Journal Of The Indonesian Medical Association

The Role of The Gut Microbiome in Attention Deficite Hyperactivity Disorder (ADHD)

Ariana Setiani — 2025-08-01

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder, associated with neurodevelopmental disorders in the form of persistent patterns of inattention or hyperactivity and impulsivity that interfere with childhood functioning and development. The prevalence of ADHD is estimated at 3.4% in children and adolescents worldwide.¹ In 60-80% of cases, ADHD symptoms persist into adulthood.²

Comparison of Hatha Yoga and "Senam Lansia" on The Cardiorespiratory Fitness of The Elderly

Ardina Nur Pramudhita — 2025-08-01

Introduction: Cardiorespiratory fitness declines with age. Regular exercise helps enhance an elderly person’s physical capacity, fitness, and overall quality of life. Senam lansia is physical activity that is frequently performed by the elderly population. Though hatha yoga has slower movements than exercise for the elderly, it still incorporates various exercise component. This study was aimed to assess the difference between hatha yoga exercise and senam lansia on cardiorespiratory fitness of the elderly.
Methods: This study was a randomized controlled pre- and post-test. The hatha yoga group and the control group were randomly selected with a total of 26 participants. For six weeks, three times a week, participants in the intervention group and control group performed hatha yoga and senam lansia, respectively. The six-minute walk test is used to measure maximum oxygen consumption (VO₂ max), a measure of cardiorespiratory fitness.
Result: The mean VO₂max value was 15.03 ± 2.63 ml/kg/minute in the hatha yoga group and 13.82 ± 2.05 ml/kg/minute in the senam lansia group with significant differences between groups. The increase in VO₂max values before and after the intervention was 1.83 ± 1.15 ml/kg/minute in the hatha yoga group and 1.35 ± 1.04 ml/kg/minute in the senam lansia group with no significant difference between the two groups.
Conclusion: Hatha yoga exercises and senam lansia have the similar effect on increasing cardiorespiratory fitness as measured by the 6-minute walk test.

Impact of Shift Work and Stress Level on Nurse Brain-Derived Neurotrophic Factor (BDNF) mRNA Expression During The Covid-19 Pandemic

Atthariq — 2025-08-01

Introduction: The project aims to investigate how the Covid-19 epidemic influenced nurses’ stress levels, shift work, and BDNF mRNA expression. Hospitalized patient numbers in Indonesia were rising sharply during the outbreak. This illness has a major impact on nurses’ levels of weariness and stress, which follow each other. High-stress workers have lower serum levels of brain-derived neurotrophic factor (BDNF). Workload, job conflicts, and sleep difficulties are some of the causes that lead to this stress.
Methods: The study was conducted at the Cempaka Putih Islamic Hospital in Central Jakarta, Indonesia, from July to September 2020. The study used an analytical observational approach and a cross-sectional design. The number of nurses who participated in this study was 89 people who were selected using This study included 89 nurses who were recruited using a purposive selection technique based on predetermined inclusion and exclusion criteria. Anthropometric measures and intravenous blood collection were used to gather data for real-time PCR analysis of the BDNF gene mRNA expression.
Result: The mean BDNF mRNA expression level was 8.93 ng/mL. Nurses reported work-related stress, with a significant correlation (p less than 0.05) between BDNF mRNA expression, work shift, and stress levels. According to the findings, those with low, moderate, and high stress levels had mean BDNF levels of 11.69, 8.65, and 7.36, respectively. Statistical testing revealed a significant difference (p less than 0.001) in the mean mRNA expression of the BDNF gene across subjects with low, moderate, and high stress levels.
Conclusion: During the Covid-19 pandemic, a statistical correlation was found between nurse stress levels, work shifts and low BDNF levels.

The Effectiveness of Adding High-Intensity Laser Therapy (HILT) to Physical Exercise in Reducing Pain, Improving Muscle Strength, and Enhancing Functional Ability in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Laksmana Rizki — 2025-08-01

Introduction: Osteoarthritis (OA) is a leading cause of disability worldwide, impacting patient’s daily functional abilities as well as quality of life due to chronic pain associated with joint damage. High-Intensity Laser Therapy (HILT) has been proven effective in reducing pain and improving function in patients with knee OA. Despite its recognition as a safe and effective modality, standardized protocols for its use in knee OA are lacking. This study aims to evaluate the effectiveness of incorporating HILT in addition to physical exercise programs for patients with knee OA.
Methods: 30 patients with knee OA were randomized into 2 groups, HILT + physical exercise (intervention group), and physical exercise only (control group). Visual Analogue Scale (VAS), quadriceps and hamstring muscle strength using exercise testing, and functional ability using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire were measured and compared.
Result: Both groups displayed statistically significant improvement in pain, muscle strength, and functional ability by the end of the program (week 4) compared to the initial examination (p less than 0.05). When compared, there was a significant difference in pain reduction and functional ability in favor of the intervention group (p less than 0.05). However, there were no significant differences in quadriceps and hamstring muscle strength between the groups (p=0.148 and p=0.345, respectively).
Conclusion: In this study, it was shown that the combination of HILT and physical exercise was more effective in alleviating pain and enhancing functional ability in patients with knee OA compared to physical exercise alone.

