Medical Profession Journal of Lampung

Validity And Reliability Of The Patient Health Questionnaire-9 (PHQ-9) Instrument For Screening Depression in Patients with Stage 5 Chronic Kidney Disease (End-Stage Renal Disease)

Denny Emilius — 2026-02-01

Depression is one of the most common comorbidities among patients with stage 5 chronic kidney disease (CKD) and has a significant impact on quality of life, treatment adherence, morbidity, and mortality. Early detection of depression in this population is essential. However, diagnosis is often challenging due to the overlap between somatic symptoms of advanced CKD and depressive symptoms. This overlap may lead to underdiagnosis and delayed intervention. Therefore, a simple, valid, and reliable screening instrument is needed for routine clinical practice. This study aimed to evaluate the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression in patients with stage 5 CKD. A descriptive-analytic design was used, focusing on psychometric testing of the instrument. Item validity was examined using item–total correlation analysis, while internal consistency reliability was assessed using Cronbach’s alpha coefficient. The results showed that item–total correlation values ranged from 0.524 to 0.886, indicating good validity for all questionnaire items. Reliability testing produced a Cronbach’s alpha value of 0.928, demonstrating excellent internal consistency. These findings indicate that the PHQ-9 is a valid and reliable instrument for screening depression in patients with stage 5 CKD. The implementation of PHQ-9 in clinical settings can support healthcare providers in early identification of depressive symptoms, enable timely psychosocial interventions, and contribute to improved quality of life and clinical outcomes for patients with advanced chronic kidney disease in both primary and referral healthcare facilities.

Association Between Footwear Usage Profile and Plantar Heel Pain Among Female Employees at Bhayangkara Hospital, Lampung Regional Police

Nurlaili Wardah Humairoh — 2026-02-01

Plantar heel pain is a common musculoskeletal complaint among female workers, particularly in workplaces that require prolonged standing, walking, and the use of formal footwear. Biomechanical factors such as duration of shoe use, heel height, and body mass index are believed to increase mechanical stress on the plantar fascia and contribute to heel pain, yet evidence in Indonesia remains limited. This study aimed to examine the relationship between shoe-wearing profiles and body mass index with plantar heel pain among female employees at Bhayangkara Hospital, Lampung Regional Police, using an analytic observational design with a cross-sectional approach. A total of 120 participants were selected through purposive sampling. Plantar heel pain was assessed using the Plantar Fasciitis/Disability Scale questionnaire, body mass index was obtained through anthropometric measurements, and heel height was measured directly. Data were analyzed using univariate and bivariate methods with Spearman correlation tests at a significance level of p < 0.05. The results showed a relatively high prevalence of plantar heel pain among participants, with a significant association between duration of shoe use and plantar heel pain, while heel height and body mass index were not significantly associated, indicating that prolonged shoe use is the main contributing factor in practice.

Profile of Colorectal Cancer Patients at RSUD Dr. H. Abdoel Moeloek from January 2022 to December 2024

Muhammad Satria — 2026-02-02

Colorectal cancer is a malignancy of the colon or rectum and is one of the leading causes of cancer-related morbidity and mortality worldwide. It ranks as the third most commonly diagnosed cancer, with more than 1.9 million new cases annually, and as the second leading cause of cancer-related death, accounting for approximately 935,000 deaths each year. In Indonesia, the incidence of colorectal cancer continues to rise, reaching 12.4 cases per 100,000 population. The majority of cases are diagnosed at an advanced stage and are often accompanied by metastatic disease. This trend is primarily attributed to inadequate early detection and screening programs, resulting in limited therapeutic options and poorer prognosis. This study aims to describe the profile of colorectal cancer patients who underwent evaluation and management at RSUD Dr. H. Abdoel Moeloek from January 2022 to December 2024. Methods: This study employed a retrospective descriptive design involving 100 colorectal cancer patients at Dr. H. Abdoel Moeloek General Hospital from January 2022 to December 2024 who met the inclusion criteria. Variables assessed included sex, age, tumor location, and histopathological findings. Data were presented in frequency and percentage distributions. Results: A total of 56 males (56%) and 44 females (44%) were included in this study, with the majority aged 45–50 years (39%). The rectum was the most common tumor location (61%), and adenocarcinoma was the predominant histopathological type (82%).

