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International Journal of Integrated Health Sciences
Published by Universitas Padjadjaran
ISSN : 23021381     EISSN : 23384506     DOI : 10.15850/ijihs
Core Subject : Health,
Health Professions
International Journal of Integrated Health Sciences (IJIHS) is a peer-review journal which publishes original articles, medical research, clinical research and case report. This journal is supported by Faculty of Medicine Universitas Padjadjaran and was launched on September 22nd 2012 and firstly published on July 2013. The first and second publications in 2013 and 2014 were published annually. In 2015 IJIHS published twice in a year, March and September.
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Articles 12 Documents
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Search results for , issue "Vol 13, No 2 (2025)" : 12 Documents clear
Electrolyte Dysregulation in Diabetic with Advanced Chronic Kidney Diseases (CKD): Comparative Analysis of CKD Stages 4 and 5 Tanjung, Asbar; Lembagus Wirawan, Riceina Javonda
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4197

Abstract

Background: Electrolyte imbalance is common in both diabetes mellitus (DM) and chronic kidney disease (CKD). While they may occur independently, their coexistence can exacerbate metabolic disturbances, thereby accelerating disease progression and impairing quality of life. Objective: to investigates the differences in electrolyte profiles between patients with CKD stages 4 and 5 with DM.Methods: A cross-sectional comparative design study was employed. A hundred participants (50 with CKD stage 4 and 50 with CKD stage 5 with DM) were recruited from a clinical laboratory during May to June 2024. Serum natrium, kalium, and chloride levels were measured alongside urea, creatinine, GFR, and glucose. The Mann-Whitney U test was applied to compare the electrolyte levels between these CKD stages.Results: Of 100 participants, more men participating in this study (66% vs. 34%). Pre-elderly (45-59 y.o.) was the most predominant (61%), followed by elderly (>60 years,  20%), and adult (26-45 y.o., 19%). Both groups showed elevated urea, creatinine, and glucose levels with reduced GFR, confirming advanced CKD and DM. There was no significant difference in glucose level between stage 4 and stage 5. A significant difference (p=0.001) was observed in natrium levels, with stage 5 CKD patients exhibiting lower levels compared to those in stage 4. In contrast, kalium and chloride levels showed no significant difference (p=0.71 and p=0.81, respectively) in both groups.Conclusion: This study highlights the specific vulnerability of natrium homeostasis in advanced CKD with diabetes. Natrium dysregulation observed in stage 5 CKD underscores the need for close monitoring and management of sodium levels in this population.
A Pediatric Case of Kawasaki Disease with Gastrointestinal Involvement Mimicking Acute Abdomen Patil, Prabhakar; Michael, Anwar Mousa
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4577

Abstract

Background: Kawasaki Disease (KD) is a childhood acute vasculitis that predominantly affects medium-sized arteries, particularly the coronaries. While classical KD is diagnosed on the basis of defined clinical criteria, atypical presentations, such as with gastrointestinal (GI) involvement, can obscure timely recognition of this disease. GI symptoms, observed in subset of cases, may mimic acute surgical abdomen.Objective: To highlight the diagnostic challenge of Kawasaki Disease with predominant gastrointestinal symptoms mimicking acute abdomen in a pediatric case, and to emphasize the importance of early recognition and timely initiation of intravenous immunoglobulin (IVIG) therapy to prevent potential cardiac complications.Case: This is the case report of a 7-year-old male who was admitted with high-grade fever, severe abdominal pain, and signs suggestive of an acute abdomen. Initial clinical assessment and abdominal ultrasound indicated mesenteric lymphadenitis. Laboratory findings revealed marked leukocytosis, anemia, thrombocytosis, and elevated inflammatory markers (ESR, CRP) along with increased NT-proBNP suggestive of systemic inflammation. Further imaging ruled out surgical pathology. The persistence of fever, along with emerging mucocutaneous signs, led to the diagnosis of KD. The patient was treated with intravenous immunoglobulin (IVIG) and supportive therapy. Fever resolved within 24 hours, and abdominal symptoms improved markedly. Patient was then discharged afebrile with no evidence of coronary artery abnormalities on echocardiography.Conclusion: This case illustrates that persistent fever and elevated inflammatory markers in the presence of GI symptoms should prompt consideration of KD, even in the absence of full diagnostic criteria. Early diagnosis and IVIG therapy are important as delayed diagnosis may lead to significant cardiac sequelae.
Arterial Blood Gas Analysis and Dyselectrolytemia in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD) Reddy, Nivedita Tayamgol; Patil, Sachin; Reddy, Kailash
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4565

