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Indonesian Journal of Medicine

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Published by Universitas Sebelas Maret

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Core Subject : Health,

Medicine & Pharmacology Public Health

Indonesian Journal of Medicine (IJM) is an international, open-access, and double-blind peer-reviewed journal, focusing on the intersection of biomedical science, clinical medicine, and community medicine. The journal began its publication on August 20, 2015, and is published online three times yearly. It is academically designed for all physicians, health researchers, and health care professionals, regardless of their medical specialties, or type of employment.

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Search results for , issue "Vol. 8 No. 1 (2023)" : 12 Documents clear

Effectiveness of Mirror Therapy on Post Stroke Functional Ability: A Meta-Analysis Samudera, Galang Aji; Prasetya, Hanung; Murti, Bhisma
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: Stroke is the third leading cause of death after heart disease and cancer. One of the impacts of stroke is it causes a decrease in the functional ability to carry out daily activities, therefore mirror therapy is carried out to restore the functional ability. The study aims to determine the effect of mirror therapy on the functional ability of post-stroke patients based on previous primary studies.Subjects and Method: It was a systematic review and meta-analysis study with PICO as follows: P= post-stroke patients, I= mirror therapy, C= conventional therapy, and O= functional ability. Data collection was conducted from databases, namely: Google Scholar and PubMed. The inclusion criteria used were full-text articles in English, with randomized control trial design, published in 2006-2021. The keywords used were "stroke" AND "mirror therapy" AND "functional independence measure" OR "FIM" AND "randomized control trial". The inclusion criteria of the study were articles using a randomized control trial study design, the effect size used was the Mean SD, the subjects of the study were patients with poststroke conditions, the intervention given was mirror therapy, the comparison was conventional therapy, with the outcome was increased functional ability. The articles were analyzed using Review Manager 5.3. application.Results: The meta-analysis was conducted on 9 primary studies from several countries such as Turkey, South Korea, India, and Italy. The results of the study showed that there was an effect of mirror therapy on the functional ability of post-stroke patients. Patients who obtained mirror therapy had a functional ability of 0.92 units higher than conventional therapy. The results were statistically significant (SMD= 0.92; 95% CI= 0.67 to 1.17; p<0.001).Conclusion: mirror therapy can improve the functional ability of post-stroke patients.Keywords: mirror therapy, functional ability, post-strokeCorrespondence: Galang Aji Samudera. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ghalangsamudera@gmail.com. Mobile: +6287836783209.Indonesian Journal of Medicine (2023), 08(01): 1-11https://doi.org/10.26911/theijmed.2023.08.01.01

Effect of Acupressure on Blood Glucose Level in Diabetes Mellitus Patients: Meta-Analysis Rosyida, Muslihatin Khuril; Tamtomo, Didik; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from abnormalities in insulin secretion that affect blood sugar levels. Chronic hyperglycemia in DM is associated with long-term damage to several organs of the body. One of the interventions that can be given to lower blood sugar levels is acupressure therapy. The purpose of this study was to determine the effect of acupressure therapy on blood sugar levels in patients with diabetes mellitus.Subjects and Method: This study is a systematic review and meta-analysis with PICO, P: Diabetes mellitus patients, I: Acupressure, C: No acupressure, O: Blood sugar levels. The process of searching for articles is done through a database of journals including: Pubmed, Google Scholar, Science Direct, Scopus, Spinger Link, CNKI and Hindawi. The keywords used in the literature search were: “acupressure” AND “diabetes” AND “blood sugar” AND “blood glucose” AND “standard controlled trial”, “acupressure for diabetes”, “diabetes standardized controlled trial”, “acupressure randomized controlled trial”. trial”, diabetes acupoint, “diabetes and placebo”, “acupressure” AND “diabetes”. The articles included in the study were full text articles with a randomized controlled trial study design and the results were reported with the effect size, mean standard deviations (SMD). Articles were collected using PRISMA flow diagrams and analyzed using the Review Manager 5.3 application.Results: A meta-analysis of 9 articles reviewed in this study came from Taiwan, China, Indonesia, Egypt and Iran with a sample size of 451. The study results showed that acupressure therapy was able to reduce blood sugar levels in diabetes mellitus patients with SMD blood sugar values. acupressure was 0.56 units lower than no acupressure and was statistically significant with a significance value of (SMD=-0.56; 95% CI= -0.76 to -0.37; p<0.001).Conclusion: Acupressure therapy has the effect of lowering blood sugar levels in diabetes mellitus patients.Keywords: acupressure, blood sugar, diabetes mellitus.Correspondence: Muslihatin Khuril Rosyida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: khurilrosyida@gmail.com. Mobile: 08564713149.Indonesian Journal of Medicine (2023), 08(01): 68-78https://doi.org/10.26911/theijmed.2023.08.01.07

