Lombok Medical Journal (LMJ) is scientific, peer-reviewed, and open access journal published by Faculty of Medicine, Universitas Mataram, West Nusa Tenggara, Indonesia.
Faculty of Medicine, Universitas Mataram
Insiden Pneumotoraks setelah Prosedur Intervensi Paru: Systematic Review
Diagnostic management of peripheral lung lesions and diffuse lung parenchymal disease faces major challenges in balancing diagnostic accuracy with the risk of complications. Pneumothorax is the most frequently reported iatrogenic complication and can increase morbidity, the need for emergency intervention, and patient length of hospital stay. This study aims to systematically evaluate the incidence of pneumothorax and the requirement for thoracic drainage in various lung intervention methods to provide safety-focused procedural selection guidance. This systematic review was prepared following PRISMA guidelines with a comprehensive literature search on PubMed, Cochrane Library, and Frontiers databases. Analysis revealed significant risk variation between intervention methods. CT-guided percutaneous transthoracic lung biopsy (CT-PTLB) procedures showed the highest risk, with pneumothorax rates reaching 25.9% and chest tube requirements at 6.9%. Conversely, transbronchial techniques offer a better safety profile, where conventional transbronchial lung biopsy has a pneumothorax incidence of 1-6%, r-EBUS approximately 1.4-5.0%, and transbronchial cryobiopsy between 6-10%. Risk factors such as emphysema, lesion depth >2 cm, and the use of larger needle sizes (18G) were identified as strong predictors of pneumothorax. Selection of the appropriate technique and patient positioning (biopsy-side down) are highly recommended to minimize complications while maintaining patient safety.
Copyright (c) 2026 Lombok Medical Journal
Peran Tim Multidisiplin dalam Penatalaksanaan Limfoma Non-Hodkin Stadium IV yang Kompleks: Laporan Kasus
Abstract : The management of advanced stage non-Hodgkin lymphoma is increasingly complex due to rapid advances in diagnostic and therapeutic modalities and the involvement of multiple medical disciplines. A multidisciplinary team (MDT) approach is widely recognized as the gold standard in cancer care, enabling coordinated, evidence-based, and patient-centered decision-making. This case report describes the role of MDT in the management of a 57-year-old woman with stage IV diffuse large B-cell lymphoma complicated by multisystem involvement. Through structured MDT discussions, optimal multimodal therapy was delivered, clinical complications were effectively managed, and significant clinical improvement was achieved within a relatively short hospitalization period, despite limited healthcare resources. This case highlights that the MDT approach is feasible and beneficial in resource-limited healthcare settings. Abstrak: Penatalaksanaan kanker, khususnya limfoma non-Hodgkin stadium lanjut, semakin kompleks seiring dengan perkembangan pesat modalitas diagnostik dan terapi serta keterlibatan berbagai disiplin medis. Pendekatan tim multidisiplin (multidisciplinary team / MDT) telah diakui sebagai standar emas dalam perawatan kanker karena memungkinkan pengambilan keputusan klinis yang terkoordinasi, berbasis bukti, dan berorientasi pada pasien. Laporan kasus ini menggambarkan peran MDT dalam penatalaksanaan seorang pasien perempuan usia 57 tahun dengan diffuse large B-cell lymphoma stadium IV yang disertai komplikasi multisistem. Melalui diskusi MDT yang terstruktur, pasien mendapatkan terapi multimodal yang optimal, komplikasi klinis dapat ditangani secara efektif, dan perbaikan klinis tercapai dalam waktu rawat inap yang relatif singkat meskipun berada pada fasilitas pelayanan kesehatan dengan keterbatasan sumber daya. Laporan kasus ini menegaskan bahwa pendekatan MDT tetap feasible dan bermanfaat dalam meningkatkan kualitas perawatan kanker di rumah sakit daerah.
Krisis Penyakit Tidak Menular pada Usia Muda: Dari Faktor Risiko ke Strategi Pencegahan
Non-communicable diseases (NCDs) are increasingly burdening the productive-age population, indicating an epidemiological shift toward an earlier onset of chronic diseases. Both global and national levels, hypertension and diabetes show high trends among younger age groups, including at the regional level. This situation is driven by the accumulation of risk factors in adolescence, such as physical inactivity, unhealthy diets, sedentary behavior, smoking, and psychosocial stress, reflecting the multidimensional nature of NCDs. Therefore, prevention must be implemented comprehensively from adolescence through lifestyle interventions, supportive social environments, public policies that promote healthy behaviors, and active youth participation. The integration of mental health into primary care is also essential to strengthen long-term NCD control
Faktor-faktor yang Berhubungan dengan Kelengkapan Imunisasi Dasar Pada Anak Usia 9-24 Bulan di Wilayah Kerja Puskesmas Jatibaru Kota Bima
Latar Belakang: Imunisasi dasar merupakan upaya penting dalam pencegahan penyakit yang dapat dicegah dengan imunisasi (PD3I) pada anak. Meskipun program imunisasi rutin telah dilaksanakan secara nasional, cakupan imunisasi dasar lengkap di Indonesia masih belum mencapai target. Oleh karena itu, diperlukan kajian mengenai faktor-faktor yang memengaruhi kelengkapan imunisasi dasar pada anak. Tujuan: Mengetahui faktor-faktor yang berhubungan dengan kelengkapan imunisasi dasar pada anak usia 9–24 bulan di wilayah kerja Puskesmas Jatibaru, Kota Bima. Metode: Penelitian ini merupakan studi analitik observasional yang dilaksanakan pada September–Oktober 2024. Sebanyak 46 anak usia 9–24 bulan dilibatkan sebagai subjek penelitian. Data dikumpulkan melalui kuesioner kepada ibu serta verifikasi buku KIA dan catatan imunisasi Puskesmas. Variabel yang dianalisis meliputi tingkat pendidikan ibu, tingkat pengetahuan ibu, status pekerjaan ibu, pendapatan keluarga, jumlah anak dalam keluarga, keterjangkauan tempat imunisasi, cara menuju tempat imunisasi, dan dukungan keluarga. Analisis data dilakukan menggunakan SPSS versi 26.0. Hasil: Hasil analisis menunjukkan adanya hubungan yang bermakna antara tingkat pengetahuan ibu (p=0,036), status pekerjaan ibu (p=0,032), dan tingkat pendapatan keluarga (p=0,044) dengan kelengkapan imunisasi dasar pada anak. Variabel lainnya tidak menunjukkan hubungan yang signifikan secara statistik. Kesimpulan: Tingkat pengetahuan ibu, status pekerjaan ibu, dan pendapatan keluarga merupakan faktor yang berhubungan dengan kelengkapan imunisasi dasar pada anak usia 9–24 bulan. Peningkatan edukasi imunisasi secara berkelanjutan diperlukan untuk mendukung pencapaian cakupan imunisasi dasar lengkap
