for less common mental health conditions: Systematic review and meta-analysis of randomized controlled trials. JMIR Mental Health, 9(3), e31780. He, Y., Chen, J., & Wang, X. (2023). Systematic review and meta-analysis of AI-based conversational agents for promoting mental health and well-being. npj Digital Medicine, 6, 236. Lewis, C. C., Boyd, M., Puspitasari, A., et al. (2019). Implementing measurement-based care in behavioral health: A review. JAMA Psychiatry, 76(3), 324-335. Linardon, J., & Fuller-Tyszkiewicz, M. (2020). Attrition and adherence in smartphone-delivered interventions for mental health problems: A systematic and meta-analytic review. Journal of Consulting and Clinical Psychology, 88(1), 1-13. Moran, N., & O'Brien, N. (2022). System Usability Scale benchmarking for digital health apps: Meta-analysis. JMIR mHealth and uHealth, 10(8), e37290. Munira, L., Liamputtong, P., & Viwattanakulvanid, P. (2023). Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study. Belitung Nursing Journal, 9(2), 110-117. Ospina-Pinillos, L., Shambo-Rodríguez, D. L., Sánchez-Nítola, M. N., et al. (2025). Co-designing, developing, and testing a mental health platform for young people using a participatory design methodology in Colombia: Mixed methods study. JMIR Human Factors, 12(1), e66558. Patel, V., Saxena, S., Lund, C., et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553-1598. Rutter, T. L., Saris, I. M., Loeffen, C., et al. (2024). The association between quality of therapeutic alliance and treatment outcomes in teletherapy: A systematic review and meta-analysis. Clinical Psychology Review, 110, 102426. Simpson, S. G., Reid, C. L., & Richardson, L. K. (2019). Videoconference-based psychotherapy: A review of the literature. In J. Practical Telehealth (Eds.), Telemental Health (pp. 45-68). Springer. Simpson, S., Richardson, L., Pietrabissa, G., Castelnuovo, G., & Reid, C. (2021). Videotherapy and therapeutic alliance in the age of COVID-19. Clinical Psychology & Psychotherapy, 28(2), 409-421. Torous, J., Linardon, J., Goldberg, S. B., et al. (2025). The evolving field of digital mental health: Current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality. World Psychiatry, 24(2), 156-174. Välimäki, M., Anttila, K., Anttila, M., & Lahti, M. (2023). Factors affecting digital tool use in client interaction according to mental health professionals: Interview study. JMIR Human Factors, 10, e44681. Wani, C., McCann, L., Lennon, M., & Radu, C. (2024). Digital mental health interventions for adolescents in low- and middle-income countries: Scoping review. Journal of Medical Internet Research, 26, e51376. World Health Organization. (2024). Ethics and governance of artificial intelligence for health: Guidance on large multi-modal models. WHO. Yew, S. Q., Trivedi, D., Adanan, N. I. H., & Chew, B. H. (2025). Facilitators and barriers to the implementation of digital health technologies in hospital settings in lower- and middle-income countries since the onset of the COVID-19 pandemic: Scoping review. Journal of Medical Internet Research, 27(1), e63482. Zayed, M., Ibrahim, A., & Hassan, M. (2024). Acceptability of tele-mental health services among users: A systematic review and meta-analysis. BMC Public Health, 24, 1012.
