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Acta Medical and Health Sciences (AMHS)
Published by Universitas Jenderal Achmad Yani
ISSN : 28305531     EISSN : 28305426     DOI : https://doi.org/10.35990
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Acta Medical and Health Sciences (AMHS) is a scientific journal that publishes research articles, case reports, literature reviews, and other topics relevant to the field of medicine and health, either clinically or to the biomolecular level. Manuscript under consideration that may be uploaded is a full text of article which has not been published in other national magazines. AMHS is published three times a year (every February, June, and October).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 72 Documents
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Pengaruh Ekstrak Etanol Buah Terong Belanda (Solanum betaceum Cav.) terhadap Penurunan Kadar Trigliserida pada Tikus Wistar dengan Dislipidemia Syahira Multazami; Yuke Ireka; Welly ratwita
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
Publisher : ACTA Medical Health Sciences

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Abstract

Dyslipidemia, an abnormality in lipid metabolism marked by elevated triglycerides, cholesterol, or LDL and low HDL, increases cardiovascular risk. Tamarillo (Solanum betaceum Cav.) contains flavonoids and anthocyanins with potential lipid-lowering effects. This study evaluated the effect of ethanol extract of Tamarillo fruit (ETB) at doses of 100 mg/kg body weight (BW)/day and 200 mg/kg BW/day on triglyceride levels in Wistar rats with dyslipidemia, compared with simvastatin at 10 mg/kg BW/day. A posttest-only control group design was applied using 25 male Wistar rats divided into five groups: negative control, positive control, ETB 100, ETB 200, and simvastatin. Dyslipidemia was induced with a high-fat diet and propylthiouracil for 14 days, followed by 14 days of treatment. Triglyceride levels were measured using the GPO-PAP method. Data were analyzed with the Shapiro–Wilk test, Levene’s test, and Kruskal–Wallis test. The results showed no statistically significant differences between groups (p > 0.05). However, ETB at 200 mg/kg BW/day demonstrated a 22.6% reduction in triglyceride levels compared with the positive control, though the effect was slightly less than simvastatin. In conclusion, Tamarillo ethanol extract did not significantly reduce triglyceride levels but showed a favorable trend at higher doses, indicating potential for further research with dose optimization, longer duration, and standardized active compounds.   DOI : 10.35990/amhs.v4n2.p51-60   REFERENCES PERKENI. Pengelolaan Dislipidemia di Indonesia 2021. Jakarta: PB PERKENI; 2021. Nasution IS, Rahmadani AD, Audina W, Sari DP, Sari ND. Ulasan sistematis: Pengaruh gaya hidup dan pengetahuan masyarakat terhadap risiko penyakit jantung koroner. Sehat Rakyat: Jurnal Kesehatan Masyarakat. 2025;4(2):287–298. Siregar MH, Fatmah F, Sartika R. Analisis faktor utama kadar trigliserida abnormal pada penduduk dewasa di Indonesia. Jurnal Delima Harapan. 2020;7(2):118–127. Yuliana AR, Martha A. Efek pemberian seduhan kulit buah naga merah (Hylocereus polyrhizus) terhadap kadar trigliserida tikus Sprague Dawley dislipidemia. Journal of Nutrition College. 2016;5(4):428–437. Puspaseruni K. Tatalaksana dislipidemia terkait penyakit kardiovaskular aterosklerosis (ASCVD): Fokus pada penurunan LDL-C. Cermin Dunia Kedokteran. 2021;48(10):395–401. Sasmita, Djabir YY, Yustisia I. Efek pemberian dangke terhadap kadar kolesterol dan trigliserida darah tikus model hiperkolesterolemia dan hipertrigliseridemia. Majalah Farmasi dan Farmakologi. 2023;27(2):43–46. Fahmi NF, Laili NN. Differences in triglyceride levels between tobacco smokers and e-cigarette smokers. Proceedings of the National Seminar of Poltekkes Karya Husada Yogyakarta. 2019;1(1):79–88. Saragih AD. Terapi dislipidemia untuk mencegah risiko penyakit jantung koroner. Indonesian Journal of Nursing and Health Sciences. 2020;1(1):15–24. Udin B, Kholifah E. Literature review: Mechanism of action of antidyslipidemia drugs. Journal of Pharmaceutical Sciences. 2023;6(1):35–44. Dwi Sandhiutami NM, Khairani S, Moordiani M, Purpranoto IN. Efek sari buah terong Belanda (Solanum betaceum Cav.) terhadap perubahan profil lipid pada mencit dislipidemia. PHARMACY: Jurnal Farmasi Indonesia. 2021;18(2):226–234. Betaceum O, Riana I, Rahmawati P, Retnowati E, Devi RK. Judul tidak lengkap. 2020;5:7–13. Fairudz A, Nisa K. Pengaruh serat pangan terhadap kadar kolesterol penderita overweight. Medical Journal of Lampung University. 2015;4(8):121–126. Panche AN, Diwan AD, Chandra SR. Flavonoids: An overview. Journal of Nutritional Science. 2016;5:e47. Widiasriani IPA, Udayani NNW, Triansyah GAP, Dewi NPEM, Wulandari NLWE, Prabandari AASS. The role of flavonoid antioxidants in inhibiting free radicals. Jurnal Syifa Science and Clinical Research. 2024;6(2):188–197. Oktarini NWOAC, Dewi P, Puspawati NM, Swantara IMD, Astiti IAR, Rita WS. Antioxidant activity of flavonoid compounds in ethanol extract of Dutch eggplant seeds (Solanum betaceum) in inhibiting lipid peroxidation in Wistar rat blood. Adriana UH, Nofita, Marcelia S. Testing the combination activity of ethanol extracts from basil leaves (Ocimum × africanum Lour.) and fragrant pandan (Pandanus amaryllifolius Roxb.) as antibacterials against Salmonella typhi. Jurnal Malahayati. 2024. Liao CJ, Huang PS, Chien HT, Lin TK, Yeh CT, Lin KH. Effects of thyroid hormones on lipid metabolism pathologies in non-alcoholic fatty liver disease. Biomedicines. 2022;10(6):1–17. Ramadhani A, Hidayatt R, Khaira DS. The effect of ramania leaf ethanol extract on insulin and GDP in obese type 2 diabetes mice. Media Penelitian dan Pengembangan Kesehatan. 2025;35(1):143–156. Sinaga H, et al. Judul tidak lengkap. 2009. Kumalaningsih S. Antioksidan Alami: Penangkal Radikal Bebas, Sumber, Manfaat, Cara Penyediaan dan Pengolahan. Surabaya: Trubus Agrisarana; 2006. Whitcomb DC. Methods for measurement of serum lipids and lipoproteins. In: Rifai N, Warnick GR, Dominiczak MH, editors. Handbook of Lipoprotein Testing. 2nd ed. Washington DC: AACC Press; 2000. p. 115–126. Usmadi. Testing of analytical requirements (homogeneity test and normality test). Inovasi Pendidikan. 2020;7(1):50–62. Andra Ningsih D, Nurhasanah, Fadillah L. The effectiveness of outdoor learning in building students’ self-confidence in science lessons in grade V at SDN 190 Cenning. Journal of Basic Education and Teaching. 2019;4(2):1–12. Mishra P, Pandey CM, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Annals of Cardiac Anaesthesia. 2019;22(1):67–72. Mishra P, Singh U, Pandey CM, Mishra P, Pandey G. Application of Student’s t-test, analysis of variance, and covariance. Annals of Cardiac Anaesthesia. 2019;22(4):407–411. Mohammed A, Samara F, Alzaatreh A, Knuteson SL. Statistical analysis for water quality assessment: A case study of Al Wasit Nature Reserve. Water (Switzerland). 2022;14(19):1–19. Rozi F, Irma, Maulidiya D. Analysis of inflation changes in several major cities in Indonesia using the Kruskal–Wallis test. Multi Proxima Journal of Statistics, Universitas Jambi. 2022;1(2):103–115. Naaktgeboren CA, Ochodo EA, Van Enst WA, De Groot JAH, Hooft L, Leeflang MMG, et al. Evaluation of result variability in systematic reviews of diagnostic studies. BMC Medical Research Methodology. 2016;16(1):1–8. Sudisma IGN, Soma IG, Sudira IW, Rastiti NM. Clinical and physiological responses of white rats (Rattus norvegicus) administered with Datura metel L. flower extract as anesthesia. Journal of Veterinary Science. 2023;41(3):323–335.
Acne vulgaris and self-confidence among medical students of universitas jenderal achmad yani class of 2023 Dinda F M Afifah; Arlisa Wulandari; Rina Munirah
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
Publisher : ACTA Medical Health Sciences

