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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 449 Documents

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The Comprehensive Systematic Review of Association of the Glasgow Coma Scale (GCS) Score to Prognosis After Head Injury Nabilah Safira; Melissa Theresia; Aurum Rizky Putri; Maydina Sifa Fauziah; Tri Wahyuni Puji Lestari; Dirga Filannira Desky; Ade Faisal
The International Journal of Medical Science and Health Research Vol. 22 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/m7y7aw19

Introduction: The Glasgow Coma Scale (GCS) is a cornerstone in the initial assessment of traumatic brain injury (TBI), yet its precise prognostic value across diverse populations and clinical contexts remains nuanced. This systematic review synthesizes contemporary evidence on the association between GCS scores and prognosis after head injury. Methods: A comprehensive systematic review was conducted, screening studies based on predefined criteria including adult TBI populations, GCS assessment as a prognostic factor, and reported outcomes such as mortality or functional status (e.g., Glasgow Outcome Scale). Data from 80 included studies, encompassing over 2.3 million patients, were extracted regarding study design, population characteristics, GCS assessment details, outcomes, and moderating factors. Results: The evidence consistently demonstrates a strong negative association between lower GCS scores and worse outcomes. Meta-analyses revealed that patients with severe TBI (GCS 3-8) had dramatically higher mortality (OR 28.46) and lower odds of favorable outcomes (OR 0.03) compared to those with higher GCS (Karras et al., 2022). A clear dose-response relationship exists, particularly in elderly populations where mortality rates escalated from 12.3% (mild TBI) to 65.3% (severe TBI) (McIntyre et al., 2013). The GCS showed strong predictive accuracy for mortality (pooled AUC 0.90). However, its prognostic value is significantly moderated by age, timing of assessment, and the addition of clinical factors like pupillary reactivity, which improved predictive models (Marmarou et al., 2007; Vreeburg et al., 2024). Discussion: While GCS is a robust population-level predictor, its application for individual prognosis requires careful consideration of temporal dynamics, age-related effects, and injury severity subgroups. Early GCS assessments can be volatile, and significant recovery is possible even after severe initial presentations (McCrea et al., 2021). Multimodal assessment integrating GCS with pupillary response, CT findings, and age is essential for accurate prognostication. Conclusion: The GCS remains a fundamental, strongly prognostic tool in TBI. Clinicians must interpret GCS within a broader clinical context, employing multimodal models and recognizing that early scores should not solely dictate long-term prognostic judgments or limit therapeutic interventions, especially in salvageable subgroups.

COMPLICATIONS OF TRACHEOSTOMY IN CHILDREN : A SYSTEMATIC REVIEW Jeremy Stephen Hermanto; Andrew Theodorous Timothy; Mellvin Telasman
The International Journal of Medical Science and Health Research Vol. 23 No. 1 (2026): 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/e7zh2142

Tracheostomy is the term that is used to describe an opening that has been created in the trachea, whereas tracheotomy is the phrase that is solely used to refer to the act of producing an incision in the trachea. Tracheostomy is a term that was first coined in the 1960s to describe an opening that had been created in the trachea. When there is a sudden or prolonged obstruction of the upper airway, a tracheostomy can be performed to help bypass the obstruction. Although tracheostomy is sometimes performed as a last-ditch effort in the treatment of severe obstructive sleep apnea, the procedure is rarely used as an initial method of treatment. A tracheostomy is performed in place of an endotracheal tube in patients who need artificial ventilation for an extended period of time. Those who have inadequate control of their secretions and suffer from chronic aspiration may benefit from having a tracheostomy performed because it gives them access to deep pulmonary suctioning. Those who are born with or develop subglottic stenosis as a result of medical treatment may be able to circumvent this obstruction with the use of a tracheostomy. The potential for complications after surgery can be divided into two groups: intraoperative and postoperative, with the latter group being further subdivided into early and late postoperative difficulties. The findings of this research point to a diverse set of potential scenarios regarding the prevalence and distribution of these issues. This article demonstrates that granulation were the most common problems that we encountered in the research that were conducted above as recently as 2017. In tracheostomized patients, death is a possible unwelcome event. Most of the time, it is unrelated to the procedure and occurs as a result of the progression of the underlying disease.