Association Between Alcohol Consumption and Periodontal Pocket Formation
Background: Periodontal disease is one of the most prevalent chronic diseases affecting the oral cavity worldwide. Various risk factors contribute to the development of periodontal disease, one of which is alcohol consumption. Excessive alcohol intake is widely recognized as a major public health problem and has been associated with systemic conditions such as liver disease, cardiovascular disorders, and behavioral and mental health problems. Alcohol abuse has also been reported to impair host immune responses by reducing neutrophil, macrophage, and T-cell function, thereby increasing susceptibility to infection. Consequently, alcohol consumption may contribute to the development of periodontal pockets. Objective: This literature review aimed to summarize current evidence regarding the association between alcohol consumption and the risk of periodontal pocket formation. Methods: A narrative literature review was conducted by searching the PubMed, Scopus, and Google Scholar databases for peer-reviewed articles published between 2008 and 2025. The search combined the terms “alcohol consumption,” “periodontal pocket,” “periodontitis,” and “clinical attachment loss.” Observational, longitudinal, cohort, and cross-sectional studies, as well as systematic reviews and meta-analyses, were included, and their findings were synthesized descriptively. Results: Seven primary clinical studies were examined, together with supporting mechanistic and review evidence. Two studies reported no consistent association between light-to-moderate alcohol consumption and periodontal pocket development, whereas five reported that heavy or long-term alcohol consumption was associated with increased periodontal pocket depth and clinical attachment loss, most notably among heavy drinkers and smokers. Conclusion: This review demonstrates that excessive alcohol consumption is associated with periodontitis-related clinical manifestations, including periodontal pocket formation and clinical attachment loss.
Bioinformatics in Genomic Analysis: Opportunities and Challenges of Leveraging Big Data for Personalized Medicine
Advances in bioinformatics and genomics technology have created great opportunities in realizing personalized medicine. This study aims to analyze the role of bioinformatics in the use of genomic big data, emphasizing the opportunities, challenges, and integration strategies needed. The research method used is qualitative with an exploratory approach. Data were collected through in-depth interviews, focus group discussions, and documentation studies, then analyzed using thematic analysis techniques. The results of the study show that bioinformatics offers a variety of opportunities, such as the utilization of pharmacogenomics for drug response prediction, disease biomarker identification, multi-omics data integration, machine learning algorithm development, and early detection of genetic diseases. However, a number of challenges still hinder implementation, including genomic data privacy and security issues, limited computing infrastructure, lack of interdisciplinary human resources, lack of standardization of data formats, and regulatory and policy barriers. This research also emphasizes the importance of the strategy of integrating bioinformatics and big data through strengthening technological infrastructure, global data standardization, the use of artificial intelligence, privacy protection based on adaptive regulations, international collaboration, and the development of interdisciplinary education. The implications of this research not only enrich the academic literature, but also provide a practical basis for the formulation of more precise and equitable health policies. Thus, this study confirms that the use of bioinformatics is a strategic path towards the transformation of data-based health services, which is oriented to individual needs while maintaining the ethics and sustainability of the health system.
Patient Experience With Side Effects Of Chemotherapy Drugs In Hospital Oncology Facilities
Cancer is one of the leading causes of death in the world, with an ever-increasing incidence. Based on GLOBOCAN 2022 data, more than 20 million new cancer cases and 9.7 million deaths were recorded globally, with a projected increase of up to 28.4 million cases by 2040. This study aims to explore and describe the subjective experience of patients in dealing with chemotherapy side effects in the Oncology Installation of Hospital X. The method used is a qualitative research with a descriptive phenomenological design, involving 15 patients who meet the inclusion criteria. Data were collected through in-depth interviews, participatory observations, and semi-structured questionnaires. The results showed that nausea and vomiting were the most common side effects (93%, severity score 7.8), followed by fatigue (87%, 8.2) and hair loss (80%, 6.5). Family support has been shown to affect patients' ability to manage symptoms, while limited pre-chemotherapy education and the number of clinical pharmacists are barriers to treatment. In conclusion, the treatment of chemotherapy patients requires a holistic approach based on patient-centered care that integrates physical, psychological, and social aspects, as well as the strengthening of educational and clinical pharmacy services to improve the patient's quality of life during therapy.