Effects of Virtual Reality Therapy and Range of Motion Exercise on Range of Motion in Stroke Patients: Meta-Analysis Nugroho, Septyan Dwi; Tamtomo, Didik; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: Stroke is a disease caused by interference with blood flow in the brain which is still a global problem today. Post-stroke care needs to be done to prevent the worsening of the condition. One of the right interventions that can be done is virtual reality therapy and range of motion exercise. This study aims to examine, analyze and estimate changes in the range of motion of stroke patients with virtual reality therapy and range of motion exercise.Subjects and Method: Metaanalysis was carried out according to the PRISMA flow chart and the PICO model (Population: stroke patients, Intervention: virtual reality therapy and range of motion exercise, Comparison: not performed virtual reality therapy and range of motion exercise Outcome: range of motion). The databases used are Google Scholar, PubMed, and Science Direct. The keywords used (“virtual reality” OR VR) AND (stroke OR CVD) AND (“range of motion exercise” OR ROM OR “motor exercise”) AND (stroke OR CVD) AND “Randomized Control Trial”. The inclusion criteria were full-text articles with RCT studies published in 2012-2022, articles in English, and bivariate and multivariate analysis. Analysis was performed using ReVman 5.3.Results: There were 20 articles with a randomized control trial design originating from Iran, Turkey, China, Egypt, Myanmar, South Korea, Spain, the Netherlands, Italy, Switzerland, and Canada involving 799 people. A meta-analysis of 10 RCT studies concluded that virtual reality therapy increased the range of motion of stroke patients by 2.77 units (SMD= 2.77; 95% CI = 1.29 to 4.24; p<0.001) compared to no virtual reality therapy. In addition, the range of motion exercise intervention can also increase the stroke patient's range of motion by 0.84 units (SMD= 0.84; 95% CI= 0.35 to 1.33; p<0.001) compared to not being given range of motion exercise.Conclusion: Virtual Reality Therapy and Range of Motion exercises can increase the range of motion of stroke patients.Keywords: virtual reality therapy, range of motion exercise, stroke, range of motion, meta-analysis.Correspondence: Septyan Dwi Nugroho. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java. Email: septyandwin@gmail.com. Mobile: 081804418933.Indonesian Journal of Medicine (2023), 08(01): 23-36https://doi.org/10.26911/theijmed.2023.08.01.03

Effect of Date Palm (Phoenix dactylifera) Fruits Consumption on Birth Delivery Outcome: Meta-Analysis Siwi, Ratna Purwani; Murti, Bhisma; Tamtomo, Didik
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: The choice of cesarean section continues to increase in the world and is expected to continue to increase over the coming decades, which is almost a third of all deliveries in 2030. The benefits of dates for improving labor processes are considered to increase vaginal deliveries and also reduce the frequency of cesarean sections with the aim of reducing bigger complications. This study aims to analyze and estimate the influence of the consumption of dates on labor outcomes.Subjects and Method: This study is a systematic review and meta-analysis with PICO, P: Pregnant women, I: consumption of dates, C: No consumption dates, O: Bishop's score, length of labor, and postpartum hemorrhage. Data collection was obtained from databases, namely: PubMed, Science Direct, Springer Link, and Google Scholar. Keywords used “date fruit” OR “date palm” OR “phoenix dactylifera” AND “labor” AND “delivery”, AND “oxytocin” AND “hemorrhage”. The inclusion criteria used were full papers in English with the design of randomized controlled trials in 20002022. This study was analyzed using RevMan 5.3 software.Results: Meta-analysis was conducted on 4 primary studies from several countries such as Iran, Malaysia, and Saudi Arabia with a sample size of 603 pregnant women. The meta-analysis concluded that there was an effect of date consumption on cervical dilatation upon admission to the hospital (SMD= 0.73; CI 95%= 0.09 to 1.38; p=0.030). Consumption of dates also has an effect on the duration of active 1st stage labor (SMD= 0.46; CI 95%= 0.82 to 0.09; p= 0.010). Consumption of dates has a weak effect on the length of stage II labor (SMD= 0.05; 95% CI= 0.88 to 0.78; p= 0.910). In addition, the consumption of dates also has a weak effect on the length of stage III labor (SMD=0.16; CI95%=0.46 to 0.79; p=0.610).Conclusion: Consumption of dates has an influence on labor outcomes.Keywords: phoenix dactylifera, dates, labor, postpartum hemorrhage, Bishop scoreCorrespondence: Ratna Purwani Siwi. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ratnapsiwi@yahoo.com. Mobile: 085602389598.Indonesian Journal of Medicine (2023), 08(01): 79-91https://doi.org/10.26911/theijmed.2023.08.01.08