A Comprehensive Systematic Review of Diagnostic Approaches in Acute Appendicitis: A Comparative Analysis Jeremy Stephen Hermanto; Andrew Theodorous Timothy; Mellvin Telasman
The International Journal of Medical Science and Health Research Vol. 23 No. 1 (2026): 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/w4p7yh33

Introduction: Acute appendicitis is one of the most common surgical emergencies worldwide. Despite its frequency, accurate diagnosis remains challenging due to atypical presentations, leading to high rates of negative appendectomy and missed diagnoses. A wide array of diagnostic tools exists, including clinical scoring systems, laboratory biomarkers, and imaging modalities such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). However, there is significant heterogeneity in their reported accuracy, and an optimal, context-specific diagnostic pathway is still debated. This systematic review aimed to comprehensively compare the diagnostic performance of all available approaches and synthesize evidence to guide clinical decision-making. Methods: A systematic review was conducted following a predefined protocol. Electronic databases were searched for studies published up to 2025. Eligibility criteria included original research (RCTs, cohort studies, diagnostic accuracy studies) involving patients with suspected acute appendicitis that evaluated at least one diagnostic method and reported sufficient data to calculate performance metrics. Data on diagnostic methods, study population, reference standard, performance metrics (sensitivity, specificity, AUC), and moderating factors were extracted. Methodological quality was assessed. Results: Eighty studies were included. CT demonstrated the highest and most consistent diagnostic accuracy across populations, with pooled sensitivity of 94–97% and specificity of 94–98%. Low-dose CT protocols provided comparable accuracy to standard-dose CT while reducing radiation exposure by approximately 78% (Yoon et al., 2018; Sippola et al., 2020). Ultrasound performance was highly variable (sensitivity 55–97%), heavily dependent on operator expertise and patient selection. Emergency physician-performed point-of-care ultrasound (POCUS) showed excellent performance, particularly in pediatrics (Miller et al., 2025). MRI was highly accurate (sensitivity 92–96%, specificity 97–98%), especially in pregnant women (Kave et al., 2019; D'Souza et al., 2021). Among clinical scores, the Appendicitis Inflammatory Response (AIR) score outperformed the Alvarado score (Andersson & Stark, 2025), while the RIPASA score had high sensitivity but low specificity (Favara et al., 2022). The neutrophil-to-lymphocyte ratio (NLR) emerged as a promising biomarker, with a cut-off >4.7 showing good diagnostic accuracy (Hajibandeh et al., 2019). Discussion: The diagnostic performance of any tool is not absolute but is significantly moderated by clinical context, patient factors, technical protocols, and operator skill. CT remains the gold standard imaging modality for most adults, but its use must be balanced against radiation risk. Ultrasound is the recommended first-line imaging in children and pregnant women, with MRI as an excellent second-line option. Clinical scores and biomarkers are most valuable in resource-limited settings or as part of integrated algorithms. The review reconciles apparent contradictions in the literature by highlighting these moderating factors. Conclusion: No single diagnostic approach is universally superior. An integrated, context-specific framework is recommended: CT (preferably low-dose) for typical adults; US first-line for children, with selective CT/MRI; MRI for pregnant women; and clinical scores (AIR) combined with biomarkers (NLR, WBC/CRP) in resource-limited settings. Future research should focus on validating AI tools, standardizing ultrasound training, and evaluating cost-effectiveness of tailored pathways.

PREVALENCE AND RISK FACTORS OF SARCOPENIA IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS Putu Ayu Kevin Komala Dewi Mahayuna Putri; I Wayan Yuna Ariawan; I Wayan Eka Saputra
The International Journal of Medical Science and Health Research Vol. 23 No. 1 (2026): 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/kckrp454