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Abstract

Acne vulgaris is a common inflammatory disorder that can affect psychological well-being in adolescents and young adults. This study aimed to examine the association between clinically confirmed acne vulgaris and self-confidence among undergraduate medical students. An analytical cross-sectional design was applied, involving 112 students from the Faculty of Medicine, Universitas Jenderal Achmad Yani, Class of 2023, recruited through consecutive sampling. Acne vulgaris was diagnosed clinically by a board-certified dermatologist, whereas self-confidence was assessed using the Ratnasari (2021) self-confidence questionnaire and the Rosenberg Self-Esteem Scale. Chi-square analysis was used to evaluate associations between acne status and self-confidence levels, with significance set at p < 0.05. Ethical approval was obtained from the Faculty of Medicine Ethics Committee (Approval No. 031/UM1.08/2024). Of the 112 respondents, 62 students (55.4%) were diagnosed with acne vulgaris. Most participants demonstrated high self-confidence based on both the Ratnasari questionnaire (67 students, 59.8%) and the Rosenberg scale (68 students, 60.7%). Statistical analysis showed no significant relationship between the presence of acne vulgaris and self-confidence (Ratnasari: p = 0.673; Rosenberg: p = 0.304). In conclusion, although acne vulgaris was common in this population, it was not associated with self-confidence levels. Further studies are recommended to explore additional psychological or environmental factors that may influence self-confidence among medical students.   DOI : 10.35990/amhs.v4n2.p61-67   REFERENCES Tan ST, Firmansyah Y, Elizabeth J. Enhancing adolescent self-confidence by controlling acne. Jurnal Pengabdian Mandiri. 2022;1(5):723–730. Sibero HT, Anggraini DI. Prevalence and epidemiological profile of acne vulgaris in Lampung Province. Jurnal Kedokteran Universitas Lampung. 2019;3(2):308–312. Teresa A. Adult acne vulgaris: Etiology, pathogenesis, and current management. Jurnal Kedokteran Universitas Palangka Raya. 2020;8(1):952–964. Saiya GD, Manuputty AG, Saiya AF, Yakobus S, Titaley CR, Tanamal RS. Relationship between acne vulgaris severity and self-confidence among medical students at Universitas Pattimura Ambon. PAMERI: Pattimura Medical Review. 2023;5(1):47–54. Sitohang MN, Teresa A. Literature review: Relationship between facial hygiene behavior and acne vulgaris. Jurnal Kedokteran Universitas Palangka Raya. 2022;10(1):13–17. Murlistyarini S. Acne Vulgaris. Malang: Universitas Brawijaya Press; 2019. Annisa F, Sulistiasari R. Relationship between sleep quality and acne vulgaris incidence in patients at Dr. Nur Afni Practice, Medan, 2020. Jurnal Kedokteran Ibnu Nafis. 2021;10(1):49–52. Sachio A, Toruan VML, Yuniati Y. Relationship between acne vulgaris severity and quality of life using the Dermatology Life Quality Index (DLQI). Jurnal Kebidanan Mutiara Mahakam. 2020;8(2):77–83. Rais MR. Self-confidence and its development in adolescents. Al-Irsyad: Jurnal Pendidikan dan Konseling. 2022;12(1):40–47. Fitri E, Zola N, Ifdil I. Profile of adolescent self-confidence and influencing factors. JPPI (Jurnal Penelitian Pendidikan Indonesia). 2018;4(1):1–5. Xu S, Zhu Y, Hu H, et al. The analysis of acne increasing suicide risk. Medicine. 2021;100(24):e26035. Tayel K, Attia M, Agamia N, Fadl N. Acne vulgaris: Prevalence, severity, and impact on quality of life and self-esteem among Egyptian adolescents. Journal of the Egyptian Public Health Association. 2020;95:1–7. Ompi EE, David L, Opod H. Relationship between self-confidence and acne vulgaris in adolescents at SMAN 7 Manado. eBiomedik. 2016;4(1). Aryani DT, Riyaningrum W. Relationship between acne vulgaris and self-confidence in students at Universitas Muhammadiyah Purwokerto, class of 2021. Jurnal Kesehatan Tambusai. 2022;3(3):434–441. Sitohang IBS, Wasitatmadja SM. Ilmu Penyakit Kulit dan Kelamin. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2015. p. 288–289. Hasanah RL, Rianto Y, Riana D. Identification of acne vulgaris type in facial acne images using GLCM feature extraction and Extreme Learning Machine algorithm. Rekayasa. 2022;15(2):204–214. Wibisono EA, Indramaya DM, Rochmanti M. Retrospective study: Initial pharmacotherapy profile of new acne vulgaris patients. Jurnal Berkala Epidemiologi. 2020;8(3):236–245. Deliana R, Amalia R, Jusuf NK. Relationship between body mass index and acne vulgaris in students at SMA Negeri 7 Medan. Cermin Dunia Kedokteran. 2019;46(4):253–255. Fadilah AA. Correlation between psychological stress and the incidence of acne vulgaris. Jurnal Ilmiah Kesehatan Sandi Husada. 2021;10(2):390–395. Saragih DF, Opod H, Pali C. Relationship between self-confidence and acne vulgaris in senior high school students at SMA Negeri 1 Manado. eBiomedik. 2016;4(1). Harahap M. Anatomy and function of the skin. In: Harahap M, editor. Ilmu Penyakit Kulit. Jakarta: Hipokrates; 2000. p. 35–45. Ulfah N. Relationship between cosmetic exposure and acne vulgaris incidence in female medical students. Jurnal Health Sains. 2020;1(6):393–400. Ramadhianti S. Relationship between acne vulgaris incidence and self-confidence of female medical students at Universitas Islam Sumatera Utara. 2023. Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al. Acne vulgaris. In: Kang S, et al., editors. Fitzpatrick’s Dermatology. 9th ed. New York: McGraw-Hill Education; 2019. p. 1392–1412. Tanojo N, Anggraeni S. The use of dermoscopy to distinguish between pityrosporum folliculitis and acne vulgaris. 2023. Juliyanti J. Dermoscopy. Jurnal Pandu Husada. 2023;4(2):58–78. Mescher AL. Histology: Junqueira’s Text and Atlas. Jakarta: EGC; 2011. p. 364–373. Nabillah R. Prevalence of seborrheic dermatitis in dermatology outpatient clinic of RSUD Meuraxa Banda Aceh, 2016–2019. Jurnal Health Sains. 2021;2(1):112–119. Unzilla DA. Concept of self-confidence in adolescent girls. Educatio. 2016;2(2):43–52. Marbun KAF, Siagian IO, Sinaga H. Self-confidence and anxiety levels in final-year students completing their thesis at Institut Kesehatan Immanuel Bandung. Jurnal Kesehatan. 2023;12(2):321–332. Savira SI. Relationship between self-concept and self-confidence with social media usage intensity as a moderator in psychology students at Universitas Negeri Surabaya. E-Journal Unesa. 2021;8(2). Sulasih. Enhancing self-confidence through group guidance services. Hartamedia. 2016:1–71. Syam A, Amri A. The effect of self-confidence training based on IMM cadre system on student academic performance: A case study in the biology education program at Universitas Muhammadiyah Parepare. Jurnal Biotek. 2017;5(1):87–102. Lauster P. Tes Kepribadian. Diterjemahkan oleh D.H. Gulo. Jakarta: PT Gramedia Pustaka Utama; 1998. p. 1–13. Hulukati W, Djibran MR. Analysis of developmental tasks of students in the Faculty of Education, Universitas Negeri Gorontalo. Jurnal Bikotetik (Bimbingan dan Konseling: Teori dan Praktik). 2018;2(1):73–80. Kamus Besar Bahasa Indonesia (KBBI). Kamus daring. Tersedia pada: https://kbbi.web.id/didik Matheus KG, Wungouw HPL, Rante SDT. Relationship between acne vulgaris incidence and self-confidence among female students at SMAN 3 Kupang. Cendana Medical Journal. 2018;6(3):369–375. Sugiyono. Metode Penelitian Kuantitatif, Kualitatif, dan R&D. Bandung: Alfabeta; 2019. p. 112–125. Maroqi N. Construct validity testing of the Rosenberg Self-Esteem Scale instrument using confirmatory factor analysis (CFA). Jurnal Pengukuran Psikologi dan Pendidikan Indonesia (JP3I). 2019;7(2):92–96. Ratnasari NIPD. Profil Kepercayaan Diri Remaja dengan Akne di SMA Dwijendra Denpasar. Bali: Institut Teknologi dan Kesehatan Bali; 2021. Suwarjana IK. Statistik Kesehatan. Yogyakarta: Penerbit Andi; 2016. p. 132.
Effects of a multiepitope covid-19 vaccine with chitosan nano-adjuvant on colon histopathology in BALB/c mice Razky P Raharja; Endah Hamidah; Sayu P Y Paryati
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
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Abstract

