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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.

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Articles 529 Documents

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The Interplay of Partner Support and History of Anxiety in the Etiology of Postpartum Depression: A Systematic Review Irma Gama Setyarini; Andy Soemara
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/x4q1p138

Introduction: Postpartum depression (PPD) is a significant global health concern with detrimental effects on maternal, infant, and family well-being. While its etiology is multifactorial, a history of anxiety and the quality of partner support have emerged as two of the most critical psychosocial predictors. This systematic review aims to synthesize quantitative evidence on the individual and combined associations of partner support and history of anxiety with the development of PPD. Methods: A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library databases was conducted for quantitative observational studies published from 2004 to 2024. Studies were included if they assessed postpartum depressive symptoms as an outcome and included measures of both partner support (or a related construct) and anxiety. Data on study design, sample characteristics, measurement tools, and key quantitative findings were extracted. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Results: Sixteen studies, comprising cross-sectional and longitudinal cohort designs, met the inclusion criteria. The evidence consistently demonstrated that inadequate or negative partner support (e.g., low satisfaction, high conflict, intimate partner violence) and a history of anxiety (both antenatal and trait anxiety) are strong, independent predictors of higher PPD symptom severity. Low partner support was associated with significantly increased odds of PPD, while antenatal anxiety was a robust predictor of subsequent PPD. Furthermore, evidence suggests an interactive relationship, where poor partner support is also linked to increased perinatal anxiety, creating a pathway that elevates PPD risk. Discussion: The findings support a biopsychosocial model where anxiety may confer a biological and psychological vulnerability to PPD, which is either exacerbated by poor partner support or buffered by a positive, supportive relationship. The high comorbidity of anxiety and PPD, coupled with the influence of the partner relationship, suggests that these conditions often manifest in a syndemic fashion. This underscores the need for a paradigm shift in perinatal care from an individual, mother-centric model to a dyadic, family-centered approach. Conclusion: Partner support and a history of anxiety are pivotal factors in the etiology of PPD. Clinical practice should incorporate integrated screening for both anxiety and relationship quality during the perinatal period. Future research should prioritize longitudinal, dyadic studies to further elucidate causal pathways and test the efficacy of partner-inclusive preventative interventions.

Central Venous Disease in Hemodialysis Patients: A Comprehensive Systematic Review of Pathophysiology, Management, and Outcomes Edelwis Christine; Charles Sanjaya
The International Journal of Medical Science and Health Research Vol. 17 No. 1 (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: 10.70070/9qtn3g23

INTRODUCTION: Central Venous Disease (CVD), encompassing stenosis and occlusion of major thoracic veins, represents a critical challenge in the management of hemodialysis (HD) patients. It is a leading cause of vascular access dysfunction, contributing to significant morbidity, inadequate dialysis delivery, and compromised quality of life. This review systematically evaluates the evidence base for the pathophysiology, diagnosis, and management of CVD in this vulnerable population. METHODS: A systematic literature search was conducted across PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library for cohort studies, randomized controlled trials (RCTs), and systematic reviews published between 1995 and 2024. Studies were included if they evaluated risk factors or treatment outcomes for CVD in adult HD patients. Primary outcomes analyzed were technical success, clinical success, primary patency, assisted-primary patency, and secondary patency. Secondary outcomes included complication rates and re-intervention frequency. Study quality was assessed using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies. RESULTS: Seventeen studies met the inclusion criteria for detailed outcome analysis, supplemented by numerous others for epidemiological and pathophysiological context. The evidence overwhelmingly identifies prior central venous catheter (CVC) placement as the principal risk factor for CVD, with risk increasing with catheter duration and number of placements. Endovascular therapy is the first-line treatment for symptomatic lesions. Comparative analysis revealed that while percutaneous transluminal angioplasty (PTA) has high initial success, it suffers from poor long-term primary patency (21-29% at 12 months). Stent grafts (SGs) demonstrate significantly superior primary patency (84-100% at 12 months) compared to both PTA and bare-metal stents (BMS). Drug-coated balloons (DCBs) show promise over PTA but require further validation in central venous anatomy. Surgical bypass remains a viable salvage option for refractory cases. DISCUSSION: The pathogenesis of CVD is a CVC-driven process of endothelial injury and neointimal hyperplasia, exacerbated by high access flow. The management paradigm has shifted from PTA-dominant strategies to a more durable, device-oriented approach, with SGs offering the best primary patency. However, high rates of re-intervention across all modalities underscore the recalcitrant nature of the disease, highlighting a critical need for preventative strategies centered on CVC avoidance. CONCLUSION: CVD is a frequent and serious complication in HD patients, primarily caused by CVCs. While endovascular interventions can effectively manage symptomatic lesions, SGs provide the most durable outcomes. The cornerstone of management should be prevention through timely creation of permanent vascular access.

