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Frontiers on Healthcare Research
Published by RSUP Dr M Djamil Padang
ISSN : 30327725     EISSN : -     DOI : https://doi.org/10.63918/fhr.v2.n2
Core Subject : Health,
Health Professions Public Health
The principal aim of Frontiers on Healthcare Research is to catalyze advancements in healthcare research that directly inform and improve the efficacy of health system operations, enrich patient experiences, and guarantee fairness in health service access
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 11 Documents
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Search results for , issue "Vol. 2 No. 2 (2025)" : 11 Documents clear
Effect of Papaya Seed on Mortality and Midgut Histopathology in Aedes aegypti Larvaes Agustini, Cynthia; Hasmiwati, Hasmiwati; Afriwardi
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p66-75.2025

Abstract

Background: Indonesia is an endemic region for Dengue infection. The World Health Organization (WHO) reported Dengue as one of the top ten global health threats in 2020. Dengue is a viral infection transmitted primarily by the Aedes aegypti mosquito, causing Dengue Fever and Dengue Hemorrhagic Fever. Temephos 1.25% has been the WHO recommended standard larvicide. However, prolonged use and continuously increasing doses may result in resistance and toxicity, posing risks to the environment and human health. This necessitates the discovery of alternative larvicides that are effective in killing larvae with minimal side effects, particularly those derived from natural materials. Methods: This research intends to illustrate the impact of papaya seed extract on the death rate of larvae and the histopathological changes in the midgut of Ae. aegypti larvae. A genuine experimental framework featuring a control group with only post-testing was utilized for this investigation. The sample comprised 750 Ae. aegypti larvae, which were categorized into six groups: one negative control group (aquades), one positive control group (temephos 1. 25%), and four treatment groups using papaya seed extract at varying concentrations of 2 mg/ml (P1), 2. 5 mg/ml (P2), 3 mg/ml (P3), and 3. 5 mg/ml (P4). Results: The results showed that all larvaes died within 24 hours in the positive control, P1, P2, P3, and P4 groups. Probit analysis of papaya seed extract revealed LC50 at 2.599 mg/ml and LC90 at 4.776 mg/ml after 8 hours of exposure. Conclusion: This study concludes that papaya seed extract affects larval mortality and midgut histopathology alterations in Ae.aegypti larvae. These findings indicate that papaya seed extract holds great potential as a natural and environmentally safe as alternative larvicide to disrupt the development of dengue fever vectors.
Comparison of Rockall and Glasgow-Blatchford Scores in GI Bleeding Boğa, Erkan
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p1-9.2025

Abstract

Background: This study aimed to compare the clinical effectiveness of the Rockall score and the Glasgow-Blatchford Score (GBS) in patients presenting to the emergency department with suspected gastrointestinal bleeding. Methods: A retrospective cross-sectional study was conducted on 350 patients admitted to Esenyurt Necmi Kadıoğlu State Hospital between January 1, 2023, and December 31, 2024, with complete clinical data. The study evaluated the predictive performance of both scoring systems regarding 30-day mortality, rebleeding, need for blood transfusion, and intensive care unit (ICU) admission. Results: The GBS demonstrated superior performance over the Rockall score in early risk assessment and in guiding hospital admission or discharge decisions. Conversely, the Rockall score was more effective in predicting long-term prognosis and the risk of rebleeding. According to ROC analysis, GBS (AUC: 0.83) outperformed the Rockall score (AUC: 0.78) in predicting mortality. Subgroup analysis indicated that the predictive value of the Rockall score declined in patients on anticoagulant therapy, while both scores showed increased predictive accuracy in patients aged ≥65 years. Conclusion: The findings suggest that the GBS is more suitable for early clinical decision-making in the emergency setting, whereas the Rockall score should be considered for long-term risk evaluation in patients with gastrointestinal bleeding.
Coexistence of Infective Endocarditis and Recurrent Acute Rheumatic Fever: A Case Report Kino, Kino; Hariyanto, Didik; Fernando, Harben; Fahlevi, Indra
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p29-34.2025

