Medicine and Health Sciences Commons^™

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …

Determinants Of Multimorbidity Among Stroke Patients For Epidemiological Management In Indonesia's Agro-Coastal Communities, Krish Naufal Anugrah Robby, Isa Ma'rufi, Farida Wahyu Ningtyias, Latifatul Izzah, Nurjazuli Nurjazuli, Suhartono Suhartono, Muchlis Achsan Udji Sofro, Ida Srisurani Wiji Astuti, Olivia Listiowati Prawoto, Dedek Sutinbuk, Taufik Kurrohman, Elhoussin Ouassou

Kesmas

Multimorbidity remains a major public health challenge among stroke patients, particularly in agro-coastal communities characterized by socioeconomic vulnerability, limited healthcare access, and lifestyle changes. This study aimed to analyze the determinants of multimorbidity among stroke patients in agro-coastal communities. A quantitative observational analytical design was employed, involving 45 stroke patients selected through total sampling in Jember District, Indonesia. Data were collected through structured interviews, anthropometric measurements, and secondary health records. The model included biological, socioeconomic, healthcare access, and lifestyle as exogenous variables, with multimorbidity as the endogenous variable. Data were analyzed using PLS-SEM, including evaluation of measurement and structural models …

Comparison Between The Tooth Coronal Index And Kvaal’S Method In Age Estimation In The Indonesian Population, Astika Swastirani, Nabilah Shafiyyah Rahmayati, Sari Kurniawati, Ferdy Jonathan Walelang

Journal of Dentistry Indonesia

Background: Age estimation in adults is important in forensic odontology, and radiographic approaches such as the Tooth Coronal Index (TCI) and Kvaal's method are commonly applied to panoramic radiographs. This study aimed to compare the agreement of TCI and Kvaal age estimates with chronological age in adults.

Methods: This cross-sectional analytic study evaluated 100 panoramic radiographs (50 males, 50 females) of adults aged 23–45 years. Measurements were performed on mandibular first premolars using ImageJ. Accuracy was operationalized as the closeness of the estimated age to the chronological age and assessed using mean differences and Wilcoxon signed-rank tests.

Results …

Morphometric Evaluation Of The Styloid Process Using Cone-Beam Ct In A Central Anatolian Population, Melda Misirlioglu, Aslı Atacan Aslan

Journal of Dentistry Indonesia

Background: Accurate evaluation of craniofacial anatomy is essential for diagnostic planning. Variations of the styloid process (SP) provide anatomical data that guide evidence-based clinical and surgical decisions in the head and neck region.

Methods: Retrospective cone-beam computed tomography (CBCT) scans retrieved from the Department of Oral and Maxillofacial Radiology were examined. SP length, medial angles, calcification patterns, and the radiomorphometric index were assessed.

Results: Middle-aged adults represented the majority of the sample. Gender had a statistically significant effect on SP morphology Type 1 was the most common bilaterally, followed by Type 2. Calcification patterns varied between genders …

Clinical Outcomes Of Adjunctive Use Of Oxygen-Releasing Formula In Non-Surgical Treatment Of Periodontal Abscess Associated With Type 2 Diabetes Mellitus, Anil Kumar Kanakamedala, Laxmi Kavya Gangireddy, Gautami S Penmetsa, Sruthima Gottumukkala, Mohan Kumar Pasupuleti, Konathala Santhosh Venkata Ramesh

Journal of Dentistry Indonesia

Background: This study aimed to evaluate the effectiveness of oxygen-releasing formula (ORF) as an adjunct in the non-surgical management of periodontal abscess in patients with type 2 diabetes mellitus.

Methods: This split-mouth clinical trial was conducted on 14 patients with periodontal abscess with type 2 diabetes mellitus (T2DM), who were divided into a control group, nonsurgical periodontal therapy (NSPT) alone, and a test group (NSPT+ORF). Parameters such as Landry's healing index (HI) were evaluated at 1 week, 2 weeks, and 1 month. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing presence or absence (BOP) …

Diode Laser And Conventional Ferric Sulfate Pulpotomy In Deciduous Molars: Comparative Outcomes In Myanmar Children, Moe Myat Noe Phyu Dr, Ei Ei Myo, Soe Naing

Journal of Dentistry Indonesia

Background: Pulpotomy is a widely accepted treatment for carious exposure of vital primary molars, using various medicaments. Currently, lasers have emerged as a non-pharmacologic pulpotomy technique. However, comparative clinical studies in Myanmar remain limited. This study aimed to compare the effectiveness of diode laser and conventional ferric sulfate pulpotomy in deciduous molars among children in Myanmar.

