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Asian Journal of Health Research
Published by Ikatan Dokter Indonesia Wilayah Jawa Timur
ISSN : 28292979     EISSN : 28289269     DOI : https://doi.org/10.55561/ajhr
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Asian Journal of Health Research (AJHR) is an open access journal published by Ikatan Dokter Indonesia Wilayah Jawa Timur and launched in 2022. This journal is peer reviewed publishing to communicate high quality research, general articles, and all fundamental research/ clinical studies relevant to health science. The journal publishes articles Medical Sciences scope including (Obstetrics and Gynaecology, Pediatrics, Internal medicine, Ophthalmology, Surgery, Neurology, Otolaryngology, Cardiology and Vascular Medicine, Anaesthesiology and Reanimation, Dermatovenerology, Orthopaedics and Traumatology, Urology, neurosurgery, Cardiothoracic surgery, Orthopaedics and Traumatology, Plastic Reconstructive Surgery and Aesthetics, Pulmonology and Respiratory Medicine, Forensic Medicine, and Medicolegal, Psychiatry Medicine and Rehabilitation). AJHR journal is published three times per year in April, August, and December.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 160 Documents
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Effect of Menopausal Hormonal Therapy on Cardiovascular Disease Risk Reduction in Women with Menopausal Condition: A Systematic Review and Meta-Analysis Pati, Ferdinand Umbu; Dwijayasa, Pande Made
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.258

Abstract

Introduction: Women with menopausal conditions are more likely to cardiovascular illness compared to women without menopausal problems. Menopausal Hormone Therapy (MHT) has been proposed to lowers the risk of cardiovascular disease events. However, current proof of the utility of this therapy is still needed.    Material and Methods: A systematic search was conducted in PubMed, Cochrane Library, and Science Direct were searched for RCTs, as well as cohort or case-control research that evaluated the impact of monitoring on the incidence of cardiovascular diseases in patients undergoing hormone replacement therapy. Data were analyzed using a fixed/random effect model based on using heterogeneity to evaluate odds ratios (ORs) and 95% CIs, and calculated through the Inverse Variance method.    Results: Four RCTs involving 8,198 patients on MHT and compared with 8,249 control patients met the inclusion criteria. The pooled analysis showed no significant reduction in the risk of cardiovascular disease events among women treated with MHT compared with placebo (OR = 0.98; 95% CI 0.88–1.09; p = 0.72). There was no statistical evidence of heterogeneity across studies (I² = 0%, p = 0.50). All studies were assessed as a low overall risk of bias.    Conclusion: Six of seven studies found no difference in disease‐free or overall survival between MIS and open RH. One study reported worse outcomes with RRH among patients with FIGO IIB disease and multi‐agent NACT (HR 2.5–3.0; p<0.05), suggesting risk in higher‐stage, heavily pretreated cases. Overall, robotic‐assisted RH appears to be a safe and effective alternative to open surgery for appropriately selected FIGO IB₂–IIA₂ cervical cancer patients after NACT. 
A Rare Pediatric Case of Dengue Hemorrhagic Fever with Encephalopathy and Suspected Subdural Hemorrhage Cempakasari, Aulia; Rahmawati, Tiara; Arifin, Alief Qobidh Al Bashor; Syahputri, Dewi; Hutami, Firdha Yekti; Prameswari, Renata; Nugraheni, Pramita Anindya; Adiwinoto, Ronald Pratama; Adnyana, I Made Dwi Mertha
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.262

Abstract

Introduction: Dengue Hemorrhagic Fever (DHF) is a severe arboviral infection that rarely leads to neurological complications. Dengue encephalopathy, often secondary to metabolic disturbances or shock, presents a significant diagnostic and management challenge in the pediatric population. Case Presentation: We report the case of a 4-year-3-month-old obese girl presenting with fever, gastrointestinal symptoms, and progressively decreasing consciousness (apathetic). Diagnosis of DHF was confirmed by a positive NS1 antigen test, severe thrombocytopenia (nadir 14,000/µL), and hemoconcentration with pleural effusion. Hepatic involvement was noted (SGOT 117.81 U/L). Neurological involvement was characterized by clinical encephalopathy, and a head CT scan revealed hyperdense lesions suspecting subdural hemorrhage (SDH). The patient required multidisciplinary management in the Intensive Care Unit (ICU) for supportive fluid therapy, inotropic support (Dobutamine), and platelet transfusion. The patient showed marked clinical improvement and was discharged on day nine. At a two-week post-discharge follow-up, she demonstrated full cognitive and motor recovery with no neurological sequelae Conclusion: This case highlights the critical need for clinical vigilance for rare, simultaneous neurological complications (encephalopathy and suspected SDH) in pediatric DHF. It underscores that early diagnosis and aggressive, multidisciplinary supportive care can lead to complete recovery even in severe presentations.
Symptoms and Clinical Manifestations in Perimenopausal and Postmenopausal Women in Asia: A Systematic Review and Meta-Analysis Cahyaningtyas, Rara Arisya; Aisyah, Kayla Faradita; Kamila HS , Vina; Pratisto , Rifdi Gadiantwan; Herdawati, Deska Pradita
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.273