The COVID-19 pandemic caused by SARS-CoV-2 has posed major global challenges in infectious disease control. Vaccination remains the primary strategy to reduce morbidity and mortality; however, concerns persist regarding vaccine safety, including gastrointestinal adverse events. Multiepitope vaccines represent a promising approach to induce broader immune responses, while chitosan nanoparticles are widely studied as biocompatible adjuvants to enhance vaccine safety and efficacy. This study aimed to evaluate the histopathological effects of a multiepitope COVID-19 vaccine, with and without chitosan nanoparticles, on the colon of male BALB/c mice. A post-test-only control group design was employed using 25 male BALB/c mice, divided into five groups (n = 5 per group). Colon tissues were examined histopathologically using Hematoxylin–Eosin (H&E) staining andassessed according to the Harpaz Histological Scoring System (HSS). The results demonstrated that 100% of samples across all treatment groups exhibited an HSS score of 1, indicating mild inflammatory cell infiltration involving less than 50% of crypts without erosion or ulceration. No samples showed HSS scores of 0, 2, or 3. Due to the homogeneous distribution of histopathological scores across all groups, inferential statistical analysis could not be performed. In conclusion, administration of the multiepitope COVID-19 vaccine, either alone or combined with chitosan nanoparticles, did not induce pathological changes in the colon of BALB/c mice. These findings support the gastrointestinal safety of the vaccine formulation and its potential for further development as a safe and effective COVID-19 vaccine candidate   DOI: 10.35990/amhs.v4n2.p68-76   REFERENCES Wulan D, Suwandewi A, Khatimah H. Faktor risiko penularan COVID-19 di masyarakat Diah. Jurnal Penelitian Kesehatan Suara Forikes. 2023;14(7):73–76. Aditia A. COVID-19: Epidemiologi, virologi, penularan, gejala klinis, diagnosis, tatalaksana, faktor risiko, dan pencegahan. Jurnal Penelitian Perawat Profesional. 2021;3(4):653–660. Tersedia pada: https://jurnal.globalhealthsciencegroup.com/index.php/JPPP/article/view/574/410 Kementerian Kesehatan Republik Indonesia. Vaksinasi COVID-19 Nasional. 2025. Tersedia pada: https://vaksin.kemkes.go.id/#/vaccines Wahyudi F, Nugraheni A, Margawati A, et al. Adverse events following immunization (AEFI): COVID-19 vaccine dose and characteristics in Central Java, Indonesia. Germs. 2023;13(1):40–49. Muthoharoh A, Waznah U. Survey gejala dan pengobatan yang dilakukan masyarakat Jawa Tengah pasca vaksin COVID-19. Jurnal Ilmiah Farmasi. 2024;3(3):289–296. Akaishi T, Takahashi T, Sato S, Jin X, Masamune A, Ishii T. Prolonged diarrhea following COVID-19 vaccination: A case report and literature review. Tohoku Journal of Experimental Medicine. 2022;257(3):251–259. Ajmera K, Bansal R, Wilkinson H, Goyal L. Gastrointestinal complications of COVID-19 vaccines. Cureus. 2022. Shimada T, Takada J, Baba A, et al. An elderly patient developed ulcerative colitis after SARS-CoV-2 mRNA vaccination: A case report and review of the literature. Internal Medicine. 2024;63(6):809–814. Taida T, Kato J, Ishikawa K, et al. Severe ulcerative colitis induced by COVID-19 vaccination. Clinical Journal of Gastroenterology. 2024;17(3):447–450. Weaver KN, Zhang X, Dai X, et al. Impact of SARS-CoV-2 vaccination on inflammatory bowel disease activity and development of vaccine-related adverse events: Results from PREVENT-COVID. Inflammatory Bowel Diseases. 2022;28(10):1497–1505. Ren LL, Wang YM, Wu ZQ, et al. Identification of a novel coronavirus causing severe pneumonia in humans: A descriptive study. Chinese Medical Journal (English). 2020;133(9):1015–1024. Lidiana EH, Mustikasari H, Pradana KA, Permatasari A. Gambaran karakteristik kejadian ikutan pasca vaksinasi COVID-19 pada tenaga kesehatan alumni Universitas ‘Aisyiyah Surakarta. Jurnal Ilmiah Kesehatan. 2021;11(1):11–17. Oladipo EK, Ajayi AF, Ariyo OE, et al. Exploration of surface glycoprotein to design multi-epitope vaccine for the prevention of COVID-19. Informatics in Medicine Unlocked. 2020;21:100438. Yang Z, Bogdan P, Nazarian S. An in silico deep learning approach to multi-epitope vaccine design: A SARS-CoV-2 case study. Scientific Reports. 2021;11(1):1–21. Tersedia pada: https://doi.org/10.1038/s41598-021-81749-9 Marshall JS, Warrington R, Watson W, Kim HL. An introduction to immunology and immunopathology. Allergy, Asthma & Clinical Immunology. 2018;14(Suppl 2):1–10. Tersedia pada: https://doi.org/10.1186/s13223-018-0278-1 Castrodeza-Sanz J, Sanz-Muñoz I. Adjuvants for COVID-19 vaccines. 2023:1–17. Dmour I, Islam N. Recent advances on chitosan as an adjuvant for vaccine delivery. International Journal of Biological Macromolecules. 2022;200:498–519. Schwedhelm P, Kusnick J, Heinl C, Schönfelder G, Bert B. How many animals are used for SARS-CoV-2 research? EMBO Reports. 2021;22(10):e52812. Atmojo JT, Akbar PS, Kuntari S, Yulianti I, Darmayanti AT. Definisi dan jalur penularan Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) atau COVID-19. Jurnal Pendidikan Kesehatan. 2020;9(1):57. Mudzakkir M, Risnasari N, Nugraha MFE, Mawadha SA. Upaya pencegahan penularan COVID-19 pada masyarakat Kabupaten Kediri. Kontribusi: Jurnal Penelitian dan Pengabdian kepada Masyarakat. 2021;2(1):56–65. Yüce M, Filiztekin E, Özkaya KG. COVID-19 diagnosis: A review of current methods. Biosensors and Bioelectronics. 2021;172:112752. Gorkhali R, Koirala P, Rijal S, Mainali A, Baral A, Bhattarai HK. Structure and function of major SARS-CoV-2 and SARS-CoV proteins. Bioinformatics and Biology Insights. 2021;15:1–11. Sukmana M. The pathogenesis of COVID-19 in the context of establishing a nursing diagnosis. Jurnal Kesehatan Pasak Bumi Kalimantan. 2020;3(1):21–28. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS coronavirus. Journal of Virology. 2020;94(7):e00127-20. Mönkemüller K, Fry LC, Rickes S. COVID-19, coronavirus, SARS-CoV-2 and the small bowel. Revista Española de Enfermedades Digestivas. 2020;112(5):383–388. Achard V, Aebersold DM, Allal AS, et al. A national survey on radiation oncology patterns of practice in Switzerland during the COVID-19 pandemic: Present changes and future perspectives. Radiotherapy and Oncology. 2020;150:1–3. Elbadry M, Medhat MA, Zaky S, Kassas ME. Ulcerative colitis as a possible sequela of COVID-19 infection: The endless story. Arab Journal of Gastroenterology. 2022;23(2):134–137. Kementerian Kesehatan Republik Indonesia. 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Clinical and laboratory manifestations of dengue fever cases at subang regional general hospital Rifky R Sulthan; Yoke Ayukarningsih; Siska T Pratiwi; Diana Rosifah
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
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Abstract