Background : HIV patients have a life expectancy that is close to the life expectancy of the general population after using ARVs, so that increasing HIV patients suffer from age-related diseases and chronic inflammation, one of which is sarcopenia. Research on sarcopenia in HIV patients in Indonesia is still limited, so the author is interested in conducting this study with the aim of determining the prevalence and risk factors for sarcopenia in HIV patients. Method : A cross-sectional study conducted at Sanjiwani Hospital Gianyar on October 2025. This study included 125 HIV patients, aged 20-75 and receiving ARV for more than a year. Sarcopenia was determined based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria, health status based on questionnaires, measurments, and medical records. Logistic regression analysis was used to determine the risk of sarcopenia occurrence. Result : A total of 125 sampel consisted of 40.8% women, and 59.2% men with an average age of 48.35 ± 10.8 years. Most of them had suffered from HIV for more than 5 years (60%). The prevalence of sarcopenia was 20.8%. Risk factors for sarcopenia included advanced age (≥50 years, OR =6,01, female gender (OR=5,07). Conclusion : This prevalence of sarcopenia in HIV patients was 20.8%, advance age, female gender are risk factors for sarcopenia in HIV patients.

The Comprehensive Systematic Review of Association of QT prolonging medications torsades de pointes in hospitalized patients Fionny Novira Azelikha; Irma Winastuti Rosmanadewi
The International Journal of Medical Science and Health Research Vol. 23 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/z9rt9n62

Introduction: Drug-induced QT interval prolongation and its progression to torsades de pointes (TdP), a potentially fatal polymorphic ventricular tachycardia, represent a significant clinical challenge in hospitalized patients. Numerous medications across various therapeutic classes possess this off-target adverse effect, creating a complex landscape for risk management, especially in vulnerable inpatient populations often burdened by comorbidities, polypharmacy, and acute illness. A comprehensive synthesis of the evidence regarding the incidence, risk factors, and mitigation strategies is crucial for optimizing patient safety. Methods: This systematic review was conducted by screening studies from multiple databases based on pre-defined criteria. The population of interest was hospitalized patients of any age receiving medications known to prolong the QT interval. The primary outcome was the occurrence of TdP, with clear diagnostic criteria required. Included study designs were observational studies, randomized controlled trials, systematic reviews, meta-analyses, or case series with ≥10 patients. Data extraction covered study population, specific QT-prolonging drugs, TdP outcomes, risk factors, QT monitoring methodologies, and key statistical findings (Tleyjeh et al., 2020; Vandael et al., 2017). Results: Analysis of 80 included studies revealed marked heterogeneity in TdP incidence across drug classes. Class III antiarrhythmics (e.g., dofetilide, ibutilide) demonstrated the highest risk (1-17%), directly related to their potassium channel-blocking mechanism (Mazur et al., 2001; Bianconi et al., 2000). Antimalarials (hydroxychloroquine/chloroquine), widely used during the COVID-19 pandemic, showed a TdP incidence of 0.06-0.72%, which increased when combined with azithromycin (Aleem et al., 2021; Diaz-Arocutipa et al., 2021). Other agents like fluoroquinolones, antipsychotics, and methadone were associated with lower absolute TdP risk (<0.1-1%) but significant QTc prolongation (Gorelik et al., 2018; Garcia et al., 2025; Lovell et al., 2018). Key patient-related risk factors included female sex, advanced age, baseline cardiac disease, electrolyte disturbances (hypokalemia, hypomagnesemia), and polypharmacy with multiple QT-prolonging drugs (Johnston et al., 2013; Vandael et al., 2017). Discussion: The disparity between high rates of QTc prolongation and low incidence of TdP highlights the poor positive predictive value of QT elongation alone for arrhythmic events. The translation from prolonged repolarization to TdP depends on additional factors such as increased repolarization heterogeneity (e.g., Tpeak-Tend interval), the presence of triggers (e.g., bradycardia, pauses), and individual genetic susceptibility (Strauss et al., 2017; Tse et al., 2018). Effective risk mitigation involves vigilant monitoring (using optimal correction formulas like Rautaharju's), maintaining normal electrolyte levels, employing clinical decision support systems, and considering protective interventions like magnesium administration for high-risk drugs like ibutilide (Patsilinakos et al., 2010; Othong et al., 2018). Conclusion: The risk of drug-induced TdP in hospitalized patients is highly variable and contingent on a multifactorial interplay between specific drug properties, patient susceptibility, and clinical context. While certain drug classes (Class III antiarrhythmics) necessitate stringent inpatient monitoring protocols, for many others, the absolute risk of TdP is low when prescribed judiciously with appropriate patient assessment and monitoring. A stratified, individualized approach to risk assessment and management, incorporating modifiable risk factors and systematic monitoring strategies, is essential to maximize therapeutic benefits while minimizing arrhythmic hazards.

