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.

Dilated Cardiomyopathy Following Total Thyroidectomy Complicated by Severe Mitral Regurgitation: A Case Report and Literature Review

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Cardiac dysfunction following thyroid and parathyroid surgery is rare but clinically significant. Hormonal disturbances, including iatrogenic hypothyroidism and calcium metabolism disorders, may adversely affect myocardial function and the mitral valve.

We report the case of a 56-year-old woman who underwent thyroidectomy and parathyroidectomy in 2024. One year later, after discontinuation of thyroid hormone replacement and calcium supplementation, she progressively developed dyspnea, peripheral edema, and heart failure. Transthoracic echocardiography revealed hypokinetic dilated cardiomyopathy (left ventricular ejection fraction [LVEF] 32%) associated with severe functional mitral regurgitation. Laboratory tests showed marked hypothyroidism (TSH 95 µIU/mL, free T4 2.39 pmol/L), hypocalcemia (total calcium 43 mg/L), and elevated NT-proBNP levels (7,850 ng/L).

Management combined guideline-directed medical therapy for heart failure, gradual thyroid hormone replacement, calcium supplementation, and discussion of potential surgical/valvular intervention. After six months of follow-up, a significant improvement in cardiac function and regression of mitral regurgitation were observed.

This case highlights the importance of cardiologic and endocrinologic surveillance after thyroid and parathyroid surgery. Early recognition of hormonal abnormalities and cardiac dysfunction is crucial to optimize management and improve prognosis.

The Effect of Screen Time Duration on Fine Motor Development in Children Aged 2–5 Years in Kupang, East Nusa Tenggara

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Background: Preschool children in Indonesia continue to experience developmental challenges. National data indicate that fewer than half of children aged 1–59 months receive standardized developmental monitoring. At the same time, increased access to digital devices has made screen time a routine part of early childhood, potentially reducing opportunities for physical play that are essential for fine motor skill development.

Objective: To examine the association between screen-time duration and fine motor development among children aged 2–5 years in the service areas of the Sikumana and Tarus Community Health Centers.

Methods: This study employed an analytic correlational design with a cross-sectional approach. A total of 55 children aged 24–60 months were recruited using consecutive sampling. Screen-time duration was assessed using a questionnaire adapted from the SMALL-Q, while fine motor development was evaluated using age-specific fine motor items from the Developmental Pre-Screening Questionnaire (Kuesioner Pra Skrining Perkembangan/KPSP). Data were analyzed using the Spearman rank correlation test.

Results: The results showed that 54.5% of children were exposed to excessive screen time (>60 minutes/day), and 63.6% demonstrated fine motor development that was not appropriate for their age. A significant moderate negative correlation was observed between screen-time duration and fine motor development (r = −0.449; p = 0.001). Children with excessive screen time had a substantially lower proportion of age-appropriate fine motor development (16.7%) compared with children who adhered to recommended screen-time limits (60%).

Conclusion: There is a significant and moderately strong association between screen-time duration and fine motor development among children aged 2–5 years. Parental education on limiting screen time and ensuring active supervision is crucial to support optimal fine motor development in early childhood.

Service Quality and Patient Satisfaction in Pharmacy Settings: A Systematic Review Using SERVQUAL Dimensions

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Background: Service quality is a fundamental determinant of patient satisfaction in pharmacy services. SERVQUAL, consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy, is widely applied; however, the magnitude and consistency of its association with satisfaction vary by context. Objective: To synthesize available evidence on the relationship between SERVQUAL dimensions and patient satisfaction in hospital and community pharmacy settings amid growing digital healthcare adoption. Methods: This systematic review followed PRISMA 2020 guidelines. A total of 8,225 records were screened from Google Scholar and PubMed. Twelve quantitative studies conducted between 2017–2025 met inclusion criteria. The JBI Cross-Sectional Critical Appraisal Checklist was applied to assess methodological rigor. Results: All studies showed positive satisfaction outcomes, but predictive power varied across settings. In community pharmacies, medicine supply, environment, and communication were dominant satisfaction predictors. Meanwhile, reliability, assurance, and empathy were most influential in hospital pharmacies. Several studies reported non-significant effects for responsiveness and tangibles, indicating expectation–performance discrepancies and contextual constraints. Digital service readiness appears to influence patient experience but is rarely assessed using SERVQUAL. Conclusion: SERVQUAL remains a robust predictor of pharmacy service satisfaction; however, its impact is context-dependent. Strategic integration of SERVQUAL into digital transformation processes such as electronic prescriptions, automated dispensing, and digital queue systems will be essential to maintain quality and patient-centered outcomes.

