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MEDISAINS
Published by Universitas Muhammadiyah Purwokerto
ISSN : 16937309     EISSN : 26212366     DOI : -
Core Subject : Health,
Medicine & Pharmacology Nursing Public Health
MEDISAINS: Jurnal Ilmiah Ilmu-ilmu kesehatan merupakan sarana penyebarluasan ilmu pengetahuan, riset, teknologi dan inovasi dibidang kesehatan yang diterbitkan tiga kali dalam setahun (April, Agustus dan Desember). Jurnal Medisains adalah jurnal peer reviewed dan Open-Access yang dikelola oleh Fakultas Ilmu Kesehatan Universitas Muhammadiyah Purwokerto dan di terbitkan dibawah Lembaga Publikasi Ilmiah dan Penerbitan (LPIP) Universitas Muhammadiyah Purwokerto.
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Articles 290 Documents
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Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and Ki-67 expression in diffuse large B-cell lymphoma Ni Made Renny Anggreni Rena; Sang Ayu Putu Gandhitri
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.28576

Abstract

Background: Diffuse large B-cell lymphoma (DLBCL) is an aggressive malignancy with heterogeneous outcomes, highlighting the need for accessible and reliable prognostic markers, particularly in resource-limited settings. Inflammation-based indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), together with the proliferation marker Ki-67, have been investigated as prognostic biomarkers; however, their prognostic value remains inconsistent across studies. Purpose: This study aimed to evaluate the prognostic value of baseline NLR, PLR, and Ki-67 expression for one-year overall survival in patients with DLBCL. Methods: A retrospective cohort study was conducted at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Indonesia, involving 43 adult patients with histopathologically and immunohistochemically confirmed DLBCL. Overall survival was estimated using the Kaplan–Meier method, and differences between groups were assessed using the log-rank test. Associations between NLR, PLR, Ki-67 expression, and survival were evaluated using univariate Cox proportional hazards regression. Results: The one-year overall survival rate was 60.5%. NLR ≥4 was not significantly associated with survival (HR=0.802; p=0.664), while NLR ≥7.6 showed a higher but non-significant hazard of death (HR=2.374; p=0.107). Similarly, PLR ≥170 (HR=1.514; p=0.401) and PLR ≥213 (HR=1.909; p=0.191) were not significantly associated with survival. Among the evaluated Ki-67 cut-off values (70%, 80%, and 90%), only Ki-67 ≥90% was significantly associated with poorer one-year survival (HR=4.240; 95% CI: 1.470–12.260; p=0.008). Conclusion: Ki-67 expression ≥90% was the only evaluated biomarker significantly associated with poorer one-year overall survival in patients with DLBCL. These findings suggest that very high Ki-67 expression may have practical prognostic value for risk stratification, particularly in settings with limited access to advanced molecular diagnostics.
Comparative cholesterol-lowering effects of ethanolic leaf extracts of Paederia foetida and Abrus precatorius: an in vivo study khoirul ngibad; Elok Faiqotul Jannah; Tengku Rahmadito Putra Samudra; Gaby Ayu Patricia; Cicik Wijayanti; Hidayatullah Hidayatullah
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.29373

Abstract

Background: Hypercholesterolemia is a major risk factor for cardiovascular disease. Although statins are effective, their long-term use may be associated with adverse effects, encouraging investigation of plant-derived alternatives. Comparative in vivo evidence regarding the cholesterol-lowering effects of Paederia foetida and Abrus precatorius remains limited. Purpose: This study aimed to compare the cholesterol-lowering effects of ethanolic leaf extracts of P. foetida and A. precatorius in an experimental model of hypercholesterolemia. Methods: Fifty-four mice were randomly allocated into nine groups, including negative and positive controls, a simvastatin group, and three dose groups each of P. foetida and A. precatorius extracts (3.5, 7, and 14 mg/20 g body weight). Hypercholesterolemia was induced using propylthiouracil and a high-fat diet. The extracts were administered for three days. Changes in total cholesterol levels were analyzed using one-way ANOVA followed by Tukey’s post hoc test. Results: Cholesterol reduction differed significantly among the experimental groups (p<0.001). Both extracts reduced total cholesterol compared with the positive control. At the highest tested dose (14 mg/20 g body weight), A. precatorius showed a numerically greater reduction than P. foetida (25.33 vs. 19.17 mg/dL), while simvastatin produced the greatest reduction (48.67 mg/dL). Conclusions: Both extracts demonstrated cholesterol-lowering activity in hypercholesterolemic mice, with A. precatorius showing greater efficacy than P. foetida at the highest tested dose.
Comparative antibacterial activity of Ziziphus spina-christi and Piper betle extracts against Escherichia coli across different concentrations Amiruddin Eso; Sulastrianah; Sufiah Asri Mulyawati; Aanisah Rahman; Arif Eka Surya; Aliyyah Zhafirah Bafadal; Annisa Dwi Aulia Putri
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.30324

