Jurnal Health Sains

The Unseen Complexities of Digital Mental Health Services in Indonesia (COVID-19 Era): A Qualitative Study

2026-05-19T04:10:13+00:00

The COVID-19 pandemic accelerated the adoption of digital mental health services (DMHS) in Indonesia as an alternative approach to addressing limited access to conventional psychological services. However, the rapid implementation of these services also revealed various structural, technological, and regulatory challenges within Indonesia’s mental health system. This study aimed to explore stakeholders’ experiences in implementing DMHS during the COVID-19 era, including the challenges encountered, adaptive strategies employed, and recommendations for future service development. This research employed a qualitative exploratory design using semi-structured interviews involving 14 stakeholders, consisting of psychologists, platform managers, founders, and representatives of professional organizations in Indonesia. Data were collected through online interviews and analyzed using inductive thematic analysis supported by NVivo 14 software. The findings identified several major themes, including community and client readiness, service provider readiness, regulatory and legal conditions, technological limitations, service effectiveness and quality challenges, and capacity building and innovation. The study revealed that stigma, digital inequality, unclear regulations, and therapist burnout significantly affected the effectiveness of DMHS implementation. Nevertheless, stakeholders adopted adaptive strategies such as hybrid services, peer learning, structured evaluations, and digital innovation to maintain service quality. In conclusion, strengthening regulations, infrastructure, professional competence, and ethical standards is essential to ensure sustainable and effective digital mental health services in Indonesia.

From Stones to Signals: Harnessing Artificial Intelligence for Precision Diagnosis and Recurrence Prediction in Urolithiasis: A Comprehensive Review

2026-05-05T07:59:48+00:00

Urolithiasis is a common urological disorder with increasing global prevalence and a high recurrence rate, creating significant clinical and economic burdens on healthcare systems worldwide. Advances in medical imaging, minimally invasive surgery, and artificial intelligence (AI) technologies have transformed the diagnosis and management of urinary tract stones. This review aimed to evaluate the role of AI and modern therapeutic innovations in improving diagnostic accuracy, treatment planning, and prediction of clinical outcomes in patients with urolithiasis. A comprehensive literature review was conducted using electronic databases, including PubMed, Scopus, ScienceDirect, SpringerLink, and Google Scholar. Relevant articles published between 2016 and 2026 were selected based on inclusion and exclusion criteria related to AI applications, imaging technologies, and minimally invasive interventions in urolithiasis management. The findings demonstrated that AI-based technologies, particularly machine learning and convolutional neural network algorithms, significantly improved the detection and classification of urinary stones through CT scan and ultrasound imaging. AI also contributed to individualized therapy planning, prediction of stone recurrence, and optimization of minimally invasive procedures such as ESWL, URS, PCNL, and RIRS. In addition, innovations in laser technologies, including Holmium:YAG and Thulium Fiber Laser, enhanced stone fragmentation efficiency and reduced complications. In conclusion, AI and technological advancements have substantial potential to support precision medicine and improve clinical outcomes in urolithiasis management, although further large-scale clinical validation remains necessary.

Analysis of Variations Apparent Diffusion Coefficient (ADC) Values in Brain Areas Using Dwi Resolve Sequence

