MEDICA (International Medical Scientific Journal)

The Effectiveness of Electronic Medical Records by Nurses at Hospitals in East Kalimantan

Ratanto Ratanto — 2026-05-31

The implementation of electronic medical records (EMRs) has increased significantly in hospitals worldwide, including in Indonesia, due to their potential to improve healthcare quality, enhance efficiency, reduce medical errors, and support clinical decision-making. However, the effectiveness of EMR implementation varies across healthcare settings, highlighting the need for systematic evaluation. This study aimed to assess the effectiveness of EMR implementation in hospitals in East Kalimantan, Indonesia. A quasi-experimental study with a two-group post-test-only design was conducted involving 188 participants from two hospitals. Data were collected simultaneously and analyzed using the Mann–Whitney U test with a significance level of 0.05. The results revealed significant differences between the two hospitals in the dimensions of quality (p = 0.001), facilities (p = 0.028), functionality (p = 0.017), user satisfaction (p = 0.003), and overall effectiveness (p = 0.014). Hospitals implementing EMRs demonstrated higher effectiveness scores compared with hospitals that had not implemented EMRs. In conclusion, EMR implementation significantly influences the effectiveness of medical record management. These findings highlight the importance of optimizing EMR systems to improve healthcare service quality and operational performance in hospitals.

Effects of Stability Ball Core Exercises on Gluteus Maximus, Hamstring, Gastrocnemius, and Soleus Muscle Strength Among Post-Stroke Patients

Annisa Nuraini — 2026-05-31

Indonesia is the first rank of people with stroke in Asia and contribute 4.62% of all causes of mortality. It was predicted that in 2030, the number will increase to 23.3 million mortalities due to stroke. In Indonesia, in 2021, 12 people out of 1000 were diagnosed with stroke. Most of these conditions resulted in muscle weaknesses, especially in the lower extremities. This condition is a barrier to daily activities related to physical movement. The aim of this study is to test the effect of stability ball core exercises on gluteus maximus, hamstring, gastrocnemius, and soleus muscle strength among post-stroke patients. This study is a quasi-experiment pre and post-test with intervention and control groups. The sample size in this study consisted of 20 patients for each group selected by purposive sampling. The Mann-Whitney statistical test analyzed the data. The result found that stability ball core exercise significantly improved the muscle strength of the Gluteus Maximus and Hamstring, but found no significance with the gastrocnemius and soleus muscles. The future study could add a follow-up study to evaluate the long-term impact of this treatment.

Association Between 2-Hour Postprandial Blood Glucose Levels and Acid Fast Bacilli Positivity

Azhari Muslim — 2026-05-31

Pulmonary tuberculosis (TB) and hyperglycemia have a bidirectional relationship, whereby impaired glucose metabolism can weaken cellular immunity and potentially increase the bacterial burden, resulting in a higher degree of acid-fast bacilli (AFB) positivity. Although the 2-hour postprandial blood glucose (2h-PPBG) test is a practical indicator of glucose intolerance, its association with AFB positivity in pulmonary TB patients remains inadequately explored. This study aimed to analyze the relationship between 2h-PPBG levels and the degree of AFB positivity among patients with pulmonary TB. A cross-sectional study was conducted at the Sukamaju Community Health Center in 2024 involving 60 adult patients (≥18 years) diagnosed with pulmonary TB and diabetes mellitus. Participants were selected based on confirmed pulmonary TB diagnosis and complete blood glucose records. Data were analyzed using Spearman’s correlation test and binary logistic regression. The results demonstrated a strong and statistically significant positive correlation between 2h-PPBG levels and the degree of AFB positivity. Logistic regression analysis indicated that every 10 mg/dL increase in 2h-PPBG was associated with a 9.3% increase in the odds of higher AFB positivity. In conclusion, elevated 2h-PPBG levels were significantly associated with greater AFB positivity among patients with pulmonary TB and diabetes mellitus. These findings highlight the importance of routine glycemic screening and optimal glucose control as part of comprehensive tuberculosis management to reduce disease severity and improve treatment outcomes.

Maternal Health Interventions and Other Determinants of Childhood Stunting: A Cross-Sectional Study

Astuti Setiyani — 2026-05-31

Stunting remains a major public health problem in developing countries and is associated with impaired cognitive development, poor educational attainment, reduced productivity, and an increased risk of chronic diseases later in life. Maternal health during pregnancy is considered a key determinant of child growth and development. This study aimed to identify factors associated with stunting among children under five years of age, with a particular focus on maternal health interventions during pregnancy, including antenatal care, nutritional monitoring, and micronutrient supplementation. A cross-sectional study was conducted among 140 mothers of children under five years of age attending four community health centers in Surabaya, East Java, Indonesia. Participants were selected using proportionate stratified random sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics, Chi-square tests, and binary logistic regression, with a significance level of p < 0.05. The results of the study show that the prevalence of stunting was 21.4%. Bivariate analysis showed that maternal health interventions were significantly associated with stunting (p = 0.040), while breastfeeding and complementary feeding practices demonstrated a marginal association (p = 0.074). Child nutritional intake (p = 0.271), immunization and growth monitoring (p = 1.000), and environmental sanitation (p = 0.526) were not significantly associated with stunting. Multivariable logistic regression analysis identified maternal health intervention as the most influential factor associated with stunting (OR = 0.46; 95% CI: 0.23–0.94; p = 0.032), indicating a protective effect against stunting among children under five years of age. In conclusion, maternal health interventions during pregnancy play a significant role in reducing the risk of childhood stunting. Strengthening antenatal care services, maternal nutrition support, and health education for pregnant women should therefore be prioritized as part of integrated stunting prevention strategies at the primary healthcare level.