Abstract

Background: Antimicrobial resistance among Gram-negative bacteria, including Escherichia coli, has increased the need to explore alternative antibacterial agents. Although medicinal plants have demonstrated antibacterial potential, comparative evidence on the activity of Ziziphus spina-christi and Piper betle extracts against E. coli across different concentrations remains limited. Objective: This study aimed to compare the antibacterial activity of ethanolic extracts of Z. spina-christi and P. betle against E. coli and to evaluate the effects of extract type, concentration, and their interaction. Method: A laboratory experimental study using a 2×3 factorial completely randomized design with additional positive and negative control groups was conducted. Ethanolic extracts of Z. spina-christi and P. betle were evaluated at concentrations of 1500, 2000, and 2500 ppm using the disk diffusion method. Inhibition-zone diameters were analyzed using two-way analysis of variance followed by Tukey’s honestly significant difference test.  Results: The mean inhibition-zone diameter of Z. spina-christi increased from 8.83±0.76 mm at 1500 ppm to 30.33±2.08 mm at 2500 ppm, whereas that of P. betle increased from 16.33±0.38 mm to 23.08±3.51 mm. Concentration significantly affected antibacterial activity (F(2,12)=105.02; p<0.001), whereas extract type showed no significant main effect (F(1,12)=1.89; p=0.194). A significant interaction between extract type and concentration was observed (F(2,12)=29.34; p<0.001). Conclusion: The antibacterial activity of Z. spina-christi and P. betle extracts against E. coli varied according to concentration, with a significant interaction between extract type and concentration. The greatest inhibition among the extract treatments was observed with Z. spina-christi at 2500 ppm.
Serial wound changes during hydrogel-assisted autolytic debridement combined with antimicrobial dressings in diabetes-related wounds: a case series Juli Widiyanto, S.Kep., M.Kes (Epid); Silvia Elki Putri; Pratiwi Gasril; Alma’ratus Sholikhah Putri Ramdhani; Zaidatul Akmal Othman
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.30517

Abstract

Background: Diabetes-related wounds are challenging to manage because impaired tissue repair, necrotic tissue, infection risk, and poor metabolic control may delay wound healing. Hydrogel dressings can support autolytic debridement by maintaining a moist wound environment, while antimicrobial dressings may be used as adjuncts when microbial burden is clinically relevant. Clinical documentation of serial wound changes during their combined use remains limited. This case series aimed to describe serial wound changes during hydrogel-assisted autolytic debridement combined with antimicrobial dressings in patients with diabetes-related wounds. Case Presentation: Three women with type 2 diabetes mellitus and necrotic or devitalized wounds were treated at an independent wound care clinic in Pekanbaru, Indonesia. Wound status was assessed using the Bates-jensen wound assessment tool (BJWAT) and serial photographs at baseline and on days 4, 8, and 12. Hydrogel-assisted autolytic debridement combined with antimicrobial dressings was applied as part of local wound management. BJWAT scores decreased from 28 to 18 in Case 1, from 20 to 10 in Case 2, and from 33 to 27 in Case 3. Serial wound assessments showed changes in wound appearance over the 12-day observation period, with varying degrees of improvement across the three cases. Conclusion: Decreases in BJWAT scores and improvements in wound appearance were observed across the three cases during the 12-day wound-care period. These findings provide descriptive clinical observations of wound progression during hydrogel-assisted autolytic debridement combined with antimicrobial dressings but do not establish the effectiveness of this treatment approach. Further controlled studies with longer follow-up and standardized assessment of wound characteristics and relevant patient-related factors are needed.
Paternal knowledge, maternal self-efficacy, and exclusive breastfeeding following a digital paternal-support intervention: a quasi-experimental study Evy Nurachma; Diah Evawana; Fara Imelda Theresia; Elisa Goretti; Lidia Lushinta
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.30658

