Proceedings International Conference on Lifestyle Diseases and Natural Medicine (ICOLIFEMED)
Copyright (c) 2025 Proceedings International Conference on Lifestyle Diseases and Natural Medicine (ICOLIFEMED)
The Relationship Between Spirituality and Health Perception on the Quality of Life of Diabetes Mellitus Patients Undergoing Hemodialysis at RSUD Arifin Achmad, Riau Province
Uncontrolled diabetes mellitus can lead to serious complications, one of which is kidney failure requiring hemodialysis therapy. Patients undergoing hemodialysis often face significant challenges, both physically, mentally, and emotionally. Therefore, improving their quality of life becomes crucial. Factors such as spirituality and health perception play a significant role in influencing the quality of life of these patients. This study aims to analyze the effect of spirituality and health perception on the quality of life of diabetes mellitus patients undergoing hemodialysis. A quantitative method with a non-experimental approach was used on 156 respondents at RSUD Arifin Achmad, Riau Province. Data were collected through questionnaires and analyzed using Partial Least Squares (PLS). The results showed that spirituality and health perception have a positive and significant effect on patients' quality of life. Spirituality provides inner strength and meaning in life, while a positive perception of health condition increases patients’ motivation and confidence in managing their illness. The integration of spiritual care and education tailored to the culture and needs of patients is highly recommended to improve quality of life. This study provides an important basis for the development of holistic care for diabetes mellitus patients undergoing hemodialysis therapy.
Behavioural Changes in Blood Sugar Control and Dietary Patterns of Type 2 Diabetes Mellitus Patients Based on Animated Video Media
Type 2 Diabetes Mellitus is a global health problem that continues to increase, requiring proper management, including behavioural changes related to blood sugar control and dietary patterns. This study aims to evaluate the effect of animation-based media education on changes in blood sugar control behaviour and dietary patterns in patients with Type 2 Diabetes Mellitus. The research design used was a quasi-experimental study with a One Group Pretest-Posttest Design approach. The study sample consisted of 100 respondents selected using purposive sampling. Data were collected through questionnaire completion during the pretest and posttest. Data analysis was performed using the Wilcoxon Signed Rank Test. The results of the study showed a significant improvement in blood sugar control behaviour, from an average of 24.19 in the pretest to 33.55 in the posttest (Z = -7.692, p = 0.0001). Similarly, dietary patterns improved, with the average score increasing from 3.40 in the pretest to 6.59 in the posttest (Z = -7.123, p = 0.0001). These findings support the use of animated video media as an effective alternative educational tool in diabetes management, as well as the importance of technology-based education to enhance patient awareness and adherence to blood sugar control and healthy eating patterns.
Lifestyle as a Predictor of Diabetes Mellitus Incidence in Early Adulthood in Urban Areas: A Cross-Sectional Survey
Diabetes mellitus is an increasing health problem, especially in the early adult age group in urban areas. This study aims to analyse the relationship between lifestyle, namely stress levels, physical activity, sleep patterns, and smoking behaviour, with the incidence of Diabetes Mellitus in early adults in urban areas of Riau Province, as well as identifying the dominant factors that influence balanced diet adherence in people with diabetes. The research design used a cross-sectional quantitative method with a sample of 375 respondents selected by simple random sampling. Data were collected through a structured questionnaire and analysed using the chi-square test and multiple logistic regression. The results showed that severe stress level (p=0.012; OR=1.853), low physical activity (p=0.0001; OR=3.040), and poor sleep pattern (p=0.007; OR=1.863) were significantly associated with the incidence of Diabetes Mellitus, while smoking behaviour was not significantly associated (p=1.000; OR=0.978). Multivariate analysis revealed physical activity as the dominant factor (p=0.001; OR=3.961). These findings emphasise the importance of lifestyle management especially increased physical activity, stress control, and improved sleep patterns in the prevention and management of Diabetes Mellitus in early adulthood. It is recommended that public health programmes integrate education and holistic interventions based on a multidisciplinary approach.
Model of Determination of Cooperative Learning Techniques using AHP Method
Cooperative learning can accelerate knowledge transfer and social interaction between students. There are various cooperative learning techniques that can be used in the learning process. The determination of cooperative learning techniques needs to pay attention to the objectives to be achieved from the application of cooperative learning. In general, there are 5 goals to be achieved in cooperative learning, namely: Reward Interdependence, Task Interdependence, Individual Accountability, Teacher Imposed Structure, and Group Competition. Each cooperative learning technique will provide different results for each objective. Therefore, it is necessary to determine the weight of each goal properly so that later it can be considered which cooperative learning techniques can be used. One method that is very good in the process of determining the weight using a pairwise comparison matrix is ​​the Analytical Hierarchy Process (AHP). The reason for using the AHP method is that the expert sometimes finds it difficult to directly assess which goals of cooperative learning should be prioritized and it will be more comfortable to provide an assessment in the form of comparisons between existing goals. The purpose of this study is to propose a model for determining cooperative learning techniques using the AHP method. The novelty of this research is to produce a model that can assist universities in determining the cooperative learning model that best suits their conditions. The results showed that the existence of this model can help the process of determining the type of cooperative learning based on priority cooperative learning goals. The results showed that the Jigsaw II method is the best cooperative learning technique.
Effectiveness Of Lime Leaves (Citrus aurantifolia) as an Antibacterial For Cut Wound Infections Caused By Staphylococcus aureus In Male Wistar Rats
Skin infections caused by Staphylococcus aureus are a health problem that often hinders the wound healing process due to the bacteria's ability to form biofilms and resistance to antibiotics. The increasing cases of resistance require the development of alternative therapies based on natural ingredients. Lime peel (Citrus aurantifolia) contains flavonoids, saponins, tannins, alkaloids, and glycosides that have the potential to be antibacterial agents and wound-healing agents. This study aims to evaluate the antibacterial activity of an ethanol extract from lime peel against S. aureus and its effectiveness in accelerating the healing of infected wounds in vivo. Phytochemical screening showed positive results for flavonoids, saponins, tannins, alkaloids, and glycosides. Characterization tests showed a water content of 8.64%, a total ash content of 5.62%, and an ethanol-soluble extract content of 18.14%, in accordance with the Indonesian Herbal Pharmacopoeia standards. Antibacterial activity showed an increase in the diameter of the inhibition zone from 8.07 ± 0.05 mm at a concentration of 20% to 22.47 ± 0.05 mm at 100%, approaching the positive control ciprofloxacin (28.32 ± 0.12 mm). Statistical analysis using the Kruskal–Wallis test showed significant differences between groups (p < 0.05) with homogeneous data. Histopathologically, the extract group showed a lower number of fibroblasts (28.22 ± 0.72) and blood vessels (5.00 ± 4.80) compared to the negative control, as well as an increase in collagen density at a score of 2, indicating an optimal healing process. It was concluded that the ethanol extract of lime peel has antibacterial activity and accelerates the healing of wounds infected with S. aureus by increasing collagen formation and regulating the inflammatory response.
Clinicopathological Characteristics and Immunohistochemical Profile (CD20, CD3, CD45, CD30) of Lymphoma Patients at Royal Prima General Hospital Medan, 2023–2025
Lymphoma is a malignancy of the lymphoid system arising from the abnormal proliferation of lymphocytes. The diagnosis and classification of lymphoma require immunohistochemical (IHC) examination to determine the tumor cell immunophenotype, which plays a crucial role in definitive diagnosis and treatment planning. IHC is essential for distinguishing lymphomas into B-cell or T-cell types, low-grade or high-grade, and Hodgkin or non-Hodgkin categories—each differing in biological behavior and therapeutic approach. This study aimed to describe the clinicopathological characteristics and immunohistochemical (CD20, CD3, CD45, CD30) profiles of lymphoma patients treated at Royal Prima General Hospital Medan during 2023–2025. This retrospective descriptive study used medical record data and IHC examination results from 44 patients diagnosed with lymphoma at Royal Prima General Hospital Medan between 2023 and 2025. Collected data included age, sex, lymphoma site (nodal or extranodal), clinical manifestations, clinical diagnosis, cell origin, IHC findings, histopathological diagnosis, and IHC-based diagnosis. Data were analyzed descriptively and presented as frequency distributions and tables. Among 44 lymphoma patients analyzed, the majority were male (63.64%), with the most prevalent age group being 48–58 years (40.91%). The most frequent lymphoma site was nodal (61.36%), and the predominant clinical presentation was a neck mass (29.55%). IHC examination revealed that most cases originated from B-cells (88.64%) with positive CD20 expression, followed by T-cell cases (11.36%) with positive CD3 expression; CD30 positivity was observed in 75% of cases. The most frequent IHC diagnosis was non-Hodgkin lymphoma, favoring diffuse large B-cell lymphoma (DLBCL) (63.64%). The lymphoma profile at Royal Prima General Hospital Medan was dominated by B-cell non-Hodgkin lymphoma, particularly Diffuse Large B-Cell Lymphoma (DLBCL), consistent with global epidemiological patterns. These findings highlight the pivotal role of IHC examination in establishing a definitive diagnosis and guiding appropriate therapeutic strategies.
Potential of Curcuma xanthorrhiza Extract in Protecting Fibroblast Cells from UV-Induced Aging
The skin serves as the body's first line of defence against environmental exposures, making it vulnerable to tissue damage, especially skin aging, which is characterised by a decrease in integrity and structure. Extrinsic factors contribute significantly to skin aging, with UV exposure as the main contributor. In Indonesia, most women realise the signs of ageing in their mid-twenties. This study aimed to investigate the potential of Curcuma xanthorrhiza extract (CXE) as an anti-aging agent by examining its effects on UV-irradiated fibroblast cell viability, MMP-1 gene expression, and collagen content. Cell viability was measured using a cytotoxic assay, MMP-1 expression was measured by RT-PCR, and collagen content was evaluated by ELISA assay. The results showed that CXE significantly increased fibroblast cell viability, with safe concentrations of 12.5; 6.25; 3.13 µg/mL. In addition, CXE administration resulted in a significant decrease in MMP-1 expression and an increase in collagen content in aging cell model, with the best results observed at a concentration of 12.5 µg/mL. These findings suggest that CXE may serve as a natural antioxidant agent to reduce the adverse effects of UV exposure on skin aging, highlighting its potential applications in skin care and dermatological treatments.
EVALUATION OF PATIENT FLOW MANAGEMENT AT PRIMA DENTAL AND ORAL HOSPITAL: CLINICAL DENTAL STUDENTS’ PERCEPTIONS OF THE PATIENT FLOW MANAGEMENT SYSTEM USING THE TECHNOLOGY ACCEPTANCE MODEL (TAM)
Prima Dental and Oral Hospital (RSGM Prima), as an educational and service institution, has implemented a digital-based patient flow management system to support the clinical learning process for clinical dental students. However, the success of this system implementation does not rely solely on technical aspects, but also on user acceptance, particularly the clinical dental students as direct users. This study aims to analyze the influence of Perceived Usefulness (PU) and Perceived Ease of Use (PEOU) on Attitude Toward Using (ATU) and Behavioral Intention to Use (BIU) of the patient flow management system based on the perceptions of clinical dental students at Prima Dental and Oral Hospital (RSGM Prima). The method used was a mixed methods approach with both quantitative and qualitative approaches simultaneously. Quantitative data were obtained through the distribution of questionnaires to 77 clinical dental students, while qualitative data were collected through in-depth interviews with 6 purposively selected informants. The quantitative analysis results showed a significant relationship between PU and PEOU with ATU and BIU, each with a significance value of < 0.05. Pearson correlation analysis showed that PU had a strong correlation with ATU (r = 0.658) and BIU (r = 0.627), while PEOU also showed a significant relationship with ATU (r = 0.523) and BIU (r = 0.595). The interview results supported the quantitative findings, where informants stated that the system facilitated the implementation of clinical tasks, increased efficiency, and provided a positive user experience. This study concludes that perceptions of ease of use and usefulness of the system have an important influence on students’ attitudes and intentions to continuously use the patient flow management system.
The Effectiveness of Ethanol Extract of Terminalia catappa L. Leaves on Blood Glucose Levels and Pancreatic Histopathology in Streptozotocin-Induced Male Wistar Rats.
Diabetes mellitus is a condition in which the body experiences an increase in blood glucose levels but is unable to produce energy effectively. This condition is commonly known as hyperglycemia, which occurs due to impaired insulin secretion, decreased insulin sensitivity, or a combination of both. Uncontrolled hyperglycemia in patients can lead to serious damage to various body systems. In the pancreas, it may cause a reduction in both the number and size of the islets of Langerhans, particularly affecting the insulin-producing beta cells. This condition is characterized by a decrease in the cellular population within the islets of Langerhans compared to a normal pancreas, along with a reduction in the number of alpha, beta, and delta cells. Ketapang (Terminalia catappa L.) leaves contain antioxidant compounds known to act as free radical scavengers. These antioxidants help prevent conditions in which the number of free radicals in the body exceeds the body’s capacity to neutralize them, leading to oxidative stress. The main bioactive components found in Ketapang (Terminalia catappa L.) leaves include flavonoids, tannins, terpenoids, and saponins. Flavonoids, a class of polyphenolic compounds, are known for their pharmacological properties, particularly their antidiabetic activity. Based on this background, the present study aims to evaluate the effectiveness of the ethanol extract of Ketapang (Terminalia catappa L.) leaves on blood glucose levels and pancreatic histology in streptozotocin-induced male Wistar rats.
Determinants of Metabolic Syndrome in Asian Adults: A Scoping Review
This review shows that metabolic syndrome (MetS) develops from a combination of several factors that work together rather than from one single cause. The studies reviewed indicate that excess body weight, poor diet, lack of physical activity, and sedentary habits are the main contributors to MetS. People who follow balanced and traditional diets that include fruits, vegetables, and natural foods tend to have a lower risk. Meanwhile, modern eating habits and processed foods increase the likelihood of developing MetS. In addition, higher levels of inflammation and poor socioeconomic conditions also make individuals more vulnerable. These findings suggest that MetS prevention should focus on promoting healthy lifestyle changes through better nutrition, regular exercise, and early risk detection. Future programs and research need to integrate these factors and adapt them to local cultures to reduce the growing burden of MetS in the community.
The Effectiveness Of Moringa Extract Cream On Collagen Fiber Density In The Wound Healing Process After Incision In White Rats (Rattus Norvegicus)
Moringa (Moringa oleifera) leaf extract cream is believed to accelerate wound healing by enhancing collagen fiber density and compactness in skin tissue. This experimental study aimed to evaluate the effectiveness of Moringa oleifera leaf extract cream on collagen fiber density during the healing of incision wounds in white rats (Rattus norvegicus). Twenty-four male C57BL/6 strain rats were divided into four groups: control (placebo) and treatment groups receiving 5%, 10%, and 15% moringa extract cream. The cream was applied twice daily for 14 days. Wound tissues were then examined histopathologically using Masson’s Trichrome staining to assess collagen density. Macroscopic observations showed that the treatment groups, particularly the 15% concentration, exhibited faster wound closure compared to the control. Histologically, the treatment groups demonstrated higher collagen deposition and denser fiber organization. However, one-way ANOVA analysis (p = 0.791) indicated no statistically significant differences among groups. Despite the lack of significance, an increasing trend in collagen density was evident in the 10% and 15% treatment groups. These findings suggest that Moringa oleifera extract cream may promote wound healing and improve collagen formation, though further studies with larger samples and longer observation periods are needed to confirm its efficacy.
The Effect Of Hospital Information Management System Implementation, Digital Competence, And Administrative Burden On Work Efficiency
The work efficiency of hospital administrative staff still faces challenges in the form of suboptimal implementation of the Hospital Information Management System (HIMS), low digital competency, and high administrative burden, which impacts the smooth operation of healthcare services. This study aims to analyze the influence of HIMS, digital competency, and administrative burden on the work efficiency of administrative staff at Madani General Hospital, Medan, based on scientific management and digital innovation theories. This is a quantitative study using an associative approach, using a cross-sectional study. The study was conducted at Madani General Hospital, Medan. The population was all 135 employees, and a sample size of 112 was obtained. Sampling was conducted using purposive sampling. The data were analyzed univariate bivariate (Chi-Square test), and multivariate analysis using multiple logistic regression. The results showed that the work efficiency of administrative staff at Madani General Hospital, Medan, was significantly influenced by the implementation of HIMS (p=0.003), information and data literacy (p=0.013), digital communication and collaboration (p=0.013), time burden (p=0.003), and compliance burden (p=0.001). While digital content creation (p=0.073), digital security (p=0.311), digital problem-solving (p=0.111), and psychological burden (p=0.203) did not significantly influence work efficiency. HIMS implementation had the largest contribution to work efficiency with an OR of 10.632, and a simultaneous multiple logistic regression model showed significant variables explaining 72.11% of the variation in work efficiency, while 27.89% was influenced by other factors outside this study. Future research is recommended to include variables such as leadership, motivation, organizational culture, technological facilities, and work stress. A mixed methods or qualitative approach can also be used to explore employee experiences in using HIMS and strategies to improve work efficiency.
