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Dian Andriani RD
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Fakultas Kedokteran Militer, Universitas Pertahanan Republik Indonesia In collaboration with Perdokmil (Perkumpulan Kedokteran Militer)
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The ASEAN Journal of Military and Preventive Medicine
Published by Universitas Pertahanan Republik Indonesia
ISSN : 30319447     EISSN : 3031870X     DOI : https://doi.org/10.47353/ajmpm
Core Subject :
The ASEAN Journal of Military and Preventive Medicine is an open-access, peer-reviewed scientific journal dedicated to advancing knowledge and innovation in the fields of military medicine, preventive medicine, biodefense, emergency medicine, disaster response, humanitarian health, and global public health. As one of the leading scholarly platforms in Indonesia and the ASEAN region, the journal provides an essential forum for researchers, military health professionals, clinicians, academics, and policymakers to disseminate high-quality research findings, emerging technologies, and interdisciplinary perspectives relevant to military and civilian healthcare systems. While military medicine remains the journal’s primary focus, contributions from allied disciplines with translational and practical impact are highly encouraged, particularly studies related to medical preparedness, humanitarian assistance, operational medicine, epidemiology, tropical diseases, public health resilience, and preventive healthcare strategies.
Arjuna Subject : -
Articles 32 Documents
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Effects of Switching from Conventional Cigarettes to Combustion-Free Nicotine Delivery Systems (C-FNDS) on Salivary TNF-alpha Levels and Gingival Conditions: A Randomized Controlled Trial Hanna Adianita; Indra Pribadi; Amaliya
The ASEAN Journal of Military and Preventive Medicine Vol. 2 No. 2 (2025): July
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v2i2.28

Abstract

Background: Tobacco smoking is an independent risk factor for periodontitis. Smokers may show impaired inflammatory responses, altered gingival vascular function, and increased salivary tumor necrosis factor-alpha (TNF-alpha). This study evaluated changes in salivary TNF-alpha levels and gingival conditions among smokers who switched from combustible tobacco cigarettes to combustion-free nicotine delivery systems (C-FNDS). Methods: This single-blind, open-label randomized controlled trial with 6-month follow-up was conducted at the Department of Periodontics, Dental and Oral Hospital, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia. Forty smokers were randomized into a C-FNDS switching group and a control group that continued combustible tobacco use. Gingival inflammation was assessed using the Modified Gingival Index (MGI), saliva samples were collected to measure TNF-alpha at baseline, 3 months, and 6 months, and exhaled carbon monoxide (CO) was assessed as a secondary outcome. Results: A total of 40 participants were analyzed. Switching to C-FNDS was associated with a reduction in salivary TNF-alpha levels over 6 months and lower MGI scores compared with continued combustible tobacco smoking. Exhaled CO decreased in the switching group, supporting reduced exposure to combustible tobacco products. Conclusion: Switching from conventional cigarettes to C-FNDS for 6 months was associated with reduced salivary TNF-alpha levels, lower gingival inflammation, and lower exhaled CO levels compared with continued combustible cigarette use.
Trauma and Body Temperature Management in Tropical Regions Frédéric Lapostolle; Dabor Resiere; Bruno Megarbane; Jean-Marc Pujo
The ASEAN Journal of Military and Preventive Medicine Vol. 2 No. 2 (2025): July
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v2i2.29

Abstract

Background: Trauma patients remain vulnerable to hypothermia even in tropical climates. Hypothermia worsens trauma outcomes through deleterious effects on hemostasis and cardiovascular function. Methods: This manuscript summarizes published evidence on trauma-related hypothermia, including mechanisms of heat loss, risk factors, physiologic consequences, and prevention strategies applicable to prehospital trauma care in tropical regions. Results: Hypothermia in trauma is multifactorial and may be triggered by environmental exposure, wet or undressed patients, head trauma, intubation, severe injury, impaired shivering, and infusion of unwarmed fluids. Body temperature below 36°C should be considered clinically relevant. Evidence indicates that hypothermia is associated with increased mortality, coagulopathy, platelet dysfunction, cardiovascular compromise, and greater transfusion requirements. Prevention requires systematic temperature measurement, limiting heat loss, early thermal protection, heated transport environments, warmed intravenous fluids, and rapid transport to hospital care. Conclusion: Trauma-related hypothermia is a poor prognostic factor and should be prevented and corrected worldwide, including in tropical areas. The therapeutic objective is to maintain body temperature at least 36°C.
The Relationship Between Body Composition and 12-Minute Run Test Among Cadet Medical Students in the Undergraduate Medical Program, Republic of Indonesia Defense University Disty Chania; Justin Munawar; Hanum Fadhilah; Antonius Reuben; Grace Corlesa; Roby Firmansyah; Markus Wibowo; Nirawan Putranto
The ASEAN Journal of Military and Preventive Medicine Vol. 2 No. 2 (2025): July
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v2i2.30

