Journal La Medihealtico

Analysis of Managerial Support, Communication Patterns, and Work Motivation in Shaping the Quality of Medical Team Performance

2026-04-09T10:37:39+07:00

The quality of medical team performance constitutes a crucial determinant of excellence in hospital services. Organizational dimensions such as managerial support, communication patterns, and work motivation are widely recognized as key factors influencing employee performance within healthcare institutions. A comprehensive understanding of the relative contributions of these variables is essential for the formulation of effective human resource management strategies. This study aims to examine the influence of managerial support, communication patterns, and work motivation on the quality of medical team performance at Benyamin Guluh Hospital Kolaka. This research employed a quantitative approach utilizing a survey design. Data were collected through structured questionnaires administered to 78 medical personnel. The data were analyzed using Partial Least Squares–Structural Equation Modeling with the assistance of SmartPLS software to assess the relationships among variables and test the proposed hypotheses. The findings reveal that managerial support and communication patterns do not exert a statistically significant effect on the quality of medical team performance. Conversely, work motivation demonstrates a positive and significant influence and emerges as the most dominant factor affecting performance outcomes. The coefficient of determination (R²) value of 0.499 indicates that managerial support, communication patterns, and work motivation collectively account for 49.9% of the variance in medical team performance. Work motivation plays a central role in enhancing the quality of medical team performance. The implementation of targeted motivational strategies among medical personnel proves more effective than relying solely on managerial support or communication enhancement initiatives.

Analysis of the Influence of Motivation on Service Quality and Staff Performance in the Emergency Department

2026-04-09T10:37:12+07:00

The performance of Emergency Department (ED) personnel constitutes a critical determinant of hospital service quality. This study aims to analyze the influence of work motivation on service quality and staff performance, as well as the effect of service quality on staff performance at the Emergency Department of Lakipadada Regional Hospital, Tana Toraja, while identifying the most dominant factor affecting staff performance. The research employed a quantitative approach with an analytical design. The sample comprised 50 ED personnel selected through total sampling. Data were collected using structured questionnaires and analyzed through multiple linear regression, including t-tests, F-tests, and the coefficient of determination (R²). The findings indicate that work motivation has a significant effect on service quality (β = 0.393; p = 0.005). Partially, both work motivation (β = 0.393; p = 0.005) and service quality (β = 0.479; p = 0.001) significantly influence ED staff performance. Simultaneously, work motivation and service quality significantly affect staff performance (F = 49.521; p = 0.001). The coefficient of determination reveals that 67.8% of the variance in staff performance can be explained by work motivation and service quality (R² = 0.678), with service quality emerging as the most dominant factor. These findings underscore the necessity of managerial strategies focused on enhancing both work motivation and service quality to improve the performance of ED personnel at Lakipadada Regional Hospital, Tana Toraja.

Meta Analysis: The Role of Herbal Medicines in the Management of Functional Gastric Disorders

2026-04-22T10:11:13+07:00

Functional gastric disorders (FGDs), including functional dyspepsia, are highly prevalent worldwide and significantly affect patients’ quality of life. Herbal medicines are increasingly used as complementary therapies, yet their overall effectiveness remains uncertain due to variability across studies. This study aimed to evaluate the effectiveness of herbal medicines in the management of functional gastric disorders through a systematic review and meta-analysis. A systematic literature search was conducted in PubMed, Scopus, Web of Science, ScienceDirect, and relevant national databases for studies published between 2015 and 2025. The review followed PRISMA guidelines. Randomized controlled trials assessing herbal interventions in adults with FGDs were included. Data were analyzed using a random-effects model due to substantial heterogeneity. Effect sizes, 95% confidence intervals (CI), and heterogeneity indices (Q, I², τ²) were calculated. Five randomized controlled trials met the inclusion criteria. The pooled effect size was 0.105 (95% CI: 0.000–0.216; p ≈ 0.050), indicating a small but positive effect of herbal medicines on symptom improvement. However, heterogeneity was very high (I² = 98.90%), reflecting considerable inter-study variability. Herbal medicines demonstrate modest potential as complementary therapies for FGDs. Nevertheless, the small effect size and high heterogeneity warrant cautious interpretation and highlight the need for larger, high-quality clinical trials.