The Impact of Air Pollution on the Prevalence of Acute Respiratory Infections among Outdoor Workers
This study aims to examine the impact of ambient air pollution exposure on the prevalence of acute respiratory infections (ARI) among outdoor workers. Given the increasing urban air pollution levels in Indonesia, outdoor laborers such as street vendors, construction workers, and traffic police represent a vulnerable population with prolonged exposure to hazardous air pollutants. A cross-sectional observational study was conducted among 300 outdoor workers in three urban areas with varying pollution levels. Air quality data, including concentrations of particulate matter (PM2.5 and PM10), were obtained from local monitoring stations. Health outcomes were assessed through standardized questionnaires on respiratory symptoms and medical history, alongside clinical examinations conducted by health professionals. Logistic regression analysis was applied to evaluate the association between exposure levels and ARI prevalence, controlling for confounders such as age, smoking habits, and socioeconomic status. The study revealed a significantly higher prevalence of ARI among outdoor workers in high-pollution areas compared to those in lower-pollution regions (37.2% vs. 18.9%; p < 0.01). Logistic regression analysis indicated that exposure to elevated PM2.5 levels was strongly associated with increased risk of ARI (OR = 2.41, 95% CI: 1.52–3.82). Smoking and low socioeconomic status were also identified as contributing risk factors, though air pollution remained the strongest predictor. Air pollution substantially elevates the risk of ARI among outdoor workers. These findings highlight the urgent need for targeted occupational health interventions, improved air quality policies, and the provision of personal protective measures to safeguard vulnerable populations.
Normal Standards for Uric Acid, Blood Sugar, Blood Pressure, Body Mass Index as a Step to Control the Risk of Non-Communicable Diseases (NCDs) in the Kumelembuai Dua Village Community in South Minahasa Regency, North Sulawesi Province
Non-communicable diseases (NCDs) are often considered trivial and can trap humans due to ignorance within normal limits: uric acid, blood sugar, blood pressure, and body mass index, which can lead to disease. Abnormal conditions can trigger NCDs gradually but surely. These conditions, if not anticipated through symptom observation and control of normal levels, can cause death. The causes are diverse, including genetic factors and environmental influences such as diet, sleep, activity, and social environment. Data from Kumelembuai Village, South Minahasa Regency, North Sulawesi, shows that this research uses qualitative methods, following Basrowi & Suwandi (2014). Blood samples were taken in February-March 2025 to determine normal standards for uric acid, blood sugar, and BMI in adult men and women, mainly housewives, with a total of 72 respondents. The results show that women’s average uric acid level is 9.12 mg/dL, men’s 9.4 mg/dL; blood sugar averages are 98.02 mg/dL for women and 115.94 mg/dL for men; blood pressure averages are 135.34/79.21 mmHg for women and 151.56/80.25 mmHg for men; BMI averages are 26.46 for women and 24.75 for men. Overall, some values exceed normal thresholds, indicating a risk of NCDs. The conclusion is that these levels surpass standard normal limits and could lead to health issues. Early steps are necessary to prevent NCDs by paying attention to factors such as genetics, environmental influences, and lifestyle patterns, including eating, sleeping, activity, and social gatherings that may trigger the consumption of foods increasing disease risk.
PFAS Exposure in Consumer Products and the Risk of Recurrent Miscarriage: A Clinical Study and Health Policy Implications
Exposure to Per- and Polyfluoroalkyl Substances (PFAS) from everyday consumer products has become a global issue of concern due to its persistent chemical properties and negative impact on reproductive health. This study aims to analyze the association between PFAS exposure and the risk of recurrent miscarriage in women of reproductive age in urban areas of Indonesia and examine the implications of public health policies. The research method uses a qualitative approach with a clinical case study design. Data were collected through in-depth interviews with hospital management, questionnaires to licensed medical personnel, field observations in respondents' households, and analysis of medical documents. The results showed that the majority of respondents were exposed to PFAS through various channels, such as the use of non-stick pans (73%), the consumption of fast food with plastic-coated packaging (67%), household cleaning products (80%), and drinking water in plastic packaging (100%). Interviews with hospital management indicate an increase in cases of recurrent miscarriages that cannot be medically explained, while medical personnel emphasize the need for PFAS regulation. These findings are in line with global research, but reveal gap research and gap policies in Indonesia. This study emphasizes the urgency of integrating environmental factors in clinical assessments and the preparation of national regulations to reduce PFAS exposure, as well as providing practical recommendations for the public in choosing safer products.