The Analysis Study of Prevalence of Ruptur Uteri in Vaginal Birth After A Cesarean (VBAC): A Comprehensive Systematic Review Hansen; Rafennia N.M Kakalang; Andrianto H.V Wongkar
The International Journal of Medical Science and Health Research Vol. 17 No. 1 (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: 10.70070/3zh4y634

Background: Uterine rupture (UR) is a significant concern in obstetrics, particularly for women attempting a vaginal birth after cesarean section (VBAC). This systematic review focused to analyze the prevalence of uterine rupture in women who undergo VBAC based on literature from the past decade. Methods: The study followed PRISMA 2020 guidelines, reviewing English-language publications from 2014 to 2024. 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 630 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: Uterine rupture in VBAC is rare but linked to risks like labor induction, short interdelivery intervals, and maternal health. Enhanced patient selection, monitoring, and access to antenatal care can improve safety and outcomes, especially in resource-limited settings.

The Association Between Sugar-Sweetened Beverage Consumption and Toddler's Diarrhea: A Systematic Review Aferita Sari; Aprilliana Risma Nugrahella
The International Journal of Medical Science and Health Research Vol. 17 No. 1 (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/gpe2rf15

Introduction: Toddler's diarrhea, or Chronic Nonspecific Diarrhea of Childhood (CNSD), is a common functional gastrointestinal disorder in children aged 6 months to 5 years. It is characterized by chronic, loose stools in otherwise healthy, thriving children. While dietary factors are implicated, particularly fruit juice, a comprehensive synthesis of the evidence across all types of sugar-sweetened beverages (SSBs) is lacking. This systematic review aims to evaluate the association between SSB consumption and toddler's diarrhea. Methods: A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for studies published in English. Randomized controlled trials (RCTs), controlled trials, cohort studies, case-control studies, and case series (N≥5) evaluating the association between SSB (including fruit juices, sodas, and other sweetened drinks) consumption and diarrheal outcomes in children aged 6 months to 5 years were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Findings were synthesized narratively. Results: Seventeen studies, comprising six RCTs/controlled trials, six observational studies, and five case series, met the inclusion criteria. The evidence consistently demonstrated a strong association between the consumption of SSBs and toddler's diarrhea. An RCT found that infants consuming apple juice or white grape juice had significantly higher fecal output (3.94 g/kg/h and 3.59 g/kg/h, respectively) and longer diarrhea duration (49.4 hours and 47.5 hours, respectively) compared to those consuming water (2.19 g/kg/h and 26.5 hours) (Valdovinos et al., 2005). Observational studies linked excessive fluid intake, particularly from juice, to increased stool frequency (4-10 stools/day) (Greene and Ghishan, 1983). Breath hydrogen tests confirmed carbohydrate malabsorption (fructose and sorbitol) as a key mechanism (Hyams and Leichtner, 1985; Smith and Lifshitz, 1995). Dietary intervention studies showed that restricting or eliminating SSBs was curative or led to significant symptom resolution in most cases (Hyams and Leichtner, 1985). Beverages with a high fructose-to-glucose ratio and sorbitol content, such as apple and pear juice, were most frequently implicated (Gormally et al., 1997). Discussion: The findings support a multifactorial pathophysiological model where the high osmotic load from poorly absorbed sugars (fructose, sorbitol) in SSBs exceeds the absorptive capacity of a toddler's immature gut. This effect is often compounded by rapid intestinal transit from low-fat diets and high overall fluid volume. The mechanistic principles derived from studies on fruit juice can be logically extended to other SSBs sweetened with high-fructose corn syrup. While some evidence supports dilute juice for rehydration in mild acute gastroenteritis due to palatability, its role is distinct from its causal contribution to chronic functional diarrhea (Freedman et al., 2016). Conclusion: There is strong evidence to support a causal association between the consumption of SSBs and the etiology of toddler's diarrhea. A detailed dietary history focusing on SSB intake is the cornerstone of diagnosis, and dietary modification is the primary, most effective management strategy.

