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Journal : mejora

Biological, Environmental, and Behavioural Determinants of Human Secondary Sex Ratio: A Systematic Literature Review and Critical Medical Analysis Pardomuan Robinson Sihombing
MEJORA Medical Journal Awatara Vol 4 No 1 (2026): January 2026
Publisher : Awatara Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61434/mejora.v4i1.344

Abstract

Introduction: This study presents a Systematic Literature Review to evaluate the medical validity of pre-conception interventions and environmental factors claimed to influence the secondary sex ratio (SSR). Amidst the persistence of popular but controversial sex selection methods, alongside strong cultural preferences for certain genders in various Indonesian ethnic groups, there is a clinical urgency to separate myth from valid biological mechanisms. Methods: Following the PRISMA 2020 guidelines, a comprehensive search of the PubMed and Scopus databases filtered 1,495 articles into 25 high-quality primary studies. The analysis focused on the validity of methods involving timing of sexual intercourse, physical position, dietary manipulation, vaginal pH environment, and the impact of parental stress. Results: The synthesis of evidence shows no empirical support for the effectiveness of timing coitus or sleeping on one's side in influencing sex. Conversely, the data support a variant of the Trivers-Willard Hypothesis, in which high maternal energy status correlates with male births, while chronic maternal stress and paternal toxic exposure suppress the ratio. Paradoxical findings emerge regarding paternal stress, where paternal anxiety correlates with increased male births. Conclusion: This report provides an evidence base for practitioners to deliver ethical, science-based pre-conception education.
Integration of Geopsychiatry: A Synthesis and Analysis of Case Studies and Field Research on Possession Trance Disorder (PTD) in Indonesia Pardomuan Robinson Sihombing
MEJORA Medical Journal Awatara Vol 4 No 2 (2026): April 2026
Publisher : Awatara Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61434/mejora.v4i2.345

Abstract

Background: In Indonesia, the treatment of the phenomenon of Possession Trance Disorder (PTD) and visual hallucinations is often hampered by the dichotomy between medical and spiritual approaches. Many interventions fail because they rely solely on theoretical assumptions without sufficient empirical field evidence. Objective: This study aims to dissect the etiology, mechanisms, and effectiveness of mystical phenomena therapy using primary data (case studies and experiments) and to formulate integrative intervention models and methods. This study was conducted using the Systematic Review of Primary Studies method, following the PRISMA 2020 protocol. Inclusion criteria are strictly limited to primary data articles (case studies, qualitative field studies, EEG experiments) published between 2019 and 2025. Results: Analysis of 15 selected primary studies showed that PTD consistently appeared as a comorbidity of undiagnosed dysthymia and trauma. Neurophysiological evidence (EEG) confirms that trance is a biological hyperarousal condition, not just hysteria. Therapies based on Indigenous Psychology (Kawruh Jiwa) and cultural distraction techniques (Drawing/Murottal) have proven effective in real clinical settings. Conclusion: The most effective treatment model is an integrated approach or hybridization: medical biological stabilization combined with the restructuring of meaning through local psychology.
Meta-Analysis: Malaria Vaccine Effectiveness Pardomuan Robinson Sihombing
MEJORA Medical Journal Awatara Vol 4 No 3 (2026): July 2026
Publisher : Awatara Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61434/mejora.v4i3.350

