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Medicosphere
Published by Universitas Pembangunan Nasional Veteran Jawa Timur
ISSN : -     EISSN : 30639433     DOI : https://doi.org/10.33005
Core Subject : Health, Science, Social, Engineering,
Immunology & microbiology Mechanical Engineering Medicine & Pharmacology Public Health Social Sciences
Journal of Diverse Medical Research is an open access and peerreviewed journal published every month by Faculty of Medicine Universitas Pembangunan Nasional Veteran Jawa Timur. This journal is a dissemination medium for research result from various areas in medical science.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 87 Documents
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Wastewater Surveillance of SARS-CoV-2 as Monitoring Tool for COVID-19: A Literature Review Satyafebrianti, Kendra Callista; Tedjaprasadja, Leonardo; Durry, Fara Disa; Seliana, Irma
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 8 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Abstract

Background: The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted global health, requiring effective surveillance methods. Wastewater surveillance has emerged as a cost-effective and non-invasive tool to detect viral RNA from both symptomatic and asymptomatic individuals, allowing early detection of outbreaks. Objective: This study analyzes the effectiveness of wastewater surveillance in detecting SARS-CoV-2 RNA in untreated wastewater, comparing it with clinical surveillance and evaluating its role in public health monitoring. Method: A literature review was conducted using PubMed, Google Scholar, and Scopus, focusing on studies published between 2015–2025. Articles were selected based on relevance, availability, and originality, applying the PICO strategy to refine the search. From ten initially identified studies, two were selected for in-depth analysis. Result: The findings demonstrate that wastewater surveillance effectively tracks SARS-CoV-2 trends in communities. A study in Brazil showed a strong correlation between viral loads in wastewater and clinical case trends, proving its potential as an early warning system. Meanwhile, research in Australia confirmed the presence of SARS-CoV-2 in wastewater and estimated infection prevalence using Monte Carlo simulation, aligning with reported clinical cases. These studies highlight wastewater surveillance as a reliable tool for population-wide monitoring. Conclusion: Wastewater surveillance is a proven method for detecting SARS-CoV-2, complementing clinical surveillance by enabling early detection, wider coverage, and cost efficiency. Challenges such as RNA degradation and detection standardization require further research, but integrating RT-qPCR and genomic sequencing enhances its accuracy for future epidemiological monitoring.
Early Detection and Treatment of Pediatric Amblyopia: A Cost-Benefit Analysis in the Indonesia: A Literature Review Tedjaprasadja, Leonardo
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 8 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Background: Amblyopia is a leading cause of preventable visual impairment in children. Despite effective treatment, delayed diagnosis limits visual recovery and may reduce lifetime productivity. In Indonesia, where pediatric vision screening is not yet universal, undiagnosed amblyopia may lead to lifelong productivity losses. This study evaluates the cost-effectiveness of early screening and intervention for amblyopia from a societal perspective. Methods: A Markov model simulated a cohort of 100,000 children aged 3 over a 70-year period. Two strategies were compared: (1) early vision screening and treatment through primary care (e.g., Puskesmas), and (2) no structured screening. Costs, utilities, productivity losses, benefit-cost ratio were estimated using local data where available and adjusted using purchasing power parity (PPP) and Indonesian-specific parameters from WHO-CHOICE, BPJS Kesehatan reimbursement rates, and labor market data. Results: The findings affirm that nationwide early screening and treatment for amblyopia in Indonesia are not only clinically effective but also economically justified. The estimated lifetime productivity gain per successfully treated child was USD 4,130, yielding a total indirect savings of over USD 11.3 million. The benefit-cost ratio was 7.8:1, The calculated ICER was USD 183.54 per QALY gained Conclusion: Universal amblyopia screening in Indonesia is cost benefit and highly cost-effective. Integration into school-based health programs and the Puskesmas system could optimize early detection, reduce visual disability burden, and improve long-term national productivity.