Hemiarthroplasty in Intertrochanteric Femur Fractures: A Descriptive Study of Length of Stay and Postoperative Complications in a Peripheral Hospital Setting Bobby Satria Aji; Muhammad Nazir Zubaidi; Alfian Marthunus
The International Journal of Medical Science and Health Research Vol. 17 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/xyyqbm02

Introduction: Intertrochanteric femur fractures in the elderly represent a significant clinical and socioeconomic challenge, particularly in resource-limited healthcare settings. The optimal surgical management remains debated, with hemiarthroplasty (HA) emerging as a viable alternative to internal fixation (IF) by allowing for immediate weight-bearing. This study aims to describe the postoperative outcomes, specifically length of stay (LOS) and complication rates, for patients undergoing HA for intertrochanteric fractures in a peripheral Type C hospital in Indonesia. Methods: A retrospective, descriptive case series was conducted on patients treated with primary HA for intertrochanteric femur fractures between mid-2024 and mid-2025. Data on patient demographics, postoperative LOS, and the incidence of postoperative complications were extracted from hospital medical records. Descriptive statistics, including mean, median, standard deviation (SD), range, frequencies, and percentages, were used for analysis. Results: A total of 26 patients were included in the study, with a mean age of 69.8 ± 8.1 years; 65.4% (n=17) were female. The principal finding was an exceptionally short mean postoperative LOS of 2.5 ± 1.0 days (median: 2.5 days; range: 1-4 days). However, the overall complication rate was high at 46.2% (n=12). The most common complications were postoperative anemia, recorded in 26.9% (n=7) of patients, and prosthetic dislocation, which occurred in 19.2% (n=5) of patients. Discussion: The observed ultra-short LOS is a significant deviation from international benchmarks and suggests a healthcare delivery model that prioritizes operational efficiency and rapid patient turnover, likely driven by resource constraints. This efficiency presents a compelling argument for the cost-effectiveness of HA in this specific context. The high complication rates, particularly for dislocation, are concerning but may reflect systemic factors such as surgical technique and the lack of supervised post-discharge care rather than an inherent failure of the procedure itself. Conclusion: Hemiarthroplasty for intertrochanteric fractures in a peripheral hospital setting facilitates a remarkably short hospital stay, offering substantial benefits for resource management. While associated with a high rate of manageable complications, the procedure represents a strategically advantageous treatment modality. Future efforts should focus on implementing targeted quality improvement initiatives to mitigate the risks of dislocation and anemia, thereby optimizing the overall value of this efficient surgical approach.

The Triple Burden: A Case of Very Severe Chronic Obstructive Pulmonary Disease at the Intersection of Tobacco Smoke, Occupational Dust, and Post-Tuberculosis Sequelae Siti Ulfa Furiani; Diana Rahmaniar
The International Journal of Medical Science and Health Research Vol. 17 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/jhnrq952

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous condition with multiple etiologies. The confluence of tobacco smoke, occupational hazards, and post-tuberculosis lung disease (PTLD) presents a significant diagnostic and therapeutic challenge, often resulting in a severe clinical phenotype. Case Illustration: We present the case of a 56-year-old male construction worker with a significant smoking history and a history of cured pulmonary tuberculosis, who presented with an acute exacerbation of dyspnea. Physical examination revealed signs of severe airflow obstruction, including tachypnea, pursed-lip breathing, and a barrel chest. Diagnostic workup, including a Pulmonary Update in Medical Assessment (PUMA) score of 8 and a COPD Assessment Test (CAT) score of 36, indicated a high disease burden. Post-bronchodilator spirometry confirmed very severe, irreversible airflow obstruction (Forced Expiratory Volume in 1 second [FEV1] 23% predicted; FEV1/Forced Vital Capacity [FVC] ratio 0.337). Chest radiography demonstrated emphysematous changes superimposed on fibrotic sequelae from prior tuberculosis. Discussion: The patient's profound respiratory impairment is attributed to a "triple hit" pathophysiology. Smoking-induced emphysema, chronic inorganic dust exposure from his 40-year occupation, and tuberculosis-induced structural damage—including fibrosis and potential bronchiectasis—have synergistically contributed to his very severe airflow limitation. This case exemplifies the distinct entity of tuberculosis-associated COPD, which is characterized by more severe and less reversible obstruction compared to smoking-induced disease alone. Conclusion: This case highlights the critical need for clinicians to recognize the cumulative impact of multiple risk factors in COPD. A comprehensive history, including past infections and occupational exposures, is paramount for accurate diagnosis and for tailoring management, which must include aggressive non-pharmacological interventions like pulmonary rehabilitation.