Abstract

Background: Infective endocarditis (IE) and recurrent acute rheumatic fever (ARF) are two serious cardiovascular conditions frequently associated with rheumatic heart disease (RHD). Their coexistence complicates diagnosis and management due to overlapping clinical features such as fever, migratory arthritis, and valvular dysfunction. This case report aims to elucidate the clinical presentation, diagnostic challenges, and treatment strategies in a pediatric patient with coexisting IE and recurrent ARF.   Methods: A detailed clinical case study was conducted involving a 10-year-old boy with a history of RHD presenting with joint pain and intermittent fever. Diagnostic evaluations included physical examination, laboratory investigations (including blood cultures and antistreptolysin O titers), and serial transthoracic echocardiography. Therapeutic interventions combined targeted intravenous antibiotics, corticosteroids, and secondary prophylaxis with benzathine penicillin G. Multidisciplinary consultations were employed to optimize management. Results: The patient exhibited echocardiographic evidence of mitral valve vegetations along with severe mitral regurgitation. Blood cultures remained negative, likely due to prior antibiotic exposure. Elevated antistreptolysin O titers confirmed recent streptococcal infection supporting recurrent ARF diagnosis. Clinical improvement was observed with symptom resolution and reduction in vegetation size on follow-up echocardiography. Multimodal therapy was well-tolerated, preventing further complications. Conclusion: This case highlights the diagnostic complexity and therapeutic balancing act required in managing coexisting IE and recurrent ARF in children with RHD. Early recognition through comprehensive evaluation and integrated treatment combining antimicrobial and immunomodulatory approaches can improve outcomes. Continued vigilance and multidisciplinary care are essential for preventing morbidity in this high-risk population.
Single denture as a treatment for a patient with TMD: a case report Andi, Adytha Mutiah; Arsista, Dede; Aprianto, Dharma Satya; Priambodo, Agung
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p76-81.2025

Abstract

Background: Temporomandibular joint disorder is a chronic pain caused by various factors including trauma, occlusal condition, and stress. This case report will explain about TMD case in prosthodontic which is treated with a single denture. Methods: A 50-year-old woman came to the dental clinic with aches and pains in the jaw and muscles around the head and neck. She has been using a removable denture since two months ago, but she feels uncomfortable with it. We made a new denture with an appropriate vertical dimension for the patient, with the tooth arrangement as close to the compensating curves as possible. We also trained her to do some exercises for the head and neck muscle. Results: After wearing the new denture and doing a series of muscle therapy, the patient begins to feel that the aches and pains are starting to decrease. She can more easily open and close her mouth and her lower jaw no longer feels so vibrating. Conclusion: Based on the results of clinical and subjective examinations, apart from tooth loss, all the conditions experienced by the patient also seem to be related to emotional stress due to the problems encountered.
Incidence and Risk Factors of Stroke-Associated Pneumonia in Ischemic Stroke with Dysphagia: A Cross-Sectional Study Sukiandra, Riki; Maryanti, Yossi; Sucipto; Juananda, Desby; Trihardi, Rizfan; Risman, Salsa Wiratama; Qadriyyah, Lu’lu’ul; Ashiddiqi, Hafil
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p51-57.2025

Abstract

Background: Stroke-associated pneumonia (SAP) is a common and debilitating complication following stroke, typically occurring within the first 7 days of onset in about one-third of patients with acute ischemic stroke. SAP significantly contributes to increased morbidity, mortality, and healthcare costs due to prolonged hospitalizations. In Riau, the reported prevalence of stroke is 8.3%, which has been rising since 2013, alongside an increase in SAP cases. Dysphagia, defined as difficulty swallowing, is a major risk factor for SAP as it predisposes patients to aspiration, a leading cause of pneumonia. If left untreated, dysphagia can lead to dehydration and electrolyte imbalance. Despite the clinical importance of SAP, local data regarding its incidence and associated risk factors at Arifin Achmad General Hospital in Riau Province is lacking. This study aims to investigate the incidence and risk factors associated with SAP in ischemic stroke patients with dysphagia. The findings are expected to provide evidence-based references to improve neurointensive care and preventive strategies for SAP in this patient population. Methods: This cross-sectional study was conducted at Arifin Achmad General Hospital, Riau Province, from August to November 2023. Ischemic stroke patients who underwent the Water Swallow Test (WST) were included. Dysphagia, electrolyte imbalance, and SAP were the key variables. Data were collected from medical records and observation sheets. Statistical analysis was performed using the Chi-square test (p < 0.05) with SPSS version 25. Results: The study found that 37.5% (15 patients) of ischemic stroke patients developed stroke-associated pneumonia, while 42.5% experienced dysphagia. The majority of these patients were aged 51-60 years (41.2%), male (58.8%), had their first stroke attack (60%), and had multiple risk factors (73.3%). A significant number of dysphagia patients had low electrolyte levels. The most common lesion locations in dysphagia patients were bilateral (66.7%). There was a significant correlation between dysphagia and the incidence of SAP (p=0.000). Patients with dysphagia had 78.75 times higher odds of developing SAP (95% CI: 9.95-622.6) compared to those without dysphagia. Conclusion: SAP is a frequent complication in ischemic stroke patients. Future prospective studies should adopt a unified definition, strict inclusion criteria, and long-term follow-up to better identify the incidence, prognosis, and related factors of SAP.
Weighted Scoring Design for ART Healthcare Centre Devarakonda, Shiva; Vaghela, Arjunsinh; Chudasama, Jalpaba
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p18-28.2025