Abstract

Background: Malaria remains a significant global public health problem with a disproportionate impact on children in endemic areas. With the approval of the RTS,S/AS01 and R21/Matrix-M by WHO, a comprehensive evaluation of the effectiveness of malaria vaccines is crucial to inform public health policy. Aims: This study aimed to evaluate the effectiveness of malaria vaccines through a systematic review and meta-analysis of intervention studies that compared treatment versus control groups. Methods: The research methodology followed the PRISMA guidelines with systematic searches in PubMed and Scopus databases for open-access primary articles reporting randomized controlled clinical trials of malaria vaccines. Inclusion criteria included intervention studies (vaccine vs. placebo/control), child populations, and malaria clinical outcomes. Meta-analysis was performed using the Jamovi package ESCI with a random effects model to calculate the pooled risk ratio and 95% confidence interval, and prediction interval. Results: The results of the meta-analysis showed that the RTS,S/AS01 provided a 36.3% efficacy against clinical malaria at follow-up, while the R21/Matrix-M vaccine showed a higher efficacy of 70.0%, especially in the seasonal transmission setting. Forest plots indicated significant heterogeneity between studies (I²>98%, p <0.001) and a wide prediction interval, reflecting the expected variability across different epidemiological settings. Conclusion: The study's conclusions suggest the malaria vaccine, particularly R21/Matrix-M, provide substantial protection against clinical malaria with an acceptable safety profile, but require a booster dose strategy to maintain long-term efficacy. The implications of these findings support the implementation of malaria vaccination programs as a complement to vector control interventions in efforts to eliminate global malaria.
Co-Authors Abdul Gofur Rochman Ade Famalika Ade Famalika Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Ade Marsinta Arsani Adina Astasia Ahid Nur Istinah Ahmaddien, Iskandar Aji, Lexi Jalu Al Aqilah, Muhamad Refkhi Amin Prawiro Madhani Anang Kurnia Anindita Ramadhani Arhaninka, Dewi Arsani, Ade Marsinta Artha Satwika Astawa, I Gede Putu Banu Avior Ocean Noya Bagus Sartono Basmallah, Fikri Dias Bayu Adinugroho Bekti Endar Susilowati Bekti Endar Susilowati Bekti Endar Susilowati Bertho Tantular Budiantono, Sigit Bungkus Sasongko Purnomo Bungkus Sasongko Purnomo Busminoloan Busminoloan Busminoloan Busminoloan Cahya Alkahfi Daniel Pangaribuan Daqiqil Id, Ibnu Deden Achmad Sunarjo Desak Ari Gita Wahyuni Deva A. Nurul Huda Devitama Patria Nagara Dhinnessa Prabowo DRAJAT INDRA PURNAMA Drajat Indra Purnama Dwi Muslianti Dyah Purwanti Dyah Purwanti Ekowati Retnaningsih Erfiani Erfiani Erfiani Erfiani Erfiani, Erfiani Erica Indryani Fadlol Muhammad Fajar Faiza Aina Nurrizqi Feri Fernandes Fitri Mudia Sari Frisca Adriana Gregorius Ivan Aditya Purwahendra Gultom, Yulifar Amin Gumilang, Gabiela Gunawan, Ghina Hanifa HAMIDAH Hastoro Dwinantoaji Hema Malini, Hema Hendiva Tri Nugraha Hendry Frananda, Hendry Herman, Nur Ashilah Raihanah Hertanto, Rus I Dewa Gede Sunanjaya I Gede Heprin Prayasta I Gede Heprin Prayasta Ida Ayu Candrawati Ida Ayu Candrawati Iis Hayyun Nurul Islam Ine Ratna Dewi Irma Nurmala Dewi Iskandar Ahmaddien Islami, Rahmi Lathifah Istiqomatul Fajriyah Yuliati Istiqomatul Fajriyah Yuliati Jaka Wijaya Kusuma Januar Ramadhan Karel Fauzan Hakim Kartika Maulidya Irzain Khairil Anwar Notodiputro Khairil Anwar Notodiputro Khalimi Khalimi, Khalimi Krisdianto, Boby Febri Kuat Sidik Wahyono Kurnia, Anang Leni Merdawati Lexi Jalu Aji Lina Sari Lisna Sari Lisna Sari Luh Putu Widya Adnyani Luh Putu Widya Adnyani Maharani, Arya Putri Mahuda, Isnaini Maisaroh Maisaroh Marselinus Nirwan Luru Marta Sundari Marta Sundari Marta Sundari Martina Cecilia Adriana Maryani, Sri Masruri Mochtar Maulidiyah, Syafrina Maydita Ayu Nursaskiawati Mella Anisa Miftahul Huda Miftahul Huda Miftahul Huda Miftakhul Jannah Mohamad Arif Kurniawan Mohamad Arif Kurniawan Muchtar, Masruri Muhammad Hafiz Fadhilah Muhammad Heru Akhmadi Muhammad Ramadhan Zulfi Muliantino, Mulyanti Roberto Mun'im, Akhmad Neni Nur Laili Ersela Zain Ni Kadek Sinarwati Novitha, Irni Nurhidayati Nurhidayati Nurhidayati Nurhidayati Nurhidayati Nurhidayati Nurul Islam, Iis Hayyun Nuryanto Nuryanto Octaviana, Aniek Oki Prasetia Hendarsin Olivia, Theresia Padhilah Dikri Pangaribuan, Daniel Pascal, Emilio Pradita Galih Sekar Palupi Pudjiono, Bjardianto Puput Puspito Rini Putri Indi Rahayu Putri, Ayudya Purwani Putu Pande Wahyu Diatmika Rahayu, Putri Indi Rahmi Lathifah Islami Rama Bhaskara Praja Ramadhanti, Ajeng Taufina Ramadhisa Fadli, Diva Aisyaliani Rini Rahani Risqi Nurika Fatha Hidayati Saeful Hidayat Sagala, Eliza Clara Yeremia Sarah Sholikhatun Risma Septie Wulandary Setiawan, Prayoga Sigit Budiantono Sigit Budiantono Sigit Budiantono Sigit Budiantono Sigit Budiantono Simanjuntak, Johana Veronika Sinarta Putra P. Surbakti Sitorus, Yosef Felix Sodiqin, Achmad Sri Murdaningrum Sri Murtiningsih Stephanus, Matthew Sukarsa, Galuh Prabaningrum Ayu Supriatna, Yayat Suryadiningrat Suryadiningrat Suryadiningrat SYAMSUL HIDAYAT Taufik Febriyanto Temy Setiawan, Temy Triana Mauliasih Aritonang Triana Mauliasih Aritonang Ulfa Anggraini Usep Nugraha Usep Nugraha Wahyu Puji Lestari Widdia Angraini Widdia Angraini Wiradinata Lambok Silaban Wiranegara, Hanny Wahidin Wisely Yahya Wisnu Pratiko Wisnu Pratiko Y Yunita Yanti, Ni Komang Semara Yesi, Desri Yoshep Paulus Apri Caraka Yuda Yudhie Andriyana Yuninda Anggraini Putri Yunita Yunita Yunita Zain Yudha Prawira Zakir, Supratman