Effectiveness Of Combination Of Interferential Current (Ifc) Intervention And Core Stability Exercise In Reducing Pain And Improving Functionality In Patients With Non-Specific Lbp
Non-specific-low back pain (LBP) is a highly prevalent musculoskeletal disorder and a leading cause of global disability, characterized by pain, postural imbalance, and functional limitations. Interferential current (IFC) effectively reduces pain through medium-frequency electrical stimulation, while core-stability exercises enhance postural control and lumbopelvic stability. However, the effectiveness of combining IFC with core-stability compared with transcutaneous electrical nerve stimulation (TENS) plus core-stability has been rarely examined. This quasi-experimental pretest–posttest control-group study compared the two combinations in 100 patients aged 20–60 years with Non-specific-LBP, randomly allocated to IFC+core (n=50) or TENS+core (n=50). Interventions were delivered three times per week for two weeks. Pain intensity was measured with the Visual Analogue Scale (VAS) and function with the Oswestry Disability Index (ODI). Paired and independent t-tests were used (α=0.05). Both groups showed significant improvements on VAS and ODI; greater reductions in pain and disability occurred in the IFC+core group (p<0.05). These findings support integrating IFC with core-stability exercises in Non-specific-LBP rehabilitation.
The Effect of Basil Leaf Extract (Ocimum Bacilicum L) on Beta 2 Microglobulin Levels, Uric Acid and Kidney Histology in White Galuh Wistar Rats (Rattus Norvegicus Strain Wistar) Induced by Monosodium Glutamate (MSG)
In this research, the author aim to investigate the influence of basil leaf administration on Beta-2 microglobulin levels, uric acid concentration, and kidney histology in Wistar rats induced with MSG, as well as to determine the most effective dose of basil leaf extract for improving kidney function. Basil leaves (Ocimum basilicum) are known as one of the traditional medicinal plants commonly used for therapeutic purposes. A total of 25 male Wistar rats weighing 200–230 grams were used in this study. The animals were divided into five treatment groups. The first group served as the control and received neither MSG nor basil leaf extract. The second group was given only MSG without basil leaf extract. The third, fourth, and fifth groups were administered MSG followed by basil leaf extract at doses of 87.5 mg/kg BW, 175 mg/kg BW, and 350 mg/kg BW, respectively. At the end of the treatment period, blood samples were collected for the measurement of Beta-2 microglobulin and uric acid levels, while kidney tissues were taken for histological examination. The findings revealed that the administration of basil leaf extract led to significant differences in Beta-2 microglobulin, uric acid levels, and kidney histopathology compared to the MSG-only group. In conclusion, basil leaf extract was shown to lower B2M and uric acid levels and improve kidney tissue structure damaged by MSG exposure.
Comparison of Prolactin Levels in Women with Polycystic Ovary Syndrome (PCOS) and Women without PCOS in North Sumatra
Background: Polycystic Ovary Syndrome (PCOS) is one of the most frequent endocrine disorders affecting women of reproductive age, marked by persistent anovulation and elevated androgen levels. Prolactin, a hormone produced by the anterior pituitary gland, likewise plays a vital role in reproductive function. Elevated prolactin levels, or hyperprolactinemia, may disturb gonadotropin regulation, ovulation, and fertility. However, the relationship between PCOS and prolactin imbalance remains controversial. This study aimed to compare the serum prolactin levels of women with PCOS to those of women without PCOS in North Sumatra. Methods: A comparative analytic observational study was conducted involving 120 women aged 18–45 years, consisting of 60 women diagnosed with PCOS and 60 without PCOS, based on the 2003 Rotterdam criteria. Serum prolactin levels were determined using the enzyme-linked immunosorbent assay (ELISA) method. Statistical analyses were conducted using an independent t-test to compare prolactin levels and a Pearson correlation test to examine their association with age and body mass index (BMI). Results: The mean serum prolactin level was significantly higher in women with PCOS (3.99 ± 0.58 ng/mL) compared to non-PCOS women (3.41 ± 0.47 ng/mL; p < 0.001). No significant correlation was found between prolactin and age (p = 0.412) or BMI (p = 0.298). Conclusion: Prolactin levels were found to be significantly higher in women with PCOS than in those without PCOS in North Sumatra. Age and BMI did not influence prolactin concentrations, suggesting that prolactin elevation may result from intrinsic neuroendocrine factors in PCOS Routine evaluation of prolactin may help clinicians in the hormonal assessment and management of PCOS patients.
Muhammad Ernesto Azguevara Ganis Siregar
ANALYSIS OF HOSPITAL MANAGEMENT PERCEPTION TOWARDS DIFFERENCE BETWEEN REAL RATE OF HOSPITAL AND RATE OF INACBGS IN HEMODIALYSIS SERVICES: A STUDY QUALITATIVE AT PERTAMINA HOSPITAL PANGKALAN BRANDAN
This study analyzes the perception of hospital management at Pertamina Hospital Pangkalan Brandan regarding the discrepancy between actual hospital costs and INA-CBGs reimbursement rates for hemodialysis services. The research was prompted by concerns over the financial gap that may impact service sustainability and quality for chronic kidney disease patients. A qualitative case study approach was used, involving in-depth interviews with key informants such as the hospital director, head of finance, medical personnel, and administrative staff. Findings revealed a significant disparity between real costs—ranging from IDR 1,200,000 to IDR 1,600,000 per hemodialysis session—and INA-CBGs reimbursements of only IDR 850,000 to IDR 950,000. The largest cost components were medications, disposable medical equipment, and human resources. This discrepancy places operational burdens on the hospital, which are managed through efficiency measures and cross-subsidies. Informants emphasized that INA-CBGs tariffs do not adequately reflect the clinical complexity of patients, particularly those with comorbidities or frequent dialysis needs. The study recommends revising the INA-CBGs scheme by aligning reimbursement rates with clinical realities and involving hospitals in policy development. In conclusion, reforming the INA-CBGs tariff system is essential to maintaining the financial viability and quality of hemodialysis services in Indonesian hospitals.
Perspectives and Challenges of Integrating Public Health Education into the Medical Curriculum in Indonesia: An Administrative and Implementation Study in Public and Private Medical Faculties
The integration of Public Health Education (PKM) in medical curricula faces challenges related to curriculum alignment, implementation processes, and lecturer involvement across medical schools in Indonesia. This study analyzes policies and curriculum components supporting PKM integration, identifies key implementation factors, and evaluates its contribution to graduate competency. Using a descriptive qualitative approach, data were collected from 14 informants, including 10 lecturers from public and private medical faculties and 4 students or alumni. Findings indicate that both faculties have implemented PKM integration based on the Indonesian Doctor Competency Standards (SKDI) 2019, Ministerial Regulation No. 53/2023, and Indonesian Medical Council (KKI) guidelines. Public medical faculties apply a structured Community-Based Education (CBE) model, while private faculties use thematic learning and community service approaches. Supporting factors include leadership commitment, lecturer engagement, and institutional collaboration, while constraints involve limited time, resources, and lecturers with public health expertise. Overall, PKM integration enhances students’ communication, empathy, and social responsibility, contributing significantly to producing doctors who are promotive, preventive, and community-oriented.
Analysis Of The Relationship Between Customer Relationship Management And Inpatient Loyalty At Royal Prima Hospital Medan
The increasing competition among hospitals demands that every healthcare institution not only focuses on the quality of its services but also on its ability to build and maintain long-term relationships with patients. In this context, patient loyalty becomes a strategic indicator determining the hospital’s sustainability. However, challenges such as declining patient return rates, complaints about service quality, and limited use of information technology to support Customer Relationship Management (CRM) systems persist. Therefore, this study is essential for analyzing the factors influencing patient loyalty through the CRM approach, particularly from the perspectives of people (human resources), process (service processes), and technology (information technology). This study employed a quantitative method with a cross-sectional design. The sample consisted of 100 inpatient respondents selected through purposive sampling. Data were collected through questionnaires and analyzed using the Chi-Square test for bivariate analysis and multiple logistic regression for multivariate analysis. The results showed a significant relationship between the people (p = 0.000), process (p = 0.000), and technology (p = 0.000) factors and inpatient loyalty. The multivariate analysis revealed that the three factors simultaneously had a significant relationship with patient loyalty (p = 0.000), with the most dominant factor being people (human resources), as indicated by the highest t-value of 4.365. In conclusion, the better the quality of human resources, service processes, and information technology implemented in the hospital, the higher the level of inpatient loyalty. It is recommended that hospital management continuously improve healthcare workers' competencies through training, optimize service flow for greater efficiency, and enhance the use of information technology to support faster, more accurate services.
The Use of Benson Relaxation Therapy in Reducing Anxiety in Type II Diabetes Mellitus Patients at Royal Prima General Hospital, Medan: A Case Study
Diabetes mellitus has now become one of the leading causes of death worldwide. Lifestyle changes such as higher calorie intake, increased consumption of processed foods, and unhealthy lifestyles are factors that contribute to the increase in cases of diabetes mellitus. Diabetes mellitus is a chronic disease that patients will suffer from for the rest of their lives and can occur in both men and women. Patients will feel uncomfortable with the condition they are experiencing. Feelings of discomfort or vague concerns about the disease they are experiencing are accompanied by an autonomic response, a feeling of fear caused by anticipation of the dangers of diabetes mellitus. Method: This study is a descriptive study with a case study design using a nursing process approach. The sample size in this study was one case that was treated for three days. Data collection was conducted through interviews and observations as well as documentation of the actions taken for the patient. Results: The results of the evaluation are as follows: The patient reports decreased dizziness, blood glucose level of 200 mg/dl, level of consciousness: compos mentis, V:5 M:5 V:5 GCS: 11. Coordination has improved, consciousness has improved, drowsiness has decreased, dizziness has decreased, complaints of hunger have decreased. Blood glucose levels improved. On the third day, the evaluation results began to improve, and blood glucose levels had improved. Conclusion: Nursing management for patients with diabetes mellitus has been carried out comprehensively through the stages of assessment, diagnosis formulation, nursing plan, and nursing evaluation
Analysis Of Factors Influencing Switching Intention In Inpatient Services At Royal Prima Hospital Medan
RSU Royal Prima Medan, one of the private hospitals in the city of Medan, North Sumatra, which is the location for this research, has many competitors with other similar hospitals. This will affect the brand switching behavior of customers at RSU Royal Prima Medan, so RSU Royal Prima Medan tries to carry out various strategies to attract and retain customers and prevent the desire to switch to another hospital or what is usually called witching intention. The aim of this research is to analyze the factors that influence switching intention in inpatient services at RSU Royal Prima Medan. The research conducted by researchers used quantitative methods with cross sectional. In this study, the population used was 3,319 inpatients at RSU Royal Prima Medan in the last 3 months. The sample was determined using interpretive estimation with Structural Equation Modeling with a sample size of 210 patients. The data analysis used is univariate, bivariate and multivariate analysis. The results showed that in this study the dominant patients aged 31-40 years were 104 (49.5%), 160 (76.2%) female, with the majority having a bachelor's degree, 159 (75.7%). There is an influence of price, patient satisfaction, hospital image, service quality, and trust on witching intention in inpatient services at RSU Royal Prima Medan. The factor that most influences witching intention in inpatient services at RSU Royal Prima Medan is patient satisfaction (X2).
Evaluation Of Healthcare Worker Knowledge Enhancement Regarding Comprehensive Service Delivery Through Interprofessional Focus Group Discussion Method At Pertamina Hospital Tarakan
Comprehensive healthcare service delivery represents a holistic approach integrating medical, psychological, social, and spiritual patient care dimensions. This qualitative descriptive study evaluated interprofessional Focus Group Discussion (FGD) effectiveness in enhancing healthcare worker (HCW) knowledge about comprehensive service delivery at Pertamina Hospital Tarakan. Seven healthcare workers participated in in-depth interviews and interprofessional FGD sessions during May 2025. Data analysis employed qualitative thematic analysis with triangulation methods. Findings revealed HCWs possessed good comprehensive service delivery understanding, conceptualizing it as patient-centered care incorporating biological, psychological, social, and spiritual dimensions. Primary implementation barriers included communication challenges, interprofessional coordination gaps, and cultural patient differences. Interprofessional FGD sessions demonstrated significant effectiveness in improving understanding, enhancing communication, and facilitating cross-professional collaborative problem-solving. Weekly Tuesday FGD forums served as effective service evaluation and solution development platforms. Conclusions indicate interprofessional FGD methodology proves effective for enhancing HCW comprehensive service delivery knowledge. Sustained communication training, optimized FGD implementation with clear themes and complete participant attendance, and continuous professional development are essential for strengthening interprofessional collaboration and improving service quality.
Activity Test of Ginger (Zingiber Officinale) Extract Nanoemulsion on Decreasing Sgpt, Sgot Levels, Assessment of Necrosis, Fibrosis and Liver Lobules in Male Rats Induced by Streptozotocin and Histopathological of the Liver
This study aims to test the activity of ginger ( Zingiber officinale ) extract nanoemulsion on reducing SGPT and SGOT levels, as well as assessing the level of necrosis, fibrosis, and liver lobule condition in streptozotocin-induced male rats. Rats were divided into control and treatment groups, where the treatment group received ginger extract nanoemulsion preparation. The results showed that treatment with nanoemulsion significantly reduced SGPT and SGOT levels, as well as reduced the level of necrosis and fibrosis in liver tissue compared to the control group. Phytochemical screening results on ginger ( Zingiber officinale ) extract revealed the presence of flavonoids, tannins, saponins, alkaloids, and polyphenols. These compounds act as natural antioxidants that support antidiabetic effects in test animals. Treatment group 3 with a nanoemulsion of ginger extract ( zingiber officinale ) at a dose of 200 mg/kgBW experienced a significant decrease in SGOT and SGPT levels compared to the other treatment groups, approaching the control group. The ANOVA test showed a significant difference between groups (p < 0.05), which was confirmed by the results of the LSD test. Microscopic image of the liver of mice in treatment group 3 showed improvement. structure histology heart However Still There is degeneration hydropic , so that Still enter in category Score 1. The percentage of necrosis decreased to 5% . Histopathological findings showed improvements in the structure of the liver lobules. This study concluded that ginger extract nanoemulsion preparations can function as an effective therapy in protecting the liver from diabetes-induced damage.
Phytochemical screening and in vitro anti-inflammatory evaluation of Sechium Edule fruit extract
Inflammation is a protective biological process, yet excessive or chronic inflammation can contribute to the development of degenerative and autoimmune diseases. Natural products are increasingly investigated as safer alternatives to synthetic anti-inflammatory drugs. This study aimed to evaluate the phytochemical constituents and in vitro anti-inflammatory activity of Sechium edule (Jacq.) Sw. fruit extract. The fruits were extracted with 70% ethanol by maceration, and qualitative phytochemical screening confirmed the presence of alkaloids, flavonoids, tannins, saponins, triterpenoids, and glycosides. Anti-inflammatory activity was determined through inhibition of bovine serum albumin (BSA) and egg albumin denaturation assays at extract concentrations of 100, 200, and 400 µg/mL, using aspirin as a standard. The extract demonstrated concentration-dependent inhibition of BSA denaturation (61.73–69.60%) comparable to aspirin (67.38–71.96%), and moderate inhibition in the egg albumin assay (6.34–27.87% versus 28.32–49.70% for aspirin). These findings suggest that S. edule possesses significant anti-inflammatory potential, likely due to the synergistic effects of its polyphenolic and triterpenoid constituents, supporting its traditional medicinal use and indicating its promise as a source of natural anti-inflammatory agents.
Phytochemical screening and in vitro anti-inflammatory evaluation of Garcinia mangostana peel extract
Inflammation is a natural defense mechanism that can become harmful when chronic, contributing to several degenerative diseases. This study evaluated the phytochemical composition and in vitro anti-inflammatory activity of Garcinia mangostana peel extract. The peels were macerated in 70 percent ethanol, and qualitative screening revealed the presence of xanthones, flavonoids, tannins, saponins, triterpenoids, and glycosides, while alkaloids were absent. Anti-inflammatory activity was assessed through inhibition of Bovine Serum Albumin and egg albumin denaturation, with aspirin serving as the reference drug. The extract demonstrated concentration-dependent inhibition of Bovine Serum Albumin denaturation ranging from 58.45 to 73.50 percent, closely comparable to aspirin 66.90 to 76.20 percent. In the egg albumin assay, inhibition increased from 12.80 to 33.40 percent, while aspirin showed 30.40 to 52.60 percent. The strong presence of xanthones and flavonoids likely contributes to the observed effects by stabilizing protein structures and preventing heat-induced denaturation. These findings confirm that Garcinia mangostana peel extract possesses promising anti-inflammatory potential, supporting its traditional medicinal use and highlighting its value as a natural source for developing safer anti-inflammatory agents.
