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The International Journal of Medical Science and Health Research

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Published by International Medical Journal Corp. Ltd.

ISSN : 30481376 EISSN : 30481368 DOI : -

Core Subject : Health,

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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 577 Documents

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The Role of Emergency Evacuation Plans in Pro Texting Workers : A Comprehensive Systematic Review Kevin Chaniago Tanudirjo; Egin Cipta Wiguna; Dendi Handriansyah
The International Journal of Medical Science and Health Research Vol. 37 No. 2 (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: 10.70070/3s1pts84

Introduction: Workplace emergencies pose significant risks to worker safety globally. Emergency evacuation plans are critical components of occupational safety, yet their effectiveness in protecting workers varies substantially across settings. This systematic review synthesizes evidence on the role, components, effectiveness, and implementation factors of emergency evacuation plans for worker protection. Methods: A systematic review was conducted following PRISMA guidelines. Eight screening criteria were applied, including worker population focus, emergency evacuation intervention, worker safety outcomes, empirical data, workplace setting, workplace context, evacuation procedures, and worker population focus. Data extraction covered worker populations, evacuation plan types, protective mechanisms, plan components, effectiveness evidence, implementation factors, challenges, and key findings from 80 included studies across diverse industries. Results: Studies spanned healthcare, construction, mining, manufacturing, oil and gas, and other sectors globally. Eight primary plan components were identified: detection/alarm systems, evacuation route design, assembly points, communication protocols, role assignments, training/drills, equipment provision, and emergency services coordination. Integrated multi-component interventions reduced evacuation times by 64% (581 to 212 seconds) and achieved 100% worker survival in severe events. Training improved knowledge by 57-76%, while smart technologies enhanced evacuation efficiency by 35-37%. Critical success factors included regular drills, clear communication, management commitment, and technology integration. Major barriers comprised worker non-compliance (51-70% ignoring instructions), physical obstacles, communication failures, and insufficient training (83.3% demonstrating poor knowledge). Conclusion: Emergency evacuation plans significantly improve worker protection when implemented as integrated systems rather than standalone documents. Effectiveness depends on context-specific tailoring, regular practical training, management commitment, and systematic maintenance. Future efforts should address vulnerable worker populations, technology optimization, and cross-cultural effectiveness. Keywords: Emergency evacuation, worker safety, occupational health, disaster preparedness, systematic review

Association Between Cardio-Ankle Vascular Index and Early Detection of Heart Failure with Preserved Ejection Fraction: A Meta-Analysis Pramuliansyah Haq; Andi Muhammad Ariansyah N
The International Journal of Medical Science and Health Research Vol. 37 No. 2 (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/vg1x7670

Introduction: Heart failure with preserved ejection fraction (HFpEF) represents a growing clinical challenge with limited diagnostic tools for early detection. The Cardio-Ankle Vascular Index (CAVI) is a novel non-invasive measure of arterial stiffness that may facilitate early identification of HFpEF. Methods: This meta-analysis systematically reviewed 48 sources examining the association between CAVI and HFpEF. Studies were included if they assessed adult populations, measured CAVI, and reported quantitative associations with HFpEF or its surrogates. Data extraction focused on study design, CAVI measurement protocols, HFpEF definitions, and association measures. Results: Cross-sectional analyses demonstrated significant correlations between CAVI and diastolic function parameters: E/A ratio (r = -0.405, 95% CI -0.324 to -0.481) and e' velocity (r = -0.449, 95% CI -0.340 to -0.630) (1). CAVI ≥10 was associated with HFpEF hospitalization (OR 9.76) (6). Meta-analyses showed CAVI predicted cardiovascular events (HR 1.20-1.46 per SD/category increase) (8-10). Longitudinal data demonstrated CAVI progression correlated with left ventricular global longitudinal strain deterioration over 26.8 months (5). Sex-specific analysis revealed stronger associations in women (OR 1.67, P=0.007) (3). Discussion: CAVI demonstrates consistent associations with subclinical diastolic dysfunction and HFpEF outcomes. The evidence supports mechanistic plausibility through ventricular-vascular coupling, with distinct patterns in hypertensive and female subpopulations. However, significant limitations include predominance of Asian populations, absence of prospective screening studies, and lack of validated early detection thresholds. Conclusion: CAVI shows promise as a screening tool for early HFpEF detection, particularly in high-risk populations. Future research requires prospective studies with standardized protocols, population-specific thresholds, and evaluation of CAVI-guided intervention strategies.