Right Femoral Lengthening: A Case Report

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We present the case report of a 34-year-old female patient with a history of epilepsy, presenting with a 10-cm congenital shortening and varus deformity of the right femur, in addition to a 1-cm tibial shortening resulting from a previous open fracture during adolescence. Surgical correction was performed using diaphyseal osteotomy and bone lengthening with a monoplanar external fixator (Orthofix). Following a 6-day latency period, progressive distraction was initiated at a rate of 0.75 mm/day. A total femoral lengthening of 9 cm and axis correction were achieved over 4 months. The consolidation phase lasted 9 months. Complications included superficial pin-tract infection and knee stiffness, both successfully managed with medical treatment and physical therapy. The fixator was removed after 14 months of evolution. Upon discharge, the patient achieved stable functional recovery without significant claudication.

Pediculicide Resistance and Current Therapeutic Effectiveness in Pediculus Humanus Capitis: A Literature Review

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Pediculus humanus capitis infestation remains a persistent global public health burden, with recent evidence showing a sharp decline in treatment success due to widespread pediculicide resistance. Over the past decade, molecular studies have consistently identified a high frequency of voltage-gated sodium channel (kdr) mutations—particularly T917I, L920F, T929I, and L932F—which significantly reduce lice sensitivity to pyrethroid-based agents such as permethrin and fenothrin. These mutations are often accompanied by increased activity of detoxification enzymes, including acetylcholinesterase, glutathione S-transferase, and cytochrome P450 oxidase, which contribute to cross-resistance and explain repeated treatment failures in communities. Clinical and laboratory bioassays conducted between 2020 and 2025 in Indonesia, Thailand, Iran, India, Saudi Arabia, Turkey, and several African regions consistently reported low mortality and longer survival after pyrethroid exposure, confirming that resistance is now globally entrenched. In contrast, emerging non-pyrethroid therapies such as dimethicone formulations, 0.5% topical ivermectin, squalane-based preparations, and standardized botanical shampoos demonstrate strong and sustained pediculicidal activity with minimal evidence of resistance, reduced reinfestation, and a good safety profile. These alternatives primarily work through physical mechanisms or neuro-inhibitory pathways unaffected by kdr mutations, making them promising first-line options. This literature review synthesizes findings from 10–12 primary studies supported by 26 recent publications to provide an up-to-date overview of resistance mechanisms, kdr mutation distribution, and the comparative effectiveness of existing therapies. Overall, the available evidence highlights the need to revise treatment guidelines, enhance molecular surveillance, and prioritize non-pyrethroid agents.

Assessment of Systemic Inflammatory and Metabolic Markers in Patients of Waja’ al-Rukba (Knee Pain): A Clinical Laboratory-Based Study

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Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability in older adults. Knee osteoarthritis, a major subtype, closely resembles Waja’-al-Rukba described in Unani medicine, both sharing chronicity, pain, stiffness, and restricted mobility. Unani scholars attribute its origin to Sū’-i-Mizāj (abnormal temperament) and accumulation of Mawād-e-Fuzūni (morbid material) in joints.

Our aim is to evaluate the relationship between Mizāj (temperament) and biochemical markers of inflammation and metabolism (CRP, uric acid, BMI) in patients with Waja’-al-Rukba (knee pain), and to assess their role in disease risk and progression.

