Journal of Asian-african Focus in Health

Literatur Review: The Relationship Between Macronutrient Intake and Sleep Duration and the Occurrence of Menstrual Disorders in Women of Reproductive Age

2026-08-22T16:08:53+07:00

This literature review examines the relationship between macronutrient intake and sleep duration with the incidence of menstrual disorders in women of reproductive age. Based on a systematic analysis of ten selected scientific studies, the findings indicate that carbohydrate intake is significantly associated with menstrual disorders, particularly when high glycemic index foods and excessive added sugars are consumed, leading to hormonal imbalances through insulin dysregulation. Protein intake also shows a significant relationship, where both deficiency and excessive consumption of animal protein may disrupt ovulation, while plant-based protein demonstrates a protective effect. Fat intake, especially high saturated fat consumption, is linked to increased severity of dysmenorrhea and premenstrual syndrome (PMS), whereas omega-3 fatty acids contribute to symptom relief. In addition, insufficient sleep duration (less than 7 hours per day) significantly increases the risk of menstrual irregularities and pain intensity. Biologically, these relationships are explained through multiple mechanisms, including disruption of the hypothalamic-pituitary-ovarian (HPO) axis, insulin resistance, increased prostaglandin production, and the reciprocal interaction between poor diet and inadequate sleep. Despite strong evidence, significant research gaps remain, particularly the lack of experimental or clinical studies examining the combined effects of dietary and sleep interventions on menstrual health. Therefore, a comprehensive approach integrating nutritional and lifestyle modifications is essential in managing menstrual disorders.

P3PM Poster Improves Knowledge and Attitudes Toward Personal Hygiene of Food Handlers at SPPG A

2026-08-22T16:19:40+07:00

Effective educational interventions are necessary to ensure food safety in the Free Nutritional Meal Program (MBG) by promoting personal hygiene among food workers. The purpose of this research is to examine how nutrition fulfillment service unit (SPPG) A food handlers' knowledge and attitudes toward personal hygiene were affected by counseling that made use of the P3PM posters (Personal Hygiene, Use of PPE, and Handwashing Practices for Food Handlers). A pre-experimental design with a one-group pre-test-post-test layout was utilized in this investigation. Thirteen food handlers chosen at random using a complete sample method made up the study's subjects. Before and after the intervention, data was collected using a knowledge and attitude questionnaire. Installation of three A3-sized P3PM posters in the food processing area and 45 minutes of counseling comprised the intervention. The results demonstrated that food handlers' expertise increased following the intervention, as evidenced by a change from adequate to good. Counseling also led to an 8.9 point improvement in food workers' attitudes about personal cleanliness. The results of the statistical analysis demonstrated a notable change in both knowledge and attitudes from the pre- to post-intervention periods (p0.005). The results show that food handlers in SPPG A can benefit from counseling using P3PM posters in terms of both knowledge and attitude.

Integration of Medical Ethics from an Islamic Perspective in Shaping Professionalism in Medical Education: A Literature Review

2026-08-22T16:40:17+07:00

Medical education is a long-term professional education that requires students to comprehensively master academic competencies and clinical practice. Developing professionalism is a crucial aspect because it determines the quality of service and public trust in the medical profession. Medical ethics, in this process, serves as a moral and behavioral foundation, including Islamic values that emphasize trustworthiness, justice, and responsibility in healthcare. The application of these values in medical education is crucial for the holistic development of character, moral integrity, and professionalism in medical students. This study used a literature review approach by analyzing relevant publications obtained from databases such as PubMed, Research Gate, and Google Scholar. The selected literature focused on medical ethics from an Islamic perspective, professionalism, medical education, and the integration of Islamic values. This study demonstrates that Islamic medical ethics, grounded in the Qur'an, Hadith, and the principles of Sharia law (maqasid sharia), such as trustworthiness, justice, ihsan, honesty, hifz al-nafs (protection of life), and la darar wa la dirar (do not harm oneself or others), play a significant role in shaping student professionalism. Integrating these values into the curriculum, learning, and academic environment can enhance components of professionalism such as altruism, accountability, excellence, and humanism. Furthermore, the systematic application of Islamic ethical values in the educational process strengthens empathy, responsibility, and the ability to make decisions grounded in ethical principles within modern medical practice. The integration of medical ethics from an Islamic perspective is an essential strategy in medical education to produce physicians who are not only academically competent but also possess high moral integrity and professionalism and are able to provide holistic healthcare services.

