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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 : -

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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 comparative outcomes of laparoscopic versus open surgical techniques in the management of intestinal obstruction in adult patients? : A Systematic Review Ruditya Lukman Hakim; Rezky Putri Wahyu Agustine
The International Journal of Medical Science and Health Research Vol. 16 No. 5 (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/bw9pzj51

Introduction: Intestinal obstruction is a common surgical emergency traditionally managed by open laparotomy. While laparoscopic surgery has emerged as an alternative with documented short-term benefits, gaps remain, particularly concerning long-term outcomes like recurrence and reoperation rates. This systematic review evaluates the comparative outcomes of laparoscopic versus open surgery for intestinal obstruction in adults to consolidate current evidence and inform clinical practice. Methods: This review followed PRISMA 2020 guidelines. A comprehensive search was conducted across PubMed, Springer, Google Scholar, and other databases for studies published since 2015 comparing laparoscopic and open surgery for intestinal obstruction in adults. Twenty-five studies, including RCTs, cohort studies, and meta-analyses, were selected. Data on operative metrics, recovery outcomes (length of stay, return of bowel function), complications, mortality, and patient-centered outcomes were extracted and synthesized. Results: The synthesis of evidence consistently showed that laparoscopic surgery is associated with significant short-term benefits. These include shorter hospital stays (reported in 17 studies), faster recovery of bowel function (9 studies), lower overall complication rates (20 studies), and reduced intraoperative blood loss (5 studies). Mortality was also generally lower in the laparoscopic group. However, data on operative time was conflicting, and long-term outcomes such as obstruction recurrence and reoperation rates were infrequently and inconsistently reported. Conclusion: Laparoscopic surgery is superior to open surgery for managing intestinal obstruction in adults regarding short-term outcomes, demonstrating clear advantages in recovery, safety, and efficiency. Despite these benefits, a significant evidence gap exists for long-term outcomes. While laparoscopy should be the preferred initial approach, further high-quality, long-term research is needed to solidify its role as the definitive standard of care.

The Comprehensive Systematic Review of Diagnosis and Management of Non Arteritic Anterior Ischemic Optic Neuropathy Endah Tri Widanarti; Syarafina Kusmaheidi; Abdul Rahman; Bambang Setiohadji
The International Journal of Medical Science and Health Research Vol. 16 No. 5 (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/cxhrqw12

Background: Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION) is a leading cause of acute optic neuropathy and permanent vision loss in adults over the age of 50. This systematic review aims to provide a comprehensive analysis of the current understanding of NA-AION, including its pathophysiology, diagnostic approach, and management strategies. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2015 to 2025. Editorials, duplicate reviews from the same journal, and papers lacking a DOI were excluded. The literature search was conducted using PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 2,172 articles were initially identified through online databases (PubMed, SagePub, SpringerLink, and Google Scholar). After three rounds of screening, eight relevant studies were selected for full-text analysis. Conclusion: NA-AION remains a challenging condition with no definitive cure. Advances in imaging techniques, particularly OCT-A, have improved diagnostic accuracy and understanding of disease progression. Risk factor modification remains the cornerstone of management, with emerging therapies focusing on neuroprotection and vascular health. Further research is needed to develop targeted treatments and improve outcomes for patients with NA-AION.

Pleural Effusion in Pulmonary Tuberculosis Patients: A Case Review and Diagnostic Challenges with Radiological Examination Nidaul Khairy Nurfan; Shofiyah Latief; Nur Ahmad Tabri
The International Journal of Medical Science and Health Research Vol. 16 No. 6 (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: 10.70070/6jn9de39

Tuberculous pleural effusion is a common form of extrapulmonary tuberculosis, especially in regions with a high tuberculosis incidence. This condition may result from an immunological response to Mycobacterium tuberculosis infection or the rupture of subpleural lesions into the pleural cavity. This study aims to assess the role of radiological examination in diagnosing tuberculous pleural effusion and compare the accuracy of different imaging modalities, including chest radiography, computed tomography (CT) scans, and ultrasonography. The study adopts an analytical observational design involving a 74-year-old male patient suspected of having pulmonary tuberculosis with right-sided pleural effusion. The diagnosis was supported by clinical evaluation, radiological assessment, and laboratory analysis of pleural fluid. Chest radiography in the posteroanterior (PA) position revealed active pulmonary tuberculosis with right pleural effusion. Radiological examinations, particularly CT scans and ultrasonography, play a crucial role in distinguishing tuberculous pleural effusion from other causes, such as malignancy or parapneumonic effusion. Early detection through accurate imaging facilitates better clinical decision-making, ensuring optimal patient treatment.