Abstract

Introduction: Menopause is a physiological transition marked by the permanent cessation of menstruation due to declining ovarian function and estrogen production. The menopausal transition, particularly the perimenopausal phase, is frequently accompanied by symptoms that adversely affect women’s daily functioning and quality of life. This meta-analysis aimed to estimate the relative risk (odds ratio [OR]) of somatic, psychological, and urogenital symptoms among perimenopausal compared with postmenopausal women in Asia.   Material and Methods: A systematic review was conducted following PRISMA guidelines, including studies published within the last 10 years. A total of 14,331 participants were analyzed. Quantitative synthesis was performed using RevMan Cochrane version 5.4.1, with subgroup analysis focusing on hot flushes. Risk of bias assessment indicated moderate to high bias across most included studies.    Results: Perimenopausal women had a significantly higher risk of somatic symptoms than postmenopausal women (OR 1.24; 95% CI 1.20–1.29), particularly hot flushes, night sweats, sleep disturbances, and musculoskeletal pain. Psychological symptoms were also more prevalent during perimenopause (OR 1.05; 95% CI 1.01–1.10), notably anxiety and memory impairment. Urogenital symptoms showed the greatest increase (OR 1.31; 95% CI 1.23–1.40), with vaginal dryness being the most prominent complaint (OR 1.77; 95% CI 1.58–1.98).    Conclusion: Perimenopausal women are at greater risk of experiencing somatic, psychological, and urogenital symptoms than postmenopausal women, with vaginal dryness, sleep disturbances, and cognitive complaints being most pronounced. These findings underscore the impact of hormonal fluctuations during the menopausal transition and highlight the need for early identification and targeted management of menopausal symptoms. 
Diagnostic and Therapeutic Dilemmas in Inguinal Endometriosis: A Case Report Auliya, Faiza Fardha; Siswanto, Yudi
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.275

Abstract

Introduction: Endometriosis is a common gynecological condition, but its extragenital forms, particularly inguinal endometriosis, are rare and pose significant diagnostic and therapeutic challenges. This case highlights the complexities encountered in managing endometriosis in an unusual location. Case Presentation: We report the case of Mrs. C, a 34-year-old married woman, who presented with a 4-year history of a painful, cyclically bleeding lump in the right pubic region, was initially misdiagnosed as a traumatic cyst. Histopathological examination of an external genital biopsy in 2023 confirmed endometriosis. Initial monthly Depo Medroxyprogesterone Acetate (DMPA) therapy for six cycles proved ineffective. Subsequently, Gonadotropin-Releasing Hormone (GnRH) agonist (Endrolin) injections were administered for a total of 12 cycles, with symptom improvement, specifically cessation of bleeding, noted only after the seventh cycle. No hypoestrogenic side effects were reported despite prolonged GnRH agonist use without add-back therapy. Conclusion: This case illustrates the diagnostic delay often associated with extragenital endometriosis due to its atypical presentation, with the patient receiving only symptomatic treatment for years. The need for prolonged GnRH agonist therapy (12 cycles), exceeding standard guidelines of six months, highlights individual variability in treatment response, even without add-back therapy. Recurrence of bleeding occurred shortly after cessation of Dienogest maintenance therapy due to economic constraints, underscoring the chronic, hormone-dependent nature of the disease and the importance of continuous, accessible treatment. The patient consistently declined operative laparoscopy for wider excision.
Effectiveness of Lipopolysaccharide (LPS) Induction in Wistar Rats as a Low Birth Weight (LBW) Model Patridina, Geneung; Prasetyorini , Nugrahanti
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.278

