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Effect of Ethyl Acetate Fraction of Avocado Peel (Persea americana Mill.) on Total Cholesterol Levels in Hypercholesterolemic Wistar Rats
Full text linkBackground: Hypercholesterolemia is a condition that can increase the risk of coronary heart disease, stroke, high blood pressure, obesity and other health problems. The ethyl acetate fraction of avocado peel offers a novel approach by isolating key bioactive compounds while separating them from other components, focusing on the desired properties of compounds such as flavonoids, saponins, and phenolics, which are well-known for their antihyperlipidemic effects.
Aims: To analyze the effect of ethyl acetate fraction of avocado peel (Persea americana Mill.) on total cholesterol levels of Wistar white rats with hypercholesterolemia.
Methods: This study was experimental with a pre and post test with control group design using 20 male white rats (Rattus norvegicus) of the Wistar strain that had been fed high-fat feed for 14 days and divided into 5 groups for 7 days of treatment, namely the negative control group that was given only high-fat feed, the positive control group that was given the drug simvastatin 0.18 mg/200gBW, and 3 treatment groups that were given the ethyl acetate fraction of avocado peel with a tiered dose of 100 mg/KgBW, 75 mg/KgBW, and 50 mg/kgBW. The data were analyzed using a one-way ANOVA test with a post hoc test
Results: The ethyl acetate fraction of avocado fruit peel positively contains alkaloids, flavonoids, phenolics, saponins, tannins, and triterpenoids or steroids. The average reduction in total cholesterol levels is 19.5 mg/dL (p < 0.05) at a dose of 100 mg/kgBW, 17.5 mg/dL (p < 0.05) at a dose of 75 mg/kgBW, and 13 mg/dL (p < 0.05) at a dose of 50 mg/kgBW.
Conclusion: The ethyl acetate fraction of avocado peel is effective in reducing total cholesterol levels with an effective dose of 100 mg/kgBW. With an effective dose of 100 mg/kg body weight that has been established, subsequent research can focus on the development of more stable and efficient formulations for clinical applications. The effect of lowering cholesterol levels is associated with the content of secondary metabolite compounds contained in the ethyl acetate fraction of avocado peels, namely flavonoids, phenolics, saponins, tannins, triterpenoids and steroids
Toxic Inequities: The Global Health Burden of Pesticide Exports to Low- and Middle-Income Countries
Full text linkBackground: The continued export of banned pesticides from high-income countries (HICs) to low- and middle-income countries (LMICs) remains a critical yet under-addressed global health issue. These hazardous chemicals are legally shipped to nations with weaker regulatory frameworks. As a result, workers and communities in LMICs face disproportionate exposure to toxic substances that contribute to acute poisoning, developmental disorders, and chronic disease.
Aims: This paper examines the international trade of banned pesticides through view of global health equity and frames these practices as a form of structural violence that endangers LMIC populations and violates the right to health.
Methods: This qualitative study uses document and policy analysis of international trade records, legal frameworks, and public health literature. It outlines the legal mechanisms and policy gaps, such as the weaknesses of the Rotterdam Convention and the permissiveness of export laws in the EU, U.S., and Switzerland that enable the ongoing flow of hazardous substances.
Results: Pulling on case studies, epidemiological evidence, and international human rights frameworks, the paper investigates the health impacts of pesticide exposure and highlights the ethical failures related to current trade practices.
Conclusion: Our synthesis foregrounds the research gap and advances a rights-based, structural-violence framing that clarifies the policy mandate. We suggest aligning export bans with domestic prohibitions, strengthening Rotterdam prior-informed-consent and enforcement, and financing transitions to IPM, biopesticides, and agroecology in LMIC supply chains
Evaluation of The Implementation of Sharia-Based Pharmaceutical Service Standards (A Qualitative Case Study)
Full text linkBackground: National health laws and best practices from other countries have helped Indonesia set standards for pharmaceutical services. However, there is still limited research on the application of Sharia principles in pharmacy services, particularly within community pharmacies. These standards are based on ideas from the Quran, Hadith, and fatwas from well-known Islamic scholars. They put these ideas into action by making sure that medicines don't contain any illegal substances, being sensitive to gender issues, and providing services that respect patients' dignity, as Islamic teachings say they should.