The Periodontal Tissue Health Status of Patients with Chronic Kidney Disease

Ani Subekti — 2026-05-31

Chronic Kidney Disease (CKD) is a significant global health issue, affecting approximately 700 million people worldwide. This study investigates the periodontal health of CKD patients in Banyumanik District, Semarang, Central Java, Indonesia, where the prevalence of CKD is notably high. A cross-sectional analysis involving 44 CKD patients from three community health centers was conducted. Data were collected through medical records and periodontal examinations using the Community Periodontal Index of Treatment Needs (CPITN) and the Gingival Index (GI). Results indicated that 70% of participants exhibited moderate to severe gingival inflammation, with an average GI score of 1.75. The majority required phase I periodontal treatment, including scaling and root planning. Significant correlations were found between gingival inflammation and factors such as hemodialysis history and the duration of CKD. Patients undergoing hemodialysis showed higher levels of gingival inflammation compared to those who were not. The findings highlight the critical need for regular periodontal assessments and interventions in CKD patients to mitigate oral health complications and improve overall quality of life. This study underscores the importance of integrating oral health management into the care of CKD patients, particularly in regions with high prevalence rates.

The Effectiveness of Online Nutrition Counseling on Fish and Protein Consumption to Prevent Stunting in Children Aged 4-6 Years

Lusyta Puri Ardhiyanti — 2026-05-31

Stunting remains a significant public health problem in Indonesia, and inadequate fish and protein intake among preschool children is a key modifiable risk factor. The use of Zoom- and telephone-based nutritional counseling represents a novel, accessible strategy for community-based dietary education, yet evidence on its effectiveness in the Posyandu setting remains limited. This study aimed to evaluate the effect of nutritional counseling delivered through Zoom meetings and telephone communication on fish consumption and protein intake among children aged 4–6 years. A quasi-experimental one-group pretest–posttest design was employed at Posyandu Rajawali 1 and 2, Tugu Village, Depok, West Java. All 22 eligible children were included using total sampling. Mothers served as respondents. Dietary intake was assessed using 24-hour dietary recall and food frequency questionnaires over three non-consecutive days, administered before and after three educational sessions held in April–May 2025. Paired t-test was used for bivariate analysis. The results of the study show that mean fish consumption increased significantly from 23.91 g to 30.68 g (Δ = 6.77 g; p = 0.0001) and mean protein intake from 30.94 g to 38.45 g (Δ = 7.51 g; p = 0.0001). In conclusions, zoom and telephone-based nutritional counseling was associated with significant short-term improvements in fish and protein intake. However, given the absence of a control group and small sample size, causal inference is limited. Post-intervention intake levels remained below recommendations, suggesting the need for complementary structural and repeated educational interventions. Future studies with larger samples, control groups, and anthropometric outcome measures are strongly recommended.

Nursing Interventions for Bone Healing After Open Reduction and Internal Fixation: A Scoping Review

Faisal Abda’u — 2026-05-31

Nursing care plays an important role in supporting postoperative recovery and optimizing clinical outcomes in patients undergoing Open Reduction and Internal Fixation (ORIF). However, nursing interventions that support bone healing in this population have not been comprehensively mapped. This scoping review aimed to identify and map nursing interventions that support bone healing and postoperative recovery in patients undergoing ORIF. Literature searches were conducted in PubMed, ScienceDirect, ProQuest, and Google Scholar using keywords based on the Population–Concept–Context (PCC) framework for studies published between 2015 and 2025. Article screening and selection were conducted using predefined inclusion and exclusion criteria in accordance with the PRISMA-ScR guidelines. Data from the included studies were extracted, categorized, and synthesized thematically. A total of 20 studies were included in this review. The findings demonstrated that nursing interventions could be classified into four major domains: observational, therapeutic, educational, and collaborative interventions. Frequently reported interventions included pain management, early mobilization and rehabilitation support, clinical monitoring, health education, discharge planning, nutritional support, and multidisciplinary collaboration. The reviewed studies suggested that these interventions were associated with improved postoperative clinical outcomes, including reduced pain and complications, enhanced mobility and functional recovery, improved self-care ability, and better quality of life. However, most studies evaluated indirect clinical outcomes rather than direct radiographic indicators of bone healing. Further research is needed to evaluate the effectiveness of specific nursing interventions on radiographic bone healing outcomes across different fracture types and patient populations.