Abstract

Background: Body composition influences physical performance, including running ability. Muscle mass and fat mass are important determinants of strength, endurance, and movement efficiency. This study analyzed the relationship between body composition and 12-minute running distance among cadet medical students. Methods: This quantitative observational analytic study used a cross-sectional design. Cadet medical students from Cohort 4 of the Republic of Indonesia Defense University were recruited. Body composition was measured using bioelectrical impedance analysis, and running performance was assessed with a 12-minute run test. Associations between muscle mass, fat mass, and running distance were analyzed using simple linear regression. Results: Seventy-two cadets were included. The mean muscle mass was 43.5%, mean fat mass was 21.6%, and mean 12-minute running distance was 2376 m. Muscle mass showed a strong positive correlation with running distance, whereas fat mass showed a strong negative correlation. Male cadets had higher muscle mass and achieved longer running distances than female cadets. Conclusion: Body composition is significantly associated with 12-minute running performance. Higher muscle mass supports better running distance, whereas higher fat mass reduces running efficiency. Individualized training and nutritional strategies should consider body composition to optimize cadet fitness.
Heated Tobacco Products as a Harm Reduction Strategy in Surgical Patients Safer Than Smoking? : A Review Article Jeffrey Putra; Dianita Angeline
The ASEAN Journal of Military and Preventive Medicine Vol. 2 No. 2 (2025): July
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v2i2.31

Abstract

Background: Tobacco smoking is a well-established modifiable risk factor for poor postoperative outcomes, including delayed wound healing, increased infection risk, wound dehiscence, tissue hypoxia, and cardiopulmonary complications. In Indonesia, smoking prevalence remains high among surgical patients, while access to and compliance with preoperative cessation interventions remain limited. Heated tobacco products (HTPs), which deliver nicotine by heating rather than combusting tobacco, have emerged as a potential harm reduction alternative; however, their role and safety in surgical populations remain uncertain. Objective: This review aimed to evaluate current biological, toxicological, and clinical evidence comparing HTPs with conventional cigarettes in relation to wound healing and perioperative complications, and to assess their potential role as a harm reduction strategy in surgical patients. Methods: A narrative review was conducted using literature obtained from PubMed, Scopus, and Google Scholar, supplemented by grey literature from authoritative public health institutions. Publications from January 2010 to June 2025 were considered. Eligible studies included original articles, reviews, systematic reviews, human clinical studies, observational studies, and relevant preclinical studies reporting toxicological profiles, tissue oxygenation, immune response, inflammation, endothelial function, wound healing, infection, or perioperative complications. Data were extracted and synthesized thematically. Discussion: Conventional cigarette combustion generates numerous harmful substances, including tar, carbon monoxide, polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, aldehydes, heavy metals, and reactive oxygen species, which contribute to endothelial dysfunction, vasoconstriction, tissue hypoxia, oxidative stress, immune suppression, impaired fibroblast activity, reduced collagen synthesis, delayed wound healing, surgical site infection, and wound dehiscence. HTPs avoid direct combustion and may substantially reduce exposure to tar, carbon monoxide, and selected toxicants, potentially supporting better tissue oxygenation, vascular function, and microvascular perfusion. However, HTP aerosols still contain nicotine, volatile organic compounds, aldehydes, heavy metals, and tobacco-specific nitrosamines, which may continue to interfere with wound healing. Current evidence suggests that HTPs may pose a lower biological risk than conventional cigarettes, but direct clinical evidence in surgical populations remains limited. Conclusion: HTPs may offer a transitional harm reduction option for selected surgical patients unable or unwilling to achieve complete smoking cessation. Nevertheless, HTPs are not risk-free and should not replace complete smoking cessation as the standard of care for minimizing perioperative complications. Further prospective clinical trials and wound healing studies are required to evaluate the safety and effectiveness of HTPs in surgical populations.
Factors Influencing The Incidence Of Stress Fractures Based On The Characteristics of Command Education Students At The Special Forces Command Education And Training Center In Batujajar, West Java, Indonesia: A Retrospective Approach With Secondary Data claudiva kirana; Dian Andriani Ratna Dewi; Sissy chen; sausan maulida
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.34