A cross-sectional study was conducted on 75 patients (aged 40–80 years) attending the OPD and IPD of of Ilaj bit Tadbeer and Moalejat in Ajmal Khan Tibbiya College and hospital, Ajmal Khan Tibbiya College, AMU, Aligarh. Mizāj was assessed using standard Unani parameters. Laboratory investigations included ESR, CRP, uric acid and BMI.

In our study we have find that most of the patients (76%) were aged between 40–50 years with females predominance (89%). Balghamī Mizāj (phlegmatic) was the most common temperament (41%), followed by Ṣafrāwī (27%), Damawī (20%), and Sawdāwī (12%). Balghamī individuals had the highest mean BMI (27–29.6 kg/m²) and mean uric acid level (5.98 ± 0.9 mg/dl). CRP positivity was also highest in the Balghamī group (12 cases). These findings indicate a strong association of Balghamī Mizāj with obesity, hyperuricemia, and inflammation.

The study demonstrates a significant correlation between Mizāj (temperament) and metabolic–inflammatory markers, validating Unani concepts through modern biomedical parameters. Balghamī temperament predisposes individuals to inflammatory and metabolic derangements such as osteoarthritis, supporting the integration of Unani temperament-based assessment in preventive and therapeutic frameworks.

The Effect of Health Education on Knowledge and Attitudes Toward Depression Among Eleventh-Grade Students at SMK Umi Kulsum Banjaran Bandung

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Objective: This study aimed to evaluate the effect of health education on students’ knowledge and attitudes toward depression among adolescents.

Theoretical Framework: The research is grounded in health behavior theories such as the Health Belief Model and mental health literacy frameworks, emphasizing the role of education in shaping awareness and behavioral responses to mental health issues.

Method: A pre-experimental one-group pretest-posttest design was used. The sample consisted of 85 eleventh-grade students at SMK Umi Kulsum Banjaran Bandung, selected through total sampling. Data were collected using structured questionnaires before and after a health education session on depression. Statistical analysis was conducted using the Wilcoxon Signed-Rank Test.

Results and Discussion: The study revealed a statistically significant increase in students’ knowledge (p = 0.000) and attitudes (p = 0.001) regarding depression after the intervention. These results indicate that structured health education effectively enhances awareness and fosters a more positive attitude toward mental health issues in adolescents. Limitations include the absence of a control group and short-term evaluation.

Research Implications: The findings suggest that integrating mental health topics into school-based health education programs can improve mental health literacy among students, potentially leading to earlier recognition and intervention in cases of adolescent depression.

Originality/Value: This research contributes to the growing field of adolescent mental health promotion by demonstrating the practical impact of targeted educational interventions in vocational school settings.

Acute and Sub acute Toxicity Studies of Euphorbia hirta on Mice and Wistar rats

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This study aimed at evaluating the acute and subacute toxicity of the aqueous leaf extract of Euphorbia hirta in experimental animals. For acute toxicity assessment, mice were orally administered single doses of 2000 and 3000 mg/kg  body weight (bw), with the administration volume set at 1 mL/100 g bw. A limit test was conducted to estimate the median lethal dose (LD₅₀). In the subacute toxicity study, rats received daily oral doses of 500, 1000, 2000 and 3000 mg/kg bw for 28 consecutive days. A control group received distilled water. Biochemical parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), Alanine phosphatase (ALP), Total protein, creatinine and Urea were analyzed in plasma samples. Hematological parameters such as red and white blood cell counts, hemoglobin, hematocrit and platelets were also evaluated. Histopathological examination of the liver and kidneys was performed to assess organ-specific toxicity. The results indicated that the LD₅₀ of the aqueous extract of Euphorbia hirta is greater than 3000 mg/kg, suggesting low acute toxicity. In the subacute study, histological examination of rat organs revealed no acute or chronic damage, although minor liver changes such as sinusoidal dialatation and mild portal inflammation were observed at high doses which is supported with elevated AST and ALT. In conclusion, the toxicological profile indicates that these extracts are safe at tested doses, although higher concentrations may warrant caution due to mild histological and biochemical changes.