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The International Journal of Medical Science and Health Research

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Published by International Medical Journal Corp. Ltd.

ISSN : 30481376 EISSN : 30481368 DOI : -

Core Subject : Health,

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

The International Journal of Medical Science and Health Research, published by International Medical Journal Corp. Ltd. is dedicated to providing physicians with the best research and important information in the world of medical research and science and to present the information in a format that is understandable and clinically useful. Committed to publishing multidisciplinary research that spans the entire spectrum of healthcare and medicine access, The American Journal of Medical Science and Health Research aims at an international audience of pharmacists, clinicians, medical ethicists, regulators, and researchers, providing an online forum for the rapid dissemination of recent research and perspectives in this area.

Arjuna Subject : Kedokteran - Review dan Referensi, Kedokteran

Articles 529 Documents

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What Are The Most Effective Management Strategies For Nonalcoholic Fatty Liver Disease Across Different Age Groups, Obesity Levels, And Metabolic Risk Profiles? : A Systematic Review Luthfiyya Syafiqa Tahany; Sinarty Hartanto
The International Journal of Medical Science and Health Research Vol. 8 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/p1nt9150

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a growing global health issue linked to obesity and metabolic syndrome, ranging from simple steatosis to severe conditions like cirrhosis. Its complex pathophysiology, centered around insulin resistance, necessitates a multifaceted management approach to address its hepatic and extrahepatic consequences. This systematic review synthesizes evidence from recent randomized controlled trials to identify the most effective management strategies across diverse patient populations. Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Semantic Scholar, Springer, and Google Scholar. Inclusion criteria targeted randomized controlled trials examining lifestyle, dietary, exercise, or pharmacological interventions for NAFLD, with quantifiable liver and metabolic outcomes. Nine studies were selected for data extraction and quality assessment. Results: The nine trials demonstrated significant improvements with various interventions. Exercise interventions reduced intrahepatic triglycerides by up to 16%. Dietary changes were highly effective; a "green" Mediterranean diet reduced intrahepatic fat by 38.9%, and an Indo-Mediterranean diet improved steatosis in children. Pharmacological agents also showed promise; the combination of dapagliflozin and omega-3 carboxylic acids reduced liver fat by 21%, while resmetirom achieved reductions of 42-49%. Mobile app-supported lifestyle interventions and intensive weight loss programs also led to significant metabolic and hepatic benefits. Discussion: The evidence confirms that tailored interventions are crucial. Exercise provides benefits independent of significant weight loss. The superiority of specific diets, like the polyphenol-rich green Mediterranean diet, highlights the importance of dietary quality over mere caloric restriction. Pharmacological therapies, particularly resmetirom, are emerging as powerful options for high-risk patients. The effectiveness of interventions is modified by factors like age, comorbidities, and adherence, underscoring the need for personalized medicine. Conclusion: NAFLD is a manageable condition. Effective management is achievable through diverse, tailored pathways, including structured exercise, specific diets, intensive lifestyle programs, and targeted pharmacotherapies. A personalized, multifaceted approach that considers individual patient characteristics is essential for optimizing both liver-specific and systemic metabolic outcomes.

How Does Metformin as First-Line Therapy Impact Long-Term Cardio- Vascular and Metabolic Outcomes in Patients with Type 2 Diabetes Mellitus over A 5-Year Period ? : A Systematic Review Firman Gustina; Amelinda Nur Amalina; Fajar Nugraha; Fitriah Hany
The International Journal of Medical Science and Health Research Vol. 13 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/8c4yz749

Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder requiring effective long-term management strategies. Metformin is established as a first-line therapy, and understanding its long-term (≥5 years) cardiovascular and metabolic implications is crucial for optimizing patient care. This systematic review aimed to synthesize existing academic literature on these long-term outcomes. Methods: This systematic review adhered to PRISMA 2020 guidelines. Results: Metformin demonstrated significant long-term cardiovascular benefits, including a notable reduction in heart failure incidence (Hazard Ratio [HR] 0.51) and a lower overall cardiovascular risk (Odds Ratio [OR] 0.57). Effects on specific events like myocardial infarction were modest (e.g., Risk Ratio [RR] 0.89, HR 0.88), and results for stroke were varied, though benefits were observed in specific subgroups such as patients with chronic kidney disease (CKD) (RR 0.76 for cardiovascular events) or post-stroke (OR 0.66 for poor course). Metabolically, metformin consistently led to reductions in HbA1c (ranging from 0.06% to 1.13%), modest decreases in BMI (up to 0.46 kg/m²), and reductions in LDL cholesterol (around 5-6 mg/dL). Discussion: The substantial reduction in heart failure incidence and overall cardiovascular risk highlights metformin's role in primary prevention in T2DM patients. While the impact on specific major adverse cardiovascular events like myocardial infarction and stroke is more nuanced, clear benefits emerge in high-risk subgroups. Sustained improvements in glycemic control are crucial for long-term complication reduction. Conclusion: First-line metformin therapy is associated with favorable long-term cardiovascular and metabolic profiles in adults with T2DM over five years or more. Key benefits include significant reductions in heart failure incidence, improved overall cardiovascular risk, consistent glycemic control, and modest weight and lipid improvements. Its well-established safety record, including a lower risk of hypoglycemia compared to sulfonylureas and manageable side effects with formulation adjustments, solidifies its foundational role in the comprehensive, long-term management of T2DM.

Hot and Cold: Coexistent Graves’ and Hashimoto’s Thyroiditis: A Case Series Luthfiyya Syafiqa Tahany; I Made Wisnu Wardhana; Darma Irawan
The International Journal of Medical Science and Health Research Vol. 6 No. 2 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/zbvjt594

Introduction: Autoimmune Thyroid Disease (AITD) is a common endocrine disorder, with Graves’ Disease (GD) and Hashimoto’s Thyroiditis (HT) as its primary manifestations. Both conditions share overlapping pathophysiological mechanisms, often leading to diagnostic challenges. This case series aims to describe and analyze cases of hyperthyroidism with complex clinical and laboratory features, suggesting GD, HT, or both. Case Reports: Three patients (Mr. D, 42 years old; Mr. RKA, 47 years old; Ms. MMR, 26 years old) presented with clinical manifestations of hyperthyroidism. Laboratory examinations consistently showed low or very low TSH levels, along with increased Free T3 (FT3) and Free T4 (FT4) levels. A significant finding in all three cases was positive TSH Receptor Antibodies (TRAb), typical for GD, accompanied by very high Anti-Thyroid Peroxidase (Anti-TPO) levels, characteristic of HT. This indicates the possibility of a dual autoimmune process. Discussion: The simultaneous findings of positive TRAb and very high Anti-TPO in all three patients support the concept that GD and HT exist within a single spectrum of AITD and can coexist. The term "Hot and Cold" in the title reflects the dynamics between the hyperthyroid ("hot") phase, caused by TRAb stimulation in GD or Hashitoxicosis, and the potential transition to hypothyroidism ("cold") due to glandular damage by the Hashimoto autoimmune process. These cases highlight the diagnostic complexity, where dominant hyperthyroidism manifestations due to GD coexist with markers of chronic thyroid destruction from HT. Therapeutic implications include administering antithyroid drugs to control hyperthyroidism and the necessity of long-term monitoring to anticipate changes in thyroid function. Conclusion: This case series illustrates the diagnostic and management complexity in AITD patients with overlapping features of GD and HT. The concomitant presence of positive TRAb and very high Anti-TPO underscores the spectrum nature of AITD. Understanding this variability is crucial for clinicians for accurate diagnosis, personalized management, and effective long-term monitoring.

