International Journal on Health and Medical Sciences

Risk analysis of unsafe actions and unsafe conditions associated with occupational accidents among patchouli oil distillery workers

Hesti Hesti — 2026-08-19

Traditional patchouli oil distillation exposes workers to heat, pressure, unsafe equipment, and limited safety measures. However, studies have rarely combined worker level statistical evidence on accident related factors with task specific risk prioritization in this industry. This study examined associations between unsafe actions, unsafe conditions, and occupational accidents and identified priority risks and controls. A cross-sectional study included all 130 workers in Benua and Lalembu Districts, South Konawe Regency, Indonesia. Data were collected using questionnaires, interviews, and direct observation. Associations were assessed using chi-square tests and odds ratios with 95% confidence intervals. Hazard Identification, Risk Assessment, and Determining Control was used to connect hazard identification and likelihood severity assessment with the selection of practical controls. Overall, 73.8% reported a history of occupational accidents. Burns were most common (42.3%), and opening (58.5%) and closing (57.7%) vessels were the most accident prone activities. Unsafe actions (OR=4.10; 95% CI: 1.69–9.96; p=0.001) and unsafe conditions (OR=2.68; 95% CI: 1.13–6.35; p=0.022) were significantly associated with accidents. HIRADC generated a tas -specific hazard register, risk-priority ranking, and control plan. High priority risks included vessel explosions, hot surfaces, leakage, inadequate maintenance, and absent safety instruments and operating procedures. Integrating statistical association analysis with HIRADC provides a context-specific risk control framework for this understudied industry. The findings support engineering controls, inspections, standard operating procedures, training, supervision, and appropriate personal protective equipment, providing distillery owners and occupational health authorities with practical priorities for preventing severe accidents.

Determinants of antenatal care attendance among women in Akabiluru District: A cross-sectional study

Vittria Meilinda — 2026-07-15

Antenatal care (ANC) is essential for the early detection of pregnancy complications and the preparation for safe childbirth. Despite national targets of 90% coverage for the fourth ANC visit (K4) and 80% for the sixth ANC visit (K6), ANC utilization in Akabiluru District remains below these standards. In 2024, K4 and K6 coverage reached only 65.2% and 67.6%, respectively, at Piladang Primary Health Center, while Batu Hampar Primary Health Center reported lower rates of 42.0% and 36.0%. This study aimed to identify factors associated with ANC visits among women in Akabiluru District. A descriptive quantitative study with a cross-sectional design was conducted among 48 postpartum mothers within two months after delivery, selected through total sampling. Data were collected using structured questionnaires and analyzed using frequency distribution and Chi-square tests. The findings revealed that most respondents were aged 20–34 years (79.2%), multiparous (66.7%), had completed senior high school education (58.3%), and had family incomes below the regional minimum wage (66.7%). More than half of the respondents had low knowledge (58.3%) and did not complete the recommended ANC visits (58.3%). Bivariate analysis showed that attitude (p=0.000), motivation (p=0.001), husband’s support (p=0.008), and access to information media (p=0.000) were significantly associated with ANC visits. Knowledge, healthcare provider support, and socio-cultural factors were not significantly associated. Strengthening health promotion, antenatal education, and family planning programs may improve ANC utilization among pregnant women.

Knowledge of early stunting detection among posyandu cadres and mothers of under-five children: A cross-sectional study in Jambi city

Anindya Gizca Pramesti — 2026-08-06

Stunting remained a persistent public health problem in Jambi City, and Tanjung Sari Village recorded the highest number of stunted toddlers within its community health center working area. Since Posyandu cadres and mothers of toddlers served as the two key actors responsible for early stunting detection, this study analyzed the knowledge levels of both groups regarding early detection of stunting in that village. A quantitative descriptive design with a cross sectional approach was applied. Total sampling was used to enroll thirty five active Posyandu cadres, while seventy five mothers of toddlers were selected through simple random sampling. Data were collected using structured questionnaires that had been tested for validity and reliability, and were analyzed univariately. The results showed that most cadres, sixty eight point six percent, and most mothers, fifty eight point seven percent, had a high level of knowledge. However, both groups demonstrated weaker understanding in specific technical areas, cadres in interpreting child growth curves and mothers in recognizing physical signs of stunting and determining the appropriate timing for complementary feeding. These complementary gaps suggested that generally adequate knowledge alone had not been sufficient to lower the stunting burden in the study area. The findings indicated a need for targeted, technically focused, and jointly delivered training for cadres and mothers to strengthen community based early stunting detection efforts in Jambi City.

