Biomedical Research and Theory Letters (BRTL) is an international peer‑reviewed journal dedicated to advancing the frontiers of biomedical science through the integration of theory, experimentation, and clinical application. The journal provides a platform for disseminating high‑quality research that bridges fundamental discoveries in the laboratory with translational and clinical practices, while also encouraging theoretical contributions that enrich the conceptual foundations of biomedical knowledge. By fostering dialogue between empirical research and theoretical frameworks, BRTL seeks to promote innovation, methodological rigor, and interdisciplinary collaboration across the biomedical sciences
Holistic Management of Dyslipidemia in a Geriatric Patient with Comorbid Hypertension and History of Hyperuricemia Following Lower Extremity Trauma
Dyslipidemia is a major metabolic disorder and a key risk factor for atherosclerotic cardiovascular disease (ASCVD), particularly in the geriatric population. Elderly patients frequently present with multiple comorbidities, such as hypertension and hyperuricemia, which complicate clinical management and substantially increase cardiovascular risk. Moreover, acute conditions, including trauma-related injuries, may further disrupt metabolic control, functional capacity, and adherence to long-term therapy. This case report describes a 70-year-old male patient (RE) who presented to a primary healthcare center with swelling and intermittent pain in the right lower extremity following a fall. The patient had a known history of dyslipidemia, hypertension, and hyperuricemia. Laboratory investigations revealed elevated total cholesterol (242 mg/dL), borderline fasting plasma glucose (102 mg/dL), and uric acid level of 6.6 mg/dL. Physical examination was unremarkable except for edema and localized tenderness in the affected limb, consistent with a soft tissue injury. A holistic management approach was implemented, integrating pharmacological and non-pharmacological interventions. Statin therapy was initiated to address dyslipidemia, antihypertensive treatment was optimized, and analgesic therapy combined with limb elevation was provided to manage acute pain and edema. Non-pharmacological strategies included comprehensive lifestyle modification, encompassing dietary counseling (low saturated fat, low salt, and low purine diet), gradual resumption of physical activity following injury recovery, and structured patient–family education to improve adherence and prevent recurrent falls. Follow-up evaluation demonstrated clinical improvement, including resolution of edema, improved functional mobility, and better metabolic control. The novelty of this case lies in demonstrating how acute trauma in geriatric patients can act as a critical entry point for integrated chronic disease management within primary care settings. This case emphasizes that holistic, biopsychosocial–spiritual management not only improves lipid and blood pressure control but also enhances functional outcomes and quality of life in elderly patients with complex comorbidities.
Copyright (c) 2026 Muhammad Hatta, Agustina Hadjar, Muhammad Iqbal Pratama, Muhammad Irham Fadil Al Muhsin, Muhammad Yusuf Al Afif, Muhammad Zaidan Afkar, Mutiara Salsabila (Author) https://creativecommons.org/licenses/by-sa/4.0/
Holistic Primary Care–Based Management of Typhoid Fever in a Toddler from a Resource-Limited Community Setting
Typhoid fever remains a significant public health challenge in many low- and middle-income countries, including Indonesia, where inadequate sanitation, limited access to clean water, and suboptimal hygiene practices continue to facilitate disease transmission. Although typhoid fever is more commonly reported in school-aged children and adolescents, its occurrence in toddlers poses unique diagnostic and management challenges due to atypical clinical presentations and increased vulnerability to dehydration and complications. Early recognition and comprehensive management at the primary health care level are therefore critical. This study describes the holistic primary care–based management of typhoid fever in a 14-month-old boy presenting to a community health center in Bandar Lampung, Indonesia. The patient was brought with a three-day history of persistent fever and a one-week history of watery diarrhea, accompanied by decreased appetite, irritability, and generalized weakness. A holistic diagnostic approach integrating clinical symptoms, physical examination, environmental exposure, and family hygiene practices was applied. Key clinical features included a fever pattern worsening in the late afternoon to evening, prolonged diarrhea, and a coated tongue with erythematous margins, strongly suggestive of typhoid fever in the absence of other focal infections. Management combined pharmacological and non-pharmacological interventions tailored to the toddler age group and primary care setting. Pharmacological therapy consisted of first-line antibiotic treatment with cotrimoxazole, antipyretic therapy, zinc supplementation, and oral rehydration therapy to prevent dehydration. Non-pharmacological interventions emphasized continued breastfeeding, adequate fluid intake, safe food preparation, access to clean drinking water, and strict hand hygiene practices within the household. Family members were actively involved in the care process to ensure adherence to treatment and implementation of preventive measures. Clinical improvement was observed following the integrated intervention, with resolution of fever and gastrointestinal symptoms and restoration of appetite and activity levels. This approach highlights the importance of combining clinical management with family-centered hygiene education and environmental risk assessment. The findings underscore the critical role of primary health care services in early detection, effective treatment, and prevention of typhoid fever among vulnerable pediatric populations.