A Comparative Descriptive Analysis of Routine Hematological Profiles in First-Trimester Incomplete Abortion and Anembryonic Pregnancy Indira Putri Fiana Dewi; Adang Muhammad Gugun
The International Journal of Medical Science and Health Research Vol. 17 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/kqfc7t48

Introduction: Early pregnancy loss presents in diverse forms, yet a direct comparison of routine hematological profiles between incomplete abortion and anembryonic pregnancy is not well-documented. This study aimed to provide a descriptive comparison of these profiles to highlight potential differences linked to their distinct pathophysiology. Methods: A retrospective, descriptive study was conducted on 60 first-trimester patients: 30 with incomplete abortion and 30 with anembryonic pregnancy. The analysis focused on leukocyte count, platelet count, bleeding time (BT), and clotting time (CT), using descriptive statistics to compare the two cohorts. Results: The incomplete abortion group showed a higher mean leukocyte count (10,883 /µL) and a wider range (6,400–20,100 /µL) compared to the anembryonic pregnancy group (10,110 /µL; range 4,800–17,900 /µL). Mean platelet counts were also slightly higher in the incomplete abortion group. BT and CT were normal and nearly identical between groups. Discussion: The pronounced leukocytosis in the incomplete abortion group is consistent with the greater inflammatory and hemorrhagic nature of this condition. In contrast, the more quiescent hematological profile of anembryonic pregnancy reflects its state as a silent, or "missed," embryonic demise. Conclusion: Routine hematological parameters, particularly leukocyte count, differ between incomplete abortion and anembryonic pregnancy, mirroring the distinct underlying pathophysiology of each condition.

Challenges in Managing a Moderate Burn with Suspected Mild Inhalation Injury in a Resource-Limited Setting: A Case Report David Herryanto; Nugroho Muji Pamungkas
The International Journal of Medical Science and Health Research Vol. 17 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/atz5jy94

Introduction: Burn injuries complicated by inhalation injury present a significant management challenge, associated with increased morbidity and mortality. This challenge is amplified in resource-limited settings where gold-standard diagnostic tools, such as fiberoptic bronchoscopy, are often unavailable. Case Illustration: We present the case of a 43-year-old male smoker with a history of asthma who sustained 24.5% Total Body Surface Area (TBSA) second-degree burns to the face, bilateral forearms, and lower legs following a gas cylinder explosion. Clinical findings upon admission, including hoarseness and singed nasal hairs, were highly suspicious for a mild inhalation injury. His hospital course was further complicated by newly diagnosed Stage 2 hypertension, prediabetes, and bronchopneumonia identified on the initial chest radiograph. Discussion: The diagnosis of inhalation injury was established on clinical grounds, necessitating close observation in an intensive care setting rather than immediate intubation. The patient's management involved aggressive fluid resuscitation guided by the Parkland formula, meticulous wound care with topical antimicrobials, and a coordinated multidisciplinary approach to address his complex respiratory status and multiple comorbidities. This case underscores the efficacy of relying on strong clinical judgment and collaborative care to navigate complex clinical scenarios. Conclusion: This case demonstrates that successful outcomes for complex burn patients with suspected inhalation injury are achievable in regional hospitals through a high index of suspicion, aggressive supportive care, and a robust multidisciplinary team, even in the absence of advanced diagnostic modalities.

Anterior Cruciate Ligament Reconstruction and Radiographic Progression to Knee Osteoarthritis: A Systematic Review Robbi Tri Atmaja; Arifin; Maya Hapsari Kusumaningtyas
The International Journal of Medical Science and Health Research Vol. 17 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: 10.70070/2bamxw67

INTRODUCTION: Anterior cruciate ligament (ACL) injury is a well-established risk factor for the premature development of knee osteoarthritis (OA). ACL reconstruction (ACLR) is the standard of care for restoring knee stability, yet its role in mitigating the long-term radiographic progression of OA remains a subject of intense debate. This review systematically evaluates the evidence on the relationship between ACLR and the long-term development of radiographic knee OA. METHODS: A systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for studies reporting on radiographic OA outcomes at a minimum 10-year follow-up after ACL injury, with or without reconstruction. Randomized controlled trials (RCTs) and long-term cohort studies were included. Study quality was assessed using the Cochrane Risk of Bias tool for RCTs. Data on OA prevalence, management comparisons (ACLR versus non-operative), surgical variables, and associated risk factors were extracted and synthesized. RESULTS: Seventeen studies involving over 5,000 patients met the inclusion criteria. The prevalence of radiographic knee OA (Kellgren-Lawrence grade ≥2) at a mean follow-up of over 14 years post-ACLR was consistently high, ranging from 20% to over 50%. Comparative analyses between ACLR and non-operative management yielded conflicting results; some evidence suggests ACLR reduces the risk of any degenerative change, while other high-level evidence indicates a higher risk of moderate-to-severe OA in surgically managed cohorts. Concomitant meniscectomy was consistently identified as the most potent predictor of OA progression, with odds ratios ranging from 1.87 to 3.6. No significant differences in tibiofemoral OA rates were found between bone-patellar tendon-bone and hamstring autografts, though graft-specific morbidities were noted. DISCUSSION: The evidence suggests that the initial traumatic event of an ACL injury initiates a degenerative biological cascade that ACLR, a mechanical solution, cannot fully reverse. The procedure's primary benefit is mechanical stabilization, which can prevent secondary meniscal damage. However, its direct chondroprotective effect is often overshadowed by the profound impact of associated meniscal and chondral damage sustained at the time of injury. CONCLUSION: ACLR is effective for restoring knee function but does not eliminate the high long-term risk of radiographic OA. The progression to OA is multifactorial, with the initial injury pattern, particularly meniscal integrity, being a more critical determinant than the surgical intervention itself. Future research should focus on biological interventions to modulate the post-injury inflammatory response.