Cost-Effectiveness of Pembrolizumab as First-Line Treatment for PD-L1 Positive NSCLC: A Systematic Review Muhammad Akbar Ramadhan Munandar; Hendra Priatna Munandar; Liana Herlina
The International Journal of Medical Science and Health Research Vol. 23 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/h3zdy035

Introduction: For patients with advanced non-small cell lung cancer (NSCLC) without actionable driver mutations, first-line treatment has been revolutionized by immune checkpoint inhibitors (ICIs), particularly pembrolizumab. While pivotal trials demonstrate superior efficacy of pembrolizumab monotherapy in high PD-L1 expressors (TPS ≥50%) and pembrolizumab-chemotherapy combinations in broader populations, real-world effectiveness, long-term outcomes, and economic sustainability require comprehensive evaluation (Addeo et al., 2019; Rodríguez-Abreu et al., 2021). Methods: This systematic review synthesizes evidence from randomized controlled trials (RCTs), real-world observational studies, and economic evaluations. Literature was sourced from databases including PubMed, Google Scholar, Semantic Scholar, Springer, Wiley Online Library up to 2025. Analyses encompass efficacy (overall survival [OS], progression-free survival [PFS]), safety (immune-related adverse events [irAEs]), and cost-effectiveness (incremental cost-effectiveness ratios [ICERs]). Results: Pembrolizumab-based regimens consistently demonstrate superior OS and PFS compared to chemotherapy alone. In KEYNOTE-024, pembrolizumab monotherapy in PD-L1 TPS ≥50% significantly improved median OS (30.0 vs 14.2 months) (Lisberg et al., 2017). KEYNOTE-189 established pembrolizumab-pemetrexed-platinum as standard for non-squamous NSCLC, showing a 51% reduction in risk of death (Rodríguez-Abreu et al., 2021). Real-world studies confirm this efficacy but note variable outcomes in underrepresented subgroups (Verschueren et al., 2023; Yang et al., 2023). Safety profiles are manageable but distinct, with increased irAEs. Economic analyses show pembrolizumab is cost-effective in the US and several European countries at specific willingness-to-pay thresholds, though results are sensitive to drug costs and healthcare system context (Huang et al., 2017; Chouaid et al., 2019; Kuznik et al., 2021). Discussion: The transformative benefit of pembrolizumab is unequivocal, establishing a new therapeutic paradigm. However, challenges remain in optimizing patient selection beyond PD-L1, managing long-term toxicity and financial toxicity, and integrating novel combinations. The discussion delves into efficacy nuances, safety management, economic implications, and future directions including biomarker refinement and dosing strategies. Conclusion: Pembrolizumab, alone or with chemotherapy, is a cornerstone of first-line advanced NSCLC treatment, offering sustained survival benefits. To maximize its value, future efforts must focus on predictive biomarker development, personalized treatment algorithms, cost-containment strategies, and equitable access.

A Comprehensive Systematic Review of The Role of Genetic Factors in Brain Tumor Development Muhammad Rizal Nur Fauzi; Almira Fadhila Az Zahra
The International Journal of Medical Science and Health Research Vol. 23 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/qv6qzt84