The Role Of Wearable Devices Technology In Monitoring Heart Health In The Elderly In Indonesia
Cardiovascular disease is still the leading cause of death in the world, including in Indonesia, with an increasing prevalence in the elderly. Limited access to health services, low digital literacy, and limited medical personnel in rural areas add to the complexity of heart health problems. This study aims to explore the role of wearable devices technology in monitoring heart health in the elderly in Indonesia. The research method uses a qualitative approach with a case study design. The research subjects consisted of 12 elderly people aged 60–75 years, 5 family members, and 3 health workers in the city of Bandung and Cirebon Regency. Data were collected through in-depth interviews, participatory observations, simple questionnaires, and documentation studies. The results of the study show that the majority of the elderly consider wearable devices useful in early detection of heart symptoms, increasing health awareness, and providing a sense of security for families. The main obstacles identified include low digital literacy (42%), device costs (33%), and inconvenience of use (25%). Seniors who live with their families are more compliant with devices than those who live alone. This study confirms that the effectiveness of wearable devices is influenced by social, economic, and cultural factors. With the support of families, health workers, and inclusive public policies, this technology has the potential to strengthen the digital transformation of elderly health services in Indonesia.
Efficacy and Safety of Acupuncture Compared with Standard Treatment in Migraine Without Aura: A Systematic Review of Randomized Controlled Trials
Introduction:Migraine without aura is a common neurological disorder that imposes a substantial global burden. While pharmacological therapy remains the cornerstone of treatment, limitations such as side effects, contraindications, and medication overuse highlight the need for complementary approaches. Acupuncture has been proposed as a potential alternative due to its neuromodulatory and analgesic effects. Methods: This systematic review followed PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Searches were conducted in PubMed, ProQuest, SAGE Journals, and EuropePMC, including only randomized controlled trials comparing acupuncture with standard pharmacological treatments in migraine without aura. Outcomes of interest included headache frequency, intensity, acute medication use, quality of life, and safety. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Eight randomized controlled trials involving patients with migraine without aura were included. Acupuncture consistently reduced migraine frequency, with greater decreases in headache days and attack frequency compared with drugs such as flunarizine and valproic acid. Significant reductions in pain intensity were observed in several studies, with acupuncture showing either comparable or superior effects relative to pharmacological therapy. Acupuncture also led to earlier and more sustained reductions in acute medication use, potentially lowering the risk of medication overuse headache. Quality of life improvements were reported in domains of physical function, emotional well-being, and migraine-specific indices. Adverse events were generally mild and transient (e.g., local bleeding, discomfort), and occurred less frequently than with standard medications, which were associated with drowsiness, weight gain, or gastrointestinal symptoms. Discussion and Conclusion: Acupuncture demonstrates favorable efficacy and safety compared with standard pharmacological treatments in migraine without aura, offering reductions in frequency, intensity, and medication use, alongside improvements in quality of life. Given heterogeneity in protocols and some methodological limitations, further large-scale multicenter trials with standardized designs are warranted to confirm these findings and guide clinical practice.
Multisymptom Oral Presentation in Type II Diabetes Mellitus: A Case of Candidiasis, Xerostomia, and Burning Mouth Syndrome
Background: Oral candidiasis is a fungal infection of the tongue and oral mucosa caused by Candida species, characterized by overgrowth and superficial tissue invasion. One of the main predisposing factors is an immunocompromised state such as type II diabetes mellitus. Fungal infections in diabetic patients may be associated with additional oral symptoms, including Burning Mouth Syndrome (BMS) and xerostomia. Case Presentation: A 53-year-old male presented with a three-day history of burning sensation localized to the left side of the tongue. The complaint had not been previously treated. The patient reported a reduced sense of taste, limited to salty and spicy sensations, and persistent dry mouth. Medical history revealed a diagnosis of type II diabetes mellitus for six years, with discontinuation of antidiabetic medication over the past three months. Management and Outcome: The treatment plan included chlorinated dioxide mouthwash (used three times daily), xylitol (taken three times daily), nystatin oral suspension (applied four times daily), a single dose of fluconazole 150 mg, and Becomzet (taken once daily). The patient was instructed to maintain strict adherence to the medication regimen, practice good oral hygiene, and attend regular follow-ups. Improvement in symptoms was observed after consistent use of the prescribed therapy. Conclusion: Effective management of oral candidiasis in patients with poorly controlled type II diabetes mellitus, particularly when accompanied by Burning Mouth Syndrome and xerostomia, requires a comprehensive treatment approach. Success is largely dependent on accurate drug selection and patient compliance with therapy and oral hygiene practices. This case highlights the importance of addressing systemic factors in conjunction with local treatment to ensure resolution of symptoms and prevent recurrence.