Meta-Analysis: The Effect of Acupuncture Therapy in Reducing Migraine Recurrence Tursina, Elsa; Prasetya, Hanung; Murti, Bhisma
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: Acupuncture therapy is an effective treatment for reducing headache intensity, migraine recurrence, and improving quality of life. This study aims to analyze and estimate the effect of acupuncture therapy on reducing migraine recurrence.Subjects and Method: This study used a systematic review and meta-analysis by following PICO, Population: migraine patients. Intervention: acupuncture therapy. Comparison: no acupuncture therapy. Result: reduction in migraine recurrence. The data used were obtained from scientific research articles from the Pubmed, Google Scholar, Science Direct, and SpringerLink electronic databases with a Randomized Control Trial (RCT) design from 2011 to 2022 which reports effect sizes with Mean and SD. The keywords used in the search for scientific articles are “Acupuncture” AND “Profilaxis Migraine” AND “Migraine Frequency”. The selection of articles was carried out using the PRISMA flowchart. Data were analyzed using Review Manager software version 5.4.1.Results: A total of 9 articles with qualified RCT designs from Asia, America, Australia, and Europe were selected for the systematic review and meta-analysis. The results of the meta-analysis showed that patients with migraine who received acupuncture therapy experienced migraine recurrence 0.31 units lower than those who were not treated with acupuncture (SMD= -0.31; 95% CI= -0.61 to -0.01; p=0.040).Conclusion: Acupuncture therapy reduces migraine recurrence.Keywords: acupuncture, relapse, migraine.Correspondence: Elsa Tursina. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: elsa090798@gmail.com. Mobile: +6285655751077.Indonesian Journal of Medicine (2023), 08(01): 47-58https://doi.org/10.26911/theijmed.2023.08.01.05

Brixia Score as Predictor of D-Dimer Levels of COVID-19 Patients in Intensive Care Unit Adyanata, Yanuareza Totti; Soewondo, Widiastuti; Arifin, Arifin; Redhono, Dhani
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: COVID-19 is caused by a novel virus that can cause lung abnormalities which can be measured with new chest x-ray scoring system named Brixia score. In COVID-19 patients, coagulation disorders are often found that can be seen through D-Dimer levels. This study aimed to prove the Brixia Score as a predictor of D-Dimer levels.Subjects and Method: This study was an observational analytic study with a cross-sectional approach. The subjects were 94 COVID-19 patients which taken from ICU Melati 1 Dr. Moewardi General Hospital, Surakarta from March 2021 to August 2021 who met the exclusion and inclusion criteria. The independent variable is the Brixia score performed by radiologists and the dependent variable is D-Dimer levels taken from laboratory results. Sampling was obtained by purposive sampling and the data were investigated using the receiver operating characteristic (ROC) curve.Results: 94 samples were obtained for analysis. The average Brixia Score of patients with D-Dimer <2 µg/mL was Mean= 15.85; SD= 1.43 and D-Dimer ≥2 µg/mL was Mean= 17.29; SD= 0.96. There was a significant difference between the Brixia Score of patients with D-Dimer <2 µg/mL and D-Dimer ≥2 µg/mL (p<0.001). Analysis with the ROC curve shows an area under the curve (AUC) of 0.793. The optimal cutoff value of the Brixia Score for predicting D-Dimer levels was 16.5 (sensitivity 77.9%, specificity 73.1%).Conclusion: Brixia Score proved to be a predictor of D-Dimer levels of COVID-19 patients in ICU care.Keywords: COVID-19, ICU, brixia score, predictor, D-Dimer.Correspondence: Widiastuti Soewondo, Radiology Department, Faculty of Medicine, Universitas Sebelas Maret. JL. Ir. Soetami No. 36A, Surakarta 57126, Indonesia. E-mail: widiastuti.sprad56@staff.uns.ac.id. Mobile: 082134368592Indonesian Journal of Medicine (2023), 08(01): 92-99https://doi.org/10.26911/theijmed.2023.08.01.09