Chronic Adenotonsillitis as a Cause of Airway Obstruction: A Case Report

2026-04-29T10:10:40+07:00

Chronic adenotonsillitis is a chronic inflammation of the palatine tonsils and adenoid tissue that lasts for more than three months or recurs several times a year. Chronic adenotonsillitis accompanied by enlargement of the adenoid tissue can cause airway obstruction. A 14-year-old boy came to the ENT clinic with a main complaint of pain when swallowing for the past ±3 months, which was intermittent, especially when swallowing hard or hot food. The complaint was accompanied by itching and discomfort in the throat and bad breath. The patient also experienced mild fever recurring every 2–3 days. In addition, the patient complained of chronic nasal congestion, especially at night, accompanied by thick mucus, mouth breathing, and loud snoring during sleep. Physical examination by pharyngoscopy revealed T2-T2 tonsils with widened crypts and an uneven surface, as well as visible adenoids. The patient was diagnosed with Chronic Adenotonsillitis and scheduled for surgical intervention. This case shows that chronic adenotonsillitis can cause airway obstruction. Based on theory, chronic adenotonsillitis is often accompanied by enlarged adenoid tissue that causes obstruction of the upper airway, leading to symptoms such as chronic nasal congestion, mouth breathing, and snoring during sleep. In this case, the patient presented with the same complaints, namely chronic nasal congestion and loud snoring during sleep. The habit of breathing through the mouth and restless sleep also indicated nasopharyngeal obstruction due to adenoid hypertrophy. Recurrent infections can cause chronic adenotonsillitis and lead to adenoid hypertrophy and tonsil hypertrophy, resulting in symptoms such as snoring and mouth breathing, as well as complications like posterior nares obstruction, perituba lymphadenitis, and otitis media.

Factors Influencing the Enhancement of Flexibility and Accountability in Financial Management Services under the BLUD Scheme at Community Health

2026-04-30T16:14:05+07:00

Transparent healthcare services has driven Community Health Centers (Puskesmas) to adopt the Financial Management Pattern of Regional Public Service Agencies (PPK-BLUD). This study aims to examine the factors influencing the flexibility and accountability of BLUD-based financial management within Community Health Centers in Kotabaru Regency. The research employs a literature review approach, utilizing content analysis of scholarly articles and relevant regulatory documents published within the last five years. The findings reveal that the effectiveness of BLUD implementation is predominantly shaped by four key determinants: the quality of human resources, regulatory frameworks, infrastructural capacity, and the structure of authority and governance

Analysis of Factors Associated with Patient Satisfaction in the Outpatient Unit

2026-04-30T16:14:03+07:00

The patient satisfaction level at the Outpatient Unit of the Sengayam Regional General Hospital (RSUD) in the second quarter of 2025 was recorded at 84.23, which means it is still below the minimum service standard of ≥95%. This study aims to analyze factors associated with patient satisfaction through a literature review using a qualitative descriptive approach on scientific articles published between 2015 and 2025. The analysis results indicate that the reliability dimension is the most critical factor as it is directly related to the consistency of staff in accurately following standard operating procedures. In addition to clinical aspects, cost factors such as tariff transparency and physical facilities including the comfort of waiting areas and cleanliness were found to be significant in shaping patients’ perceived value. This satisfaction dynamic is not static but continues to evolve alongside patients’ demographic characteristics and the ease of accessing digital information, which makes the public’s expectations regarding healthcare services increasingly critical and personalized. In conclusion, effective coordination across the SERVQUAL dimensions, particularly regarding reliability and tangible evidence, serves as the primary strategy for Sengayam General Hospital to enhance service quality and achieve the established satisfaction standards.