2026-05-22T06:39:19+00:00

Magnetic Resonance Imaging (MRI) with Diffusion-Weighted Imaging (DWI) evaluates the microstructure of brain tissue through the Apparent Diffusion Coefficient (ADC) parameter. Although often used clinically, the accurate standardization of physiological values of ADCs is still a challenge due to the high regional variability. This study aims to analyze the difference in ADC values in various anatomical structures of the adult brain using the DWI Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence. This retrospective analytical observational study involved 12 normal subjects examined using 1.5 Tesla MRI. Measurements were made manually on 14 anatomical structures using a circular Region of Interest (ROI) (±20 mm²). Reliability is validated by the Intraclass Correlation Coefficient (ICC). Statistical analysis included Repeated Measures ANOVA, Spearman correlation (age), and Wilcoxon test (grey vs White matter). The results showed that the ROI had excellent reliability (ICC 0.845–0.998). There was a very significant difference in ADC values between anatomical structures (p < 0.001; Partial η² = 0.700), with an average range of 0.70–0.83 ×10⁻³ mm²/s. There was no significant correlation between age (22–68 years) and regional ADC fluctuations (p > 0.05). However, the ADC of Grey matter was found to be significantly higher than that of White matter (p = 0.002). In conclusion, the RESOLVE DWI sequence results in reliable ADC measurements. Variations in diffusion values are inherently dependent on anatomical location and tissue type, but are very stable with age.

Obstructive Sleep Apnea-Hypopnea Syndrome as a Risk Factor for Polycystic Ovary Syndrome: A Narrative Review of Prevalence, Pathophysiological Mechanisms, and Clinical Implications

2026-05-05T08:00:19+00:00

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine and metabolic disorders affecting women of reproductive age worldwide. Recent evidence indicates that Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is frequently associated with PCOS and may contribute to worsening metabolic, hormonal, and reproductive dysfunctions. This study aimed to examine the role of OSAHS as a risk factor for PCOS by reviewing its prevalence, pathophysiological mechanisms, and clinical implications. This research employed a narrative review approach using relevant scientific literature obtained from PubMed, ResearchGate, and HHS Public Access databases. Articles discussing OSAHS and PCOS published in indexed journals were systematically analyzed to identify prevalence patterns, biological interactions, and therapeutic implications. The findings demonstrated that the prevalence of OSAHS in women with PCOS ranged from 20% to 37%, with higher incidence reported among obese and adult women. Several studies also identified a bidirectional causal relationship between OSAHS and PCOS. Pathophysiologically, intermittent hypoxia, oxidative stress, insulin resistance, inflammation, sympathetic activation, and hypothalamic-pituitary-gonadal axis dysfunction were found to contribute to hyperandrogenism, infertility, and increased cardiovascular risk. In conclusion, OSAHS plays a significant role in aggravating PCOS manifestations, highlighting the importance of early screening and comprehensive management to improve metabolic and reproductive outcomes in affected women.

Penile Trauma in a Pediatric Patient Caused by Physical Abuse: A Case Report

2026-04-24T02:23:58+00:00

Penile trauma in pediatric patients is a rare but clinically significant condition. While most cases result from accidental mechanisms such as falls or sports injuries, clinicians must maintain a high index of suspicion for non-accidental injury (NAI), particularly when the presenting history is inconsistent with the injury pattern or when the mechanism involves interpersonal violence. This case report aims to describe the clinical presentation, diagnostic evaluation, surgical management, and outcome of an 8-year-old boy who sustained penile trauma following suspected physical abuse. A descriptive observational design in the form of a case report was employed. Data were collected retrospectively from the patient's medical records, encompassing demographic information, clinical history, physical examination findings, imaging studies (ultrasonography with Doppler), treatment interventions, and postoperative outcomes. The patient presented with progressive penile swelling and pain. Imaging revealed intact corpora cavernosa and corpus spongiosum, with soft tissue oedema and fluid collection at the distal glans. Initial conservative management was insufficient, necessitating surgical intervention comprising debridement, penile reconstruction, and defect closure using a complex local flap technique combined with circumcision. Postoperatively, the patient demonstrated gradual wound healing with no signs of surgical site infection or early postoperative complications. The possibility of non-accidental injury should always be considered in pediatric penile trauma, particularly in cases with an inconsistent history or delayed presentation. Ultrasonography with Doppler is a valuable non-invasive imaging modality for the assessment of penile injuries. When conservative management is inadequate or presentation is delayed, timely surgical reconstruction using local flap techniques can achieve favorable functional and cosmetic outcomes while minimizing long-term morbidity.