The Effect Of N-Hexane, Ethyl Acetate, And Water Fractions Of Peanut Seeds (Arachis Hypogaea L.) On Antioxidant Activity With The Dpph Method
Free radicals are one of the causes of various degenerative diseases, for example cardiovascular, high blood pressure, stroke, cirrhosis of the liver, cataracts, diabetes mellitus, and cancer. Antioxidants are compounds that can absorb or neutralize free radicals so that they are able to prevent disease due to damage to body cells, one of the plants that can be used as a natural source of antioxidants is peanut seeds. Peanut seeds contain flavonoid compounds that have the ability to act as antioxidants. The purpose of this study is to determine the presence of antioxidant activity, maximum concentration, EC50(ppm), and differences in antioxidant activity of n-hexane fraction, ethyl acetate fraction, and water fraction in peanut seeds in vitro. The method used in peanut seed extraction is remaceration with 96% ethanol solvent for 3 days. This study used solvents of n-hexane fraction, ethyl acetate fraction, and water fraction. Fractionation process for separation of compounds. The results of each fraction were tested by phytochemical screening and tested by thin layer chromatography (KLT). Quantitative analysis of antioxidants using the DPPH method at a maximum wavelength of 517.5 nm. The results of the study showed that the average yield from the extract was 24.15%. The n-hexane fraction, ethyl acetate fraction, and water fraction of peanut seed extract were 20.33%, 25.61%, 33.28%, respectively. The results of phytochemical screening obtained the results that were positive for flavonoids containing antioxidants in vitro. An average of EC50(ppm) was obtained in the standard quercetin, n-hexane fraction, ethyl acetate fraction, water fraction of 12.02 ppm; 10.62 ppm; 12.25 ppm; 11.75 ppm. The results of the statistical test according to ANAVA I showed that the significance was more than 0.05 which was 0.105 so that it can be concluded that the difference was not significant between the concentration groups of n-hexane, ethyl acetate, and water fractions of peanut seed extract in invitro antioxidant activity.
HIV/AIDS Young Adult with Diabetes Mellitus Presenting with Newly Diagnosed Pulmonary Tuberculosis, Pneumonia Hypokalemia and Atrial Fibrillation : A Rare Case Report
Pneumonia, pulmonary tuberculosis (TB), Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS), and metabolic disorders such as diabetes mellitus (DM) represent complex clinical challenges, particularly in young adults. Hypokalemia and cardiac arrhythmias such as atrial fibrillation (AF) may further worsen the prognosis in these conditions. Recent studies have highlighted the association between TB, pneumonia, and AF, suggesting an increased risk of systemic inflammation and electrolyte disturbances. We report and analyze a rare case of a young male patient with a unique combination of HIV infection, diabetes mellitus, clinical pulmonary TB, pneumonia, hypokalemia, and atrial fibrillation. This is a descriptive case report study. Data were collected through history taking, physical examination, supporting investigations, and management during hospitalization. A 25-year-old male presented with shortness of breath for one day, a history of cough for more than three months, weight loss, fever, and a history of insulin use five years prior. Physical examination revealed pale conjunctiva and oral candidiasis; no other abnormalities were found. Laboratory tests showed hemoglobin 10.8 g/dL, leukocytes 8,280/µL, platelets 296,000/µL, MCV 89.4 fL, MCHC 33.9 g/dL, HbA1c 8.4%, potassium 2.7 mmol/L, lymphocytes 6.6%, and reactive results for HIV qualitative testing (R1, R2, R3). Electrocardiogram (ECG) showed atrial fibrillation with normal ventricular response. Chest X-ray revealed normal cardiac size and findings suggestive of bronchitis and suspected pneumonia. Thoracic CT scan with and without contrast demonstrated features consistent with pneumonia and multiple bilateral paratracheal and subcarinal lymphadenopathy. This case highlights the need for multidisciplinary management involving anesthesiology, pulmonology, internal medicine, cardiology, and pharmacy to ensure comprehensive care and optimize clinical outcomes, while preventing potentially fatal complications.