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is one of the important causes of  morbidity, mortality, and healthcare burden. Electrolyte disturbances and acid–base imbalances are frequent but under-recognized complications that may worsen outcomes in cases of AECOPD.Objective: To understand the prevalence of serum electrolyte abnormalities and arterial blood gas (ABG) parameters in patients admitted with AECOPD.Methods: This prospective observational study enrolled 200 patients with confirmed AECOPD admitted to a tertiary care hospital in Kalaburagi, India, over an 18 month period. The ABG analysis and serum electrolytes (sodium, potassium, magnesium, chloride) measurement were performed at admission. Demographic, clinical, and radiological data were also collected. Data were then analyzed using SSPS 23.0, with a P value of < 0.05 considered statistically significant.Results: Abnormalities related to sodium (91.5%), potassium (90.5%), magnesium (80.5%), and chloride (56%) were common in cases admitted with AECOPD. In 45% cases, the PaO₂ <50 mmHg  was seen whereas PaCO₂ >45 mmHg was found in 43%. Acid–base imbalance was seen  in 35% cases, with 4.5% showing severe acidosis (pH ≤7.1). Cough (72.5%) and breathlessness (60.5%) were most common symptoms. The majority were elderly males (65%) whereas 57% were smokers. Diabetes was the most common comorbidity (30.5%).Conclusion: Electrolyte abnormalities and ABG derangements are nearly universal in AECOPD and have important prognostic implications. Routine metabolic profiling should be integrated into the acute management of COPD to improve outcomes, particularly in resource-constrained settings.
Gastrointestinal Manifestations and Neutrophil-to-Lymphocyte Ratio as Marker of Occult Bleeding in COVID -19 Maghfirah, Desi; Yusuf, Fauzi; Marisa, Marisa; Eljatin, Muhammad Ridho Akbar
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4210

Abstract

Background: Coronavirus disease 2019 (COVID-19) was initially recognized as a respiratory illness; however, it has been gradually recognized as a disease that affects multiple organ systems, including the gastrointestinal (GI) tract. GI involvement ranges from mild symptoms, such as nausea and diarrhea, to complications like gastrointestinal bleeding. The neutrophil-to-lymphocyte ratio (NLR) has been proposed as a simple biomarker of inflammation and disease severity in COVID-19.Objective: To describe gastrointestinal manifestations of COVID-19 and examine the association between NLR levels and occult gastrointestinal bleeding.Methods: This cross-sectional study was conducted in 2021 at the New-Emerging and Re-Emerging Infectious Diseases inpatient unit of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia. COVID-19-positive patients aged ≥18 years with gastrointestinal symptoms were included, excluding those who were pregnant or had pre-existing GI disorders. Data were collected from medical records and patient interviews. Statistical analysis was performed using the Mann–Whitney U test, with p < 0.05 considered significantResults: The most frequent symptoms were appetite loss and nausea (93%), bloating and vomiting (87%), and diarrhea (57%). Occult GI bleeding occurred in seven patients (23.3%) who had significantly higher NLR values than those without bleeding (p = 0.041).Conclusion: The most frequent GI manifestations of COVID-19 are loss of appetite, nausea, bloating, vomiting, and diarrhea, while occult gastrointestinal bleeding occurs in about one-fourth of cases. Elevated NLR levels are associated with occult bleeding, suggesting its potential role as a simple and accessible biomarker of intestinal inflammation and disease severity.
In-Hospital Outcomes Comparison Between Off-Pump and On-Pump CABG: Indonesian Tertiary Center Experience Dewi, Triwedya Indra; Jungjunan, Ridho; Raharjo, Pradana Pratomo; Rezkita, Aliya Rahmadewi; Hidayat, Syarief; Martha, Januar Wibawa; Nusjirwan, Rama; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4119

Abstract

Background: Coronary artery disease (CAD) often requires revascularization. Coronary artery bypass grafting (CABG) is a cornerstone intervention that improves patients’ survival. Both on-pump and off-pump CABG have their own advantages and limitations, with reported outcomes vary across studies.Objective: to investigate the differences in the outcomes of patients undergoing off-pump and on-pump CABG.Methods: A retrospective cohort study was performed on 186 patients aged ≥18 years undergoing on-pump or off-pump CABG between June 2020 and December 2023. Outcomes included were all-cause mortality, postoperative acute renal failure, length of postoperative stay, and complete revascularization rate. Comparative analysis was conducted using Chi-Square test and independent T-test. Multivariate analysis, including logistic regression tests, was carried out to identify independent predictors associated with each outcome.Results: The on-pump group presented more diabetes (42.9% vs. 28.4%; P=0.040) and lower left ventricular ejection fraction (LVEF) values (43 [IQR 16–79] vs. 53 [23–75]; P=0.001). Patients in this group also had higher rates of postoperative renal failure (61.5% vs. 24.2%; P<0.001), longer stays (64.8% vs. 41.1%; P=0.001), and better complete revascularization (98.9% vs. 92.6%; P=0.035), but no significant difference in mortality (16.5% vs. 13.7%; P =0.594). Multivariate analysis identified diabetes, LVEF ≤40%, and postoperative renal failure as predictors of mortality.Conclusions: On-pump CABG is associated with higher rates of complete revascularization. However, the adoption of this technique is linked to a higher risk of postoperative acute kidney failure and prolonged hospital stays. No difference in mortality is observed between those with off-pump and on-pump.
Correlation between Health Service Quality, TB Patient Behavior, and Treatment Compliance Syahadat, Dilla Srikandi; Buchair, Nur Hikmah; Sari, Nur Fadhilah; Azzahra, Nur Azizah
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4265