Methods: A total of 40 deciduous mandibular molars requiring pulpotomy treatment were selected from children between 4 and 8 years of age. The subjects were randomly assigned to the diode laser group (Group A) or the ferric sulfate group (Group B) using …

The Association Between Hypodontia, Supernumerary Teeth, Cleft Type, And Cleft Side In Pediatric Non-Syndromic Cleft Patients In Malaysia, Tan Hwa En, Mohammad Majduddin Sulaiman, Norsamsu Arni Samsudin, Nurhafizah Ghani

Journal of Dentistry Indonesia

Background: Cleft lip and palate are the fourth most common congenital facial anomalies worldwide. Cleft patients have a higher prevalence of dental anomalies than the general population. This study aimed to evaluate the prevalence of hypodontia and supernumerary teeth among the permanent teeth of pediatric patients with clefts at Hospital Pakar Universiti Sains Malaysia (USM).

Methods: A retrospective record review study was conducted using dental records and panoramic radiographs from 64 non-syndromic cleft patients aged 6 to 17 years who attended Hospital Pakar USM between 2019 and 2024. Inter-examiner reliability for the assessment of hypodontia was strong, with …

Psychosocial And Functional Impact Of Temporomandibular Disorder Subtypes Among Adults: A Cross-Sectional Study In Indonesia, Ni Luh Dewi, Wita Anggraini, Maria Valiente-Lopez, Carolina Marpaung

Journal of Dentistry Indonesia

Background: Temporomandibular disorders (TMDs) affect psychological, functional, and pain-related aspects of oral health-related quality of life (OHRQoL). However, the differential impact of pain-related and non-pain-related TMDs remains limited. This study aimed to evaluate the impact of different TMD subtypes on psychological distress, jaw function, and OHRQoL in young adults and to determine whether pain-related TMDs exert a greater effect than non-pain-related TMDs.

Methods: In this cross-sectional study, 278 university students (aged 18–24 years) were categorized into no TMD (NT), pain-related TMD (PT), intra-articular TMD (IT), and combined TMD (CT). Diagnoses were made using the 5Ts Questionnaire screening tool …

Adverse Drug Reaction Reporting In Dental Practice And The Importance Of Pharmacovigilance In Dental Education, Radhakrishna Lagishetty, Lakshmi Ramya T, Kvr Barath Raju, Mohan Kumar Pasupuleti

Journal of Dentistry Indonesia

Background: Adverse drug reactions (ADRs) are a critical component of patient safety; however, ADR monitoring remains underutilized in dentistry. This study aimed to assess knowledge, attitudes, and practices regarding ADR reporting among undergraduate and postgraduate students and practicing dentists.

Methods: A cross-sectional observational study was conducted using a structured, validated 19-item questionnaire covering socio-demographics, knowledge (6 items), attitude (4 items), and practice (5 items), which was distributed both in person and online. A total of 258 complete responses were analyzed out of 300 individuals contacted (response rate: 86%). Descriptive statistics and Chi-square tests were applied, with p < 0.05 considered statistically significant.

Results …

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Flaxseed Ethanolic Extract Modulates Β-Catenin And Dkk1 Expressions During Osteoblast Differentiation Of Dental Pulp-Derived Stem Cells, Nur Sazwi Nordin, Khairani Idah Mokhtar, Omar Abdul Jabbar Abdul Qader, Basma Ezzat Mustafa, Widya Lestari, Deny Susanti Darnis, Thirumulu Ponnuraj Kannan, Azlina Ahmad, Solachuddin Jauhari Arief Ichwan

Journal of Dentistry Indonesia

Background: WNT signaling regulates osteogenic differentiation of mesenchymal stem cells (MSC) through the canonical WNT pathway. β-catenin; an important molecule of WNT pathway, and DKK1; a WNT antagonist, play important roles in regulating bone formation. Although flaxseed (Linum usitatissimum) has various health benefits, including promoting bone health, our previous study showed that flaxseed ethanolic extract (FEE) reduced the osteoblast differentiation potential of stem cells from human exfoliated deciduous teeth (SHED). This study aimed to determine the effects of FEE on WNT pathway-related molecules, β-catenin and DKK1, during osteoblast differentiation of SHED.