An Updated Systematic Review of Evidence-Based Practices for Management of Rehabilitation Femoral Anteversion and Intoeing Gait in the Pediatric Population Fiki Ferindra Mulrony; Arkhan Kurniawan
The International Journal of Medical Science and Health Research Vol. 16 No. 6 (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/rcn9r696

INTRODUCTION: Intoeing gait secondary to increased femoral anteversion (IFA) is a prevalent pediatric condition and a common source of parental concern. Despite its typically benign, self-resolving nature, management strategies have varied widely, and the evidence base for non-surgical interventions has historically been weak. This systematic review aims to provide an updated analysis of the evidence for rehabilitation management, focusing on functional outcomes rather than solely on the correction of the underlying bony torsion. METHODS: This review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search of PubMed, Google Scholar, Semanthic Scholar, Springer, Oxford Academic was performed to identify studies published up to October 2024. Studies evaluating non-surgical rehabilitation interventions for intoeing gait associated with IFA in children aged 3-16 years were included. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) were appraised using the Cochrane Risk of Bias 2 (RoB 2) and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tools, respectively. Data on study design, participants, interventions, and a minimum of 15 distinct outcomes—including femoral anteversion angle (FAA), foot progression angle (FPA), hip rotation range of motion, and functional metrics like tripping frequency—were extracted and synthesized narratively. RESULTS: Seventeen studies, comprising 5 RCTs and 12 NRSIs with a total of 1,215 participants, met the inclusion criteria. The evidence strongly reaffirms that IFA has a high rate of spontaneous resolution, with longitudinal studies demonstrating significant decreases in FAA without active treatment. Interventions such as twister cables and non-specific corrective shoes were found to be ineffective. In contrast, specific orthotic interventions demonstrated functional benefits; gait plates were shown to significantly improve FPA by up to 11.1°, and medial-wedge insoles were effective in reducing the frequency of falls in 80.8% of children. Targeted physical therapy programs, including strengthening of hip external rotators and gait training, resulted in statistically significant improvements in hip external rotation range of motion, FPA, and postural control. DISCUSSION: The synthesized evidence supports a paradigm shift in the management of IFA-associated intoeing, moving away from attempts to alter the natural history of bony development towards a focus on managing functional impairments. For the majority of asymptomatic children, parental education and observation remain the standard of care. For a subset of children with significant functional limitations, such as frequent falls or poor balance, targeted interventions like gait plate orthoses or structured physical therapy can provide meaningful symptomatic relief and functional improvement. The quality of the available evidence is variable, with many studies having a moderate to serious risk of bias, highlighting the need for more rigorous research. CONCLUSION: While the natural history of increased femoral anteversion is overwhelmingly favorable, specific rehabilitation strategies can effectively manage the functional consequences of intoeing gait. There is weak to moderate evidence to support the use of gait plates and targeted physical therapy for symptomatic children. Ineffective historical treatments should be abandoned in favor of an evidence-based, function-focused approach.

The Predictive Value of Sleep Disturbance, REM Latency, and Chronotype on the Onset of Major Depressive Episodes: A Systematic Review Anisa Faradiba Ratrin; Andy Soemara
The International Journal of Medical Science and Health Research Vol. 16 No. 6 (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/tmt9mz58