Cedera Paru pada Near Drowning : Patofisiologi dan Penatalaksanaan
Near drowning is a major cause of respiratory emergencies and can lead to significant pulmonary complications. Aspiration of water disrupts normal lung function, resulting in hypoxemia, surfactant washout, alveolar collapse, and in severe cases, acute lung injury or ARDS. The extent of injury is influenced by several factors, including the amount of aspirated water, contamination with pathogens, and the victim’s physiological condition at the time of submersion. Both freshwater and seawater aspiration can produce similar clinical consequences, ultimately impairing gas exchange and triggering an inflammatory response in the lungs. Early assessment and management are crucial to prevent deterioration. Key evaluations include monitoring oxygen saturation, arterial blood gases, chest radiography, and continuous clinical observation to detect early signs of respiratory compromise. Management focuses on maintaining adequate oxygenation, preventing further heat loss, and addressing complications such as pulmonary edema or infection. The use of positive end-expiratory pressure (PEEP) may be required in patients who develop significant hypoxemia. Near drowning victims who remain asymptomatic after four to six hours of observation generally have a good prognosis, while those with aspiration require close monitoring due to the risk of delayed respiratory failure.
Acute Kidney Injury in 43 Years Old Male Patient Caused by Severe Leptospirosis
Leptospirosis is a zoonotic infectious disease commonly found in tropical regions, caused by Leptospira interrogans, a pathogenic spirochete. The main reservoir is rodents, especially rats. Human transmission occurs either directly through inoculation from infected animal tissues, body fluids and urine, or indirectly through contact via mucosal surfaces or abraded skin. The excretion of organisms through the urine of infected animals represents the most common source of Leptospira infection. As of mid-2024, 367 cases of leptospirosis with 42 deaths had been reported in Indonesia. However, the true incidence is likely underreported due to diagnostic challenges. In West Nusa Tenggara (NTB), no formal report exists; however, a data from Mataram City Hospital between 2013-2025 recorded three cases of leptospirosis involving renal impairment requiring hemodialysis (HD). The clinical course of leptospirosis is typically acute, following an incubation period of five to fourteen days. Most patients present with mild, anicteric febrile, but a smaller subset develop severe multiorgan involvement known as Weil’s Disease. The severe form is characterized by acute high-grade fever, acute kidney injury, hepatic failure, pulmonary involvement, cardiovascular instability, neurological deficits, and hemorrhagic diathesis.
Rasio Neutrofil - Limfosit sebagai Prediktor Hasil Klinis pada Pasien dengan PPOK Eksaserbasi Akut: Tinjauan Literatur
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease characterized by chronic respiratory symptoms that cause progressive and persistent airflow obstruction. Numerous inflammatory markers can be used to assess the inflammatory state in COPD patients. Neutrophil-to-Lymphocyte Ratio (NLR) is an inflammatory marker that is easy and practical to examine, which is included in a complete blood count (CBC). We conducted a narrative literature review using a thematic synthesis approach on 12 articles. Five articles demonstrated that the NLR is a good predictor of mortality or death in hospitalized patients with COPD. Two articles stated that a higher NLR in COPD patients increases the likelihood of requiring intensive care (ICU), while the other five articles explained that the NLR can be a good predictor of exacerbations in COPD patients.
Paparan Timbal dan Stres Oksidatif: Dampak Klinis dan Mekanismenya
Lead (Pb) exposure is a significant global environmental health concern, as this heavy metal lacks physiological function in the human body and is toxic, leading to various health disorders. One of the primary mechanisms of lead toxicity is the induction of oxidative stress, defined as an imbalance between the production of reactive oxygen species (ROS) and the capacity of endogenous antioxidant systems to neutralize them. Lead enhances ROS generation through mitochondrial dysfunction and reduces the activity of critical antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT), resulting in oxidative damage to lipids, proteins, and DNA, which subsequently triggers cellular and tissue dysfunction. The clinical consequences of lead-induced oxidative stress are observed across multiple organ systems, including the nervous system (cognitive impairment, memory loss, neuropathy), kidneys (nephropathy, decreased filtration function), liver (hepatotoxicity, metabolic disturbances), and the hematopoietic system (anemia, blood cell dysfunction). This literature review indicates that lead exposure induces cellular and tissue damage through multiple cellular pathways related to oxidative stress, elucidating the fundamental mechanisms by which lead causes clinical disorders in these organs. In conclusion, understanding these cellular mechanisms provides a scientific basis for linking lead exposure to the development of multi-organ diseases.
