Sriwijaya Journal of Medicine

Factors Influencing Maternal Mortality in The Bangka Belitung Archipelago

2025-09-22T23:24:31+00:00

Maternal mortality remains a key indicator of health system performance. Although Indonesia has seen a general decline in maternal mortality rates, they remain high, with notable fluctuations observed in the Bangka Belitung Islands, particularly an upward trend following the COVID-19 pandemic peak in 2021. This study aimed to identify factors associated with maternal mortality in the province. A case-control design was employed using secondary data from 2023, including Maternal Verbal Autopsy reports, medical records from the Maternal Perinatal Death Notification (MPDN) system, and maternal cohort data from local health centers. A total of 117 subjects were included, comprising 39 cases and 78 controls. Two variables were found to significantly influence maternal mortality in the Bangka Belitung Islands Province in 2023: parity (p = 0.020; OR = 0.306; 95% CI: 0.113–0.831) and antenatal care visits (p < 0.001; OR = 23.233; 95% CI: 7.266–74.226). Of these, antenatal care visits were identified as the most dominant predictor. These findings underscore the urgent need to strengthen maternal healthcare services in line with clinical standards, particularly ensuring comprehensive and timely antenatal care. Improving service governance may enhance early detection of high-risk pregnancies, facilitate safer deliveries, and ultimately reduce maternal mortality in the Bangka Belitung Islands.

The Role of Blood Pressure, Diabetes Panel, Vitamin D, and Albumin in Sleep Quality Among the Elderly Population

2025-10-20T01:45:36+00:00

Sleep disturbances are common among the elderly, influenced by multiple physiological factors, including blood pressure regulation, metabolic markers, nutritional status, and inflammation. Poor sleep quality has been linked to cardiovascular diseases, cognitive decline, and reduced overall well-being. Understanding the relationship between blood pressure, diabetes markers, vitamin D, and albumin levels with sleep quality may provide insights into potential interventions to improve sleep health in older adults. This study aims to analyze the correlation between blood pressure, diabetes panel (fasting blood glucose, fasting insulin, and HbA1c), vitamin D, and albumin levels with sleep quality in the elderly population. This Cross-sectional study was conducted at Bina Bhakti Nursing Home in 2024 to 58 elderly participants selected through total sampling. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), while physiological parameters were measured using validated clinical and laboratory methods. Data were analyzed using Spearman’s Rho test to determine correlations between these factors and sleep disturbances. This study found that diastolic blood pressure and HbA1c level showed weak correlations with sleep quality. Low diastolic blood pressure and poor glycemic control demonstrated weak but statistically significant correlations with sleep quality among older adults. These findings indicate that certain physiological and metabolic factors, particularly diastolic blood pressure and HbA1c, may be associated with variations in sleep regulation among the elderly. Future research should explore targeted interventions, such as blood pressure management and metabolic regulation, that may improve sleep quality and overall health in the aging population.

The Difference in Mean Blood Pressure Before and After Dark Chocolate Administration in the Elderly

2025-12-21T10:13:15+00:00

Hypertension is particularly prevalent among the elderly and requires careful therapy to minimize cardiovascular consequences. Flavanol chemicals found in dark chocolate are thought to enhance endothelial function by increasing the availability of nitric oxide, which may lower blood pressure. This study assessed the acute effect of dark chocolate consumption on systolic and diastolic blood pressure in older persons. A quasi-experimental pre–post design was undertaken among 65 elderly people of Panti Werdha Wisma Mulia and Panti Santa Anna who met the inclusion criteria and given informed consent. A digital sphygmomanometer was used to assess each participant's blood pressure prior to consumption and at 15, 30, and 60 minutes after consuming 30 grammes of 72% dark chocolate. Data normality was assessed using the Kolmogorov–Smirnov test, and paired t-test or Wilcoxon analysis. Systolic blood pressure at 30 minutes (126.14 ± 16.17 mmHg; p = 0.015) and 60 minutes (122.57 ± 16.36 mmHg; p = 0.000) was significantly lower than baseline (130.51 ± 17.54 mmHg). Diastolic blood pressure revealed a significant drop only at 60 minutes (74.26 ± 9.98 mmHg; p = 0.005) from baseline (77.89 ± 14.24 mmHg). Although early post-consumption measures indicated no statistically significant changes, the overall results indicate that dark chocolate produces a considerable short-term hypotensive impact in the elderly. These data imply that dark chocolate may serve as a complementary non-pharmacological strategy to blood pressure management in older populations.