Methods: RNA at Day 7, 14, …

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …

The Correlation Between Medication Adherence, Blood Glucose Levels, And Quality Of Life In Patients With Type 2 Diabetes Mellitus At Ciamis Regional Hospital, Amyla Putri Nurul Nazmi, Nur Rahayuningsih, Lusi N

Pharmacology and Clinical Pharmacy Research

Type 2 diabetes mellitus is a chronic condition requiring continuous treatment, including patient adherence to prescribed medication. This study aimed to explore the relationship between medication adherence, blood glucose levels, and quality of life in patients with type 2 diabetes mellitus at Ciamis Regional Hospital, conducted from January to March 2025, the research employed a quantitative, prospective cross-sectional design involving 49 hospitalized patients. Data included blood glucose levels (RPG, FPG, 2hPG), medication adherence measured using the Medication Adherence Report Scale (MARS-5), and quality of life assessed via the Diabetes Quality of Life-Brief Clinical Inventory (DQOL-BCI). The chi-square test was used …

The Phytochemical Content And Antibacterial Activity Of Purified Extract Of Mangifera Indica L. Against Gram Positive Pathogen, Dewi Andini Kunti Mulangsri, Masduki Faqih, Sugar Arifin, Mutiara Trie Sieya Agustin

Pharmacology and Clinical Pharmacy Research

The purified extract of arum manis mango leaves contained flavonoid compounds by TLC methods and antibacterial activity against Gram-positive and negative pathogens. This research aimed to identify and determine the phytochemical content (mangiferin and flavonoids content) and antibacterial activity against other Gram-positive pathogens. Purification of ethanol extract of arum manis mango leaves by liquid-liquid fraction method. Determination of total flavonoid content and identification of mangiferin used respectively by aluminum chloride and Thin Layer Chromatography method. The disk diffusion method was used to assay antibacterial activity against S. epidermidis, and B. subtilis bacteria with the concentration of the sample such …

Association Between Athletic Trainers And Frequency Of Pediatric Orthopedic Visits, Abaigeal Field, James M. Mensch, Courtney Meyer, Susan W. Yeargin

Clinical Practice in Athletic Training

Context: There is sparse research on the relationship between athletic trainer (AT) employment and the number of athletes presenting to orthopedic clinics with sports-related injuries. The purpose of this study is to determine if athletic training services are associated with the frequency of first-time orthopedic office visits for sports-related injuries.

Methods: A retrospective chart review collected injuries between January 1, 2018 and December 31, 2020 from the electronic health records system for a hospital network in the Southeast United States with 6 orthopedic clinics and included 48 high schools hosting 20 sports with at least 1 AT per school. Patients …

Implementation Of Medical Documentation Sign-In Sheets For Patient Evaluations And Treatments: A Quality Improvement Project, Madicyn Barnes, Beth Davis, Kaitlyn L. Holland, Zachary K. Winkelmann

Clinical Practice in Athletic Training

Context: Medical documentation of athletic training services at a large, public secondary school was limited to clinically significant or legally sensitive information entered into the electronic medical record (EMR) system. There are only 2 full-time athletic trainers (ATs) providing medical services to over 800 student-athletes across 45 different teams throughout the school year. Due to the large patient load, documentation is difficult to complete and, therefore, limited to the most “significant” information. The purpose of this quality improvement project was to improve medical documentation at this secondary school by implementing physical sign-in sheets in the athletic training facility (ATF) to …

Building On A Strong Foundation: Celebrating Our Past And Looking Toward The Future, Zachary K. Winkelmann

Clinical Practice in Athletic Training

No abstract

The Correlation Between Ankle Proprioception And Lower Extremity Muscle Reactions In Response To Simulated Ankle Sprains, Erin Carroll, Justin Stanek, Abby Salvadore

Clinical Practice in Athletic Training

Context: Neurological structures of the somatosensory system provide proprioceptive and neuromuscular input regarding joint positioning to the brain. Lower extremity motor control relies on local proprioceptive input to the central nervous system and neuromuscular control of individual joints to produce coordinated, global responses to external events. The purpose of this study was to investigate the relationship between ankle proprioception and lower extremity muscle reaction time in response to an unexpected ankle inversion perturbation.