Optimalisasi Nanopartikel Lipid Eksopolisakarida Termodifikasi Asam Folat untuk Penghantaran Trastuzumab Biosimilar Target HER2 pada Kanker Payudara
Breast cancer remains a leading cause of cancer-related mortality, with HER2-positive subtypes accounting for 20-30% of cases. While trastuzumab has revolutionized treatment, its efficacy is limited by poor tumor penetration, systemic toxicity, and high costs. This literature review explores folic acid-modified exopolysaccharide lipid nanoparticles (FA-EPS-LNPs) as a novel delivery system for trastuzumab biosimilar. Exopolysaccharides offer biocompatibility and biodegradability, while lipid nanoparticles protect therapeutic proteins and enhance cellular uptake. Folic acid conjugation enables dual targeting through folate receptors overexpressed in cancer cells and HER2-specific activity. The review examines physicochemical properties, optimization parameters including particle size, surface charge, encapsulation efficiency, and folic acid conjugation methods. Evidence demonstrates enhanced cellular uptake, improved cytotoxicity, reduced off-target effects, and superior pharmacokinetics compared to conventional formulations. Challenges include scale-up manufacturing, stability, immunogenicity, and regulatory considerations. This review identifies knowledge gaps and highlights FA-EPS-LNPs' potential to improve treatment outcomes, reduce costs, and enhance patient quality of life in HER2-positive breast cancer therapy.
The Role of Galactose-induced Oxidative Stress on Cellular Aging: A Literature Review
Aging is a complex process impacted by both internal and external causes. Nutrition is a crucial extrinsic factor in the development of aging and degenerative disorders. D-galactose is involved in many aging mechanisms in the brain, heart, liver, kidney, and skin. Galactose-induced cellular aging is primarily caused by oxidative stress and a reduced antioxidant system. Overproduction of ROS can damage proteins, lipids, and DNA. The recommended daily dietary limit for D-galactose is 50 grams for healthy people who can completely remove it within 8 hours. An in vivo study revealed that consuming 150 mg/kg/day of galactose led to metabolic issues, heightened blood pressure, and disrupted cardiac sympathovagal balance. These outcomes resulted from compromised cardiac mitochondrial activity, elevated oxidative stress, inflammation, and mitochondrial dysfunction, which caused cell death and eventually cardiac failure. A diet high in carbohydrates, particularly those derived from dairy products and their derivatives, can lead to the accumulation of galactose and its metabolites within cells. This buildup subsequently increases reactive oxygen species and reduces antioxidant capacity, resulting in mitochondrial dysfunction and heightened oxidative and osmotic stress. The culmination of these processes is a decline in cellular function, senescence, and accelerated organ aging.
Paradoxical Reactions in Tuberculous Meningitis : Clinical Insight and Management, a Literature Review
Tuberculous meningitis (TBM) is a type of TB with the most severe clinical symptoms of extrapulmonary tuberculosis, with high mortality and neurological morbidity rates. Paradoxical reactions are clinical symptoms characterized by the worsening of existing tuberculosis lesions or the emergence of new lesions despite receiving appropriate antituberculosis therapy (ATT), often leading to diagnostic confusion and management challenges for patients. This study aims to explain the definition, epidemiology, mechanism, clinical manifestations, diagnosis, and management of PR in TBM, based on various literature reviews. The main findings show that PR is triggered by complex immune mechanisms, often involving an excessive inflammatory response to mycobacterial antigens and known as Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV patients. PR presents with varying clinical symptoms, including fever, headache, impaired consciousness, as well as hydrocephalus and tuberculoma on radiological examination. Therefore, clear clinical guidelines are needed to optimize the diagnosis and management of PR in TBM. Keywords: Tuberculous meningitis, paradoxical reaction, IRIS
Copyright (c) 2025 Lombok Medical Journal
Analisis Faktor yang Berhubungan dengan Kejadian Seksio Sesarea Berulang di Rumah Sakit Umum Daerah Kota Kendari Periode 2023-2024
Cesarean section (CS) deliveries have increased globally to 30% and reached 25.9% in Indonesia. Kendari City Regional Hospital shows a higher rate of 37.5%, exceeding the WHO recommendation of 30%. This increase is associated with rising risks of morbidity and mortality in both mothers and babies. One of the main contributors is repeat cesarean sections, which account for more than one-third of all cesarean deliveries globally. Repeat cesarean sections carry higher risks of intraoperative complications and uterine rupture, making this group a high-risk category that requires special attention in efforts to reduce maternal and perinatal morbidity and mortality rates. Method. This was an analytical observational study using a cross-sectional design based on medical record data. The study population included all mothers who delivered via cesarean section at the Regional General Hospital of Kendari during 2023–2024. A total of 245 samples were selected using purposive sampling. Data were analyzed using the chi-square test, with a significance level set at > 0.05. Results. The study found 148 cases (60.4%) were repeat cesarean sections and 97 cases (39.6%) were primary cesarean sections. The analysis showed significant associations between maternal age (p=0.000) and PROM (p=0.000) with repeat CS. There was no significant association between cervical dilatation (p=0.172) and repeat CS. Conclusion. This study demonstrates significant associations between maternal age and premature rupture of membranes with the incidence of repeat cesarean section at Kendari General Hospital during 2023–2024.