The Relationship Between Nighttime Smartphone Use and Insomnia in Adolescents in Mataram City

Mohammad Sany Rosafi Amanullah — 2025-08-01

Introduction: Smartphone use among adolescents, particularly in Mataram City, West Nusa Tenggara, is highly prevalent. Nighttime smartphone useis associated with delayed sleep onset, as it extends the time adolescents more time to engage in various activities. Several studies have shown that smartphones use can contribute to sleep disturbances, including insomnia. This study aims to investigate the relationship between nighttime smartphone use and insomnia among adolescents in Mataram City.
Methods: This study employed a cross-sectional design and included 362 students from Mataram City, selected through non-probability consecutive sampling method. Participants completed questionnaires assessing nighttime smartphone use and insomnia symptoms using Insomnia Severity Index. Data were analyzed using Spearman’s rank correlation test.
Result: Of the total sample (44.5% male), the majority were 16 years old (62.4%), enrolled in Grade 11 (82.6%), and most (66.9%) were in the natural science program. The majority of participants were classified as having subclinical insomnia (43.9%), while only 2.5% experienced severe insomnia. The findings revealed a positive correlation between the frequency of nighttime smartphone and insomnia among adolescents (r=0.104; p=0.049).
Conclusion: There is a significant relationship between the frequency of nighttime smartphone use and insomnia among adolescents in Mataram City.

Clinical and Demographic Characteristics of Patients with ST-Elevation Myocardial Infarction in Siloam Heart Center: A Single Center Study

Sidhi Laksono — 2025-08-01

Introduction: Cardiovascular disease remains the leading cause of death globally, with ST-elevation myocardial infarction (STEMI) posing the highest mortality among acute coronary syndromes (ACS). Early intervention, such as percutaneous coronary intervention (PCI), improves outcomes. Objective: To describe the clinical and demographic profile of STEMI patients in Indonesia and identify risk factors associated with disease severity.
Methods: A retrospective descriptive study was conducted on STEMI patients who underwent PCI at a Heart Center Hospital from January to December 2024. Data from electronic medical records were analyzed, including only confirmed STEMI cases with complete documentation.
Result: 87 patients were included, most male (92%) and aged over 50 (66.7%). Hypertension (49.4%), smoking (46%), and diabetes mellitus (27.6%) were common comorbidities. Leukocytosis occurred in 86.2%, with universally elevated troponin levels. Despite frequent cardiomegaly on chest X-rays, 46% had preserved ejection fraction on echocardiography. Inferior (34.5%) and anterior (19.5%, 17.2%) infarctions were the most common ECG findings. The left anterior descending (LAD) artery was affected in 85.1%, with three-vessel disease present in 49.4%. Mean door-to-balloon (DTB) time was 86.25 minutes. In Intra-PCI Complications, dissection in 2.3%.
Conclusion: STEMI in Indonesia predominantly affects older males with modifiable cardiovascular risk factors. These factors are closely linked to severe coronary involvement, particularly multi-vessel disease.

Comprehensive Review of Pichia kudriavzevii: Epidemiology, Biology, and Clinical Manifestation as Parasite in Human Body

Ayu Eka Fatril — 2025-08-01

Pichia kudriavzevii previously known as Candida krusei, is a non-conventional yeast commonly found in the environment and widely utilized in the fermentation industry. Besides its industrial benefits, P. kudriavzevii also acts as an opportunistic pathogen that can cause severe infections, particularly in immunocompromised individuals. This study is a literature review analyzing the epidemiology, biology, pathogenicity, immune response and clinical manifestations associated with P. kudriavzevii. Relevant literature was collated from databases such as PubMed, Scopus, and Google Scholar, selected based on article relevance and quality. The review findings indicate that P. kudriavzevii is among the five most common Candida species that infect humans, particularly in patients with compromised immune systems, cancer, hematologic malignancies, diabetes mellitus, and those undergoing prolonged antibiotic or corticosteroid therapy. Biologically, P. kudriavzevii exhibits high tolerance to extreme environmental conditions, possesses biofilm-forming capabilities and demonstrates intrinsic resistance to fluconazole. Infections caused by P. kudriavzevii, reffered to as candidiasis krusei, range from mucocutaneous infections (oral/oropharyngeal candidiasis, vaginal candidiasis, and cutaneous candidiasis) to invasive candidiasis which can be life-threatening. The increasing incidence of P. kudriavzevii infections and its antifungal resistance demand greater attention in developing effective diagnostic and therapeutic strategies. Further studies are essential to elucidate its resistance mechanisms and explore alternative therapeutic approaches for improving clinical management.