Abstract

Background: Antiretroviral Therapy (ART) centers are critical in providing medical, psychological, and social support to People Living with HIV (PLHIV), as per the National AIDS Control Organization (NACO) guidelines. However, many ART centers in India face infrastructural inefficiencies, including overcrowding, poor ventilation, inadequate sanitation, and non-compliance with updated regulations. The existing layout of a long-operational ART center, established in 2008, has demonstrated such inefficiencies, necessitating a strategic redesign to optimize operational flow and improve patient outcomes. Methods: This study employed a weighted scoring system to evaluate and compare three proposed layout alternatives against the existing design. The methodology included activity flowchart mapping, space utilization studies, stakeholder input, and multi-criteria decision analysis. Twelve design evaluation criteria were prioritized using weighted scores, including feasibility (11%), patient safety (10.5%), workflow efficiency (10%), and objective adherence (13%). Designs were assessed for spatial efficiency, safety, robustness, usability, and environmental impact. Results: Design 3 achieved the highest weighted score of 6.91, outperforming Design 2 (6.865), Design 1 (5.645), and the original layout (5.275). The optimal layout improved patient flow, integrated dedicated counseling areas, enhanced staff workspaces, and improved sanitation and ventilation. Correlation analyses highlighted critical interdependencies and trade-offs among feasibility, safety, and cost factors. Design 3 also demonstrated a 30–40% reduction in congestion, compliance with NACO standards, and enhanced operational efficiency. Conclusion: The weighted scoring methodology effectively identified the optimal ART center layout. Design 3 significantly improved spatial organization, privacy, hygiene, and workflow. Future work could incorporate IoT-based monitoring and AI-driven real-time optimization for adaptive facility management. This model can be extended to other healthcare infrastructure redesigns to enhance quality and compliance.
Comparing Postoperative Fentanyl Use: Ibuprofen VS Ibuprofen-Dexamethasone as Preemptive Analgesia Herman, Awanda; Hidayat, Nopian; Sukiandra, Riki; Johannas
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p45-50.2025

Abstract

Background: Fentanyl is the most frequently used opioid analgesic for managing postoperative pain. While effective, it is associated with various side effects. Postoperative pain is mainly due to acute tissue damage. Several studies have shown that administering preemptive analgesia before anesthesia can help reduce postoperative pain, thus decreasing the need for fentanyl and its side effects. Methods: This research employed a randomized controlled trial (RCT) with a double-blind design. Postoperative pain was measured using the Numeric Rating Scale (NRS). Patients with an NRS score above 6 received fentanyl. Statistical analysis was conducted to compare the impact of preemptive analgesia with Ibuprofen 800 mg alone versus Ibuprofen 800 mg combined with Dexamethasone 10 mg in patients undergoing postoperative gynecological abdominal surgery. Results: The findings revealed a significant difference in NRS pain scores between the groups. The group receiving the combination of Ibuprofen 800 mg and Dexamethasone 10 mg had a 69% reduction in the need for postoperative fentanyl compared to the group that received only Ibuprofen. Conclusion: Patients who received preemptive analgesia with Ibuprofen and Dexamethasone had lower pain scores and a reduced need for fentanyl in the postoperative period compared to those receiving Ibuprofen alone.
Xenotransplantation in Healthcare: A Literature Review of Clinical Advances, Immunological Barriers, and Ethical Challenges Thongwichian, Phonchai; Sari, Melsi Pita
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p82-91.2025