Systematic Literature Review: Effects of Different Forms of Iron Supplementation on Gut Microbiota Composition and Immune Function in Children with Iron Deficiency Anemia Firda Nur Laila; Ardita Fara
The International Journal of Medical Science and Health Research Vol. 13 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/y78zxj96

Background: Iron deficiency anemia (IDA) is a public health concern with this major global health concern seeming to be affecting the child population more, since it can prove detrimental to growth, cognitive functioning, and immune function. Though iron supplementation is the primary intervention for IDA treatment, its effects on gut microbiota and immune function are still not fully understood. Different forms of supplementation might have different effects on the gut microbiome and immunity. Methods: This systematic review examined studies published between 2014 and 2024 using electronic databases including PubMed, Scopus, and Cochrane Library. This review, abiding by the guidelines of PRISMA and following the PICOS construction, deals with children of ages comprising 0-12 years, diagnosed with IDA, investigating the various modes of delivering iron such as nano-iron, fortified foods, oral or parenteral iron, and their influence on gut microbiota composition and immune function. Results: Studies report variable responses of iron supplementation on gut microbiota and immunity based on formulation, dosage, and concurrent nutrient administration. Some studies show that there is no considerable change to the gut microbiota profiles resulting from synbiotic additions; however, they have also linked IDA with microbial dysbiosis. High-dose iron interventions tend to disrupt the gut microbiota and significantly increase the chances of infection, especially in settings with poor hygiene. On the other hand, even prebiotics have been tried to alleviate this side effect besides continuing iron therapies. Conclusion: Iron supplementation is necessary for treating IDA in children, and the effect on gut microbiota and immunity depend on various factors. The administration of prebiotics or adjusting doses could minimize side effects and benefit treatment. Future studies should be conducted with a focus on personalized intervention considering diet, environment, and microbiological factors to better manage IDA and alleviate adverse effects.

What Are The Most Effective First-Line Pharmacological Treatments For Managing Bullous Pemphigoid In Elderly Patients Over 65 Years Old? : A Systematic Review Anak Agung Istri Indah Paramita; I Dewa Ayu Supriyantini; Ni Putu Devi Gema Partamayani; Natasha Caroline Gigir
The International Journal of Medical Science and Health Research Vol. 13 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/dk1c9f42

Introduction: Bullous pemphigoid is an autoimmune blistering disease primarily affecting older adults. Managing this condition in patients over 65 is challenging, requiring a balance between controlling severe symptoms and minimizing treatment-related risks. This review synthesizes evidence on the most effective and safe first-line pharmacological treatments for this vulnerable population. Methods: A systematic review was conducted following PRISMA guidelines. We searched PubMed, Semantic Scholar, Springer, and Google Scholar for randomized controlled trials, systematic reviews, and prospective cohort studies investigating first-line pharmacological treatments for bullous pemphigoid in patients over 65. Results: Systemic corticosteroids like prednisolone offer rapid disease control (91% achieving ≤3 blisters at 6 weeks) but are associated with a high rate of severe adverse events (36% at 1 year). Doxycycline was found to be non-inferior for short-term control (74% achieving ≤3 blisters at 6 weeks) with a significantly better safety profile, halving the rate of severe adverse events to 18%. High-potency topical corticosteroids were effective and well-tolerated for moderate disease. Discussion: The evidence supports a risk-stratified approach. While effective, the high toxicity of systemic corticosteroids makes them less ideal as a universal first-line choice. Doxycycline and high-potency topical corticosteroids represent a safer initial strategy, balancing good efficacy with significantly lower risk. Novel biologics, particularly dupilumab, are poised to become a new standard of care, offering high efficacy without the severe risks of broad immunosuppression, pending results from ongoing randomized controlled trials. Conclusion: For elderly patients with bullous pemphigoid, doxycycline and high-potency topical corticosteroids are the preferred first-line treatments due to their favorable balance of efficacy and safety. Systemic corticosteroids should be reserved for specific cases where rapid control is essential and risks are manageable. Novel therapies like dupilumab show great promise and may soon redefine the standard of care, pending final evidence from ongoing trials.