Wa Ode Nurhiqmah Basri Wa Ode Nurhiqmah Basri
Oral Cancer and Reconstruction: A Serial Case Report
Introduction : The head and neck cancer are sixth most common cancers worldwide with cancer of oral cavity. The basic treatment modality for the carcinoma of oral cavity has been surgery and the large defects resulting from the ablation of the tumors require reconstruction. Reconstruction after wide excision of oral cancer challenge in itself, because it requires an appropriate method of reconstruction, in accordance with oncology rules and while maintaining the function . In this case serial, several methods of reconstruction from oral cancer are discussed. Case Report : We report 3 cases of patients female aged 48-71 years with complaints of lumps on the tongue. Patients with risk factors poor oral hygiene. On physical examination, cervical lymph node enlargement was found at levels I-IV. All patients underwent a CT scan of the head and neck. On histopathological examination, squamous cell carcinoma was found, the stage of oral cancer in this case series was stage I-III. The surgery was performed with a combined mandibular and neck dissection operation (Commando) with LD flap, and SCM flap. The patient is then treated in the intensive care unit for 1-2 days, then treated in the usual room and discharged on the 5-7th day of treatment without complications Discussion : Although there is increasing use of microvascular free flap in this era, however, conventional flap like LD and SCM still remains very reliable and versatile myocutaneous flap for primary as well as secondary reconstruction, In head and neck reconstruction, LD and SCM flap is used extensively due to its proven reliability and multipurpose nature . The main advantage of LD and SCM flap is that it can be used in a very wide range of defects in the head and neck region including the maxilla, neck as well as tempero-orbital area. Like the other myocutaneous flap, LD and SCM is harvested by single stage reconstructive procedure and does not require any flap delay or release. The morbidity of the donor site is surprisingly low, however, few patients may complain pain. It is also very useful in the patients with poor clinical conditions as well as for elderly patients. This flap can be used in the cases where there is inadequate recipient vessels for microanastomosis in the neck of the patients who underwent high dose radiotherapy or when there is contraindication to free flap such as medical conditions that make the patients unable to tolerate long surgical procedures or can be used as a salvage procedure after necrosis of free flap. wound dehiscence, infection, vascular rapture with marked increase in the morbidity. There is less mentioning of the incidence of recurrence at flap harvesting site however, few cases are reported in the literature. Conclusion : Reconstruction of composite oro mandibular defects of oral malignancy is a challenging problem for oncology surgeons. LD and SCM myocutaneous flap was found to be a versatile flap for reconstruction of large defects in the head and neck region with minimal complication rate. In today’s world of micro vascular flaps, in spite of associated complications, loco regional flaps play a crucial role at oncology centers. LD and SCM offer a faster, easier and reliable option for reconstruction in post-ablative head and neck surgery.
Diagnosis dan Tatalaksana Postherpetic Neuralgia
Postherpetic Neuralgia (PHN) is a chronic pain condition that occurs after the resolution of Herpes zoster, significantly affecting patients’ quality of life. PHN is characterized by spontaneous pain, hyperalgesia, allodynia, and paresthesia. Major risk factors include advanced age, severity of rash, and ophthalmic involvement. The pathophysiology involves reactivation of the varicella-zoster virus (VZV), leading to nerve inflammation and peripheral sensitization. Management of PHN includes analgesics, antiepileptic drugs (pregabalin, gabapentin), antidepressants, and topical therapies such as capsaicin and lidocaine. Prevention can be achieved through zoster vaccination. Combination therapy is often required to optimize treatment outcomes in PHN.
Mengenal Human Metha Pneumo Virus (HMPV) yang merebak di beberapa Negara
Abstract Human Meta Pneumo Virus (HMPV) is a single strain virus identifies as a cause of upper airway infection. Recently, several new cases reported in some countries, including Indonesia. After the virus infected the epithelial cell, it will replicated exponentially and spreading to adjacent cells. As a result, it will break the tissue and lead to inflammation. In patient with immunocompromised, HMPV infection will continued to pneumonia and other serious complication. Therefore, it is necessary to inform this virus characteristics to the health care professionals to allow them can tackle the disease accurately. Finally, it could limiting the potency of the occurrence of epidemic in population.
Klasifikasi dan Faktor Risiko Ruptur Aneurisma Intrakranial; Sebuah Tinjauan Pustaka
Abstract: Intracranial aneurysms are cerebrovascular abnormalities resulting from structural weakness in the arterial wall, which may rupture and lead to aneurysmal subarachnoid hemorrhage (aSAH), a condition associated with high morbidity and mortality rates. The formation of aneurysms is a multifactorial process that culminates in degenerative changes within the vessel wall. Aneurysms are classified based on morphology (saccular, fusiform, dissecting), size (ranging from small to giant), and anatomical location. The mechanism underlying aneurysm rupture can be explained by the concept of wall shear stress (WSS) in cerebral vessels. Other critical risk factors for aneurysm rupture include aneurysm size and location. A thorough understanding of the classification and risk factors for aneurysm rupture is essential to improve preventive management strategies in clinical practice.
