International Journal of Social Health

Mandibular Reconstruction Post Mandibular Resection Operation in Head and Neck Tumor Patients at Dr Soetomo General Hospital

2026-08-10T03:29:28+00:00

Surgeons still find challenges with mandibular reconstruction following removal of head and neck malignancies, osteomyelitis, and osteoradionecrotic mandible. Mastication, articulation, swallowing, and breathing issues can all result from the loss of a portion of the mandibular bone as a result of resection. Improved function, contour, and aesthetics are the goals of comprehensive mandibular reconstruction. Over the past few decades, various mandibular reconstructive techniques have been developed, along with their potential for difficulties. This research was an observational descriptive study with retrospective data collected from January 2018 to May 2022 to identify the clinical outcomes of patients undergoing post-resection mandibular reconstruction and the profile of patients with head and neck tumors at Dr. Soetomo General Hospital, Surabaya. We analyze a total of 55 patients. The majority of mandibular reconstruction patients at RSUD Dr. Soetomo Surabaya following resection are in the age range of 40 to 49 years, with the majority of abnormalities resulting from ameloblastoma. The reconstruction plate was the most often used reconstructive technique for mandibular deformity, which measured around 8 cm in length. In this study, the exposed plate was the most frequent problem, and the average period of mandibular reconstructive therapy was about 8 days. Mandibular reconstruction can give different results in each patient. For patients with recurring head and neck cancers, in particular, adequate cosmetic and functional outcomes, as well as radiation tolerance, are necessary.

Quality of Life of Patients with Chronic Obstructive Pulmonary Disease (COPD) as Assessed by the Saint George’s Respiratory Questionnaire for Chronic Obstructive Pulmonary Disease (SGRQ-C) at Waled Regional General Hospital in 2024

2026-08-12T08:21:20+00:00

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by chronic respiratory symptoms resulting from abnormalities of the airways and/or alveoli. A validated and reliable instrument is required to assess health-related quality of life in patients with COPD. The St George’s Respiratory Questionnaire for COPD (SGRQ-C) has been translated and validated in several countries for assessing health-related quality of life in patients with COPD. This study aimed to assess the quality of life of patients with COPD at Waled Regional General Hospital in 2024. This study employed a descriptive observational method with a cross-sectional design. Participants were recruited using a nonprobability consecutive sampling technique, resulting in a total sample of 40 patients. Most respondents were older adults, with 16 patients (40.25%), and the majority were male, with 29 patients (72.5%). Eighteen patients (45%) were former smokers, 12 patients (40%) were classified as heavy smokers, and 21 patients (52.5%) had a normal body mass index. In the symptom domain, 24 patients (60%) had poor quality of life; in the activity domain, 22 patients (55%) had good quality of life; and in the impact domain, 29 patients (72.5%) had good quality of life. Overall, 24 patients (60%) had good quality of life. Most respondents were older adult males and former smokers, with a substantial proportion classified as heavy smokers and more than half having a normal body mass index. Most patients had poor quality of life in the symptom domain, whereas most had good quality of life in the activity and impact domains and overall.

The Impact of Clinical Microbiologists’ Interpretations and Therapeutic Recommendations Regarding Culture Test and Antibiotic Susceptibility Test Results on Antibiotic Management in Hospitalized Patients with Infections: A Systematic Literature Review

2026-08-10T03:27:04+00:00

Antimicrobial resistance (AMR) is one of the most pressing global public health threats of the 21st century, driving healthcare systems to implement robust antimicrobial stewardship programs (ASPs) in hospital settings. Clinical microbiologists contribute directly to these programs by generating interpretive comments, applying selective or cascade susceptibility reporting, and offering real-time therapeutic consultations based on culture and antibiotic susceptibility test (AST) results. This research aimed to systematically review the evidence on the impact of clinical microbiologists' interpretations and therapeutic recommendations on antibiotic management for hospitalized patients with infections. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Three databases SciSpace, Google Scholar, and PubMed were searched, yielding 1,338 records; after deduplication and two-stage screening, 55 studies met the inclusion criteria. Three intervention types were identified: interpretive comments and nudges (n?=?28), selective or cascade reporting (n?=?21), and real-time microbiology consultation services (n?=?6). Microbiology-based interventions consistently improved antibiotic stewardship outcomes: appropriate antibiotic selection ranged from 47–92%, de-escalation rates from 19–67%, broad-spectrum antibiotic use was reduced by a median of 3–5 days, and time to optimal therapy was shortened by 20–43 hours. Clinical outcomes including mortality and length of hospital stay showed no significant differences. These findings demonstrate that microbiology-based stewardship interventions are clinically effective and safe, supporting their integration into routine hospital laboratory workflows.