The Effect Of Providing Snack Bar Vegetable Snacks Combining Sweet Potatoes And Almonds, High-Intensity Interval Training, And Mindfulness Therapy On Blood Glucose Control In Type 2 Diabetes Mellitus Patients In Medan Selayang District, Medan City
Fiber is a complex carbohydrate that is good for people with diabetes mellitus. People with diabetes who consume foods high in fiber with a low glycemic index can lower their postprandial glucose and HbA1c levels. This is a quantitative study with a true experimental design and a pretest-posttest randomized control trial. This study analyzed the effect of consuming a snack bar combining purple sweet potatoes and almonds on controlling postprandial blood sugar levels in type 2 diabetes patients. The population in this study consisted of all type 2 diabetes patients in the Medan Selayang District of Medan City, with a sample of productive age (18-59 years). Data analysis was performed using univariate, bivariate, and multivariate methods. The results showed that the snack bar consumed by type 2 DM patients was snack bar F3, which had the highest crude fiber content, a very strong sweet potato aroma, a slightly sweet taste, a soft texture, and a pleasant aftertaste. The results of the two-way ANOVA test showed a difference in blood sugar levels in the treatment before and after consuming a snack bar combination of sweet potato and almonds, high-intensity interval training, and mindfulness therapy for 2 months. There was a significant difference in the average blood sugar levels in the case and control groups before and after treatment.
The Effect of IL-17A Kinoid Vaccine on Anti-dsDNA Levels and Plasma Cell Count in a Mouse Model of Systemic Lupus Erythematosus
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by dysregulated immune response, including overproduction of Interleukin-17A (IL-17A), which promotes B-cell differentiation into autoantibody-producing plasma cells. This study aimed to investigate the effect of an IL-17A kinoid vaccine on improving immune regulation in a Pristane-Induced Lupus (PIL) mouse model by measuring serum anti-double stranded DNA (anti-dsDNA) levels and splenic plasma cell count. Methods: A true experimental study with a randomized post-test-only controlled group design was conducted. Female Balb/c mice were divided into five groups: negative control (KN), positive control (KP, PIL-induced), and three treatment groups (P1, P2, P3) that were PIL-induced and received the IL-17A kinoid vaccine at doses of 125 µg/ml, 250 µg/ml, and 500 µg/ml, respectively, administered intramuscularly on days 0, 21, and 42. On day 60, serum anti-dsDNA levels were measured by ELISA, and splenic plasma cells (CD19+CD38+) were quantified by flow cytometry. Data were analyzed using One-Way ANOVA and Pearson correlation. Results: Induction with pristane successfully created a lupus model, evidenced by significantly positive ANA and proteinuria (p<0.05). The KP group showed a significant increase in plasma cell count (47.09 ± 3.77%) and anti-dsDNA levels (0.650 ± 0.01 µg/ml) compared to the KN group (27.71 ± 1.72%, p=0.000 and 0.517 ± 0.01 µg/ml, p=0.000, respectively). Treatment with the IL-17A kinoid vaccine significantly reduced both parameters. The most effective dose was 250 µg/ml (P2), resulting in a plasma cell count of 28.33 ± 1.70% (p=0.000 vs. KP) and anti-dsDNA level of 0.544 ± 0.16 µg/ml (p=0.000 vs. KP). A strong positive correlation was found between plasma cell count and anti-dsDNA levels (r=0.708, p=0.000). Conclusion: The IL-17A kinoid vaccine improves immune regulation in a PIL mouse model by significantly reducing the number of splenic plasma cells and the level of serum anti-dsDNA, with the most effective dose being 250 µg/ml..
Wound Healing Activity of Polyscias scutellaria Leaves Extract Ointment
Burns is still a challenge for health workers and one of the global community’s health problems. Many synthetic drugs are used as wound treatment, but it has high cost and much side effects. Hence, this study was designed to explore the wound healing activity from Polyscias scutellaria leaves. This experimental study used 25 male Wistar rats grouped into five groups: control (Ointment base), standard (Nebacetin), 12.5%, 25%, and 50% Polyscias scutellaria leaves extract ointment. The Polyscias scutellaria leaves ointment was made of Polyscias scutellaria leaves ethanol extract, which was obtained by maceration. Two parameters were analyzed, viz. wound contraction and epithelialization period. The result showed that on the 15th day, the highest wound contraction was found in 25% Polyscias scutellaria leaves extract ointment group (80.97%), followed by the 50% (79.46%), 12.5% ​​(67.19%), the standard (65.86%), and the control group (55.46%). Meanwhile, the most extended period of epithelialization was found in the control group (14 days), followed by the 50% (13 days), 25% (12 days), standard (12 days), and 12.5% Polyscias scutellaria leaves ointment (10 days). Overall, it can be concluded that the lowest concentration (12.5%) of ointment already has wound healing activity.
Activity Test of Nano Emulsion Preparation of Star Anise (Illicium Verum) Extract on Reducing Urea and Renal Creatinine Levels in Male Rats Induced by Alloxan
Diabetes mellitus is a disease that knows no boundaries, this disease appears when the body cannot control glucose levels. This study aims to test and analyze the effectiveness of the nanoemulsion preparation of star anise (Illicium verum) extract on reducing urea, creatinine, and kidney histopathology in male Wistar rats (Rattus norvegicus) induced by alloxan. The sample of rats used was 24 in 4 groups (positive and negative controls, treatments 1 and 2) where the extract preparation in the treatment was a nanoemulsion of star anise (Illicium verum) extract with a concentration of 10% and 20%. The results of this observation indicate that administration of star anise (Illicium verum) extract with a concentration of 20% can improve the histological structure of the kidneys in male Wistar rats (Rattus norvegicus) with diabetes.
Effectiveness Test of Chia Seed (Salvia Hispanica) Extract Nanoemulsion Preparation on Reducing Blood Glucose Levels (Kgd), Low Density Lipoprotein (LDL) Levels and Histopathological Features of the Liver of White Rats (Rattus Norvegicus) Wistar Strain In
This lack of physical activity is often accompanied by excessive energy intake due to the wide variety of energy-rich foods, such as fast food. This study aims to test and analyze the effectiveness of chia seed (Salvia hispanica) extract nanoemulsion preparations on reducing blood cholesterol, low-density lipoprotein (LDL), and liver histopathology in male Wistar rats (Rattus norvegicus) induced by alloxan. Twenty-six rat samples were used in four groups (positive control, negative control, treatment 1, and 2), where the extract preparation in the treatment was chia seed extract nanoemulsion with concentrations of 10% and 20%. The results of histopathological observations showed that the negative control group experienced severe liver damage (score 3.16 ± 0.40), while the treatment group given chia seed extract nanoemulsion, especially the 20% concentration, showed improved liver structure with a lower damage score (1.5 ± 0.54). This indicates that chia seeds have the potential to protect liver tissue from damage.
The Effectiveness of Star Anise (Illicium Verum) Extract Nanoemulsion on Fibroblast Density and Collagen in the Skin of Male Wistar Rats (Rattus Norvegicus) Exposed to Ultraviolet Light
UV radiation can also cause sun damage to the skin through DNA damage, inflammation, oxidative stress, which is a condition where the production of Reactive oxygen species (ROS) exceeds the body's antioxidant defenses, which causes cell damage.. This research aims toTesting and analyzing the effectiveness of nano emulsion of star anise (Illicium verum) extract on the number of fibroblast and collagen density in the skin of male white rats (Rattus norvegicus) Wistar strain after exposure to UVB rays.The sample of mice used was 25 in 5 groups (positive and negative controls, treatments 1, 2, and 3) where the extract preparation in the treatment was a nanoemulsion of star anise extract (Illicium verum) with a concentration of 10% and 20%. The results were Based on histological assessment, treatment group 2 also showed high collagen density with a score of 3, similar to the normal group and the positive control (vitamin C). In contrast, the negative control group experienced severe collagen damage with a score of 0. This indicates that a concentration of 20% is able to repair collagen tissue damaged by UVB exposure.
The Effectiveness of Nanoemulsion Preparation of Star Anise (Illicium Verum) Extract on Blood Sugar Levels and Pancreas in Male Wistar Rats (Rattus Norvegicus) Induced by Alloxan
Prolonged hyperglycemia results in the onset of diabetes mellitus... The pancreas is an organ responsible for, among other things, maintaining blood glucose levels at a level that is tolerable by the body. This study aims to test and analyze the effectiveness of a nanoemulsion preparation of star anise (Illicium verum) extract on blood sugar levels and the pancreas in male rats induced by Alloxan. The sample used was 25 rats in 5 groups (positive and negative controls, treatments 1, 2, and 3) where the extract preparation in the treatment was a nanoemulsion of star anise (Illicium verum) extract with concentrations of 5%, 10%, and 20%. The results showed that pancreatic histology showed the highest level of damage in the negative control group, while treatment group 3 (20%) and the positive control showed significant improvement in the structure of the islets of Langerhans. The tissue damage score decreased in treatment group 3, indicating that the star anise nanoemulsion has a protective effect on pancreatic tissue and is able to reduce necrosis and cell degeneration.
The Effectiveness of Star Anise (Illicium Verum) Extract Nanoemulsion on Malondialdehyde (MDA) and Blood Glucose Levels (BGL) and Histopathological Features of Alloxan-Induced Rat Liver
Diabetes mellitus is a collective term for heterogeneous metabolic disorders whose main finding is chronic hyperglycemia. High MDA levels in the liver are associated with liver damage and non-alcoholic fatty liver disease (NAFLD). This study aims to test and analyze the effectiveness of star anise (Illicium verum) extract nanoemulsion preparations on reducing MDA levels, KGD, and liver histopathology in alloxan-induced male Wistar rats (Rattus norvegicus). The sample of rats used was 24 in 4 groups (control, treatment 1, 2 and 3) where the extract preparation in the treatment was star anise (Illicium verum) extract nanoemulsion with concentrations of 10% and 20%. Administration of star anise extract nanoemulsion, especially at a concentration of 20%, showed a significant decrease in blood glucose levels approaching the value of the negative control group (p = 0.333)
Effectiveness of Chia Seed (Salvia Hispanica) Extract Nano Emulsion Preparation on Alloxan-Induced Blood Sugar and Pancreas of Male Wistar Rats
Type 2 Diabetes Mellitus is one of the most common metabolic disorders worldwide and its development is mainly caused by a combination of two main factors: imperfect insulin secretion by pancreatic β-cells. Serum amylase and lipase levels are used to diagnose pancreatic damage. This study was conducted to test and analyze the effectiveness of Chia seed (Salvia hispanica) extract nanoemulsion preparations on blood sugar and pancreas in male Wistar rats (Rattus norvegicus) induced by Alloxan. The sample of rats used was 25 in 5 groups (positive control, negative control, treatment 1, 2 and 3) where the extract preparation in the treatment was chia seed extract nanoemulsion with concentrations of 5%, 10% and 20%. With the results at a concentration of 20% also providing a decrease in amylase and lipase enzyme levels that were closer to the negative control group, indicating the potential for restoration of pancreatic function.
The Relationship Between Work Shifts, Nurse Workload, and Patient Satisfaction in Inpatient Nursing Services
Shift work and nurses' workload are critical factors that significantly influence the quality of nursing services and patient satisfaction in inpatient care units. This review aims to analyze the relationship between shift work, nurse workload, and patient satisfaction based on international literature indexed in Scopus from 2023 to 2025. The method used is a literature review, which involves examining theories, findings, and other research materials from references to establish a solid conceptual framework and research problem formulation. A total of 15 relevant scientific articles were analyzed, focusing on the effects of working hours, fatigue, and scheduling on service satisfaction aspects. The analysis results indicate that night shifts and work durations of ≥12 hours are correlated with increased burnout and decreased service quality, including the phenomenon of care left undone. High workloads also increase the risk of medical errors, disrupt nurse-patient communication, and negatively impact patients' perceptions of care. Conversely, strategies such as technology-based scheduling, increased staff ratios, and reduced administrative burdens have been proven to improve nurse satisfaction and service quality. These findings highlight the importance of managerial interventions in hospitals, including at Drs. Haji Amri Tambunan Regional General Hospital, to optimize work scheduling and equitably distribute workloads to maintain the quality of nursing care.
THE EFFECT OF GIVING SWEET ORANGE PEEL ETHANOL EXTRACT LOTION (CITRUS SINENSIS) ON WOUND HEALING WISTAR WHITE RAT
Wounds are one of the health problems that require proper treatment to speed up the healing process. Natural ingredients, such as sweet orange peel (Citrus sinensis), are known to contain flavonoid compounds, tannins, and antioxidants that have the potential to speed up the wound healing process. This study aims to determine the effect of giving sweet orange peel ethanol extract lotion (Citrus sinensis) on the wound healing process in Wistar white rats, both through macroscopic and microscopic assessments, as well as comparing the effectiveness of various doses (5%, 10%, and 15%). This study uses a true experimental post test only control group design. Wistar white rats were divided into several treatment groups with the administration of EEKNJ lotion concentrations of 5%, 10%, and 15%. Data were analyzed using ANOVA tests. The results showed that the administration of EEKNJ lotion of 5% (sig = 0.005), 10% (sig = 0.000), and 15% (sig = 0.001) had a significant effect in accelerating wound healing. However, ANOVA results on the percentage of wound healing showed a value of sig = 0.901 (> 0.05), which means that there was no significant difference between doses of EEKNJ lotion. Descriptively, the average percentage of highest wound healing was obtained in the EEKNJ group of 10% (38.72%), followed by EEKNJ 5% (35.22%), and the lowest EEKNJ 15% (26.44%). The conclusion of this study is that sweet orange peel ethanol extract lotion has the potential to accelerate wound healing in Wistar white rats, but the dose variations of 5%, 10%, and 15% did not show a significant difference in the wound healing percentage. Keywords: Sweet orange peel, Lotion, Wound healing, Wistar white rat
Effectiveness of Ginger (Zingiber Officinale) Extract Nanoemulsion Preparation on Blood Glucose Levels, Lipid Profiles, Hba1c and Liver Histopathology in Male Rats Induced by Streptozotocin
Study This aim For evaluate effectiveness stock nanoemulsi extract ginger ( Zingiber officinale ) against level glucose blood , lipid profile , and HbA1c in mouse induced male​ streptozotocin , as well as For analyze description histopathology heart . Results study show that stock nanoemulsi extract ginger in a way significant lower level glucose blood , repair lipid profile , and lower level glucose blood , lipid profile , and HbA1c were compared with group control. Administration of ginger extract nanoemulsion ( zingiber officinale ) at a dose of 200 mg/kgBW had an effect on reducing HbA1c levels, indicating an effect on long-term glycemic control. The results of the ANOVA test showed a significant difference between groups (p < 0.05) . Histopathology of ginger extract nanoemulsion ( zingiber officinale ) at a dose of 200 mg/kgBW showed a microscopic picture of the liver of mice in treatment group 3 (P3). It looked normal, no inflammation was seen, the cells began to improve, no looks necrosis and fatty. And scoring For this picture is 1 that is normal. Conclusion from study This is that stock nanoemulsi extract ginger effective in control level glucose blood And lipid profile as well own potential as therapy addition for diabetes mellitus , with effect positive on health heart.
SMOKING AS A LIFESTYLE RISK FOR PREHYPERTENSION IN TYPE 2 DIABETES
Type 2 diabetes mellitus and hypertension are lifestyle-related diseases of major public health concern. Preventive strategies have increasingly shifted toward addressing pre-disease stages. Prehypertension, defined as systolic 120–139 mmHg and/or diastolic 80–89 mmHg, is particularly important in T2DM as it increases cardiovascular risk. This study examined the prevalence and associated factors of prehypertension among T2DM patients in Kelantan using 2022 National Diabetes Registry data. Out of 8,657 clinical audit records, 825 non-hypertensive T2DM patients were identified. Prehypertension was present in 73.5% of this group. Logistic regression analysis revealed age (aOR 1.02; 95% CI: 1.003–1.03), female sex (aOR 1.54; 95% CI: 1.10–2.15), and smoking (aOR 2.19; 95% CI: 1.02–4.73) as significant predictors. Although only 6.8% of patients were smokers, smoking more than doubled the risk of prehypertension. In conclusion, prehypertension is highly prevalent among T2DM patients in Kelantan. Both non-modifiable factors (age, sex) and a key modifiable lifestyle factor (smoking) contribute to the increased risk. These findings underscore the need for targeted lifestyle interventions, particularly smoking cessation programs, to prevent progression to hypertension and reduce cardiovascular complications in this vulnerable population.