Copyright (c) 2026 Zaleha Ulfa, Putri Nabila Febrianti, Putri Novita Sari, Rahmawati Sari, Ratna Gumilang Sari, Rahmi Rahmawati, Manmeet Kaur, Alok Shukla (Author) https://creativecommons.org/licenses/by-sa/4.0/
Clinical Management and Lifestyle Intervention for Hypertension in an Elderly Patient at a Primary Health Care Facility in Indonesia
Hypertension remains one of the most prevalent chronic non-communicable diseases worldwide and constitutes a major risk factor for cardiovascular morbidity and mortality, particularly among elderly populations. Despite the availability of effective antihypertensive therapies, blood pressure control remains suboptimal in many patients due to delayed diagnosis, inadequate treatment adherence, and unhealthy lifestyle practices. Primary health care facilities play a critical role in the early detection, management, and long-term monitoring of hypertension, especially in low- and middle-income settings. This study describes the clinical management and outcomes of an elderly patient with poorly controlled hypertension treated at a community-based primary health care center in Bandar Lampung, Indonesia. A 70-year-old woman presented with persistent headaches, dizziness, and fatigue lasting for approximately two weeks. Initial clinical assessment revealed elevated blood pressure of 170/90 mmHg. The patient had a five-year history of hypertension but reported inconsistent use of antihypertensive medication and suboptimal lifestyle behaviors, including frequent caffeine consumption and limited physical activity. Management involved pharmacological therapy using amlodipine at a daily dose of 5 mg, combined with comprehensive non-pharmacological interventions. The patient received individualized counseling focused on lifestyle modification, including dietary salt restriction, reduction of caffeine intake, encouragement of regular physical activity, and routine blood pressure monitoring. Emphasis was also placed on improving medication adherence through patient education and follow-up support. At a two-week follow-up evaluation, the patient demonstrated a clinically meaningful reduction in blood pressure to 150/80 mmHg, accompanied by a marked improvement in reported symptoms. Additionally, the patient showed enhanced understanding of hypertension management and greater adherence to dietary and lifestyle recommendations. These findings underscore the importance of integrated hypertension management strategies in primary care settings, particularly for elderly patients. The combination of appropriate pharmacological treatment, lifestyle modification, and patient education can significantly improve blood pressure control and reduce the risk of long-term complications. Strengthening primary care–based hypertension programs may contribute to better cardiovascular health outcomes at the community level.
Copyright (c) 2026 Festy Ladyani, Susi, Yustira Mayasari, Welvin Kurniawan Susanto, Widi Anggaraini, Widya Karina Sari, Wijihan Rusi Nur Aulia, Windy Septrihani, Mikael Syväjärvi (Author) https://creativecommons.org/licenses/by-sa/4.0/
Acute Non-Erosive Gastritis Associated with Irregular Dietary Habits and Psychological Stress in a Young Adult
Acute gastritis is a common gastrointestinal disorder characterized by sudden inflammation of the gastric mucosa, frequently associated with dietary irritation, psychological stress, and dysregulation of gastric acid secretion. Although generally considered a benign and self-limiting condition, acute gastritis may significantly impair daily functioning, particularly among young adults with irregular lifestyles. This article describes the clinical course and holistic management of acute non-erosive gastritis in a young adult, emphasizing the contribution of modifiable behavioral and psychosocial factors. A 24-year-old woman presented to a primary healthcare facility with a four-day history of epigastric burning and pressing pain, aggravated by delayed meals and the consumption of spicy and acidic foods. The patient reported irregular eating patterns and considerable academic- and work-related psychological stress. There was no history of NSAID use, alcohol consumption, smoking, or previous gastrointestinal disease. Clinical assessment was conducted through structured history taking, comprehensive physical examination, and anthropometric measurement. No laboratory or endoscopic investigations were initially performed due to the absence of alarm features. The diagnosis of acute non-erosive gastritis was established based on clinical criteria. Management consisted of an integrated approach combining pharmacological and non-pharmacological interventions. Pharmacological therapy included omeprazole 20 mg once daily to suppress gastric acid secretion and antacids administered as needed for symptomatic relief. Non-pharmacological management focused on patient and family education regarding gastric-friendly dietary patterns, regular meal timing, avoidance of trigger foods and beverages, and stress management strategies. Follow-up evaluation was planned to monitor symptom resolution and determine the need for further diagnostic investigations, including Helicobacter pylori testing or endoscopy, if symptoms persisted or worsened. Following the initiation of combined therapy and lifestyle modification, the patient demonstrated clinical improvement with reduced frequency and intensity of epigastric pain. This case underscores the importance of addressing lifestyle and psychosocial contributors in addition to pharmacological treatment in acute gastritis. The novelty of this report lies in its explicit integration of holistic clinical assessment including functional, psychological, and family-based factors within the management of acute gastritis in a young adult, highlighting a practical, patient-centered model that may reduce symptom recurrence and improve long-term outcomes in primary care settings.