How Do Different Mechanical Ventilation Modes (Volume-Controlled Vs Pressure-Controlled) Affect Patient Outcomes And Weaning Success In Intensive Care Unit Patients? : A Systematic Review Ade Faisal; Melissa Theresia
The International Journal of Medical Science and Health Research Vol. 13 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/vrzxpc88

Introduction: Mechanical ventilation is a critical intervention in intensive care units (ICU), with volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) being two primary modes. This study investigates how different mechanical ventilation modes, specifically volume-controlled versus pressure-controlled, impact patient outcomes and weaning success in adult ICU patients. Methods: A comprehensive search was conducted across over 126 million academic papers from the Semantic Scholar corpus, retrieving the 500 most relevant to the research question. Papers were screened based on predefined criteria, including adult ICU population, invasive mechanical ventilation, direct comparison of VCV and PCV, robust study designs (RCT, prospective cohort, systematic review/meta-analysis), and reporting of key outcomes such as mortality, ventilation duration, complications, or respiratory parameters. Data extraction from included studies was performed using a large language model to gather information on study design, blinding, patient characteristics, ventilation modes, and primary outcomes. Results: Analysis of the included studies revealed that pressure-controlled and hybrid ventilation modes generally improved respiratory mechanics, such as higher PaO2/FiO2 ratios, lower peak airway pressures, and higher dynamic compliance, compared to VCV. For example, one study reported a PaO2/FiO2 ratio of 176 with pressure-regulated volume control versus 146 with conventional volume control. While some studies showed shorter ventilation durations and more ventilator-free days with pressure-controlled or adaptive modes, others found no significant difference in weaning success. Overall, 11 studies reported significant differences favoring pressure-controlled ventilation or its variants in at least one measured domain (e.g., higher oxygenation, lower inflammation, shorter ventilation/ICU stay, less asynchrony, improved respiratory mechanics, fewer pulmonary complications). No study reported advantages for volume-controlled ventilation over pressure-controlled modes. Discussion: The physiological benefits observed with pressure-controlled modes, such as improved respiratory mechanics, do not consistently translate into improved clinical outcomes like reduced postoperative pulmonary complications, mortality, or duration of ventilation across all studies. This suggests that adherence to lung-protective strategies might be more crucial than the specific mode choice. Heterogeneity in patient populations, ventilation protocols, and outcome definitions, along with the prevalence of single-center studies and lack of blinding, are limitations affecting the generalizability and comparability of findings. Conclusion: Pressure-controlled and hybrid ventilation modes tend to offer superior or equivalent outcomes to volume-controlled modes, particularly in improving respiratory mechanics. While some studies indicate benefits in weaning success and reduced complications, these advantages are not universally observed across all clinical outcomes. The overall evidence quality is limited, highlighting the need for more robust, multicenter research. Keywords: Mechanical Ventilation, Volume-Controlled Ventilation, Pressure-Controlled Ventilation, Patient Outcomes, Weaning Success, Intensive Care Unit, Respiratory Mechanics.

Does Improving Sleep Patterns Modify Insulin Resistance In Patients With Type 2 Diabetes? : A Systematic Review I Komang Swardika; I Wayan Eri Purnama Yuda
The International Journal of Medical Science and Health Research Vol. 13 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/5x4gyg25

Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycemia. Emerging research highlights the bidirectional relationship between sleep disturbances and metabolic health, suggesting that improving sleep patterns may mitigate insulin resistance in T2DM patients. This systematic review evaluates the effectiveness of sleep interventions in modifying insulin resistance. Methods: Adhering to PRISMA 2020 guidelines, this study screened randomized controlled trials, quasi-experimental studies, and systematic reviews from databases like PubMed, Springer, and Google Scholar. Inclusion criteria focused on adults with T2DM, sleep interventions (e.g., cognitive behavioral therapy for insomnia [CBT-I], sleep hygiene, pharmacological agents), and outcomes measuring insulin resistance (e.g., HOMA-IR, HbA1c). Data extraction included study design, participant characteristics, intervention details, and metabolic outcomes. Results: Nineteen studies were included. Behavioral interventions, particularly CBT-I and sleep hygiene training, consistently improved sleep quality and insulin resistance markers, such as reductions in PSQI scores (-1.48) and HOMA-IR (-1.29). Pharmacological agents (e.g., melatonin, trazodone) enhanced sleep but showed inconsistent metabolic benefits. Longer-term interventions (up to 12 months) demonstrated more robust improvements compared to short-term approaches. Secondary benefits included better glycemic control, reduced blood pressure, and improved well-being. Discussion: Behavioral interventions were more effective than pharmacological ones in addressing both sleep and metabolic outcomes. The variability in results underscores the need for standardized protocols and larger trials. Limitations included small sample sizes and methodological heterogeneity. Conclusion: Improving sleep patterns, especially through CBT-I and sleep hygiene, can significantly reduce insulin resistance in T2DM patients. Integrating these interventions into diabetes management may offer holistic benefits, though further research is needed to optimize their efficacy.