Abstract

Stress fractures caused by repetitive mechanical loading represent a significant threat to physical performance and operational readiness among military personnel. This study aimed to identify factors associated with stress fracture occurrence among command education students at the Special Forces Education and Training Center in Batujajar, West Java, Indonesia. A retrospective descriptive study was conducted using secondary data from forty-three documented stress fracture cases collected over a six-year period. The variables analyzed included age, body mass index (BMI), and anatomical location of the fracture. Data were analyzed using univariate and bivariate descriptive analysis to characterize the distribution of stress fractures based on the studied variables. The results showed that the majority of cases occurred in individuals aged 20–25 years (90.7%), with the left tibia being the most frequently affected anatomical site (34.9%). All subjects had BMI values within the normal range, indicating no significant association between abnormal BMI and stress fracture occurrence. These findings suggest that age and fracture location are key characteristics of stress fractures among command education students. The study provides evidence to support the development of targeted prevention and early intervention strategies aimed at reducing stress fracture incidence, improving training completion rates, and enhancing the operational readiness of special forces personnel.
Application of Tactical Combat Casualty Care in the Management of a Proximal Left Leg Gunshot Wound: From Battlefield to Surgical Amputation – A Case Report Indra Pehulisa Sitepu; Hafidz Addatuang Ambong
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.35

Abstract

Gunshot wounds to the lower extremities can cause life-threatening haemorrhage and vascular injury, requiring rapid intervention according to Tactical Combat Casualty Care (TCCC) principles. This case describes a 24-year-old soldier with a proximal left cruris gunshot wound managed initially under fire with a tourniquet, hemostatic agents, analgesia, and tranexamic acid. After delayed evacuation due to battlefield conditions, further stabilization and surgical management revealed open fractures and popliteal artery injury. Despite vascular repair, prolonged ischemia exceeding the golden period resulted in irreversible tissue damage, necessitating amputation. This case highlights that while TCCC effectively improves survival, timely evacuation and early definitive vascular treatment are critical for limb salvage in combat settings.
Autoimmune Bullous Diseases In Pregnancy: A Systematic Review Of Clinical Presentation, Management, And Outcomes sausan maulida; Dian Andriani Ratna Dewi
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.36

Abstract

Background: Autoimmune bullous diseases during pregnancy are rare but clinically significant conditions that require special attention due to pregnancy-related immunological changes and the potential risk of maternal and fetal complications. Objective: This systematic review aimed to summarize the clinical characteristics, management strategies, and maternal–fetal outcomes of autoimmune bullous diseases occurring during pregnancy. Methods: A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, Web of Science, Embase, and the Cochrane Library for studies published between January 2021 and January 2025. From the 309 articles initially identified, 10 studies met the inclusion criteria and were included in the qualitative synthesis. Results: Pemphigoid gestationis was the most frequently reported autoimmune bullous disease, with disease onset predominantly occurring during the second to third trimester of pregnancy. Clinical manifestations varied widely, ranging from mild localized lesions to generalized bullous eruptions. Systemic and topical corticosteroids were the mainstay of treatment and were associated with favorable maternal outcomes in most cases. Reported maternal complications included intrauterine growth restriction (33%), oligohydramnios, and gestational hypertension. Neonatal involvement was observed in approximately 10–17% of cases and was generally self-limiting with a good prognosis. Conclusions: The management of autoimmune bullous diseases during pregnancy requires a multidisciplinary approach to optimize both maternal and fetal outcomes. However, current evidence remains limited, highlighting the need for further studies to establish standardized and evidence-based management protocols.
The Relationship Between Body Composition and 12 Minute Run Test Among Cadet Medical Students in The Undergraduate Medical Program Republic of Indonesia Defense University Disty Chania; grace corlesa; roby syah putra firmansyah; markus wibowo; nirawan putranto; justin ibnu hakim munawar; hanum fadhilah; Antonius Reuben
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.37