Copyright (c) 2025 Rinto Hardiarto, Athifah Dewi Ghinaa Yusriyyah, Audry Rizki Hasanah, Aufa Nabila Rahmalya, Azzelia Zaskia Alifah, Belinda Dewi (Author) https://creativecommons.org/licenses/by-sa/4.0
Clinical Identification and Management of Hypertension in a Primary Care Setting at Segala Mider Public Health Center
Hypertension remains a major global health challenge and a leading contributor to cardiovascular morbidity and mortality. Its asymptomatic nature causes many individuals to remain undiagnosed, increasing the risk of severe complications such as stroke, coronary artery disease, and renal impairment. Despite advancements in diagnostic and therapeutic approaches, hypertension awareness and treatment adherence remain low, particularly in primary care settings where early detection is crucial. This study describes the clinical identification and management process of a hypertensive adult patient at Segala Mider Public Health Center as an illustration of the essential role of primary healthcare services in improving hypertension control at the community level. Clinical data were collected through patient interviews, vital sign assessment, physical examination, and review of medical records. The patient, a 42-year-old male, presented with recurrent dizziness triggered by physical activity and consumption of sweet foods. Initial evaluation showed severely elevated blood pressure at 164/122 mmHg with otherwise normal cardiopulmonary findings. The patient had previously been taking amlodipine 5 mg daily with suboptimal response. Management involved titration of amlodipine to 10 mg daily for 15 days, accompanied by short-term furosemide therapy and vitamin B complex supplementation. The intervention produced symptomatic improvement and facilitated better blood pressure control during follow-up. The findings highlight the importance of timely recognition of uncontrolled hypertension, appropriate pharmacological adjustment, and continuous monitoring. This report emphasizes the relevance of primary care in initiating evidence-based treatment, identifying modifiable risk factors, and ensuring patient education regarding lifestyle modification. The novelty of this study lies in demonstrating how structured evaluation and treatment optimization in a resource-limited primary care setting can effectively support hypertension control while preventing long-term complications, reinforcing the vital role of frontline healthcare facilities in managing chronic diseases.
Copyright (c) 2025 Nita Sahara, Destriana Hasan, A Fatwa Alwaliu, Achmad Farhan, Adelia Putri Sardi, Adis Adelia, Ady Wahyu Pratama (Author) https://creativecommons.org/licenses/by-sa/4.0
Effective Hydration-Centered Management of Acute Gastroenteritis in a 13-Year-Old Patient: Insights from Primary Care Practice
Acute gastroenteritis remains one of the most common acute conditions in children and adolescents, frequently leading to dehydration and requiring prompt clinical assessment to prevent further complications. Although management guidelines are well established, variability in presentation and progression highlights the importance of individualized and holistic diagnostic approaches in primary care. This report describes a case involving a 13-year-old male who presented with severe gastrointestinal symptoms, including diarrhea exceeding ten episodes per day over three consecutive days, more than five episodes of vomiting, abdominal pain, fever, and generalized weakness. Clinical examination demonstrated a weakened overall condition, blood pressure of 100/70 mmHg, pulse 85 beats per minute, respiratory rate 20 breaths per minute, temperature 36.7°C, and signs consistent with mild to moderate dehydration. Laboratory evaluation revealed slightly decreased leukocyte levels, suggesting a likely viral etiology. The management in this case reflects the methodological core of the intervention: a holistic, stepwise approach integrating intravenous rehydration, symptomatic therapy, and adaptive pharmaceutical adjustments based on evolving clinical features. The patient was administered Ringer’s Lactate intravenously through a loading dose followed by controlled infusion at 25 drops per minute. Antiemetic therapy with ondansetron, antipyretics, antacids, attapulgite, and oral rehydration solution were provided initially. On the second day, antibiotics and ranitidine were introduced in response to persistent gastrointestinal complaints and to prevent potential secondary complications. The results demonstrated clear clinical improvement within 72 hours, marked by decreased diarrhea frequency, cessation of vomiting, and normalization of vital signs (blood pressure 100/65 mmHg; pulse 80 beats per minute). Hydration status returned to normal, and no complications or referral indications were identified. This case underscores the conclusion that integrating holistic assessment with tailored rehydration strategies and selective pharmacologic therapy can produce rapid and effective recovery in pediatric acute gastroenteritis. The novelty lies in demonstrating how a dynamic, symptom-guided model of care in a primary health setting can optimize outcomes while minimizing unnecessary escalation of treatment.