Analysis of Factors Associated with the Utilization of the Kotabaru Community Health Center in the Era of Primary Care Integration

2026-04-30T16:14:01+07:00

Health constitutes a fundamental investment in both human well-being and economic development. Strengthening the primary healthcare system through the Primary Care Integration (PCI) program has therefore emerged as a national priority aimed at delivering comprehensive, accessible, and affordable services. This study seeks to examine the factors associated with the utilization of the Kotabaru Community Health Center (Puskesmas) in the PCI era, with particular emphasis on the relationships among access to healthcare services, health status, and educational attainment in shaping community health-seeking behavior. Employing a literature review approach based on scientific publications from the past five years, the findings indicate that access to healthcare services in the PCI era extends beyond mere geographical proximity, encompassing affordability, administrative simplicity, and the integration of electronic medical records. These dimensions collectively influence the frequency of community visits. Subjective health status emerges as the most dominant determinant, as the PCI system has effectively shifted service utilization patterns from reactive, curative practices toward continuous, life-cycle-based health risk monitoring. Educational level functions as a critical predisposing factor, shaping health literacy and the cognitive capacity of individuals to navigate the newly implemented cluster-based service system. The utilization of the Kotabaru Community Health Center within the PCI framework is therefore significantly shaped by the interplay between accessibility, risk-based health awareness, and the level of community health literacy in making informed medical decisions.

The Effectiveness of Black Seed Extract (Nigella Sativa) on the Movement of Ascaridia Galli Worms in Vitro

2026-05-08T08:24:16+07:00

This study concludes that Black Seed (Nigella sativa) extract demonstrates significant anthelmintic activity against Ascaridia galli in vitro, as evidenced by decreased worm motility and reduced time to death across treatment groups. The findings highlight a clear dose–response relationship, where higher extract concentrations produce stronger and faster anthelmintic effects. Statistical analyses, including the Friedman test and One-Way ANOVA, confirm that most treatment groups show significant differences in worm motility and mortality compared to the negative control, while the highest concentration (100%) exhibits effectiveness comparable to the positive control (pyrantel pamoate). The presence of bioactive compounds such as alkaloids, flavonoids, saponins, tannins, and triterpenoids further supports the biological mechanism underlying this effect, particularly through pathways involving neuromuscular disruption, protein denaturation, and inhibition of energy metabolism in worms. Overall, these results indicate that Black Seed extract has strong potential as a natural alternative anthelmintic agent, although further in vivo studies and clinical validation are required to confirm its safety, efficacy, and practical application in both veterinary and human health contexts

Meta Analysis: Fungal Distribution in the Large Intestine

2026-05-05T09:49:06+07:00

The human colon hosts a diverse microbial ecosystem, including fungi (mycobiome), which, although comprising a small proportion of the microbiota, play a crucial role in maintaining gut homeostasis, metabolism, and immune regulation. Imbalances in fungal communities are associated with gastrointestinal disorders such as inflammatory bowel disease and colorectal cancer. This study employed a systematic literature review with meta-analysis following PRISMA guidelines. Data were collected from major databases (2015–2025) using PICO-based keywords. Eligible studies were analyzed using statistical software to calculate pooled effect sizes, heterogeneity (I²), and significance levels. A random-effects model was applied due to high variability among studies. Five studies were included, revealing that fungi are consistently present across all colon segments, with dominant genera including Candida and Saccharomyces. The pooled effect size (0.125; 95% CI: 0.005–0.248; p < 0.001) confirms a stable fungal presence. However, heterogeneity was very high (I² = 97.85%), influenced by differences in populations, methodologies, and disease conditions. Findings highlight the role of fungi in microbial interactions, inflammation, and potential use as biomarkers in gastrointestinal diseases. Colonic fungi are integral to gut health, though highly variable across individuals. Further standardized and longitudinal research is needed to clarify their clinical significance and therapeutic potential.