The Influence of Stigma and Family Support on Long-Term Outcomes of Schizophrenia Patients: A Literature Review

2026-08-22T15:33:13+07:00

Schizophrenia is a chronic and severe mental disorder that significantly affects patients’ quality of life, social functioning, and long-term recovery. In addition to biological factors, psychosocial factors such as family support and stigma play crucial roles in determining treatment outcomes and recovery trajectories among individuals with schizophrenia. This study aimed to examine the influence of family support and stigma on the long-term outcomes of patients with schizophrenia through a narrative review of the existing literature. A narrative literature review was conducted using articles retrieved from PubMed, Google Scholar, ScienceDirect, ResearchGate, and Gale. The search employed keywords related to schizophrenia, stigma, family support, long-term outcomes, and mental health. Studies published in English and Indonesian that examined the relationship between family support, stigma, and outcomes among individuals with schizophrenia were included. Following the screening and eligibility assessment process, 20 studies met the inclusion criteria and were analyzed using a narrative synthesis approach. The review revealed that family support is consistently associated with improved quality of life, better medication adherence, reduced relapse rates, increased treatment motivation, and enhanced psychosocial functioning among patients with schizophrenia. Conversely, stigma was found to negatively affect psychological well-being, resilience, caregiving capacity, treatment engagement, and quality of life. The findings further indicated that supportive family environments may mitigate the adverse effects of stigma by promoting acceptance, emotional stability, and social integration. Structured family involvement was also shown to improve clinical and functional outcomes. Family support and stigma are important psychosocial determinants of long-term outcomes in schizophrenia. Strengthening family involvement and implementing stigma-reduction strategies should be considered essential components of comprehensive and recovery-oriented mental health care for individuals living with schizophrenia.

Literature Review: Myocardial infarction in Young Adults

2026-08-22T15:44:36+07:00

Myocardial infarction (MI) has traditionally been considered a disease of older adults; however, recent evidence indicates an increasing incidence among younger populations. This trend has raised significant clinical and public health concerns because MI occurring during productive years is associated with substantial long-term health, social, and economic consequences. Understanding the risk factors, clinical characteristics, and outcomes of MI in young adults is essential for improving prevention and management strategies. This study aimed to systematically review the current literature regarding myocardial infarction in young adults, with a particular focus on risk factors, clinical characteristics, and patient outcomes. A literature review was conducted using articles retrieved from PubMed, ScienceDirect, and Google Scholar. The search covered publications from 2021 to 2026 using keywords related to myocardial infarction, young adults, acute coronary syndrome, and cardiovascular risk factors. Articles were screened according to predefined inclusion and exclusion criteria. Following the selection process, 20 eligible studies consisting of observational studies, cohort studies, registry analyses, case series, and review articles were included in the final analysis. he findings demonstrate that myocardial infarction in young adults is a growing global health issue. Traditional risk factors, particularly smoking, dyslipidemia, obesity, hypertension, diabetes mellitus, and family history of cardiovascular disease, remain the primary determinants of disease occurrence. Emerging risk factors, including psychosocial stress, sleep disorders, autoimmune diseases, chronic inflammation, and substance abuse, also contribute significantly. Clinically, young patients commonly present with typical chest pain and predominantly single-vessel coronary artery disease, although non-atherosclerotic mechanisms such as spontaneous coronary artery dissection and myocardial infarction with non-obstructive coronary arteries are increasingly recognized. While short-term outcomes are generally more favorable than in older patients, long-term risks of recurrent cardiovascular events and persistent morbidity remain substantial. Myocardial infarction in young adults is a multifactorial condition requiring comprehensive risk assessment, early prevention, and long-term management strategies to reduce future cardiovascular burden.

Interprofessionalism in the Clinical Clerkship of the Medical Profession

2026-08-22T16:31:21+07:00

Interprofessional Education (IPE) has become an essential component of healthcare education, aiming to prepare future health professionals for collaborative practice and improved patient care. Clinical clerkship provides a unique environment in which medical students can develop interprofessional competencies through direct interaction with healthcare teams. However, evidence regarding the effectiveness, learning mechanisms, and implementation challenges of IPE during clinical clerkships remains scattered across the literature. This review aimed to synthesize current evidence on interprofessional education in clinical clerkships, focusing on learning mechanisms, competency development, implementation barriers and facilitators, and educational outcomes. A literature review was conducted using PubMed, Google Scholar, and ScienceDirect databases. Articles published between 2016 and 2026 were searched using keywords related to interprofessional education, interprofessional learning, medical education, and clinical clerkship. Eligible studies included original research, qualitative studies, mixed-methods studies, systematic reviews, and scoping reviews involving clinical clerkship students. Data were analyzed descriptively and comparatively to identify recurring themes and patterns across studies. Ten key studies were included in the review. The findings indicate that interprofessional learning during clinical clerkships occurs through three developmental phases: entering unfamiliar territory, sensemaking, and meaningful participation. Teamwork and communication emerged as the most consistently developed competencies, whereas understanding roles and responsibilities remained a persistent challenge. Facilitators of successful IPE implementation included institutional support, faculty commitment, and structured learning activities, while barriers included professional stereotypes, limited resources, and logistical constraints. Although most studies reported positive educational outcomes, evidence was predominantly concentrated at lower Kirkpatrick levels, with limited evidence demonstrating organizational or patient-level benefits. IPE in clinical clerkships contributes positively to the development of collaborative competencies among medical students. However, further longitudinal research employing objective assessments and patient-centered outcome measures is required to establish its long-term impact on healthcare practice and patient outcomes.