Methods: Twenty healthy college-aged volunteers were recruited to participate by word of mouth. Absolute and exact errors for passive joint position sense (PJPS) were assessed using a …

The Evaluation Of A Soft Skills Curriculum In Athletic Training Education: A Mixed Methods Study, Emily A. Duckett, Heather Schugar, Alison Gardiner-Shires, Jacqueline S. Hodes

Clinical Practice in Athletic Training

Context: Developing athletic training students’ soft skills to effectively engage in patient-centered care is integrated throughout multiple Commission on Accreditation of Athletic Training Education Curricular Content Standards. Despite evidence supporting the importance of compassionate care, there is currently data to suggest that health care is experiencing a compassion crisis. The purpose of this study was to investigate the ways pre-professional athletic training students transfer knowledge from a soft skills curriculum to clinical experiences as students in an entry level master’s program.

Methods: This study is an explanatory sequential mixed methods design. Phase 1 includes participants (n = 19) enrolled in …

Electrical Stimulation And Localized Heat After Dry Needling Treatment To Reduce Low Back Pain, Morgan M. Mersola, Amanda Hawkes, Adam Mendenhall

Clinical Practice in Athletic Training

Context: Chronic low back pain (CLBP) is a musculoskeletal condition that often leads to reduced quality of life, prompting the need for effective conservative interventions such as dry needling (DN). A randomized controlled pilot study involving 12 participants was conducted at a physical therapy clinic.

Methods: The final subject pool consisted of a convenience sample of adults with CLBP lasting > 3 months. Participants were randomly assigned to either a dry needling-only group (DNO) or a dry needling plus modalities group (DN+M). The DNO group received a single dry needling treatment located at various sites along the multifidus by a physical …

Cost Effectiveness Analysis Of Psychopharmaca Therapy Combination Compared With Psychopharmaca Therapy And Ect Combination In Schizoaffective Inpatients At The Rsj Provinsi Jawa Barat, Yasmin Fadillah, Sani Asmi Ramdani Lestari, Ardilla Kemala Dewi

Pharmacology and Clinical Pharmacy Research

Mental disorders constitute an economic burden on health, estimated at USD 2.5 trillion in 2010 and expected to increase to USD 6 trillion by 2030. Treatment of schizoaffective disorder involves a combination of medication and psychotherapy. Pharmacoeconomics is an important consideration in drug selection. This study aims to determine the cost-effectiveness of psychopharmaca therapy combination compared with psychopharmaca therapy and ECT combination in schizoaffective inpatients at the RSJ Provinsi Jawa Barat. Data collection was conducted retrospectively from patient medical records for the period December 2023–December 2024. Total costs, based on a health perspective, include psychopharmaca drug costs, inpatient care costs, …

Evaluation Of Antibiotic Use Using The Gyssens Method On Clinical Outcomes In Ischemic Stroke Patients, Juniarto Mende, Graciano A. Maturbongs, Yohana K. A. Mbulang

Pharmacology and Clinical Pharmacy Research

Ischemic stroke is a health problem that causes death and neurovascular disability worldwide. The inflammatory response due to infection can increase ischemic stroke and increase brain damage through changes in blood pressure, coagulation, immune response, and endothelial function. This study aims to evaluate the rationality of antibiotic use on clinical outcomes in ischemic stroke patients. This study used a cross-sectional design. Retrospective data were taken from the medical records of Jayapura Regional Hospital for the period January 1, 2023, to May 31, 2025. The study subjects were all patients who suffered ischemic stroke and received antibiotics. Evaluation of the rationality …

Retrospective Analysis Of Antimicrobial Resistance Patterns In Gram-Positive And Gram-Negative Blood Isolates, Helman Kurniadi, Timbul Partogi Haposan Simorangkir, Ros Sumarny, Fitria Heldiana