The Role of Risk Factors in the Early Manifestation of Gout in Young Women: A Case Report BASHOR, FURQON ABDULLAH; pratiwi, Prasetyaning Estu
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 8 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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ABSTRACT Introduction: Gout is an inflammatory form of arthritis caused by the deposition of monosodium urate crystals in tissues and joints due to hyperuricemia. Although it is more common in middle-aged men, the increasing incidence in young women with genetic predisposition and certain lifestyle factors has become a clinical concern. Early identification and management of risk factors are crucial to prevent disease progression. Case Illustration: A 33-year-old woman with a family history of gout and dyslipidaemia presented with intermittent joint pain in the lower extremities exacerbated by consumption of high-purine foods. The patient was diagnosed with hyperuricaemia in 2017 but did not undergo regular follow-up. Use of allopurinol and corticosteroids was effective in alleviating symptoms, but the complaints persisted. Discussion: This case illustrates the significant role of hereditary risk factors, high-purine dietary patterns, and inadequate medical supervision in the onset of early gout. Pathophysiologically, gout begins with chronic hyperuricemia, which then triggers an inflammatory process through uric acid crystallisation. Genetic factors such as the T allele at SNP rs2231142 of the ABCG2 gene are known to impair uric acid excretion through the intestines, increasing the risk of hyperuricemia and early-onset gout. Epidemiological evidence shows a 3.64-fold increased risk of gout in individuals with high genetic risk and unhealthy lifestyles. Conclusion: The manifestation of gout in young women is the result of a complex interaction between genetic predisposition, environmental factors, and lifestyle. Early detection of risk factors and lifestyle-based interventions particularly a low-purine diet and monitoring of uric acid levels are key approaches in the prevention and management of gout in the productive age population.
A Case Study: The Vicious Cycle of Headache, Uncontrolled Hypertension, and Paracetamol in 49 Years Old Woman: A Literature Review Yudinda, Salsabilla Cathabell; Aulia Fahira
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 8 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Background: Hypertension is a chronic condition that often presents without clear symptoms, but may cause complaints such as headaches. Many individuals with hypertension manage these symptoms independently using over-the-counter medications like paracetamol, without addressing the underlying cause. This case report aims to describe the clinical course of uncontrolled hypertension, recurrent headaches, and habitual paracetamol use. Case Illustration: A 49-year-old woman with a history of hypertension experienced recurrent headache and self-medicated with paracetamol without a prescription. The patient demonstrated poor adherence to antihypertensive therapy and maintained an unhealthy lifestyle, including frequent sleep deprivation, work-related stress, regular consumption of coffee, tea, and fried foods. Clinical evaluation revealed elevated blood pressure of 140/100 mmHg. Discussion: Non-adherence to antihypertensive treatment and unhealthy lifestyle choices were major contributing factors that exacerbated the patient’s condition. The use of paracetamol as a symptomatic treatment masked the underlying problem and poses long-term risks to organ function. Persistent headache may serve as a clinical indicator of uncontrolled blood pressure due to irregular therapy. Conclusion: Patients with hypertension require comprehensive management, including lifestyle modification, consistent adherence to medication, and education on the risks of self-medication. The use of symptomatic drugs such as paracetamol without medical supervision may worsen the condition if not accompanied by adequate blood pressure control.
Association between Gender and Occupation with Hypercholesterolemia Risk among Hypertension Population: A Cross-sectional Study: A Case Report Adnan, Muhammad Luthfi; Pratama, Yanasta Yudo
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 9 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Metabolic syndrome is one of the major global health problems. Hypertension and hypercholesterolemia are indicators in the diagnosis of metabolic syndrome. However, the analysis of the relationship between risk factors for hypercholesterolemia in the hypertensive population needs further study. This study aims to analyze the risk factors for hypercholesterolemia in hypertensive patients. This cross-sectional study was conducted at Depok 2 Community Healthcare Center with a focus on adult hypertensive patients. The results of blood pressure measurements, total cholesterol examinations, and participant characteristics were then analyzed using the Chi-Square test. 117 hypertensive patients were analyzed in this study with the majority being women (60.7%), elderly (70.1%), and household-based occupancy (70.1%). The majority of participants were diagnosed with grade I hypertension (53.8%) and hypercholesterolemia (59%). Women have higher risk of developing hypercholesterolemia than men (OR 3.38 (95% CI 1.555 – 7.361); p = 0.002), and non-household based occupancy were protective factor from hypercholesterolemia (OR 0.327 (95% CI 0.144 – 0.742); p = 0.008). Gender and occupation are risk factors for hypercholesterolemia in the hypertensive population. Education at the household level is needed for early detection of the risk of metabolic syndrome in the general population.