Dengue fever remains a major public health problem in Indonesia, particularly among children. Early recognition of clinical manifestations, supported by laboratory findings, is crucial for diagnosis, monitoring disease progression, and preventing severe complications. This study aimed to describe the clinical manifestations and laboratory findings of dengue fever cases in children. A cross-sectional study design was used, based on medical records of all pediatric patients aged 0–18 years who werediagnosed with dengue infection at Subang Regional Hospital from January to December 2024. Total sampling yielded 197 cases that met the inclusion criteria. Most patients were aged 6–18 years (73.1%) and male (57.4%). The highest incidence occurred in March (20.8%). The most common clinical manifestations were fever (100%), abdominal pain (61.9%), nausea (61.4%), vomiting (53.8%), and headache (37.1%). Warning signs were identified in 46.2% of patients, with persistent vomiting and abdominal pain being the most frequent. Laboratory findings showed thrombocytopenia (75.0%) and leukopenia (62.5%), particularly in the 6–18 age group, while anemia was most common in infants aged 0–1 year (92.3%). Serological examinations showed all patients were NS1 positive at initial testing, with IgM and IgG detected in subsequent examinations, indicating progression from the acute to the convalescent phase. These findings highlight the importance of integrated clinical and laboratory evaluation for early detection and appropriate management of dengue fever.   DOI : 10.35990/amhs.v4n2.p77-86   REFERENCES Syamsir, Daramusseng A. Analisis spasial efektivitas fogging di wilayah kerja Puskesmas Makroman, Kota Samarinda. JNIK. 2018;1(2):1–7. Podung GCD, Tatura SNN, Mantik MFJ. Faktor risiko terjadinya sindroma syok dengue pada demam berdarah dengue. JBM. 2021;13(2):161–166. Ubaidillah, Kurniawan D. Faktor risiko yang mempengaruhi terjadinya kejadian demam berdarah dengue (DBD) di Puskesmas Sewon II Bantul. PHJ. 2020;11(1):7–12. Rahma FA, Rahayu DFS, Prawira LY, Nandini M, Bariyah RA. Faktor risiko aspek lingkungan dan aspek perilaku terhadap kejadian demam berdarah dengue (DBD) di wilayah kerja Puskesmas Sukmajaya, Kota Depok tahun 2022. JoPHJ. 2023;2(3):91–101. Sumampouw OJ. Epidemiologi demam berdarah dengue di Kabupaten Minahasa, Sulawesi Utara. SRJPH. 2020;1(1):1–8. Nanda M, Saragih PA, Nasution DH, Daulay A, Sari DP, Ridho NU. Analisis pengendalian faktor risiko dan vektor kejadian demam berdarah dengue. FJIK. 2023;2(2):111–116. Anggraini DR, Huda S, Agushybana F. Faktor perilaku dengan kejadian demam berdarah dengue (DBD) di daerah endemis Kota Semarang. JIKK. 2021;12(2):344–349. World Health Organization (WHO). Disease outbreak news: Dengue—Global [Internet]. 2024 [diakses 2 Apr 2025]. Tersedia pada: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON518 World Health Organization (WHO). Dengue Bulletin [Internet]. 2021 Mar [diakses 2 Apr 2025]. Tersedia pada: https://www.who.int/publications/i/item/ISSN0250-8362 Tansil MG, Rampengan NH, Wilar R. Faktor risiko terjadinya kejadian demam berdarah dengue pada anak. JBM. 2021;13(1):90–99. Kementerian Kesehatan Republik Indonesia. Survei Kesehatan Indonesia (SKI) dalam angka: data akurat, kebijakan tepat [Internet]. 2023 [diakses 7 Jan 2025]. Tersedia pada: https://kemkes.go.id/id/survei-kesehatan-indonesia-ski-2023 Wila RW, Nusa R. Gambaran klinis dan respon imun penderita demam berdarah dengue di Rumah Sakit Kristen Lindi Mara Sumba Timur selama bulan Januari sampai dengan Desember 2018. BALABA. 2020;16(2):209–216. Indriyani DPR, Gustawan IW. Manifestasi klinis dan penanganan demam berdarah dengue grade 1: sebuah tinjauan pustaka. ISM. 2020;11(3):1015–1019. Ahmad ZF, Mongilong NS, Kadir L, Nurdin SSI, Moo DR. Perbandingan manifestasi klinis penderita demam berdarah. IJPE. 2023;3(1):143–153. Dahlan MS. Besar sampel dan cara pengambilan sampel dalam penelitian kedokteran dan kesehatan. In: Suslia A, editor. Edisi ke-3. Jakarta: Salemba Medika; 2010. p. 155–157. Kementerian Kesehatan Republik Indonesia. Pedoman nasional pelayanan kedokteran: tata laksana infeksi dengue anak dan remaja [Internet]. Indonesia: Kemenkes RI; 2021 May 3. Tersedia pada: https://kemkes.go.id/id/pnpk-2021-infeksi-dengue-anak-dan-remaja Prayitno A, Taurel AF, Nealon J, Satari HI, Karyanti MR, Sekartini R, et al. Dengue seroprevalence and force of primary infection in a representative population of urban dwelling Indonesian children. PLoS Neglected Tropical Diseases. 2017;11(6). Khan MAS, Al Mosabbir A, Raheem E, Ahmed A, Rouf RR, Hasan M, et al. Clinical spectrum and predictors of severity of dengue among children in 2019 outbreak: A multicenter hospital-based study in Bangladesh. BMC Pediatrics. 2021;21(1). Burattini MN, Lopez LF, Coutinho FAB, Siqueira JB, Homsani S, Sarti E, et al. Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil, 2000–2014. Clinics. 2016;71(8):455–463. Kumar M, Verma R, Nirjhar S, Singh M. Dengue in children and young adults: A cross-sectional study from the western part of Uttar Pradesh. Journal of Family Medicine and Primary Care. 2020;9(1):293. Tchuandom SB, Tchadji JC, Tchouangueu TF, Biloa MZ, Atabonkeng EP, Fumba MIM, et al. A cross-sectional study of acute dengue infection in paediatric clinics in Cameroon. BMC Public Health. 2019;19(1):958. Lee YH, Hsieh YC, Chen CJ, Lin TY, Huang YC. Retrospective seroepidemiology study of dengue virus infection in Taiwan. BMC Infectious Diseases. 2021;21(1). Kesetyaningsih TW. Distribution of dengue hemorrhagic fever (DHF) in regards to age and sex in Sleman, Yogyakarta, Indonesia. 2019. Zohra T, Din M, Ikram A, Bashir A, Jahangir H, Baloch IS, et al. Demographic and clinical features of dengue fever infection in Pakistan: A cross-sectional epidemiological study. Tropical Diseases, Travel Medicine and Vaccines. 2024;10(1). Taufik A, Hasibuan PA, Putri FD, Wulandari A, Mutika WT, Lisa M. Case series: Angka kematian demam berdarah dengue berdasarkan jenis kelamin di Jawa Barat. Jurnal Kesmas Untika Luwuk: Public Health Journal. 2024;15(2):124–133. Setrkraising K, Kittitrakul C. Gastrointestinal manifestations and prognostic factors for severe dengue in Thai children. The American Journal of Tropical Medicine and Hygiene [Internet]. 2024 [diakses 19 Jul 2025];112(3):642–647. Tersedia pada: https://pubmed.ncbi.nlm.nih.gov/39719114/ Afroze S, Shakur S, Wahab A, Shakur S. Clinical profile of dengue and predictors of its severity among children. American Journal of Pediatrics. 2019;5(4):219. Karyanti MR, Uiterwaal CSPM, Hadinegoro SR, Widyahening IS, Saldi SRF, Heesterbeek JAPH, et al. The value of warning signs from the WHO 2009 dengue classification in detecting severe dengue in children. The Pediatric Infectious Disease Journal. 2024;43(7):630–634. Islam S, Khan MAS, Badal MFA, Khan MZI, Gozal D, Hasan MJ. Clinical and hematological profiles of children with dengue residing in a non-endemic zone of Bangladesh. PLoS Neglected Tropical Diseases. 2022;16(10). Bodinayake CK, Tillekeratne LG, Nagahawatte A, Devasiri V, Kodikara Arachchi W, Strouse JJ, et al. Evaluation of the WHO 2009 classification for diagnosis of acute dengue in a large cohort of adults and children in Sri Lanka during a dengue-1 epidemic. PLoS Neglected Tropical Diseases. 2018;12(2). Prieto-Torres AE, Medina-Lozano LJ, Ramírez-Ávila JD, Faccini-Martínez ÁA. Utility of VIDAS® dengue diagnostic assays to differentiate primary and secondary dengue infection: A cross-sectional study in a military hospital from Colombia. Tropical Medicine and Infectious Disease. 2025;10(2). Versiani AF, Kaboré A, Brossault L, Dromenq L, dos Santos TMIL, Milhim BHGA, et al. Performance of VIDAS® diagnostic tests for the automated detection of dengue virus NS1 antigen and of anti-dengue virus IgM and IgG antibodies: A multicentre, international study. Diagnostics. 2023;13(6). Premazzi Papa M, Mendoza-Torres E, Sun P, Encinales L, Goulet J, Defang G, et al. Dengue NS1 antibodies are associated with clearance of viral nonstructural protein-1. Journal of Infectious Diseases. 2024;230(6):e1226–e1234. Anika US, Islam M, Nur Mou FE, Saha M, Deb A, Tui RR, et al. The 2023 dengue outbreak in Bangladesh: Exploring the epidemiology in hospitalized patients. The American Journal of Tropical Medicine and Hygiene. 2024;110(6):1165–1171. Felix AC, Romano CM, Campos Centrone C, Rodrigues CL, Villas-Boas L, Araújo ES, et al. Low sensitivity of NS1 protein tests evidenced during a dengue type 2 virus outbreak in Santos, Brazil, in 2010. Clinical and Vaccine Immunology. 2012;19(12):1972–1976.
Body mass index and muscle strength in medical students Apen A Ridwan; Hedi H Rachmatdinata; Ilham F Saputra
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
Publisher : ACTA Medical Health Sciences