Aims: This study aims to evaluate the implementation of Sharia-based pharmaceutical service standards through a qualitative case study at the Muhammadiyah Charity Education Pharmacy. This pharmacy's unique role as an integrated platform for pharmacy education, community service, and the application of Islamic values makes it an appropriate context for examining the implementation of Sharia-compliant pharmaceutical services.
Methods: A qualitative case study design was used, involving observations and semi-structured interviews. NVivo 12 software was employed for thematic and cluster analysis. Data were coded inductively by independent researchers and validated through consensus. Pearson correlation coefficients were used to identify the strongest relationships between service quality items. The informants involved were 1 pharmacist and 3 pharmaceuticals technical staff.
Results: Reliability, responsiveness, empathy, tangibles, and assurance are the themes that emerged from this study. The studies found that in the reliability dimension, fulfilling order service and distributor reliability showed the highest correlation (r=0.98), emphasizing the importance of commitment and trust in sharia-based service. In the responsiveness dimension, the most significant relationship (r=1.00) emerged between complaint resolution and clear division of duties, reflecting the role of communication and accountability. For assurance, the highest correlation (r=0.96) indicated the critical role of clear, understandable information in building trust. The empathy dimension revealed that prioritizing humanity and non-discriminatory service (r=0.52) aligned closely with the values of justice and compassion. Lastly, in the tangibles (physical) dimension, the presence of a patient prayer space showed a strong link to perceptions of cleanliness and professionalism (r=0.67), although implementation was still limited.
Conclusion: By combining Islamic ethical principles with service quality metrics, the application of sharia-based service standards in pharmaceutical care improves patient satisfaction. However, some aspects still need improvement, especially the physical facilities and assurance under heavy workload. These findings provide insightful guidance on how to develop appropriate interventions, such as training programs, SOPs, and infrastructure modifications, to ensure pharmaceutical services comply with Sharia law while improving overall service quality for lawmakers, educational institutions, and businesses providing Islamic-based pharmaceutical services
Profile of Psoriasis Vulgaris in Waled General Hospital, Cirebon, Indonesia: A Retrospective Study (January 2020-December 2023)
Full text linkBackground: Psoriasis is a chronic skin disease that significantly impacts the quality of life. In Indonesia, it affects 2.5% of the population, with increasing cases observed in major hospitals. This study aimed to profile psoriasis vulgaris at Waled General Hospital, Cirebon, from January 2020 to December 2023.
Aims: To understand the profile of psoriasis vulgaris in the Dermatology and Venereology Clinic of Waled General Hospital, Cirebon Regency, for the period January 2020 to December 2023.
Methods: This study employed a descriptive, cross-sectional design with a retrospective approach to analyze secondary data sourced from medical records of patients treated at Waled General Hospital. The inclusion criteria focused on individuals diagnosed with psoriasis vulgaris who received treatment or consultation between January 2020 and December 2023, provided their medical records were complete. Conversely, the exclusion criteria removed patients diagnosed with other forms of psoriasis, such as guttate psoriasis, as well as those with incomplete records. The final sample size consisted of 56 patients, ensuring a focused and manageable dataset for analysis. By applying these criteria, the study aimed to provide a clear and accurate understanding of psoriasis vulgaris cases, ensuring the findings were both scientifically robust and clinically relevant.
Results: From January 2020 to December 2023, psoriasis vulgaris was most prevalent among the age group of 15-49 years, with a mean age of 42.3 ± 14.7 years comprising 53.57% of the cases. The female sex predominated over the male sex, with 53.57% versus 46.42%. The major clinical presentation in all cases was red plaques, 100%. Hypertension was the most common comorbid condition, affecting 17.85% of the patients. The universal systemic antihistamine used was 100%, while the topical corticosteroid used was performed for 80.35% of the cases.
Conclusion: These findings put into perspective the need for early recognition of symptoms, standardized treatment, and integrated care for comorbidities such as hypertension in a regional hospital setting. This study thus provides important lessons that could be used to improve psoriasis management by proactively identifying specific strategies to address demographic and clinical characteristics of affected populations and ultimately improve patient outcomes and resource use
Changes in Corneal Curvature Value Before and After Phacoemulsification in Senile Cataract Patients: A case from Waled Regional Public Hospital, Cirebon
Full text linkBackground: Cataract is the main cause of visual impairment and reversible blindness in the worldwide, especially in people over 50 years old. Cataract could be treated through cataract surgery, which one of the methods is phacoemulsification. Phacoemulsification has the advantage of reducing the risk of post-operative astigmatism due to its smaller incision compared to other techniques. Astigmatism was assessed by the curvature of the cornea, which measured using keratometry.