Introduction: Brain tumors represent a significant source of morbidity and mortality worldwide, with primary gliomas and meningiomas being the most common types. While environmental factors play a role, there is compelling evidence that genetic predisposition substantially contributes to their etiology. This systematic review aims to synthesize the current evidence on the role of germline genetic factors in the development of primary brain tumors. Methods: A comprehensive systematic review was conducted following predefined screening criteria. Data from 80 peer-reviewed sources, including genome-wide association studies (GWAS), meta-analyses, case-control studies, and Mendelian randomization analyses, were extracted and synthesized. The focus was on studies reporting quantitative associations between genetic variants and brain tumor risk, with an emphasis on germline factors, distinct tumor subtypes, and diverse populations. Results: The analysis identified multiple robust genetic susceptibility loci. Key findings include the strong, subtype-specific associations of loci such as TERT (5p15.33) for overall glioma, RTEL1 (20q13.33) and EGFR (7p11.2) for glioblastoma (GBM), and CCDC26 (8q24.21) for non-GBM gliomas (Melin et al., 2017). Significant ethnic heterogeneity was observed, particularly in DNA repair gene polymorphisms (e.g., ERCC2 rs13181 and XRCC1 rs1799782) and growth factor genes (e.g., EGF rs4444903) (Chen et al., 2014; Tavares et al., 2020). Furthermore, distinct genetic architectures were revealed based on sex, age, and molecular subtypes (e.g., IDH mutation status). Mendelian randomization studies highlighted causal links between immune traits, metabolic factors, and glioma risk, while heritability analyses estimated that approximately 25% of glioma risk is attributable to common genetic variants, with only 6% explained by currently known loci (Kinnersley et al., 2015; Ostrom et al., 2021). Discussion: The genetic landscape of brain tumors is characterized by remarkable complexity, involving subtype specificity, population diversity, and intricate biological pathways such as telomere maintenance, DNA repair, and immune regulation. These findings reconcile previously reported inconsistencies and underscore the need for stratified analyses. Conclusion: Genetic factors are pivotal in brain tumor susceptibility. Future research must prioritize large, diverse cohorts and integrative multi-omics approaches to elucidate the remaining heritability and translate these findings into improved risk prediction, prevention strategies, and targeted therapies.

A Comprehensive Systematic Review of The Role of Screening Programs in Preventing Blindness in Primary Setting Nathasya Pratiwi
The International Journal of Medical Science and Health Research Vol. 24 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/ppw50b18

Introduction: Blindness and visual impairment represent significant global public health challenges, with many causes being preventable or treatable if detected early. Screening programs in primary care settings are widely advocated as a key strategy to reduce the burden of avoidable vision loss. However, the effectiveness of these programs varies substantially across different eye conditions, populations, and healthcare contexts. Methods: This comprehensive systematic review synthesises evidence from 80 studies examining the role of screening programs in preventing blindness within primary care settings. The review employed a structured screening process to include studies conducted in primary care, involving systematic screening interventions, with outcomes related to blindness prevention. Data extraction covered screening program details, primary care context, target population, visual outcomes, effectiveness results, implementation factors, and economic considerations. Results: The evidence reveals a paradox: while screening effectively identifies individuals with visual impairment, it does not consistently lead to improved visual outcomes at the population level. General visual acuity screening in older adults showed no significant benefit in improving vision or clinical outcomes (Clarke et al., 2018; Smeeth et al., 2003; Chou et al., 2016). In contrast, screening for diabetic retinopathy (DR) demonstrated efficacy, with telemedicine and AI-supported approaches significantly increasing screening uptake, detection rates, and referral adherence (Mansberger et al., 2015; Mathenge et al., 2022; Harding et al., 2023). Evidence for glaucoma population screening remains insufficient (Mangione et al., 2022), while preschool vision screening for amblyopia shows modest benefits (Schmucker et al., 2009). Newborn red reflex testing may improve early detection of congenital cataracts (Malik et al., 2022). Economic analyses indicate that telemedicine and AI-supported screening, particularly for DR, are cost-effective, especially in resource-limited settings (Avidor et al., 2020; Teo & Ting, 2023). Discussion: The disparity in outcomes underscores the critical influence of context, including baseline healthcare access, the natural history of the disease, availability of effective treatment, and the strength of referral pathways. Successful programs integrate technology with systemic support, such as patient navigation and removal of financial barriers. Conclusion: Screening is not a uniformly effective intervention for all eye conditions in all settings. Its value is highest for conditions like diabetic retinopathy within defined high-risk populations and in contexts with limited baseline eye care access. Future programs should be condition-specific, contextually tailored, and designed as integrated care pathways rather than isolated detection activities.

