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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 199 Documents
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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.
Relationship Between Blood Pressure and Intraocular Pressure in Patients at the Ophthalmology Clinic of Hospital X Jakarta, Indonesia Purwakusuma, Anindya Emiraryanti; Batubara, Lilian; Poerwanto, Eko
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.v13n2.4319

Abstract

Background: Hypertension, a prevalent and often asymptomatic condition, has been associated with various ocular disorders. Ocular hypertension, in particular, is a notable risk factor for glaucoma. Understanding the relationship between systemic blood pressure and intraocular pressure is important for early detection of ocular hypertension and prevention of vision-threatening complications.Objective: To analyze the relationship between blood pressure and intraocular pressure, as well as the association between hypertension and ocular hypertension. Methods: This observational analytical study used secondary data from the medical records of 74 patients at the ophthalmology clinic of Hospital X Jakarta, collected between January and March 2023. The sample was selected using purposive sampling. Results: Hypertension was observed in 30 individuals (41%), including 19 females (26%) and 11 individuals aged 70–79 years (15%). Ocular hypertension was reported in 17 individuals (23%), with ten (10) females (14%) and nine (9) individuals aged 60–69 years (12%). Chi-Square analysis showed a significant relationship between blood pressure and intraocular pressure, with a p-value of 0.004 (p<α=0.05). In addition, Spearman's test showed correlations between systolic blood pressure and intraocular pressure in both the right eye (r=0.395; p=0.001) and the left eye (r=0.290; p=0.012). Additionally, there were correlations between diastolic blood pressure and intraocular pressure in the right eye (r=0.234; p=0.045) and the left eye (r=0.230; p=0.049).Conclusion: The relationship between blood pressure and intraocular pressure is found to be significant in this study, suggesting that higher blood pressure levels are associated with an increased risk of elevated intraocular pressure.
Diagnostic Utility of Claudin-4 Immunohistochemistry in Distinguishing Adenocarcinoma Cells from Reactive Mesothelial Cells in Effusion Cytology Ginnavaram, Mihira; Pamu, Pramod Kumar; Kesarapu, Swetha; Ramakrishna, Narayanan
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.v13n2.4561

Abstract

Background: Differentiating adenocarcinoma cells from reactive mesothelial cells in cases of effusion remains a diagnostic challenge due to overlapping morphological features. Claudin-4, a tight junction protein expressed in epithelial but absent in mesothelial cells, has emerged as a potential immunohistochemical (IHC) marker for this distinguishing between these cell types.Objective: to evaluate the diagnostic utility of Claudin-4 immunohistochemistry in differentiating adenocarcinoma cells from reactive mesothelial cells in effusion cytology.Methods: This prospective study was conducted at the Department of Pathology, Nizam’s Institute of Medical Sciences, Hyderabad, India, between June 2023 and December 2024. A total of 77 formalin-fixed paraffin-embedded cell block samples from effusion fluids (pleural, ascitic, and peritoneal) were analyzed. Inclusion criteria comprised cases diagnosed as malignant or reactive on cytology. Claudin-4 immunostaining was performed by using  EP417 clone. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of Claudine for differentiating malignant versus non-malignant effusion was calculated.Results: Out of the 77 studied cases, 57 were malignant and 20 were non-malignant. Claudin-4 showed positive membranous staining in 50/57 malignant cases (87.72%) and in none of the non-malignant cases (100% specificity). The PPV was 100%, and NPV was 74.10%. Pulmonary adenocarcinoma was the most common malignancy showing Claudin-4 positivity. Claudin demonstrated excellent specificity for diagnosis of malignant effusions. Conclusion: Claudin-4 immunohistochemistry is highly specific as a reliable marker for differentiating malignant cells from reactive mesothelial cells. Its high specificity and positive predictive value make it a valuable diagnostic tool. However, a negative Claudin-4 immunohistochemistry results should be interpreted cautiously, particularly in clinically suspicious cases.

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