Abstract

Background: Tuberculosis (TB) remains a major public health problem in Indonesia, where treatment adherence is essential for preventing drug resistance, treatment failure, and continued transmission. The quality of health services and patient behavior are key determinants influencing adherence, particularly at the primary healthcare level.Objective: To analyze the effect of health services and tuberculosis (TB) patients’ behavior on adherence to TB treatment in Palu City.Methods: A cross-sectional study was conducted among 100 TB patients attending 14 community health centers (Puskesmas) in Palu City, Indonesia, selected through cluster random sampling. Data were collected from August to September 2024 using structured questionnaires. Univariate and bivariate analyses were performed, with statistical testing conducted using the Spearman rank correlation at a 95% confidence level (α = 0.05).Results: Most respondents were from Talise Health Center (12%), aged 21–29 years (24%), self-employed (50%), and had completed high school education (45%). Overall, 84% were treatment-compliant, and 97% demonstrated a positive attitude. All respondents with a less favorable attitude were non-compliant, while 86.6% of those with a good attitude were compliant. Regarding health services, 96% reported good services, and 86.5% of them were compliant, compared to 25% among those with poor services. Significant associations were found between attitude (ρ = 0.000, r = 0.417), health service quality (ρ = 0.000, r = 0.455), and treatment adherence.Conclusion: There is a significant association between the quality of healthcare services,  patient attitudes, and adherence to TB treatment. Strengthening patient-centered services and ongoing counseling at Puskesmas are essential to sustain treatment success and reduce transmission.
Association Between Cardiovascular Risk Factors and CAD Severity by CAD-RADS Categories and Comprehensive CTA Score Raharjo, Pradana Pratomo; Purnomowati, Augustine; Kusumawardhani, Nuraini Yasmin; Astuti, Astri; Achmad, Chaerul; Pramudyo, Miftah; Karwiky, Giky; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4173

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide, including in Indonesia. Risk factors (RFs) play an important role in both pathogenesis and management of cardiovascular (CV) diseases. Coronary computed tomography angiography (CTA) is a reliable non-invasive diagnostic method. Coronary Artery Disease Reporting and Data System (CAD-RADS) categories and comprehensive CTA score describes CAD severity on coronary CTA and provides additional prognostic value.Objective: To explore the link between traditional cardiovascular risk factors and CAD severity based on CAD-RADS and comprehensive CTA scores.Methods: This retrospective, single-center study was conducted at a tertiary hospital using data from the Cardiovascular Imaging Database of the hospital from January 2020 to June 2022. Data meeting the inclusion and exclusion criteria were analyzed using ordinal and binary regressions.Results: A total of 423 patients' data were analyzed. Ordinal regression revealed significant links between age ≥ 65 years, male gender, hypertension, diabetes, and higher CAD severity based on both CAD-RADS and comprehensive CTA scores. Binary regression showed that older age and male gender were independently associated with CAD-RADS ≥ 3 and comprehensive CTA score ≥ 6. Diabetes was linked to CAD-RADS ≥ 3, and hypertension was tied to a comprehensive CTA score ≥ 6. The number of risk factors showed a trend toward CAD severity (p=0.069) and a significant link with comprehensive CTA score (p=0.012).Conclusion: There is a significant association between traditional cardiovascular risk factors and CAD severity as quantified by both CAD-RADS and comprehensive CTA score.
Relationship between Neutrophil-Lymphocyte Ratio and Type of Febrile Seizures Event Putra, Agus Indra Yudhistira Diva; Mustika, Putu Pradnyanita; Suryawan, Wayan Bikin
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4291

