Evaluation of Brain Masses Using Magnetic Resonance Diffusion-Weighted Imaging (DWI)

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Background: Diffusion-weighted imaging (DWI) is a valuable MRI technique that provides information about tissue cellularity and helps differentiate various brain lesions.

Objective: To evaluate the role of DWI and apparent diffusion coefficient (ADC) values in the characterization of brain masses.

Methods: A descriptive cross-sectional hospital-based prospective study was conducted between January 2019 and May 2024 at the MRI Department of Aliaa Specialist Hospital, Khartoum, Sudan. Thirty patients with suspected brain tumors on CT were included. All patients underwent conventional MRI, contrast-enhanced MRI, DWI, and ADC measurement. Histopathological confirmation was obtained in all cases.

Results: Brain lesions included gliomas, metastases, meningiomas, schwannomas, abscesses, epidermoid cysts, hemangioblastomas, and medulloblastomas. ADC values varied among lesion types, with lower values generally observed in high-grade and highly cellular tumors.

Conclusion: DWI and ADC measurements are valuable tools in differentiating brain masses, particularly in distinguishing benign from malignant lesions.

Association of Economic Status and Type of Occupation with Changes in Risky Behaviors among People Living with HIV/AIDS in Kupang City, Indonesia

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Background: Human Immunodeficiency Virus (HIV) remains a major global public health problem. Changes in risky behaviors among people living with HIV/AIDS (PLWHA) play a crucial role in preventing further transmission. Socioeconomic factors, particularly economic status and type of occupation, may influence behavioral changes by affecting access to health information and services.

Objective: This study aimed to analyze the association between economic status and type of occupation with changes in risky behaviors among people living with HIV/AIDS in Kupang City, Indonesia.

Methods: An analytical observational study with a cross-sectional design was conducted among adult PLWHA in Kupang City from August to October 2024. A total of 136 respondents were selected using non-probability consecutive sampling. Data were collected using structured questionnaires assessing economic status, type of occupation, risky behaviors, and changes in risky behaviors. Data analysis was performed using descriptive statistics and Spearman rank correlation test, with a significance level of p < 0.05.

Results: Most respondents showed changes in risky behaviors after being diagnosed with HIV. Statistical analysis demonstrated a significant association between economic status and changes in risky behaviors among PLWHA. In addition, type of occupation was also significantly associated with changes in risky behaviors.

Conclusion: Economic status and type of occupation are significantly associated with changes in risky behaviors among people living with HIV/AIDS in Kupang City. These findings highlight the importance of incorporating socioeconomic considerations into HIV prevention and behavioral intervention programs.

Sustaining Leprosy Elimination in Sri Lanka: The Way Forward

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Background: Leprosy (Hansen’s disease) remains a public health concern in Sri Lanka decades after achieving WHO elimination as a public health problem (<1 prevalence per 10,000) in 1995. Although prevalence targets were reached, new case detection rates have remained persistently elevated, with 1,000–2,000 new cases annually and evidence of ongoing transmission, including among children. Continued disability and social stigma complicate disease control.

Objectives: To evaluate current epidemiology, control efforts, and barriers to elimination in Sri Lanka, and propose an evidence-based way forward, aligned with the WHO “Towards Zero Leprosy” Strategy (2021–2030).

Methods: A mixed-methods approach was used, combining national surveillance data (Ministry of Health and Anti-Leprosy Campaign), active case finding surveys, quality of life and stigma studies, and review of global control strategies. Quantitative data on annual case detection rates by age, disability, and geographic region were compiled. A narrative synthesis of interventions and outcomes was undertaken.

Results: Sri Lanka reports approximately 1,500–2,000 new leprosy cases annually, with about 10% in children. Case detection rates fluctuate between 7 and 12 per 100,000 population. Grade 2 disability proportions (visible deformities) range from 6–8%, indicating delayed diagnosis. Active case finding in endemic districts reveals hidden disease burdens (~20/10,000 in targeted surveys). Stigma and quality-of-life impacts remain substantial. Global strategies emphasize integrated services, enhanced surveillance, and prevention of transmission, stigma reduction, and disability management.

Conclusions: While past efforts successfully reduced prevalent leprosy, sustained transmission persists. Achieving elimination of transmission and zero disability requires strengthened surveillance, integrated health services, intensified contact tracing with post-exposure prophylaxis (PEP), stigma reduction programs, and regionally tailored interventions. A roadmap toward elimination by 2035 is proposed, aligning national targets with WHO guidance.