The Relationship Between Stress And Adolescent Academic Perception Ability Based On Gender And Body Mass Index
Stress in adolescents has the potential to impact various aspects of physical and mental health, including perceived academic ability. Differences in gender and nutritional status such as body mass index (BMI) can affect stress levels and academic perception abilities in adolescents. Objective: To assess the relationship between stress and academic perception abilities based on gender and BMI in high school-aged adolescents. Methods: An observational analytical study with a cross-sectional approach was conducted on 53 students aged ≤18 years at SMAN 2 Parepare. Data were collected through an online questionnaire using the Indonesian version of the PSS-10 instrument and the TASES scale. BMI was calculated from weight and height. Data were analyzed using the t-test, ANOVA, and Pearson correlation. Results: There were no significant differences in stress scores or academic perception abilities based on gender and BMI category (p>0.05). There was no significant relationship between stress and academic perception abilities (r=–0.02; p=0.901). Conclusion: Gender and BMI status do not significantly influence stress and academic perception abilities. Other factors such as coping strategies and social support need further investigation.
Hyperosmolar Hyperglycemic State (HHS) and Diabetic Kidney Disease (DKD) as Acute and Chronic Complications of Type 2 Diabetes Mellitus in End-Stage Chronic Kidney Disease (CKD): a Case Report
Introduction: Hyperosmolar hyperglycemic state (HHS) is a life-threatening condition that often occurs in patients with type 1 and 2 diabetes mellitus characterized by hyperglycemic crises, hyperosmolarity, dehydration, with mild ketosis or no eketosis. Another chronic complication of Diabetes Mellitus is Diabetic Kidney Disease (DKD). Ni Putu Radha Premaiswari Suparthika1, I Nyoman Sutarka. Case Presentation: A 61-year-old male patient was referred with decreased consciousness since 5 days of SMRS. The patient has a history of type 2 diabetes mellitus since 20 years. In patients, signs were obtained in the form of decreased consciousness, severe hyperglycemia of 680 mg/dL, hyperosmolarity of 360 mOsm/kg, increase in anion gap >12, UTI complications as the trigger of HHS. In patients, moderate anemia was also found normochromic-normocyter, massive proteinuria, and decreased kidney function. Conclusion: In the 61-year-old male patient described in this case report, there are acute and chronic complications of Diabetes Mellitus that occur simultaneously and have caused high morbidity and mortality in patients.
The Effect of The Application of Head Coaching on The Work Motivation and Job Satisfaction of The Implementing Nurse at The Bandar Lampung Advent Hospital
Nursing human resources today are experiencing a change in the generation of workers. The need for the role of the head nurse in carrying out coaching to support, collaborate, and facilitate nursing human resources of different generations in order to build effective working relationships, increase motivation, self-potential, and staff job satisfaction. The purpose of the study was to assess the impact of coaching training on nurses' motivation and job satisfaction. Quasi-experimental research design with one group pre-posttest design. Respondents in the research were implementing nurses, using questionnaire measuring tools. The results were obtained by the majority of respondents aged 20-30 years (42.9%), PK 2 career path (37.5%), nurse education (50.0%), and length of work 1-5 years (44.6%). Before the coaching training, the average motivation was 25.13 and job satisfaction was 23.73, while after the coaching training, the average motivation increased to 43 and job satisfaction increased to 35.98. The Paired Samples Test showed a significant effect of coaching training on motivation and job satisfaction with a p-value of 0.000, as well as an R square result of 0.838. The need for the implementation of coaching by the head of the room to increase the motivation and work of nurses which will have an impact on the quality and effectiveness of nursing services.