Interplay of Maternal Nutrition, Sanitation, and Socioeconomic Factors in Childhood Stunting across Resource-Limited Rural Communities : A Systematic Review Mutawaffika Mahir; Asrita Suri; Andi Muh. Ariansyah Nazaruddin
The International Journal of Medical Science and Health Research Vol. 20 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/gbysvf70

Introduction: Childhood stunting remains a critical public health challenge in resource-limited rural communities, affecting nearly 150 million children under five globally. The interplay between maternal nutrition, sanitation, and socioeconomic factors is complex and context-dependent, with previous studies showing inconsistent results regarding the effectiveness of isolated interventions. Methods: This systematic review synthesized findings from 80 studies examining the interplay of maternal nutrition, sanitation, and socioeconomic factors on childhood stunting in resource-limited rural settings across Sub-Saharan Africa, South Asia, Southeast Asia, and Latin America. Included studies comprised cluster-randomized controlled trials, and country-level decomposition analyses. Results: Maternal nutrition interventions demonstrated consistent positive effects on linear growth across diverse settings, with effect sizes ranging from 0.13 to 0.38 increases in length-for-age Z-scores (1-3,14). In contrast, household-level WASH interventions showed minimal effectiveness on stunting despite high adherence, with three major trials reporting null effects (1-3). Socioeconomic factors, particularly maternal education and household wealth, emerged as dominant determinants, explaining 24.7% of stunting reduction in Nepal and 19.5% in Peru (5,7). Country-level decomposition analyses revealed context-specific drivers: malaria control dominated in Uganda (35%) and Senegal (35%) (4,13), while agricultural productivity accounted for 32% of improvements in Ethiopia (6). Combined WASH and nutrition interventions provided no additive benefit over nutrition alone in major trials (1-3), though integrated programs in Ethiopia showed significant effects (OR: 0.50) (11). Discussion: The discrepancy between strong observational associations and null trial results for WASH interventions suggests substantial confounding by socioeconomic status. Nutrition interventions operate through direct biological pathways addressing micronutrient deficiencies, showing consistent but modest effects. Socioeconomic factors represent long-term structural determinants operating through multiple mechanisms including improved feeding practices, healthcare utilization, and intergenerational transmission. Context-specific determinants—including malaria control, agricultural productivity, and education—must guide intervention priorities. Conclusion: Effective stunting reduction in resource-limited rural settings requires context-specific strategies prioritizing proven nutrition interventions alongside long-term investments in socioeconomic development. WASH interventions should not be abandoned but require more comprehensive community-level approaches rather than household-level infrastructure provision alone. Multisectoral coordination addressing context-specific dominant drivers is essential for sustainable progress.

The Relationship Between Testosterone Levels and the Severity of Lower Urinary Tract Symptoms : A Comprehensive Systematic Review Muhammad Zul Fahmi; Cut Dessia Zulda Muthia
The International Journal of Medical Science and Health Research Vol. 37 No. 2 (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: 10.70070/8kgbfx75

Introduction: The relationship between testosterone levels and lower urinary tract symptoms (LUTS) in men remains controversial, with conflicting evidence from observational studies and interventional trials. This systematic review aims to comprehensively evaluate the association between testosterone levels and LUTS severity, and to assess the effects of testosterone replacement therapy (TRT) on urinary symptoms. Methods: We systematically screened studies involving adult male participants with LUTS assessment using validated instruments (IPSS, AUA-SI) and testosterone measurement via validated laboratory methods. Eighty studies comprising randomized controlled trials, observational registry studies, and cross-sectional analyses were included. Results: Cross-sectional studies showed inconsistent baseline associations between testosterone levels and LUTS severity, with some demonstrating significant negative correlations (r=-0.334, p=0.031) (21) while large-scale trials found no relationship (1,3,4). However, interventional studies consistently demonstrated that long-term TRT significantly improved LUTS. In registry studies of up to 16 years, mean IPSS decreased from 7.0±3.5 to 1.5±2.0 in treated men versus worsening from 4.9±2.0 to 14.3±5.3 in controls (p<0.0001) (5). Improvements were observed independent of prostate size (6,9) and were particularly pronounced in men with metabolic comorbidities, including type 2 diabetes (7) and obesity (59). Mechanistic studies identified effects on bladder function (44), inflammation reduction (17,32), and sleep improvement (27) as potential mediators. Effect modifiers included baseline testosterone levels, prostate size, metabolic status, and treatment duration exceeding 6 months. Discussion: The heterogeneous findings can be reconciled by recognizing that severe testosterone deficiency (<300 ng/dL) contributes to LUTS through multiple mechanisms, and restoration to normal levels with adequate treatment duration produces clinically meaningful benefits. The saturation model (75) explains why variations within normal range show no association. Benefits are maximized in men with documented hypogonadism, metabolic comorbidities, and moderate-to-severe baseline symptoms. Conclusion: Testosterone replacement therapy significantly improves LUTS in hypogonadal men, particularly those with metabolic comorbidities, with benefits requiring sustained treatment beyond 6 months. Patient selection based on documented testosterone deficiency and symptom severity optimizes therapeutic outcomes.

