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Drug-Induced Toxic Epidermal Necrolysis with Rare Pneumomediastinum in Children: A Case Report Laksita Widya Kumaratih; Hafiidhaturrahmah Hafiidhaturrahmah; Saidatun Nisa
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21702

Background:Toxic Epidermal Necrolysis (TEN) is a life-threatening dermatologic emergency. While primarily a cutaneous disease, severe cases may involve the respiratory epithelium, leading to rare complications such as pneumomediastinum and subcutaneous emphysema, which signify a poor prognosis. Pneumomediastinum complicating pediatric TEN is exceptionally rarely reported, giving this case notable educational and clinical value. This case report describes the clinical approach and successful multidisciplinary management of a pediatric patient with drug-induced TEN complicated by rare air-leak syndromes and sepsis.Case Report: A 9-year-old boy presented with widespread blistering and epidermal detachment involving more than 30% of the total body surface area (TBSA) following amoxicillin administration (ALDEN score +2, possible). The condition rapidly progressed to TEN with extensive mucosal involvement and a SCORTEN of 2 (predicted mortality 12.1%) was determined on admission. Patient’s condition in Pediatric Intensive Care Unit (PICU) was complicated by sepsis, bilateral pneumonia, pneumomediastinum, and subcutaneous emphysema. Because of clinical deterioration under first-line corticosteroids, immunomodulatory therapy was escalated in a stepwise manner within a multidisciplinary intensive care setting. Significant clinical improvement followed, characterized by complete cessation of new lesion formation, progressive re-epithelialization, and radiological resolution of the pneumomediastinum. The patient was discharged after 17 days with near-complete skin healing and resolved systemic complications. Conclusion: Pediatric TEN complicated by pneumomediastinum and sepsis requires careful, multidisciplinary intensive care with early recognition of respiratory deterioration and prompt escalation of immunomodulatory therapy. In selected severe pediatric TEN cases, this approach may contribute to favorable clinical outcomes.

Angiotensin II as a Diagnostic Tool for Liver Fibrosis in Patients with Diabetes Mellitus Wahyu Siswandari; Vitasari Indriani; Pugud Samodro; Suharno Suharno; Lantip Rujito
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21703

Background: Liver fibrosis is a common complication of diabetes mellitus (DM) that may progress to cirrhosis and hepatocellular carcinoma. Angiotensin II plays an important role in hepatic fibrogenesis and has been proposed as a potential biomarker for early detection of liver fibrosis. This study aimed to evaluate the diagnostic performance of serum angiotensin II for detecting liver fibrosis using the Fibrosis-4 (FIB-4) index as the reference standard. Methods: A cross-sectional study was conducted in Purwokerto, Indonesia, between February and March 2021 involving 61 patients with DM. Liver fibrosis was defined as a FIB-4 score ≥1.43. Serum angiotensin II levels were measured by ELISA, and diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis to determine the optimal cut-off value, area under the ROC curve (AUROC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios. Results: The participants had a mean age of 60.3 ± 6.2 years, and 32.8% were classified as having liver fibrosis based on the FIB-4 index. The optimal cut-off value of serum angiotensin II was 728.83 pg/mL. The AUROC was 0.60 (95% CI: 0.45–0.76; p = 0.186), with a sensitivity of 60%, specificity of 61%, PPV of 42.9%, NPV of 75.8%, positive likelihood ratio of 1.54, and negative likelihood ratio of 0.66, indicating limited diagnostic performance. Conclusions: Serum angiotensin II demonstrated limited diagnostic accuracy for detecting liver fibrosis in patients with DM. Although it may have potential as an adjunctive non-invasive screening biomarker, its clinical utility requires further validation in larger prospective studies using validated reference standards

Antiproliferative and Anti-Inflammatory Effects of Physalis angulata L. Extract on Various Human Cancer Cell Lines in Vitro Studies: Systematic Review Arviendo Muhammad Naufali; Fitranto Arjadi; Wahyudin Wahyudin
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21704