A Pharmacogenomic Study to Predict Reverse Remodeling
Cardiac remodeling refers to structural, functional, and molecular changes in the heart in response to stress or injury. These alterations, involving both cellular and interstitial changes, contribute to the progression of heart disease. Long-term activation of the autonomic nervous system (ANS) exacerbates these changes, leading to systemic vasoconstriction, sodium and water retention, and ventricular remodeling, which accelerates disease progression. Neurohormonal activation is essential in compensating for falling cardiac output in heart failure (HF), but it also plays a major role in the progression of the disease. This study explores the role of the renin-angiotensin-aldosterone system (RAA) and the sympathetic nervous system in cardiac remodeling, particularly in heart failure, and the influence of genetic factors on drug response. The research focuses on the ß2-Adrenergic Gln/Gln Receptor genotype, a key genetic variant relevant to pharmacogenomics in left ventricular hypertrophy (LVH) treatment. Using a comprehensive review of clinical and experimental data, this study highlights how genetic polymorphisms affect the pharmacokinetics and pharmacodynamics of drugs such as beta-blockers, ACE inhibitors, and ARBs. The findings indicate that while the ß2-Adrenergic Gln/Gln Receptor genotype significantly influences drug efficacy, the challenges in applying personalized treatments based on genetic data require significant time and cost investments. The study's implications emphasize the need for personalized therapies and enhanced pharmacogenomic research to improve treatment outcomes in heart failure management, particularly in drug response and disease progression.
Literature Review: Analysis and Validation of the Effectiveness of Antidiabetic Drugs in the Biological Matrix Using the HPLC (High Performance Liquid Chromatography) Method
High-Performance Liquid Chromatography (HPLC) is a widely used analytical method for the separation, identification, and quantification of compounds in complex biological matrices, such as plasma, serum, and urine. This article discusses the analysis and validation of the effectiveness of antidiabetic drugs using HPLC, focusing on sample preparation, column selection, mobile phase, and detectors used. Method validation is performed to ensure parameters such as specificity, linearity, precision, accuracy, limit of detection (LOD), and limit of quantification (LOQ) are met. Literature study from 18 journals showed that HPLC is a sensitive, specific, and efficient method for antidiabetic drug analysis. Preparation techniques such as protein precipitation and solid-phase extraction provide optimal results in minimizing biological matrix interferences. In addition, the Photodiode Array (PDA) detector proved superior in terms of sensitivity and analyzability at low concentrations compared to other detectors. By fulfilling all validation parameters, HPLC can be relied upon as a primary method for the analysis of antidiabetic drugs in biological matrices.
Antibacteria Susceptibility Test of Garlic (Allium sativum L.) Against Enterococcus faecalis As Root Canal Medicament
This study aims to investigate the effect of garlic extract (GE) on the inhibition of Enterococcus faecalis (EF) bacterial growth. This study is a laboratory experimental research with a true experimental post-test only control group design, conducted in vitro using the well diffusion method. The experimental group consists of EF bacteria treated with different concentrations of GE, while the control group consists of EF bacteria treated with 0.2% chlorhexidine (CHX) as the positive control (PC) and 10% dimethyl sulfoxide (DMSO) as the negative control (NC). This study aims to observe the inhibition zone diameter (IZD) of bacterial growth after treatment with different concentrations of GE or control agents, measured in millimeters using a caliper. Phytochemical test revealed that the GE used in this study contains secondary metabolite compounds such as phenolics, flavonoids, saponins, and steroids, resulting in an IZD of 5.85 ± 0.26 at 100% GE and 3.25 ± 0.27 at 75% GE. The IZD formed on PC was 17.34 ± 0.33, and no IZD was formed on 50% GE or NC. The effect of GE in inhibiting the growth of EF was observed by the presence of inhibition zones at 100% and 75% concentrations, although it was not yet able to match the effectiveness of 0.2% CHX.
The Role of the Four Pillars in Heart Failure with Reduced Ejection Fraction (HFrEF) and Heart Failure with Preserved Ejection Fraction (HFpEF): How Different?
