Jurnal Health Sains

Comparison of the of Operative Treatment and Sclerotherapy Injection in the Management of Hemorrhoids: A Meta-Analysis of Randomized Controlled Trials

2025-09-02T07:49:29+00:00

Rubber-band ligation (RBL) and sclerotherapy are the two most widely used office-based interventions for symptomatic haemorrhoidal disease, yet their comparative benefits remain uncertain. This systematic review and meta-analysis evaluated the relative efficacy and safety of sclerotherapy versus operative treatments (primarily RBL and excisional procedures). The primary objective of this systematic review and meta-analysis was to evaluate the relative efficacy and safety of sclerotherapy versus operative treatments (primarily RBL and excisional procedures) in the management of hemorrhoidal disease. Treatment success was 78.2% in operative arms (701/896) versus 74.1% with sclerotherapy (665/897); pooled RR = 1.03 (95% CI 0.91–1.17; I² = 85%), indicating non-inferiority of sclerotherapy. Recurrence in two trials (n = 302) showed lower recurrence after sclerotherapy (12.9%) than after operative treatment (28.4%); RR = 2.22 (95% CI 1.37–3.58; I² = 0%). Pain in three trials (n = 335) reported a higher risk of significant pain following operative procedures (RR = 1.17, 95% CI 1.02–1.34; I² = 60%) and greater mean pain intensity (SMD = 0.96, 95% CI 0.22–1.71; I² = 89%). Sclerotherapy achieves comparable short-term symptom control to operative treatments while offering superior durability and a more favorable pain profile. Given its minimal invasiveness and ease of repetition, modern sclerotherapy should be considered a first-line option for grade I–III haemorrhoids. High between-study heterogeneity underscores the need for standardized protocols and longer follow-up.

Scoping Review: Factors Causing Claim Pending in Indonesian Hospitals

2025-08-23T04:08:34+00:00

Pending claims are one of the crucial problems often faced by hospitals in the National Health Insurance (JKN) financing system. This condition not only causes disruptions to hospital cash flow but also reflects weaknesses in the claims management system administratively, technically, and systemically. This study aims to identify and map various factors causing pending BPJS Kesehatan claims in Indonesian hospitals through a scoping review approach. The review process was carried out with reference to the Arksey and O'Malley framework and the PRISMA-ScR guidelines, using literature sources from Google Scholar, Garuda, PubMed, and Neliti databases. Article selection was conducted systematically for publications from 2022–2024, in Indonesian, available in full-text form, and indexed at least SINTA 3. Of the 268 articles identified, 10 met the inclusion criteria and were further analyzed. The results of the synthesis show that the causative factors of pending claims can be grouped into five main themes: inaccuracy in coding diagnosis and procedures, incompleteness of claim documents, limitations of information systems, low competence of human resources, as well as inconsistencies in the implementation of SOPs and weak coordination between units. This study concludes that pending claims are multifactorial and interrelated, requiring comprehensive intervention in the form of strengthening human resource capacity, optimizing the digital claims system, and improving hospital claims policies and governance systemically.

The Effectiveness of Android-Based Simantb (TB Monitoring Information System) on Medication Compliance of Pulmonary TB Patients in Ende Regency, East Nusa Tenggara

2025-09-02T07:51:45+00:00

Tuberculosis (TB) is an infectious disease and one of the leading causes of death worldwide. One indicator of the TB control program's success is the treatment success rate. Various factors are believed to hinder the success of TB treatment, including therapy failure due to non-adherence, which is one of the main factors. Therefore, appropriate interventions are needed to monitor and evaluate TB patient medication adherence using suitable media that are easy to use and accessible anytime and anywhere through mobile health technology. This study aimed to analyze the effectiveness of the Android-based SIMANTB application on medication adherence in pulmonary TB patients. The research employed a Research and Development (R&D) design with a pre-experimental approach using a static group comparison, conducted over 28 days (1 month). The sampling technique used was simple random sampling, consisting of 30 respondents divided into intervention and control groups. Research data were analyzed using the Shapiro-Wilk and Mann-Whitney tests. The SIMANTB application was found to be highly suitable for tuberculosis patients, with material feasibility percentages of 93.06% and 93.75%. The use of the Android-based SIMANTB application significantly increased medication adherence in TB patients (p = 0.004). The development of the Android-based SIMANTB application is expected to provide a solution for health workers (doctors, nurses, TB officers) to support TB patients in monitoring and motivating their treatment, thereby increasing the success rate of treatment.

The Influence of Defecation Behavior, Drinking Water Sources, and Handwashing Habits N Stunting in the Work Area of Merek Community Health Center

2025-08-23T04:11:20+00:00

This research was conducted due to the low motivation of the community in the work area of the Brand Health Center to build CTPS facilities, healthy latrines, and clean water management systems. The limited ownership of these facilities is a major factor contributing to the failure to achieve key indicators of STBM, such as the high prevalence of open defecation. This study employed an action research design with an observational approach and educational interventions. The process began with problem identification through observation and surveys, followed by community education and assistance in constructing CTPS facilities, managing clean water, and building latrines. Before the intervention, residents in several villages within the Brand Health Center area were less motivated to develop CTPS facilities, clean water systems, and latrines, due to low knowledge, financial constraints, and limited awareness of the importance of a clean and healthy lifestyle. After direct education and mentoring, there was an increase in motivation and independent efforts by the community to establish these facilities. The results showed improvements such as a reduction in open defecation, the adoption of handwashing with soap, and better practices in managing drinking water. To ensure sustainability, it is recommended that regular supervision and continued assistance be provided so that these achievements remain consistent in the long term.