Job Satisfaction of Doctors as a Foundation for Quality Healthcare in Northeastern Malaysia
Medical doctors play a vital role in primary healthcare. Understanding their job satisfaction is crucial for improving engagement, dedication, and quality of care. This study investigated job satisfaction and its associated factors among medical doctors in primary healthcare in Terengganu. A cross sectional study was conducted in eight district health offices and the state health department of Terengganu from December 2023 to February 2024. Using proportionate stratified random sampling, 200 participants were selected. The Malay version of the Psychosocial Aspect of Work Questionnaire, PAW M, consisting of 15 items measuring job satisfaction, social support, and mental stress, was applied. Data were analyzed using SPSS version 27 with linear regression to identify factors associated with job satisfaction. Results showed the mean job satisfaction score was 26.41 with a standard deviation of 4.7. Participants had a mean age of 35.45 years with a standard deviation of 4.80, a mean social support score of 16.67 with a standard deviation of 2.32, and a mean mental stress score of 17.29 with a standard deviation of 2.07. Satisfaction with income, permanent employment status, and social support were significantly associated with job satisfaction. In conclusion, enhancing income satisfaction, employment stability, and social support can improve job satisfaction among doctors, thereby strengthening the quality of healthcare services
A Decade of Survival: Median Survival Time and Prognostic Factors of Non-Hodgkin Lymphoma in Elderly Patients in Kelantan (2008–2017)
Non-Hodgkin lymphoma (NHL) is a major lymphoma subtype in Malaysia and a significant public health burden. Elderly patients often have poorer outcomes due to late presentation, comorbidities, and reduced treatment tolerance. This study examined median survival time and prognostic factors of death among NHL patients aged ≥60 years in Kelantan. A retrospective cohort was conducted using Kelantan Cancer Registry data from 2008–2017, with follow-up until December 2022. Mortality status was verified through the National Registration Department. Kaplan–Meier methods estimated survival, and Cox regression identified prognostic factors. Among 156 patients, 95 (60.9%) were male and 150 (96.2%) Malay. The median age was 67 years (IQR: 12). Most had Mature B-cell lymphoma (74.4%), and 89.1% were aggressive types. The overall median survival time was 4.18 months (95% CI: 2.26–6.08). Stage IV disease showed higher risk (Adj. HR: 2.33, 95% CI: 0.87–6.27, p=0.092). Patients without chemotherapy had significantly increased mortality (Adj. HR: 1.58, 95% CI: 1.02–2.43, p=0.040). Survival outcomes for elderly NHL patients were poor, highlighting the need for earlier diagnosis, improved access to chemotherapy, and lifestyle-based supportive care to enhance quality of life.
ANALYSIS OF FACTORS INFLUENCING THE IMPLEMENTATION OF HOSPITAL MANAGEMENT INFORMATION SYSTEMS AT SANTA ELISABET HOSPITAL MEDAN IN 2025
SIMRS is an information communication technology system that processes and integrates the entire flow of hospital service processes in the form of a network of coordination, reporting and administrative procedures to obtain information precisely and accurately, and is part of the Health Information System. This study aims to analyze the factors that influence the implementation of the hospital management information system. This study uses a sample of 70 people, obtain by total sampling. Qualitative data are analyzed univariately, bivariately, and multivariately, qualitative data are analyzed using interactive analysis (interviews). Based on the results of quantitative research at the univariate stage, it is known that from the respondents studied as many as 70 respondents, most of the respondents were aged 26-36 years, namely: 32 (45.7%). S1 nursing education level 29 people (41.4%), bivariate results show that there is an influence of HR (P = 0.017) Organization (P = 0.001) and technology (P = 0.023) on the implementation of the Hospital management information system, while the most dominant variable is the Technology variable. the results of qualitative research show that employees have been able to operate SIMRS, and in general all units have used SIMRS, it is hoped that Santa Elisabeth Hospital Medan will increasingly optimize the use of SIMRS for effective and efficient services. The conclusion of this study is that there is an influence of HR, Organization and Technology on the implementation / implementation of the Hospital Management Information System at Santa Elisabeth Hospital Medan.
CORRELATION BETWEEN IMPLEMENTATION OF INFECTION PREVENTION AND CONTROL TO INCREASE SERVICE QUALITY AT DENTAL AND ORAL HOSPITAL UNIVERSITAS SUMATRA UTARA
Healthcare-associated infections significantly affect patient safety and service quality. The implementation of infection prevention and control (IPC) programs has not always been optimal, and its relationship with service quality needs further evaluation. This study aimed to analyze the implementation of the IPC program at the Dental and Oral Hospital, Universitas Sumatera Utara, based on the five SERVQUAL dimensions: tangibles, reliability, responsiveness, assurance, and empathy. A mixed-method design was applied, combining quantitative and qualitative approaches. Quantitative data were obtained from questionnaires distributed to 68 healthcare workers, while qualitative data were collected through in-depth interviews with four participants and one key informant. The results showed that IPC implementation was rated moderate in 73.5%, good in 17.6% and low 8.8% of respondents. Service quality was rated moderate in 76.5%, good in 22.1% and low at 1.5%. Statistical analysis revealed a significant relationship between IPC implementation and service quality (p = 0.000; p < 0.05). Qualitative findings supported the quantitative results, highlighting the importance of continuous training and adequate facilities.In conclusion, the implementation of IPC programs has a positive impact on service quality and infection prevention. Continuous evaluation and regular staff training are essential to ensure long-term quality improvement.
The relationship between age, blood pressure, sex, and blood glucose levels with the risk of cardiomegaly and atherosclerosis: A retrospective study
Cardiomegaly and atherosclerosis are pivotal radiographic indicators of cardiovascular pathology, often associated with significant morbidity and mortality. This retrospective analytical study investigates the relationships between age, blood pressure, sex, and blood glucose levels and their influence on the risk of cardiomegaly and aortic arch atherosclerosis in patients under 50 years of age. Medical records from 133 patients treated at Royal Prima General Hospital, Medan, between May 2024 and May 2025 were analyzed using logistic regression to identify significant predictors. Results demonstrated that both advancing age and elevated blood pressure were strong, independent, and statistically significant risk factors for cardiomegaly and atherosclerosis (p < 0.001). Each one-year increment in age increased the odds of cardiomegaly by 12.7% and atherosclerosis by 11.8%, while each unit rise in blood pressure was associated with a 4.3% and 8.6% increase in odds for cardiomegaly and atherosclerosis, respectively. In contrast, sex and blood glucose levels did not show statistically significant associations in the studied cohort. These findings underscore the critical role of age- and blood pressure-related cardiovascular remodeling and vascular pathology in early-onset cardiomegaly and atherosclerosis. The lack of significant association with sex and blood glucose suggests complex, multifactorial interactions warranting further investigation in larger, more diverse populations. Clinically, this study highlights the imperative for rigorous, lifelong blood pressure control and cardiovascular monitoring to mitigate the progression of these conditions. Keywords: cardiomegaly, atherosclerosis, blood pressure, aging, cardiovascular risk factors
The Impact Of Age And Gender On Cholelithiasis In Patients With Hypertension: A Retrospective Study
Cholelithiasis and hypertension are prevalent conditions with potentially interrelated pathophysiological mechanisms involving metabolic dysfunction and systemic inflammation. This retrospective observational study investigated the association of age and gender with hypertension stages among adult patients diagnosed with cholelithiasis using non-contrast abdominal CT scans at Royal Prima General Hospital Medan. A total of 133 hypertensive patients meeting inclusion criteria were analyzed, with 27.1% classified as stage I hypertension and 72.9% as stage II. Female patients predominated in both stages (63.9% and 64.9%, respectively), without statistically significant sex differences between stages (p=0.910). Age distributions revealed a significant association with hypertension severity: individuals aged 30–44 years mainly presented with stage I hypertension (83.3%), whereas older groups, particularly those 45 years and above, predominantly exhibited stage II hypertension (p < 0.001). These findings align with current understanding of vascular aging and the impact of systemic inflammatory pathways exacerbated by comorbid cholelithiasis, which may diminish estrogen’s cardiovascular protective effects in females. The study underscores the necessity for early detection and tailored management strategies focusing on aging populations with comorbid conditions to mitigate progression to advanced hypertension stages. Keywords: hypertension stages, cholelithiasis, age, gender differences
Evaluation of the Antibacterial Potential of Jatropha multifida Leaf Extract using Microwave-Assisted Extraction
Oral diseases, such as dental caries and oral candidiasis, are often caused by a microbial imbalance. Conventional antifungal and antibacterial treatments, including Nystatin and Povidone-Iodine, face challenges like microbial resistance and side effects. Given Indonesia's rich biodiversity and the public's growing interest in herbal medicine. This study aims to explore the antimicrobial potential of Jatropha multifida leaf extract as a base for a new mouthwash formulation. Utilizing a post-test only control group experimental design, the study first extracted Jatropha multifida leaves with Microwave-Assisted Extraction. The agar disk diffusion method was then employed to screen various extract concentrations against Staphylococcus aureus to identify the most effective one. The collected data on microbial inhibition zones will be statistically analyzed using a One-Way ANOVA and the Dunnet Post Hoc test. We anticipate that the Jatropha multifida will exhibit significant antimicrobial activity, suggesting its potential as a natural and effective alternative to conventional antiseptics. This research provides a foundation for developing a novel herbal-based oral care product that addresses the current challenges of antimicrobial resistance and treatment side effects.
Therapeutic Potential of Moringa oleifera-Based Cream on Burn Wound Healing: Inflammation Suppression and TGF-β1 Modulation in Mice
Burns are tissue injuries that trigger complex inflammatory responses and require proper treatment to prevent further complications. Moringa oleifera L., or known as kelor, is a herbal plant containing bioactive compounds such as flavonoids, phenols, and tannins that have the potential as wound healing agents through anti-inflammatory mechanisms and stimulation of tissue regeneration. This study aims to evaluate the potential of M. oleifera leaf extract cream in reducing inflammation and increasing the expression of Transforming Growth Factor-β1 (TGF-β1) in mice (Mus musculus) with a second-degree burn model. The method used includes administering Moringa oleifera cream (MOC) with concentrations of 1.25%, 2.5%, and 5% on thermally induced burns. Evaluation of wound healing was carried out through histopathological observation with Hematoxylin-Eosin (HE) staining to determine the inflammation score, as well as immunohistochemistry (IHC) to measure TGF-β1 expression. The results showed that MOC was able to significantly reduced inflammation scores, and increased TGF-β1 expression compared to the negative control group. Cream with a concentration of 5% gave the most optimal effect in reducing inflammatory cell infiltration and increasing TGF-β1 expression. Thus, it can be concluded that M. oleifera leaf extract cream has the potential as a topical therapeutic agent for healing second-degree burns. A concentration of 5% is the most effective dose in accelerating the healing process through the mechanism of reducing inflammation and increasing TGF-β1 expression.
Neutrophil-Lymphocyte Ratio as a Mortality Predictor in Intensive Care Patients
Systemic inflammatory response markers such as lactate, C-reactive protein, and procalcitonin are commonly used to predict mortality in intensive care unit patients. One potential alternative to these markers is the neutrophil-lymphocyte ratio, which can be calculated based on a patient’s blood cell count. This study aims to determine the potential of the neutrophil-lymphocyte ratio as a predictor of length of stay and mortality in intensive care patients. This study employed an analytical cross-sectional design, conducted at the Intensive Care Unit of Royal Prima Hospital in Medan, involving 170 patients. The data used in this study were secondary data obtained from patients’ medical records. The results of this study found that the majority of intensive care patients had a neutrophil-lymphocyte ratio greater than 3 (94.1%), were hospitalized for less than 7 days (84.7%), and 92.4% of patients died during their hospitalization. Data analysis revealed that although the neutrophil-lymphocyte ratio was not significantly associated with the length of stay (p > 0.05), patient mortality was significantly associated with both the neutrophil-lymphocyte ratio (p < 0.005) and the length of stay (p < 0.05). Multivariate analysis revealed that patient mortality in the intensive care unit was influenced by the neutrophil-lymphocyte ratio and length of hospitalization, with the neutrophil-lymphocyte ratio being the most significant factor affecting patient mortality (p < 0.005; OR: 11.978). It can be concluded that the neutrophil-lymphocyte ratio is a reliable predictor of mortality in intensive care patients, but its accuracy in predicting patient length of stay is less pronounced.
Evaluating the impact of PIK-KRR and family physician counseling on adolescent reproductive health
Adolescents are a vulnerable population concerning reproductive health due to a lack of accurate knowledge and information. The Adolescent Reproductive Health Information and Counseling Center (Pusat Informasi dan Konseling Kesehatan Reproduksi Remaja; PIK-KRR), alongside the role of family physicians, plays a critical role in providing education and counseling related to reproductive health. This study aimed to evaluate the effectiveness of PIK-KRR and the involvement of family physicians in enhancing adolescents’ knowledge of reproductive health at MAN 2 Model Medan. A quasi-experimental design was employed, using pre-test and post-test assessments in both intervention and control groups. The study population comprised all students at MAN 2 Model Medan, with a purposive sample of 30 respondents selected. Data were collected via a structured questionnaire and analyzed using paired t-tests and independent t-tests. The results indicated a statistically significant improvement in adolescents’ reproductive health knowledge following interventions delivered through both PIK-KRR and family physician counseling (p < 0.05). Moreover, the involvement of family physicians had a greater impact compared to PIK-KRR alone. In conclusion, both PIK-KRR and family physicians are effective in improving adolescents’ reproductive health knowledge, with counseling provided by family physicians yielding a more pronounced effect. It is recommended that schools and relevant stakeholders enhance the sustainability of PIK-KRR programs and strengthen the role of family physicians in adolescent health education. Keywords: PIK-KRR, family physician, adolescent knowledge, reproductive health
EFFECTIVENESS OF MELINJO SEED EXTRACT (Gnetum gnemon L.) ON BODY WEIGHT, SUBCUTANEOUS FAT, VISCERAL FAT, AND CHOLESTEROL IN WISTAR MALE WHITE RATS (Rattus Norvegicus) WITH OBESITY GIVEN MODERATE INTENSITY PHYSICAL ACTIVITY
Obesity is a global health issue linked to several metabolic disorders. Natural products, including those containing bioactive compounds, are gaining attention as complementary approaches for weight management. Melinjo seeds (Gnetum gnemon L.) are rich in phytochemicals that may support metabolic health. The purpose of this study was to evaluate the impact of melinjo seed extract combined with moderate-intensity physical activity on body weight, abdominal subcutaneous fat, abdominal visceral fat, and cholesterol levels in obese male Wistar rats. A randomized controlled trial was performed with 24 rats, which were assigned to three groups: control (P0), moderate-intensity physical activity (P1), and moderate-intensity physical activity with melinjo extract (P2). Following a 42-day high-fat diet to induce obesity, the rats underwent a 28-day intervention period. Significant improvements were observed in group P2, with reductions in body weight, subcutaneous fat, visceral fat, and cholesterol. Group P1 showed improvements but to a lesser extent, while group P0 showed no significant changes. These results suggest that melinjo seed extract combined with physical activity effectively reduces weight and fat. Future research should investigate the molecular mechanisms and potential human applications.
Socioeconomic and clinical factors associated with quality of life among diabetic patient
The global impact of type 2 diabetes is considerable, profoundly affecting patients' quality of life. This study aimed to assess the quality of life among T2DM patients receiving care at Royal Prima Hospital and to identify factors influencing it. A quantitative, cross-sectional design was employed, involving 97 T2DM patients selected through convenience sampling. Data were collected via structured questionnaires and analyzed using the Chi-square test. The results indicated that the majority of patients (60.8%) experienced a poor quality of life. Significant factors associated with lower quality of life included older age (p < 0.001), lower educational attainment (p < 0.001), income below the minimum wage (p < 0.001), longer duration of T2DM (p < 0.001), and the presence of complications (p < 0.001). Among these, income and complications were identified as the strongest predictors. No significant association was found between gender and quality of life. These findings highlight the importance of adopting a holistic approach to T2DM management that integrates socioeconomic and psychological support, particularly for high-risk populations.