Abstract

Background: Most breastfeeding interventions primarily target mothers, while evidence regarding digitally delivered paternal support and its effects on maternal breastfeeding self-efficacy and exclusive breastfeeding remains limited. Objective: This study aimed to assess changes in paternal knowledge and maternal breastfeeding self-efficacy following a digital paternal-support intervention and to identify factors associated with exclusive breastfeeding. Method: A quasi-experimental pretest–posttest study with a non-equivalent control group was conducted from January to March 2026 at Loa Bakung Health Center, Samarinda, Indonesia. Sixty mother–father couples were included, with 30 couples in each group. The intervention group received a digital paternal-support intervention, while the control group received routine breastfeeding education. Changes in paternal knowledge and maternal breastfeeding self-efficacy were assessed using paired t-tests, while factors associated with exclusive breastfeeding were examined using multivariable logistic regression. Results: Paternal knowledge and maternal breastfeeding self-efficacy increased significantly from pretest to posttest following the digital paternal-support intervention (both p<0.001). In multivariable analysis, paternal support was positively associated with exclusive breastfeeding (AOR=4.52; 95% CI: 2.81–7.25; p<0.001), whereas maternal employment was negatively associated with exclusive breastfeeding (AOR=0.45; 95% CI: 0.26–0.78; p=0.003). Maternal education was not significantly associated with exclusive breastfeeding (AOR=1.21; 95% CI: 0.61–2.40; p=0.575). Conclusions: Paternal knowledge and maternal breastfeeding self-efficacy increased following the digital paternal-support intervention. Paternal support was positively associated with exclusive breastfeeding, whereas maternal employment was negatively associated with this outcome. These findings support further evaluation of digitally delivered paternal-support strategies using comparative analyses that directly assess intervention effects.
Ketogenic diet adherence and cardiovascular biomarkers following digital education and structured family support among adults at risk for coronary heart disease: a mixed-methods study Andika Herlina; vinorika Nofia; Siska Sakti Angraini; Siti Aisyah Nur; Wan Nor Aliza; Wan Abdul Rahman
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.30848

Abstract

Background: Adherence to ketogenic diets remains challenging among adults at risk for coronary heart disease (CHD), potentially limiting the sustainability of dietary interventions. Evidence regarding the combined use of digital education and structured family support in relation to dietary adherence, psychosocial outcomes, and cardiovascular biomarkers remains limited, particularly in Indonesian primary healthcare settings. Purpose: This study aimed to assess ketogenic diet adherence, psychosocial outcomes, and cardiovascular biomarkers following digital education combined with structured family support among adults at risk for CHD and to explore factors influencing dietary adherence. Methods: This quantitative-dominant sequential explanatory mixed-methods study included a quasi-experimental pretest–posttest control-group phase involving 60 adults at risk for CHD. The intervention group received six months of digital ketogenic diet education combined with structured family support, whereas the control group received routine nutritional education. Outcomes included ketogenic diet adherence, self-efficacy, perceived family support, LDL cholesterol, HDL cholesterol, triglycerides, and small dense LDL (sd-LDL). Quantitative outcomes were analyzed using analysis of covariance (ANCOVA), with adjustment for relevant baseline covariates. The subsequent qualitative phase used interviews and focus group discussions, followed by thematic analysis to explore factors influencing dietary adherence. Results: The intervention group showed significantly greater improvements in ketogenic diet adherence, self-efficacy, and perceived family support vs. control group (p<0.001). Significant between-group differences were also observed in sd-LDL, LDL cholesterol, triglycerides, and HDL cholesterol (p<0.05). Qualitative findings indicated that practical family involvement, emotional support, and flexible access to digital education facilitated dietary adherence, whereas habitual consumption of carbohydrate-rich foods remained an important barrier. Conclusion: Digital ketogenic diet education combined with structured family support was associated with greater improvements in dietary adherence, psychosocial outcomes, and cardiovascular biomarkers among adults at risk for CHD. Qualitative findings further identified family involvement and accessible digital education as facilitators of adherence, while habitual carbohydrate consumption remained a barrier. Further studies are warranted to confirm these findings using larger samples and more rigorous experimental designs.
Optimization of toothpaste containing the ethyl acetate fraction of Stelechocarpus burahol leaves and its antibacterial activity against Streptococcus mutans Zhicizha Estara Suyit; Titik Sunarni; Ilham Kuncahyo
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.30870