Cancer was a leading cause of mortality worldwide and in Indonesia, with limited access to modern therapies and significant adverse effects associated with chemotherapy. The medicinal plant Physalis angulata L. was investigated as a potential alternative due to its cytotoxic and anti-inflammatory properties against cancer cells. This review aimed to evaluate evidence from studies examining the anticancer potential of isolated compounds from this plant. A systematic search was conducted using PubMed and ScienceDirect databases following PRISMA guidelines, focusing on in vitro studies published within the last ten years. Six studies met the inclusion and exclusion criteria. Data were extracted based on plant parts, isolation methods, tested cell lines, and study outcomes using IC50 values. The results show that all studies produce withanolide fractions through extraction using polar to semi-polar solvents, followed by purification with various chromatographic techniques. The main compounds in Physalis angulata, particularly withanolides such as physalin and physagulide, exhibit moderate to strong anticancer activity across various cancer cell lines (IC₅₀ 0.18–21.75 μM) and demonstrate anti-inflammatory effects by inhibiting iNOS and COX-2 production. Physalins increase reactive oxygen species, leading to mitochondrial damage and activation of apoptosis. Several compounds also inhibit key signaling pathways involved in cell survival, including MAPK, JAK/STAT3, Wnt/β-catenin, and Hedgehog pathways. The anti-inflammatory effects occur through inhibition of the NF-κB pathway, resulting in reduced expression of pro-inflammatory mediators. In conclusion, Physalis angulata L. shows promising anticancer and anti-inflammatory potential in vitro, supporting its development as a candidate for future therapeutic applications. Further studies are required to validate these findings in vivo and in clinical settings.

Nurses' Work Motivation, Head Nurse Leadership Style, and Patient Safety Among Staff Nurses Ernawati Ernawati; Hamka Hamka; Kamriana Kamriana; Suriani Bahrun; Cristian Ardiansah; Yuliana Awalia
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21745

Patient safety remains a global healthcare priority because preventable adverse events continue to occur despite ongoing quality improvement efforts. This study aimed to determine the relationship between nurses' work motivation, head nurse leadership style, and patient safety practices among staff nurses at Maryam Citra Medika Hospital, Takalar. This cross-sectional study was conducted among 50 staff nurses using a total sampling technique. Most respondents were female (86.0%), aged ≤30 years (58.0%), had 1–4 years of work experience (62.0%), and all had previously participated in patient safety training. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC) Version 2, a work motivation questionnaire, and a head nurse leadership questionnaire. Fisher's Exact Test was used to examine the associations between variables. Good work motivation was reported by 41 respondents (82.0%), while positive head nurse leadership and good patient safety practices were each reported by 44 respondents (88.0%). Work motivation was significantly associated with patient safety practices (Fisher's Exact Test, p = 0.043), with nurses who had good work motivation being 5.76 times more likely to demonstrate good patient safety practices (OR = 5.76; 95% CI: 1.15–28.92). Head nurse leadership was also significantly associated with patient safety practices (p = 0.007), with nurses perceiving good leadership having 15.60 times higher odds of demonstrating good patient safety practices (OR = 15.60; 95% CI: 2.25–108.12)

Physical Activity Associated With Knee Osteoarthritis Severity Fathia Al Aida Hassa; Mohamad Fakih; Tisna Sendy Pratama; Massita Dwi Yuliani; Indah Nura'ini
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21983

Background: Knee osteoarthritis (OA) is a chronic degenerative disease causing articular cartilage damage and potentially leading to long-term disability. Physical Activity Level (PAL) is a modifiable risk factor; however, previous studies have shown inconsistent results regarding the relationship between PAL and the severity of knee OA. Objective: To determine the relationship between Physical Activity Level (PAL) and the severity of knee OA at RST Wijayakusuma Purwokerto. Methods: An analytic observational study with a cross-sectional design was conducted at RST Wijayakusuma Purwokerto involving 32 respondents selected via consecutive sampling. Physical activity levels were measured using the IPAQ-LF questionnaire, while knee OA severity was assessed based on the Kellgren-Lawrence classification. Results: Bivariate analysis revealed a significant relationship between PAL and knee OA severity (p = 0.016). Logistic regression analysis showed that PAL was significantly associated with knee OA severity (p = 0.015); respondents with physical activity levels classified as "at-risk" had 9.334 times higher odds of developing severe knee OA compared to those with non-risk activity levels (OR = 9.334; 95% CI: 1.537–56.674). Conclusion: There is a relationship between PAL and the severity of knee OA. Respondents with at-risk physical activity levels have higher odds of experiencing severe knee osteoarthritis

Work Position and Low Back Pain in Batik Stamped Craftsmen in Cipocok Jaya Lily Kusumasita Burkon; Prasetyo Tri Kuncoro
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.21999