Pharmacology and Clinical Pharmacy Research

Bloodstream infections are an important cause of morbidity and mortality, while antimicrobial resistance limits treatment options. This retrospective study evaluated bacterial distribution and antimicrobial susceptibility in blood cultures at RSPAD Gatot Soebroto, Jakarta, using microbiology and medical record data from January-December 2019. Clinically significant isolates were included, while duplicates and contaminants were excluded. Identification and susceptibility testing followed standard procedures and CLSI 2019 guidelines. Data were analyzed descriptively. Among 482 isolates, 246 (51.0%) were Gram-positive and 236 (49.0%) were Gram-negative. The Gram-positive isolates were mainly coagulase-negative staphylococci, including Staphylococcus epidermidis (62, 25.2%), S. hominis (61, 24.8%), and S. haemolyticus (50, …

Analysis Of Pharmacotherapy And Non-Pharmacotherapy Burden From The Ina-Cbgs Package For Cesarean Section Surgery At The Regional General Hospital Dr. Soedarso In 2023, Ananda Rizky Awwaliyah, Nurmainah Nurmainah, Ridha Ulfah

Pharmacology and Clinical Pharmacy Research

The prevalence of cesarean sections has been increasing each year. Previous studies show that the cost of medications and medical supplies for cesarean patients accounts for one-third of the total care costs. In the era of National Health Insurance (NHI), medications and medical supplies are considered operational expenses for hospitals rather than sources of income. This condition requires proper medication management and the use of medical supplies. This study aims to analyze the percentage of pharmacotherapy and non-pharmacotherapy, including the types and quantities of medications as well as disposable medical supplies used on patients undergoing cesarean section procedures at the …

Alexithymia In Substance Use Disorders: A Scoping Review Of Therapeutic Approaches, Pratami Diah Herliani, Shelly Iskandar, Angela Vera Herman Efendi

Pharmacology and Clinical Pharmacy Research

Alexithymia, defined as the inability to recognize and express emotions, has a high prevalence (40–50%) among individuals with substance use disorders (SUD), particularly alcohol use disorder, and is associated with poorer clinical outcomes. Despite this, comprehensive mapping of psychotherapeutic interventions targeting this condition within the SUD population remains limited. This study aimed to systematically map the therapeutic approaches investigated to address alexithymia among individuals with substance use disorders and to summarize the reported outcomes. A scoping review was conducted in accordance with the PRISMA-ScR guidelines using systematic literature searches in the PubMed and Scopus databases. Relevant studies were screened based …

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …

Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells

The Qualitative Report

This paper introduces relational–developmental autoethnography (RDA), a qualitative method for exploring psychological growth through personal writing and reflection. Developed through lived experience, RDA traces psychological development through sustained, recursive engagement with personal writing. Drawing on an archive of my journals, letters, clinical records, and correspondence spanning more than 30 years, I show how writing and reflection were first tools for my survival, and later became catalysts for insight, healing, and transformation. RDA is grounded in two developmental frameworks: Dąbrowski’s theory of positive disintegration, which views emotional intensity and inner conflict as signs of developmental potential, and relational-cultural theory, which …

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …

Contextualizing Second Language Anxiety In Multilingual Higher Education: Classroom Conditions And Clinical Settings, Busayo O. Ige

International Journal of Teaching and Learning in Higher Education

In South African universities, multilingual students whose first language is not English face distinct challenges that impact academic participation and success. This qualitative study examines how second language (L2) anxiety shapes first-year students’ classroom and clinical experiences at the University of Cape Town. Drawing on open-ended survey data, the study reveals that fear of negative evaluation, communicative apprehension, and prevailing language ideologies contribute to students’ reluctance to speak, feelings of invisibility, and withdrawal from engagement. Although anxiety tends to lessen over time, it rarely disappears completely. Notably, students experienced anxiety differently across settings: classroom discussions elicited greater fear and self-censorship, …

A Language We Built Together: A Physician Assistant’S Reflection On A Renal Transplant, Oviya Mahendran, Sampathkumar Sakthi Selvakumar

Journal of Wellness

This is not just a story of kidney transplantation in a tertiary care hospital in a tier-2 city of South India. It is all about a true clinical journey of resilience, where a young woman with congenital hearing loss, battling chronic kidney disease, discovered hope, understanding, and companionship through a physician assistant's compassionate communication.