https://publikasi.dinus.ac.id/medical Content Health Science en-US Dian Medical Journal https://publikasi.dinus.ac.id/medical/article/view/14957 <div><strong>Background:</strong></div> <p>Chronic Suppurative Otitis Media (CSOM) is a chronic inflammatory disease of the middle ear characterized by otorrhea due to tympanic membrane perforation. The most common bacterial infection is caused by <em>Pseudomonas aeruginosa</em>. The mucosa and cilia of the middle ear may be damaged by toxins produced by this bacterium, leading to tissue-level damage.</p> <div> </div> <div><strong>Objective:</strong></div> <p>This study aimed to analyze the association between <em>Pseudomonas aeruginosa </em>infection and histopathological changes of middle ear mucosa as well as the degree of otorrhea in patients with benign CSOM.</p> <div> </div> <div><strong>Methods:</strong></div> <p>This was an observational study with a cross-sectional design. Samples were collected using consecutive sampling from patients with benign CSOM who underwent tympanoplasty at Dr. Kariadi General Hospital. The degree of otorrhea was assessed using otoscopy. Middle ear mucosa specimens were obtained from the promontorium and examined for microbiological culture and histopathological changes.</p> <div> </div> <div><strong>Results:</strong></div> <p>A total of 43 subjects were included, with <em>Pseudomonas aeruginosa </em>infection in 53.6% and non- <em>Pseudomonas aeruginosa </em>infection in 46.4%. The degree of otorrhea was classified as severe (39.5%), moderate (27.9%), and mild (32.6%). Statistical analysis revealed a significant association between <em>Pseudomonas</em>infection and the degree of otorrhea (p &lt; 0.05).</p> <div> </div> <div><strong>Conclusion:</strong></div> <div><em>Pseudomonas aeruginosa </em>infection is associated with the degree of otorrhea; however, it is not associated with histopathological changes in benign CSOM.</div> jarod wahyu Pujo Widodo Dwi Marliyawati Zulfikar Naftali Dian Ayu Ruspita Meira Dewi Kusuma Astuti Copyright (c) 2025 Dian Medical Journal 2025-12-24 2025-12-24 1 1 1 6 10.60074/dmj.v1i1.14957 https://publikasi.dinus.ac.id/medical/article/view/15007 <p><strong>Background:</strong> Ovotesticular disorder of sex development (ovotesticular DSD) is a very rare condition in which an individual is born with internal gonads of both sexes, such as ovaries, testes, or ovotestes. <strong>Objective:</strong> To report a rare case of 46,XX/46,XY ovotesticular DSD in a 16-year-old adolescent presenting with menstruation through the urinary meatus. <strong>Method:</strong> Case report including history taking, physical examination, karyotype analysis, and multidisciplinary management involving urology, gynecology, endocrinology, pediatrics, and psychiatry. <strong>Result:</strong> The patient presented with a penis, undescended left testis, and a perineal opening resembling a vagina. Until the age of 14, the patient was raised as a boy. At puberty, breast development and pubic hair appeared, followed by irregular menstruation and painful hematuria. Physical examination revealed normal sexual hair distribution, incomplete vaginal structure beneath the scrotum, and hypospadias. Gonads were located on the right labioscrotal fold. Karyotype analysis showed 46,XY (85%) / 46,XX (15%). A multidisciplinary team provided medical, surgical, and psychosocial care. <strong>Conclusion:</strong> Gender assignment as male was made by a multidisciplinary team after evaluating gender identity and role, and considering the patient’s own wishes. Comprehensive multidisciplinary management is crucial for all DSD patients.</p> Syarief Thaufik Hidayat Sultana MH Faradz Copyright (c) 2025 Dian Medical Journal 2025-12-24 2025-12-24 1 1 7 12 10.60074/dmj.v1i1.15007 https://publikasi.dinus.ac.id/medical/article/view/14945 <p><strong>Background</strong>: Healthcare provider’s reporting behavior is not merely a clinical task but is also shaped by social, institutional, and behavioral factors. In many low- and middle-income countries, under-reporting—particularly of diseases like tuberculosis—remains a major challenge due to the varying motivation and capacity of frontline healthcare providers. <strong>Objectives</strong>: This review aims to examine the influence of financial incentive strategies on the reporting behavior of healthcare providers in primary care settings. <strong>Methods</strong>: A systematic review was conducted, synthesizing evidence from 21 studies that explored the impact of financial incentives—particularly pay-for-performance schemes—on healthcare provider’s reporting behavior. <strong>Results</strong>: The analysis