Aims: To describe the differences in curvature cornea value pre and post phacoemulsification surgery in senile cataract patients at Waled Regional Public Hospital, Cirebon.
Methods: This is a descriptive observational study. Sampling was obtained from medical records at Waled Regional Public Hospital. Data analysis using univariate analysis.
Results: Subjects with preoperative keratometry difference (K1 and K2) of < 1 diopter (D) were 39 subjects (73.6%), and > 1 diopter (D) were 14 subjects (26.4%). Subjects with postoperative keratometry difference (K1 and K2) of < 1 diopter (D) were 38 subjects (71.7%), and > 1 diopter (D) were 15 subjects (28.3%). Subject who had reduction in corneal astigmatism were 21 subjects (39.6%), subject who did not have any change in corneal astigmatism were 14 subjects (26.5%), and subject who had increment in corneal astigmatism were 18 subjects (34%). Statistical analysis showed a p-value of 0.033, indicating a statistically significant change in corneal curvature value between before and after surgery (p-value = < 0.05).
Conclusion: The results showed that out of 53 samples, most subjects had preoperative and postoperative astigmatism with a keratometry value difference (K1 and K2) of < 1 diopter (D). One month after phacoemulsification surgery, most samples showed a decrement in astigmatism compared to those who showed an increment in astigmatism
Reviewer Acknowledgements: GHMJ (Global Health Management Journal), Volume 8, Number 1, 2025
Full text linkAs GHMJ (Global Health Management Journal) celebrates its 8th anniversary, we take this opportunity to express our deepest gratitude to the dedicated reviewers whose expertise and insights have significantly contributed to the quality and integrity of this edition. This edition of the Global Health Management Journal (Vol. 8, No. 1, 2025) presents a diverse range of research addressing critical health challenges. The editorial underscores the urgency of global health strategies in mitigating the adverse impacts of climate change on human health (Macnab, 2025). A perspective piece examines Thailand’s policies on PM 2.5 air pollution, revealing hidden gaps in environmental health governance (Wongtongtair, 2025). The best practice article highlights the economic and nutritional potential of Crab Abon as a sustainable fishery product in Balikpapan, Indonesia (Haqiqiansyah, et al., 2025).
In the research section, studies explore the psychosocial effects of Indonesian soap operas on Malaysian millennials (Perdana, et al., 2025), the role of HIV education in Indonesian schools (Astuti, et al., 2025), and the quality of life in heart failure patients within the obesity paradox framework (Rachmawan, et al, 2025). Other articles analyze personal hygiene among traditional jamu handlers (Suryani, et al., 2025), the transmission risks of tuberculosis in children (Pratiwi, et al., 2025), and the antioxidant and anti-proliferative properties of Murraya koenigii (L.) leaves on breast cancer cells (Nisa, et al., 2025). This collection of articles reflects our ongoing commitment to advancing global health knowledge and solutions.
Link to download: https://publications.inschool.id/index.php/ghmj/issue/view/GHMJ.08.01
Each article in this edition has undergone a rigorous double-blind peer review process, ensuring high standards of academic excellence. We extend our heartfelt appreciation to the reviewers who have played a crucial role in refining and enhancing these works.
Editor-in-chief
Prof. Andrew John Macnab
Managing Editors
Doni Marisi Sinaga, M.Sc.
Kukuh Madyaningrana, M.Biotech.