Background: Working positions in the manual stemped of batik production process involve static body posture, either sitting or bending over for a long time are contributing factors of cause Low Back Pain (LBP). The prevalence of Low Back Pain in Indonesia between 7.6% - 37% in individuals aged 30-50 years, with risk factors including physical activity involving lifting heavy objects and in cases of obesity. Complaints of LBP among the populations of stamped batik craftsman in Cipocok Jaya Subdistrict have not been previously study, thus it is necessary to understand the relationship between working positions and the incidence of LBP. Objective: Identify the relationship between work position and the incidence of LBP in batik stamped craftsman in Cipocok Jaya. Method: This analytical observational research with a cross-sectional study approach using purposive sampling method involving 42 participants. The exclusion criteria were related to analgesic consumption, the use of vertebral support devices, systemic disease, and pregnancy. Work position risk levels were assessed using the Rapid Entire Body Assessment (REBA) instrument while LBP complaints were based on the Nordic Body Map (NBM). Bivariate analysis was done using the Chi-square test. Result: The research results showed that 21 craftsmen (50%) had LBP, while 21 others did not had LBP. A total of 15 craftsmen (35.7%) were classified as mild–moderate risk (REBA 7) while the others 27 people (64.3%) were classified as high–very high risk (REBA >7). Bivariate analysis showed a moderate correlation between REBA scores and LBP complaints (p=0.001; contingency coefficient=0.480). Conclusion: There was a relationship between work position and the incidence of LBP among stamped batik craftsmen in Cipocok Jaya Subdistrict. Therefore, improvements in the ergonomic aspects of work positions that have the potential to cause LBP complaints are needed by performing muscle stretching activities before working and receiving support from the management of the central batik center in providing work facilities that promote health.

Parental Smoking Behavior Inside the Home and Pneumonia Incidence Among Under-Five Children Vivi Suryaningsih Suratman; Sri Andriani Ibrahim; Rini Wahyuni Mohamad
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar

Pneumonia is an acute lower respiratory tract infection that remains a major health problem among infants and young children worldwide, including in Indonesia. Globally, pneumonia poses a serious health threat, with more than 700,000 deaths occurring among infants and young children each year. This situation is also evident in Gorontalo Province, where reported cases of pneumonia have increased annually from 2021 to 2024, with the highest number of cases in Gorontalo City recorded at the Dungingi Community Health Center. Exposure to secondhand smoke indoors is a modifiable risk factor for pneumonia; however, local evidence regarding the association between parental smoking behavior and the incidence of pneumonia among infants in Gorontalo City remains limited. This study aims to analyze the association between parental smoking behavior indoors and the incidence of pneumonia among toddlers in the service area of the Dungingi Community Health Center in Gorontalo City. The study employed an analytical observational design with a cross-sectional approach involving 95 respondents selected using accidental sampling. Data on smoking behavior were collected via a structured questionnaire, while data on pneumonia incidence were obtained from medical records. Analyses were conducted using univariate and bivariate methods, including the Kolmogorov-Smirnov test. The results showed that the majority of respondents exhibited moderate smoking behavior (80.0%), followed by high (15.8%) and low (4.2%) levels, and 18.9% of toddlers were diagnosed with pneumonia. Bivariate analysis revealed a significant association between parental smoking behavior indoors and the incidence of pneumonia in toddlers (p=0.011). These findings suggest that exposure to secondhand smoke in the home environment is associated with an increased incidence of pneumonia in toddlers. The study results can serve as a basis for strengthening education on smoke-free homes as part of pneumonia prevention efforts at the family level and in primary health care.

Evidence Based Case Report: Comparison of Fixed-Dose Combinations Vs Separate Combinations of First-Line Antituberculosis Drugs in Patients With Drug-Sensitive Pulmonary Tuberculosis and Obesity Fajar Wahyu Pribadi; Agian Jeffilano Barinda; Nukman Syafrul Panigoro
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22052

Pulmonary tuberculosis (TB) remains a global health problem, while obesity has the potential to affect the pharmacokinetics of rifampicin and the effectiveness of therapy. Although the WHO recommends a fixed-dose combination (FDC), its effectiveness compared to a single-drug formulation (SDF) in obese patients remains controversial. This Evidence-Based Case Report aims to evaluate the efficacy and safety of FDCs compared to SDFs in obese adult patients with drug-sensitive pulmonary TB. A literature search was conducted in PubMed, Cochrane, and Scopus, yielding four studies that met the criteria (three randomized controlled trials and one cohort study). A critical review revealed mixed results, with some studies supporting the non-inferiority of FDCs, while others indicated a risk of less favorable clinical outcomes. Based on the available evidence, the use of SDFs is more strongly recommended for obese patients with a suboptimal response to FDCs, as this approach has the potential to reduce the risk of underdosing and treatment failure through more optimal monitoring of dosage and clinical response