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Abstract

Body mass index (BMI) is an indicator of nutritional status that affects health and muscle strength. Obesity inhibits adenosine monophosphate activated protein kinase (AMPK), thereby reducing endurance, decreasing muscle function, and increasing disease risk. This study aims to determine the relationship between BMI and muscle strength. A cross-sectional analyticalstudy was conducted among preclinical students of the Faculty of Medicine, Universitas Jenderal Achmad Yani. BMI, grip strength, and standing long jump performance were measured in all respondents. Data were analyzed using Statistical Product and Service Solutions (SPSS). The results showed that most students had a normal BMI (50%), indicating good nutritional status. All respondents with overweight and obesity class I and II BMI demonstrated standing long jump results far below the average (100%), while only 7.1% of respondents with normal BMI reached the average category. Most respondents with normal BMI had normal hand strength (57.1%), as did those with obesity class II (83.3%). Statistical analysis using the chi-square test showed no significant relationship between BMI and muscle strength, with pvalues of 0.629 and 0.792. In conclusion, most students had a normal BMI, normal handgrip strength, and low standing long jump performance. There was no significant relationship between BMI and muscle strength.   DOI : 10.35990/amhs.v4n2.p87-93   REFERENCES Nuttall FQ. Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today. 2015;50:117–128. Khanna D, Peltzer C, Kahar P, Parmar MS. Body mass index (BMI): A screening tool analysis. Cureus. 2022;14. Catatan: nomor artikel/e-location & nomor edisi belum dicantumkan (hanya “Feb 11”). Adab P, Pallan M, Whincup PH. Is BMI the best measure of obesity? BMJ. 2018;k1274. Gutin I. In BMI we trust: Reframing the body mass index as a measure of health. Social Theory & Health. 2018;16(3):256–271. Sihombing MRBS, Siregar NP, Ismail WM, Bestari R. Relationship between body mass index and upper and lower limb muscle strength in athletes of Zauzy Taekwondo Club, Binjai. Ibnu Sina: Jurnal Kedokteran dan Kesehatan (Fakultas Kedokteran Universitas Islam Sumatera Utara). 2024;23(2):138–144. Zierle-Ghosh A, Jan A. Physiology, body mass index. StatPearls [Internet]. 2023. Tersedia pada: https://www.ncbi.nlm.nih.gov/books/NBK535456/ Keevil VL, Luben R, Dalzell N, Hayat S, Sayer AA, Wareham NJ, et al. Cross-sectional associations between different measures of obesity and muscle strength in men and women in a British cohort study. Journal of Nutrition, Health & Aging. 2015;19(1):3–11. Bennie JA, Shakespear-Druery J, De Cocker K. Muscle-strengthening exercise epidemiology: A new frontier in chronic disease prevention. Sports Medicine - Open. 2020;6(1):40. Cianferotti L, Brandi ML. Muscle–bone interactions: Basic and clinical aspects. Endocrine. 2014;45(2):165–177. Srinivas-Shankar U, Roberts SA, Connolly MJ, O’Connell MDL, Adams JE, Oldham JA, et al. Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: A randomized, double-blind, placebo-controlled study. Journal of Clinical Endocrinology & Metabolism. 2010;95(2):639–650. Intan K, Dewi M, Ayu I, Widiastuti E, Ayu AA, Wedayani N. Relationship between body mass index and muscle strength in medical students at Universitas Mataram. Jurnal Kedokteran Unram. 2020;9(1):63–72. Soraya N, Parwanto E. The controversial relationship between body mass index and handgrip strength in the elderly: An overview. Malaysian Journal of Medical Sciences. 2023;30(3):73. Lin X, Li H. Obesity: Epidemiology, pathophysiology, and therapeutics. Frontiers in Endocrinology (Lausanne). 2021;12. Tersedia pada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450866/ Núñez-Cortés R, Cruz B del P, Gallardo-Gómez D, Calatayud J, Cruz-Montecinos C, López-Gil JF, et al. Handgrip strength measurement protocols for all-cause and cause-specific mortality outcomes in more than 3 million participants: A systematic review and meta-regression analysis. Clinical Nutrition. 2022;41(11):2473–2489. Castro-Piñero J, Ortega FB, Artero EG, Girela-Rejón MJ, Mora J, Sjöström M, et al. Assessing muscular strength in youth: Usefulness of standing long jump as a general index of muscular fitness. Journal of Strength and Conditioning Research. 2010;24(7):1810–1817. Ceschia A, Giacomini S, Santarossa S, Rugo M, Salvadego D, Da Ponte A, et al. Deleterious effects of obesity on physical fitness in pre-pubertal children. European Journal of Sport Science. 2016;16(2):271–278. Krishnan A, Sharma D, Bhatt M, Dixit A, Pradeep P. Comparison between standing broad jump test and Wingate test for assessing lower limb anaerobic power in elite sportsmen. Medical Journal Armed Forces India. 2017;73(2):140–145. Rahman ZA. Reliability, validity, and norm references of standing broad jump. Revista Gestão Inovação e Tecnologias. 2021;11(3):1340–1354. Tomlinson DJ, Erskine RM, Morse CI, Winwood K, Onambélé-Pearson G. The impact of obesity on skeletal muscle strength and structure through adolescence to old age. Biogerontology. 2016;17:467–483. Pasdar Y, Darbandi M, Mirtaher E, Rezaeian S, Najafi F, Hamzeh B. Associations between muscle strength with different measures of obesity and lipid profiles in men and women: Results from RaNCD cohort study. Clinical Nutrition Research [Internet]. 2019;8(2):148. Martínez EJ, Martínez-López M, López L, Torre-Cruz LA, Suárez S, et al. Analysis of the effect size of overweight in muscular strength tests among adolescents: Reference values according to sex, age, and body mass index. Journal of Strength and Conditioning Research. 2018;32(5):1404–1414. Thivel D, Ring-Dimitriou S, Weghuber D, Frelut ML, O’Malley G. Muscle strength and fitness in pediatric obesity: A systematic review from the European Childhood Obesity Group. Obesity Facts. 2016;9(1):52–63. Hall JE. Guyton and Hall Textbook of Medical Physiology. 13th ed. 2018. p. 80. Tallis J, James RS, Seebacher F. The effects of obesity on skeletal muscle contractile function. Journal of Experimental Biology. 2018;221(13). Al-Asadi JN. Handgrip strength in medical students: Correlation with body mass index and hand dimensions. Asian Journal of Medical Sciences [Internet]. 2018;9(1):21–26.
The relationship between maternal personal hygiene and the incidence of diarrhea in toddlers at the cibeureum health center Anastasia Y Triningtyas; Emma M Hidayat; Beryl E Widyaningrum
ACTA Medical Health Sciences Vol. 4 No. 2 (2025): Acta Medical and Health Sciences
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Diarrhea is one of the leading causes of mortality in children under five years of age. Hygienic living behavior plays a crucial role in preventing the transmission of diarrhea. Maternal behavior is closely associated with the prevention and reduction of diarrhea in toddlers. This study aims to describe and determine the relationship between maternal knowledge, attitudes,and personal hygiene practices and the incidence of diarrhea among toddlers at the Cibeureum Public Health Center, South Cimahi, Indonesia. This study employed an analytical crosssectional design. Data were collected from 70 respondents using a consecutive sampling technique. Information was obtained through structured questionnaires. Data analysis was conducted using the chi-square test and Fisher’s exact test. The results showed that the majority of mothers demonstrated good levels of knowledge, positive attitudes, and personal hygiene practices. Accordingly, 81.4% of toddlers were reported to rarely experience diarrhea (p-value = 0.22). Statistical analysis indicated no significant relationship between maternal knowledge, attitudes, and personal hygiene practices and the incidence of diarrhea in toddlers. These findings suggest that multiple factors contribute to the occurrence of diarrhea in toddlers. Nevertheless, adequate knowledge, positive attitudes, and personal hygiene practices remain important preventive measures against diarrhea in this population.   DOI: 10.35990/amhs.v4n2.p94-102   REFERENCES Indonesian Pediatric Society (IDAI). Textbook of Gastroenterology–Hepatology. I. Jakarta: Pediatric Gastroenterology–Hepatology Working Group, IDAI; 2009. World Health Organization. The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. Geneva: WHO; 2005. World Health Organization. Diarrhoeal disease [Internet]. Tersedia pada:https://www.who.int/newsroom/fact-sheets/detail/diarrhoeal-disease Ministry of Health of the Republic of Indonesia. 2022 Performance Report: Directorate of Communicable Disease Prevention and Control. Jakarta: Ministry of Health of the Republic of Indonesia; 2023. Heryanto E, Sarwoko S, Meliyanti F. Risk factors of diarrhea in children under five at UPTD Sukaraya Health Center, OKU District, 2021. Indonesian Journal of Health Medicine. 2022;2:10–21. Sipayung RR, Sinurat LRE, Pardede JA. Improving maternal knowledge in the prevention and management of diarrhea in children under five at Bestari Health Center. Tour Abdimas Journal. 2023;2:1–7. Indrayani M. Correlation between maternal knowledge of personal hygiene and diarrhea incidence in children under five at Imelda Workers General Hospital, Medan, 2020. Journal of Health Medical Science. 2022;1:110–116. Aisyah IS. Analysis of the correlation between hygienic practices and diarrhea incidence: Case of Jagabaya Hamlet. Nusantara Journal of Health and Midwifery. 2024;5(039):6–9. Santri IN, Wardani Y. Environmental risk factors of diarrhea in children under five: A cross-sectional study in Indonesia. Public Health and Preventive Medicine Archive. 2023;11. Indonesian Pediatric Society (IDAI). Digestive problems in children: Causes and solutions [Internet]. Tersedia pada:https://www.idai.or.id/artikel/seputar-kesehatan-anak/masalah-saluran-cerna-anak-penyebab-dan-mengatasinya Lestari F, Azahra H, Neng A, Rizka A, Salma A. Factors associated with diarrhea in infants and toddlers at Diny Nahrudiani Midwifery Clinic, Karacak Village, Leuwiliang Subdistrict, Bogor Regency. Student Scientific Journal and Nursing Research. 2024;9. Amir ETP, Erlani, Ain K. Maternal personal hygiene and diarrhea incidence in children under five at Bajoe Health Center, Bone Regency. Jurnal Sulolipu: Academic and Community Communication Media. 2024;24:296–305. Ningsih SA, Putri DUP, Maritasari DY. Correlation between knowledge, personal hygiene, and diarrhea incidence in children under five. An Idea Health Journal. 2024;4:99–104. Simamora DN, Sihite H, Ogi MP. Correlation between maternal knowledge and attitudes on hygiene in preventing diarrhea in children under five at Pakkat Toruan Village, Doloksanggul Subdistrict, Humbang Hasundutan Regency, 2024. Jurnal Medika Kesehatan Baru Doloksanggul. 2024;2. Aghadiati F, Setyarsih L, Merlisia M, Simatupang YM. Correlation between personal hygiene and diarrhea incidence in children under five at Aur Duri Health Center, Jambi City. Bahana Journal of Public Health. 2023;6:10–14. Utama SYA, Inayati A, Sugiarto S. Association between family latrine conditions and clean water facilities with diarrhea in children under five in Arosbaya Health Center, Bangkalan. Dinamika Kesehatan: Midwifery and Nursing Journal. 2019;2:820–832. Maternal behavior in diarrhea prevention and its association with diarrhea incidence in toddlers aged 1–3 years at Mitra Medika Hospital. Community Health Journal. 2021;3:52–63. Widhiastiti IAMU, Nyoman S, Wayan S, Ayu MA. Correlation between maternal knowledge, attitude, and practices with diarrhea incidence in children under five at Bungaya Village, 2023. Journal of Environmental Health. 2023;2. Hermanita Y, Dian RA, Raja FL, Agnita U. Maternal attitudes in managing diarrhea in children under five. Journal of Public Health Sciences. Nurwahidah S, Prajayanti ED. Overview of maternal personal hygiene and its relation to diarrhea in children under five at Mliwis Village, Cepogo Subdistrict, Boyolali Regency. Jurnal Ilmu Kesehatan Mandira Cendikia. 2023;2:358–359. Cantika C, Mita, Yoga P, Ali M, Faisal KF. Maternal knowledge and attitudes regarding diarrhea in children under five in North Pontianak Subdistrict. BSI Nursing Journal. 2024;2. Noviyanti, F Siti. Correlation study of maternal personal hygiene and diarrhea in children under five in Surakarta City. Aisyiyah Surakarta Journal of Nursing.  
The Effect Ethanol Extract of Tamarillo (Solanum betaceum Cav.) on Reducing Total Cholesterol Levels in Dislipidemic Wistar Rats Siti F Fajriyah; Vina Dwitia; Welly Ratwita
ACTA Medical Health Sciences Vol. 4 No. 3 (2026): Acta Medical and Health Sciences
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Abstract