Abstract

Background: Febrile seizure is a common neurological condition affecting children. Complete blood count (CBC)  is often used as the initial test to help determine the etiology of fever based on hematology parameters in the emergency ward.Objective: To analyze the relationship between neutrophil-lymphocyte ratio (NLR) and the type of febrile seizure  among pediatric patients admitted to Wangaya General Hospital Denpasar, Indonesia.Methods: A cross-sectional design was implemented on a study using medical records of 44 children aged 6 month-5 years old admitted to the Wangaya Hospital between January 1, 2023, and September 8, 2024. Participants were grouped into simple and complex febrile seizures.Results: Among patients who experienced the first febrile seizure, the complex type accounted for most hospitalizations (n=33, 75.0%). The majority of cases occurred in children aged ≤24 months (n=32, 72.7%) with a temperature of >38°C (n=27, 61.4%). Seizure duration was ≤15 minutes in most cases (n=41, 93.9%), with upper Respiratory Infection being the most common etiology (n=20, 45.5%). NLR did not differ significantly between the simple and complex febrile seizures (P value =0.894), with a prevalence ratio (PR) of 1.1. Additionally, leukopenia, lymphocytopenia, and neutrophilia were observed in 28 (63.6%), 23 (52.3%), and 24 (54.5%) patients, respectively.Conclusion: There is no significant relationship between NLR and the type of first febrile seizures. Seizures are more frequently observed in males, particularly those aged 6-24 months with body temperature exceeding 38°C. The mean NLR of 2.78 ± 2.38 and upper respiratory infection are the most frequently associated conditions.
Impact of Nutrition Education on Dietary Habits among Bachelor-in-Medicine, Bachelor-in-Surgery (MBBS) Students: A Study in an Indian Medical College Kumar, Sudeep; Sah, Sumesh Prasad; Kumar, Dinesh; Arora, Manish; Sharma, Shiwani
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4309

Abstract

Background: Unhealthy eating patterns, often triggered by academic pressures and erratic schedules, can negatively impact students’ health and hinder their ability to effectively guide future patients. Nutrition education offers a valuable opportunity to promote healthier eating habits by providing critical knowledge that supports both students’ personal wellbeing and professional competence.Objective: To evaluate the effect of nutrition education on eating habits of first-year Bachelor-in-Medicine, Bachelor-in-Surgery (MBBS) among medical students.Methods: A pre-post interventional study was carried out on 200 Phase-1 MBBS students of Muzaffarnagar Medical College between January and June 2024. Initial dietary habits were assessed using a validated questionnaire. A structured session of nutrition education was provided. The dietary habits were then re-assessed after four weeks, and changes were analyzed using paired statistical tests.Results: Data collected after the intervention showed notable enhancements in dietary practices. The percentage of students consuming three balanced meals a day increased from 32% to 68% (p < 0.001). The intake of fast food decreased from 65% to 35%, and the consumption of sugar-sweetened beverages fell from 58% to 30%. The average servings of fruits and vegetables consumed daily rose from 2.1 to 4.5 (p < 0.01). Nutrition knowledge scores presented a 30% improvement, indicating greater awareness.Conclusion: Medical students' eating habits are much improved by nutrition education, underscoring its significance in medical education. Future healthcare workers may benefit from lifelong good eating habits if such programs are incorporated into the curriculum, which would improve patient care and their own health.
Predictive Factors of Neutropenia Following First Cycle of Chemotherapy in Patients with Non-Hodgkin’s Lymphoma in Bali, Indonesia Pratiwi, Made Sindy Astri; Agustini, Made Priska Arya; Yani, Made Violin Weda; Rena, Ni Made Renny Anggreni
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4178

Abstract

Background: Chemotherapy-induced neutropenia (CIN) is a common hematologic toxicity that increases infection risk, hospitalization, and treatment delay. Limited data exist on predictive factors of CIN among non-Hodgkin’s lymphoma (NHL) patients in Indonesia, particularly in Bali.Objective: To identify predictive factors of neutropenia following the first cycle of chemotherapy in patients with NHL at Prof. I.G.N.G Ngoerah General Hospital, Bali, Indonesia.Methods: This retrospective cohort study included all NHL patients treated from 2020–2023. Eligible patients were aged ≥18 years, received CHOP-based regimens with or without rituximab, and did not receive G-CSF prophylaxis. Data were obtained from medical records. Assessed risk factors were age, gender, BMI, comorbidities, histopathology grading, extranodal involvement, ECOG status, Ann Arbor stage, IPI score, chemotherapy regimen, pre-treatment blood count, eGFR, LDH, and albumin. The incidence of neutropenia was evaluated after the first chemotherapy cycle.Results: The mean age of the eligible patients (n=112) was 54.53 ± 14.64 years; 46 of them (41%) developed neutropenia. Significant factors associated with neutropenia were histopathology grading (p = 0.030), Ann Arbor stage (p = 0.048), IPI score (p = 0.037), chemotherapy regimen (p = 0.019), and LDH above normal (p = 0.049). Multivariate analysis identified high IPI scores (p = 0.016; OR 6.375; 95% CI 1.416–28.698) and CHOP regimen (p = 0.016; OR 3.033; 95% CI 1.230–7.476) as independent predictors of CIN.Conclusion: High IPI scores and CHOP regimens are strong predictors of neutropenia after the first chemotherapy cycle in NHL patients. Early identification of high-risk patients is essential for preventive management and improved treatment outcomes.

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