Abstract

Background: Dental caries is associated with cariogenic microorganisms, particularly Streptococcus mutans. Stelechocarpus burahol leaves contain bioactive compounds with potential antibacterial activity, but their incorporation into an optimized toothpaste formulation remains insufficiently investigated. Purpose: This study aimed to evaluate the antibacterial activity of S. burahol leaf fractions against S. mutans and to optimize a toothpaste formulation containing the most active fraction using Carbopol 940, sodium carboxymethyl cellulose, and glycerin. Method: his laboratory experimental study included ethanolic extraction, solvent fractionation, antibacterial screening, and toothpaste optimization using Simplex Lattice Design. Antibacterial activity against S. mutans was evaluated using diffusion and dilution methods. The toothpaste formulations were assessed for pH, viscosity, homogeneity, and antibacterial activity. Model adequacy and numerical optimization were analyzed using Design-Expert version 13. Results: The ethyl acetate fraction showed the highest antibacterial activity, with an inhibition zone of 19.39±1.50 mm, a minimum inhibitory concentration of 1.562%, and a minimum bactericidal concentration of 3.125%. The optimum formulation contained 1% Carbopol 940, 1% sodium carboxymethyl cellulose, and 5% glycerin, with a desirability value of 0.819. The optimized toothpaste had a pH of 8.25, viscosity of 258.33±7.64 dPa·s, and an inhibition zone of 13.32±0.29 mm. The experimental responses were within their respective prediction intervals. Conclusion: The ethyl acetate fraction of S. burahol leaves was successfully incorporated into an optimized toothpaste formulation while maintaining antibacterial activity against S. mutans. Further studies are needed to assess formulation stability, active-compound release, antibiofilm activity, and safety.
The Development and preliminary usability testing of a digital reproductive health education model for maternal preparedness in disaster-prone areas Dini Afriani; Gita Arisara; Hana Fitria Andayani; Muhammad Agreindra Helmiawan
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.31177

Abstract

Background: Pregnant women are particularly vulnerable during disasters because disruptions in healthcare services, limited access to reproductive health information, and inadequate disaster preparedness may compromise continuity of maternal care. Maternal health education and disaster-preparedness interventions are often delivered separately, highlighting the need for an integrated digital approach. Purpose: This study aimed to develop a digital reproductive health education model for maternal preparedness in disaster-prone areas and evaluate its preliminary usability among intended users. Methods: This study employed Type 1 Design and Development Research consisting of four phases: needs assessment, prototype design and development, expert evaluation and refinement, and preliminary usability testing. The needs assessment included a survey of 32 pregnant women and semi-structured interviews with five participants. Quantitative and qualitative findings from the needs assessment were integrated to inform the design requirements for the digital model. Four multidisciplinary experts evaluated the prototype, which underwent two revision cycles before preliminary usability testing with 10 pregnant women. Quantitative data were analyzed descriptively, while qualitative interview data were analyzed thematically. Results: The needs assessment identified limited disaster preparedness, barriers to maternal healthcare access during emergencies, and substantial educational needs. Four qualitative themes reflected uncertainty during disasters, difficulties accessing maternal healthcare, fragmented health information, and preference for an integrated digital platform. Based on these findings, a digital reproductive health education model named LERINA (Layanan Edukasi Kesehatan Reproduksi Tanggap Bencana) was developed, comprising six integrated modules: education, preparedness assessment, maternal monitoring, emergency support, consultation, and an administrative dashboard. Expert evaluation yielded mean scores of 4.74 for content and 4.78 for interface. Preliminary user testing demonstrated favorable usability, with an overall score of 4.71 ± 0.28. Conclusion: LERINA, a needs-informed digital reproductive health education model, was systematically developed and demonstrated favorable preliminary usability among intended users. Further studies are needed to evaluate its acceptability, implementation feasibility, effectiveness, and broader applicability.
Expert appraisal and design decisions: a multidisciplinary review of a user-centered digital tuberculosis treatment support and monitoring system Agus Santosa; Neti Juniarti; Tuti Pahria; Raini Diah Susanti
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.32445