Abstract

Body composition significantly influences physical performance, including running ability. Muscle mass and fat mass are key factors in determining strength, endurance, and efficiency. This study analyzes the relationship between body composition and 12- minute running distance among cadet students in the Undergraduate Medical Program Cohort 4 at the Republic of Indonesia Defense University. This cross-sectional study measured body composition using bioelectrical impedance analysis (BIA) and assessed running performance through a 12-minute run test. Statistical analysis was conducted to evaluate the relationship between muscle mass, fat mass, and running distance. The study found a significant relationship between body composition and running performance. Male participants, with higher muscle mass and lower fat mass, outperformed females in average running distance and maximum distance achieved. Muscle mass and fat mass significantly affect 12-minute running performance, highlighting their importance in designing effective physical training programs. Further research is needed to explore additional factors influencing physical performance.
Cutaneous Anthrax In The Era Of Biodefense: Clinical Recognition, Biosurveillance, And Biosecurity Implications For Modern Health Care Systems — A Systematic Review sausan maulida; Dian Andriani Ratna Dewi
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.38

Abstract

Background: Cutaneous anthrax represents the most frequent clinical manifestation of Bacillus anthracis infection with dual threat as endemic zoonotic disease and potential bioterrorism agent, necessitating modern health systems to integrate proactive biosurveillance capabilities with robust biosecurity protocols for epidemiological and national security risk mitigation. Objective: To identify pathognomonic clinical characteristics and differential diagnostic algorithms, evaluate effectiveness of integrated biosurveillance platforms in detecting outbreak early warning signals, and formulate biosecurity implications for policy development and operational readiness of health facilities. Methods: Systematic literature review utilizing PubMed, Scopus, Web of Science, and Google Scholar databases covering 2015-2025 period with inclusion criteria of original research articles, systematic reviews, and clinical guidelines. Seven high-quality articles were analyzed using thematic narrative synthesis. Results: Identification of diagnostic complexity requiring laboratory confirmation through bacteriological culture or molecular testing, temporal gap in notification averaging 6.3 days, environmental pathogen persistence of 11.40% in soil samples, seroprevalence 9-11% in high-risk populations, and corticosteroid therapy efficacy in edema reduction (P<0.002). Conclusion: Optimization of clinical recognition through molecular diagnostic integration, strengthening biosurveillance architecture based on spatiotemporal One Health analysis, and formulation of responsive biosecurity policy represent essential pillars of preparedness against emergent biological threats. Keywords: Cutaneous Anthrax, Biosurveillance, Biosecurity
The Relationship Between Physical Activity Levels and Cardiorespiratory Fitness Among Cadet Medical Students in The Undergraduate Medical Program Cohort 4 at The Republic of Indonesia Defense University justin ibnu hakim munawar; Grace joselini corlesa; Roby syah putra firmansyah; Markus Wibowo; Nirawan Putranto; Disty Chania; Hanum zahra faras fadhilah; Antonius Reuben
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 1 (2026): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i1.39

Abstract

Background: Physical activity plays a crucial role in maintaining cardiovascular and pulmonary health, especially for Cadet Medical Students who are required to achieve optimal physical fitness. However, it remains unclear whether the physical activity levels of Cadet Medical Students in the Undergraduate Medical Program Cohort 4 at the Republic of Indonesia Defense University meet the necessary fitness standards. Objective: This study aims to analyze the relationship between physical activity levels and cardiorespiratory fitness among cadet students. Methods: A quantitative cross-sectional design was employed, involving 72 respondents selected using a total sampling technique. Physical activity levels were assessed using the Bouchard Activity Diary, while cardiorespiratory fitness was evaluated through the 12-minute Cooper Test, which was converted into VO2max values. Result and Analysis: The results showed that the majority of respondents had moderate (81.9%) and vigorous (18.1%) physical activity levels. The distribution of cardiorespiratory fitness indicated that 45.5% of male respondents had VO2max classified as excellent, whereas among female respondents, the majority (53.8%) fell into the good category. Spearman’s correlation test revealed a significant positive relationship between physical activity levels and cardiorespiratory fitness (r = 0.585, p < 0.001). These findings indicate that higher physical activity levels are associated with better cardiorespiratory fitness. In conclusion, there is a significant correlation between physical activity levels and cardiorespiratory fitness among Cadet Medical Students in the Undergraduate Medical Program Cohort 4 at the Republic of Indonesia Defense University. These results highlight the importance of maintaining an optimal level of physical activity to improve cardiorespiratory.

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