Journal Managers
Suyitno, M.PHM
Maretalinia, M.A
External Reviewers
Prof. Dr. Solikhah S.KM., M.Kes. (Universitas Ahmad Dahlan, Indonesia)
Dr. Tulus Handra Kadir, M.Pd. (Universitas Negeri Padang, Indonesia)
dr. Hawani Sasmaya Prameswari, SpJP. (Universitas Padjajaran, Indonesia)
dr. Raymond Pranata (Universitas Pelita Harapan, Indonesia)
dr. Tiar Masykuroh Pratamawati, M.M., M.Biomed. (Universitas Swadaya Gunung Jati, Indonesia)
Fanisya Dwiyani, S.T, M.Eng. (Sekolah Tinggi Teknologi Cipasung, Indonesia)
Fataa Kusumattaqiin, M.Sc. Ph.D (Politeknik Negeri Samarinda, Indonesia)
Musparlin Halid, S.Pd., MPH. (Politeknik Medica Farma Husada Mataram)
Sari Hastuti, S.SiT., MPH. (Poltekkes Kemenkes Yogyakarta, Indonesia)
Siti Rahmah, SKM., MPH. (Poltekes Kemenkes Mamuju, Indonesia)
GHMJ (Global Health Management Journal) welcomes scholars and professionals to contribute to the advancement of global health research by joining our team of reviewers. If you are passionate about supporting high-quality publications, we invite you to be part of our review process. Simply register on our website and select the "Reviewer" option during sign-up.
Why Join as a Reviewer?
Recognition – Your contributions will be acknowledged in each edition you review.
Professional Growth – Eligible reviewers may be considered for future roles on our Editorial Board.
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Acceptance Rate : 44%
Days to First Editorial Decision : 21 days
Days to accept : 28 days
Published: 28 February 2025
Comparing Chest Radiograph Lesion Areas in Pulmonary Tuberculosis Patients with and without Diabetes Mellitus: A 2023 Study at Waled Hospital, Cirebon, Indonesia
Full text linkBackground: The Global Tuberculosis Report emphasizes a significant number of TB cases, and Indonesia is the second country in Southeast Asia with the most TB cases. Prevalence of TB increases along with the increase of Diabetes Mellitus (DM) prevalence, which both are known to have a negative impact on each other. Clinical symptoms in TB with DM differ from those in TB without DM. However, whether there is any difference in radiology examinations is unknown. This can be a consideration for determining patient therapy based on differences in the chest radiographs.
Aims: To determine the Lesion Area Difference on Chest Radiographs of Pulmonary Tuberculosis Patients with and without Diabetes Mellitus at Waled Hospital in 2023.
Methods: There were 96 data points based on the first taken chest radiograph from both inpatient and outpatient data, which were obtained from medical records in 2023 at Waled Hospital, Cirebon. Statistical analysis was performed using the Chi-Squared comparative test in this observational study with a cross-sectional design.
Results: There were 69 tuberculosis (TB) patients without diabetes mellitus (DM) and 27 TB patients with DM. Overall, patients had minimal lesions (14.6%), moderate lesions (26.0%), and far-advanced lesions (59.4%). The Chi-Square analysis from these samples showed a p-value of 0.870.
Conclusion: There is no difference in lesion area on chest x-rays in pulmonary tuberculosis patients with or without diabetes mellitus. Further research is expected to include the type of TB and history of treatment for either TB or DM
Examination of Coliform and Escherichia coli Contamination in Refilled Drinking Water in Cirebon Regency, Indonesia
Full text linkBackground: Refillable drinking water is a commonly used source of water for the public. Contamination of this water can lead to various diseases, including waterborne diarrhea. Coliform bacteria and Escherichia coli are indicators of faecal contamination and can cause waterborne diseases. This study aims to determine whether Coliform and Escherichia coli are present in refillable drinking water in Cirebon Regency.
Aims: To identify the presence of Coliform and Escherichia coli bacteria in refillable drinking water in Cirebon Regency.
Methods: This descriptive study employed purposive sampling to collect six samples of refillable drinking water from six different depots located in Cirebon Regency. Each sample was tested four times using various laboratory tests, including Nutrient Agar, Mac Conkey Agar, Gram Staining, IMVIC, and TSIA.
Results: All samples showed the presence of Coliform (100%), as shown by the Mac Conkey Agar test indicating lactose fermentation and Gramme Staining revealing rod-shaped bacteria. However, Escherichia coli was not found (0%) in any of the samples. The results of the Mac Conkey Agar test as a lactose fermenter, Gram Staining showing rod-shaped bacteria, and IMVIC tests showed the following profile: Indole +, MR +, VP -, Citrate -, and TSIA: A/A, H₂S -, Gas +. While Escherichia coli was absent, the detection of other Coliforms suggests persistent hygiene issues; Citrobacter freundii and Klebsiella were found to be Coliform bacteria.