Abstract

Introduction: Low birth weight (LBW) is linked to stunting, neurodevelopmental delays, and neonatal mortality of up to 80%, with risk factors including maternal infection, poor nutrition, gestational age, obstetric history, and socioeconomic conditions. This study assessed the effectiveness of lipopolysaccharide (LPS) induction in Wistar rats as an LBW model, given LPS’s ability to mimic maternal infection and induce a controlled inflammatory response, while addressing the lack of updated data on inflammatory mediators such as VEGF, TNF-α, and IL-6 in LPS-induced LBW. Material and Methods: Four groups of Wistar rats were used in an in vivo true experimental post-test only design.  LPS injection as the independent variable, and the dependent variables include TNF-α and IL-6 levels in the mother's serum and amniotic fluid as determined by ELISA, fetal weight, mortality, crown-rump length, and tail length. Distribution-appropriate statistical tests were used to assess the data, and a p-value of less than 0.05 was considered significant. Results: Administration of LPS (50–100 µg/kg) significantly reduced fetal weight (p=0.04) and increased mortality. The fetal weight decreased by 57.4% in LPS100, and 32 deaths occurred compared to the control group. Crown-rump length (CRL) also significantly decreased at doses of 75 and 100 µg/kg (p<0.05), while tail length showed no significant difference (p>0.01). Additionally, LPS increased IL-6 and TNF-α levels compared to the control (p<0.05), with significant increases in the LPS75 and LPS100 groups compared to LPS50 (p<0.001). Conclusion: LPS induction in Wistar rats decreases birth weight, CRL, and increases fetal mortality, IL-6, and TNF-α, but does not affect fetal tail length.
Relationship between C-Reactive Protein Levels and Preeclampsia in Pregnant Women Karmila, Hartatiek Nila; Sari, Nathalya Dwi Kartika; Mardiyanti, Ika; Matin, Nur Sophia
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.281

Abstract

Introduction: Preeclampsia remains a major contributor to maternal morbidity and mortality worldwide, including in Indonesia. Increasing evidence suggests that inflammation plays an important role in its development. C-reactive protein (CRP), an easily accessible inflammatory marker, has been proposed as a potential indicator for early identification. This study aimed to examine the association between CRP levels and preeclampsia in pregnant women. Material and Methods: A case–control study was conducted at RSI A. Yani Surabaya between August and October 2022. Fifty pregnant women beyond 20 weeks of gestation were enrolled, consisting of 25 normotensive and 25 preeclamptic participants. CRP levels were measured using the ichromsa™ system following standard laboratory procedures. Data were analyzed using the Mann–Whitney U test with a significance level of p<0.05. Results: The mean maternal age was slightly higher in the preeclampsia group. Most participants were in the late third trimester. CRP levels differed significantly between groups, with higher values observed among women with preeclampsia (p<0.001). A greater proportion of preeclamptic women had CRP concentrations ≥5 mg/L. Conclusion: This study demonstrates a significant difference in CRP levels between normotensive and preeclamptic pregnancies, supporting the role of inflammation in the condition. However, given the limited sample size and lack of adjustment for confounding factors, the findings should be interpreted cautiously. Larger studies with broader analytical approaches are needed before CRP can be considered for clinical screening or risk stratification.
Transarterial Embolisation for Intractable Haematuria: A Case Report and Review of Management Strategies Amalia, Aisyah; Aslam, Achmad Bayhaqi Nasir; Nurdiana, Farah; Siswidiyati
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.286

Abstract

Introduction: Refractory gross haematuria is a significant urological emergency, characterised by prolonged and life-threatening bleeding that does not respond to standard treatment. The main recognised aetiologies encompass malignant neoplasms of the bladder and haemorrhagic cystitis. When conservative treatments and intravesical medications fail, transarterial embolisation (TAE) is a dependable and effective technique for achieving haemostasis. This study aims to report cases of haematuria resulting from bladder pathology, the role of interventional radiology in embolisation, and technical considerations. Case Presentation: We present two cases of refractory gross haematuria from the bladder managed with TAE. Case 1 involved a 65-year-old male with locally advanced, hypervascularised bladder squamous cell carcinoma (cT4aN3M1b). Case 2 involved a 69-year-old woman with haemorrhagic cystitis secondary to pelvic radiotherapy for stage IVb cervical carcinoma. Pre-embolisation angiography showed prominent blushing of feeder arteries arising from the superior vesical artery (SVA) bilaterally. Embolisation used gelfoam and PVA particles. The procedure reduces tumour blushing (Case 1) and hypervascularisation (Case 2), controlling haematuria. Conclusion: TAE is a safe and effective treatment modality for managing persistent gross haematuria due to diverse bladder pathologies, including bladder malignancy and radiation cystitis. Bilateral vesical artery embolisation was performed in both cases to ensure a more sustained response and reduce the likelihood of recurrence.
The Use of Hounsfield Unit as a Quantitative Indicator for Detecting Stroke Phases on Non-Contrast Head CT-Scan Aslam, Achmad Bayhaqi Nasir; Fauzi, Dimas Noor Zulfikar
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.288