Leptospirosis-Associated Acute Kidney Injury Presenting with Polyuria and Hypokalemia-Induced Flaccid Quadriparesis in a Young Farmer: A Case Report

2026-08-18T04:10:42+00:00

Leptospirosis is a globally distributed zoonotic infection that can cause acute kidney injury (AKI), electrolyte disturbances, and rare neuromuscular complications. Non-oliguric AKI accompanied by polyuria and hypokalemia represents an important but often underrecognized manifestation of leptospiral nephropathy. This case report aimed to describe the clinical presentation, diagnostic evaluation, management, and outcome of leptospirosis-associated AKI complicated by severe hypokalemia and flaccid quadriparesis. A 36-year-old male farmer was evaluated through clinical examination, serial laboratory assessments, serologic testing, urinalysis, electrocardiography, abdominal ultrasonography, urine output monitoring, and muscle strength evaluation. The patient developed marked polyuria of 7,000 mL/24 hours, severe hypokalemia with serum potassium levels decreasing to 2.3 mmol/L, azotemia, and acute flaccid quadriparesis characterized by grade 2 muscle strength and absent deep tendon reflexes. Leptospira IgM was positive, while ultrasonography findings suggested bilateral acute tubulointerstitial nephritis. The findings indicated that renal tubular dysfunction and potassium wasting were key mechanisms contributing to polyuria and neuromuscular impairment. Management included intravenous fluid therapy, controlled potassium and sodium replacement, ceftriaxone administration, and continuous electrolyte and electrocardiographic monitoring. Muscle strength gradually recovered to grade 5, serum potassium normalized to 3.6 mmol/L, urine output decreased, and renal function improved within six days. Early recognition and systematic correction of fluid and electrolyte disturbances can lead to complete recovery from this severe complication of leptospirosis.

The Relationship Between Troponin I Levels and Mortality in Patients with Acute Myocardial Infarction at Gunung Jati General Hospital in Cirebon, 2023–2024

2026-08-10T03:25:57+00:00

The mortality rate of patients hospitalized due to Acute Coronary Syndrome (ACS) in Indonesia reached 32.3%, with Acute Myocardial Infarction (AMI) being one of the most fatal classifications. The cardiac troponin I test is the first-line standard for diagnosing AMI due to its high specificity and sensitivity. Troponin I not only reflects myocardial damage but also serves as a prognostic indicator for patient outcomes. This research aims to determine the relationship between troponin I levels and mortality in patients with Acute Myocardial Infarction at Gunung Jati Cirebon Hospital during the 2023–2024 period. This research employed a cross-sectional design using secondary data from medical records. A total sampling technique was applied, involving 240 patients who met the inclusion and exclusion criteria. Data were analyzed univariately and bivariately using the Spearman's rho correlation test. Troponin I levels had a median of 1.78 ng/mL (range: 0.03–10 ng/mL). The majority of patients were in the non-death category (207 patients; 86.25%). Bivariate analysis showed a significant relationship between troponin I levels and mortality (p = 0.009; p < 0.01) with a correlation coefficient (r) of 0.167, indicating that higher troponin I levels tend to be associated with increased mortality risk, although the correlation strength is weak. There is a significant correlation between troponin I levels and mortality in patients with Acute Myocardial Infarction, with weak correlation strength. Although the relationship is weak, these findings suggest that troponin I can still be used as one of the risk indicators for mortality in AMI patients.

Improvement of Disease-Specific Quality of Life and Dyspeptic Symptoms with Dlbs2411, A Bioactive Fraction of Cinnamomum Burmannii, in Patients with Functional Dyspepsia

2026-08-24T07:06:13+00:00

Functional dyspepsia is a common disorder of gut–brain interaction that substantially impairs quality of life, while available pharmacological treatments provide modest benefits and may cause adverse effects during prolonged use. This study aimed to evaluate the effects, durability, and safety of DLBS2411, a standardized bioactive fraction of Cinnamomum burmannii, in adults with functional dyspepsia. This prospective multicenter study enrolled 53 adults with Rome IV-defined, Helicobacter pylori-negative functional dyspepsia from seven hospitals in Indonesia. Participants received DLBS2411 at a dose of 250 mg twice daily for 28 days and were followed for an additional eight weeks. Disease-specific quality of life was assessed using the Short-Form Nepean Dyspepsia Index (SF-NDI), while eight dyspeptic symptoms were evaluated using visual analog scales (VAS). Safety was assessed through adverse event monitoring, vital signs, electrocardiography, and laboratory examinations. The mean SF-NDI score improved by 53% at Week 4 and 67% at Week 12. All eight dyspeptic symptoms showed significant improvement, and the proportion of participants reporting adequate relief increased from 55% at Week 2 to 76% at Week 12. DLBS2411 was generally well tolerated, with no treatment-related serious adverse events reported. In conclusion, DLBS2411 was associated with early and sustained improvements in disease-specific quality of life and dyspeptic symptoms; however, placebo-controlled trials are required to confirm its efficacy and clinical therapeutic value.