Analisis Kelayakan Integrasi Otopsi Virtual dalam Sistem Visum et Repertum di Indonesia: Perspektif Medis, Yuridis, dan Teknologis
Otopsi virtual (virtopsi) menawarkan alternatif non-invasif untuk otopsi konvensional dengan memanfaatkan teknik pencitraan radiologi. Integrasinya ke dalam sistem visum et repertum Indonesia, yang berfungsi sebagai kerangka pelaporan mediko-hukum utama, menjanjikan tetapi tertantang oleh keterbatasan hukum, pendidikan, dan infrastruktur. Makalah ini mengulas kelayakan dan prospektus penerapan virtopsi di Indonesia dari empat perspektif—medis, hukum, pendidikan, dan teknologi—yang didukung oleh studi kasus internasional. Penelitian ini mengkaji integrasi virtopsi ke dalam pendidikan kedokteran dan praktik forensik, menganalisis kelayakan, manfaat, dan kendalanya dalam konteks mediko-hukum Indonesia. Penulis berpendapat bahwa meskipun virtopsi, yang memanfaatkan teknik pencitraan canggih seperti CT dan MRI, menawarkan alternatif minimal invasif dan meningkatkan presisi diagnostik dan penerimaan budaya, reformasi regulasi, program pelatihan, dan investasi dalam infrastruktur pencitraan sangat penting untuk keberhasilan penerapannya.
Additionally, the Author Examines the Management, Prognosis, and Complications Associated with RBBB.
Right Bundle Branch Block (RBBB) is an abnormality in the physiological electrical conduction system of the heart, resulting from a blockade of the right bundle branch. The global incidence of RBBB is estimated to be approximately 0.8% annually. Typically, RBBB is considered a mild finding that does not increase the risk in otherwise healthy individuals without structural heart disease. However, RBBB may also be indicative of myocardial disease and has been identified as a predictor of mortality in certain populations. This literature review aims to summarize the pathophysiology and clinical approach to RBBB, with a particular focus on echocardiography (ECG) examinations, based on literature sourced from PubMed, Google Scholar, and additional manual searches conducted between 2016 and 2021. Additionally, the author examines the management, prognosis, and complications associated with RBBB.
A Case Report Disfonia et causa Nodul Vocal Cords Bilateral
Dysphonia is a commonly used term for any voice disorder resulting from abnormalities in the organs of phonation, especially the larynx, whether organic or functional. Vocal cord nodules or often known as “singer's nodes”, “screamer's nodes” or “teacher's nodes” are one of the most common causes of dysphonia in children. It is known that vocal cord nodules are a condition where there is swelling of the bilateral vocal cords of varying sizes, which can generally be found in the center of the vocal cord membrane. These nodules are characterized by epithelial thickening with different levels of inflammatory reaction in the superficial layer of the lamina propia. In this case report will discusses abouta 49-year-old woman who came to the ENT clinic of the NTB Provincial Hospital with a chief complaint of hoarseness. Furthermore, from the anamnesis, physical examination and supporting examination, the patient was diagnosed with dysphonia ec bilateral vocal cord nodules.
Analisis Faktor yang Berhubungan dengan Cara Persalinan pada Ibu Hamil Usia Dini
Abstract: Adolescent pregnancy refers to pregnancy occurring in girls under the age of 20. This condition poses unique challenges due to the incomplete physical and psychological maturity of the adolescent. Determining the appropriate mode of delivery requires consideration of various factors, including maternal and fetal health, as well as patient preferences. This study aims to identify the factors influencing the mode of delivery among adolescent pregnancies. This research employed an observational analytic with a cross-sectional design. The study population included all adolescent pregnant individuals who delivered at RSAD dr. R. Ismoyo Kendari from 2022 to 2024. A total of 68 cases were examined using total sampling. Data collection was conducted through medical record reviews, and analysis was performed using Fisher’s Exact Test. The analysis revealed significant associations between age (p 0.015) and education level (p 0.028) with the mode of delivery among adolescent pregnancies. In contrast, place of residence (p 1.000) and occupation (p 1.000) showed no significant relationship with the mode of delivery. Age and education level are significant factors influencing the mode of delivery in adolescent pregnancies. However, place of residence and occupation do not appear to have a significant impact on the mode of delivery. Keywords: Adolescent, Mode of Delivery, Educational Level, Occupation, Place of Residence. Abstrak: Kehamilan usia dini merupakan kehamilan yang terjadi pada remaja putri berusia < 20 tahun. Kehamilan pada usia < 20 tahun dapat menimbulkan masalah, karena kondisi fisik dan psikis yang belum sepenuhnya berkembang. Setiap cara persalinan memiliki kelebihan, risiko, indikasi dan keputusan tentang cara yang akan digunakan biasanya bergantung pada kondisi medis ibu dan bayi serta preferensi pribadi. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan cara persalinan pada ibu hamil usia dini. Penelitian ini menggunakan analitik observasional dengan pendekatan cross-sectional. Populasi penelitian seluruh ibu hamil usia dini yang melakukan persalinan di RSAD TK. IV dr. R. Ismoyo Kendari tahun 2022-2024. Jumlah sampel kasus sebanyak 68 sampel dengan teknik total sampling. Data dikumpulkan melalui data rekam medik. Data dianalisis menggunakan uji Fisher’s Exact Test. Berdasarkan hasil penelitian terdapat hubungan antara usia (p 0,015) dan tingkat pendidikan (p 0,028) terhadap cara persalinan pada ibu hamil usia dini. Variabel tempat tinggal (p 1,000) dan pekerjaan (p 1,000) menunjukkan tidak terdapat hubungan terhadap cara persalinan pada ibu hamil usia dini. Simpulan dari penelitian ini yaitu faktor yang berhubungan dengan cara persalinan pada ibu hamil usia dini adalah usia dan tingkat pendidikan. Sedangkan tempat tinggal dan pekerjaan tidak berhubungan dengan cara persalinan pada ibu hamil usia dini. Kata kunci. Usia Dini, Cara Persalinan, Tingkat Pendidikan, Pekerjaan, Tempat Tinggal.
