Journal Of The Indonesian Medical Association

Acne Treatment in Pregnancy

Khairina Zahra Triamanda Lubis, Nelva Karmila Jusuf — Mon, 14 Sep 2026 14:23:00 +0700

Acne vulgaris (AV) is a chronic inflammatory disorder that commonly occurs across various age groups, especially in adolescents and young adults. Although often considered merely a cosmetic issue, acne has a significant impact on quality of life and mental health. In women, particularly during pregnancy, acne can become more complex due to hormonal changes and immune responses that affect the severity of the condition. Managing acne during pregnancy requires a careful approach, given the limitations of therapy due to potential risks to the fetus. Topical therapies such as clindamycin, erythromycin, and benzoyl peroxide are commonly used as first-line options, while safe systemic agents like beta-lactam antibiotics may be considered for severe cases. Education and communication between doctors and patients are crucial to ensure the safety of treatment while minimizing the psychological and physical impacts of acne during pregnancy.

The Effectiveness of the Ankle Balance Taping Technique Compared to Sham Accompanied with Strengthening Leg Muscles Against Static and Dynamic Balance: A Single Blind, Randomized Control Trial

Fracella Putri, Tirza Z. Tamin, Retno Asti Werdhani — Mon, 14 Sep 2026 14:28:02 +0700

Introduction: Recurrent lateral ankle ligament injuries in runners may lead to chronic ankle instability and balance impairment. Ankle Balance Taping (ABT) is a potential adjunctive intervention to improve balance function. Aim: This study aims to compare the effects of kinesio taping with Ankle Balance Taping (ABT) and Sham techniques accompanied by strengthening exercise on dynamic and static balance in runners with chronic ankle instability.
Methods: This single-blind randomized controlled trial included 36 male runners allocated by block randomization to the ABT group (n=19) or sham group (n=17). The intervention was given for 3 weeks. Dynamic balance was measured using the Star Excursion Balance Test (SEBT), while static balance was measured using the Stork Test. Data were analyzed using parametric or nonparametric tests according to data distribution, and effect size was calculated using Cohen’s d.
Results: At week 3, the ABT group showed greater SEBT improvement than the sham group in the anterior (13.58±9.16 vs 1.24±1.11 cm; p less than 0.001; d=1.84), posteromedial (7.03±3.21 vs 4.42±4.07 cm; p=0.028; d=0.72), and posterolateral directions (10.73±7.46 vs 1.49±1.18 cm; p less than 0.001; d=1.68). No differences were found in the other five directions. Static balance improved in both groups without a significant between-group difference.
Conclusion: ABT as an adjunct to strengthening exercise provides short-term benefits mainly for dynamic balance in the anterior, posteromedial, and posterolateral directions, whereas static balance did not show superiority over sham.

Association Of Hypertension And Diabetes Mellitus With Recurrent Stroke In Post-Stroke Patients

Hani Retno Asih, Candra Bumi, Citra Anggun Kinanthi — Mon, 14 Sep 2026 14:29:41 +0700

Introduction: Stroke remains a global health problem with high mortality and morbidity rates worldwide. Post-stroke patients who do not manage risk factors well are at high risk of recurrent stroke. Recurrent stroke has a more fatal impact with higher mortality rates, the risk of more serious severity and worse neurological disorders that can affect the economic conditions and patient quality of life. This study aimed to analize the association of hypertension and diabetes mellitus with the incidence of recurrent stroke in post-stroke patients.
Methods: This study was conducted at RSD dr. Soebandi Jember using a case-control design with 54 patients in the case group and 108 patients in the control group selected by simple random sampling. Data collection used hospital medical records and data analysis was performed univariate, bivariate and multivariate.
Results: The results of bivariate analysis showed a significant association between age and diabetes mellitus with recurrent stroke (p-value less than 0,05). Mutivariate analysis showed that age, hypertension, and diabetes mellitus had an effect on recurrent stroke, with diabetes mellitus as the main determinant of recurrent stroke.
Conclusion: Diabetes mellitus is the main determinan of recurrent stroke in post- stroke patients, followed by hypertension and age.

Factors Associated with Knee Osteoarthritis Severity Degree Based on Kellgren-Lawrence Criteria at Atma Jaya Hospital

Mon, 14 Sep 2026 14:31:14 +0700

Introduction: Osteoarthritis (OA) is a global health issue that can cause disability. The risk of developing OA increases with age, female gender, and obesity. This study was specifically conducted to analyze the relationship between age, gender and Body Mass Index (BMI) with the severity of knee OA based on the Kellgren-Lawrence criteria in patients of Atma Jaya Hospital from 2020-2023.
Method: This research is a descriptive analytical study using cross-sectional design. The research was conducted from January until May 2024 at Atma Jaya Hospital with a total of 668 samples from 2020 to 2023 taken using total sampling. The severity of knee osteoarthritis is measured based on radiographic examination; other variables were taken from medical records.
Results: Based on 668 samples, the majority were greater than 60 years old (68.1%), female (75.3%), obese (50.1%), and had severe to very severe knee OA severity based on the Kellgren-Lawrence criteria (54.9%). A significant relationship has been observed using Chi-square analysis between age (p= 0.000; OR= 2.188) and BMI (p= 0.044; OR= 1.369) with the severity of knee OA based on the Kellgren-Lawrence criteria. However, there was no significant relationship between gender (p=0.402; OR= 1.163) and the severity of knee OA based on the Kellgren-Lawrence criteria.
Conclusion: There is a significant association between age and BMI and the severity degree of knee OA based on plain radiographs referred to the Kellgren-Lawrence grading scale in patients of Atma Jaya Hospital from 2020-2023.