“TRISNA” Conceptual Model and Spiritual Approach to Build Body Image, Self-Esteem, and Quality of Life in Cervical Cancer Patients at Dr. Moewardi Hospital, Surakarta, Indonesia Adriani, Rita Benya; Handayani, Siti; Prabowo, Tri
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: The problems of cervical cancer patient’s psychological response to advanced cancer are acute crisis, struggle, anxiety, and sadness, which will interfere with their life, especially sexual relations with their partners. Sexual relations in the Javanese view are a noble, sacred bond and have the function to maintain harmony. The spiritual approach and "TRISNA" which contains the principles of Javanese teachings about sincerity should be applied by cervical cancer patients and their sexual partners. This study aimed to determine the effect of palliative sexuality treatment with a "TRISNA" and spiritual approach to body image, self-esteem, and quality of life in cervical cancer patients at Moewardi Hospital Surakarta.Subjects and Method: This study was a quasi-experimental design using 138 samples divided into three groups, namely the TRISNA, Spiritual, and control groups with a pre-test-post-test control group design conducted at Dr. Moewardi Hospital Surakarta, Central Java, in May to August 2019. The dependent variable in this study is the body image scale, self-esteem, and quality of life. The independent variables in this study are the TRISNA and spiritual approaches. The instruments used are the body image scale, self-esteem scale, and the European Organization for Research and Treatment of Cancer (EORTC) QOQ-CX24. Statistical analysis using t-test with SPSS 13 application software.Results: The results showed that sexuality with the TRISNA and spiritual approaches can improve body image (F= 137.67), self-esteem (F= 241.05), and quality of life (F= 76.95) of cervical cancer patients with a significant value for each group (p≤0.001).Conclusion: Sexuality with TRISNA's approach is the most influential in body image, self-esteem, and quality of life in cervical cancer patients in cervical patients Moewardi Hospital Surakarta.Keywords: body image scale, self-esteem, quality of life, sexuality, spiritualCorrespondence: Rita Benya Adriani, Ministry of Health of Surakarta, Health Polytechnics Surakarta, Letjend Sutoyo Street, Mojosongo, Surakarta 57127, Central Java, Indonesia. Email: benyaadriani@gmail.com. Mobile +628122617033.Indonesian Journal of Medicine (2023), 08(01): 37-46https://doi.org/10.26911/theijmed.2023.08.01.04

The Difference of Neiguan Acupressure Points (Pc6), Hypnotherapy, and Hypnopressure in Reducing Anxiety of Hemodialysis Patients Prasetya, Hanung; Yatmihatun, Sri
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.1.608

Background: The anxiety felt by patients undergoing hemodialysis can decrease the quality of life, cause a sleep disorder, and even aggravate the disease. Acupressure, hypnotherapy, or hypnopressure have minimal side effects and are easy to do in reducing anxiety. The study aims to analyze the different effects of acupressure, hypnotherapy, and hypnopressure in reducing anxiety in patients undergoing hemodialysis programs.Subjects and Method: It was an experimental study using a randomized controlled trial. It was conducted at Dr. Moewardi Hospital Surakarta, Central Java. The number of study subjects from March 2021 - July 2022 was 300 patients undergoing the hemodialysis program, with 75 subjects obtaining acupressure intervention, 75 subjects obtaining hypnotherapy intervention, 75 subjects obtaining hypnopressure intervention, and 75 subjects obtaining standard/control treatment. The sampling technique used was purposive sampling. The dependent variables in this study were acupressure, hypnotherapy, and hypnopressure, while the independent variable was the anxiety of patients who underwent a hemodialysis program for less than a year or less than 10 times. Anxiety was tested using the Hamilton Rating Scale for Anxiety questionnaire. Data analysis was conducted using an independent t-test, with the SPSS statistics program.Results: Post-acupressure anxiety score (Mean= 17.31; SD= 3.22) was lower than pre-acupressure (Mean= 23.17; SD= 2.68) and the result was statistically significant (p<0.001). Post-hypnotherapy anxiety score (Mean= 15.13; SD= 2.83) was lower than pre-hypnotherapy (Mean= 23.09; SD= 2.38), and the result was statistically significant (p<0.001). anxiety score after hypnopressure (Mean= 12.64; SD= 2.23) was lower than before hypnopressure (Mean= 23.13; SD= 2.53) and the result was statistically significant (p<0.001).Conclusion: Hypnopressure is more effective in lowering anxiety in patients undergoing a hemodialysis program.Keywords: anxiety, acupressure, hypnotherapy, hypnopressure, hemodialysisCorrespondence: Hanung Prasetya. Health Polytechnique of Health Ministry Surakarta. Jl. Letjend Sutoyo, Mojosongo, Surakarta 57127. Email: hanungprasetya168@gmail.com. Mobile: 08122638908Indonesian Journal of Medicine (2023), 08(01): 59-67https://doi.org/10.26911/theijmed.2023.08.01.06

