Introduction: The Triglycerides-Glucose Index (TyG), as a cost-effective and novel biomarker for insulin resistance, plays a pivotal role in the pathogenesis of heart disease. This study aims to assess the TyG’s capacity to predict cardiovascular risk. To investigate the correlation between the TyG and the 10-year risk of heart disease determined by the Framingham Risk Score (FRS). Materials and methods: A comprehensive study of 3,832 Indonesian participants (aged 19-65, Male 3,415). TyG Index threshold determined by ROC curve analyses. Its relationship with cardiovascular risk was assessed using the chi-square test and bivariate correlation analysis. Results: 3,832 participants (1,647 with high TyG≥8.7795, mean age 38.86). There was a significant association between TyG Index and FRS (P=0.02, sensitivity 0.53 specificity 0.57 PR 1.537). TyG-BMI and FRS (P<0.001, sensitivity 0.63, specificity 0.55, PR 2.18). METS-IR (P<0.001, sensitivity 0.59, specificity 0.55, PR 1.862), treadmill exercise test and FRS (P<0.025, sensitivity 0.07, specificity 0.96, PR 2). Bivariate correlation analysis between FRS and TyG, TyG BMI, METS-IR, SBP, heart rate, weight, waist circumference, and fasting blood glucose (P<0.001). In subgroup analyses, there was no significant correlation between TyG Index and FRS in the diabetes and hypertension groups (P=0.360, P=0.344). Conclusion: This study shows a strong connection between the Triglycerides-Glucose Index and an elevated 10-year cardiovascular disease risk as determined by Framingham Risk Score. The effectiveness of The TyG Index in predicting cardiovascular risk is affected by hypertension and diabetes.

BACKGROUND : Diabetes mellitus (DM) remains a major global health challenge, and its burden is intensified by comorbidities, such as obesity, hyperglycemia, and kidney dysfunction. Diverse geography and population, such as Indonesia, create unique provincial variations in DM risk factors, necessitating detailed sub-nationwide analyses to guide policymaking. This study aimed to evaluate regional disparities in diabetes-related mortality and associated risk factors across Indonesian provinces and to examine whether population density influences the distribution of these risk factors. METHODS : We analyzed age-standardized DM mortality and summary exposure values for 9 comorbidities across 34 provinces (GBD 2021), using Pearson's/Spearman's correlations nationally and provincially. Coefficient power was classified as weak (0.01–0.29), moderate (0.30–0.69), or strong (0.70–1.00). RESULTS : At the national scale, DM mortality was moderately associated with high BMI, high FPG, and kidney dysfunction (all R = 0.60; p<0.001). Associations were stronger in high-density provinces and negligible in low-density provinces. Across provinces, BMI and FPG were the most consistent correlates of DM mortality while diet-related factors (e.g., sugar intake) showed the largest gradient by density. CONCLUSIONS These findings support the development of tailored strategies based on population density to effectively reduce diabetes-related mortality. These results indicate that interventions in urban provinces should prioritize curbing sugar intake and reducing obesity prevalence. In intermediate-density regions, the focus should shift to the intensification of management for kidney disease and the optimization of blood pressure control. For low-density provinces, a critical approach involves expanding systematic screening programs and enhancing patient access to healthcare services.
comorbidity ; diabetes ; mortality ; Indonesia ; policy ; regional health planning

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Introduction: Discharge planning is an important part of the nursing process because it can assist patients and families in preparing for future care at home. Discharge planning that begins from the outset can shorten the length of stay of patients in the hospital, reduce readmission following hospitalization, and arrange for patient discharge on time. Several factors influence the implementation of discharge planning. It is intended that by understanding all the factors that influence discharge planning, the implementation of discharge planning may be optimized. The study aims to determine the factors associated with the implementation of discharge planning in one of the private hospitals in Purwakarta. Materials and methods: The study employed a cross-sectional design with total population sampling. Nurses' knowledge, motivation, education level, and work length were all studied. The study involved 162 inpatient room nurses and critical care rooms. The instrument was an online questionnaire that had been validated and reliable. This study has been ethically approved. Results: Most respondents have a bachelor’s degree (74%), work experience ≤5 years (61%), good motivation (86.4%), sufficient knowledge (64.8%), and good discharge planning implementation (91.4%). The findings revealed a relationship between nurse motivation and discharge planning implementation; however, knowledge, education level, and nurses' work length were unrelated to the implementation. Conclusion: Nurse motivation is critical for successful hospital discharge planning implementation. Hospitals can boost nurse motivation in discharge planning implementation by mentoring, monitoring, and rewarding nurses who perform well.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.

Background: Digestive system diseases pose a significant global health challenge. In many developing countries, inappropriate antibiotic use is common, and the COVID-19 pandemic further disrupted standard antibiotic prescribing practices. This study evaluated antibiotic prescribing patterns for digestive system diseases in a major Indonesian hospital during 2021. Methods: We conducted a retrospective, observational analysis of antibiotic prescriptions for 47,698 inpatients with digestive system diseases at Cilacap Government Teaching Hospital, Indonesia, throughout 2021. Data were extracted from electronic medical records and analyzed based on patient demographics, International Classification of Diseases, 10th revision classifications, World Health Organization Access, Watch, and Reserve categories, and routes of administration. Statistical analyses and visualizations were performed using Microsoft Excel (Microsoft) and R Studio (Posit). Results: Among 2,183 patients diagnosed with digestive system diseases, the majority were active adults, with a predominance of male patients. The most frequently prescribed antibiotics belonged to the “Watch” group. Acute appendicitis (n = 416), inguinal hernia (n = 250), and functional dyspepsia (n = 169) were the leading diagnoses. Antibiotic administration was more prevalent among females for these conditions, despite higher overall antibiotic use for digestive system diseases among males. Cases peaked at 319 in December and dropped to 65 in July. The dry season months recorded fewer cases (July: 65, August: 129). The most prescribed antibiotics were ceftriaxone (n = 638), metronidazole (n = 486), and cefazolin (n = 216), indicating a predominant use of broad-spectrum agents. Conclusion The study reveals a high reliance on broad-spectrum antibiotics, particularly those in the “Watch” group, suggesting potential overuse.These findings underscore the need for improved antibiotic stewardship practices, especially in regions facing the compounded challenges of the COVID-19 pandemic.