Copyright (c) 2025 Nia Triswanti, Dian Vitria, Syalwa Lutfhi Rahmadini, Shafa Annisa Rembulan E. K, Shevani Adelia, Silviatara Putri Maharani, Siti Aisyah, Siti Rahayu (Author) https://creativecommons.org/licenses/by-sa/4.0
Integrated Biomedical and Holistic Management of Bilateral Knee Osteoarthritis with Hypertension in a 71-Year-Old Woman: A Case-Based Analysis
Bilateral knee osteoarthritis is a progressive degenerative joint condition frequently observed in the elderly and often complicated by comorbid hypertension, which can exacerbate systemic inflammation and impair functional outcomes. This case report presents a 71-year-old woman with acute worsening of bilateral knee pain and restricted flexion over three days, accompanied by neck discomfort. Her medical history included longstanding hypertension and a positive maternal family history of the same condition. A holistic, family-medicine–based assessment revealed interacting biomedical factors (pain, limited mobility, elevated blood pressure), psychological concerns related to fear of functional decline, adequate family and social support, and environmental-behavioral contributors affecting daily activities. The patient underwent integrated management consisting of patient education, lifestyle modification, joint-protective behavior counseling, and tailored low-intensity physical exercise. Pharmacological therapy included sodium diclofenac 50 mg, amlodipine 5 mg, dexamethasone 0.5 mg, and pyridoxine HCl. Follow-up evaluation demonstrated reduced pain intensity, improved knee mobility, better hypertension control, and enhanced disease understanding, indicating positive response to combined biomedical and holistic interventions. This report aims to document the identification, management, and clinical progression of bilateral knee osteoarthritis with comorbid hypertension using a structured family medicine approach. A literature review indicates that osteoarthritis progression in the elderly is commonly influenced not only by degenerative aging processes and obesity but also by comorbidities such as hypertension, which may worsen joint microcirculation, increase inflammatory mediators, and accelerate cartilage degradation. The novelty of this report lies in the integration of a comprehensive holistic assessment encompassing biomedical, psychological, social, and behavioral dimensions into the management plan, demonstrating its measurable impact on short-term clinical improvement. This case underscores that elderly patients with coexisting osteoarthritis and hypertension benefit significantly from an interdisciplinary, patient-centered model of care. The findings support that early holistic intervention may optimize functional capacity, enhance self-management, and potentially slow the progression of disability, offering valuable insights for future community-based geriatric care frameworks.