Toxicity Test of Sentul Fruit (Sandoricum koetjape) Peel Extract on Mice Wirata, I Nyoman; Agung, Anak Agung Gede; Arini, Ni Wayan; Raiyanti, I Gusti Ayu; Novya Dewi, I Gusti Agung Ayu
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.1.619

Background: Sentul fruit peel extract has an antibacterial activity since it contains saponin, flavonoid, phenol, and tannin. Hence, it can be utilized in oral infection treatment. The safety level of herbal medicines needs to be studied by using a toxicity test. The study aims to discover the toxicity of Sentul fruit peel extract.Subjects and Method: The study was conducted in the laboratory of the Faculty of Food Technology of Warmadewa University and the laboratory of the Faculty of Medicine and Health Sciences of Warmadewa University. The independent variables of the study were the various doses of Sentul peel extract administered orally. The dependent variable was an acute toxicity test. The toxicity test in mice used an experimental study design in the laboratory that was observed qualitatively and quantitatively. The animals used were 25 male white mice (Mus musculus) and were divided into 5 groups. Data were collected based on the results of examinations from the laboratory and subsequently analyzed qualitatively and descriptively.Results: Based on the results of the LD50 Toxicity Test on Mice, Sentul peel extract samples did not cause toxic symptoms in the form of decreased heart activity, convulsions, decreased movement activity, and slow breathing. The administration of Sentul peel extract was categorized as non-toxic because mice do not experience abnormal symptoms and there was no death after the administration of the extract using the oral gavage method at all doses for 14 days, thus Sentul peel extract was safe to use as a medicinal ingredient.Conclusion: Sentul peel extract is categorized as non-toxic because mice do not experience abnormal symptoms and no death occurs.Keywords: Sentul peel, extraction, oral infection, mice, toxicityCorrespondence: I Nyoman Wirata, Health Polytechnic of the Ministry of Health Denpasar. Jl. Sanitasi No.1, Sidakarya, South Denpasar, Denpasar City, Bali 80224. Email: wiratainyoman@gmail.com. Mobile: 08123649998.Indonesian Journal of Medicine (2023), 08(01): 114-120https://doi.org/10.26911/theijmed.2023.08.01.11

Effect of Bamboo Shoot (Gigantochloa Nigrociliata) Extract on Decreased Blood Pressure and Tnf-Α in Male Wistar Rats (Rattus Norvegicus) Surati, Surati; Setyowatiningsih, Lilik; Aulia, Qurrotu A’yuni; Widiyanto, Santo Yoseph Didik; Sutrisna, EM
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.8.1.639

Background: Hypertension is a non-communicable disease based on increased pathologies such as RAS, inflammation, and oxidative stress. Bamboo shoot extract contains BSP, phenol, and flavonoids that can reduce inflammatory status, oxidative stress, and ACE. The study aims to determine the effect of bamboo shoot extract on decreased blood pressure and TNF-α in male Wistar Rats made hypertensive.Subjects and Method: This study used a True Experimental Design with the Posttest Only Control Group Design. The study was located at the Integrated Biomedical Laboratory of the Faculty of Medicine, Sultan Agung Islamic University, Semarang in April-July 2021. The study sample of 24 male Wistar Rats was randomly divided into 4 groups. The dependent variables of the study were Blood pressure and TNF-α. The independent variable was bamboo shoot extract. Blood pressure was measured by Pressure Recording Tail Cuff, and TNF-α was measured by using the ELISA method with CATALOG Number KET 9007-48 well. The data were analyzed by using the One Way Anova Test.Results: This study showed no significant difference from systolic or diastolic blood pressure results of male Wistar rats in the K1, K2, and K3 groups after the intervention. Meanwhile, the average levels of TNF-α decreased significantly in the K3 group (Mean= 1.99; SD= 1.13) compared with the control group K0 (Mean= 16.70; SD= 7.45) and it was statistically significant p<0.001.Conclusion: There is no significant effect on blood pressure in male Wistar rats that obtained bamboo shoot extract, but there is a significant effect on TNF-α levels in male wistar rats that obtained bamboo shoot extract.Keywords: bamboo shoots, hypertension, blood pressure, TNF-α, male wistar rat.Correspondence: Surati. Department of Cytohistotechnology, Study Program of Health Analyst, Health Polytechnic, Ministry of Health Semarang. Jl. Wolter Monginsidi No. 115, Pedurungan, Semarang, Central Java, Indonesia, Email: analis_surati@yahoo.com. Mobile: 085226825024.Indonesian Journal of Medicine (2023), 08(01): 121-127https://doi.org/10.26911/theijmed.2023.08.01.12

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