The Relationship Between Hot-Cold Compression Therapy and Delayed Onset Muscle Soreness (DOMS) : A Comprehensive Systematic Review Dendy Edyana; Wianne Carima
The International Journal of Medical Science and Health Research Vol. 38 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/r4raqf18

Introduction: Delayed Onset Muscle Soreness (DOMS) represents a common consequence of unaccustomed or intense exercise, characterized by pain, reduced function, and inflammation. Despite widespread use of thermal and compression therapies in sports recovery, the optimal application parameters and comparative effectiveness remain unclear. This systematic review evaluated the relationship between hot-cold compression therapy and DOMS outcomes. Methods: A comprehensive systematic review was conducted across multiple databases, screening studies based on predefined criteria including population (healthy individuals or athletes), intervention (thermal and/or compression therapies), outcomes (DOMS-related measures), and study design (RCTs, controlled trials, systematic reviews). Data extraction focused on intervention parameters, population characteristics, DOMS assessment methods, and primary findings. Results: Eighty studies were included, encompassing diverse interventions including contrast water therapy (CWT), cold water immersion (CWI), compression therapy, and combined approaches. CWI at 10-15°C for 10-15 minutes demonstrated consistent benefits for pain reduction (SMD -0.48 to -0.75) and functional recovery. Compression therapy, particularly pneumatic devices, improved muscle soreness (SMD -0.33) and performance measures. Combined thermal-compression approaches showed synergistic effects in some contexts (d = 0.67-1.12 for strength recovery), though not universally superior. Discussion: Intervention effectiveness demonstrated systematic variation based on temperature (optimal CWI: 10-15°C), duration (CWT optimal at 6 minutes), timing (immediate post-exercise application critical), and population (trained males show robust responses; females may respond differently). Methodological quality varied substantially, with placebo effects potentially contributing to reported benefits. Conclusion: Cold water immersion at 10-15°C for 10-15 minutes immediately post-exercise represents the most consistently beneficial single modality for DOMS, particularly in trained male athletes. Compression therapies offer viable alternatives with distinct mechanisms. Personalized approaches considering individual response patterns and resource availability are recommended over universal protocols.

The Relationship Between Fasting Blood Glucose and the Severity of Diabetic Retinopathy : A Comprehensive Systematic Review Ramadhani Ferrial Nugraha; Djonny Djuarsa; Gaby Syafira Siti Halimatussa'diah
The International Journal of Medical Science and Health Research Vol. 38 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/pqypab80

Introduction: Diabetic retinopathy (DR) is a leading cause of blindness. While glycated hemoglobin (HbA1c) is the standard glycemic metric, the role of fasting blood glucose (FBG) as an independent predictor of DR severity remains debated. This systematic review synthesizes evidence on the relationship between FBG and DR severity. Methods: A systematic review of 80 studies (cross-sectional, cohort, RCTs, et al) was conducted. Data were extracted on FBG measurement, DR severity classification, study populations, confounding variables, and the direct association between FBG and DR. Results: A positive association between elevated FBG and DR presence/severity was found across diverse populations. Meta-analyses reported pooled odds ratios (OR) for DR per unit FBG increase ranging from 1.19 (95% CI: 1.13-1.26) to 2.41 (95% CI: 1.63-3.57) when combined with HbA1c. Longitudinal studies identified FBG thresholds (e.g., 6.9-7.4 mmol/L) for predicting DR risk. Large RCTs (ACCORD, DCCT) confirmed that intensive glycemic control, which reduces FBG, significantly slows DR progression. Fasting glucose variability emerged as an independent risk factor for DR in type 2 diabetes, even after adjusting for HbA1c. However, several studies found FBG lost independent significance when HbA1c was included in multivariable models. Key confounders included diabetes duration, hypertension, and renal function. Discussion: The relationship between FBG and DR is significant but complex. The evidence supports FBG as a robust risk marker, particularly in type 2 diabetes, with a dose-response relationship and the added risk of glycemic variability. However, HbA1c remains a superior predictor of cumulative glycemic exposure. Discrepancies across studies may be explained by differences in diabetes type, study design (cross-sectional vs. longitudinal), and whether analyses adjusted for HbA1c. The effect of FBG is most pronounced in settings where HbA1c is unavailable or as a component of overall glycemic control. Conclusion: Elevated FBG and its variability are significant, independent risk factors for DR presence and severity, especially in type 2 diabetes. While HbA1c remains a crucial metric, FBG provides valuable prognostic information. Clinical management should focus on achieving recommended FBG targets and minimizing glycemic variability to reduce DR risk.