Abstract

Background: Expert appraisal can identify issues before digital health systems are evaluated with intended users. However, less attention is given to how expert feedback is translated into subsequent design decisions. Objective: This study examined how multidisciplinary expert appraisal informed design decisions for a user-centered digital tuberculosis treatment support and monitoring system before field evaluation. Methods: Five purposively selected experts representing information technology, public health, tuberculosis program management, and frontline tuberculosis care appraised an alpha prototype using a 26-item structured evaluation form and open-ended feedback. Ratings were analyzed descriptively, and expert feedback was synthesized into design issues and traced to documented design decisions and implementation status. Development dispositions were organized as Retain, Refine, Defer, or Field-test. Results: The prototype received favorable appraisal, with an overall mean score of 4.63/5 and domain means ranging from 4.56 to 4.72. Despite these ratings, experts identified concerns related to medication-documentation integrity, information quality, privacy, accessibility, programmatic alignment, interoperability, monitoring, and implementation readiness. Core user-informed functions were largely retained, while actionable concerns prompted targeted refinements, including direct camera capture, privacy-sensitive photo guidance, interface-readability improvements, and refinement of monitoring information. Other recommendations were deferred or partially implemented, while questions concerning limited digital ability and context-dependent conditions were carried forward for field evaluation. Conclusion: Multidisciplinary expert appraisal supported selective refinement rather than fundamental redesign and identified design considerations not apparent from favorable ratings alone. Expert appraisal may therefore serve as a complementary checkpoint between user-centered development and field evaluation, distinguishing actionable refinements from issues requiring further development or evaluation with intended users.
Perioperative outcomes following local tranexamic acid infiltration and tourniquet application in primary total knee arthroplasty: a case series Mirza Halim Othman; Subhan Thaib
MEDISAINS: Jurnal Ilmiah Ilmu-Ilmu Kesehatan Vol. 24 No. 2 (2026)
Publisher : Universitas Muhammadiyah Purwokerto

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30595/medisains.v24i2.31891

Abstract

Background: Total knee arthroplasty (TKA) may be associated with perioperative blood loss and postoperative hemoglobin reduction. Tranexamic acid (TXA) is widely used to reduce perioperative blood loss in total joint arthroplasty, with variation in dose, route, and timing of administration. This case series describes perioperative outcomes following local TXA infiltration and tourniquet application in two patients undergoing primary TKA. Case Presentation: Two men with advanced knee osteoarthritis (Kellgren–Lawrence grade IV) underwent primary TKA under spinal anesthesia. Case 1 was a 41-year-old man with chronic left knee pain and valgus deformity, whereas Case 2 was a 68-year-old man with progressive right knee pain and varus deformity. In both cases, a pneumatic tourniquet was applied at 250 mmHg, and 250 mg of TXA was locally infiltrated into the tissues surrounding the surgical site before wound closure. Hemoglobin concentration decreased from 16.1 to 14.9 g/dL in Case 1 and from 13.3 to 11.8 g/dL in Case 2 at 24 hours postoperatively. Neither patient received an allogeneic blood transfusion. Both patients ambulated with a walker on postoperative day three, had postoperative pain scores of 3–4 on the visual analogue scale, and had no documented surgical wound complications. At six-month follow-up, both were reported to have recovered full knee range of motion. Conclusions: Local TXA infiltration combined with tourniquet application in two primary TKA cases was followed by postoperative hemoglobin reductions without allogeneic blood transfusion and postoperative recovery. Given the descriptive nature of this case series, these observations do not establish the effectiveness of either intervention.

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