Relationship between Knowledge and Attitudes Regarding Preventive Behaviors for Sexually Transmitted Infections Among Prisoners in Ambon City’s Women's Correctional Institution

2025-12-21T12:16:01+00:00

Sexually transmitted infections (STIs) are diseases that are transmitted through sexual intercourse, whether vaginal, anal, or oral. STIs cases specifically target key groups such as FSWs (female sex workers), MSM (men who have sex with men), WSW (women who have sex with women), injecting drug users and prisoners in correctional institutions who are closely related to risky sexual behavior. Risky sexual behavior in these groups is often caused by low knowledge about the dangers and impacts of STIs. Preventing the transmission of STIs is very important to control their spread. Good knowledge and attitudes about STIs can improve effective preventive behaviors. This research aims to determine the relationship between knowledge and attitude towards STIs prevention behavior in Ambon City’s Class III Women's Correctional Institution. This research used a cross-sectional design with a total sampling technique, involving 68 female inmates. Data were collected through a questionnaire containing questions about knowledge, attitudes, and STIs prevention behavior. The results showed that 44 respondents (64.7%) had good knowledge of STIs, 50 respondents (73.5%) had a supportive attitude towards STIs, and 58 respondents (85.3%) had good STIs prevention behavior. The results of bivariate analysis using the Fisher exact test showed a significant relationship between knowledge and prevention behavior (p=0.003) and between attitude and STIs prevention behavior (p=0.017). Good knowledge and attitudes towards STIs correlate with better prevention behaviors. Therefore, it is important to improve knowledge and attitudes that support STIs prevention in prisons.

Penta Herbs Forte: The Effect of PHF Extract on Superoxide Dismutase Activity in Hypoxic Sprague Dawley Rat’s Heart

2025-12-21T10:11:39+00:00

Hypoxia is a condition in which tissues receive insufficient oxygen, leading to increased production of reactive oxygen species (ROS) and triggering oxidative stress that can cause heart damage. Penta Herbs Forte (PHF), a combination of Blumea balsamifera, Curcuma xanthorrhiza, Zingiber officinale var. rubrum, Phyllanthus niruri, and Andrographis paniculata, contains bioactive compounds with antioxidant properties that may help strengthen the body’s defense against oxidative injury. This study aimed to evaluate the effect of PHF extract on the activity of the antioxidant enzyme Superoxide Dismutase (SOD) in the hearts of hypoxia-induced Sprague Dawley rats. The research included in vitro assessments (total phenolic content, BSLT toxicity, and FRAP assays) and in vivo experiments involving eight groups of rats receiving PHF extract with different hypoxia exposure durations (0, 1, 7, and 14 days). Heart tissues were processed into homogenates, and SOD activity was measure by spectrophotometry, followed by statistical analysis using the Mann-Whitney and Kruskal-Wallis tests. Although PHF groups showed higher SOD activity, significant differences between control and treated groups were observed only at 1-day hypoxia. These findings suggest that PHF may help protect the heart from hypoxia-related oxidative stress by enhancing antioxidant enzyme activity.

Quantitative Analysis of Borax in Cilok from Selected School-area Vendors in Seberang Ulu II, Palembang Using UV–Vis Spectrophotometry

2026-01-25T02:23:55+00:00

Cilok is one of the most popular traditional street foods in Indonesia because of its chewy consistency, low price, and unique flavor. Despite its popularity, concerns regarding food safety remain, especially related to the misuse of hazardous additives such as borax. Based on the Regulation of the Indonesian Ministry of Health issued in 2012, the use of borax in food products is prohibited due to its harmful effects on human health. However, several studies have reported the continued presence of borax in traditional foods and snacks sold in the community. Therefore, this study was conducted to evaluate the physical characteristics of cilok suspected of containing borax and to measure borax concentrations quantitatively. Samples were obtained from selected vendors in the Seberang Ulu II district through purposive sampling with enrichment criteria. Borax analysis was performed using a curcumin-based UV–Vis spectrophotometric method. All collected samples showed diverse physical characteristics and were confirmed positive for borax contamination, with concentrations ranging from 2.84 to 56.28 mg/kg. These results demonstrate that borax is still being used in cilok sold by certain vendors in Seberang Ulu II, Palembang City. This condition suggests that food safety supervision by authorities, including the National Agency of Drug and Food Control and local Health Offices, has not yet achieved optimal effectiveness. Greater efforts are needed to strengthen policy implementation, improve routine monitoring, and increase educational campaigns for the public, particularly parents and school communities, in order to enhance the safety of street food products and safeguard public health.

Nonpharmacological Management of Postpartum Pain After Cesarean and Vaginal Delivery: A Systematic Review

2025-11-16T13:26:12+00:00

Postpartum pain is a common and clinically significant issue following both cesarean and vaginal deliveries, affecting maternal comfort, mobility, breastfeeding, and early mother-infant bonding. While pharmacological analgesics are effective, they carry risks such as gastrointestinal disturbances, sedation, and interference with lactation, prompting interest in nonpharmacological alternatives. This systematic review evaluated randomized controlled trials (RCTs) published between 2015 and 2025 that assessed nonpharmacological interventions for postpartum pain including acupressure, transcutaneous electrical nerve stimulation (TENS), hand and back massage, abdominal binders, cryotherapy, and photobiomodulation. Ten studies were included, comprising 7 cesarean and 3 vaginal delivery trials. Acupressure, TENS, and massage consistently reduced pain scores, enhanced functional recovery, and improved maternal comfort without significant adverse effects, whereas abdominal binder use showed limited benefit. For vaginal deliveries, cryotherapy and photobiomodulation effectively decreased perineal pain and edema. Overall, nonpharmacological interventions were safe, low-cost, and patient-centered, offering meaningful reductions in postpartum pain and improvements in functional outcomes. However, variability in intervention protocols, dosing, and outcome measures limits direct comparisons, highlighting the need for further research to establish standardized approaches and optimize clinical application. These findings support incorporating nonpharmacological strategies as adjuncts or alternatives to pharmacological pain management in postpartum care.