Acute Decompensated Heart Failure in a 41-Year-Old Woman with Stage V Chronic Kidney Disease: A Case Report

Amanda Dewi Rosita — 2026-02-02

Acute decompensated heart failure (ADHF) is a cardiovascular emergency that frequently occurs in patients with advanced chronic kidney disease (CKD) due to impaired fluid regulation, electrolyte imbalance, and cardiorenal syndrome. This condition increases the risk of acute pulmonary congestion, severe metabolic disturbances, and reduced tissue perfusion, which may be life-threatening. A 41-year-old woman with stage V CKD presented with progressive acute dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and decreased activity tolerance for several days before hospital admission. Physical examination revealed tachypnea, hypertension, peripheral edema, bilateral basal crackles, and elevated jugular venous pressure. Laboratory findings showed severe anemia, hyperkalemia, metabolic acidosis, and elevated urea and creatinine levels, while chest radiography demonstrated cardiomegaly and pulmonary congestion. Electrocardiography and echocardiography supported the presence of cardiac dysfunction that aggravated the clinical condition. Based on clinical and diagnostic findings, the patient was diagnosed with acute decompensated heart failure with pulmonary congestion in the setting of stage V CKD. Management included oxygen therapy, fluid restriction, intravenous loop diuretics, nitroglycerin, correction of metabolic abnormalities, and packed red cell transfusion. Due to persistent fluid overload and severe metabolic disturbances unresponsive to conservative treatment, emergency hemodialysis was planned as definitive therapy. ADHF in patients with stage V CKD is a serious condition that requires early detection, comprehensive evaluation, and multidisciplinary management. Renal replacement therapy plays a crucial role in improving hemodynamic stability, reducing fluid burden, and preventing recurrent decompensation.

The Relationship Between Social Determinants And Knowledge With Efforts to Prevent Tuberculosis Transmission at Panjang Health Center, Bandar Lampung City

Jefri Irawan — 2026-02-04

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. The primary symptom of TB is a cough with phlegm that lasts for two weeks or more. The general objective of this study was to determine the relationship between social determinants and knowledge of TB transmission prevention efforts at Panjang Community Health Center, Bandar Lampung. This was an analytical cross-sectional study, with samples comprised of TB patients registered at Panjang Community Health Center between December and January 2022 and meeting the inclusion criteria. The sampling technique used total sampling. Data were obtained using a questionnaire. Data were analyzed using the Chi-square test. Low income, low education (elementary and junior high school), have a job, belong to the lower social class group, are male and have good knowledge. The results of statistical tests show a significant relationship between income and efforts to prevent TB transmission (p-value = 0.034), There is no significant relationship between education level (p-value = 0.076), employment (p-value = 0.079) and efforts to prevent TB transmission, and there is a significant relationship between class (p-value = 0.026), gender (p-value = 0.017), knowledge (p-value = 0.000) and efforts to prevent TB transmission. There is a relationship between social determinants and knowledge and efforts to prevent tuberculosis (TB) transmission at Panjang Community Health Center, Bandar Lampung City.