Opioid-Sparing and Multimodal Analgesia in Cesarean Delivery: A Systematic Review of Evidence and Implementation Across High and Low-Middle Income Countries: A Systematic Review Agastya, Wayan Dhea; Rahmadinie, Amalia
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 9 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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ABSTRACT Introduction: Cesarean delivery is a common surgical procedure worldwide, often accompanied by significant postoperative pain that can negatively impact recovery, early breastfeeding, and maternal mobility. Opioids have traditionally been central to post-cesarean analgesia but are associated with side effects such as nausea, vomiting, pruritus, sedation, and respiratory depression. Recently, opioid-sparing and multimodal analgesia strategies—combining neuraxial opioids, regional blocks (e.g., transversus abdominis plane [TAP] block), and non-opioid systemic agents (NSAIDs, acetaminophen)—have been increasingly adopted to reduce opioid consumption while maintaining effective analgesia. Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published from January 2021 to August 2025. Eligible studies included randomized controlled trials, cohort studies, and quality improvement projects evaluating opioid-sparing multimodal analgesia in women undergoing cesarean delivery in both high-income countries (HICs) and low- and middle-income countries (LMICs). Primary outcomes were postoperative opioid consumption and pain scores; secondary outcomes included opioid-related side effects, recovery milestones, maternal satisfaction, and neonatal safety. Data extraction and quality assessment were performed independently by two reviewers following PRISMA 2020 guidelines. Discussion: The review included nine studies from diverse settings. Multimodal analgesia regimens consistently reduced opioid consumption and pain scores, improved maternal satisfaction, and decreased opioid-related adverse effects. Regional techniques such as TAP block were effective adjuncts or alternatives to neuraxial opioids, especially in LMICs where opioid availability and monitoring are limited. Adoption of multimodal protocols was more widespread in HICs, often integrated within enhanced recovery after cesarean (ERAC) pathways. Barriers in LMICs included limited regional anesthesia expertise, drug availability, cost, and institutional protocols, highlighting the need for capacity building and context-specific guidelines. Conclusion: Opioid-sparing multimodal analgesia is effective, safe, and feasible across various healthcare settings, improving postoperative pain control and recovery after cesarean delivery. Addressing implementation gaps between HICs and LMICs through training, resource allocation, and simplified protocols is essential to optimize global obstetric analgesia. Future research should focus on standardizing regimens, evaluating long-term maternal and neonatal outcomes, and overcoming implementation challenges to facilitate broader adoption.
The Role Of Motility And Gastric Acid Secretion in The Pathophysiology of Gastroesophageal Reflux Disease (GERD): A Literature Review el mahroos, rifda
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 9 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Introduction: Gastroesophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract that involves a complex interaction between physiologic and pathologic factors. The two main components that play a role in this dynamic are gastric motility and acid secretion. Methods: This review used a narrative literature review approach by searching the current scientific literature from various databases between 2015-2024. Discussion: Normal gastric motility maintains gastric emptying efficiency and lowers the risk of reflux, while disorders such as delayed gastric emptying increase intragastric pressure and trigger reflux. Excessive secretion of gastric acid, especially HCl and pepsin, amplifies the aggressive nature of gastric contents and exacerbates damage to the esophageal mucosa. These two aspects interact to create an imbalance between protective and aggressive factors in GERD. Conclusion: The interplay between gastric motility and acid secretion plays a key role in the transition from physiologic to pathologic mechanisms in GERD, so a thorough understanding of both is important in diagnosis and treatment strategies.

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