Abstract

Introduction: Ischemic stroke is a major cause of morbidity and mortality worldwide. Early determination of the stroke phase is essential for guiding appropriate management and predicting prognosis. Non-contrast head computed tomography (CT) remains the first-line imaging modality in acute stroke evaluation. Material and Methods: This analytic observational study with a cross-sectional approach was conducted at Dr. Saiful Anwar General Hospital, Malang, Indonesia. A total of 45 patients diagnosed with ischemic stroke were included and divided equally into three groups: acute, subacute, and chronic (15 patients each). HU values were measured using three regions of interest (ROIs) of 1 cm² placed within the infarcted area and averaged for analysis. Results: Mean HU values decreased progressively with stroke phase progression: acute 25.84 ± 1.07, subacute 18.11 ± 0.96, and chronic 9.24 ± 0.96. The Kruskal–Wallis test revealed a significant difference in HU values among the three groups (p < 0.001). Post hoc analysis using Dunn’s test confirmed significant differences between all phases (acute–subacute = 7.73 HU; subacute–chronic = 8.87 HU; acute–chronic = 16.60 HU; all p < 0.001). Clinically, decreased consciousness predominated in the acute phase (66.7%), while hemiparesis was more common in subacute (66.7%) and chronic (60%) phases, reflecting underlying tissue pathophysiology. Conclusion: Quantitative HU measurement on non-contrast CT provides a reliable and objective tool for differentiating ischemic stroke phases. The progressive decline in HU values corresponds with the temporal evolution of infarction, making HU analysis a useful adjunct to conventional qualitative CT interpretation.
Hand Dexterity and Its Effect on Acquiring Basic Suturing Skills among Pre-clinical Medical Students Shah, Pranjal; Caszo, Brinnell; Ponnudurai, Gnanajothy; Ikram, Mohammad Arshad; Dhanaraj, Siddharth; Gnanou, Justin
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.289

Abstract

Introduction: Hand dexterity is essential for executing fine motor tasks, especially in surgical procedures such as suturing. Comprehending the significance of hand dexterity in suturing is essential for enhancing surgical training and expertise. Thus, this study aimed to examine hand dexterity on suturing skills among pre-clinical students. Material and Methods: A prospective study design was used and was conducted on twenty male undergraduate medical students with no prior surgical suturing experience. The Purdue Pegboard test was used to assess hand dexterity. This was followed by assessing basic suturing skills, which involved assessment of participants' suturing skills on two types of sutures (simple interrupted and simple continuous) by independent raters using a standardized rubric and time metrics. Pearson regression analysis was used to assess the dexterity-suturing relationships. Results: The study results indicated no association between hand dexterity and suture time for simple interrupted suture (r=0.085), while a weak negative association was observed for hand dexterity and suture time for simple continuous suture (r=0.303), suggesting individuals with a high dexterity score tool less time to complete the suture. Overall surgical assessment score showed a weak positive correlation between hand dexterity and suturing skill (r=0.308). However, no statistical significance was achieved for the correlations (p=0.05).. Conclusion: Our study findings highlight a weak association between hand dexterity and suturing performance, which depends on the duration and complexity of the task. This finding could be used to develop structured training among undergraduate medical students in developing suturing skills.
Vitamin D Effects on Glycemic and Cardiometabolic Profiles in PCOS: A Meta-Analysis Prabowo, Adityo
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.295

Abstract

Introduction: Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder characterized by hyperandrogenism and ovulatory dysfunction. Beyond reproductive consequences, PCOS is fundamentally associated with metabolic dysregulation, including insulin resistance and dyslipidaemia. High rates of Vitamin D deficiency in this population suggest a link to these metabolic characteristics. This systematic review and meta-analysis assessed the efficacy of Vitamin D supplementation compared to placebo on glycemic control markers (HOMA-IR, fasting glucose) and cardiometabolic risk profiles in women with PCOS.   Material and Methods: A comprehensive search was executed across PubMed, Europe PMC, Open Alex, and Science Direct (2015- 2025) following PRISMA 2020 guidelines. The review included Randomized Controlled Trials (RCTs) involving women diagnosed via Rotterdam or NIH criteria. Quality was assessed using the Cochrane Risk of Bias 2.0 tool, with quantitative synthesis performed using appropriate statistical models.    Results: Fourteen RCTs were synthesized. The meta-analysis indicated that Vitamin D supplementation significantly improved insulin resistance, with a pooled Mean Difference in HOMA-IR of -0.61 (95% CI: -0.81 to -0.41; p < 0.001). Furthermore, a consistent decrease in serum triglycerides was observed (MD = -17.12 mg/dL; 95% CI: -18.60 to -15.64; p < 0.001). Secondary outcomes suggested improvements in ovulation and oxidative stress biomarkers and visceral adiposity.    Conclusion: Vitamin D supplementation demonstrates a beneficial therapeutic profile in women with PCOS, providing substantial advantages in enhancing insulin sensitivity and lipid metabolism. Thus, it appears to be a safe, effective adjuvant strategy for reducing long-term cardiometabolic risk.

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