Background. Major Depressive Disorder (MDD) is a leading cause of global disability, creating an urgent need for effective prevention strategies. The clinical paradigm is shifting from viewing sleep disturbance as a mere symptom of depression to recognizing it as a prodromal risk factor. This systematic review aims to synthesize and critically evaluate prospective, longitudinal evidence on the association of general sleep disturbance (primarily insomnia), the objective polysomnographic marker of Rapid Eye Movement (REM) latency, and the circadian trait of chronotype with the first-onset of a major depressive episode in initially non-depressed populations. Methods. A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library databases was conducted from inception to the present, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria, structured by the Population, Intervention/Comparator, Outcome (PICO) framework, included prospective cohort studies assessing baseline sleep parameters in populations free of depression at enrolment. The primary outcome was incident MDD. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Results. Twenty-one prospective cohort studies, encompassing over 250,000 participants, met the inclusion criteria. The evidence consistently demonstrates a strong, dose-dependent association between baseline insomnia and the subsequent onset of depression, with risk ratios often exceeding 2.0. Objective polysomnographic data reveal that shortened REM latency is a significant predictor of incident depression, particularly in cohorts with a high familial risk for affective disorders, suggesting it serves as a potent vulnerability marker. Furthermore, a robust body of evidence from large-scale cohort studies identifies an evening chronotype as an independent risk factor for incident depression, even after controlling for sleep duration and other potential confounders. Discussion. The convergence of evidence from subjective reports, objective neurophysiology, and circadian assessments points toward a multi-faceted dysregulation of sleep-wake systems as a core etiological pathway in the development of MDD. The findings are interpreted through integrated neurobiological frameworks, including the hyperarousal-HPA axis hypothesis, the emotional dysregulation hypothesis centered on REM sleep's role in affective homeostasis, and the circadian misalignment hypothesis. These mechanisms suggest that sleep disturbance is not an epiphenomenon but a potentially causal factor that precedes and precipitates the clinical manifestation of depression. Conclusion. General sleep disturbance, shortened REM latency, and an evening chronotype are significant and reliable antecedent risk factors for the onset of major depressive episodes. These findings have profound clinical implications, advocating for the integration of sleep and circadian assessments into standard mental health screening and positioning interventions such as Cognitive Behavioral Therapy for Insomnia (CBT-I) and chronotherapy as viable primary prevention strategies for depression.

Decompensated Heart Failure in a 10-Year-Old Male: A Case of Rheumatic Heart Disease with Severe Mitral Regurgitation and Pulmonary Hypertension Puteri Kemala Indah Fedina; Puteri Reno Fadila; Puteri Ayudia Fadita
The International Journal of Medical Science and Health Research Vol. 16 No. 7 (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: 10.70070/3c1ctf28

Introduction: Rheumatic Heart Disease (RHD) remains a principal cause of acquired heart disease and subsequent heart failure among children and young adults in developing nations, despite being largely preventable. This report details a case of advanced RHD presenting as decompensated heart failure in a pediatric patient, highlighting the severe consequences of the disease. Case Illustration: A 10-year-old male presented with a two-month history of progressive abdominal distension, dyspnea on exertion, and lower limb edema. Physical examination was significant for hypertension, tachycardia, a pansystolic murmur, ascites, and bilateral pitting edema. A comprehensive diagnostic workup confirmed the clinical suspicion. Electrocardiography revealed sinus tachycardia and left atrial enlargement (P mitrale). Chest radiography demonstrated marked cardiomegaly. Transthoracic echocardiography was pivotal, identifying severe mitral regurgitation secondary to anterior mitral leaflet prolapse, severe left atrial dilation, and a high probability of pulmonary hypertension. Pertinent laboratory findings included mild anemia, leukocytosis, hypokalemia, borderline hypoalbuminemia, and proteinuria. Discussion: The patient's clinical presentation is a classic manifestation of chronic volume and pressure overload resulting from severe mitral regurgitation, which has culminated in biventricular failure. The discussion explores the pathophysiological cascade from valvular incompetence to systemic congestion, the significance of the counterintuitive finding of hypertension in decompensated heart failure, and the multi-organ involvement indicated by the laboratory abnormalities. The management strategy, employing guideline-directed medical therapy with diuretics, renin-angiotensin-aldosterone system inhibitors, and beta-blockers, is detailed. Conclusion: This case underscores the devastating consequences of untreated or recurrent acute rheumatic fever. It highlights the critical and urgent need for robust primary and secondary prevention strategies for RHD, particularly in endemic regions such as Indonesia, to avert preventable morbidity and mortality in the young.

Preeclampsia and the Long-Term Risk of Ischemic and Hemorrhagic Stroke: A Systematic Review and Analysis of Population-Based Studies Andre Gunawan Halim; Harry Verial L Simatupang
The International Journal of Medical Science and Health Research Vol. 16 No. 7 (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: 10.70070/2exne461