Comparison of acute kidney injury incidence after doxorubicin and cyclophosphamide chemotherapy in breast cancer patients with and without adequate oral hydration prevention

Samuel Pola Karta Sembiring — 2026-08-03

Background: Breast cancer is the leading cause of cancer death among Indonesian women, and the Doxorubicin and Cyclophosphamide (AC) regimen remains one of the primary systemic therapy options. This regimen carries significant nephrotoxic effects that can trigger acute kidney injury (AKI) in 10%–32.8% of patients, potentially causing permanent kidney damage and disrupting treatment continuity. Adequate oral hydration (30 mL/kg body weight/day) is an economical, practical preventive approach that accelerates drug metabolite excretion, but its effectiveness in reducing AKI incidence in clinical practice remains unclear. Aim: To compare AKI incidence in breast cancer patients undergoing AC chemotherapy between those who received adequate oral hydration prevention and those who did not. Methods: A prospective cohort study was conducted at the Surgical Oncology Clinic of Dr. Hasan Sadikin General Hospital, Bandung, from October 2025 to February 2026. Fifty-six subjects selected by consecutive sampling were divided into a prevention group and a no-prevention group (28 each). AKI was assessed using KDIGO criteria via serum creatinine at 48 hours and 7 days post-chemotherapy, and data were analyzed with the Chi-Square test. Results: Overall AKI incidence was 25% (14 of 56 subjects): 8 cases (28.5%) in the no-prevention group versus 6 cases (21.4%) in the prevention group. The Pearson Chi-Square test yielded p = 0.469 (p > 0.05). Conclusion: Although AKI cases were numerically lower in the prevention group, adequate oral hydration did not significantly reduce AKI incidence compared with no prevention in breast cancer patients undergoing AC chemotherapy.

Correlation between smartphone thermographic temperature and visual infusion phlebitis score in surgical patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital

Teguh Marfen Djajakusumah — 2026-08-03

Phlebitis is a common complication of peripheral intravenous catheter use that increases patient morbidity and length of hospital stay. The Visual Infusion Phlebitis (VIP) score is widely used for clinical assessment but remains subjective and does not incorporate temperature as an inflammatory marker. Smartphone-based infrared thermography offers a potential objective, non-invasive, and practical adjunct parameter. This study aimed to determine the correlation between local temperature measured by smartphone thermography and VIP score in patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital. An observational analytic study with a cross-sectional design was conducted in 37 patients with catheter dwell time ≥72 hours. Temperature at the infusion site was measured using a smartphone-based thermal camera and compared with the contralateral healthy area, while phlebitis severity was simultaneously assessed using the VIP score. Data were analyzed using the Shapiro–Wilk normality test and Spearman correlation test at a 95% confidence level. The mean VIP score was 1.86 ± 1.38 (range 0–4), and the mean infusion-site temperature was 35.9 ± 1.7°C (range 33.2–38.1°C). A statistically significant, moderate positive correlation was found between VIP score and thermographic temperature (r = 0.52; p = 0.002), indicating that higher VIP scores were associated with increased local temperature, reflecting the underlying inflammatory process. These findings suggest that smartphone-based thermographic imaging may serve as a useful objective adjunct in phlebitis evaluation among patients with peripheral intravenous access, complementing rather than replacing comprehensive clinical assessment.

Environmental health risk analysis of exposure to airborne particulate matter (PM10 and PM2.5) in residential areas surrounding a nickel smelter

Sukmawati Sukmawati — 2026-08-18

Comunities surrounding nickel smelters may be exposed to particulate emissions, yet evidence from Indonesia remains limited, particularly studies integrating measured PM₁₀ and PM₂.₅ concentrations with individual exposure characteristics. This study estimated non-carcinogenic inhalation risks among residents of Borongloe Village, which was selected because its settlements are located close to a nickel smelter industrial area in Bantaeng Regency. A descriptive study using Environmental Health Risk Assessment (EHRA) included 40 adult residents, with 10 representing the area surrounding each of four sampling points. Ambient concentrations were measured gravimetrically using a high-volume air sampler. EHRA integrated the measured concentrations with individual exposure time, frequency, duration, and body weight to estimate inhalation intake and risk quotients (RQs). Mean concentrations were 30.65 µg/m³ for PM₁₀ and 11.57 µg/m³ for PM₂.₅. The corresponding mean RQs were 0.0546 and 0.0287, while the maximum RQs were 0.2035 and 0.1169. All RQs were below one, although residents exposed for more than four hours per day had the highest estimates. Because measurements lasted only 90–120 minutes and the smelter was not operating at full capacity, these values indicate no appreciable non-carcinogenic risk only under the observed exposure scenario and do not demonstrate long-term safety. The results provide a practical basis for prioritizing air-quality monitoring, emission control, risk communication, and protection of residents with longer outdoor exposure. By integrating environmental measurements with individual exposure parameters, this study provides a site-specific baseline EHRA for an understudied community near an Indonesian nickel smelter. Repeated 24-hour and long-term monitoring during normal operations is required to determine risks under representative operating conditions.