Risk Factors for Narcotics, Psychotropics, and Addictive Substances (NAPZA) Use in Adolescents: A Systematic Review

2026-08-22T15:57:39+07:00

The use of Narcotics, Psychotropic Substances, and Addictive Substances (NAPZA) among adolescents is a global public health issue that continues to increase. Adolescents are a vulnerable group to risky behaviors due to biological, psychological, and social changes. This study aims to identify and analyze the risk factors of NAPZA use among adolescents using a systematic review approach. The research method applied the PICO framework with literature searches conducted in PubMed and Google Scholar databases within the 2021-2025 period. A total of 148 articles were initially identified, and after the selection process, 18 articles were included as the main sources of analysis. In addition, 5 national journal articles were included as supporting references, resulting in a total of 23 analyzed articles. The data were extracted, classified, and analyzed using a scoring approach based on three categories of risk factors: individual, family, and social-environmental factors. The results indicate that the risk factors for NAPZA use among adolescents are multifactorial. Based on frequency analysis, social and environmental factors were the most dominant, appearing in 21 articles, followed by individual factors in 20 articles and family factors in 18 articles. Individual factors include depression, anxiety, low self-control, and curiosity; family factors include lack of parental supervision, family conflict, and economic conditions; while social and environmental factors include peer influence, ease of access to substances, and living environment conditions. Peer influence was identified as the most dominant and consistently reported risk factor across countries. Additionally, variations in risk factors across countries were influenced by social, cultural, and economic conditions. Therefore, NAPZA use among adolescents is a complex phenomenon that requires comprehensive and context-specific prevention approaches.

Risk Factors Associated with the Incidence of Hypertension in Dukupuntang, Cirebon, West Java, Indonesia

2026-08-22T17:06:43+07:00

Hypertension is a major global public health problem and a leading risk factor for cardiovascular disease, stroke, and premature mortality. Despite extensive research, evidence regarding hypertension risk factors remains inconsistent across different populations and settings, particularly in rural communities. This study aimed to identify demographic, hereditary, socioeconomic, and behavioral factors associated with hypertension among adults attending the Dukupuntang Health Center, Cirebon Regency, Indonesia. A cross-sectional analytic study was conducted in June 2024 involving 147 adult respondents recruited through consecutive sampling. Data were collected using structured questionnaires, medical records, and blood pressure measurements. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Independent variables included gender, age, education level, occupation, family history of hypertension, smoking habits, physical activity, sodium intake, obesity status, and socioeconomic status. Data were analyzed using descriptive statistics and Chi-square tests with a significance level of p < 0.05. Of the 147 respondents, 51.0% were classified as hypertensive. Bivariate analysis revealed significant associations between hypertension and gender (p = 0.018), age (p = 0.015), education level (p = 0.015), occupation (p = 0.010), and family history of hypertension (p < 0.001). In contrast, smoking habits (p = 0.056), physical activity (p = 0.154), sodium intake (p = 0.808), obesity status (p = 0.134), and socioeconomic status (p = 0.301) were not significantly associated with hypertension. Hypertension in this rural population was primarily associated with demographic, hereditary, and social determinants. These findings highlight the importance of targeted screening, health education, and family-history-based prevention strategies to strengthen hypertension control and cardiovascular disease prevention in rural communities.