A Relationship Between Attitudes, Behaviors, and Knowledge of Preconception Nutrition Among Women Reproductive Age
Background. According to data from the Indonesian Ministry of Health in 2018, a significant proportion of women of reproductive age (15–24 years) in Indonesia experience nutritional deficiencies, particularly Chronic Energy Deficiency (CED), with prevalence rates of 36.3% among non-pregnant women and 33.5% among pregnant women. These findings highlight that non-pregnant women are at a higher risk of CED. This study aims to examine the relationship between attitudes and behaviors of women of reproductive age and their knowledge of preconception nutrition in Anduonohu Village. Method. This observational analytic study utilized a cross-sectional design and was conducted in Anduonohu Village. A total of 97 respondents were recruited using purposive sampling. The dependent variable in this study was knowledge of preconception nutrition, while the independent variables were attitudes and behaviors. Data were analyzed using chi-square tests and logistic regression, with a significance level set at p<0.05. Results.Bivariate analysis demonstrated a significant relationship between attitudes and knowledge of preconception nutrition (p=0.000) as well as between behaviors and knowledge of preconception nutrition (p=0.030). Multivariate analysis further confirmed a significant association between attitudes and behaviors of women of reproductive age and their knowledge of preconception nutrition (p=0.000). Conclusion. There is a significant relationship between the attitudes and behaviors of women of reproductive age and their knowledge of preconception nutrition in Anduonohu Village. Keywords: women of reproductive age, attitude, behavior, knowledge, preconception nutrition Latar Belakang. Berdasarkan data Kemenkes RI tahun 2018, di Indonesia masih banyak wanita usia subur usia 15-24 tahun yang mengalami masalah gizi seperti kekurangan energi kronis sebanyak 36,3% pada WUS tidak hamil dan 33,5% pada WUS hamil, dimana menurut data tersebut lebih banyak WUS yang tidak hamil mengalami kekurangan energi kronis. Penelitian ini bertujuan untuk mengetahui hubungan sikap dan perilaku wanita usia subur terhadap pengetahuan tentang gizi prakonsepsi di Wilayah Kelurahan Anduonohu. Metode. Penelitian ini dilakukan dengan metode analitik observasional dengan menggunakan pendekatan cross sectional yang dilakukan di Wilayah Kelurahan Anduonohu dengan jumlah sampel sebanyak 97 responden. Variabel terikat pada penelitian ini adalah pengetahuan dan variable bebasnya adalah sikap dan perilaku. Data dikumpulkan dengan teknik purposive sampling dan dianalisis menggunakan uji chi square dan regresi logistic ganda dengan nilai signifikan p<0,05. Hasil. Analisis bivariat penelitian menunjukkan bahwa terdapat hubungan yang signifikan antara variabel sikap terhadap pengetahuan dengan nilai p-Value sebesar 0,000 , hubungan yang signifikan antara perilaku terhadap dengan nilai p-Value sebesar 0,030. Pada analisis multivariat terdapat hubungan yang signifikan antara sikap dan perilaku wanita usia subur terhadap gizi prakonsepsi dengan nilai p value sebesar 0,000. Simpulan. Terdapat hubungan antara sikap dan perilaku wanita usia subur terhadap pengetahuan tentang gizi prakonsepsi di Wilayah Kelurahan Anduonohu. Kata kunci: : Wanita Usia Subur, Sikap, Perilaku, Pengetahuan, Gizi Prakonsepsi
A Description 0f the Level of Satisfaction of Family Planning (KB) Acceptors with Long-Term Contraceptive Method Services (MKJP))
Abstract. The increasingly discussed contraceptive method is the long-term contraceptive method, which offers safety, effectiveness, and comfort. However, the implementation of family planning services is still not optimal, as can be seen from the low participation in the MKJP. The prevalence of MKJP usage according to SDKI baseline data in 2019 is 21.39% while the 2024 RPJMN target is 28.39%. The thing that affects participation in participating in family planning is the satisfaction of the acceptor with the services of health facilities. This study was conducted to find out the overview of the level of satisfaction of family planning acceptors with MKJP services. This study uses a type of quantitative descriptive research. The number of samples in this study was 56 respondents of Women of Childbearing Age (WUS), data collection was obtained using questionnaires distributed to WUS who received MKJP family planning services at the Poasia Health Center, the data obtained will be analyzed using SPSS version 24 in the form of a frequency distribution table. The study's findings included satisfaction levels in the "very satisfied" category for the reliability dimension (83.2%), Assurance dimension (85.4%), Tangibles dimension (86.9%), empathy dimension (85.5%), and responsiveness dimension (85%). Overall, mothers who received MKJP family planning services at the Poasia Health Center felt "very satisfied" (85.4%) with the services provided by paying attention to the five dimensions of service quality (Reliability, Assurance, Tangibles, Emphaty, Responsiveness). Keywords. Satisfaction Level, KB Acceptors, MKJP Abstrak. Metode kontrasepsi yang semakin banyak dibahas adalah metode kontrasepsi jangka panjang, yang menawarkan keamanan, efektivitas, dan