Dyslipidemia is characterized by an increase in total cholesterol, low-density lipoprotein, triglycerides, and a decrease in high-density lipoprotein. Hypercholesterol-emia is a major contributor to the high mortality rate associated with cardiovascular disease. Tamarillo (Solanum betaceum Cav.) contains flavonoids and anthocyanins with antioxidant and hypolipidemic potential. This study aimed to determine the effect of tamarillo ethanol extract (EET) on total cholesterol levels in Wistar rats with dyslipidemia. This experimental study used a post-test only control group design with 25 male Wistar rats divided into five groups (n = 5). K1: negative control, K2: positive control, K3: high-fat diet (HFD) + propylthiouracil (PTU) + EET 100 mg/kgBW, K4: HFD + PTU + EET 200 mg/kgBW, and K5: HFD + PTU + simvastatin 10 mg/kgBW. Total cholesterol levels were measured using the CHOD-PAP method after a 14-day intervention. Data were analyzed using ANOVA followed by Tukey's post-hoc test. The ANOVA test showed significant differences among the groups (F = 16.42; p < 0.001). The highest cholesterol level was observed in the positive control group (148.80 ± 4.86 mg/dL). Administration of EET 200 mg/kgBW reduced cholesterol to 142.60 ± 4.50 mg/dL, which was statistically comparable to the reduction achieved by simvastatin (135.80 ± 6.38 mg/dL; p = 0.633). In contrast, EET at 100 mg/kgBW (148.00 ± 11.95 mg/dL) was not significantly different from the positive control. The findings of this study indicate that administration of EET at a dose of 200 mg/kgBW significantly reduces total cholesterol levels, demonstrating an efficacy comparable to simvastatin. EET has potential as an adjuvant therapy in the management of dyslipidemia, but cannot yet replace simvastatin as the standard therapy.   DOI : 10.35990/amhs.v4n3.p103-113   REFERENCES Dwi Sandhiutami NM, Khairani S, Moordiani M, Purpranoto IN. Efek sari buah terong belanda (Solanum betaceum Cav.) terhadap perubahan profil lipid pada mencit dislipidemia. Pharmacy: Jurnal Farmasi Indonesia. 2021;18(2):226–233. Aman AM, Soewondo P, Soelistijo SA, Arsana PM. Pedoman pengelolaan dislipidemia di Indonesia 2021. PB PERKENI. 2021. World Health Organization. Global Health Observatory data: cholesterol. Geneva: WHO; 2024. Available from: http://www.who.int/gho/ncd/risk_factors/cholesterol_text/en/ Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Laporan Nasional Riskesdas 2018. Jakarta: Kemenkes RI; 2019. Expert Panel on Detection E and T of HBC in A. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA: The Journal of the American Medical Association. 2001;285(19):2486–2497. Kandi V, Vadakedath S. Clinical trials and clinical research: a comprehensive review. Cureus. 2023;15(2):e35040. Karam I, Yang YJ, Li JY. Hyperlipidemia: background and progress. SM J Cardiol Cardiovasc Disord. 2017;3(2):1–6. Wayan N, Dewi OAC. Antioxidant activity of ethanol extracts of tamarillo peel, pulp, and seeds. In: Prosiding Seminar Nasional Pendidikan dan Sains Kimia (SNP-SK) FKIP-Undana 2020;3(1):117–120. Rahmawati RP, Retnowati E, Devi RK. In vitro antioxidant activity of ethanolic extract of tamarillo peel. Indonesian Journal of Pharmacy. 2021;5(2):1–7. Pratama DR, Purwati E, Yuherman, Melia S. The potential of probiotic frozen yoghurt with the addition of fruits tamarillo to increase immunity. IOP Conf Ser Earth Environ Sci. 2021;694(1):012070. Rito M, Marques J, Costa RMF, et al. Antioxidant potential of tamarillo fruits: chemical and infrared spectroscopy analysis. Antioxidants. 2023;12(2):536. Diep T, Pook C, Yoo M. Phenolic and Anthocyanin Compounds and Antioxidant Activity of Tamarillo (Solanum betaceum Cav.). Antioxidants (Basel). 2020;9(2):169. Pereira RO, Correia LA, Farah D, Komoni G, Farah V, Fiorino P. Wistar rat as an animal model to study high-fat induced kidney damage: a systematic review. Arch Physiol Biochem. 2024;130(2):205–214. Amisha F, Rehman A. Propylthiouracil (PTU). StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Yang W, Wu D, Zhang R, Deng Q, Ding H, Tian Y. Effects of propylthiouracil-induced hypothyroidism on nonalcoholic fatty liver disease in rats fed a high-fat and high-cholesterol diet. Pak Vet J. 2015;35(1):1–6. Abdul Kadir NAA, Rahmat A, Jaafar HZE. Protective effects of tamarillo (Cyphomandra extract against high fat diet induced obesity in sprague-dawley rats. J Obes. 2015;2015:1–8. Masbintoro A, Agustini SM, Thontowi D. Effect of tamarillo (Solanum betaceum) fruit extract as an antioxidant on malondialdehyde levels in white rats (Rattus norvegicus) induced by CCl₄. Saintika Medika. 2016;12(1):38–44. Hakim AR, Saputri R. Optimization of ethanol as a solvent for flavonoid and phenolic compounds: a narrative review. J Surya Medika. 2020;6(1):177–180. Dwi Sandhiutami NM, Khairani S, Moordiani M, Purpranoto IN. Effect of tamarillo (Solanum betaceum Cav.) juice on changes in lipid profile in dyslipidemic mice. Pharmacy: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia). 2021;18(2):226–233. Prawitha Pinatih PT, Dewi NNA, Sutadarma IWG. Effects of high-fat diet feeding on lipid profile in rats. E-Jurnal Medika Udayana. 2022;11(10):21–27. Wulandari RL, Susilowati S, Asih M. Combination of soursop leaf extract and simvastatin on lipid profile in rats fed a high-fat diet. J Ilmu Farmasi dan Farmasi Klinik. 2015;12(2):24–32. Astiti Asih IAR, Manuaba IBP, Berata K, Rita WS, Suirta W. In vivo evaluation of antioxidant activity of flavonoid glycoside extract from tamarillo (Solanum betaceum Cav.). IOP Conf Ser Earth Environ Sci. 2023;1:12–39. Djufry F, Limbongan J, Lade N, Saranga B. Characterization of tamarillo plant in South Sulawesi. Buletin Plasma Nutfah. 2016;22(2):127–136. McPherson RA, Pincus MR. Henry’s clinical diagnosis and management by laboratory methods. 24th ed. Philadelphia: Elsevier; 2021. Miranda J, Eseberri I, Lasa A, Portillo MP. Lipid metabolism in adipose tissue and liver from diet-induced obese rats: a comparison between Wistar and Sprague-Dawley strains. J Physiol Biochem. 2018;74(4):655–
Pre-operative tachycardia is not always a sign of sepsis or pain: a case report of pheochromocytoma Fitriardi Sejati; Jasmine S Dzakira; Esyl F Rahma
ACTA Medical Health Sciences Vol. 4 No. 3 (2026): Acta Medical and Health Sciences
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Abstract