Case Report: Modified Arthroplasty and Cement Augmentation for Proximal Humerus Osteosarcoma Reconstruction—Short-Term Functional Outcomes Muhamad Naseh Sajadi Budi; Muhammad Rifki Faiz; Masganjar Nugraha
The International Journal of Medical Science and Health Research Vol. 38 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/tmpx0g22

Introduction : Reconstruction of the proximal humerus after wide tumor excision presents a significant surgical challenge. This case report evaluates the short-term functional outcomes of a modified arthroplasty technique reinforced with bone cement and internal fixation for proximal humerus osteosarcoma. Case Presentation: A 25-year-old male presented with a progressively painful and enlarging mass on his left shoulder over eight months. Imaging and histopathology confirmed high-grade osteosarcoma of the left proximal humerus, Enneking classification IIB. The patient underwent limb-salvage surgery starting with a wide en bloc tumor excision. Reconstruction was performed using a modified shoulder arthroplasty technique: a size-24 shoulder stem prosthesis was implanted and augmented with polymethyl methacrylate (PMMA) bone cement for enhanced stability. To provide additional mechanical reinforcement and secure anchor points for soft-tissue reattachment, a 4.5 narrow locking 9-hole plate and screws were secured to the construct. The patient subsequently completed six cycles of adjuvant chemotherapy. Results: At the 12-month follow-up, the patient achieved an excellent Musculoskeletal Tumor Society (MSTS) score of 80%. Clinical evaluation demonstrated good active range of motion with no signs of local recurrence or distant metastasis. Discussion: The use of PMMA cement provided immediate rigid fixation for early mobilization, while the supplemental locking plate acted as a critical anchor for reattaching the joint capsule and remaining musculature. Compared to conventional silver-coated or standard modular megaprostheses, which often face challenges regarding soft-tissue integration and high costs in developing regions, this modified approach offers a more accessible and biomechanically stable alternative for restoring shoulder mechanics. This modification effectively addresses the common clinical problem of postoperative shoulder instability caused by the extensive loss of dynamic stabilizers during oncological resection. Conclusion : The combination of cemented tumor arthroplasty with supplemental plate fixation is a feasible and effective strategy, providing immediate mechanical stability and reliable soft-tissue reattachment for complex proximal humerus reconstruction.

SYSTEMATIC LITERATURE REVIEW: THE RELATIONSHIP BETWEEN CLEAN AND HEALTHY LIVING BEHAVIOR (PHBS) AS A PREVENTION OF DIARRHEAL DISEASE Nurul Maghfirah Junaid; Armanto Makmun; Abbas Zavey Nurdin; Husni Esa Darussalam; Ardiyanto
The International Journal of Medical Science and Health Research Vol. 38 No. 2 (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: 10.70070/90865g54

Diarrhea remains a global public health problem, especially in developing countries, one of which is Indonesia, with a high incidence rate in vulnerable groups such as toddlers. The implementation of Clean and Healthy Living Behavior (PHBS) is an essential preventive strategy in reducing the incidence of diarrhea, but previous research results have shown varying findings. This study systematically examines the relationship between the implementation of Clean and Healthy Living Behavior (PHBS) and the prevention of diarrheal disease based on current scientific evidence. This study uses a systematic literature review design with the PICOS approach. Literature searches were conducted through Google Scholar, PubMed, ScienceDirect, ResearchGate, and ProQuest for articles published between 2021 and 2025 in Indonesian and English. Study selection was carried out through title and abstract screening stages, followed by full-text review according to criteria. A total of 20 articles were analyzed descriptively and systematically. Most of the literature reveals a significant relationship between the implementation of PHBS and a reduced risk of diarrhea incidence. Individuals or groups with good PHBS implementation have a lower risk of diarrhea compared to those who do not implement PHBS optimally. The PHBS components that play a dominant role include hand hygiene practices with soap, use of clean water sources, use of proper sanitation facilities, and hygienic food and waste management. Factors influencing the effectiveness of PHBS include knowledge, attitudes, socioeconomic conditions, availability of sanitation facilities, as well as environmental support and health policies. The implementation of PHBS is an effective, evidence-based preventive strategy for preventing diarrheal disease. Strengthening education and improving access to adequate sanitation are needed to support sustainable public health interventions.