Introduction: Preeclampsia, a multi-system hypertensive disorder of pregnancy, is increasingly recognized as a potent, sex-specific risk factor for future cardiovascular disease. However, a comprehensive synthesis of the long-term risk for specific stroke subtypes remains a critical need for guiding clinical practice. This systematic review aims to quantify the association between a history of preeclampsia and the long-term risk of ischemic and hemorrhagic stroke, based on evidence from large-scale, population-based studies. Methods: A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for population-based cohort and case-control studies that evaluated the association between preeclampsia and the long-term risk of ischemic and/or hemorrhagic stroke. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data on study design, population characteristics, follow-up duration, and quantitative risk estimates (Hazard Ratios, Odds Ratios, or Relative Risks with 95% Confidence Intervals) were extracted. The methodological quality and risk of bias of included studies were assessed using the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool. Results: Seventeen population-based studies, encompassing over 10 million women, met the inclusion criteria. The evidence consistently demonstrated a statistically significant association between a history of preeclampsia and an increased risk of future stroke. Women with a history of preeclampsia had an approximately two-fold increased risk of overall stroke compared to women with normotensive pregnancies. The risk was significantly elevated for both ischemic stroke (pooled risk estimates ranging from 1.8 to 4.1) and hemorrhagic stroke (pooled risk estimates ranging from 2.2 to 4.1), with several studies indicating a proportionally higher risk for hemorrhagic events. The risk was magnified in cases of severe, early-onset, or recurrent preeclampsia, indicating a dose-response relationship. Temporal analyses revealed distinct risk trajectories: the risk of ischemic stroke peaked within the first 5 years postpartum, whereas the risk of hemorrhagic stroke appeared to increase more gradually and persist for decades. Discussion: The robust epidemiological association is supported by strong biological plausibility. Preeclampsia induces a state of systemic endothelial dysfunction, inflammation, and hypercoagulability, driven by placental anti-angiogenic factors. This vascular insult may not fully resolve postpartum, leading to persistent subclinical damage and accelerating the development of chronic hypertension and other cardiovascular risk factors. The early peak in ischemic stroke risk may reflect the subacute prothrombotic state, while the later, sustained risk of hemorrhagic stroke is likely a consequence of long-term hypertensive vasculopathy. Conclusion: A history of preeclampsia is a significant and independent risk factor for both ischemic and hemorrhagic stroke, conferring a lifelong burden of increased cerebrovascular risk. Obstetric history must be integrated into routine cardiovascular risk assessment for women. Postpartum surveillance, focused on aggressive blood pressure management and lifestyle modification, is imperative for women with a history of preeclampsia to mitigate their long-term risk of stroke.

Advanced Imaging Modalities for the Assessment of Osteoarthritis: A Systematic Review Danny Marga Rezha; Aria Chandra Gunawan Triwibowo Soedomo
The International Journal of Medical Science and Health Research Vol. 16 No. 7 (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/a28jgh28

Introduction: Osteoarthritis (OA) is a whole-joint disease, yet its assessment has traditionally relied on radiography, which has known limitations in visualizing soft tissue and early cartilage changes. This systematic review evaluates the utility and performance of various imaging modalities in the comprehensive assessment of OA. Methods: A systematic review of the literature was conducted to identify studies comparing imaging techniques (radiography, MRI, CT, ultrasound) for OA assessment. Key studies were evaluated for design, population, and outcomes. A risk of bias assessment was performed for pivotal longitudinal and comparative studies. Data on diagnostic performance, correlation with clinical symptoms, and prediction of disease progression were synthesized. Results: The analysis included studies evaluating radiography, MRI, CT, and ultrasound. MRI was consistently found to be the most sensitive modality for whole-organ assessment, capable of detecting cartilage defects, bone marrow lesions (BMLs), and synovitis before they are radiographically apparent. Radiographic joint space narrowing (JSN) proved to be a specific (91%) but insensitive (23%) marker for MRI-detected cartilage loss.1 BMLs and synovitis on MRI were significantly associated with clinical outcomes; BMLs strongly predicted knee pain and future joint replacement (OR 1.57).2 Ultrasound demonstrated superiority over radiography in detecting osteophytes and soft-tissue inflammation.5 A high prevalence of MRI abnormalities was found in radiographically normal and asymptomatic knees, highlighting a significant clinic-radiological discordance.8 Discussion: The findings confirm a paradigm shift from a cartilage-centric view to a whole-organ understanding of OA, driven by advanced imaging. While radiography remains the first-line tool in clinical practice due to accessibility, its limitations for monitoring progression and detecting early disease are profound. MRI, particularly with quantitative techniques, is the gold standard for research and complex cases, identifying key prognostic markers like BMLs. The high prevalence of imaging findings in asymptomatic individuals complicates their use for routine diagnosis but underscores their potential for identifying disease phenotypes and therapeutic targets. Conclusion: Advanced imaging modalities, particularly MRI, provide a comprehensive assessment of OA pathology that far exceeds the capabilities of conventional radiography. The future of OA management will likely involve an imaging-guided approach to phenotype patients and tailor interventions, moving toward a more personalized treatment strategy.