The Effect of the Pre-Screening Questionnaire for Child Development on Increasing Parental Compliance in Monitoring Child Development

Matje Meriaty Huru — 2026-05-31

Early childhood represents a critical period for growth and development that substantially influences the quality of future human resources. Therefore, regular developmental monitoring is essential to ensure the early identification of developmental problems. However, parental compliance with child development monitoring remains suboptimal, including in East Penfui Village. The Pre-Screening Developmental Questionnaire (PSDQ/KPSP) is a practical and user-friendly tool that may enhance parental involvement in developmental surveillance. This study aimed to analyze the effect of KPSP utilization on parental compliance in monitoring child development. A pre-experimental study with a one-group pretest–posttest design was conducted among 64 parents of children aged 0–6 years selected through purposive sampling. Data were collected using a respondent characteristics questionnaire, a parental compliance questionnaire, and the KPSP as the intervention instrument. Descriptive statistics were used to summarize respondent characteristics, while the Wilcoxon Signed Rank Test was employed to assess differences in compliance scores before and after the intervention due to the non-normal distribution of data (Shapiro–Wilk test, p < 0.05). The results showed that most respondents were aged 25–35 years, had completed senior high school education, were housewives, and had two to three children. Parental compliance scores increased significantly following the intervention, with the mean score rising from 56.25 ± 10.32 before KPSP implementation to 82.40 ± 8.15 after the intervention. The Wilcoxon Signed Rank Test demonstrated a statistically significant difference between pretest and posttest compliance scores (p < 0.001). The findings indicate that the use of KPSP significantly improves parental compliance in monitoring child development. Integrating KPSP into community-based child health services may strengthen parental participation in developmental surveillance and support the early detection of developmental delays.

Lifestyle Related Chronic Kidney Disease Among Young Adults of Productive Age In Indonesia: Analysis of The 2023 Indonesian Health Survey

Akmal Fauzi — 2026-05-31

Chronic Kidney Disease (CKD) has traditionally been associated with older adults; however, its prevalence among adolescents and young adults has increased in recent years, largely due to changing lifestyle patterns. This trend threatens the productivity of the younger generation and may increase the burden on Indonesia’s healthcare system. This study aimed to analyze lifestyle-related factors associated with CKD among Indonesian young adult males aged 15–24 years. A quantitative cross-sectional study was conducted using secondary data from the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia/SKI). Total sampling was applied to eligible respondents, resulting in 46,510 male participants after excluding female respondents to minimize sex-related confounding. Data were analyzed using Chi-square tests and multivariable logistic regression. The results showed that the consumption of sugar-sweetened beverages (p < 0.001) and hypertension status (p = 0.001) were significantly associated with CKD. Multivariable analysis revealed that hypertension was the strongest factor associated with CKD among young adults, while the consumption of sugar-sweetened beverages also remained significantly associated with the condition. These findings highlight the importance of early prevention strategies focusing on blood pressure control and healthier dietary behaviors to reduce the risk of CKD in young populations. However, because of the cross-sectional design, the study can only identify associations and cannot establish causal relationships between lifestyle factors and CKD.

Development of A Website-Integrated MobileNet Model for Ischemic Stroke Detection Based on CT Scan Images

Naufal Lutfi Ardiawan — 2026-05-31

The prevalence of ischemic stroke in Indonesia continues to increase, highlighting the need for rapid and accurate diagnostic approaches. Computed Tomography (CT) imaging plays a crucial role in the early detection of ischemic stroke, particularly within the therapeutic window of 3–4.5 hours after symptom onset. This study aimed to develop and evaluate a website-based ischemic stroke detection system using a MobileNet deep learning model integrated with CT scan image analysis. A Research and Development (R&D) approach employing the Rapid Application Development (RAD) framework was applied. The model was developed using 2,000 CT scan images obtained from a Kaggle dataset, comprising 1,000 ischemic stroke images and 1,000 normal control images. The dataset was divided into training and validation sets, with 800 images per class used for training and 200 images per class used for validation. External clinical validation was conducted using 600 CT scan images collected from hospitals, consisting of 300 ischemic stroke images and 300 normal control images. Model performance was evaluated using accuracy, precision, sensitivity, and specificity metrics, while system usability was assessed using the System Usability Scale (SUS). The developed model achieved an accuracy of 92.25%, precision of 92.00%, sensitivity of 92.50%, and specificity of 92.00% on the validation dataset. However, performance decreased during external clinical testing, yielding an accuracy of 71.50%, precision of 73.12%, sensitivity of 68.00%, and specificity of 75.00%. These findings are consistent with previous studies indicating that models trained solely on public datasets often experience performance degradation when applied to real-world clinical data, emphasizing the importance of multi-institutional training datasets and extensive external validation. The usability evaluation produced an average SUS score of 83, indicating excellent user acceptance and system usability. The proposed website-based MobileNet model demonstrates strong potential as an accessible tool for supporting early ischemic stroke detection from CT scan images and may be further enhanced through the incorporation of multi-slice or volumetric imaging data to improve clinical performance.