Copyright (c) 2025 Yessi Nurmalasari, Famela Mutiarasari, Faradillah Puspitasari, Fauziatus Sabila, Fernando Hoky Saputra, Feni Fadila (Author) https://creativecommons.org/licenses/by-sa/4.0
Symptom-Based Management of Chronic Gastroesophageal Reflux Disease in a Young Adult: A Holistic Therapeutic Approach
Gastroesophageal Reflux Disease (GERD) is a chronic gastrointestinal disorder resulting from the retrograde movement of gastric contents into the esophagus, often due to lower esophageal sphincter dysfunction. It is characterized by hallmark symptoms such as heartburn, regurgitation, epigastric pain, and may also present with extra-esophageal manifestations including chronic cough, hoarseness, or dental erosion. GERD significantly affects quality of life and, if left untreated, may lead to complications such as esophagitis, strictures, or Barrett’s esophagus. This case report presents a 21-year-old female with a history of recurrent GERD symptoms since childhood. She presented with complaints of persistent epigastric pain, nausea, and a burning sensation in the chest, particularly after meals. Physical examination revealed epigastric tenderness and clinical signs suggestive of anemia, including pallor and fatigue. A detailed clinical history and symptom pattern strongly supported a diagnosis of GERD. Given the classic presentation and absence of alarm features, a non-invasive, symptom-based diagnostic approach was adopted, avoiding the need for endoscopy or pH monitoring. The patient was managed with a combination of pharmacological therapy omeprazole (a proton pump inhibitor), antacids for symptomatic relief, paracetamol for pain management, and vitamin B6 to address nutritional deficiencies. Additionally, lifestyle modifications were emphasized, including dietary regulation, avoidance of trigger foods (such as spicy and acidic items), elevation of the head during sleep, and meal timing adjustments. Within one week of initiating treatment, the patient reported significant improvement in symptoms, with reduced frequency and intensity of heartburn and nausea. This case highlights the importance of early recognition and comprehensive management of GERD, especially in young adults with a chronic history of symptoms. It underscores the effectiveness of combining pharmacological treatment with lifestyle interventions and demonstrates that a symptom-based, non-invasive approach can be both practical and effective in primary care settings. Patient education and adherence to therapy remain critical in preventing recurrence and improving long-term outcomes.
Copyright (c) 2025 Rhomy Leokrisnha, Anggunan, M Raihan Raid Ijlal, Maisa Aqila Fazilatun Nisa, Marisha Alsahda Hr, Mely Shanrina Br Regar, Mentari Kusuma Putri (Author) https://creativecommons.org/licenses/by-sa/4.0
Integrative Approach to Dengue Hemorrhagic Fever: Clinical Management and Preventive Strategies
Dengue Hemorrhagic Fever (DHF) is a viral disease transmitted by Aedes aegypti mosquitoes, presenting with a wide spectrum of clinical manifestations ranging from mild fever to severe complications such as bleeding and shock. This case report describes a 12-year-old patient who presented to the Satellite Inpatient Health Center Bandar Lampung with a three-day history of high fever, headache, joint pain, skin rash, and nausea, accompanied by a positive history of mosquito bites in a dengue-endemic area. A holistic diagnostic approach was applied, including clinical history, physical examination, and symptomatic assessment. The patient was managed with fluid therapy consisting of 1500 ml oral fluids within six hours and intravenous infusion of Ringer Lactate solution (500 cc at a rate of 20 drops per minute). Preventive measures included hospitalization for observation, avoidance of mosquito bites through nets and protective clothing, fogging, and environmental sanitation. Pharmacological therapy was prescribed, including paracetamol 500 mg three times daily, ambroxol 30 mg twice daily, vitamin C 500 mg once daily, antacid 30 ml three times daily, intravenous fluids 500 cc at 20 tpm, ranitidine 150 mg twice daily, and domperidone 10 mg twice daily. Physical examination revealed a body temperature of 39°C, petechial rash, and joint tenderness, while other parameters were within normal limits. The patient reported no history of vomiting, smoking, or alcohol consumption. Following intervention, fever and pain subsided, skin rash improved, and overall clinical condition stabilized. Preventive measures were effective in reducing mosquito exposure, while supportive therapy minimized the risk of complications. This case confirms that Aedes aegypti mosquito bites caused dengue virus infection in the patient, and demonstrates that a holistic management strategy combining pharmacological therapy, fluid replacement, preventive measures, and psychosocial support can effectively reduce symptoms and prevent complications. The novelty of this report lies in its integrative approach, emphasizing early recognition and comprehensive management as essential strategies to improve patient outcomes and reduce the burden of dengue in endemic areas.