Pre-operative tachycardia is a frequent clinical manifestation commonly attributed to pain, anxiety, or systemic infection.1,2 However, uncommon endocrine emergencies such as pheochromocytoma may present with nonspecific cardiovascular instability and remain clinically unrecognized until catastrophic perioperative deterioration occurs.3,4 This case report describes a 26-year-old female who presented with a painful hyperemic right breast mass accompanied by persistent tachycardia and respiratory distress. In accordance with CARE case report principles, clinical data were retrospectively collected from medical records, including serial hemodynamic monitoring, laboratory investigations, electrocardiography, thoracic imaging, perioperative management, and intensive care interventions. Initial evaluation demonstrated persistent tachycardia (153 bpm), tachypnea, and hypertensive episodes that were disproportionate to the localized breast pathology. Despite surgical intervention and initial postoperative stabilization, the patient developed progressive hemodynamic instability characterized by persistent tachyarrhythmia, a Burch-Wartofsky Point Scale score of 20, severe hyperglycemia (858 mg/dL), ketonuria, and electrolyte imbalance, which eventually culminated in asystolic cardiac arrest. This constellation of cardiovascular and metabolic abnormalities strongly suggested a pheochromocytoma crisis precipitated by surgical stress and excessive catecholamine release.1,3,4 Catecholamine-induced insulin resistance and impaired peripheral glucose utilization likely contributed to the profound metabolic derangement observed in this patient.5,6 This case underscores the importance of recognizing unexplained perioperative tachycardia and hyperglycemia as potential indicators of occult pheochromocytoma.7–9 Early endocrine evaluation and appropriate perioperative preparation are critical to prevent fatal cardiovascular complications and improving surgical outcomes.   DOI : 10.35990/amhs.v4n3.p151-158   REFERENCES Nazari MA, Rosenblum JS, Haigney MC, Rosing DR, Pacak K. Pathophysiology and Acute Management of Tachyarrhythmias in Pheochromocytoma: JACC Review Topic of the Week. J Am Coll Cardiol. 2020 Jul 28;76(4):451–64. http://doi:10.1016/J.JACC.2020.04.080; PAGEGROUP:STRING PubMed PMID: 32703516. Kamath AS, Singh K. Perioperative Management of Pheochromocytoma. StatPearls. 2023 Jul 6. PubMed PMID: Meijs AC, Snel M, Corssmit EPM. Pheochromocytoma/paraganglioma crisis: case series from a tertiary referral center for pheochromocytomas and paragangliomas. Hormones (Athens). 2021 Jun 1;20(2):395–403. http://doi:10.1007/S42000-021-00274-6 PubMed PMID: 33575936. Whitelaw BC, Prague JK, Mustafa OG, Schulte KM, Hopkins PA, Gilbert JA, et al. Phaeochromcytoma crisis. Clin Endocrinol (Oxf). 2014 Jan;80(1):13–22. http://doi:10.1111/CEN.12324 PubMed PMID: 24102156. Zhou Y, Tai Y, Shang J. Progress in treatment and follow-up of pheochromocytoma. European Journal of Surgical Oncology. W.B. Saunders Ltd; 2025. http://doi:10.1016/j.ejso.2025.110144 PubMed PMID: 40373734. Komada H, Hirota Y, So A, Nakamura T, Okuno Y, Fukuoka H, et al. Insulin Secretion and Insulin Sensitivity Before and After Surgical Treatment of Pheochromocytoma or Paraganglioma. J Clin Endocrinol Metab. 2017 Sep 1;102(9):3400–5. http://doi:10.1210/JC.2017-00357 PubMed PMID: 28666346. Amalia R, Dewi IP, Wardhani LFK, Pikir BS. Cardiovascular Presentation in Pheochromocytoma: What We Should be Aware. Siriraj Med J. 2022 Jan 1;74(1):68–74. http://doi:10.33192/SMJ.2022.9 Gupta PK, Marwaha B. Pheochromocytoma. StatPearls. 2024 Nov 7. PubMed PMID: 36944004. Buscemi S, Di Buono G, D’andrea R, Ricci C, Alberici L, Querci L, et al. Perioperative Management of Pheochromocytoma: From a Dogmatic to a Tailored Approach. J Clin Med. 2021 Aug 2;10(16):3759. http://doi:10.3390/JCM10163759 PubMed PMID: 34442056. Odierna I, Pagano T, Erra A, Oliveri L, Pasquale M, Muoio R, et al. Pheochromocytoma-induced inverted takotsubo cardiomyopathy and cardiogenic shock: case report. Anaesthesiol Intensive Ther. 2022;54(4):341. http://doi:10.5114/AIT.2022.121100 PubMed PMID: 36458670. Wu HY, Gao TJ, Cao YW, Liang L. Case Report: Pheochromocytoma in a 59-Year-Old Woman Presenting With Hypotension. Front Cardiovasc Med. 2021 Mar 11;8:648725. http://doi:10.3389/FCVM.2021.648725/TEXT Akamizu T. Thyroid Storm: A Japanese Perspective. Thyroid. 2018 Jan 1;28(1):32–40. http://doi:10.1089/THY.2017.0243 PubMed PMID: 28899229. Villarraga N, Palani G, Risk M, Sibley S. Unique Presentation and Perioperative Management of a Giant Pheochromocytoma. JCEM Case Reports. 2023 May 8;1(3). http://doi:10.1210/JCEMCR/LUAD065 PubMed PMID: 37908578. Miao J, Hu X, Wang T, Liu F, Zhang D, Wei H. Case Report: Giant pheochromocytoma complicated by takotsubo syndrome: a case of emergency robot-assisted left adrenalectomy and multidisciplinary management. Front Oncol. 2025 Jun 16;15:1603477. http://doi:10.3389/FONC.2025.1603477/TEXT Wu R, Tong N, Chen X, Xu S, Zhang F, Tang L, et al. Pheochromocytoma crisis presenting with hypotension, hemoptysis, and abnormal liver function: A case report. Medicine. 2018 Jun 1;97(25). http://doi:10.1097/MD.0000000000011054 PubMed PMID: 29923996.
Airborne bacteria and fungi monitoring in a microbiology laboratory Alya S A Ramadhani; Siska T Pratiwi; Kiki Puspitasari
ACTA Medical Health Sciences Vol. 4 No. 3 (2026): Acta Medical and Health Sciences
Publisher : ACTA Medical Health Sciences

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Abstract

The presence of airborne microorganisms in laboratory environments may increase the risk of microbial exposure among laboratory personnel. Indoor bioaerosols can affect air quality and potentially pose health risks if environmental conditions are not adequately controlled. This study aimed to identify airborne bacteria and fungi present in the office room of the Microbiology Laboratory, Faculty of Medicine, Universitas Jenderal Achmad Yani. Air sampling was performed using the passive settle plate method at three sampling points, with Tryptic Soy Agar (TSA) used for bacterial isolation and Sabouraud Dextrose Agar (SDA) used for fungal isolation. Environmental measurements during sampling recorded a temperature of 25.1°C and a relative humidity of 63%. Bacterial and fungal growth were observed on TSA and SDA plates, respectively, with bacterial colony counts ranging from 0 to 24 colonies. A total of six bacterial isolates were successfully recovered. Bacterial identification was performed based on colony morphology observation, Gram staining, biochemical tests, and molecular analysis using polymerase chain reaction (PCR) and DNA sequencing. Fungal identification was conducted based on macroscopic characteristics and microscopic examination using Lactophenol Cotton Blue staining. Molecular analysis identified the bacterial isolates as Staphylococcus hominis, Staphylococcus epidermidis, Mammaliicoccus sciuri, and Stutzerimonas stutzeri, whereas fungal isolates were morphologically consistent with Penicillium sp. and other suspected hyaline filamentous fungi. The predominance of Gram-positive bacteria and the detection of airborne fungi may be associated with limited ventilation, indoor humidity, and human-related activities within the laboratory environment. These findings demonstrate the diversity of indoor bioaerosols in a laboratory environment and highlight the importance of routine microbiological air monitoring, humidity control, and adequate ventilation to support occupational health and laboratory safety.   DOI : 10.35990/amhs.v4n3.p124-132   REFERENCES Abatenh A, Habtemariam Z, Gizaw B. Contamination in a microbiological laboratory. Int J Res Stud Biosci. 2018;6(4):7–13. https://doi:10.20431/2349-0365.0604002 Kumar P, Kausar MA, Singh AB, Singh R. Biological contaminants in the indoor air environment and their impacts on human health. Air Qual Atmos Health. 2021;14(11):1723–. https://doi:10.1007/s11869-021-00978-z Firdaussyah AT, Montolalu IA, Azzahra S. Indoor air quality: sources, health effects, and mitigation strategies. Glob Int J Innov Res. 2024;2(11):2558–2581. https://doi:10.59613/global.v2i11.354 Seseña S, Rodríguez AM, Palop ML. Indoor air quality analysis in naturally ventilated university training laboratories. Air Qual Atmos Health. 2022;15(10):1817–1837. https://doi:10.1007/s11869-022-01220-0 Lee H, Lee BG, Kim YJ, Shim J, Yeo M. Assessment of airborne bacteria in public-use facilities. Air Qual Atmos Health. 2024;17(8):1725–1738. https://doi:10.1007/s11869-024-01540-3 Asri WA, Fatimah S, Hapsari IN, Rifansaputra Y, Dewi L. Identifikasi mikroorganisme di lingkungan udara dalam laboratorium mikrobiologi. J Ilm Mhs. 2024;2(4):42–47. Wei X, Ma X, Tian F, Wei Z, Zhang L, Hu K. Sampling and analysis methods of airborne microorganisms in hospital air. Biotechniques. 2024;76(8):395–. https://doi:10.1080/07366205.2024.2372939 Song CG, Park JH, Lee PM, Jung MG. Survey of airborne microorganisms in a traditional market. Int J Environ Res Public Health. 2022;19(11):6667. https://doi:10.3390/ijerph19116667 Madhaiyan M, Wirth JS, Saravanan VS. Phylogenomic analyses of the Staphylococcaceae family. Int J Syst Evol Microbiol. 2020;70(11):5926–5936. https://doi:10.1099/ijsem.0.004498 Ilies AB, Burtă O, Hadeel SAH, Mircea C, Shomali M, Caciora T, et al. Integrated analysis of indoor air quality and fungal microbiota in educational heritage buildings. Sustainability. 2025;17(3):1091. https://doi:10.3390/su17031091 Rahmah WN, SF, MYES. Identifikasi bakteri pada nutrient agar plate di Laboratorium Mikrobiologi Universitas Muhammadiyah Palangka Raya. Borneo J Med Lab Technol. 2023;:338–343. Najjar AA. Fungi as indicators of indoor air quality: a survey of a building in a university. JKAU Met Environ Arid Land Agric Sci. 2025;34(1):1–14. https://doi:10.4197/Met.34-1.1 Jones ER, Cedeño Laurent JG, Young AS, Coull BA, Spengler JD, Allen J. Indoor humidity levels and associations with reported symptoms in office buildings. Indoor Air. 2022;32(1):e12961. https://doi:10.1111/ina.12961 Echioda-Ogbole M, Ameh JA, Mailafia S, et al. Characterization of Mammaliicoccus sciuri. UJMR. 2025;10(3):64–69. https://doi:10.47430/ujmr.25103.008 Rahman A, Akter S, Sadique A, et al. Whole genome sequence of Stutzerimonas stutzeri. Microbiol Resour Announc. 2024;13(4). https://doi:10.1128/mra.00001-24 Saif FA, Yaseen SA, Alameen AS, Mane S, Undre P. Identification of Penicillium species using morphology. J Phys Conf Ser. 2020;1644:012019. https://doi:10.1088/1742-6596/1644/1/012019 Dissanayake AJ, Liu JK. Ascomycota: diversity, taxonomy and phylogeny. J Fungi. 2025;11(6):419. https://doi:10.3390/jof11060419 Rana U, Juyal P, Joshi K, Pant P, Rawat S, Gupta S. Fungi, lichen, viruses and bacteria. Haldwani: Uttarakhand Open University; 2021. Bhosale NK, Prabha R, Munuswamy R, Pramodhini S, Easow JM. Phenotypic versus molecular identification of clinical dermatophytes. J Pure Appl Microbiol. 2022;16(2):1138–1146. https://doi:10.22207/JPAM.16.2.40 Garcia-Rubio R, de Oliveira HC, Rivera J, Trevijano-Contador N. The fungal cell wall: structure, synthesis and assembly. Front Microbiol. 2020;10:2993. https://doi:10.3389/fmicb.2019.02993
Uji Efektivitas Infusa Bunga Kenanga (Cananga odorata) Terhadap Mortalitas Larva Aedes aegypti Lutfhi Nurlaela; Hidayatul Rachman; Novi M Resa
ACTA Medical Health Sciences Vol. 4 No. 3 (2026): Acta Medical and Health Sciences
Publisher : ACTA Medical Health Sciences