Psychosocial Impact of Recurrent Pregnancy Loss in a G7P0A6 Patient with Hyperthyroidism: A Case Report

2025-10-16T13:47:17+00:00

Recurrent pregnancy loss presents significant physical and psychosocial challenges, especially when complicated by comorbidities such as Graves’ disease and polycystic ovary syndrome (PCO) with suspected insulin resistance. This case involves a G7P0A6 woman at 21 weeks’ gestation with euthyroid-phase Graves’ disease and PCO, expressing a desire for tubectomy if another miscarriage occurs. She has no living children and shows psychosocial distress related to previous losses. Termination at 21 weeks carries risks of hemorrhage, infection, and endocrine instability, particularly in patients with autoimmune and metabolic disorders. Continuing the pregnancy, however, also entails potential complications including endocrine imbalance, fetal growth restriction, preterm delivery, or intrauterine death. Psychologically, repeated miscarriage can provoke anxiety, guilt, and depressive symptoms, often influencing irreversible decisions like sterilization without full consideration of alternatives. Given her emotional vulnerability and absence of living offspring, permanent contraception should be deferred. A multidisciplinary approach—integrating obstetrics, internal medicine, psychiatry, and psychology—is essential to optimize maternal health and guide ethical decision-making. Continuing the pregnancy with close medical and psychological monitoring is preferable to termination, as both options carry comparable risks, but continuation preserves the possibility of a living child. Antenatal psychological support and comprehensive contraceptive counseling should be provided to help the patient make well-informed, emotionally balanced decisions regarding future fertility.

Case of Omphalocele Diagnosed Prenatally: A Case Report

2025-12-21T10:14:39+00:00

Omphalocele is congenital malformation resulted from abnormal closure of anterior abdominal wall. Omphalocele may exist in isolation or a part of syndromic congenital malformations. Several etiologies of omphalocele are known, including genetic, teratogenic, nutritional, or idiopathic causes. We reported a case of isolated omphalocele with no known risk factor. Female, 29 years old, G2P1A0, 21 weeks pregnant with no remarkable history referred to our institution for evaluation and management of suspected pregnancy complicated with omphalocele. Upon ultrasonographic examination, we discovered live singleton pregnancy with clear evidence of omphalocele. Patient was then planned to undergo elective cesarean section at 37^th week of pregnancy. Subsequently, neonate was managed by the team of neonatologist and pediatric surgeon and the defect was repaired successfully. Prenatal diagnosis of omphalocele lead into improved outcome due to preparedness of the team, particularly in case of isolated case of omphalocele with no other congenital anomalies present.

COPD in a Construction Worker with Heavy Smoking History: Application of the PERDOKI Seven-Step Work-Relatedness Assessment

2026-05-04T17:32:25+00:00

Chronic obstructive pulmonary disease (COPD) is a multifactorial disease in which tobacco smoking remains the dominant risk factor, while occupational exposure to vapours, gases, dusts, and fumes may contribute to disease development and progression. This case report describes a 65-year-old male construction labourer with a 48-pack-year smoking history and more than 30 years of unprotected occupational exposure to cement dust, sand, road dust, and probable respirable crystalline silica. He presented with worsening dyspnea and a productive cough consistent with an acute exacerbation of COPD. Spirometry showed airflow obstruction with FEV1/FVC of 59% and FEV1 of 60% predicted, corresponding to GOLD 2 airflow obstruction if confirmed by post-bronchodilator spirometry. Chest radiography demonstrated emphysematous changes, including bilateral hyperinflation, flattened diaphragms, attenuated vascular markings, and a vertical cardiac silhouette. Using the seven-step work-relatedness assessment of the Indonesian Association of Occupational Medicine Specialists (PERDOKI), occupational exposure was interpreted as a possible contributing factor rather than a definitive or sole cause, given the patient’s substantial smoking history and the absence of quantitative exposure monitoring. Management combined guideline-based COPD pharmacotherapy, smoking abstinence, workplace exposure reduction, respiratory protection, work modification, pulmonary rehabilitation referral, and periodic occupational health surveillance. This case highlights the importance of systematic occupational history taking in COPD patients, especially among construction workers with dual exposure to smoking and mineral dust.