Literature Review: Evaluation of the Use of Tonsillectomy as a Surgical Intervention in Patients with Recurrent Tonsillitis

2026-05-05T15:42:12+07:00

Recurrent tonsillitis is one of the most common diagnoses in ENT practice that significantly impacts patients' quality of life. Although antibiotic therapy is the first line of treatment, persistent infection often requires surgical intervention. This study aims to evaluate the clinical efficacy, impact on quality of life, and pharmacoeconomic aspects of tonsillectomy compared to conservative management. The method used was a narrative systematic review of international literature from 2016 to 2025 obtained from Google Scholar, PubMed, and NCBI. The results of the search of 17 selected articles showed that tonsillectomy significantly reduced the frequency of sore throat episodes and antibiotic use compared to medical therapy. The use of modern techniques such as Coblation has been shown to reduce postoperative pain and accelerate recovery compared to conventional techniques. In addition, tonsillectomy provides significant long-term improvements in quality of life, both physically and mentally. In conclusion, tonsillectomy is an effective, safe, and cost-efficient surgical procedure for patients with recurrent tonsillitis, with strict indications to optimize clinical outcomes.

Diagnostic Approach to Anorectal Malformations in Neonates

2026-05-05T15:42:10+07:00

an incidence of approximately 1 in 5,000 live births. The wide spectrum of abnormalities necessitates accurate classification and early diagnosis during the neonatal period to guide appropriate surgical management and predict long-term continence outcomes. One of the major diagnostic challenges lies in the limitations of conventional invasive techniques and the potential risks associated with radiation exposure. This study aims to identify effective diagnostic approaches for ARM in neonates. This research employs a literature review design with a narrative review approach. The data consist of secondary sources derived from 20 selected studies, including national and international journals as well as textbooks published between 2014 and 2025, accessed through databases such as ClinicalKey and Google Scholar. The analysis focuses on clinical, radiological, prenatal, and systemic factors relevant to establishing an accurate diagnosis. The findings indicate that diagnosis should begin with a thorough perineal physical examination to identify fistulas and signs of obstruction. A high-pressure distal colostogram remains the gold standard for delineating fistula anatomy prior to surgery. In addition, high-resolution transperineal ultrasound and magnetic resonance imaging have emerged as reliable non-invasive modalities for evaluating rectal position and the sphincter muscle complex. Anorectal manometry also plays a significant role in detecting subtle forms of ARM that may be overlooked during routine examinations. A systematic and multidisciplinary diagnostic approach that integrates clinical assessment, screening for associated anomalies, and multimodal imaging is essential to optimize surgical planning and improve patient outcomes.

The Relationship Between Nutritional Status and Nutritional Intake Towards Intelligence Level (IQ)

2026-05-05T16:13:46+07:00

Nutritional status plays an important role in children's growth and development, including cognitive development and intelligence. School-aged children are a vulnerable group to nutritional problems that may affect learning ability. An observational analytic study with a cross-sectional design was conducted among 36 students aged 11–12 years. Nutritional status was assessed using Body Mass Index-for-Age (BMI-for-age) based on CDC standards, nutrient intake was measured using a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ), and intelligence was measured using the Wechsler Intelligence Scale for Children (WISC). Data analysis was performed using univariate, bivariate (One Way ANOVA), and multivariate (linear regression) analyses. Most respondents had normal nutritional status and average IQ scores. There was no significant relationship between nutritional status and IQ (p = 0.095). Multivariate analysis also showed no significant effect of nutritional status and nutrient intake on IQ (p = 0.797; R² = 0.072). Nutritional status and nutrient intake were not significantly associated with intelligence levels among school-aged children in this study.