Wide Excision of Basal Cell Carcinoma on The Axilla

Asmaul Khusna — 2026-02-10

Basal cell carcinoma (BCC) is a malignant neoplasm arising from the basal layer of the epidermis and is the most common type of skin cancer, yet it is rarely found in the axillary region due to minimal ultraviolet exposure. Wide local excision is the main therapeutic option to achieve tumor-free margins and prevent recurrence. We report a case of a 46-year-old man presenting with a tumor in the left axilla that had gradually enlarged over one year and developed ulceration within the last three months. The initial lesion appeared as a small pruritic nodule that progressively enlarged and ruptured due to scratching. Physical examination revealed a 5 × 2 × 2 cm tumor with a necrotic base, regular margins, elevated edges, and firm consistency. A clinical diagnosis of BCC was established and confirmed by histopathological examination as nodular type. The patient underwent wide local excision with adequate margins. One-month postoperative evaluation showed good wound healing without signs of recurrence. Repeated trauma and chronic inflammation are considered potential risk factors for BCC in sun-protected areas such as the axilla. BCC rarely metastasizes and has a favorable prognosis when diagnosed and treated early. Adequate wide local excision plays a crucial role in reducing recurrence, with a recurrence rate of approximately 1% when completely excised.

The Effectiveness of Amoxicillin and Piperacillin Against Klebsiella pneumoniae in Acute Respiratory Infections at Dr. H. Abdul Moeloek Hospital From 2019 to 2023

Nadhira Azalia — 2026-02-22

Acute respiratory tract infection (ARI) is one of the leading causes of morbidity that often requires antibiotic therapy, with Klebsiella pneumoniae being one of the most commonly found bacterial pathogens and known to have a high level of antibiotic resistance. Irrational use of antibiotics can accelerate the development of resistance, so the effectiveness of antibiotics needs to be evaluated periodically. Amoxicillin and piperacillin are commonly used antibiotics in the management of ARTI. This study aimed to evaluate the effectiveness of amoxicillin and piperacillin against Klebsiella pneumoniae in cases of ARTI at Dr. H. Abdul Moeloek General Hospital from 2019 to 2023. This study is an observational analytical study with a cross-sectional design using secondary data in the form of culture results and antibiotic sensitivity tests from patient medical records. The sampling technique used total sampling with a total of 106 Klebsiella pneumoniae isolates. Data analysis was performed using the Chi-Square test. The results showed that the resistance rate of Klebsiella pneumoniae to amoxicillin was 92.5% with a sensitivity of 7.5%. In contrast, piperacillin showed a higher sensitivity of 58.5% although resistance was still found at 41.5%. Statistical tests showed a significant relationship between the type of antibiotic and the level of bacterial sensitivity (p-value < 0.001). The conclusion of this study indicates that piperacillin is more effective than amoxicillin in the management of ARI caused by Klebsiella pneumoniae and can be considered in the selection of empirical antibiotic therapy.

A Congestive Heart Failure in A Patient with Hypertensive Heart Disease: A Case Report

Putri Amelia Djamil — 2026-02-24

Chronic heart failure is a major cause of morbidity among older adults and is frequently associated with uncontrolled hypertension. This case report aims to describe the management of chronic heart failure in a patient with hypertensive heart disease using a comprehensive family medicine approach. Data were obtained through detailed history taking, physical examination, medical record review, and home visits to assess family dynamics, health behaviors, and environmental factors influencing the patient’s condition. A 65 year old woman presented with progressive dyspnea that worsened during physical activity and when lying down. Her blood pressure was 142 over 95 mmHg, and chest radiography showed cardiomegaly. The patient was diagnosed with chronic heart failure with a history of long standing uncontrolled hypertension. Interventions included pharmacological and non pharmacological strategies consisting of optimization of antihypertensive therapy, low sodium diet education, fluid intake adjustment based on clinical status, structured physical activity recommendations, and active family involvement in monitoring treatment adherence and lifestyle modification. After three weeks of follow up, clinical improvement was observed with blood pressure reduced to 123 over 76 mmHg and a decrease in dyspnea severity measured by the visual analog scale from three to one. The knowledge score of the patient and family increased from 60 percent to 100 percent, accompanied by better medication adherence and routine follow up. A family based comprehensive approach contributed to symptom improvement, enhanced treatment adherence, and better blood pressure control in a patient with chronic heart failure and hypertension.