The Relationship of a Balanced Diet with Blood Pressure and Blood Sugar in Patients with type 2 Diabetes Mellitus in Urang agung Sidoarjo Village

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Type 2 diabetes mellitus (T2DM) causes metabolic disorders related to a pathological condition characterized by an increase in glucose concentration in the bloodstream beyond a set threshold (hyperglycemia). Hyperglycemia often accompanies metabolic syndrome especially involving hypertension which can worsen complications in people with diabetes. One effective way to control blood sugar and blood pressure levels is by implementing a balanced diet. There are 50 people with T2DM in the village of Urang Agung Sidoarjo with an increase of 1-3 people every month. The purpose of this study was to determine the relationship between a balanced diet with blood pressure and blood sugar levels measured by the GOD-POD method. This research is a quantitative study using chi-square analysis. tional. The study sample of 44 people was taken with purposive sampling technique. The results showed that blood sugar levels were significantly associated with blood pressure, especially systole in patients with T2DM. In addition, a balanced diet was also found to be significantly related to blood sugar levels, but not significantly related to blood pressure.

The Relationship Between Worm Infection and Nutritional Status of Elementary School Students in the Working Area of the Nulle Public Health Center

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Background: Soil-transmitted helminth (STH) infections remain a neglected public health problem in tropical regions, particularly in areas with poor sanitation and hygiene. These infections predominantly affect school-aged children and may contribute to impaired nutritional status. The working area of the Nulle Public Health Center is located in South Central Timor Regency, an area known to have a high prevalence of chronic malnutrition, highlighting the need to evaluate factors associated with nutritional problems.

Objective: To determine the prevalence of worm infection, nutritional status, and the association between worm infection and nutritional status among elementary school students in the working area of the Nulle Public Health Center.

Methods: This study employed a descriptive-analytic design with a cross-sectional approach. A total of 263 elementary school students were selected using cluster random sampling. Data collection included a risk-factor questionnaire, microscopic stool examination using 1% Lugol solution and eosin, and anthropometric assessment for nutritional status. Data were analyzed using univariate and bivariate methods. Fisher’s exact test was applied with a significance level of p<0.05.

Results: The prevalence of worm infection was 4.6% (12 out of 263 students). The most common helminth species identified was Ascaris lumbricoides (83.3%), followed by Trichuris trichiura and mixed infections (8.3% each). Nutritional status was predominantly normal (61.6%), followed by undernutrition (21.3%), severe malnutrition (13.3%), and overnutrition (3.8%). Among students with positive worm infection, the majority were classified as severely malnourished. Statistical analysis demonstrated a significant association between worm infection and nutritional status (p<0.05).

Conclusion: There is a significant relationship between worm infection and nutritional status among elementary school students in the working area of the Nulle Public Health Center.

Effect of Black Garlic Extract on Aspirin-Induced Gastric Mucosal Injury in Wistar Rats (Rattus norvegicus)

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, are widely used but are associated with gastric mucosal injury through inhibition of prostaglandin synthesis and oxidative stress mechanisms. Black garlic, a processed form of Allium sativum, has been reported to possess antioxidant and anti-inflammatory properties that may provide gastroprotective effects. Objective: To evaluate the effect of black garlic extract on aspirin-induced gastric mucosal injury in Wistar rats (Rattus norvegicus). Methods: This experimental laboratory study used a posttest-only control group design. Male Wistar rats were allocated into a negative control group, a positive control group receiving aspirin, and three treatment groups administered black garlic extract at doses of 50 mg/kg, 100 mg/kg, and 200 mg/kg body weight. Aspirin was administered orally at 104 mg/kg body weight for seven days to induce gastric mucosal injury, followed by seven days of black garlic extract administration in the treatment groups. Gastric tissues were collected for histopathological examination, and epithelial injury was assessed using the Barthel Manja scoring system. Data were analyzed using non-parametric statistical tests.

Results: Histopathological evaluation demonstrated gastric mucosal epithelial injury in the positive control group, predominantly in the form of desquamation and erosion. Administration of black garlic extract was associated with reduced severity of mucosal injury, with progressive improvement observed at higher doses. The group receiving 200 mg/kg body weight showed no detectable gastric mucosal lesions. A significant difference in gastric mucosal injury was observed among groups (p<0.001).

Conclusion: Black garlic extract exhibited a protective effect against aspirin-induced gastric mucosal injury in Wistar rats, with the highest dose demonstrating the most favorable histopathological outcome.

The Effect of Moringa Leaf Soup (Moringa oleifera) on Total Cholesterol Levels among Overweight Employees at Nusa Cendana University

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Background: Overweight and obesity remain major global health problems and are closely associated with metabolic disorders, including hypercholesterolemia. Elevated total cholesterol levels contribute significantly to the development of atherosclerosis and increase the risk of cardiovascular diseases. In Indonesia, particularly in East Nusa Tenggara, the prevalence of overweight and obesity is relatively high among employees. Moringa oleifera, a locally available plant widely consumed as food, contains dietary fiber and bioactive compounds with antioxidant properties that may influence lipid metabolism.

Objective: This study aimed to evaluate the effect of moringa leaf soup consumption on changes in total cholesterol levels among overweight employees at Nusa Cendana University.

Methods: A pre-experimental study with a one-group pre-test–post-test design was conducted among 27 employees selected using purposive sampling. Participants received moringa leaf soup as an intervention for seven consecutive days. Total cholesterol levels were measured before and after the intervention using capillary blood samples analyzed with a point-of-care testing device. Data were analyzed using a paired sample t-test.