The Role of Estrogen and Progesterone Fluctuations in the Pathogenesis of Postpartum Psychosis: A Neurobiological Review

2026-05-07T10:11:46+07:00

Postpartum psychosis is an acute psychiatric disorder characterized by rapid onset following childbirth, posing significant risks to both maternal and neonatal safety. Its underlying mechanisms remain incompletely understood; however, fluctuations in reproductive hormones particularly estrogen and progesterone are strongly implicated in its pathogenesis. The abrupt decline of these hormones after delivery may disrupt neurotransmitter systems, especially dopaminergic and GABAergic pathways, thereby precipitating neurobiological imbalance in vulnerable individuals. This study employs a literature review method using a narrative review approach, drawing upon databases such as PubMed, ScienceDirect, and Google Scholar, complemented by manual searches. Following the PRISMA framework, a total of 20 articles met the inclusion criteria and were systematically analyzed. The findings indicate that estrogen demonstrates a more consistent association with psychotic symptomatology, whereas progesterone exerts its effects primarily through its metabolite, allopregnanolone, which modulates the GABAergic system. In addition, genetic predisposition, sleep disturbances, and alterations in neuroplasticity contribute to the condition. Postpartum psychosis therefore emerges as a multifactorial disorder resulting from the complex interplay between hormonal fluctuations and underlying neurobiological vulnerability.

Effectiveness of Angiotensin Converting Enzyme Inhibitors and Beta-Blockers in Reducing Mortality in Patients with Congestive Heart Failure

2026-05-09T10:12:11+07:00

CHF is a chronic and progressive cardiovascular disease with high morbidity, frequent hospitalization and a high mortality rate, especially for individuals with HFREF. The purpose of this study is to assess the efficacy of angiotensin converting enzyme inhibitors and beta blockers in the reduction of mortality in congestive heart failure patients especially in terms of the neurohormonal modulation and long-term clinical results. In this study, a narrative literature review design was used to obtain secondary data from national and international journals, textbooks, ClinicalKey, ScienceDirect, PubMed, Google Scholar, scientific websites of publishers, and other relevant scientific sources. The existing literature focused on studies from 2015 to 2026, with the exception of landmark studies from the past that provided foundational evidence relevant to heart failure pharmacotherapy. The results suggest that ACE inhibitors and beta blockers are associated with consistently lower mortality, hospitalization rate and clinical stability, particularly in those with heart failure with reduced EF. Angiotensin converting enzyme inhibitors (ACE inhibitors) can help decrease the harmful effects of activation of the renin angiotensin aldosterone system (RAAS) while beta blockers can help to reduce excessive sympathetic nervous system activity. They both have complementary neurohormonal control and can have a wider clinical effect than monotherapy, if used appropriately. The therapeutic efficacy, however, is not consistent in every patient, and may be affected by the level of ejection fraction (EF), age, comorbidities, disease severity, drug tolerance, dose optimization, and adherence to therapy. This review demonstrates that ACE inhibitors and beta blockers are still employed by patients with CHF and are still considered critical components of guideline directed pharmacologic therapy, especially in those patients with reduced EF.

Plasma Exchange is a Therapeutic Procedure used in the Management of Rapidly Progressive Glomerulonephritis (RPGN): A Case Report