kenyamanan. Namun, pelaksanaan pelayanan KB masih belum optimal, terlihat dari rendahnya partisipasi dalam MKJP. Prevalensi penggunaan MKJP menurut data baseline SDKI tahun 2019 sebesar 21,39% sedangkan target RPJMN tahun 2024 sebesar 28,39%. Hal yang mempengaruhi partisipasi dalam mengikuti KB adalah kepuasan akseptor terhadap pelayanan fasilitas kesehatan. Penelitian ini dilakukan untuk mengetahui gambaran tingkat kepuasan akseptor KB terhadap layanan MKJP. Penelitian ini menggunakan jenis penelitian deskriptif kuantitatif. Jumlah sampel dalam penelitian ini sebanyak 56 responden Putri Usia Subur (WUS), pengumpulan data diperoleh dengan menggunakan kuesioner yang dibagikan kepada WUS yang mendapatkan layanan KK berencana MKJP di Puskesmas Poasia, data yang diperoleh akan dianalisis menggunakan SPSS versi 24 berupa tabel distribusi frekuensi. Temuan penelitian ini mencakup tingkat kepuasan dalam kategori "sangat puas" untuk dimensi keandalan (83,2%), dimensi Jaminan (85,4%), dimensi Tangibles (86,9%), dimensi empati (85,5%), dan dimensi responsif (85%). Secara keseluruhan, ibu-ibu yang mendapatkan pelayanan KB MKJP di Puskesmas Poasia merasa "sangat puas" (85,4%) dengan pelayanan yang diberikan dengan memperhatikan lima dimensi kualitas pelayanan (Reliability, Assurance, Tangibles, Emphaty, Responsiveness). Kata kunci. Tingkat Kepuasan, Akseptor KB, MKJP
Stroke Kardioemboli dan Faktor Risiko Atrial Fibrilasi ; Sebuah Tinjauan Pustaka
Abstract: Stroke merupakan manifestasi klinis akut akibat gangguan fungsi neurologis pada otak, medula spinalis, atau retina yang disebabkan oleh masalah pembuluh darah. Stroke iskemik, yang mencapai 80% dari semua kasus, sering dikaitkan dengan atrial fibrilasi (AF), suatu bentuk aritmia yang meningkatkan risiko stroke hingga lima kali lipat. AF menyebabkan stasis darah di atrium kiri, meningkatkan pembentukan trombus, yang dapat mengarah pada stroke emboli. Prevalensi AF meningkat dengan usia dan komorbiditas kardiovaskular, dan diperkirakan akan terus meningkat seiring bertambahnya usia harapan hidup. Diagnosis AF dilakukan dengan EKG, dan gejala stroke kardioemboli sering meliputi defisit neurologis mendadak. Pencegahan stroke pada pasien AF melibatkan pemberian antikoagulan berdasarkan stratifikasi risiko menggunakan skor CHA2DS2-VASc dan HAS-BLED. Penggunaan antikoagulan oral direkomendasikan untuk mengurangi risiko stroke pada pasien AF, namun dengan pengawasan untuk menghindari perdarahan.
Manifestasi Kelainan Kulit dan Penyakit Menular Seksual Pada Pasien HIV/AIDS di Poli VCT RSUD Provinsi NTB Periode Januari 2023 – Juni 2024
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) merupakan masalah besar yang mengancam penduduk di seluruh dunia. Sejak pertama kali di temukan di Indonesia pada tahun 1987 penyakit menular ini terus meningkat dengan jumlah kumulatif sampai dengan tahun 2022 sebanyak 1,3 juta kasus baru HIV dilaporkan di seluruh dunia dan terdapat 39.9 juta orang yang mengidap AIDS pada tahun 2023. Penularan HIV terjadi dalam berbagai cara, baik melalui hubungan seksual, penggunaan jarum suntik yang sama secara bergilir pada pengguna narkotika, transfusi komponen darah, hingga penularan dari ibu yang positif HIV kepada bayi yang dilahirkannya. Penelitian ini bertujuan untuk mengevaluasi manifestasi kelainan kulit dan penyakit menular seksual pada pasien HIV/AIDS di poli VCT RSUD Provinsi NTB selama periode Januari 2023 – Juni 2024. Penelitian deskriptif retrospektif ini menggunakan data rekam medis dari 321 pasien HIV/AIDS. Hasil menunjukkan bahwa kelompok umur 24-44 tahun (61,9%) dan jenis kelamin laki-laki (74,5%) mendominasi kasus HIV/AIDS. Kandidiasis oral menjadi kelainan kulit terbanyak (26,8%), diikuti oleh dermatitis (3,4%). Pada penyakit menular seksual, sifilis (4%) dan kondiloma akuminata (1,9%) merupakan kasus terbanyak. Infeksi oportunistik yang dominan adalah tuberkulosis (19,9%). Pemeriksaan CD4 dilakukan oleh 32,7% pasien, dengan sebagian besar memiliki CD4 <100 sel/µL. Penelitian ini menggarisbawahi tingginya prevalensi kelainan kulit dan penyakit menular seksual pada pasien HIV/AIDS, menunjukkan perlunya deteksi dini dan tata laksana komprehensif untuk meningkatkan kualitas hidup pasien. Keywords: HIV/AIDS, kelainan kulit, penyakit menular seksual, kandidiasis oral, sifilis
Spesies Merkuri dan Manifestasi Klinis yang Ditimbulkannya di Daerah Pesisir yang Terdampak Pertambangan Emas Skala Kecil
Gold mining that uses mercury in coastal areas exposes various mercury species to the environment and humans living in contaminated areas. The mercury species that reach the population in these areas include elemental mercury, inorganic mercury, and organic mercury. The mercury cycle from gold mining begins with the release of elemental and inorganic mercury into the sea. The bioaccumulation and biomagnification of organic mercury in the ocean will expose coastal populations to methylmercury. The exposure routes of mercury to humans from these different mercury species vary, including through the skin, respiratory system, and digestive system. Organ damage and clinical symptoms that appear depend on the affinity of the mercury species for specific organs. Symptoms of intoxication can range from central nervous system dysfunction, kidney damage, and a spectrum of disorders in other organs.