Evaluation of Waste Management in Dental and Oral Health Services at Mitra Sejati Hospital Medan
The amount of medical waste continues to increase as healthcare facilities, including dental health services, increase. If not managed properly, medical waste can have a negative impact from the collection stage to final disposal. This study aims to evaluate waste management in dental and oral health services at RSU Mitra Sejati Medan with a qualitative descriptive approach. The informants totaled six people, consisting of leaders, management, K3 officers, and nurses. Data analysis is carried out with the help of NVivo software through data reduction, coding, inductive and deductive analysis, and conclusion drawn. The results of the study show that waste management has gone well. Human resources are considered adequate, comply with SOPs, and have competencies according to their duties. The infrastructure facilities are complete and up to standard, although there are still minor mistakes by the new officers. The budget is available and sufficient, but it has not been allocated specifically for the dental and oral unit, although the needs are still met. The level of conformity of waste management with the Regulation of the Minister of Environment and Forestry No. 56 of 2015 reached 98.6%, which is included in the category according to the provisions. This reflects the hospital's commitment to safe and sustainable waste management. In conclusion, waste management at the dental and oral service unit of Mitra Sejati Hospital Medan is considered good. It is recommended that the recording of the budget per unit be improved, the supervision system is strengthened, and the means of waste collection and destruction are updated regularly.
Gc-Ms Instrument Analysis of Turmeric Rhizome Extract Nanoemulsion Preparation (Curcuma Domestica Val.) on Amylase, Lipase Levels and Pancreatic Beta Cell Damage Scoring in Male Rats with Diabetes Mellitus and Histopathological Images of the Pancreas
Study This aim For analyze stock nanoemulsi extract rhizome turmeric ( Curcuma domestica Val .) uses GC-MS instruments , as well as the impact to level amylase , lipase, and damage scoring pancreatic beta cells on mouse males who suffer from diabetes mellitus . In addition that , research This Also evaluate description histopathology pancreas. Results study show that The results of GC-MS (Gas Chromatography-Mass Spectrometry) analysis for turmeric compound content usually include a number of chemical compounds that have various health benefits. Here are some of the main compounds often found in turmeric: Curcumin (30%): The main active compound that gives turmeric its yellow color and has anti-inflammatory and antioxidant properties, demethoxycurcumin (15.3%): A variant of curcumin with anti-inflammatory properties, bisdemethoxycurcumin (8.2%): Other compounds that play a role in the biological activity of turmeric, turmerone (5.7%): Compounds that contribute to aroma and have potential therapeutic effects, zingiberene (41%), beta-turmerone (2.8%) and volatile compounds (33.4): Such as zingiberene and beta-turmerone, which also have health benefits. Nanoemulsion of turmeric rhizome extract ( Curcuma Domestica val.) was proven to be effective in reducing amylase and lipase levels in alloxan-induced male white rats (Rattus norvegicus). The treatment group given nanoemulsion of turmeric rhizome extract ( Curcuma Domestica val.) at a dose of 180 mg/kgbb showed the most optimal results, with a significant decrease in amylase and lipase levels, approaching the values shown by the control group. In histopathological examination of the pancreas, the group given nanoemulsion of turmeric rhizome extract ( Curcuma Domestica val.) at a dose of 180 mg/kgbb also showed minimal tissue damage, marked by reduced β cell necrosis, reduced vacuosis, and increased islet density. Score 1 because the number of degenerative cells with a degree of damage (<1-25%) of the entire LP (Field of View), the number of necrotic cells <25% of the entire LP. and the number of inflammatory cells <10 in the entire space. Keywords: Nanoemulsi Turmeric , GC-MS, Amylase , Lipase, Pancreas.
Analysis of Workload and Factors Related to Work Discipline of Nurses in Inpatient Rooms of Hospitals: Literature Review
Discipline is something that is a benchmark to determine whether the role of a manager or leader as a whole can be carried out well or not. Discipline is also a form of nurse self-control and regular implementation in showing the level of seriousness of nurses' work in a hospital, where nurses who do not comply with the regulations set by the hospital will be sanctioned. Therefore, this disciplinary action cannot be applied carelessly, so it requires wise consideration. This study is a literature review that aims to analyze Workload and Factors Related to Work Discipline of Nurses in Inpatient Rooms of Hospitals.This research was conducted by searching journals through Proquest, Pubmed, Google Scholar, Garuda, and Sinta which were then selected according to the topic. This research is a study published in the last 5 years.The results of the literature review study showed that the relationship between workload and nurse characteristics and nurse work discipline was very significant.
Exploring Patients’ Perceptions of Evidence-Based Early Mobilization in Gastric Function Recovery After Abdominal Surgery: A Qualitative Phenomenological Study
Early mobilization after abdominal surgery is a critical component in the recovery of gastric function; however, its implementation in clinical settings remains challenged by various barriers and the absence of standardized protocols. This study aims to explore patients’ perceptions of early mobilization based on Evidence-Based Practice (EBP) in the context of gastric function recovery. A qualitative approach with a descriptive phenomenological design was employed, involving seven post-abdominal surgery patients selected through purposive sampling at Royal Prima Hospital Jambi. Data were collected using in-depth semi-structured interviews and analyzed through reflexive thematic analysis. The study identified four main themes: the meaning of early mobilization for patients, barriers to mobilization, the role of nurses and families, and patients' expectations of mobilization protocols. The findings reveal that while patients perceive early mobilization as an essential part of the healing process, fears, pain, and the lack of clear guidance emerged as major obstacles. The study concludes that the development of early mobilization protocols grounded in Evidence-Based Nursing and tailored to patients’ subjective experiences and local cultural contexts is crucial for effective and sustainable implementation in medical-surgical nursing practice.
The Effect of Pakkat (Calamus caesius Blume) Consumptionon Blood Glucose Levels in Diabetes Mellitus Patients
Background: Diabetes Mellitus (DM) is a global health problem with increasing prevalence. Pakkat (Calamus caesius Blume), a local plant from North Sumatra, is hypothesized to have hypoglycemic effects due to its phytochemical content, including flavonoids, saponins, and tannins. Objective: To determine the effect of pakkat consumption on blood glucose levels in DM patients. Methods: A quasi-experimental study with a one-group pretest-posttest design was conducted on 23 DM patients at Batang Toru Community Health Center. The intervention involved consuming 100 grams of pakkat for 4 consecutive days. Blood glucose levels were measured before and after the intervention. Data were analyzed using the Wilcoxon test. Results: The mean blood glucose level decreased from 238.1 mg/dL (pretest) to 181.4 mg/dL (posttest). Statistical analysis showed a significant difference (p-value < 0.05). Conclusion: Pakkat consumption effectively reduces blood glucose levels in DM patients. .Keywords: Pakkat, Blood Glucose Levels, Diabetes Mellitus, Hypoglycemic
The Effect Of Physical Activity On The Knowledge And Attitudes Of People With Diabetes Mellitus
Diabetes mellitus (DM) remains a major global health problem due to its increasing prevalence each year. Effective DM management aims to establish a healthy and balanced lifestyle, while failure to do so can lead to serious complications. One key component of diabetes management is regular physical activity. Efforts to promote such activity include improving patients’ knowledge and attitudes toward exercise. However, many DM patients still have limited understanding and maintain a focus solely on medication. This study analyzed the influence of knowledge and attitudes on physical activity among patients with DM at the Tenayan Raya Community Health Center, Pekanbaru. Using a quantitative cross-sectional design, the research involved 70 respondents who completed questionnaires assessing physical activity, knowledge, and attitudes. Data were analyzed using SPSS 25 and SmartPLS to test validity, reliability, and correlations. Reliability results were strong, with Cronbach’s Alpha (CA), Composite Reliability (CR), and Average Variance Extracted (AVE) values as follows: physical activity (CA = 0.933, CR = 0.937, AVE = 0.625), knowledge (CA = 0.932, CR = 0.941, AVE = 0.624), and attitude (CA = 0.929, CR = 0.933, AVE = 0.610). Path analysis revealed significant relationships, with T-statistics > 1.96 and p < 0.05 for all tested variables. The effect of knowledge on physical activity showed T = 8.060, p = 0.000, and the effect of attitude on physical activity showed T = 7.825, p = 0.000. These findings demonstrate that better knowledge and positive attitudes significantly enhance the likelihood of engaging in physical activity among DM patients, emphasizing the vital role of behavioral factors in diabetes self-management. Keywords: Diabetes Mellitus, Knowledge and Attitudes, Physical Activity, Diabetes Mellitus Management.
The Effect of Goji Berry Extract (Lycium barbarum L.) on the Number of Staphylococcus aureus Colonies in Total Plate Count (TPC) in Wistar Rats (Rattus novergicus) with Conjunctivitis
Background: Conjunctivitis is a common ocular infection that can be experimentally induced in animal models to evaluate potential therapeutic agents. This study investigated the antibacterial and healing effects of Lycium barbarum L. extract at varying concentrations compared with a standard antibiotic treatment in Wistar rats (Rattus novergicus) with induced conjunctivitis. Methods: Twenty-five male Wistar rats were randomly assigned to five groups: (1) placebo control, (2) levofloxacin-treated, (3) 25% extract, (4) 35% extract, and (5) 45% extract. Conjunctivitis was induced using Staphylococcus aureus, followed by topical administration of the assigned treatments. Clinical signs of inflammation and total bacteria on plate count were assessed before and after treatment. Data were analyzed using mixed-design ANOVA with Tukey’s post hoc test. Results: Significant differences were found across groups and between pretest and posttest treatment conditions (p < 0.05). The levofloxacin group showed the greatest reduction in bacterial colonies and inflammation. The 45% extract groups demonstrated marked improvement compared to the placebo, 25%, and 35% extract groups, indicating a concentration-dependent response. Conclusion: While levofloxacin exhibited superior antimicrobial efficacy, higher concentrations of Lycium barbarum L. extract also promoted recovery, supporting its potential as an adjunct therapy for bacterial conjunctivitis. Keywords: Conjunctivitis, Wistar rats, plant extract, antibiotic, ocular infection
Analysis of the Effect of Quality of Nursing Work Life (QNWL) Components on Nurses' Work Productivity at Royal Prima Hospital, Medan, in 2025
This study examines the influence of Quality of Nursing Work Life (QNWL) on the work productivity of nurses at Royal Prima General Hospital Medan. Nurses at the hospital have reported experiencing fatigue, heavy workloads, and dissatisfaction with the work environment, factors that potentially compromise the quality of nursing services. This study applied an analytical quantitative design with a cross-sectional approach. This study utilized total sampling, involving the entire population of 259 nurses at the hospital. The research instrument was a questionnaire distributed to the respondents. Findings revealed that 44.8% of nurses rated their QNWL as moderate, 34.0% as good, and 21.2% as low. Meanwhile, 78.4% of nurses demonstrated good work productivity, with 21.6% categorized as low. Statistical analysis indicated a significant positive correlation between QNWL and nurses’ work productivity (p = 0.000; p < 0.05). These results suggest that enhancing aspects of QNWL such as the work environment, job design, and work–life balance is important for sustaining and improving nurses’ productivity. Consequently, hospital management should prioritize optimizing these factors to support the delivery of high-quality nursing care. Keywords: Quality of Nursing Work Life, Work Productivity, Nurses, Hospital
The Effect of Spiritually-Based Acupressure Modification on Blood Sugar and Stress in Patients with Type 2 Diabetes Mellitus at the Pekanbaru Health Centre
Background: Type 2 Diabetes Mellitus (DM) is a chronic disease with rising prevalence, including in Pekanbaru, where the Garuda Health Centre reports the highest cases. Beyond blood sugar control, DM patients often experience stress due to long-term therapy and complication risks. Complementary therapies such as acupressure and spiritual approaches (dhikr) may help reduce stress and improve glycemic regulation. Objective: To determine the effect of spirituality-based acupressure modification on blood sugar and stress levels in type 2 DM patients at the Garuda Pekanbaru Health Centre. Methods: A quasi-experimental study with a non-equivalent control group design was conducted on 42 patients (21 intervention, 21 control) selected by purposive sampling. Stress was measured using the Depression Anxiety Stress Scale (DASS), and blood sugar levels were measured using a glucometer. The intervention combined dhikr and acupressure therapy administered for three days. Data were analyzed using Independent t-test and Linear Mixed Model. Results: Before the intervention, no significant difference was found in blood sugar levels (p=0.617), while stress levels differed significantly (p<0.001). After the intervention, the intervention group showed a significant reduction in stress (p=0.030) and blood sugar levels (p=0.027) compared to controls. Linear Mixed Model analysis confirmed significant time×group interactions for both stress (p<0.001) and blood sugar (p<0.001), indicating greater decreases in the intervention group. Conclusion: Spirituality-based acupressure modification effectively reduces stress and blood sugar levels in type 2 DM patients, suggesting its potential as a holistic, affordable, non-pharmacological therapy in healthcare practice. Keywords: Type 2 Diabetes Mellitus, Acupressure, Dhikr, Spiritual, Stress, Blood Sugar
Junior Doctors’ Perception of Professionalism in Clinical Practice at Drs. H. Amri Tambunan General Hospital: A Qualitative Study
Background: Junior doctors are at a critical early stage in their medical careers, where professionalism plays a central role in ensuring the quality of healthcare services. This study aims to evaluate the perceptions of junior doctors regarding professionalism in clinical practice at Drs. H. Amri Tambunan General Hospital, as well as to identify the influencing factors and challenges faced in its application. Method: This research employed a qualitative descriptive design, with data collected through observations and in-depth interviews with five junior doctors from various outpatient departments. The data were analyzed using thematic analysis as introduced by Braun and Clarke (2021). Result: The findings indicate that although junior doctors generally have a good conceptual understanding of professionalism, its implementation is often hindered by high workloads, environmental pressures, and a lack of structural support and effective role models. Conclusion: This study provides valuable insights for healthcare institutions to develop training programs and support systems that can strengthen the professionalism of junior doctors in medical practice.
Evaluation of Referral System Barriers at Dr. Pirngadi Hospital, Medan City: Qualitative Study of In-depth Interviews
The referral system plays an important role in ensuring the continuity of health services, especially in advanced referral hospitals such as RSUD dr. Pirngadi Medan City. However, its implementation still faces various obstacles, ranging from coordination between health facilities, limited facilities, to administrative issues. The purpose of this study was to analyze the obstacles in the implementation of the referral system at RSUD dr. Pirngadi Medan City and evaluate its impact on the effectiveness and quality of health services. The study used a qualitative approach with a case study method and in-depth interview techniques with key informants, consisting of specialist doctors, nurses, and administrative officers. Data were analyzed thematically using the Braun & Clarke method (2021). The results of the study showed that internal hospital coordination was effective, but obstacles still emerged when making external referrals to other hospitals, especially related to slow responses and bed availability. Several units at RS Pirngadi also experienced limited medical personnel and equipment. However, administrative procedures were considered not to be a significant obstacle because they were supported by an electronic medical record system and BPJS/UHC policies. It was found that there were obstacles in the referral system at RSUD dr. Pirngadi Medan generally came from external factors and certain resource limitations. Strengthening external coordination, provision of facilities, and optimization of information systems are needed to increase the effectiveness of referrals.
Nursing Care With Back Massage Therapy in Overcoming Fatigue in Chronic Kidney Disease (CKD) Patients
Chronic kidney failure is a disorder of the structure or function of the kidneys that is damaged. Patients must receive Renal Replacement Therapy, one of which is hemodialysis. Hemodialysis needs to be done routinely by patients 1-3 times a week and takes about 4-5 hours in each session. One of the side effects that often occurs in hemodialysis patients is fatigue. Fatigue can be overcome with non-pharmacological therapy, namely back massage. The purpose of this study was to determine how researchers can provide nursing care by providing back massage therapy to overcome fatigue in Chronic Kidney Disease patients. This case study was conducted with a pretest-posttest design using the FAS questionnaire. The results of the study were conducted for 3 days, where on the first day before being given a back massage it was in the category of severe fatigue and after being given a back massage on the third day the results were in the category of moderate fatigue. Where the patient said his body felt more relaxed and did not feel tired, felt there was energy. It can be concluded that providing back massage therapy can reduce fatigue in Chronic Kidney Disease patients undergoing hemodialysis.