2026-05-10T10:12:01+07:00

Rapidly Progressive Glomerulonephritis (RPGN) is a clinical syndrome characterized by a rapid decline in kidney function and the presence of crescents on kidney biopsy, requiring immediate treatment to prevent disease progression. A 34-year-old man was admitted to the hospital with generalized body swelling that began in the eyelids one week prior. He had a history of fever before admission, which subsided upon hospitalization. Additional complaints included shortness of breath, cough, and runny nose. Past medical history included hypertension and hiperuresemia. In recent days, he experienced oliguria. Physical examination revealed pitting edema in the lower extremities. Laboratory tests showed anemia, hypoalbuminemia, and rapid decline in kidney function. Urinalysis revealed protein +3, leukocytes sediment 80.1/µL, erythrocytes sediment 468/µL, and Esbach 0.5 g/L. Complement C3 53 mg/dL, C4 13.8 mg/dL, ANA, and anti-dsDNA were negative, with no available data for anti-GBM, ANCA and kidney biopsy Segmental Mesangial Hypercellular Glomerulus and focal segmental sclerosis. Chest X-ray showed cardiomegaly, bronchopneumonia, and left pleural effusion. Abdominal ultrasound revealed bilateral parenchymal renal disease. The patient was treated with high dose steroids, antibiotics, antihypertensives, symptomatic medications, two sessions of hemodialysis, and four sessions of plasma exchange (PLEX). The combination therapy of high dose steroids and followed by hemodialysis and plasma exchange, resulted in significant reduction of edema and improvement in kidney function, demonstrating the effectiveness of an aggressive immunomodulatory regimen. In pauci-immune or idiopathic RPGN, the combination of high-dose steroids and plasma exchange along with dialysis provides a rapid clinical response, increases the chance of remission, and preserves kidney function.

The Effect of Brain Gym as a Cognitive Stimulation Strategy in Improving Learning Concentration among School Aged Children

2026-05-13T10:14:42+07:00

School-age children are at the concrete operational development stage which requires good concentration skills in the learning process. However, the results of a preliminary study at SDIT Al-Kamiliyyah Bekasi Regency showed that many students still experience low concentration levels. Brain Gym is a non-pharmacological intervention in the form of a series of simple movements aimed at optimizing brain function and helping improve children's learning concentration. This study aims to determine the effect of the Brain Gym method on the level of learning concentration in school-age children at SDIT Al-Kamiliyyah Bekasi Regency. This study is a quantitative method with a pre-experimental design through a one group pretest - posttest approach. The study population was all 150 students in grades I and V, with a sample of 110 students selected using a purposive sampling technique. The concentration level was measured using the Grid Concentration Test (GCT). The Brain Gym intervention was given for two weeks with a frequency of three times a week. Data were analyzed using the Wilcoxon Signed Rank Test. Results: The analysis results showed a p-value <0.05, which means there is an effect of the Brain Gym method on increasing the level of learning concentration. Conclusion: The Brain Gym method is effective in increasing learning concentration in school-age children and is recommended as a non-pharmacological nursing therapy.

Persistent Pain After Decompression: Unmasking the Role of Facet Joint Pathology

2026-05-13T10:14:12+07:00

Lumbar facet joint cysts are an uncommon but important cause of radiculopathy, often associated with degenerative changes and segmental instability of the facet joint. Although endoscopic resection effectively relieves nerve root compression, persistent axial low back pain remains a frequent postoperative problem, likely because the underlying facet pathology is not fully addressed. This study assessed long-term outcomes after endoscopic cyst resection, with emphasis on persistent axial pain. A retrospective cohort study was conducted at a tertiary care center involving patients who underwent endoscopic laminotomy and resection of MRI-confirmed lumbar facet joint cysts between January 2022 and December 2025. Only patients with at least 24 months of follow-up were included. Demographic, clinical, surgical, imaging, and outcome data were reviewed. The primary endpoint was persistent axial low back pain at 24 months measured by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Secondary outcomes included facet degeneration and cyst recurrence on imaging. Twenty-seven patients met inclusion criteria. Radicular symptoms improved in 90.5% of cases. VAS and ODI scores improved significantly at 24 months (p < 0.01). However, 59.2% (16 patients) continued to report axial low back pain. Follow-up MRI often showed progressive facet degeneration and residual or recurrent cysts in symptomatic patients. Conservative treatment gave limited benefit, and these patients later required percutaneous pedicle screw fixation. Endoscopic cyst resection reliably improves radicular symptoms, but persistent axial pain remains common when facet pathology is untreated. Adjunctive procedures such as facet denervation or segmental stabilization may improve long-term outcomes. Prospective studies are needed to define the role of these additional techniques.