Implementing sidik gizi: A digital screening program for mapping nutritional status of adolescents in islamic boarding school

Fatati Larasati — 2026-07-15

Traditional, paper-based health logging in residential schools often hinders timely public health responses due to manual diagnostic calculation lags. This study aimed to implement and evaluate "SIDIK GIZI" (Sistem Digital Skrining Gizi Mandiri), an e-Health application designed to streamline adolescent nutritional surveillance and assess end-user satisfaction. A cross-sectional implementation study was conducted in May 2026 at Pondok Salafy Al Fithroh, Gresik, Indonesia. Anthropometric data, comprising body weight, height, mid-upper arm circumference (MUAC), and waist circumference, were digitally registered from adolescent students (santri). Concurrently, system validation was measured using an integrated 5-point Likert scale survey completed by Santri Husada volunteers who operated the system across three domains: Ease of Use, Efficiency & Usability, and Usefulness & Impact. The application successfully mapped double-burden malnutrition indicators, flagging specific prevalence rates for underweight, stunting, chronic energy deficiency (CED) risks, and abdominal obesity. Furthermore, user satisfaction analysis demonstrated exceptionally positive feedback, specifically highlighting automated formula calculations, practical navigation layouts, and enhanced operational confidence among non-medical peer cadres. SIDIK GIZI reduced field screening times to 15–20 minutes per student while eliminating manual recording errors. In conclusion, this digital tracking model offers a sustainable, highly accepted health informatics framework that empowers boarding school communities to execute autonomous health monitoring, paving the way for data-driven preventive nutrition programs.

Guided biofilm therapy before recession type 2 coverage: Case report

Leonardo Jaya Setiadi Tanumiharja — 2026-08-18

Recession Type 2 defects are challenging because interproximal attachment loss reduces the predictability of complete root coverage. This case report describes the integration of a structured Guided Biofilm Therapy protocol into presurgical and supportive care for a 26-year-old male smoker with a Recession Type 2 defect at tooth 41 after unsuccessful orthodontic treatment. At baseline, the plaque index was 93% and bleeding on probing was 36%. Tobacco-cessation counselling, individualised oral-hygiene instruction, biofilm disclosure, air polishing, and site-specific instrumentation were provided over three preparatory visits. Before surgery, the plaque index and bleeding on probing had decreased to 7% and 4%, respectively. The defect was then treated with a laterally closed tunnel and a palatal subepithelial connective tissue graft. At 6 months, the plaque index was 11% and bleeding on probing was 5%; at 12 months, the corresponding values were 7% and 5%. Complete clinical root coverage was maintained at both follow-ups, and serial radiographs showed changes suggestive of increased interproximal bone fill. The favourable outcome followed a combined program of risk-factor control, professional biofilm management, surgery, and maintenance; the independent effect of Guided Biofilm Therapy cannot be determined from a single case. Standardised controlled studies are required to clarify its adjunctive value in periodontal plastic surgery.

Omega-3 with guided biofilm therapy in periodontitis: Case report

Leonardo Jaya Setiadi Tanumiharja — 2026-08-19

Stage IV periodontitis requires sustained biofilm and inflammatory control. Evidence for omega-3 adjuncts is heterogeneous, and their use within a structured Guided Biofilm Therapy (GBT) pathway for Stage IV disease has not been evaluated. This case report describes a 54-year-old man recorded as having generalised Stage IV, Grade C periodontitis who received GBT, site-specific ultrasonic and hand instrumentation, and adjunctive omega-3 supplementation. NOW Ultra Omega-3 was prescribed as one 1,000-mg softgel once daily before breakfast for 90 days; each softgel provided 500 mg eicosapentaenoic acid and 250 mg docosahexaenoic acid. From baseline to 6 months, full-mouth plaque and bleeding-on-probing scores decreased from 100% to 28%, mean probing depth from 4.8 to 3.2 mm, and mean clinical attachment level from 5.6 to 4.7 mm. Total leukocytes decreased from 8.87 to 6.70 × 10³/μL and C-reactive protein from 4.5 to 3.9 mg/L. The periodontal changes are compatible with a favourable short-term response to comprehensive non-surgical care, whereas the laboratory shifts remain descriptive. Because behaviour change, air polishing, instrumentation, supportive care, and omega-3 were delivered concurrently in one patient, neither component-specific efficacy nor causality can be inferred. A placebo-controlled randomised trial using identical periodontal care in both arms is required to isolate omega-3 effects; a factorial design would additionally test the GBT pathway. This case therefore provides a detailed hypothesis-generating observation rather than evidence of efficacy.