Effect of Catfish (Clarias batrachus) Flour and Pre-Gelatinized Red Bean (Vigna angularis) Flour Substitution on the Saturated and Trans Fat Content of Dried Sponge Cake

2026-08-22T17:58:34+07:00

Stunting prevention requires not only nutritional intervention but also the development of practical, acceptable, and locally based functional food products for pregnant women. This study aimed to analyze the effect of substituting catfish flour (Clarias batrachus) and pregelatinized red bean flour (Vigna angularis) in dried sponge cake on saturated fat and trans-fat content, while positioning the product as a potential value-added innovation in maternal nutrition management. This study used an experimental design with a Completely Randomized Design consisting of three formulations and two replications. Formula A served as the control with 100% wheat flour, Formula B used 15% catfish flour and 20% pregelatinized red bean flour, and Formula C used 25% catfish flour and 10% pregelatinized red bean flour. Saturated fat and trans-fat contents were analyzed using laboratory fat analysis procedures, and the data were processed using the Kruskal-Walli’s test. The results showed that saturated fat content decreased descriptively in the substitution formulas, with the lowest value found in Formula B at 2.91%, although the difference was not statistically significant (p>0.05). Trans fat content showed a significant difference among formulations (p<0.05), with Formula B producing the lowest value at 16.81%. These findings indicate that the combination of catfish flour and pregelatinized red bean flour, especially Formula B, can improve the lipid quality of dried sponge cake. The product has potential as a healthier local functional food innovation that supports maternal nutrition, food diversification, and stunting prevention strategies. Further sensory, shelf-life, and feasibility studies are needed before commercialization.

Understanding of Menstruation on Anxiety in Facing Menarche Among 4th–6th Grade Students at SDN Tebon, Barat District, Magetan Regency

2026-08-22T16:49:09+07:00

Menarche is a major developmental event for girls because it marks the beginning of reproductive maturity and requires both physical and psychological adjustment. Limited knowledge about menstruation may cause fear, confusion, and anxiety, especially among elementary school students who have not yet experienced their first menstruation. This study aimed to determine the relationship between knowledge about menstruation and anxiety in facing menarche among female students in grades 4 to 6 at SDN Tebon, Barat District, Magetan Regency. This study used a quantitative correlational design with an analytical survey and a cross-sectional approach. The sample consisted of 32 female students who had not experienced menarche and met the study criteria. Data were collected using a menstruation knowledge questionnaire and the Zung Self-Rating Anxiety Scale. Data were analyzed using descriptive statistics and the Spearman Rank correlation test with a significance level of 0.05. The results showed that most respondents had moderate knowledge about menstruation, accounting for 14 students or 43.8%. Anxiety in facing menarche was mostly in the moderate category, with 12 students or 37.5%. The Spearman Rank test showed a significant relationship between knowledge about menstruation and anxiety in facing menarche, with a p-value of <0.001 and a correlation coefficient of 0.873. These findings indicate a very strong relationship, where better menstrual knowledge is associated with lower anxiety. The study concludes that early menstrual education is needed at the elementary school level to improve readiness, reduce fear, and support girls in facing menarche more confidently.

The Relationship of Work Requiring Heavy Lifting to the Severity of Inguinal Hernia at Prof. Dr. Margono Soekarjo Purwokerto General Hospital for the 2022–2023 Period

2026-08-22T18:28:22+07:00

This study examined the association between occupations involving heavy lifting and the severity of inguinal hernia among patients treated at Prof. Dr. Margono Soekarjo Hospital, Purwokerto, during the 2022-2023 period. A retrospective observational analytical study with a cross-sectional approach was conducted using secondary data from hospital medical records. The study included 190 adult patients diagnosed with inguinal hernia who met the inclusion and exclusion criteria. Occupational category was classified into blue-collar and white-collar work, with blue-collar work used as a proxy for regular manual labor and heavy lifting. Hernia severity was categorized into uncomplicated and complicated hernia based on documented clinical diagnosis. Data were analyzed using univariate analysis, Chi-square test, and Odds Ratio estimation with a 95% confidence level. Most patients were male (91.6%) and aged 46-65 years (52.6%). Blue-collar workers accounted for 56.8% of the sample, while white-collar workers accounted for 43.2%. Most patients had uncomplicated hernia (90.0%), while 10.0% had complicated hernia. The bivariate analysis showed a significant association between occupational category and inguinal hernia severity (p = 0.040). Blue-collar workers had approximately 3.1 times higher odds of experiencing complicated inguinal hernia than white-collar workers (OR = 3.145). These findings suggest that physically demanding occupations may be associated with greater clinical severity of inguinal hernia and should receive attention in occupational health screening and surgical referral decisions. However, the retrospective cross-sectional design limits causal inference, and residual confounding remains possible due to incomplete documentation of obesity, smoking, chronic cough, constipation, and comorbidities. Future prospective studies are therefore needed.