Conclusion: No Escherichia coli were detected in any of the samples, but Coliform bacteria were found in 6 out of 6 samples (100%). The maintenance of refillable drinking water depots is crucial for public health. Owners must frequently clean and disinfect the reservoirs to prevent contamination. Additionally, authorities are responsible for regularly monitoring the hygiene and sanitation of these depots
Angiotensin Converting Enzyme 2 (ACE2) G8790A Gene Polymorphism as a Risk Factor for Essential Hypertension
Full text linkBackground: Globally, the number of people with hypertension has doubled, from 650 million to 1.3 billion. The World Health Organization reported that hypertension is responsible for more than 10 million deaths every year. Essential hypertension is a multifactorial condition with genetics as one of the factors. Genome-Wide Association Study has identified several genes associated with hypertension, one of which is the Angiotensin Converting Enzyme 2 (ACE2) gene. Essential hypertension may be predisposed to by the G8790A polymorphism of the ACE2 gene, which is hypothesized to interfere with the normal function of the Renin Angiotensin System (RAS).
Aims: The purpose of this study is to determine whether the ACE2 G8790A gene polymorphism in Cirebon, West Java, Indonesia, is associated with an increased risk of essential hypertension.
Methods: This is a case-control study conducted at the Talun Health Center, Cirebon Regency, April-August 2024, involving 30 essential hypertensive patients and 30 healthy controls. The study population comprised adults aged 30 to 72 years. Data was obtained through the examination of blood pressure, DNA extraction, PCR-RFLP with ALUI restriction enzyme, and then visualization of the results with Gel Electrophoresis. The Chi-Square Test technique and the Odds Ratio (OR) computation were used to analyze the data.
Results: The G allele was higher in the case group 33 (55%), while the A allele was higher in the control group 34 (56.7%). The statistical analysis showed that there was no significant link between the ACE2 G8790A gene variation and essential hypertension, with a p-value of 0.592 (p > 0.05) (OR = 0.750; CI = 0.262–2.151).
Conclusion: The ACE2 gene G8790A polymorphism and the rate of hypertension in Cirebon, West Java, were not significantly correlated. Further research is required on a larger scale to investigate the effects of gene combinations or interactions with other locus genes on essential hypertension
Effectiveness of Virtual Reality on Fatigue and Life Quality in Geriatric Patients at Kasih Nursing Home Cirebon, Indonesia
Full text linkBackground: Fatigue is a significant challenge for geriatric patients, often leading to vulnerability and a poor quality of life. Virtual reality can potentially serve as a therapeutic intervention for fatigue and quality of life by positively influencing geriatric patients' motor and cognitive functions.
Aims: To analyze the effectiveness of virtual reality training on fatigue and quality of life in geriatric patients at Kasih Nursing Home Cirebon, Indonesia.
Methods: The research type was a quasi-experimental design with a pre-test, post-test, and nonequivalent group design. Sampling utilized non-probability sampling techniques, specifically total sampling divided into two groups. The intervention group received five treatment sessions over five weeks, each session lasting 15 minutes and conducted on the same days apart. Data was collected using the Fatigue Severity Scale and the World Health Organization Quality of Life-BREF. Data analysis employed paired t-tests, independent t-tests, and N-Gain scores.
Results: The results of the paired t-test for the control group showed a non-significant difference in fatigue (p = 0.363 > 0.05). In contrast, the intervention group showed significant improvements in fatigue (p < 0.001) and quality of life (p = 0.049). The independent t-test revealed no significant differences between groups in pre-test scores. However, post-test scores showed significant differences between groups for fatigue (p = 0.048) and quality of life (p = 0.004). The N-Gain Score test indicated that the virtual reality motor cognitive intervention was effective in reducing fatigue (83.96%) but had a limited impact on quality of life (28.32%).
Conclusion: Virtual reality training is effective against fatigue, however, while there was a significant increase in quality of life after the virtual reality intervention; virtual reality was not significantly effective in improving the overall quality of life of geriatric patients.
Received: 24 September 2024 | Reviewed: 16 October 2024 |
Revised: 30 November 2024 | Accepted: 11 December 2024