Copyright (c) 2025 Tria Yune, Ovi Hawila, Pradita Dwi, Puteri Aulia, Putri Azizah, Putri Binta, Endah Kinarya Palupi (Author) https://creativecommons.org/licenses/by-sa/4.0
Optimizing Glycemic Control through Multidisciplinary Care: A Case of Type 2 Diabetes Mellitus with Foot Ulceration
Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder characterized by impaired insulin secretion or resistance, which frequently remains undiagnosed until complications develop, and persistent hyperglycemia contributes to multisystem damage, particularly involving vascular, neural, renal, and integumentary systems, with major risk factors including family history, obesity, unhealthy dietary patterns, and physical inactivity; in this context, a 63-year-old woman presented with blistering lesions on the left hallux accompanied by swelling, pain, and paresthesia, with a medical history of hypertension, irregular eating habits, insufficient physical activity, and a familial predisposition to diabetes, while physical examination revealed a body mass index of 26.84 kg/m² with stable vital signs, and random blood glucose was 328 mg/dL, confirming severe hyperglycemia and establishing the diagnosis of T2DM, for which management encompassed pharmacological therapy (metformin, glimepiride, amlodipine, antibiotics, analgesics), patient education, psychosocial support, and lifestyle modification, and following comprehensive intervention the patient demonstrated improved disease awareness, enhanced family support, and better adherence to lifestyle changes, with outcomes emphasizing stabilization of glycemic levels, prevention of further complications, and improvement in overall quality of life, thereby underscoring the significance of a multidisciplinary approach in T2DM management that integrates medical therapy, education, psychosocial support, and behavioral as well as environmental modifications, and highlighting that such comprehensive strategies are essential to achieve optimal glycemic control and reduce the risk of long-term complications, while also illustrating the clinical relevance of early detection and holistic intervention in patients with diabetes who present with foot lesions, since these manifestations often indicate advanced disease progression and require coordinated care to prevent disability and improve prognosis, and ultimately this case contributes to the growing evidence that effective diabetes management must extend beyond pharmacological treatment to encompass patient-centered education, psychosocial reinforcement, and lifestyle restructuring, thereby offering a model of integrated care that can be applied more broadly in clinical practice to enhance outcomes in individuals living with T2DM.
Copyright (c) 2025 Akhmad Kheru, Novi Amin Juraini, Khaula Azzahra Muslihah Dien, Kirana Dwi Rahayu, Komang Angel Ayudya, Laeli Resti Oktapiani, Lattifah Anggun, Yuri Nurdiantami (Author) https://creativecommons.org/licenses/by-sa/4.0
Integrating Gastrointestinal and Dental Management in Analgesic-Associated Dyspepsia
Dyspepsia is a prevalent gastrointestinal disorder that manifests as epigastric pain, nausea, bloating, postprandial discomfort, and burning sensations in the upper abdomen, often triggered by irregular eating patterns, stress, or the consumption of irritant foods and beverages such as coffee, spicy meals, and fatty products, but it can also be induced by prolonged use of non‑steroidal anti‑inflammatory drugs (NSAIDs). In Indonesia, self‑medication with analgesics remains widespread, yet its impact on dyspepsia in primary care settings is rarely documented, making this study relevant to highlight the clinical features and therapeutic management of drug‑induced dyspepsia. A 39‑year‑old woman presented to Way Halim II Primary Health Center in Bandar Lampung with persistent nausea, vomiting, epigastric pain, bloating, and retrosternal burning after consuming sodium diclofenac daily for three months to relieve untreated dental pain, combined with frequent coffee intake. Endoscopic and laboratory findings were normal, while dental radiography revealed an impacted molar, indicating the underlying source of chronic analgesic use. Clinical data were obtained through anamnesis, physical examination, laboratory evaluation, and imaging, and management consisted of proton pump inhibitor therapy (omeprazole 20 mg), prokinetic agents (domperidone 10 mg), and lifestyle modification, including avoidance of dietary triggers. The patient was advised to undergo dental extraction to eliminate the primary cause of analgesic dependence but declined due to procedural anxiety. Following therapy, symptoms improved significantly, with reduced nausea and epigastric discomfort, demonstrating the effectiveness of pharmacological intervention combined with behavioral modification. This study emphasizes the novelty of identifying dyspepsia linked to prolonged unsupervised NSAID use in a primary care context, underscoring the importance of early recognition of drug‑induced gastrointestinal disorders, patient education on the risks of self‑medication, and multidisciplinary management that integrates gastrointestinal and dental care. Such an approach is critical to prevent recurrence, improve patient outcomes, and strengthen primary health care responses to common but neglected conditions in resource‑limited settings.