Interactive Health Education: Quartet Card Game for Thalassemia Awareness

2026-08-22T18:14:58+07:00

Thalassemia remains a preventable inherited blood disorder with major clinical, social, and economic consequences, particularly in countries with high carrier prevalence such as Indonesia. University students represent a strategic population for premarital prevention because they are approaching reproductive age and may soon make decisions related to marriage, family planning, and genetic screening. This study aimed to evaluate the effectiveness of a Quartet Card Game as an interactive educational medium for improving knowledge, attitudes, and behavioral intention toward thalassemia screening among students of YPIB Majalengka University. A quantitative experimental study with a pre-test and post-test control group design was conducted. Participants were randomly assigned to an intervention group that received education using the Quartet Card Game and a control group that received conventional lecture-based education. Data were collected using a structured questionnaire measuring thalassemia knowledge, attitudes toward screening, and intention to participate in screening. Inferential analysis showed that the intervention group experienced greater improvement in all outcome variables than the control group. The Quartet Card Game significantly increased students’ knowledge of thalassemia strengthened positive attitudes toward premarital screening and encouraged stronger intention to participate in screening programs. These findings indicate that game-based education can support health promotion by transforming genetic information into active, peer-based, and behavior-oriented learning. The study contributes to thalassemia prevention research by extending game-based educational intervention to university students and by examining cognitive and behavioral outcomes within the Health Belief Model framework. Future studies should include multicenter samples, longer follow-up, and actual screening uptake as an outcome.

Clinicopathological Characteristics of HPV-Related and HPV-Independent Cervical Cancer: Literature Review

2026-08-22T18:40:45+07:00

Cervical cancer is one of the leading malignancies in women, and most cases are associated with high-risk Human Papillomavirus (HPV) infection, particularly HPV-16 and HPV-18. However, advances in classification and molecular pathology indicate that there is a group of cervical cancers that develop without HPV involvement, namely HPV-independent cervical cancer. This literature review aims to analyze the differences in clinicopathological characteristics of HPV-related and HPV-independent cervical cancer. This study uses a narrative literature review method by examining scientific articles obtained from Google Scholar, PubMed, ScienceDirect, Semantic Scholar, and SpringerLink in the publication period 2016–2026. The analyzed literature discusses clinical, histopathological, and molecular characteristics, prognosis, and therapeutic implications based on HPV status. The results of the study indicate that HPV-related cervical cancer generally occurs at a younger age, is dominated by squamous cell carcinoma, shows strong p16 expression, and has a better therapeutic response and prognosis. In contrast, HPV-independent cervical cancer is more common in older patients, is often diagnosed at an advanced stage, has histopathological subtypes such as gastric-type adenocarcinoma, clear cell carcinoma, and mesonephric carcinoma, and is associated with mutations in genes such as TP53, KRAS, PIK3CA, and PTEN. This group also exhibits higher tumor aggressiveness, more frequent lymphovascular invasion, a greater risk of recurrence, and a poorer prognosis. Therefore, HPV status plays a crucial role in determining the clinicopathological characteristics, prognosis, and therapeutic strategies of cervical cancer. Immunohistochemistry-based diagnostic approaches, molecular testing, and more individualized therapies are needed to improve diagnostic accuracy and patient outcomes.

Disordered Eating Attitudes among Undergraduate Students in Indonesia: Associations with Food Insecurity, Perceived Stress, and Sleep Quality

2026-08-22T18:53:34+07:00

Disordered eating is an under-recognised problem among university students, and its links to social and economic adversity remain understudied in Indonesia. This study aimed to estimate the prevalence of disordered eating attitudes among undergraduate students in Indonesia and to examine its associations with food insecurity, perceived stress, and sleep quality. Methods: A cross-sectional survey was conducted in November 2024 among 635 undergraduate students from several institutions, predominantly Universitas Tidar. Disordered eating attitudes were assessed with the Eating Attitudes Test-26 (EAT-26; at-risk score ≥20), food insecurity with the United States Department of Agriculture Adult Food Security Survey Module, perceived stress with the Perceived Stress Scale-10, and sleep quality with the Pittsburgh Sleep Quality Index. Body-mass index was classified using Asia-Pacific cut-offs. Associations were examined using chi-square tests, Spearman correlations, and multivariable logistic regression adjusted for sex and body-mass index. The EAT-26 showed good internal consistency (Cronbach's α = 0.82). Overall, 22.2% of students (95% CI 19.0–25.4) were at risk of disordered eating. EAT-26 scores correlated positively with food insecurity, perceived stress, and body-mass index. In the adjusted model, disordered-eating risk was independently associated with food insecurity (adjusted odds ratio 1.99; 95% CI 1.34–2.96) and high perceived stress (adjusted odds ratio 2.40; 95% CI 1.32–4.37), and with higher body-mass index, but not with poor sleep quality. Food insecurity and perceived stress are salient correlates of disordered eating among Indonesian undergraduates, supporting integrated screening and support.