Personal Hygiene as Risk Factors for Intestinal Protozoa Infections among School Children: An Article Review

Luthfi Shiba Andana — 2026-02-24

Intestinal protozoa infections remain a significant public health problem, particularly among school children in developing countries such as Indonesia. These infections contribute substantially to morbidity related to gastrointestinal disorders, including both acute and chronic diarrhea. Transmission of intestinal protozoa generally occurs through the fecal–oral route and is strongly influenced by personal hygiene practices in daily life. This article aims to determine the association between personal hygiene and the risk of intestinal protozoa infections among elementary school children through a literature review method. A literature search was conducted in the PubMed and Google Scholar databases using the keywords personal hygiene, intestinal protozoa infections, and school children, covering publications from 2011 to 2025. Relevant articles were selected and critically analyzed to identify the relationship between personal hygiene and the incidence of intestinal protozoa infections. The findings indicate that poor personal hygiene, particularly the habit of not washing hands with soap before meals and after defecation, inadequate nail hygiene, nail biting, and poor food and beverage hygiene, is significantly associated with an increased risk of intestinal protozoa infections. Several studies also reported a statistically significant higher risk of infection among children with poor personal hygiene compared to those with good hygiene practices. In conclusion, personal hygiene is a significant risk factor for intestinal protozoa infections.

Holistic Diagnosis and Comprehensive Management of a 30-Year-Old Pregnant Woman (Mrs. N) with High-Risk Pregnancy Due to Chronic Energy Deficiency and Anemia at Bangetayu Community Health Center, Semarang

Fatuh Rohman — 2026-02-24

High-risk pregnancy due to chronic energy deficiency (CED) and anemia remains a significant concern in primary healthcare because of its association with adverse maternal and neonatal outcomes. This case report describes a 30-year-old pregnant woman at 28 weeks of gestation diagnosed with CED (mid-upper arm circumference 22.5 cm) and iron deficiency anemia (hemoglobin 10.1 g/dL) at Bangetayu Community Health Center, Semarang. A holistic diagnostic approach was applied, integrating medical assessment with family function evaluation (Family APGAR and SCREEM), nutritional behavior analysis, and environmental factors. Management included iron and folic acid supplementation, provision of fortified supplementary food, intensive nutrition counseling, and structured family and community involvement. The distinguishing aspect of this case lies in the integration of clinical management with systematic family and environmental assessment to address multifactorial risk determinants. The expected clinical outcomes were improvement in maternal nutritional status, optimized weight gain during pregnancy, prevention of low birth weight and stunting, and reduced risk of perinatal complications. This case highlights that comprehensive, family-centered, and community-oriented interventions are essential in strengthening early detection and management of high-risk pregnancies in primary care settings.

Water Quality and Community Behavior in Relation to Public Health Outcomes

Adilla Dwi Nur Yadika — 2026-03-07

Water quality is a crucial factor in maintaining public health. The quality of water is crucial for daily life, from drinking to household, industrial, and health needs. Water that does not meet standards can cause various infectious and chronic diseases. This article uses a literature approach through a review of various studies related to water quality parameters and their impact on health. Water quality can be measured using the Water Quality Index (WQI). Parameters that determine water quality include physical, chemical, and biological factors. Low water quality is associated with high levels of heavy metals (Pb, As, Fe, Cd), chemical compounds (nitrate and fluoride), and microbiological contamination (Escherichia coli). Water quality can be influenced by natural factors, such as rainfall, watershed geography, the atmosphere, and geology. Furthermore, water quality is also determined by community behavior, which in turn influences community health, such as industrial, domestic, and/or agricultural activities. Community behavior in water treatment and storage also influences the increased risk of diarrhea, cholera, and nervous system disorders. Water quality and community behavior play a significant role in community health. Cross-sectoral collaboration between government, industry, and the community is needed to maintain water quality and prevent waterborne diseases, thereby improving public health.