Family Physician Counseling, Family Support, and Medication Adherence Among Tuberculosis Patients
Tuberculosis (TB) remains a major global health threat, where treatment success is critically dependent on long-term medication adherence. Non-adherence contributes to treatment failure, drug resistance, and continued community transmission. This study aimed to analyze the impact of family physician counseling and family support on treatment adherence among TB patients in Medan Marelan, an area with a high TB burden in Indonesia. A cross-sectional study was conducted with 55 TB patients selected through total sampling. Data on the quality of family physician counseling, level of family support, and treatment adherence were collected using validated questionnaires. The relationship between variables was analyzed using the Chi-Square test. The majority of patients received good quality counseling (72.7%) and were adherent to their treatment (76.4%). A highly significant association was found between the quality of family physician counseling and treatment adherence (p=0.000). Patients who received "good" counseling had an adherence rate of 95.0%, which dropped to 0% for those receiving "poor" counseling. Family support also showed a significant association with adherence (p=0.037), with 75.0% of patients with "good" support being adherent. In conclusion, quality of family physician counseling is a powerful determinant of medication adherence among TB patients, with family support also playing a significant role. Integrating structured, high-quality counseling into standard TB care is essential for improving treatment outcomes and advancing public health goals for TB elimination. Keywords: tuberculosis, treatment adherence, family physician counseling
Analysis of Risk Factors Affecting the Occurrence Nosocomial Infections in Pediatric Inpatient Rooms
Nosocomial infections are infections that occur in patients, caregivers in hospitals or other healthcare facilities. These infections can affect various organs, such as the urinary tract, lungs, gastrointestinal tract, brain membranes, and surgical wounds. Nosocomial infections can be the biggest cause of death in patients undergoing hospitalization. The general objective of this study was to determine the risk factors that influence the occurrence of Nosocomial infections in the Pediatric Ward of RSU. Royal Prima Marelan.This type of research is quantitative research, the research design uses case control by looking at primary data from questionnaires and secondary data from patient medical records. Data collection from April to May 2025. Analysis used by univariate analysis, bivariate with chi square, multivariate with multiple logistic regression.The results showed that the three variables had a significant effect, namely nosocomial infection prevention measures, factors that influence the occurrence of nosocomial infections, and the Infection Control Program influenced each other from cases of nosocomial infections at Royal Prima Marelan Hospital with a sig p-value <0.05. Variable Nosocomial Infection Prevention Measures with an OR value of 28.367. Variable Risk Factors Affecting the Occurrence of Nosocomial Infections with an OR value of 9.462.The most dominant factor influencing the prevention of Nosocomial Infections at Royal Prima Marelan Hospital is Nosocomial Infection Prevention Measures with an OR value of 28.367 Prevention of nosocomial infections is expected to be carried out by applying aseptic and antiseptic principles during medical actions. good cooperation between staff from various professions involved in patient care is very important in infection control programs.
Analysis of Risk Factors For Work Stress Among Health Workers at Bhayangkara Hospital TK II Medan
Occupational stress among healthcare workers has many factors. Mismatch between job requirements and available resources, excessive workload, work environment, work experience, workplace conflict, gender discrimination, marital status, educational status, job satisfaction, and lack of appreciation are some factors that are significantly associated with occupational stress among healthcare professionals. The purpose of this study was to analyze the risk factors for occupational stress among healthcare workers at Bhayangkara Hospital Level II Medan. The study was conducted at Bhayangkara Hospital Level II Medan. The type of research used was an analytical survey. The population was all healthcare workers at Bhayangkara Hospital Level II Medan, totaling 335 healthcare workers. Sampling used total sampling so that the sample size was 335. Data analysis used univariate, bivariate, and multivariate analysis. The results showed that the variables of marital status, workload, work shifts, interpersonal relationships, and family situations influenced the occurrence of occupational stress among healthcare workers at Bhayangkara Hospital Level II Medan, while the variables of age, gender, and length of service did not. The variable that has the most influence on the occurrence of work stress in health workers at Bhayangkara Hospital Class II Medan is the family situation variable.
The Effect Of Motivation Work Climate and Leadership on Nurses Productivity at RS Royal Prima Jambi : A Cross-Sectional Study
This study aims to examine the effect of motivation, work climate, and leadership on nurse productivity at RS Royal Prima Jambi. Nurse productivity is essential in maintaining hospital service quality. RS Royal Prima Jambi, a private hospital in Jambi, has experienced a sharp increase in nurse turnover from 9.5% in 2023 to 19.5% in 2024, indicating workforce instability. This quantitative study used a cross-sectional design involving 69 nurses selected through total sampling. Data were collected using questionnaires and analyzed with logistic regression. The results showed that both motivation and work climate significantly influenced nurse productivity (p < 0.05), with work climate emerging as the most dominant factor (OR = 21.115), followed by motivation (OR = 6.231). Leadership, however, did not show a significant direct impact on productivity. These findings highlight the need for hospitals to improve work environments and implement motivational strategies to enhance nurse performance. It is recommended that hospital management invest in leadership development, foster recognition systems, and create supportive work conditions to maintain a productive and stable nursing workforce.
GC-MS Identification of Lime Peel Extract Nanoemulsion (Citrus Aurantifolia) Against the LevelsGDP,HbA1c and MDA And Histopathological Image of Pancreas of Male Wistar Rats Induced by Streptozotocin
Some people may not realize they have diabetes because they do not experience any symptoms..In some cases, the disease can be detected early with routine blood tests before symptoms appear.This study aims to identify the GC-MS of lime peel extract nanoemulsion (Citrus aurantifolia) against the levels ofGDP,HbA1c and MDAand histopathological picture of the pancreas of rats. Male Wistar rats induced by streptozotocin. A sample of 24 rats in 4 groups (control, treatment 1, 2, and 3) where the extract preparation in the treatment was in the form ofNanoemulsion of lime peel extract (Citrus aurantifolia) at concentrations F1 (1%), F2 (1.5%) and F3 (2%). The results showed that the compounds contained in lime extract (Citrus aurantifolia) through GC-MS analysis werelimonene, hesperidin, and limonin. Fasting blood sugar levels (GDP), glycated hemoglobin levels(HbA1c) and levelsMalondialdehyde (MDA) levels improved in the group given lime extract nanoemulsion.(Citrus aurantifolia), and the most effective is given at a concentration of 2%. In the observation of the pancreas organs of mice through histopathology of the pancreas of mice, it was seen that the administration of lime extract nanoemulsioneffective in healing pancreatic cells that suffer from diabetes mellitus.
Effectiveness Test of Mangosteen Peel Extract (Garcinia Mangostana L) Nanoemulsion Preparation on the LevelsGDP,HbA1c, MDAAnd Histopathological Image of the Pancreas of Alloxan-Induced Diabetes Mellitus Rats
A bad lifestyle can cause diabetes.Mostly, diabetes mellitus is caused by uncontrolled food consumption or side effects from the use of certain drugs.This research was conducted to see howThe effectiveness of nanoemulsion preparation of mangosteen peel extract (Garcinia mangostana L.) on GDP, HbA1c and MDA levels and histopathological features of the pancreas of alloxan-induced diabetic rats. The study usedA sample of 20 mice in 5 groups (positive control, negative, treatment 1, 2 and 3) where the extract preparation in the treatment was in the form ofnanoemulsion of skin extractmangosteen peel extract (Garcinia Mangostana L)onconcentration of F1 (1%), F2 (2%), and F3 (3%). The results of the GDP levels of groups P1, P2 and P3 are105.5 mg/dL, 92 mg/dL, 86.5 mg/dL. For blood sugar levelsHbA1c levels were 5.3%, 4.8%, and 4.6%, respectively, and MDA levels were 3.22%.nmol/mL, 2.6 nmol/mL and 2.25 nmol/mL. Administration of mangosteen peel extract nanoemulsion (Garcinia Mangostana L)effective in healing pancreatic cells that suffer from diabetes mellitus andadministration at a concentration of 3% extract showed that pancreatic cells no longer experienced necrosis.
Activity Test of Lime Peel Extract Nanoemulsion Preparation (Citrus Aurantifolia) on Reducing SGOT-SGPT Levels, Assessment of Necrosis, Fibrosis and Liver Lobules in Wistar Rats(Rattus Norvegicus) Streptozotocin-Induced
In humans, the liver is an organ involved in various processes important for life.Insulin resistance can lead to chronic liver damage, such as cirrhosis and liver failure. SGOT and SGPT are two enzymes produced by liver cells and used to assess liver function. Elevated SGOT and SGPT levels can be caused by hepatitis, fatty liver disease, gallbladder obstruction, and other diseases. This study was conducted toto see how the activity of lime peel extract nanoemulsion preparation (Citrus aurantifolia) reduces SGOT-SGPT levels, assesses the level of necrosis, fibrosis and liver lobules in rat strains(Rattus Norvegicus)streptozotocin-induced. A sample of 25 mice in 4 groups (control, treatment 1, 2, and 3) where the extract preparation in the treatment was in the form ofnanoemulsion of lime peel extract (Citrus aurantifolia) at concentrations F1 (1%), F2 (1.5%) and F3 (2%). The results observed inDiabetes mellitus can cause liver dysfunction. AndLime peel (Citrus aurantifolia) extract nanoemulsion is effective for treating liver function in diabetic rats and the effective extract concentration sequence is F3 (2%), F2 (1.5%) and F1 (1%).
Antidiabetic Activity of Mangosteen (Garcinia Mangostana L.) Peel Extract Nanoemulsion on Reducing Glucose Levels, Liver Function (SGOT-SGPT) and Liver Histopathology in Male Rats
If not properly controlled, diabetes can lead to serious complications, including hypertension, diabetic neuropathy, kidney disease, heart disease, stroke, and liver disorders. SGOT and SGPT are two types of enzymes produced by liver cells, used to examine liver function. This study was conducted to determine the antidiabetic activity of mangosteen (Garcinia mangostana L.) rind extract nanoemulsion on reducing glucose levels and liver function (SGOT-SGPT) and liver histopathology in male rats.The sample of mice used was 24 in 4 groups (control, treatment 1, 2 and 3) where the extract preparation in the treatment was in the form ofnanoemulsion of skin extractmangosteen peel extract (Garcinia Mangostana L)onconcentrations of F1 (1%), F2 (2%), and F3 (3%).OnThe average examination of the levels of KGD, SGOT-SGPT in rats that had diabetes mellitus and were given mangosteen peel extract at a concentration of 1% KGD was 124.3 mg/dL, SGOT 93.1 U/L and SGPT 26.5 U/L. At a concentration of 2% KGD was 94.5 mg/dL, SGOT 75.8 U/L and SGPT 21.1 U/L. At a concentration of 3% KGD was 80.1 mg/Dl, SGOT 52.8 U/L and SGPT 18.5 U/L. In liver histopathologyThe best result group was in treatment group 3 (P3) which was given a 3% concentration of mangosteen peel extract nanoemulsion.
Identification of Gc-Ms Nanoemulsion Preparation of Temulawak Extract (Curcuma Zanthorrhiza Roxb) in Improving Kidney Function and Histopathological Features of the Kidneys of Diabetes Mellitus Rats
The kidneys are the main organs that can excrete drugs..One of the causes of kidney damage in a person is due to continuously high blood glucose conditions which can lead to diabetes mellitus.This study aims to identify the GC-MS nanoemulsion preparation of temulawak extract (Curcuma Zanthorrhiza Roxb) in improving kidney function and histopathological features of the kidneys of diabetic rats. The sample of rats used was 20 in 5 groups (positive and negative controls, treatments 1, 2 and 3) where the extract preparation in the treatment was in the form ofnanoemulsion of temulawak extractondoses of 50 mg/kgbb, 100 mg/kgbb, 150 mg/kgbb. The results areCompounds such as xanthorrhizol, germacrone, curcumin, and β-caryophyllene are the main candidates in temulawak extract that contribute to its antidiabetic effects. The extract was effective in treating diabetes in mice and improving kidney function at a dose of 150 mg/kg body weight.
The Effect Of Nanoemulsion Preparation Of Bay Leaf Extract ( Syzygium Polyanthum ) On Reducing Regenerating Islet-Derived Protein 3 Beta (Reg3β) And C-Reactive Protein (Crp) Levels In Wistar Rats With Diabetes Mellitus
This study aims to evaluate the effect of bay leaf ( Syzygium polyanthum ) extract nanoemulsion preparations on reducing regenerating islet-derived protein 3 beta (REG3β) and C-reactive protein (CRP) levels in Wistar rats with diabetes mellitus. The method used includes the preparation of nanoemulsion preparations and measurement of REG3β and CRP levels as indicators of inflammation and pancreatic damage. Rats were divided into control and treatment groups, where the treatment group received bay leaf extract nanoemulsion preparations. The results showed that treatment with nanoemulsion significantly reduced REG3β and CRP levels compared to the control group. Nanoemulsion extract Bay leaves ( Syzygium Polyanthum) contain secondary metabolites in the form of saponins, tannins, flavonoids, and triterpenoids which help repair pancreatic cells that experience inflammation due to diabetes mellitus. Administration of nanoemulsion extract Bay leaves ( Syzygium polyanthum) at a concentration of 3.5% were effective in improving liver function in Wistar white rats ( Rattus norvegicus ) with diabetes mellitus. This improvement can be seen through CRP levels and liver histology structure which improved and resembled the control group . The results of histopathological observations of pancreatic tissue in treatment group 3 were as follows: nanoemulsion extract Bay leaves ( Syzygium Polyanthum) with a concentration of 3.5% experienced the most significant improvement and approached the control group compared to the other groups. This finding indicates that bay leaf extract has potential as an anti-inflammatory agent and pancreatic protector in diabetes mellitus.
The Effect of Bay Leaf Extract Nanoemulsion Preparation ( Syzygium Polyanthum ) on Reducing Myeloperoxidase (Mpo) and Histamine Levels in Kidney Pathology in Wistar Rats with Diabetes Melitus
Sudy aimed to evaluate the effect of bay leaf (Syzygium polyanthum) extract nanoemulsion on reducing myeloperoxidase (MPO) levels in Wistar rats with diabetes mellitus. The rats were divided into control and treatment groups, where the treatment group received bay leaf extract nanoemulsion. The results showed that treatment with nanoemulsion significantly reduced MPO levels compared to the control group. Administration of bay leaf extract nanoemulsion Bay leaves ( Syzygium polyanthum) at a concentration of 5% were effective in improving kidney function in Wistar white rats ( Rattus norvegicus ) with diabetes mellitus. This improvement was evident through MPO levels and the histopathological structure of the kidneys, which improved and resembled the control group . The results of histopathological observations of kidney tissue in treatment group 3 were as follows: nanoemulsion extract Bay leaves ( Syzygium Polyanthum) with a concentration of 5% experienced the most significant improvement and were closer to the control group compared to the other groups. Nanoemulsion extract Bay leaves ( Syzygium Polyanthum) contain secondary metabolites in the form of saponins, tannins, flavonoids, and triterpenoids which help repair liver cells that experience fatty liver and necrosis due to diabetes mellitus. Furthermore, histopathological examination of the kidneys showed improvements in kidney tissue, indicating the potential of bay leaf extract in reducing oxidative stress and inflammation. This study concluded that bay leaf extract nanoemulsion preparation could be an effective therapy for managing kidney complications in diabetes mellitus.
Activity Test of Cinnamon Bark Extract ( Cinnamomum Burmannii ) Nanoemulsion Preparation on Reducing Urea, Creatinine, and Kidney Histopathology in Male Rats Induced by Alloxan
This study aims to test the activity of a nanoemulsion preparation of cinnamon bark extract ( Cinnamomum burmannii ) in reducing urea and creatinine levels, and evaluating the histopathological features of the kidneys in alloxan-induced male rats. Rats were divided into several groups, including a control group and a group treated with a nanoemulsion preparation of cinnamon bark extract. Urea and creatinine levels were measured to assess kidney function, while histopathological analysis was performed to evaluate changes in kidney tissue morphology. The results showed that treatment with a nanoemulsion preparation of cinnamon bark extract significantly reduced urea and creatinine levels and improved the histopathological features of the kidneys compared to the control group. Nanoemulsion of cinnamon bark extract (Cinnamomum burmannii) was proven to be effective in reducing blood glucose, urea, and creatinine levels in male white rats (Rattus norvegicus) of the Wistar strain induced by alloxan. The treatment group given nanoemulsion with a concentration of 20% showed the most optimal results, with a significant decrease in blood sugar, urea, and creatinine levels, approaching the values shown by the negative control group. In histopathological examination of the kidneys, the 20% treatment group also showed minimal tissue damage, characterized by only mild thickening of the glomerular basement membrane, compared to the other groups. These findings suggest the potential of cinnamon bark extract as a nephroprotective agent in the management of diabetes-induced kidney damage.