Results: The mean total cholesterol level before the intervention was 190.18 mg/dL, which decreased to 179.22 mg/dL after the intervention. The mean reduction in total cholesterol level was 10.96 mg/dL. Statistical analysis demonstrated a significant decrease in total cholesterol levels following seven days of moringa leaf soup consumption (p = 0.012).

Conclusion: Consumption of moringa leaf soup was associated with a significant reduction in total cholesterol levels among overweight employees at Nusa Cendana University.

Evaluation of a Mass Deworming Program Achieving Zero Prevalence of Soil-Transmitted Helminth Infections among Primary School Children in Flood-Prone Areas

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Background: Soil-Transmitted Helminth (STH) infections remain a significant public health problem in tropical regions, particularly in areas with poor sanitation and susceptibility to flooding. Evaluating STH control programs is essential to measure the effectiveness of interventions.

Objective: To evaluate the effectiveness of the mass deworming program in reducing STH prevalence among primary school children in flood-prone areas.

Methods: An analytical observational cross-sectional study was conducted in Umatoos Village, Malaka District, from September to October 2025. The sample consisted of 194 primary school students (from SDK Umatoos, SDI Beilout, and SDK Loomota) selected from a population of 311 students. Stool samples were examined microscopically using the 2% Lugol method to detect STH infections. Risk factor data were collected using a structured questionnaire. Descriptive data analysis was performed using SPSS version 25.

Results: None of the 194 stool samples examined tested positive for STH, resulting in a prevalence of 0%. A total of 85.6% of respondents reported taking deworming medication regularly every six months. Hygienic behavior indicators showed that 91.2% washed their hands before meals, 95.4% washed their hands after defecation, 73.7% trimmed their nails regularly, and 87.1% consistently wore footwear. Environmental sanitation conditions were relatively good, with 93.3% of households having latrines and 93.8% using piped water or well water.

Conclusion: The mass deworming program implemented consistently since 2016, combined with good personal hygiene practices and adequate environmental sanitation, successfully achieved zero STH prevalence among primary school children in flood-prone areas. These findings support a comprehensive approach integrating medical interventions and behavioral changes in controlling neglected tropical diseases.

Factors Influencing the Occurrence of Musculoskeletal Disorders Among Naibonat Primary Health Center Staff

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Background: Musculoskeletal disorders indicate problems with the musculoskeletal system, which includes bones, muscles, tendons, ligaments, cartilage, and nerves. Discomfort in the musculoskeletal system is often felt in the neck, shoulders, arms, hands, back, waist, and lower body muscles. Musculoskeletal disorders (MSDs) experienced by workers in community health centers can reduce productivity, increase absenteeism, and decrease the quality of health services.

Objective: This study aimed to analyze the relationship between occupational and individual risk factors and the incidence of musculoskeletal disorders among workers at the Naibonat Public Health Center, Indonesia.This study applied an observational quantitative method with a cross-sectional design. The sample was taken using random sampling techniques with a total of 50 samples. Univariate and bivariate analyses were performed using the Contingency Coefficient test and Spearman’s rank correlation test with the help of the SPSS program.

Result: The results of the analysis showed that the prevalence of musculoskeletal disorders among workers was 72% at a low-risk level, 24% at a moderate-risk level, and 4% at a high-risk level. No significant associations were found between individual factors (age, sex, and body mass index) and the incidence of musculoskeletal disorders (p > 0.05). In contrast, occupational factors including work posture and length of service showed significant associations with musculoskeletal disorders (p < 0.05), while daily working duration was not significantly associated (p > 0.05).

Conclusions: MSD among workers at the Naibonat Public Health Center were predominantly at a low-risk level. Work posture and length of service were significantly associated with musculoskeletal disorders, highlighting the need for periodic ergonomic evaluations, posture training, regular stretching exercises, and promotion of physical fitness among primary healthcare workers.

The Relationship Between Family Support and Adherence with Hemodialysis in Chronic Kidney Disease Patients in Kupang City

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Background: Chronic kidney disease is a progressive condition requiring long-term therapy, one of which is hemodialysis. Adherence to hemodialysis is crucial for reducing complications and improving patients’ quality of life. Family support is considered a factor influencing adherence, but previous research findings remain inconsistent.

Objective: To determine the relationship between family support and adherence with hemodialysis in patients with chronic renal failure in Kupang City.

Methods: This study used an observational analytical cross-sectional design. Data was collected through the completion of family support and ESRD-AQ questionnaires by 163 respondents who met the inclusion and exclusion criteria. Sampling was conducted using purposive sampling. Data analysis was performed using univariate and bivariate analysis with Fisher’s exact test.

Results: The results showed that 95.7% of patients had good family support, followed by 4.3% who had poor family support. The prevalence of adherence with hemodialysis was 82.8% compliant and 17.2% non-compliant. The statistical test yielded a p-value of 0.345.

Conclusion: There was no significant relationship between family support and adherence with hemodialysis in patients with Chronic Kidney Disease in Kupang City.