Tinjauan Pustaka Epilepsi: Prevalensi, Faktor Risiko, dan Komplikasi
Epilepsy is one of the neurological diseases with increasing prevalence worldwide. Due to various factors, distribution of epilepsy is often observed to be higher in men, in children and the elderly, and in low-middle income countries. As a disease with heterogeneous etiology, the incidence of epilepsy is influenced by several risk factors that collaborate in the pathophysiological pathway of the disease. Head trauma, birth defects, central nervous system infections, and neurodegenerative diseases are associated with the incidence of epilepsy. With many obstacles to epilepsy management, the disease remains one of the causes of high mortality related to neurological diseases, especially in uncontrolled epilepsy conditions in patients who do not receive adequate treatment. This literature review aims to summarize the distribution of epilepsy cases from various countries in the world, including the associated risk factors reported in the period 2010-2024 using manual searching on PubMed and Google Scholar. Furthermore, the author discusses complications and prognostic factors in patients to emphasize the importance of comprehensive treatment to achieve remission and prevent relapse in patients.
Hubungan antara Angka Kejadian Acute Kidney Injury dengan Infeksi Saluran Kemih di RSUD Provinsi NTB
Acute Kidney Injury (AKI) is a global health problem with high morbidity and mortality rates. The prevalence of AKI in hospitalized patients ranges from 2% to 5% increasing to 67% in intensive care units (ICU). A sudden decrease in kidney function characterizes acute kidney injury and is usually reversible, risk factors include pre-existing kidney disease, such as chronic kidney disease (CKD), and sepsis. The causes of AKI can be categorized into three groups: prerenal, which is caused by reduced blood flow to the kidneys; renal, associated with glomerular or tubular damage; and postrenal, which results from obstruction that disrupts the kidney's filtration system. Uncomplicated urinary tract infections (UTIs) are bacterial infections of the bladder and related structures, which occur frequently, especially in women. UTI can progress to sepsis. A systemic inflammatory response that can cause multi-organ dysfunction or failure, including AKI. Approximately 25% of sepsis cases originate from urogenital tract infections.
Pulmonary Tuberculosis with Pneumonia, Pneumoconiosis, and Drug Induced Liver Injury (DILI)
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. According to the World Health Organization (WHO), TB is one of the top 10 causes of death in the world. TB is divided into pulmonary TB and extrapulmonary TB. Extra-pulmonary TB is defined as TB involving organs other than the lungs (pleura, lymph nodes, abdomen, skin, joints, bones, and other organs). There were 10.4 million cases of TB globally in 2017, and it is estimated that there will be 845.000 new cases of pulmonary TB in Indonesia in 2019. In 2018 approximately seven million new and relapsed TB cases were reported worldwide. The death rate due to TB may reach 1.5 million cases. TB patients can develop several complications before, during or after treatment, including coughing up blood, pneumothorax, respiratory failure, and heart failure. TB patients may have several comorbidities, including pneumonia, pneumoconiosis, and drug induced liver injury (DILI).
Hyperthyroid Status with Glycemic Control in Patients with type 2 Diabetes Mellitus at Peripheral Hospital
By 2030, it is estimated that the number of patients with type 2 diabetes mellitus (T2DM) in Indonesia will increase from 8.4 million to 21.3 million. Thyroid dysfunction (TD) has an impact on the glycemic control of patients with T2DM. This case report explores a case of a T2DM patient, with hyperthyroidism and glycemic control in a peripheral hospital, including Pre Hospital, Intra Hospital, and Post Hospital status. In this case, a 25-year-old woman presented with typical thyroid symptoms accompanied by a significant increase in blood glucose, the patient was carried out strict glycemic control in the ward, although no treatment was carried out in the intensive care unit (ICU) due to limited facilities, but on the fourth day of treatment the patient's clinical condition improved and blood glucose level was controlled. In our report, in pre-, intra, and post-hospital, type 2 DM patients with hyperthyroid status, following glycemic control before, during, and after hospitalization, we found that routine blood glucose levels monitoring had a positive impact on the patient's clinical condition in these 3 time periods. Therefore, it is essential to screen for TD in T2DM patients as each of the high cardiovascular risks in patients with diabetes mellitus and thyroid.
Peran Insulin-like Growth Factor-1 (IGF-1) terhadap Penyakit Kardiovaskular
Insulin-like growth factor 1 (IGF-1) is a major regulator of somatic growth that mediates the effects of growth hormone (GH). IGF-1 receptors are expressed by three major cells involved in the pathogenesis of atherosclerosis, namely endothelial cells, macrophages, and smooth muscle cells. Recent in vivo studies have discussed the effects of IGF-1 on the pathogenesis of atherosclerosis. This paper will discuss the relationship and role of IGF-1 in heart and blood vessel disease.
Copyright (c) 2024 Lombok Medical Journal