Gc-Ms Instrument Analysis Test Of Nano Emulsion Preparation Of Turmeric Rhizom Extract (Curcuma Domestica Val.) On The Reduction Of Ureum And Creatinine Levels And Histopathological Picture Of The Kidney In Male Rats Induced By Alloxan
Study This aim For To determine the potential of nano emulsion preparations of turmeric rhizome extract ( Curcuma domestica val.) and test it on reducing urea and creatinine levels and histopathological features of the kidneys in male rats induced by alloxan. Methods used covering distribution mouse become a number of group treatment , where stock nanoemulsi extract turmeric given orally . Urea levels And creatinine measured before And after treatment , and analysis histopathology done For evaluate change structural on kidney . Results study show that giving nanoemulsi extract turmeric in a way significant lower level urea And creatinine compared to with group control . Turmeric rhizome extract nanoemulsion ( Curcuma Domestica val.) was proven to be effective in reducing blood glucose, urea, and creatinine levels in male Wistar rats (Rattus norvegicus) induced by alloxan . The treatment group given turmeric rhizome extract nanoemulsion ( Curcuma Domestica val.) at a dose of 180 mg/kgbw showed the most optimal results, with a significant decrease in blood sugar, urea, and creatinine levels, approaching the values shown by the control group. In kidney histopathology examination, the group given turmeric rhizome extract nanoemulsion ( Curcuma Domestica val.) at a dose of 180 mg/kgbw also showed minimal tissue damage, characterized by only mild thickening of the glomerular basement membrane, compared to the other groups. Conclusion from study This is that stock nanoemulsi extract rhizome turmeric effective in lower level urea And creatinine , as well as repair condition histopathology kidneys , so that potential as therapy alternative For disturbance function kidney due to diabetes.
Activity Test of Chia Seed ( Salvia Hispanica ) Extract Nanoemulsion on Reducing Urea and Creatinine Levels in Male Rats Induced by Streptozotocin and Kidney Histopathology
This study aims to evaluate the activity of chia seed extract nanoemulsion in reducing urea and creatinine levels in streptozotocin-induced male rats, as well as to observe the histopathological features of the kidneys. Urea and creatinine levels were measured before and after treatment. The results showed Based on the results of blood glucose level measurements, administration of chia seed extract nanoemulsion with a concentration of 20% showed a more significant decrease in blood glucose levels. The results of the statistical test obtained a significance value of 0.074, so it can be concluded that treatment group 2 was not significantly different from the negative control group, indicating the potential antidiabetic effect of chia seed extract nanoemulsion . Observations on kidney function showed an improvement in urea levels. Chia seed extract nanoemulsion with a concentration of 20% was more effective in improving kidney function than a concentration of 10%. The urea value of treatment group 2 approached the negative control group, indicating the potential for nephroprotection. The results of observations on creatinine levels showed that treatment group 2 with the administration of 20% Chia seed extract nanoemulsion obtained a significance value of 0.382, the meaning of which was not different from the negative control group. Administration of a 20% concentration of chia seed extract nanoemulsion was more effective in protecting the structure of the kidney glomeruli than a 10% concentration. This nephroprotective effect is thought to be due to the flavonoids, phenolic acids, and antioxidants that suppress inflammation and oxidative stress.
Gc-Ms Instrument Analysis Test of Mint Leaf Extract Nanoemulsion ( Mentha Piperita L.) On the Reduction of NAFLD Scores and Necrosis Levels in Alloxan-Induced Hyperglycemic Wistar Rats and a picture of Histopathology Liver
Study evaluated the effectiveness of mint leaf extract nanoemulsion (Mentha piperita L.) in reducing NAFLD scores and necrosis levels in alloxan-induced hyperglycemic Wistar rats. The method used included GC-MS instrument analysis to identify the active compounds in mint extract. Rats were divided into control and treatment groups, where the treatment group received mint extract nanoemulsion. The results showed that treatment with nanoemulsion significantly reduced NAFLD scores and liver necrosis compared to the control group. The content of active substances in mint leaf extract ( Mentha piperita L) through Gc Ms Analysis, namely Menthol : 45%, Menthone : 20%, Isomenthone : 10%, Limonene : 5%, Cineole (Eucalyptol) : 3%, Borneol : 2%, Carvone : 1% and Other Compounds : 14% (including fatty acids and other minor compounds). The results showed that administration of mint leaf nanoemulsion significantly reduced NAFLD scores, with an increasing effect at higher concentrations. The 5% group showed no NAFLD symptoms, indicating the most significant protective effect . Microscopic images of the liver of mice in treatment group 3 showed improved histological structure of the liver, so that it experienced improvement entering the score category 1 with no necrotic cells . This study concluded that mint leaf extract nanoemulsion could be a therapeutic alternative for liver disorders related to hyperglycemia.
EFFECTIVENESS OF RADISH (Raphanus sativus) EXTRACT IN REDUCING TNF-α AND NITRIT OXIDA LEVELS IN TIPE II DM RAT MODELS WITH TRAUMATIC BRAIN INJURY
Introduction: The devastating effects of traumatic brain injury (TBI) are fatal, and there is no effective treatment for primary brain injury, especially in patients with diabetes mellitus (DM). Nitric oxide (NO) is a compound that causes systemic vasodilation; a decrease in NO reduces cerebral blood flow after TBI. There is an increase in TNF-α levels demonstrated by mononuclear cells surrounding the traumatic lesion in the rat brain. Raphanus sativus (radish) is a root vegetable belonging to the Brassicaceae family, which has anti-diabetic effects by lowering blood glucose levels, reducing lipid peroxidation, and improving brain function, thereby protecting against neurotoxic effects associated with oxidative stress in experimental mouse models. Objective: To evaluate the efficacy of radish extract (Raphanus sativus) in reducing TNF-α and nitric oxide levels in a rat model of type II diabetes mellitus with traumatic brain injury. Method: This study was an in vivo laboratory experimental study with a post-test only control group design. The study population consisted of 25 Wistar rats, which were then induced with diabetes and subjected to a modified Feeney Model closed head injury. After complete data collection, KGD and ELISA assessments were performed, followed by data analysis. Results: There were significant differences (p<0.05) in serum NO and serum TNF-α levels between the normal group, the 100 mg/kg radish extract group, the 300 mg/kg radish extract group, and the 500 mg/kg radish extract group compared to the negative control group. This indicates that radish extract, starting at a dose of 100 mg/kg, can reduce serum NO and serum TNF-α levels. Conclusion: Radish extract (Raphanus sativus) is effective in reducing TNF-α and nitric oxide levels in a Wistar rat model of type II DM with traumatic brain injury. Keywords: Diabetes Mellitus, Nitric Oxide, Raphanus sativus, TNF-α, Traumatic Brain Injury, Wistar Rats
Analysis of Infectious Waste Management at Dental and Oral Hospital of North Sumatra University
Hazardous medical waste management requires sustainable practices that integrate social, economic, technical, and environmental aspects. Approximately 10–25% of medical waste is categorized as hazardous and poses significant health risks. This study aims to analyze the management of infectious waste at the Dental and Oral Hospital of North Sumatra University. The research is qualitative with a case study approach. Informants were selected using purposive sampling based on specific criteria. Data were analyzed thematically using the Miles and Huberman model. Findings show that infectious waste commonly found at the Dental and Oral Hospital of North Sumatra University includes masks, gloves, bandages, tissues, syringes, and gowns. The hospital’s waste management practices align with the Indonesian Ministry of Environment and Forestry Regulation No. P.56 of 2015. Human resources involved in waste management at Dental and Oral Hospital of North Sumatra University include one Head of Medical and Non-Medical Services, Medical Support, and Nursing at Dental and Oral Hospital of North Sumatra University, two staff members, and four operational officers.The study concludes that the management of infectious waste at Dental and Oral Hospital of North Sumatra University—covering sorting, transportation, storage, destruction, and final disposal—is functioning adequately. However, improvements can still be made. It is recommended that Dental and Oral Hospital of North Sumatra University acquire its own waste destruction equipment to minimize accumulation and enhance efficiency. Additionally, increasing the number of personnel in the waste management division is advised to support more effective operations. Keywords: Hazardous Medical Waste, Management Waste, Infectious.
The Role of Education Using the Transtheoretical Stages of Change Approach in Digital Substraction Angiography Patients: A Literature Review
Introduction: Effective health education is crucial to improving procedure outcomes and patient compliance. The Transtheoretical Stages of Change approach has been proven effective in changing health behaviour by tailoring interventions to the patient's psychological readiness. This literature review aims to analyse the role and effectiveness of health education integrated with the Transtheoretical Stages of Change approach in patients undergoing DSA procedures. Method: A literature review was conducted by searching electronic databases such as PubMed, Google Scholar, and ScienceDirect. The search was limited to publications from 2020 to 2025. Results: The review results indicate that the Stages of Change approach is effective in identifying patients' readiness levels. Patients in the precontemplation and contemplation stages require education to raise awareness, while patients in the preparation and action stages require practical information and support to maintain behaviour. Integration of TTM in pre-DSA education significantly reduces anxiety levels, improves compliance with pre-procedure instructions and increases patient satisfaction. Conclusion: Personalised health education using the Transtheoretical Stages of Change framework is a strategic and effective approach to preparing patients for DSA. This approach enables targeted education, thereby improving clinical outcomes and the overall patient experience. Keywords: Transtheoretical Model, Stages of Change, Digital Subtraction Angiography, Health Education, Knowledge.
The Influence of Preceptorship on Job Satisfaction and Retention Among Newly Graduated Nurses in the Inpatient Unit at Royal Prima Hospital Jambi
Newly graduated nurses often face challenges transitioning from academic settings to clinical practice, which can negatively affect their job satisfaction and retention. Preceptorship, a model involving guidance by experienced nurses, has been proposed as a strategy to ease this transition and improve nurse outcomes. This study aimed to examine the influence of preceptorship on job satisfaction and retention among newly graduated nurses in the inpatient unit of Royal Prima Hospital, Jambi, Indonesia. Using a mixed-method explanatory sequential design, quantitative data were collected via structured questionnaires from 50 newly graduated nurses who underwent the preceptorship program. Qualitative data were gathered through in-depth interviews with selected participants. Results indicated a significant positive impact of preceptorship on both job satisfaction and intention to remain in the institution. Key factors contributing to these outcomes included emotional support, competency development, and role clarity provided by preceptors. The findings suggest that structured preceptorship programs can be effective organizational interventions to enhance new nurse adaptation, reduce turnover, and promote sustainable workforce stability. These insights are vital for healthcare managers and policymakers aiming to optimize nursing human resource strategies in Indonesia and similar contexts. Keywords: Preceptorship, Job Satisfaction, Nurse Retention, Newly Graduated Nurses, Nursing Workforce
The Effectiveness of Kaffir Lime Leaf Extract (Citrus hystrix DC) on Incised Wound in Wistar Rats (Rattus novergicus)
Incised wounds are injuries caused by cuts from sharp instruments, characterized by open wounds, pain, and a wound length greater than its depth. The extract of kaffir lime leaf (Citrus hystrix DC) is believed to have antibacterial and anti-inflammatory properties that can accelerate the wound healing process. This study aims to determine the effectiveness of kaffir lime leaf extract on the healing of incised wounds in Wistar rats. This research used a true experimental method with a control group design. A total of 25 rats were divided into five groups: a negative control group (P0) treated with 0.9% NaCl, a positive control group (P4) treated with 0.1% gentamicin, and three treatment groups (P1, P2, P3) treated with kaffir lime leaf extract at concentrations of 10%, 20%, and 30%. Observations were carried out for 14 days. The results showed macroscopic changes, particularly in the average wound length and wound condition characterized by erythema, redness, dry open wounds, and dry closed wounds. Histopathological observations revealed the highest number of fibroblasts and collagen fibers in group P1. ANOVA test showed no significant difference between groups (p > 0.05), although the 10% extract proved to be more effective in healing incised wounds.
Multivariate Analysis of Determinants of Balanced Diet Adherence among Diabetes Mellitus Patients Lia Fentia1, Chrismis Novalinda Ginting2, Linda Chiuman2,*
Diabetes mellitus is an increasing health problem that requires proper management, including adherence to a balanced diet. This study aims to analyse the factors associated with adherence to a balanced diet and identify the dominant factors in patients with type 2 Diabetes Mellitus in Pekanbaru. The research design used a cross-sectional quantitative method with a sample of 234 respondents taken by proportional random sampling from 21 health centres based on the number of registered patients according to the inclusion and exclusion criteria. Data were analysed using chi square test and multiple logistic regression. The results showed that higher education (p=0.0001; OR=3.25), positive intention (p=0.0001; OR=2.58), favourable perception (p=0.006; OR=2.18), as well as family support (p=0.0001; OR=3.02) and health worker support (p=0.0001; OR=4.90) were significantly associated with dietary adherence. Multivariate analysis revealed family support (p=0.001; OR=4.29) as the dominant factor influencing dietary adherence, followed by health professional support (p=0.001; OR=3.79) and individual intention (p=0.003; OR=2.77). Perception had no significant effect in the final model. These findings emphasise the important role of family support and healthcare professionals in improving dietary adherence of diabetic patients and the need for integrated interventions for sustainable disease management.
ANALYSIS OF WORK SAFETY MONITORING BASED ON THE THEORY OF PLANNED BEHAVIOR ON WORK SAFETY OF WORKERS IN PALM OIL FACTORIES
High-risk industries, such as palm oil mills, require the optimal implementation of occupational safety and health (OSH) procedures. However, workers' compliance with OSH procedures is still inadequate. This study aims to analyze the relationship between workplace safety monitoring and workers' OSH behavior based on the Theory of Planned Behavior (TPB). The study employs a quantitative, cross-sectional design and involves 120 PT Sumber Tani Agung workers. Data were obtained through observation instruments, namely the K3 Field Monitoring form, completed by supervisors of each division, and a K3 occupational safety and health behavior questionnaire, completed by workers. Data analysis was performed using the Spearman correlation test in SPSS 25. The results showed a strong relationship between safety monitoring and workers' safety and health behavior (r = 0.851, p < 0.001). These results reinforce the idea that external control through direct supervision plays an important role in fostering a positive safety culture in high-risk work environments.
FACTORS THAT INFLUENCE MOTHERS WITH DIABETES MELLITUS IN PROVIDING EXCLUSIVE BREASTFEEDING TO INFANTS AGED 0-6 MONTHS
Breast milk (ASI) is water produced by humans for consumption by babies and the main source of nutrition in meeting the baby's nutritional needs. Breastfeeding should be started early and is the only method used for babies. Breastfeeding helps defend the body against disease because breast milk contains antibodies. Decree of the Minister of Health Number 450/MenKes/SK/IV/2004 issued by the Ministry of Health stipulates that health workers must inform newlyweds that they are able to provide exclusive breastfeeding. The purpose of this study was to determine the Factors that Influence Exclusive Breastfeeding Mothers Diabetes melitus for Ages 0-6 Months. This type of research uses cross-sectional methodology and is analytical and observational. The sampling technique used is non-probability sampling with the Accidental Sampling approach and the number of samples is 52 respondents. Data collection through questionnaires. The results of the study showed that 40 respondents (76.92%) who provided exclusive breastfeeding were 22 respondents (48.8%) mothers with good knowledge who provided exclusive breastfeeding with a p-value of 0.000 with an OR (Odds Ratio) of 12.833, meaning that mothers Diabetes melitus with good knowledge have a 12.833 times greater chance of providing exclusive breastfeeding than mothers with less knowledge. While the relationship between maternal Diabetes melitus attitudes and the provision of exclusive breastfeeding obtained p-value 0.002, with OR (Odds Ratio) 2.429 means that mothers who have a Positive Attitude have a 2.429 times chance of giving exclusive breastfeeding compared to mothers who have a negative attitude. Health workers need to improve mothers' understanding of exclusive breastfeeding and their support, and families in an effort to increase exclusive breastfeeding need to follow the socialization of health workers and actively seek information about exclusive breastfeeding. Mothers Diabetes melitus who have babies aged 0-6 months need to improve their knowledge and attitudes about exclusive breastfeeding.
ANALYSIS OF FACTORS INFLUENCING THE LEVEL OF NURSES' DEPRESSION AT X HOSPITAL MEDAN IN 2024
This study aims to analyze the factors that influence the level of depression in nurses at XGeneral Hospital Medan in 2024. Using a quantitative method with a cross-sectional design, the study involved 246 nurses as samples. Data analysis was carried out univariately, bivariately, and multivariately. The results showed that the majority of respondents were aged 36–45 years, female, had a bachelor's degree, and had a work period of less than 3 years. The variables that significantly influenced the level of depression were workload, physical environment, role conflict, and superior supervision, with workload as the most dominant factor. Meanwhile, length of service did not significantly influence the level of depression. Most nurses experienced minor depression (67.5%). These results emphasize the importance of hospital management's attention to work factors that can trigger psychological stress. It is recommended that X General Hospital Medan improve workload management, create a comfortable work environment, manage role conflict effectively, and improve the supervision system to maintain nurses' mental health and the quality of health services.