Effectiveness of Combined Lecture and Module Education on Anemia toward Knowledge of Pregnant Women at Bandarharjo Public Health Center, Semarang

Mon, 14 Sep 2026 14:33:02 +0700

Introduction: Anemia in pregnancy remains a significant public health challenge in Indonesia. Educational intervention serves as a primary strategy to enhance health literacy among pregnant women. This study aimed to evaluate the effectiveness of a combined lecture and module educational intervention on anemia knowledge among
pregnant women at Bandarharjo Primary Health Center, Semarang.
Methods: This quantitative study employed a pre-experimental one-group pretest– posttest design without a control group involving 32 pregnant women selected through total sampling. The intervention was delivered in a single 60-minute session comprising an LCD-assisted lecture, guided module reading, and an interactive Q&A discussion. Knowledge was measured using a 30-item Guttman scale questionnaire validated for accuracy (r greater than 0.361) and reliability (α = 0.935). Pretest and posttest score differences were analyzed using the Wilcoxon signed-rank test.
Results: A significant increase in mean knowledge scores was observed, rising from 20.0 ± 4.123 to 28.7 ± 1.857 (p = 0.000). On the posttest, all respondents (100%) reached the Good knowledge category. This outcome was supported by the high educational background of respondents (53.1% high school and 31.3% higher education) and suggested a potential ceiling effect of the instrument.
Conclusion: Combined lecture and module education is effective in improving pregnant women’s knowledge about anemia. Nevertheless, findings should be interpreted with caution due to the uncontrolled design, potential ceiling effect, and respondent educational characteristics.

Placenta Accreta Spectrum in the Intrauterine Fetal Death: An Evidence-Based Case Report

Grantina Nugraha, Ida Bagus Yuda Andika, Mukhammad Arif Hadi Khoiruddin — Mon, 14 Sep 2026 14:34:27 +0700

Introduction: Placenta Accreta Spectrum (PAS) is a life-threatening obstetric disorder characterized by abnormal placental invasion into the myometrium. Although intrauterine fetal death (IUFD) and PAS are distinct conditions, their
coexistence substantially increases maternal morbidity and presents major management challenges.
Case Presentation: A 33-year-old gravida 3 para 1 woman at 21–22 weeks of gestation with a history of cesarean section and curettage presented with IUFD. Following vaginal misoprostol induction, she developed massive hemorrhage, hemodynamic instability, and hemorrhagic shock, requiring emergency hysterectomy. Histopathological examination confirmed placenta accreta.
Methods: An evidence-based case report was conducted using a structured literature search of PubMed, ScienceDirect, Springer, and the Cochrane Library. Eligible studies included systematic reviews, cohort studies, and original research evaluating the relationship between PAS and IUFD.
Results: Of 578 identified articles, four met the inclusion criteria. Evidence consistently demonstrated that PAS is associated with increased maternal morbidity in IUFD pregnancies, particularly among women with previous cesarean delivery. Severe hemorrhage frequently necessitated hysterectomy.
Conclusion: This case highlights the importance of early antenatal recognition of PAS in women with IUFD and previous uterine surgery. Prompt multidisciplinary management and preparedness for massive obstetric hemorrhage are essential to reduce maternal morbidity and mortality.

BK and JC Virus Infections in Pediatric Kidney Transplantation in Children: A Narrative Review of Risk Factors, Pathogenesis, and Monitoring Strategies

Victor Sitorus, Angky Budianti, Nina Dwi Putri, Andi Yasmon — Mon, 14 Sep 2026 14:36:05 +0700

BK virus (BKV) and John Cunningham virus (JCV) are the most common polyomaviruses infecting pediatric kidney transplant recipients. These infections primarily result from reactivation of latent viruses due to immunosuppression, and they progress through stages of viruria, viremia, and potentially polyomavirus-associated nephropathy, particularly BK virus-associated nephropathy (BKVAN). This narrative review compiles and analyzes existing data regarding the epidemiology, risk factors, virology, clinical features, and monitoring strategies of BKV and JCV in children undergoing kidney transplantation. Key risk factors include younger recipient age, male gender, obstructive uropathy as the cause of end-stage kidney disease, specific immunosuppressive regimens such as tacrolimus/MMF, and donor characteristics (older age and female sex). Molecular diagnostic techniques, particularly real-time quantitative PCR in plasma or urine, are widely used, while kidney biopsy remains the gold standard for diagnosing BKVAN. Management is centered on reducing the intensity of immunosuppression. International guidelines, including those from KDIGO, recommend routine viral load monitoring in the first year after transplant to detect reactivation early. In Indonesia, the lack of diagnostic facilities limits the ability to monitor these infections effectively. This review aims to inform clinicians about evidence-based surveillance and prevention strategies for polyomavirus infections in pediatric renal transplant recipients and underscores the urgent need for local research to develop region-specific clinical protocols.