To Intubate or Not: A Comprehensive Clinical Analysis of Airway Management and Stabilization Strategies for Neonatal Congenital Diaphragmatic Hernia in Resource-Limited Facilities Ida Ayu Sintya Pratiwi; I Wayan Dharma Artana
The International Journal of Medical Science and Health Research Vol. 24 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: 10.70070/498zkw58

Introduction: Congenital Diaphragmatic Hernia (CDH) remains a formidable challenge in neonatal medicine, particularly in low- and middle-income countries (LMICs) where diagnostic resources and advanced life support modalities, such as extracorporeal membrane oxygenation (ECMO), are often unavailable.1 This condition, characterized by the herniation of abdominal viscera into the thoracic cavity through a diaphragmatic defect, leads to a critical triad of pulmonary hypoplasia, persistent pulmonary hypertension of the newborn (PPHN), and cardiac dysfunction.3 The immediate postnatal management, specifically the decision to initiate invasive mechanical ventilation versus non-invasive support, is a pivotal determinant of survival.3 Case Illustration: This report details two distinct cases of postnatally diagnosed CDH at a Type C hospital in Bali, Indonesia. Case 1 involves a full-term female neonate (2,900g) presenting with moderate respiratory distress (Apgar 4/5/6), who was successfully stabilized using non-invasive continuous positive airway pressure (CPAP) and orogastric decompression before being referred at 20 hours of life. Case 2 involves a full-term low-birth-weight female neonate (2,325g) with prenatally suspected dextrocardia and severe hypoxemia (SpO2 40%), necessitating prompt endotracheal intubation and pressure-controlled ventilation to achieve physiological stability prior to tertiary referral. Discussion: The analysis explores the embryological origins of the diaphragmatic defect, occurring between the 4th and 12th weeks of gestation, and the physiological impact on lung development.3 It highlights the utility of the Downes score for clinical monitoring in settings where arterial blood gas analysis may be limited.6 Furthermore, the discussion contrasts the "gentle ventilation" strategy with historical hyperventilation approaches and examines the systemic challenges of neonatal transport within the Indonesian healthcare framework.7 Conclusion: Individualized airway management is essential in resource-limited settings. While immediate intubation is mandatory for severe hypoxemia, non-invasive stabilization may be appropriate for clinically stable phenotypes, provided meticulous orogastric decompression is maintained.3 Early recognition and standardized referral pathways are critical to improving survival outcomes in these complex cases.9

HIGHER BMI, HIGHER RISK? INVESTIGATING THE LINK BETWEEN OBESITY AND CHOLELITHIASIS ACROSS ASIA: A SYSTEMATIC REVIEW Ario Achwanu Shafa; Bambang Arianto
The International Journal of Medical Science and Health Research Vol. 24 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: 10.70070/68st0135

Background: Cholelithiasis represents a significant global health burden, with obesity as a major modifiable risk factor. Yet systematic reviews examining BMI-cholelithiasis relationships using WHO-recommended Asian-specific cutoffs (overweight ≥23 kg/m², obese ≥25 kg/m²) remain scarce. This review investigates how elevated BMI relates to cholelithiasis across Asian populations when appropriate thresholds are applied. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, and Cochrane Library (January 2015-December 2025). Two reviewers independently screened studies using Rayyan.ai and predefined PICOS criteria, with a critical requirement: explicit use of Asian-specific WHO BMI cutoffs. We extracted demographics, BMI-stratified outcomes, and effect estimates, then assessed quality using Newcastle-Ottawa Scale. Results: Of 366 studies screened, only four met inclusion criteria—spanning Korea, Taiwan, China, and Indonesia with sample sizes from 124 to over 724,000 participants. All four demonstrated consistent BMI-cholelithiasis associations: effect sizes ranged from modest (OR 1.5-2.0) to substantial (OR >5.0) for high-risk groups. We identified a dose-response relationship of 4.2% increased odds per 1 kg/m² BMI increment. Metabolically abnormal obese individuals under 50 years faced particularly dramatic risk (OR 5.41). Female sex, younger age, and specific ethnicities further amplified susceptibility. Conclusion: Elevated BMI strongly predicts cholelithiasis when Asian-appropriate thresholds are used. The consistent dose-response relationship and amplified risk in metabolically abnormal individuals demand urgent action. Researchers, clinicians, and policymakers must adopt Asian-specific BMI thresholds to generate and implement effective prevention strategies across Asia's diverse populations.

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Contact Name
Indra Hadi

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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