Exploring Learning Barriers Through Reflective Experiences of First-Year Medical Students Arfi Nurul Hidayah; Nisaul Maghfiroh; Alfredo Fernanda
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22114

The first year of medical education represents a critical transitional phase that requires students to adapt to the rapid and intensive dynamics of medical learning. Learning reflection can serve as a means of understanding and identifying students’ learning processes and barriers. Students’ perspectives provide valuable information for gaining a comprehensive understanding of the learning process. However, research exploring learning barriers from the perspective of medical students remains limited. This study aimed to explore and identify the main themes of learning barriers experienced by first-year medical students. A qualitative study using a phenomenological approach was conducted. Data were collected through an open-ended questionnaire addressing learning barriers, completed by 139 first-year medical students (93% response rate). To further explore the findings, interviews were conducted with six students with a grade point average (GPA) below 2.5. The data were analyzed thematically through a process of coding, categorization, and identification of major themes representing the respondents’ experiences. The findings demonstrated that students were able to identify and articulate their learning barriers through reflective processes. Based on their sources, internal barriers were the most dominant theme. Overall, 56% of students reported internal barriers, 3% reported external barriers, 34% reported a combination of internal and external barriers, and 7% reported no learning barriers. The most frequently identified internal barriers included low motivation, poor time management, and ineffective learning strategies. Meanwhile, external barriers were predominantly related to peer dynamics, non-conducive learning environments, and academic workload. These findings suggest that learning reflection can be an effective approach for identifying students’ learning barriers. Self-regulated learning mentoring programs and psychosocial support for first-year students could be further optimized. In addition, incorporating students’ reflective perspectives into educational evaluation may complement current approaches that predominantly focus on curriculum and instructional processes.

Female Urogenital Fistula Profile at RSUD Prof. Dr. Margono Soekarjo in 2020 – 2024 Basilius Samuel Laiyan; Hajid Rahmadianto Mardihusodo
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22181

Urogenital fistula is an abnormal communication between the urinary tract and the genital tract that can result in continuous urinary leakage and adversely affect quality of life. This study aimed to describe the profile of female urogenital fistula cases at Prof. Dr. Margono Soekarjo Regional General Hospital from 2020 to 2024 based on age, anatomical location, etiology, and management. A retrospective descriptive study was conducted using total sampling of medical records of female patients with urogenital fistula who met the study criteria. A total of 43 patients were included in the study. The predominant age group was 41–50 years (51,16%). The most frequent anatomical location was vesicovaginal fistula (88,37%), followed by ureterovaginal fistula (9,30%) and urethrovaginal fistula (2,33%). In terms of etiology, the cases were most commonly attributed to iatrogenic or surgical causes (51,16%), followed by malignancy (46.51%) and trauma (2,33%), no obstetric etiology was identified. Based on the management, the majority of urogenital fistula cases were treated with definitive surgical intervention (53.49%), and all vesicovaginal fistula repairs were performed using a transvaginal approach. This study demonstrates that vesicovaginal fistula was the predominant anatomical type, while iatrogenic causes were the most common etiology in the study population. These findings may serve as a basis for evaluating case patterns, management strategies, and the urogenital fistula referral system at the hospital.

Home Page

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Contact Name
Lantip Rujito

Contact Email
smhj@unsoed.ac.id

Phone
+6281343880797

Journal Mail Official
smhj@unsoed.ac.id

Editorial Address
Address: Jl. Dr. Gumbreg, Medical Street, Mersi, Purwokerto Central Java 53122 Telp. (0281) 622022, Fax. (0281) 624990

Location
Kab. banyumas,

Jawa tengah

INDONESIA

Abstract

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Lantip Rujito

Contact Email smhj@unsoed.ac.id

Phone +6281343880797

Journal Mail Official smhj@unsoed.ac.id

Editorial Address Address: Jl. Dr. Gumbreg, Medical Street, Mersi, Purwokerto Central Java 53122 Telp. (0281) 622022, Fax. (0281) 624990

Location Kab. banyumas, Jawa tengah INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Lantip Rujito

Contact Email
smhj@unsoed.ac.id

Phone
+6281343880797

Journal Mail Official
smhj@unsoed.ac.id

Editorial Address
Address: Jl. Dr. Gumbreg, Medical Street, Mersi, Purwokerto Central Java 53122 Telp. (0281) 622022, Fax. (0281) 624990

Location
Kab. banyumas,

Jawa tengah

INDONESIA