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Abstract

Dengue fever remains a major public health problem in Indonesia. Vector control commonly relies on chemical larvicides, which may lead to resistance, highlighting the need for safe and environmentally friendly alternatives. Kenanga flowers (Cananga odorata) contain secondary metabolites with potential larvicidal activity. This study aimed to evaluate the effectiveness of kenanga flower infusion on the mortality of Aedes aegypti larvae at the instar III–IV stage. An experimental study with a completely randomized post-test–only design was conducted. Larvae were divided into six treatment groups with three replicates: kenanga flower infusion at concentrations of 5%, 10%, 15%, and 20%, a positive control (1% temephos), and a negative control (distilled water). Larval mortality was observed after 24 hours and analyzed using the Shapiro–Wilk test, Kruskal–Wallis test, and Mann–Whitney post hoc test. Results showed that the 5% concentration and the negative control caused no larval mortality, while the 1% temephos positive control produced 100% mortality. The 10% concentration resulted in 31% mortality, the 15% concentration resulted in 96% mortality, and the 20% concentration achieved the highest mortality (100%) within 24 hours. The Kruskal–Wallis test indicated significant differences among the treatment groups (p = 0.008). Post hoc Mann–Whitney analysis demonstrated that the 20% concentration differed significantly from the 5%, 10%, and negative control groups (p < 0.05). Kenanga flower infusion contains flavonoids, tannins, and saponins, suggesting potential as a natural larvicide under laboratory conditions.   DOI : 10.35990/amhs.v4n3.p142-150   REFERENCES Sofia, Zulfitrah D. The effect of kenanga flower extract (Cananga odorata) as a repellent for Aedes aegypti mosquitoes. Prosiding Seminar Nasional Biotik Xl. 2023;11(1). Dengue Fever Cases in Indonesia Rise in 2022 [Internet]. [Available from: https://dataindonesia.id/health/detail/dengue-fever-cases-in-indonesia-spiked-in-2022] Dengue and Severe Dengue [Internet]. [Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue] Increase in Dengue Fever (DBD) Cases in Cimahi City in the Year 2024. No Title. 2024. Cimahi City Health Office. At the beginning of 2025, Cimahi recorded 4 cases DBD [Internet]. [Available from: https://ppid.cimahikota.go.id/article/health-department-early-2025-cimahi-records-4-dengue-cases] Ahmad ZF, Salsabila Mongilong N, Kadir L, Indah Nurdin STS, Rahmawaty Moo D. Comparison of Clinical Manifestations in Dengue Fever Patients. Indonesian Journal of Pharmaceutical Education. 2023;3(1). Indonesian Media. This is the reason why children are more vulnerable to dengue fever compared to adults [Internet]. [Available from: https://mediaindonesia.com/politik-dan-hukum/669812/this-is-the-reason-why-children-are-more-prone-to-dengue-fever-compared-to-adults] Ponlawat A, Scott JG HLC. Insecticide Susceptibility of Aedes aegypti and Aedes albopictus across Thailand. J Med Entomol. Bisset JA, Marín R, Rodríguez MM, Severson DW, Ricardo Y, French L, et al. Insecticide Resistance in Two Aedes aegypti (Diptera: Culicidae) Strains From Costa Rica. Journal of Medical Entomology. 2013;50(2):352–61. Triyana R, Adelin P, Ruhsyahadati R, Helmizar R. Comparison of the Effectiveness of Star Anise Infusion (Illicium verum) and Turmeric Leaf Infusion on the Mortality of Aedes aegypti Larvae Instar III. Health and Medical Journal. 2024;6(2):98–106. Musofi FH, Wahyuni Y, Dermawan A, Solihat F. Effectiveness of Kenanga Flower Extract (Cananga odorata) as a Larvicide Against Instar Larvae III Aedes aegypti. Siliwangi Health Journal. 2023;4(1):472–8. Ridwan E. Acute Toxicity Test Measured by Determination of the LD50 of Centella Asiatica Leaf Extract (Centella Asiatica L.) Urban) Against Mice. J Indon Med Assoc. 2013;63:112–8. Wahyuwardani S, Noor SM, Bakrie B. Animal Welfare Ethics in Research and Testing: Implementation and Its Barrier. Indonesian Bulletin of Animal and Veterinary Sciences. 2020;30(4):211. Handayani SW, Prastowo D, Boesri H, Oktsariyanti A, Joharina AS. Effectiveness of Tobacco Leaf Extract (Nicotiana tabacum L) From Semarang, Temanggung, and Kendal as Aedes aegypti Larvicide L. Balaba: Research and Development Journal on the Control of Animal-Borne Diseases in Banjarnegara. 2018;23–30. Drs. H. A. Syamsuni Apt. Pharmacy Science. 2002;270. How to Make Infusions. Waldetensai A. Guideline for Efficacy Testing of Mosquito Larvicides Ethiopian Public Health Institute (EPHI) Public Health Entomology Research Team (PHERT). Public Health Entomology Research Team. 2019;(October):1–14. Yuniarty T, Yunus R. Depiction of Larval Mortality Rates of Aedes aegypti Mosquitoes with the Administration of Kaffir Lime Peel (Citrus hystrix) as a Natural Larvicide. Journal of Health Technology. 2016;12(2):82–5. Mortalitas T, Culex L. Larvicidal Activity of Tahi Kotok Leaf Extract (Tagetes erecta L.) Larvicidal Activity of Tahi Kotok Leaf Extract (Tagetes erecta L.) on the Mortality of Culex quinquefasciatus Larvae in Dirty Water Channels Around Infected Sources Whose Transmission Causes Encephalitis (Inflammation of the Brain). 2023;(August). Haditomo I. Larvicidal Effect of Clove Leaf Extract (Syzygium aromaticum L.) on Aedes aegypti. Faculty of Medicine, Sebelas Maret University Surakarta. Thesis. 2010. Wahyuni D, Swandono HU, Diaz MR, Kristianingsih I. Natural Larvacidal Activity Ethanol Extract of Paitan Leaves (Tithonia diversifolia) Against Aedes aegypti Mosquito Larva. 2023;48–56. Supratno YH, Murtono, Mochamad W, Tulak T, Fatriyadi R, Wardi Y, et al. Larvicide Activity of Celery Leaf Infusion (Apium graveolens L.) on Aedes aegypti Mosquito Larva Mortality. Journal of Medicine and Health. 2021;8(2):136. Utami WW, Ahmad AR, Malik Abd. Larvicidal Activity Test of Castor Leaf Extract (Ricinus communis L.) Against Aedes aegypti Mosquito Larvae. Indonesian Journal of Phytopharmaca. 2016;3(1):141–5. Study P, Health I, Faculty M, Society K, Ahmad U, Nur A, et al. Aegypti Larvacidal Effectivenes of Soursop Leaf (Annona muricata L.) Infusion Against Mortality of Ae. aegypti Larvae. 2022;1–10.

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