Unit Cost Of Inpatient And Outpatient Services In The JKN Era Aslina; Hermiaty Nasruddin; Iin Widya Ningsi
The International Journal of Medical Science and Health Research Vol. 13 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/2yav7690

Background: Since the implementation of the National Health Insurance (JKN) in 2014, Indonesia's healthcare financing system has undergone significant changes, introducing a capitation scheme for primary care and INA-CBG's for referral care. This study reviews literature from 2020 to 2025 concerning the calculation of unit costs for inpatient and outpatient services within the JKN framework. The primary focus is on the alignment between tariffs and the factors influencing cost variations among healthcare facilities. Methods: A narrative literature review was conducted by searching electronic databases using relevant keywords. Qualitative analysis synthesized comparisons between unit costs and JKN tariffs, as well as the determinants of cost variability. The THUMB approach (Time, Human Resources, Material, Budget) is also discussed as a costing method. Results: Inpatient unit costs generally tend to be higher than INA-CBG's tariffs, resulting in a cost gap that requires careful management. Activity-Based Costing (ABC) provides more accurate cost estimations compared to the less precise THUMB method. Demographic factors, operational efficiency, and clinical management contribute to differences in costs across facilities. Optimizing the role of case managers and conducting periodic tariff evaluations are recommended to ensure the sustainability of the system. Conclusion: Effective unit cost management and the application of appropriate costing methods are crucial for achieving efficiency, equity, and quality of care within the JKN era.

Literature Review: The Relationship Between Malaria Infection And The Incidence Of Anemia Adinda Pradana Putri; Syamsu Rijal; Windy Nurul Aisyah
The International Journal of Medical Science and Health Research Vol. 13 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/nkr2z982

Malaria is an infectious disease caused by Plasmodium parasites, which are a primary cause of anemia. This review aims to analyze the correlation between Plasmodium species and the incidence of anemia through a literature review of studies conducted in Indonesia over the past five years. The results indicate that although both P. falciparum and P. vivax can cause anemia, a significant relationship between the Plasmodium species and the severity of anemia is not consistently found. This review emphasizes the importance of early monitoring of malaria infection to prevent hematological complications.

Pulmonary Tuberculosis and Lung Abscess: A Case Report Alifyah Alza Adawiya Latuconsina; Erlin Syahril; Dwi Anggita
The International Journal of Medical Science and Health Research Vol. 13 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/53gcfg28

A 49-year-old woman presented to the hospital with a chief complaint of dyspnea that began in the morning. She reported a history of hemoptysis, initially manifesting as clots equivalent to approximately one tablespoon, which has since diminished to blood-streaked sputum. A notable episode of hemoptysis had occurred one year prior, for which she was prescribed Anti-Tuberculosis Treatment (ATT). The patient has experienced a chronic cough since the previous year, with associated dyspnea during severe coughing episodes. She also reported intermittent fever. A thoracic examination revealed a normochest configuration with symmetric respiratory movements. Palpation identified decreased tactile fremitus in the right hemithorax. Percussion was hyperresonant and dull over the medial aspect of the right hemithorax. On auscultation, vesicular breath sounds were present bilaterally (+/+), with additional rhonchi noted (+/+) but no wheezing (-/-). Cardiac sounds I/II were pure and regular, with no additional sounds. A chest X-ray revealed cloudy opacities across both lungs, with a distinct patch containing an air-fluid level in the right lung. The heart size was normal, both sinuses were clear, and the right diaphragm was well-defined, while the left diaphragm showed tenting. The skeletal structures appeared intact. The radiological impression was pneumonia, a right lung abscess, and old left-sided tuberculosis.

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Editorial Address Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

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Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

Phone
-

Journal Mail Official
pt.internationalmedicaljournal@gmail.com

Editorial Address
Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location
Kota adm. jakarta selatan,

Dki jakarta

INDONESIA