Copyright (c) 2025 Festy Ladyani, Indramayanti Warganegara, Ida Fitriyani, Wiwin Wildaniatul Janah, Yogi Dwi Praja Saputra, Yuli Tri Purnamasari, Zada Damar Pasa, Miftha Nazsiroh (Author) https://creativecommons.org/licenses/by-sa/4.0
Scabies Transmission and Therapeutic Outcomes in a Primary Care Setting in Bandar Lampung, Indonesia
Scabies is a contagious parasitic skin disease caused by Sarcoptes scabiei var. hominis, characterized by nocturnal pruritus, erythematous papules, and burrows. Transmission occurs readily in households and communities with close contact and poor hygiene. Although scabies is a common public health problem in Indonesia, clinical documentation of household transmission and integrated management strategies in primary care settings remains limited. This study aims to describe the clinical presentation, transmission pathway, and therapeutic management of scabies in a household setting, highlighting the importance of integrated treatment and hygiene measures to prevent reinfestation. A 33‑year‑old male presented to Labuhan Ratu Public Health Center, Bandar Lampung, with severe itching localized to the wrists, interdigital spaces, and genital region. Clinical examination revealed erythematous papules and burrows consistent with scabies. Diagnosis was established clinically based on cardinal signs and a history of close contact with his son, who had similar symptoms. No laboratory investigations were performed. Management included topical 5% permethrin applied according to protocol, oral cetirizine for symptomatic relief, vitamin B complex supplementation, and simultaneous treatment of all family members. Environmental interventions included washing clothes and bed linen with hot water and reinforcing personal hygiene practices. The patient demonstrated clinical improvement following therapy, with resolution of pruritus and regression of lesions. Family members treated simultaneously also showed recovery, and no reinfestation was reported during follow‑up. Vital signs and systemic examinations remained within normal limits, confirming localized disease. This case underscores the ease of household transmission of scabies and the necessity of integrated management strategies in primary care. The novelty of this report lies in emphasizing a holistic approach—combining pharmacological therapy with family‑wide treatment and hygiene reinforcement—as a practical model for scabies control in resource‑limited settings. Such documentation contributes to global understanding of scabies management and highlights the role of community health centers in addressing neglected parasitic diseases.
Copyright (c) 2025 Mira Aprilika, Triski Febrian, Tubagus Dharis Sidqi, Tyan Raga, Vio Salsabila, Wahyu Setianing Budi (Author) https://creativecommons.org/licenses/by-sa/4.0
Clinical Features and Therapeutic Approach of Varicella Zoster in a Pediatric Patient at Way Laga Health Center, Bandar Lampung, Indonesia
Varicella, or chickenpox, is an acute infectious disease caused by the Varicella-Zoster Virus (VZV), a DNA virus of the Herpesviridae family. Despite being generally self-limiting in children, varicella remains a major public health concern due to its high transmissibility and potential complications in vulnerable populations. In Indonesia, the incidence of varicella has increased in recent years, particularly among school-aged children, reflecting gaps in vaccination coverage and heightened community mobility following the COVID-19 pandemic. This research presents the clinical features and therapeutic approach of a pediatric patient with varicella treated at Way Laga Health Center, Bandar Lampung. A 6-year and 11-month-old boy developed fluid-filled lesions that initially appeared on the trunk and subsequently spread to the face, arms, and legs within two days, accompanied by pruritus and mild fever. The patient had no comorbidities or allergies, but a clear history of close contact with a classmate diagnosed with chickenpox was identified as the primary source of infection. Physical examination revealed multiple lesions at different stages of development without secondary bacterial infection, while vital signs remained stable. Therapeutic management included acyclovir, cetirizine syrup, paracetamol, and salicylic powder, combined with non-pharmacological interventions such as hygiene education, avoidance of scratching, adequate hydration, and temporary isolation to prevent transmission. Family-focused counseling emphasized the importance of monitoring for complications and maintaining supportive care. The patient responded favorably, with resolution of fever, reduction of pruritus, and crusting of lesions within one week. This study highlights the critical role of primary health centers in the early identification and management of varicella in pediatric populations. The novelty of this research lies in demonstrating how structured holistic diagnostics, timely antiviral therapy, and standardized family education can effectively reduce symptom burden, prevent complications, and limit community transmission. Such documentation provides valuable insights for strengthening clinical practice and public health preparedness in regions with uneven vaccine coverage.
Copyright (c) 2025 Ringgo Alfarisi, Tri Aprilia Aisyah, Tri Marezha Balqis, Tria Zulfadlia, Syifa Syahirah Azzahra, Syerli Saputri (Author) https://creativecommons.org/licenses/by-sa/4.0