Laboratory Diagnosis of Lupus Anticoagulants: A Systematic Review of Assay Performance, Pre-analytical Challenges, and Clinical Utility Wahyu Agus Prastyo; Artha Investari Nugraheni; Mutia Ruliana Ayuningrum
The International Journal of Medical Science and Health Research Vol. 17 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/q03b8c43

Introduction: Lupus Anticoagulants (LA) are a heterogeneous group of autoantibodies that paradoxically increase the risk of thrombosis despite prolonging in vitro phospholipid-dependent coagulation assays. As a key laboratory criterion for the diagnosis of Antiphospholipid Syndrome (APS), accurate LA detection is critical for patient management. However, the diagnostic process is fraught with challenges, including assay variability, pre-analytical errors, and significant interference from anticoagulant therapies. This systematic review synthesizes the current evidence on laboratory testing for LA to provide a comprehensive overview of best practices and persistent challenges. Methods: A systematic search of biomedical databases was conducted to identify studies evaluating the diagnostic accuracy of LA assays, the impact of pre-analytical and analytical variables, strategies for mitigating anticoagulant interference, and the correlation of LA positivity with clinical outcomes. Studies were selected based on predefined inclusion and exclusion criteria. The methodological quality of diagnostic accuracy studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data on study design, patient populations, assays, and key outcomes were extracted and synthesized. Results: The review included 17 key studies. The evidence confirms that a dual-assay strategy using a dilute Russell's Viper Venom Time (dRVVT) and a sensitive activated Partial Thromboplastin Time (aPTT), such as the Silica Clotting Time (SCT), provides the highest diagnostic yield. The dRVVT demonstrates high specificity (>95%) and superior robustness to pre-analytical variations, whereas the SCT can offer greater sensitivity (up to 53.3% vs. 31.1% for dRVVT in one cohort). Pre-analytical variables, particularly platelet contamination, significantly risk false-negative results. Anticoagulant therapies, especially Direct Oral Anticoagulants (DOACs), cause profound interference, with rivaroxaban and apixaban leading to high rates of false-positive results (up to 92% for dRVVT). DOAC-adsorbent agents and alternative assays like the Taipan Snake Venom Time/Ecarin Time (TSVT/ET) have shown high efficacy in mitigating this interference. Persistent LA positivity is strongly associated with thrombosis (Odds Ratio up to 10.1 when co-present with other antiphospholipid antibodies) and adverse pregnancy outcomes (70% of pregnancies affected in one high-risk cohort). Discussion: The findings underscore the necessity of stringent, multi-step laboratory protocols for reliable LA detection. The differential performance and stability of dRVVT and SCT have important implications for assay selection, particularly in laboratory networks with sample transport. The management of anticoagulant interference has evolved from a strategy of avoidance to one of active mitigation, representing a significant advance in diagnostic capability and patient safety. The strong correlation between LA test results and severe clinical outcomes highlights the critical role of the laboratory in guiding therapeutic decisions, such as the choice between Vitamin K antagonists and DOACs in high-risk APS patients. Conclusion: Accurate LA detection is achievable but demands meticulous attention to pre-analytical, analytical, and post-analytical factors. Laboratories must implement robust protocols for sample processing and adopt validated strategies to manage anticoagulant interference. Clinicians must be aware of test limitations and the importance of confirming positive results. Continued efforts toward standardization, including the adoption of automated interpretation algorithms, are essential to reduce inter-laboratory variability and improve patient outcomes.

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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