The Efficacy of Pharmacological Interventions in Pulmonary Arterial Hypertension (WHO Group 1): A Systematic Review of Randomized Controlled Trials Daniel France Risa H; David Kevin Graham Lesnussa
The International Journal of Medical Science and Health Research Vol. 16 No. 8 (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/hkydpg25

Introduction: Pulmonary arterial hypertension (PAH), WHO Group 1, is a progressive vasculopathy leading to right heart failure and premature death. Pharmacological therapies targeting the endothelin, nitric oxide, and prostacyclin pathways have improved outcomes, but the optimal treatment strategy remains a subject of ongoing investigation. This systematic review synthesizes evidence from randomized controlled trials (RCTs) to evaluate the efficacy of these interventions, with a focus on the comparative benefits of monotherapy versus combination therapy. Methods: A systematic search of MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted for RCTs published from January 1990 to the present. Studies enrolling adult patients with WHO Group 1 PAH and evaluating approved pharmacological agents against placebo or another active therapy were included. Data on study design, patient characteristics, and a minimum of 15 predefined outcomes—including functional, hemodynamic, biomarker, and clinical event endpoints—were extracted. Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. A narrative synthesis was performed. Results: Seventeen pivotal RCTs were included in the final analysis. Monotherapy with endothelin receptor antagonists (ERAs), nitric oxide pathway modulators (phosphodiesterase-5 inhibitors and soluble guanylate cyclase stimulators), and prostacyclin pathway agents demonstrated significant improvements over placebo in exercise capacity (e.g., 6-minute walk distance), hemodynamic parameters (e.g., pulmonary vascular resistance, cardiac index), and functional class. Intravenous prostacyclins were unique in demonstrating a mortality benefit in a standalone RCT. Landmark event-driven trials established the superiority of combination therapy. The AMBITION trial showed that upfront dual combination therapy with ambrisentan and tadalafil reduced the risk of clinical failure by 50% compared to pooled monotherapy, primarily by reducing PAH-related hospitalizations. Sequential add-on therapy yielded mixed results, with some combinations showing benefit (e.g., sildenafil added to epoprostenol in PACES) while others did not meet their primary endpoint (e.g., bosentan added to sildenafil in COMPASS-2). Discussion: The evidence base for PAH treatment is robust, demonstrating a clear paradigm shift from sequential monotherapy to upfront combination therapy for most patients. The superiority of initial dual combination with an ERA and a PDE-5 inhibitor is well-established for delaying disease progression. The evolution of clinical trial endpoints from the 6-minute walk distance to composite morbidity/mortality outcomes reflects a more clinically meaningful assessment of therapeutic benefit. Conclusion: Pharmacological interventions have significantly improved the prognosis for patients with PAH. The current evidence strongly supports initial, risk-stratified treatment with upfront dual combination therapy to delay clinical worsening. Intravenous prostacyclins remain a critical component of therapy for high-risk patients. Future research should focus on direct comparisons of combination strategies and the role of initial triple therapy.

Case Report: A Man (47 Years Old) With Vivax Malaria, Hypotension, Anemia, Thrombocytopenia, Hypokalemia And Renal Insufficiency Karina Agusta Putri; Indria Augustina
The International Journal of Medical Science and Health Research Vol. 16 No. 8 (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/rsvv8570

Vivax malaria is an infectious disease caused by the Plasmodium vivax parasite that lives and reproduces in human blood cells and is transmitted through the bite of a female Anopheles mosquito. Malaria can reduce work productivity. In 2022, malaria in Indonesia was highest in the regions of East Kalimantan, East Nusa Tenggara, and Papua. Central Kalimantan itself is categorized as having mild-to-moderate endemicity. There were 47 cases of malaria in the Murung Raya region, Central Kalimantan in 2023. The typical clinical manifestation of malaria fever is the malaria triad. Diagnosis is made by finding the plasmodium on microscopic examination. A 47-year-old man presented with a 10-day fever; the fever was intermittent, accompanied by complaints of chills followed by cold sweats, weakness, and headache. On physical examination, decreased blood pressure and reduced motor status were found. Laboratory examinations revealed normocytic normochromic anemia, thrombocytopenia, hypokalemia, and increased creatinine; a microscopic blood smear was positive for Plasmodium vivax. The patient was diagnosed with vivax malaria. Pharmacological therapy consisted of antimalarials (a combination of dihydroartemisinin for three days and primaquine for fourteen days). Management was adjusted according to the malaria management guidelines issued by the Ministry of Health of the Republic of Indonesia.

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Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

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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