Analysis of potential drug interactions and their management in hypertensive patients receiving coronary heart disease medications at x hospital, Jambi city, Indonesia

Secio Lovellya — 2026-08-06

Hypertension is a chronic condition that may lead to various complications, including coronary heart disease (CHD). Patients with hypertension complicated by CHD commonly receive multiple medications, thereby increasing the risk of potential drug interactions that may compromise therapeutic efficacy or increase the incidence of adverse drug reactions. This study aimed to analyze the potential drug interactions based on their mechanisms and severity levels, as well as to describe the strategies used to manage these interactions among hypertensive patients receiving CHD medications at X Hospital, Jambi City. A descriptive retrospective study was conducted using outpatient medical records collected between January and December 2025. A total of 93 patients who fulfilled the inclusion and exclusion criteria were enrolled. Potential drug interactions were identified using the Drugs.com Drug Interaction Checker. The findings revealed that most patients were male and aged over 65 years. Prescriptions containing six to seven medications accounted for the highest proportion (56.99%). Based on severity, moderate interactions predominated, accounting for 507 cases (69.26%), followed by minor interactions with 167 cases (22.81%) and major interactions with 58 cases (7.92%). Regarding the underlying mechanism, pharmacodynamic interactions were considerably more frequent than pharmacokinetic interactions, representing 687 cases (93.85%) and 45 cases (6.15%), respectively. The combination of aspirin and bisoprolol was identified as the most frequently encountered drug interaction, occurring in 61 cases. Management of potential drug interactions primarily involved therapeutic monitoring and regular clinical evaluation to optimize treatment safety and effectiveness.

Effect of ergonomic seat redesign for a gingga machine on musculoskeletal disorder complaints among oil palm

Hengki Fernando Sinaga — 2026-08-19

Oil palm fertilization exposes workers to manual handling, repetitive movements, and non neutral postures, yet evidence is limited on ergonomic seating integrated into gingga machines used for fertilizer application. This study evaluated whether a redesigned gingga seat was associated with reduced musculoskeletal disorder complaints among oil palm fertilization workers. A quasi-experimental pretest posttest control-group study was conducted at an oil palm plantation in North Sumatra, Indonesia, from October to December 2025. Using purposive sampling, 84 eligible workers were allocated equally to an intervention group using gingga machines with redesigned seats (n = 42) and a control group continuing usual work (n = 42). Musculoskeletal complaints were measured using the Nordic Body Map and analyzed separately within each group using paired samples t-tests. The control group mean decreased from 61.45 to 60.80, a nonsignificant reduction of 0.65 points (p = 0.231). The intervention group mean decreased from 62.10 to 54.35, a significant reduction of 7.75 points or 12.5% (p < 0.001), with the group mean shifting from the painful to the slight-pain category. These findings suggest a potentially meaningful practical improvement following seat redesign. However, groups were not randomly assigned, baseline characteristics differed, and change scores were not compared directly between groups; therefore, a comparative intervention effect cannot be confirmed. The redesigned seats provide preliminary evidence for adapting gingga machines to workers’ physical support needs. Randomized or matched studies using anthropometric design, objective ergonomic measures, direct between group analysis, and longer follow-up are needed to confirm effectiveness and sustainability.

Preoperative lactate, wound complications, and mortality following major amputation in patients with peripheral artery disease

Teguh Marfen Djajakusumah — 2026-08-03

Introduction: Peripheral Arterial Disease (PAD) is a leading cause of major lower-extremity amputation, particularly in patients with severe ischemia, gangrene, infection, or when revascularization is no longer feasible. Preoperative blood lactate is a biomarker reflecting tissue hypoperfusion and systemic metabolic stress, but its prognostic role in predicting postoperative wound complications and mortality after major amputation in PAD remains limited. Methods: This was an analytic observational study with a prospective cohort design conducted at Dr. Hasan Sadikin General Hospital between November 2024 and November 2025. Adult patients with PAD who underwent major amputation were enrolled using total sampling. Preoperative lactate levels were categorized into <2.5, 2.5–4, and >4 mmol/L, and associations with postoperative wound complications and mortality were analyzed using Fisher's Exact test. Results: A total of 51 patients met the study criteria; 60.8% were male and 52.9% were older than 60 years. Diabetes mellitus was the most common comorbidity (64.7%). Postoperative wound complications occurred in all patients with lactate >4 mmol/L, compared with 16 of 44 patients with lactate <2.5 mmol/L (p = 0.016). Mortality occurred in 4 of 5 patients with lactate >4 mmol/L, compared with 7 of 43 patients with lactate <2.5 mmol/L (p = 0.001). Discussion: Preoperative blood lactate is significantly associated with postoperative wound complications and mortality following major amputation in patients with PAD. Elevated lactate, particularly >4 mmol/L, identifies patients with worse postoperative outcomes, supporting its use as a simple, rapid, and accessible biomarker for perioperative risk stratification.