The relationship between family social support and diabetic foot care behavior of Diabetes Mellitus patient in Pekanbaru City."
Patients with Diabetes Mellitus (DM) often experience complications such as diabetic foot syndrome, which can lead to foot amputation. Regular diabetic foot care can help prevent these complications. Family support plays a crucial role in improving foot care behavior among DM patients. The aim of this study was to determine the relationship between family social support and foot care behavior in DM patients. The study involved 59 respondents selected using purposive sampling techniques. Data collection included respondent characteristics, supporting data, a family social support questionnaire, and a diabetic foot care behavior questionnaire based on the Nottingham Assessment of Functional Footcare (NAFF), which was modified by the researcher. Data were analyzed using the Wilcoxon Signed Rank Test. The results showed that family social support is associated with diabetic foot care behavior in DM patients, with an r-value and p-value of (r = -7.170, p < 0.005). Therefore, it is recommended that public health promotion officers at community health centers strengthen family health education programs so that families can provide optimal support to members with DM, helping to prevent various diabetic complications.
The Relationship of Environmental Factors (Family Support, Health Worker Support and Friend Support) to the Improvement of Life Style Behavior in Diabates Mellitus Patients in the Pekanbaru City Health Center Area.
Diabetes mellitus is a chronic metabolic disease that can lead to serious complications, including damage to the eyes, kidneys, blood vessels, nerves and heart. A healthy lifestyle is important in the management of diabetes, but behavior change is often difficult to achieve without appropriate interventions. Although environmental factors (family support, friend support and health worker support) are one of the social cognitive theory, other factors must also be considered.Objectives This study aims to determine the relationship between family support, health worker support and friend support on improving the life style behavior of patients with diabetes mellitus. This research method uses descriptive and explanatory research approaches. The study population consisted of 326 patients with diabetes mellitus registered at five health centers in Pekanbaru City. The sampling technique used was probability sampling with random sampling method. The instrument used was a questionnaire to measure the variables of family support, health worker support and friend support on improving the life style behavior of diabetes mellitus patients. Data analysis was performed using descriptive analysis techniques and Partial Least Squares. The results showed a significant relationship between environmental factors and improving life style behavior (path coefficient = -0.314; t-statistic = 5.761). Environmental factors have a significant effect on improving lifestyle behavior. can be integrated in diabetes management programs at the Puskesmas level. Promotive policies that encourage active social support are needed for sustainable healthy lifestyle changes.
THE RELATIONSHIP BETWEEN NURSE CHARACTERISTICS AND DIABETES MELLITUS PATIENT SAFETY CULTURE IN PEKANBARU CITY
Diabetes mellitus is a long-term disease that continues to increase worldwide, including in Indonesia. It is very important for Diabetes Mellitus patients to get proper and safe care. Patient safety is very important in care, and this should be a top priority in primary health facilities, including health centers. This study aims to analyze how the relationship between nurse characteristics and patient safety culture is implemented in Pekanbaru City health centers, as well as how nurses' understanding of patient safety culture can affect the quality of care. This study used descriptive and explanatory research approaches. The study population consisted of 205 nurses working in 21 health centers in Pekanbaru City. The sampling technique used was total sampling. The instrument used to measure patient safety culture variables and nurses' understanding of diabetes mellitus patient safety was a questionnaire. Data analysis was performed using descriptive analysis techniques and Partial Least Squares. The results showed that there was a significant relationship between nurse characteristics such as length of work, employment status, and age also had a significant effect on the patient safety culture of patients with diabetes mellitus (path coefficient = 0.184 and 0.983). nurse characteristics such as length of work, employment status, and age are very influential on a good patient safety culture that can improve patient safety.
A Critical Evaluation of the JKN Claims Process Implementation at Rasyida Kidney Specialty Hospital, Medan
Quality of claims affects the cash flow of the hospital. Pending claims and disputes cause a cost burden for the hospital. The purpose of this study was to evaluate the JKN claim process at Rasyida Kidney Specialty Hospital. The research method is qualitative with triangulation testing. Results show that JKN Claim Submissions are submitted on time. The average percentage of compliant claims is 98%, while pending claims are 0.44%. The most pending outpatient claim cases in 2023 were diagnosis codes outside the hospital's specialty (80 cases). Meanwhile, the most pending inpatient claim cases were related to confirmation of the main diagnosis coding/reselection (17 cases). In conclusion, human resources are sufficient, money is allocated through a separate budget, materials still require accuracy in terms of completeness and content suitability, methods are aligned with regulations, and machines need special attention regarding server downtime. The processes of planning, organizing, actuating, and controlling are conducted routinely. The timeliness of claim submission adheres to period 2. The verification results have not yet reached 100%, and recurring pending claims still occur monthly.
Evaluation of Outpatient Queue Management System at Rasyida Specialized Kidney Hospital
An efficient and systematic outpatient queue system plays a critical role in ensuring patient satisfaction and service quality in hospitals. The Indonesian Ministry of Health recommends that outpatient waiting times should not exceed 60 minutes, from registration to completion of consultation. Hospitals must therefore continuously monitor and improve their queue management systems to meet this standard and enhance patient experience. This study aimed to evaluate the outpatient queue system at Rasyida Specialized Kidney Hospital. A qualitative research approach was used, incorporating data triangulation through observations, in-depth interviews, and document analysis. Of 81 outpatient visits analyzed, only 2 patients (2.5%) experienced waiting times of ≤ 60 minutes, while the remaining 79 patients (97.5%) exceeded this standard. Factors contributing to prolonged waiting times included limited human resources, physician schedule inconsistencies, patient behavior, and infrastructure constraints. Overall, outpatient services at Rasyida Specialized Kidney Hospital currently do not meet the national outpatient waiting time standard of ≤ 60 minutes.
The Influence of Patients' Perceptions of Service Quality on the Interest in Repeat Inpatient Visits at Wahyu General Hospital Medan in 2024
Hospital-service quality is crucial factor in maintaining patients trust and interest. Wahyu Hospital Medan was one of the favourable hospitals. There has been a twenty-nine percent (29%) declining of in-patient for the last two years (2022-2023). This declining is presumably related to patients’ perception due to the services quality provided by the hospital. This research aims to analyze the effect of patients perception about service quality on the interest of in-patients’ repeat visit at Wahyu Hospital Medan. This research is conducted in qualitative approach with retrospective design. The sampling technique applied in this research is random sampling retrieved from all in-patient population. The Data analysis applied is the invariant, bi-variant and multi-variant. Bi-variant analysis shows that there is a correlation of patient’s perception on the physical evidence quality (p<0,001), reliability (p<0,001), responsiveness (P=0,004), and assurance (p<0,001) with the interest on repeat visit. In terms of multivariate, the most significant variables effecting the in-patients’ perception are the perception on physical evidence and assurance quality. On the other hand, reliability, responsiveness and empathy are functioned as the the co-founding variables. The suggestion for Wahyu hospital is to improve its service quality aspect, primarily the physical evidence and assurance to enhance in-patient satisfaction and interest on repeat visit.
Effectiveness of 30 Minutes Walking Exercise on Blood Glucose Levels of Menopausal Women with Diabetes Mellitus in the Work Area of the Pekanbaru City Health Center
Hormonal changes during menopause affect blood sugar levels and make it difficult for some women to control DM. The study aims to analyze and prove the difference in quality of life of menopausal women with DM before and after walking exercise 30 minutes. The research design used quasi-experimental. The subjects of the study amounted to 86 people divided into 2 groups, namely 43 groups of walking exercise 30 minutes intervention, 43 control groups in menopausal women. Data were collected using the Standard Operating Procedure Walking Exercise instrument, demographic data questionnaire, Menopause Quality Of Life. Paired and unpaired t-test with a significant value of p <0.05. And data using the Wilcoxon Sign Rank test and Mann Whitney U Test. Data processing with the help of statistical software. The results of the analysis showed that there was a significant difference between before and after walking exercise 30 minutes on improving the quality of life of menopausal women with DM (t = 16.729; p = 0.000). The results of this study are expected to be a reference and a reference in making programs, especially Puskesmas in improving the quality of life of Menopause patients.
Protective Effects of Vitamins D and E on Sperm Quality and Quantity in Vodka - Exposed Male Wistar Rats ( Rattus norvegicus )
Infertility is a significant global health problem, with male factors responsible for nearly half of all cases. Alcohol exposure, particularly vodka, generates oxidative stress that disrupts sperm production and function. This study examined the protective effects of vitamin D, vitamin E, and their combination in male Wistar rats exposed to vodka. Twenty five rats were divided into five groups: control, vodka - only, vodka with vitamin D, vodka with vitamin E and vodka with combined vitamins D and E. Rats that received vodka showed a sharp decline in sperm quality, with concentration reduced to about forty two million per milliliter, motility decreased to around ten percent, and normal morphology present in only about one quarter of cells. Supplementation with vitamin D or vitamin E improved these parameters, while the combined treatment produced the greatest recovery, restoring concentration to more than sixty million per milliliter, motility to nearly one half, and normal morphology to almost two thirds. These findings suggest that the combination of vitamins D and E provides stronger protection against alcohol induced reproductive toxicity than either vitamin alone.
The Effect of Spiritual Emotional Freedom Technique (SEFT) Therapy on Blood Glucose Control in Patients with Diabetes Mellitus: The Supportive Role of Family Social Support at Community Health Centers in Pekanbaru City
Diabetes mellitus (DM) is a chronic disease with a high prevalence, posing risks to physical, psychological, and social aspects of health. Optimal blood glucose control is essential to prevent long-term complications. In addition to pharmacological treatment, non-pharmacological interventions such as Spiritual Emotional Freedom Technique (SEFT) therapy and family social support are important strategies in DM management. This research was conducted at Community Health Centers (Puskesmas) in Pekanbaru City, involving a total of 59 respondents This study employed a pre-experimental design using a one-group pre-test and post-test approach without a control group. The sample consisted of 59 DM patients selected through purposive sampling. Data were collected using blood glucose level measurements and a family social support questionnaire. The results showed that the majority of respondents received good family support (59.3%), and there was a significant positive correlation between family social support and the implementation of SEFT therapy (Spearman’s coefficient = 0.512, p = 0.001). SEFT therapy significantly reduced patients’ blood glucose levels. These findings highlight the important role of family social support in enhancing the effectiveness of therapy and metabolic control in DM patients.Conclusion: SEFT therapy has a significant effect in reducing blood glucose levels in DM patients, particularly when supported by strong family social support.
Implementation of hospital management information system at Vina Estetica Hospital
The success of implementing a hospital management information system is influenced by the quality of the system used, the commitment of hospital human resources as users of the system, as well as the supervision and evaluation provided by management during the implementation of the hospital management information system. The purpose of this study was to examine the implementation of the hospital management information system at Vina Estetica General Hospital. The method in this research is qualitative with case study design by conducting in depth interviews, observation and documentation studies. The data collected were analyzed using Miles and Huberman's model, which includes stages of data reduction, data display, and conclusion drawing/verification. The results of the study found that the implementation of the hospital management information system at RSU Vina Estetica was not yet optimal, this was because the system used was still in development process and several doctors were reluctant to use electronic medical records.
ANALYSIS OF THE EFFECT OF SBAR COMMUNICATION ON IMPROVING PATIENT SAFETY AT MITRA SEJATI HOSPITAL MEDAN IN 2025
Patient safety is a paramount priority in healthcare, where effective communication among health professionals is a crucial factor. Structured communication systems like SBAR (Situation-Background-Assessment-Recommendation) have proven to be vital in optimizing clinical communication effectiveness, which directly impacts the enhancement of patient safety. This quantitative study was designed to evaluate the influence of SBAR communication training on improving patient safety in the Mitra Sejati Hospital Medan. Utilizing a quasi-experimental (one-group pre-test post-test) design, with a sample size of 52 medical personnel (nurses and midwives). Pre-test and post-test data collection was carried out through direct observation with a questionnaire instrument, with a comprehensive SBAR communication technique training intervention given before the post-test. Statistical analysis using a paired sample t-test revealed a significant increase in the average communication score of medical personnel (2.52; p<0.001) post-intervention. The findings of this study conclusively demonstrate that SBAR communication training is effective in improving communication skills among medical personnel, which in turn is expected to directly contribute to a reduction in communication errors and an overall enhancement of patient safety. Based on these findings, it is recommended that SBAR implementation be adopted as a continuous communication standard in hospital clinical practice.
Topical Morus alba Extract Cream Reduces UVB-Induced Melanogenesis Without Affecting Melanocyte Viability in Wistar Rats
Hyperpigmentation disorders such as melasma and post-inflammatory hyperpigmentation arise from excessive melanin synthesis following chronic ultraviolet (UV) exposure. Melanin production is primarily driven by tyrosinase activation through inflammatory and oxidative stress pathways. Hydroquinone remains the standard depigmenting agent but is limited by cytotoxicity and adverse effects. Morus alba (mulberry) contains bioactive polyphenols, including oxyresveratrol and mulberroside A, known for antioxidant and tyrosinase-inhibitory activities, which may provide a safer natural alternative. To evaluate the effect of topical Morus alba extract cream on melanin density and melanocyte count in UVB-exposed Wistar rats compared with hydroquinone 4% cream. This experimental study used fifteen male Wistar rats divided into three groups: a normal UVB-exposed control, a Morus alba extract treatment group, and a hydroquinone 4% group. UVB irradiation was administered for two weeks and 30 minutes irradiation each days to induce hyperpigmentation, daily topical application of treatments for three weeks. Skin samples were analyzed histologically for melanin density using Masson–Fontana staining and immunohistochemically for melanocyte count using Melan-A markers. Data were analyzed with one-way ANOVA and Tukey’s post-hoc test, with p < 0.05 considered significant. The Morus alba extract cream produced a non-significant reduction in mean melanin density and melanocyte count compared with the UVB-exposed control. In contrast, hydroquinone 4% significantly reduced melanin density and showed a decreasing trend in melanocyte count. Although Morus alba demonstrated limited depigmenting efficacy within four weeks, its antioxidant and anti-inflammatory constituents likely attenuated melanogenesis through modulation of tyrosinase and oxidative stress pathways. Morus alba extract cream exhibits weak antimelanogenic activity without melanocytotoxicity, suggesting potential as a natural depigmenting and photoprotective agent. Keywords: Morus alba; melanogenesis; melanin density; melanocyte; hydroquinone; UVB irradiation; antioxidant; tyrosinase inhibition
Pengaruh Krim Ekstrak Goji Berry (Lycium Barbarum) Dalam Mencegah Kerusakan Kolagen Kulit Tikus Disinari Ultraviolet-B
kulit yang terjadi akibat pararan sinar ultraviolet (UV) dapat menyebabkan sel kulit memproduksi radikal bebas mengakibatkan inflamasi pada kolagen kulit. Krim tabir surya dapat mengurangi penetrasi sinar UV. Penggunaan bahan alam yang berisfat antioksidan memiliki perlindungan sebagai tabir surya. Penelitian ini bertujuan untuk menguji dan menganalisis efektifitas krim ektrak Goji berry dalam mencegah kerusakan kolagen pada kulit tikus disinari ultraviolet-B (UV-B). Penelitian ini menggunakan rancangan posttest only control grup design. Subjek 30 ekor tikus putih galur wistar yang dibagi kedalam 6 kelompok. Pertama, kelompok kontrol normal yang tidak diberikan perlakuan atau tikus sehat. Kedua, kelompok kontrol positif tikus yang diberikan krim Sun Protective Factor (SPF) 15 disinari UV-B. Ketiga kelompok kontrol negatif tikus yang diolesi base krim disinari UV-B. Keempat, kelompok yang di olesi krim ekstrak Goji Berry 4 % disinari UV-B. Kelima, kelompok yang diolesi krim ektrak goji berry 8% disinari UV-B. Keenam, kelompok yang di olesi krim ektrak goji berry 12 % disinari UV-B. Pengukuran SPF krim dengan spektrofotometri UV-Vis. Kepadatan jaringan kolagen diwarnai MassonTrichrome dan dinilai dengan software ImageJ. Analisa menunjukkan adanya perbedaan yang signifikan (p<0,05) nilai SPF dan kepadatan kolagen antar kelompok. Pemberian krim ekstrak Goji berry 12% terbukti efektif dalam mencegah degradasi kolagen akibat paparan sinar ultraviolet-B.