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All Journal CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal Journal of Psychiatry Psychology and Behavioral Research (JPPBR)
Setyanagara, Adwin
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Humanities Education Health Professions Medicine & Pharmacology Nursing Public Health

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NEUROLEPTIC MALIGNANT SYNDROME IN AN ELDERLY PERSON WITH A HISTORY OF ATYPICAL ANTIPSYCHOTIC TREATMENT AND COMORBIDITIES: A CASE REPORT Fahira, Aulia; Setyanagara, Adwin; Ulya, Zuhrotun
Journal of Psychiatry Psychology and Behavioral Research Vol. 6 No. 2 (2025): Mental Health Framework from a Multidisciplinary Perspective
Publisher : Departemen Psikiatri Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jppbr.2025.006.02.10

Abstract

Introduction: Neuroleptic Malignant Syndrome (NMS), a neuropsychiatric emergency, can develop in patients with antipsychotic medications. This is a matter of concern due to the high frequency of psychotic diseases in Indonesia, affecting an estimated 2.6 million people. This paper will examine a case of NMS who exhibited various risk factors and clinical manifestations, which happened in Kediri, a city in Indonesia that lacks of dedicated mental hospital or intensive care unit for mental health. Method: In this paper, we reveal about a case report about a 63-year-old man presented to the emergency room with abrupt onset of fever and cognitive impairment. He took olanzapine and clozapine for schizophrenia, which was not often treated. The patient had gait disturbances, pronounced tremors, rigidity, and autonomous movement of the mouth. Examination results were blood pressure of 88/55 mmHg, pulse 123x/minute, respiratory rate 24x/minute, body temperature 42°C. Supporting investigation results showed leukocytosis, hypokalemia, pneumonia and cardiomegaly. Initial management included discontinuation of neuroleptic drugs, administration of oxygen, rehydration, and symptomatic medications. Results: This is a rare case of NMS in geriatric patient happened in a rural area, Kediri, a small city in Indonesia which experiences higher temperatures in comparison to other cities. This case is quite complex due to the treatment options, a history of poor drug compliance, elderly conditions and comorbidities. Discuss: For both confirmed and suspected instances of NMS, basic treatment suggestions include stopping antipsychotic medication, continuously monitoring vital signs, minimizing extremes in temperature, introducing fluids, correcting electrolyte imbalances, and providing other supportive measures as needed Conclusion: NMS should be closely monitored in psychosis patients with a history of noncompliant medication use and concomitant conditions. To save lives, prompt and adequate medical attention is essential.
The Effect of Health Promotion on Health Cadres’ Knowledge of Tuberculosis Preventive Therapy in Sukorame, Kediri Fahira, Aulia; Setyanagara, Adwin
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 6 No. 2 (2025): October
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/comphijournal.v6i2.311

Abstract

Pulmonary tuberculosis (TB) remains a major global health challenge and is the second leading cause of death from infectious diseases after COVID-19. In Indonesia, the incidence of TB is among the highest worldwide, with East Java ranked second nationally. Knowledge and adherence to Tuberculosis Preventive Therapy (TPT) are still limited, particularly among communities at risk, making health education crucial. This study aimed to analyze the effect of health promotion on the knowledge of health cadres regarding tuberculosis preventive therapy in Sukorame, Kediri. A pre-experimental analytic study with a one-group pretest-posttest design was conducted among 41 active health cadres. Data were collected through a questionnaire covering knowledge, attitude, and practice related to TPT. Health education was delivered via presentations and leaflets, and knowledge was assessed before and after the intervention. The results showed a significant improvement in cadres’ knowledge, with pretest scores indicating poor knowledge in all respondents (100%), while posttest scores showed 52% with good knowledge, 44% with moderate knowledge, and only 4% with poor knowledge. Statistical analysis using the Wilcoxon test confirmed a significant difference (p = 0.000). It can be concluded that health promotion effectively increased health cadres’ knowledge of TB preventive therapy. Continuous monitoring and follow-up are recommended to sustain behavioral changes and strengthen TB prevention efforts.
Co-Authors Fahira, Aulia Ulya, Zuhrotun