ASSOCIATION OF INFLAMMATION DEGREE AND LENGTH OF STAY AFTER LOWER GASTROINTESTINAL SURGERY IN INTENSIVE CARE Salsabila Al-Fatih Panur; Faisal Sommeng; Farah Ekawati Mulyadi; Agung Kurniawan; Fendy Dwimartyono
The International Journal of Medical Science and Health Research Vol. 38 No. 2 (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/qybxqp11

Background: Lower gastrointestinal surgery induces a systemic inflammatory response that may influence patient recovery and duration of care. The Systemic Immune-Inflammation Index (SII) is considered a practical inflammatory marker reflecting the balance between immune and inflammatory responses. Objective: To analyze the association between inflammation degree and length of stay in patients after lower gastrointestinal surgery treated in the intensive care unit. Methods: This was an analytic observational study with a cross-sectional approach using secondary data from medical records of patients at Ibnu Sina YW-UMI Hospital in 2025. Samples were taken using total sampling, yielding 30 patients who met the study criteria. Inflammation degree was categorized based on SII values into low and high, while length of stay was categorized as short (3-5 days) and prolonged (≥6 days). The association was analyzed using the Spearman test. Results: The majority of patients were male (16; 53.3%), aged ≥50 years (19; 63.3%), and were most frequently diagnosed with rectal cancer and rectal adenocarcinoma, 12 patients each (40.0%). A total of 18 patients (60.0%) had high SII, while 22 patients (73.3%) had a short length of stay. The Spearman test showed a correlation coefficient of 0.339 with p=0.067. Conclusion: Inflammation degree was not significantly associated with length of stay in patients after lower gastrointestinal surgery treated in the intensive care unit. These findings suggest that length of stay is likely also influenced by other clinical factors beyond inflammation, and further research is still needed to predict hospital stay duration related to the inflammatory response occurring during surgery.

The Impact of Ramadan Fasting on Glycemic Control in Patients with Type 2 Diabetes : A Comprehensive Systematic Review Gusti Arlan Tio; Ramadilla
The International Journal of Medical Science and Health Research Vol. 38 No. 2 (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: 10.70070/4vng7x38

Introduction: Ramadan fasting is observed by millions of Muslims with type 2 diabetes mellitus (T2DM) worldwide, presenting unique challenges for glycemic management. This systematic review synthesizes evidence on the impact of Ramadan fasting on glycemic control in patients with T2DM. Methods: A comprehensive systematic review was conducted including 80 studies (35 randomized controlled trials and 45 observational studies) examining Ramadan fasting in adults with T2DM. Studies were included if they assessed glycemic parameters (HbA1c, fasting blood glucose, postprandial glucose, glucose variability) and reported safety outcomes. Data were extracted on study characteristics, medication regimens, educational interventions, and metabolic outcomes. Results: The majority of studies demonstrated improvements or stability in HbA1c levels during Ramadan, with reductions ranging from 0.5-1.5% in patients receiving structured interventions. Newer medication classes including SGLT-2 inhibitors (HbA1c reduction 0.49-0.65%), GLP-1 receptor agonists (mean difference -0.31%, p=0.04), and DPP-4 inhibitors showed favorable safety-efficacy profiles. Hypoglycemia rates varied considerably: sulfonylureas 14-26%, insulin 2-23%, DPP-4 inhibitors 0-5.8%, SGLT-2 inhibitors 0.3-7.3%, and GLP-1RAs 0-5%. Structured pre-Ramadan education reduced hypoglycemia from 19.5% to 4.1% and improved HbA1c by 0.7-1.5%. Dose reduction protocols (60% of usual dose) decreased hypoglycemia from 23.0% to 4.2% (OR 0.15, 95% CI 0.08-0.26). Weight changes ranged from -2.9 kg to no significant change, with SGLT-2 inhibitors and GLP-1RAs producing greatest reductions. Discussion: Ramadan fasting can be safe for many T2DM patients with appropriate risk stratification, medication adjustment, and structured education. Newer glucose-lowering agents offer superior safety profiles compared to sulfonylureas and traditional insulin regimens. Conclusion: Successful Ramadan fasting requires individualized approaches combining pre-Ramadan education, medication optimization, structured nutrition therapy, and appropriate monitoring. High-risk patients should be advised against fasting.

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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