International Journal of Social Health

Mandibular Reconstruction Post Mandibular Resection Operation in Head and Neck Tumor Patients at Dr Soetomo General Hospital

2026-08-10T03:29:28+00:00

Surgeons still find challenges with mandibular reconstruction following removal of head and neck malignancies, osteomyelitis, and osteoradionecrotic mandible. Mastication, articulation, swallowing, and breathing issues can all result from the loss of a portion of the mandibular bone as a result of resection. Improved function, contour, and aesthetics are the goals of comprehensive mandibular reconstruction. Over the past few decades, various mandibular reconstructive techniques have been developed, along with their potential for difficulties. This research was an observational descriptive study with retrospective data collected from January 2018 to May 2022 to identify the clinical outcomes of patients undergoing post-resection mandibular reconstruction and the profile of patients with head and neck tumors at Dr. Soetomo General Hospital, Surabaya. We analyze a total of 55 patients. The majority of mandibular reconstruction patients at RSUD Dr. Soetomo Surabaya following resection are in the age range of 40 to 49 years, with the majority of abnormalities resulting from ameloblastoma. The reconstruction plate was the most often used reconstructive technique for mandibular deformity, which measured around 8 cm in length. In this study, the exposed plate was the most frequent problem, and the average period of mandibular reconstructive therapy was about 8 days. Mandibular reconstruction can give different results in each patient. For patients with recurring head and neck cancers, in particular, adequate cosmetic and functional outcomes, as well as radiation tolerance, are necessary.

The Impact of Clinical Microbiologists’ Interpretations and Therapeutic Recommendations Regarding Culture Test and Antibiotic Susceptibility Test Results on Antibiotic Management in Hospitalized Patients with Infections: A Systematic Literature Review

2026-08-10T03:27:04+00:00

Antimicrobial resistance (AMR) is one of the most pressing global public health threats of the 21st century, driving healthcare systems to implement robust antimicrobial stewardship programs (ASPs) in hospital settings. Clinical microbiologists contribute directly to these programs by generating interpretive comments, applying selective or cascade susceptibility reporting, and offering real-time therapeutic consultations based on culture and antibiotic susceptibility test (AST) results. This research aimed to systematically review the evidence on the impact of clinical microbiologists' interpretations and therapeutic recommendations on antibiotic management for hospitalized patients with infections. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Three databases SciSpace, Google Scholar, and PubMed were searched, yielding 1,338 records; after deduplication and two-stage screening, 55 studies met the inclusion criteria. Three intervention types were identified: interpretive comments and nudges (n?=?28), selective or cascade reporting (n?=?21), and real-time microbiology consultation services (n?=?6). Microbiology-based interventions consistently improved antibiotic stewardship outcomes: appropriate antibiotic selection ranged from 47–92%, de-escalation rates from 19–67%, broad-spectrum antibiotic use was reduced by a median of 3–5 days, and time to optimal therapy was shortened by 20–43 hours. Clinical outcomes including mortality and length of hospital stay showed no significant differences. These findings demonstrate that microbiology-based stewardship interventions are clinically effective and safe, supporting their integration into routine hospital laboratory workflows.

The Relationship Between Troponin I Levels and Mortality in Patients with Acute Myocardial Infarction at Gunung Jati General Hospital in Cirebon, 2023–2024

2026-08-10T03:25:57+00:00

The mortality rate of patients hospitalized due to Acute Coronary Syndrome (ACS) in Indonesia reached 32.3%, with Acute Myocardial Infarction (AMI) being one of the most fatal classifications. The cardiac troponin I test is the first-line standard for diagnosing AMI due to its high specificity and sensitivity. Troponin I not only reflects myocardial damage but also serves as a prognostic indicator for patient outcomes. This research aims to determine the relationship between troponin I levels and mortality in patients with Acute Myocardial Infarction at Gunung Jati Cirebon Hospital during the 2023–2024 period. This research employed a cross-sectional design using secondary data from medical records. A total sampling technique was applied, involving 240 patients who met the inclusion and exclusion criteria. Data were analyzed univariately and bivariately using the Spearman's rho correlation test. Troponin I levels had a median of 1.78 ng/mL (range: 0.03–10 ng/mL). The majority of patients were in the non-death category (207 patients; 86.25%). Bivariate analysis showed a significant relationship between troponin I levels and mortality (p = 0.009; p < 0.01) with a correlation coefficient (r) of 0.167, indicating that higher troponin I levels tend to be associated with increased mortality risk, although the correlation strength is weak. There is a significant correlation between troponin I levels and mortality in patients with Acute Myocardial Infarction, with weak correlation strength. Although the relationship is weak, these findings suggest that troponin I can still be used as one of the risk indicators for mortality in AMI patients.