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A Case Report of A Life-Threatening Condition: Complete Heart Block Induced By Systemic Lupus Erythematosus Puji Rachmawan, Yogi; Pramudya, Arsha; Pratiwi, Witri; Irnizarifka, Irnizarifka; Imani, Fawzia Haznah Nurul
Jurnal Health Sains Vol. 7 No. 4 (2026): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v7i4.2824

Abstract

Systemic lupus erythematous is often accompanied by complications in the cardiovascular system such as pericarditis, valvular disease, coronary artery disease, but complications in the conduction pathway are rare condition. Conduction system disorders such as complete heart block can cause life-threatening conditions and require immediate treatment. This case report describes a 43-year-old woman who presented with syncope and complete heart block. The patient received high-dose corticosteroid therapy but the complete heart block did not improve so a permanent pacemaker was implanted. This case showed that SLE complications in the cardiovascular system including the cardiac conduction system must be watched out for because it is a life-threatening condition.
Excessive Polypharmacy Among Indonesian Heart Failure Patients: Clinical Correlates and Care Implications Yogi Puji Rachmawan; Witri Pratiwi; Bambang Budi Siswanto
Jurnal Kardiologi Indonesia Vol 47 No 2 (2026): April - June, 2026
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2138

Abstract

Background: Heart Failure (HF) is a major global health problem that often coexists with multiple chronic comorbidities, requiring complex pharmacotherapy. The use of numerous concurrent medications increases the risk of polypharmacy and excessive polypharmacy, which may lead to adverse drug reactions, drug–drug interactions, poor adherence, and higher healthcare utilization. Despite growing awareness of this issue, evidence on the prevalence and determinants of excessive polypharmacy among Indonesian HF patients remains scarce. Methods: This single-center cross-sectional sub-analysis was derived from a cross-sectional study involving 494 adult HF patients treated at Hasna Medika Cardiovascular Hospital, Cirebon, between January and December 2023. HF diagnosis was confirmed by cardiologists using the European Society of Cardiology (ESC) criteria. Polypharmacy was defined as the use of ≥7 medications, while excessive polypharmacy was defined as ≥10 medications. Clinical and demographic variables were extracted from electronic medical records (EMR). Bivariate analysis was performed using Chi-square or Fisher’s exact tests, followed by multivariate logistic regression to identify independent determinants of excessive polypharmacy. Results: The mean age of participants was 58.1 ± 10.5 years, and 53.4% were male. Overall, 42.5% of patients met the criteria for polypharmacy, and 15.6% (n=77) met the criteria for excessive polypharmacy. The most frequent comorbidities were Coronary Artery Disease (CAD) (80.2%), hypertension (23.1%), and Type 2 Diabetes Mellitus (T2DM, 20.0%). In multivariate analysis, T2DM (Adjusted Odds Ratio [AOR] 17.21, 95% CI 8.39–35.34), Chronic Kidney Disease (CKD) (AOR 5.97, 95% CI 2.37–15.03), Chronic Obstructive Pulmonary Disease (COPD) (AOR 6.64, 95% CI 2.64–16.69), and asthma (AOR 26.32, 95% CI 5.79–119.67) were identified as independent determinants of excessive polypharmacy. The model demonstrated good fit (McFadden pseudo-R² = 0.351; Hosmer–Lemeshow p = 0.62). Conclusion: Excessive medication burden is common among HF patients, particularly among those with metabolic and pulmonary comorbidities. These findings highlight the need for systematic medication review and rational prescribing strategies while recognizing that higher medication counts do not necessarily indicate inappropriate prescribing.
Public Knowledge about Wolbachia-Aedes Technology: A Survey among Cirebon City Residents, Indonesia Herawati Herawati; Witri Pratiwi; Muhammad Hussein Gasem
GHMJ (Global Health Management Journal) Vol. 8 No. 3 (2025)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-831220

Abstract

Background: Wolbachia-Aedes technology is one of the innovations in reducing dengue fever incidence in Indonesia. Its implementation may be limited by insufficient public knowledge, as low awareness can reduce community acceptance and participation in Wolbachia-Aedes technology, both of which are essential for the technology’s effectiveness. Aims: To determine the public knowledge about Wolbachia-Aedes technology and the associated factors in Cirebon City residents, Indonesia. Methods: This is an observational study with a cross-sectional approach that was conducted in Cirebon City Health Centers (Puskesmas) between June and July 2024, using a cluster random sampling technique. Cirebon City residents who visited Puskesmas and met the inclusion and exclusion criteria were recruited as samples. Data were collected through self-administered validated questionnaires. Results: There were 600 respondents, consisting of female (68%) who participated in the study. Most of the sample were senior high school graduates (68.2%). The results showed that 39.5% of respondents had poor knowledge, while 51.5% had moderate knowledge and 9% had good knowledge. Age [adjusted OR 1.86 (95%CI 1.32-2.63)] and education level [adjusted OR 2.12 (95%CI 1.38-3.27)] were the factors that related to public knowledge about Wolbachia-Aedes technology in Cirebon City, Indonesia. Conclusion: Most Cirebon City residents had moderate knowledge, with a substantial proportion still having poor knowledge regarding Wolbachia-Aedes technology. Older age and lower education levels were associated with poorer knowledge. The government needs to improve public knowledge about Wolbachia-Aedes technology before implementation through targeted health promotion, particularly for older populations and those with lower education levels.