Heart failure (HF) remains a major clinical challenge, with two main phenotypes: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). These conditions exhibit distinct pathophysiology, clinical manifestations, and therapeutic responses, requiring distinct management approaches. The four pillars of HFrEF therapy—renin-angiotensin system (RAS) inhibitors, β-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors—have been shown to reduce mortality and morbidity. In contrast, HFpEF management focuses more on risk factor control and symptom-based therapy, with SGLT2 inhibitors being the only treatment that has shown significant clinical benefit. This literature review aims to evaluate the different roles of the four pillars of therapy in both phenotypes of heart failure and their implications for clinical practice. Although HFrEF treatment has made significant progress with strong clinical trial evidence, HFpEF management still requires further exploration to identify more effective strategies. Therefore, a deeper understanding of each phenotype's pathophysiology and therapeutic response is essential to improve patient outcomes and optimize heart failure management.
Effectiveness of the Nutrition Education Program in Increasing Awareness of Balanced Eating Patterns in Elementary Schools
The increasing prevalence of malnutrition and diet-related health issues among children emphasizes the urgent need for effective nutrition education. This study evaluates the effectiveness of a tailored nutrition education program in increasing awareness of balanced eating patterns among elementary school students in Indonesia. Using a qualitative research design, data were collected through semi-structured interviews, focus group discussions, and observations involving 20 students and their teachers. The findings reveal significant improvements in students' knowledge and attitudes toward balanced eating, highlighting the effectiveness of interactive learning methods and culturally relevant content. Parental involvement emerged as a critical factor in reinforcing the program's lessons. Challenges such as financial constraints and varying levels of parental support were noted, suggesting the need for community-level interventions. The results align with social cognitive theory, emphasizing observational learning and environmental influences. This study underscores the importance of integrating nutrition education into school curriculums and provides a replicable model for similar interventions. Future research should explore the long-term impacts and scalability of such programs.
Copyright (c) 2024 Al Makki Health Informatics Journal
Analysis of Reproductive Health Education Program for Adolescents in Secondary Schools
Reproductive health education in secondary schools is very important considering the increasing rate of teenage pregnancy and the low knowledge of reproductive health among adolescents. This study aims to explore the effectiveness of reproductive health education programs implemented in these schools. This study aims to identify the materials taught, teaching methods used, as well as students' responses and perceptions of the reproductive health education program. The methods used in this study include in-depth interviews and focus group discussions (FGDs) with 60 students from three secondary schools in X city. Data were collected over two months and analyzed to find relevant patterns and themes. Findings showed that the education program improved students' knowledge of reproductive health, but there were challenges such as social stigma and variations in the quality of teaching. Students reported increased confidence and better understanding of reproductive health topics. Reproductive health education programs in secondary schools have significant potential to improve adolescent understanding, but improvements in materials, teaching methods, and social environmental support are needed to achieve optimal results.
Harnessing Artificial Intelligence in Generic Formulation Development and Life Cycle Management - A Comprehensive Review
Artificial intelligence (AI) is revolutionizing the pharmaceutical industry by enhancing efficiency, precision, and cost-effectiveness in drug development. This study explores the application of AI in the lifecycle management of generic drugs, focusing on key stages such as active pharmaceutical ingredient (API) synthesis, excipient selection, pre-formulation studies, bioequivalence testing, and regulatory compliance. By leveraging machine learning algorithms, AI facilitates predictive modeling, risk assessment, and optimization of drug formulation processes, reducing time-to-market and improving scalability. Despite significant advancements, challenges such as data quality, algorithm transparency, and infrastructure limitations persist, particularly in resource-constrained settings. This review highlights case studies and emerging technologies that address these challenges, providing actionable insights for pharmaceutical stakeholders. The study also discusses AI's potential to streamline supply chain logistics, enhance accessibility, and ensure regulatory adherence. By integrating AI across all stages of generic drug development, this research underscores its transformative potential in improving drug affordability, accessibility, and patient outcomes globally.