indicates that financial incentives can improve provider engagement and adherence to notification protocols. Pay-for-performance models were especially associated with increased compliance. However, the effectiveness of these strategies is context-dependent and influenced by factors such as provider trust, organizational infrastructure, policy coherence, and socio-cultural attitudes. The review also identified a tension between extrinsic motivators and intrinsic ethical responsibilities among providers. <strong>Conclusion</strong>: Financial incentive strategies can support improved reporting rate, but they must be designed with attention to the broader behavioral, institutional, and ethical context. Sustainable and socially responsive policy development should integrate both extrinsic and intrinsic motivators to foster long-term compliance and trust.</p> Suryanti Suryanti Copyright (c) 2025 Dian Medical Journal 2025-12-24 2025-12-24 1 1 13 21 10.60074/dmj.v1i1.14945 https://publikasi.dinus.ac.id/medical/article/view/14942 <p><strong>Background: </strong>Cervical cancer remains a global health problem, particularly in low- and middle-income countries. Histopathological subtypes and types of radiotherapy are thought to play a role in treatment success and survival outcomes in patients with advanced-stage cervical cancer.<strong><br>Objective: </strong>To analyze the relationship between histopathological subtypes and types of radiotherapy with treatment success and two-year survival rates in patients with advanced-stage cervical cancer.<br><strong>Methods: </strong>A retrospective study was conducted using medical records of patients with stage IIB–IIIB cervical cancer who completed radiotherapy at Dr. Kariadi General Hospital Semarang between 2017 and 2022. Survival analysis was performed using the Kaplan–Meier method and Chi-square test.<strong><br>Results: </strong>A total of 938 patients met the inclusion criteria, consisting of 243 adenocarcinoma and 695 squamous cell carcinoma cases. No significant association was found between histopathological subtype and mortality (p=0.970; RR 0.99; 95% CI 0.82–1.19). The mean survival time for adenocarcinoma was 18.87 months with a two-year survival rate of 62.1%, while for squamous cell carcinoma it was 18.68 months with a survival rate of 61.7% (p=0.852). In contrast, a significant association was observed between the type of radiotherapy and mortality. Patients who received box system therapy had a higher risk of death (58.4%) compared with those who underwent intracavitary brachytherapy (36.0%) (p&lt;0.001; RR 1.62; 95% CI 1.33–1.98).<strong><br>Conclusion: </strong>Histopathological subtype (adenocarcinoma vs. squamous cell carcinoma) did not significantly affect the two-year survival of patients with advanced-stage cervical cancer. However, the type of radiotherapy played a critical role, with intracavitary brachytherapy providing better survival outcomes compared with the box system. Optimization of radiotherapy techniques is crucial to improving prognosis in patients with advanced cervical cancer.</p> Mona Marpaung Teuku Rendiza Faizal Copyright (c) 2025 Dian Medical Journal 2025-12-24 2025-12-24 1 1 22 27 10.60074/dmj.v1i1.14942 https://publikasi.dinus.ac.id/medical/article/view/14911 <p><strong>Background: </strong>Noise intensity in the work environment can lead to health problems, particularly impaired hearing function, and decreased worker productivity. A preliminary survey of four welding workshops showed that both the Noise Threshold Limit Value (TLV) and the duration of exposure exceeded the recommended limits, ranging from 1 to 8 hours per day.</p> <p><strong>Objective: </strong>This study aimed to analyze the relationship between noise intensity and hearing impairment among welding workshop workers in Muktiharjo Kidul, Semarang City.</p> <p><strong>Methods: </strong>This research employed a cross-sectional study design. Data were obtained through observation, interviews, and audiometric examinations.</p> <p><strong>Results: </strong>A total of 45% of workers experienced hearing impairment in the right ear, while 40% showed hearing impairment in the left ear. There was a significant relationship between noise intensity and hearing impairment in the right ear (p &lt; 0.05), but no significant relationship was found with hearing impairment in the left ear.</p> <p><strong>Conclusion: </strong>There is a relationship between noise intensity and hearing impairment in the right ear, but no significant relationship in the left ear.</p> Nawang Sekar Kinanthi Copyright (c) 2025 Dian Medical Journal 2025-12-24 2025-12-24 1 1 28 33 10.60074/dmj.v1i1.14911