Stroke is the leading cause of mortality in Indonesia, with hypertension and diabetes mellitus (DM) recognized as well-established risk factors. Moreover, recent epidemiological studies have documented rising incidence, morbidity and mortality of these conditions. Understanding their spatial distribution and interrelationships is crucial for developing targeted public health interventions. This study aims to analyze the geographic distribution of stroke, DM, and hypertension across Indonesia’s provinces, evaluate their spatial correlations, and explore their interconnections using advanced spatial modeling techniques. The data were collected from the Social Health Insurance Administration Body, which manages Indonesia’s universal health coverage, between 2017 and 2022. Crude incidence rates for the diseases were calculated and spatial distribution patterns were analyzed using Global and local Moran analysis. A spatial autoregressive (SAR) model was employed to assess the spatial dependence and interrelationships between these diseases. The crude incidence rates of stroke, hypertension, and DM were 158.47, 2716.34, and 1503.06 per 100,000 population, respectively. Significant spatial heterogeneity was observed, with certain provinces consistently appearing as high-risk areas across all three diseases. Through SAR analysis, our study identified a significant positive spatial association between DM and stroke incidence, indicating that provinces with higher DM rates also tend to experience elevated stroke burden. This study mapped the geographical and spatial distribution of stroke, DM, and hypertension across Indonesia and found the pivotal role of DM in driving stroke incidence. By prioritizing high-incidence regions and addressing specific risk factors, targeted interventions can significantly reduce stroke cases and enhance public health outcomes in Indonesia.

Background: Head injury or traumatic brain injury is the leading cause of mortality and morbidity. Many modalities of neuroprotection had been developed in brain injury but there was no much information regarding folinic acid's effect on neuroinflammation associated with homocysteine, TNFα, IL-10, and HMGB1. Objective: This study aimed to investigate whether folinic acid has improving effect on head injury model. Method: This study was done in the rat's head injury model using modified Marmarou weight drop model. Fifteen rats were randomized and grouped into 3 groups: Group A: Folinic acid (+), head injury (−); Group B: Folinic acid (−), head injury (+); Group C: Folinic acid (+), head injury (+). Folinic acid was administered intraperitoneally with a dose of 60 mg/m². Blood samples were taken immediately after head injury (H0), 12 h (H12), and 24 h (H24) after head injury from the lateral vein of tail. Serum level of homocysteine, TNFα, and IL-10 were measured using ELISA, and HMGB1 gene expression was measured with Real-Time RT-PCR. Results: This study found serum level of homocysteine, TNFα, IL-10 and HMGB1 gene expression were markedly increased at all time points after head injury. Significantly lower level of serum homocysteine, TNFα, IL-10 and HMGB1 gene expression were found after 24 h treatment with folinic acid in group C compared to those in group B. Conclusion: Folinic acid may have anti-inflammatory properties in traumatic brain injury by inhibition of serum level of homocysteine, TNFα, IL-10 and HMGB1 gene expression.

Risk of Dyslipidemia in Obese Young Adult Subjects as Measured by Various Obesity Indices

Introduction: Stromal Vascular Fraction cells (SVFs) and Platelet Rich Plasma (PRP) are clinically proven to aid in cell regeneration and wound healing. The healing effects can be measured by the level of Epidermal Growth Factor (EGF). This study aims to investigate the effect of an SVFs and PRP combination on EGF levels in the anal trauma model. Method: Twenty-eight adult Wistar rats were divided into 3 groups: Group A consisted of healthy rats as a normal control group; Group B and C underwent modified anal surgical trauma and repair. Group B was treated with saline only and Group C was treated with local injection of a combination of SVFs and PRP after anal surgical repair. The EGF level was subsequently assessed on days 1, 7, and 14. Results: EGF levels were generally increased in Group C compared to Group B. A one-way ANOVA test result showed significantly increased EGF levels on days 7 (p = 0.038) and 14 (p = 0.018). Based on the linear regression test results, we found that local injection of PRP and SVFs after anal repair on an anal surgical trauma model can increase the EGF level in group C by 36.9% more than that of group B. Conclusion: The combination of PRP and SVFs can increase the EGF level in the wound healing process of anal trauma. EGF is critical in the anal trauma healing process.

The spatial variation of type 2 diabetes mellitus (T2DM) and hypertension and their potential linkage were explored in South Sulawesi Province, Indonesia. The Global Moran’s I and regression analysis were utilized to identify the characteristics involved. The methods were performed based on T2DM and hypertension data from 2017 and 2018 acquired from Social Health Insurance Administration in Indonesia. The spatial variation of T2DM and hypertension showed that the prevalence rate of T2DM and hypertension tends to occur randomly (p = 0.678, p = 0.711, respectively). By utilizing Generalized Poisson Regression Analysis, our study showed a significant relationship between T2DM and hypertension (p ≤ 0.001). This research could help policy makers to plan and support projects with the aim of overcoming the risk of T2DM and hypertension.

Objective: Ship crew as seafarers who work or are employed on board the ship by the owner or operator of the ship to carry out their duties following their position will have limitations in accessing health education, facilities, and infrastructure that support them to maintain their health. One of the non-communicable diseases that contributes to cardiovascular diseases is hypertension. This study aims to determine the risk factors related to the prevalence of hypertension in ship crew at Seaport work coverage for Poso Port Health Office, Bungku Working Area. Methods: This was a cross-sectional study with a sample size of 385 participant involve in data analysis. Chi-square analysis was employed to assess the relationship between respondent characteristic variables and independent variables concerning the occurrence of hypertension. Multivariate analysis was conducted on variables that showed an association with hypertension to obtain independent risk values using logistic regression analysis. This research used a 95% confidence level. Results: The prevalence of hypertension in ship crew is 12.73%. Logistic regression results showed that the crew members had an overweight (AOR=15.93, 95%CI: 5.080-49.981, p=0.000) and moderate and heavy smokers among crew members (AOR=2.51, 95%CI: 1.038-6.066), p=0.021) were factors associated with the prevalence of hypertension in ships crew members of hypertension in ships crew members after controlled by aged over 45 years (AOR=22.94; 95% CI: 2.587-203.477, p=0.005) and family history of hypertension (AOR=6.01; 95% CI: 2.741-13.168, p=0.000). Conclusions: Body mass index and smoking behavior among ship crew members are significant risk factors for hypertension in this study, while alcohol consumption and workplace-related environmental stress were not found to be significant risk factors in this research Implication of the research: This research can serve as a reference for determining health programs and more specific priority groups targeted for the prevention and control of hypertension among ship crew members on board.   Originality: This study was conducted on ship crew members, legally active seafarers in the operational tasks on ship, whereas most similar research uses the health data of seafarers in healthcare clinics.