Abstract

Background: The global shortage of donor organs remains a critical challenge in healthcare, driving the search for alternative strategies to reduce waiting list mortality. Xenotransplantation the transplantation of organs, tissues, or cells across species—has emerged as a promising solution. Advances in genetic engineering, immunological modulation, and tissue preservation have accelerated progress, yet clinical translation remains constrained by unresolved biological and ethical barriers.Objectives: This review aimed to systematically evaluate the current evidence on xenotransplantation, focusing on its safety, efficacy, immunological challenges, and societal implications, in order to assess its readiness for integration into clinical practice.Methods: A literature review was conducted in this study. PubMed and Scopus were searched for publications between January 2020 and August 2025. Eligible studies included clinical reports, preclinical experiments, mechanistic investigations, and survey-based studies addressing xenotransplantation. Data were extracted on study design, xenograft type, intervention details, and reported outcomes. Due to heterogeneity, results were synthesized narratively.Results: Twenty studies were included. Clinical reports demonstrated that genetically engineered pig organs could function in humans for several weeks, though rejection, coagulation dysregulation, and viral reactivation remain obstacles. Preclinical models in nonhuman primates and rodents confirmed prolonged graft survival with multigene donor modifications and costimulation blockade. Cellular approaches, including porcine islets and ovarian tissue grafts, showed promise in metabolic and reproductive medicine. Surveys revealed moderate public support but persistent concerns regarding safety and ethics.Conclusion: Xenotransplantation has progressed from experimental proof-of-concept to early clinical application. While advances in genetic editing, immunosuppression, and graft preservation are encouraging, clinical translation will require overcoming immunological and infectious barriers, alongside addressing societal and ethical considerations, to ensure safe and sustainable implementation in healthcare.
Epidemiology and Clinical Patterns of Leprosy: A Retrospective Study at Dr. M. Djamil General Hospital, Padang, Indonesia Ariani, Tutty; Triani , Aisha; Aulia , Salsabila Syafna
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p35-44.2025

Abstract

Background: Indonesia ranks third globally in the number of leprosy cases, following Brazil and India. Despite this, leprosy remains a neglected disease. Monitoring its epidemiology through retrospective studies is essential to inform effective disease control programs. Methods: This retrospective descriptive study reviewed medical records of leprosy patients who visited Dr. M. Djamil General Hospital, Padang, between 2021 and mid-2024. Data were extracted from patients’ electronic medical records. Results: A total of 92 patients were confirmed with leprosy during the study period. The incidence increased from 13 patients in 2021 to 22 in 2022, and 40 in 2023, with 17 additional cases identified by mid-2024. Of these, 70 (76.1%) were multibacillary cases and 22 (23.9%) were paucibacillary cases. Male patients predominated, with a mean age of 35 years (range: 7–79 years). Leprosy reactions occurred in 44 patients (47.8%), consisting of 20 (45.5%) reversal reactions and 24 (54.5%) erythema nodosum leprosum (ENL). Most cases originated from Pesisir Selatan Regency and Pariaman City, both recognized as high-endemic areas in West Sumatra Province. Conclusion: The incidence of leprosy is rising annually, with multibacillary cases predominating. Male patients are more frequently affected, and nearly half experience leprosy reactions, with ENL more common than reversal reactions. Strengthened disease control strategies are urgently needed to detect and reduce new cases in endemic regions. Study limitations include reliance on retrospective medical record data and a single tertiary hospital setting.
Assessment of Functional Outcome of Intertrochanteric Fractures Treated by PFN A2 in Elderly Patients in a Tertiary Care Hospital Thimmaiah, Sreenivas; TP, Avinash; B, Padmini Kumari
Frontiers on Healthcare Research Vol. 2 No. 2 (2025)
Publisher : Rumah Sakit Umum Pusat (RSUP) Dr. M. Djamil

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63918/fhr.v2.n2.p10-17.2025

Abstract

Background: The Proximal Femoral Nail Antirotation (PFNA2) surgical implant has been developed as an efficient internal fixation device for treating intertrochanteric fractures. This study aims to evaluate the functional outcomes of geriatric patients with intertrochanteric fractures treated with the PFNA2, focusing on pain alleviation and hip function recovery. Materials and Methods: This was a single-center, observational, prospective study conducted at a tertiary care hospital. A total of 100 patients with intertrochanteric fractures were included. Patients treated with PFNA2 were followed up for 6 months. The functional outcomes were measured using the Visual Analogue Scale (VAS) for pain and the Harris Hip Score (HHS) for hip function. Results: The average age of the 100 patients was 66.47 ± 6.66 years. The majority of patients in this study had A2-type fractures, as classified by the AO/OTA system. Both the VAS for pain and the HHS for hip function showed significant improvement between the pre-operative and 6-month post-operative assessments. Conclusion: The Proximal Femoral Nail A2 is an excellent treatment option for elderly patients with intertrochanteric fractures, providing significant improvements in pain relief and functional outcomes.

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