Introduction: Preterm premature rupture of membranes (PPROM) is an obstetrics condition that outcomes can vary significantly depending on gestational age. Significant maternal and fetal complications may arise, including premature birth, infection, placental abruption, cord prolapse, pulmonary hypoplasia, and even death. PPROM at 22 weeks of gestation is a rare condition that carries a high risk of morbidity and mortality. Case Presentation: Mrs. YS, 29 years old, G2P0A1, with a gestational age of 22-23 weeks, singleton live intrauterine, has experienced PPROM. At the beginning of her admission, termination was recommended; however, the patient declined and desired to continue the pregnancy. Consequently, a conservative management approach was implemented. The patient was prescribed antibiotic therapy, lung maturation, and monitored for signs of chorioamnionitis. A male baby was born via cesarean section at 28-29 weeks of gestational age due to suspected chorioamnionitis, weighing 850 grams. The baby received treatment with CPAP and antibiotics but passed away after two weeks. Discussion: Conservative management can prolong pregnancy and improve neonatal survival chances, but it carries a high risk of maternal infection, sepsis, and complications related to prematurity. Meanwhile, termination of pregnancy is more commonly performed in cases with poor neonatal prognosis or when there are medical indications that threaten the mother's safety. Conclusion: The decision between conservative management and termination in cases of PPROM at 22 weeks of gestation must consider fetal prognosis, maternal risks, and the readiness of medical facilities. Comprehensive counseling for the patient and family is crucial in the decision-making process.
Introduction : Cesarean scar pregnancy (CSP) is an implantation that occurs in the scar left by cesarean delivery. Prevalence varies and tends to increase with the high number of Cesarean deliveries. Case Presentation : A female patient, 31 years old, gravida 2 para 1, came with complaints of bleeding from the birth canal, which had been felt for the last few days. Blood clots were accompanied by tissue discharge. Lower abdominal pain and nausea were also felt. The birth history showed that the patient gave birth to her first child by cesarean section. Physical examination revealed tenderness in the abdominal region. Initial laboratory examination results were within normal limits. Ultrasonography showed the presence of a gestational sac in the lower segment of the uterus where the previous cesarean delivery had been made. The patient was diagnosed with cesarean scar pregnancy and was planned for suction curettage. Discussion : There are many management options for CSP treatment. Suction curettage plus a Foley balloon has a high success rate, is cheap, minimally invasive and easy to perform. This results in a relatively short treatment duration and makes the patient comfortable. Nonetheless, thin myometrium is a risk factor for failure of suction curettage in CSP patients. Conclusion : Cesarean scar pregnancy is a rare form of ectopic pregnancy. Early diagnosis and management are important to prevent morbidity. Suction curettage is considered as an effective initial treatment option.
Introduction: The importance of digital professionalism is increasingly recognized by higher education institutions, including those in medical education. One aspect of digital professionalism in students is reflected in their activities on social media. Objective: This study aims to investigate the relationship between medical students' role in extracurricular activities and their use of social media. Methods: A non-experimental, cross-sectional study was performed. Data were collected through surveys administered to second-year medical students. The survey included questions about the students' roles in extracurricular activities, the frequency of their social media use, and their tendency level of engagement with social media (active or passive). Results: The majority of medical students participate in extracurricular activities either as regular or executive members. Most students use social media daily, with 77% spending more than 3 hours per day, and tend to be active users (64%). While no significant correlation was found between the roles of medical students in extracurricular activities and the frequency of their social media usage (p= 0.986, r=-0.02), a low positive correlation was found between students' roles in extracurricular activities and their tendency to be active users of social media (p= 0.012, r=0.267). Conclusion: The study indicates that extracurricular activities and social media provide a good opportunity for shaping digital professionalism of medical students.
Introduction : Dysmenorrhea, characterized by lower abdominal cramping pain during menstruation, significantly impacts women's quality of life. Risk factors include stress and poor sleep quality, which are prevalent among university students due to academic pressures. This study examines the relationship between sleep quality, stress, and dysmenorrhea severity among female architecture students. Methods: A cross-sectional study was conducted with 136 female students selected via stratified random sampling. Validated questionnaires (NRS for pain, PSQI for sleep quality, and PSS for stress) were used. Data were analyzed using Spearman’s correlation test. Results: Most respondents experienced moderate dysmenorrhea (50%), poor sleep quality (93.4%), and moderate stress (65.4%). No significant correlation was found between sleep quality and dysmenorrhea severity (p=0.629). However, stress showed a significant association with dysmenorrhea (p=0.000), with higher stress levels linked to increased pain severity. Conclusion : Stress significantly exacerbates dysmenorrhea, while sleep quality does not show a direct impact. Interventions to reduce stress may alleviate dysmenorrhea symptoms in this population.
Introduction: An ectopic pregnancy is defined as the implantation of a blastocyst outside the endometrium, which is often overlooked in routine antenatal care. Approximately 40% of ectopic pregnancies are initially misdiagnosed due to symptoms that are similar to those of other diseases. Case Presentation: A 31-year-old female was referred to the Digestive Surgery Department from the local hospital with suspected colorectal malignancy. The patient complained of cramping and abdominal pain that had persisted for five days, along with a history of ignored blood-tinged mucus in her stool 15 days before admission. The patient denied the possibility of pregnancy but was later found to be pregnant with suspected ectopic pregnancy when examined by the Obstetrics and Gynecology Department. Discussion: Ectopic pregnancy presents various signs and symptoms that can often lead to misdiagnosis. Initially, the patient was suspected of having colorectal malignancy due to the history of blood-tinged mucus in her stool, which occurred 15 days before admission. A pregnancy test was then performed, which heightened the suspicion of ectopic pregnancy. An immediate laparotomy confirmed the rupture of the left tube, followed by a left salpingectomy. Conclusion: Ectopic pregnancy is an obstetric emergency that requires timely treatment to prevent maternal deaths. However, it is often misdiagnosed due to many symptoms that mimic other diseases. Misdiagnosis poses a concern that can lead to increased mortality and morbidity. Therefore, all obstetrical conditions must be ruled out for female patients of reproductive age presenting with abdominal pain and vaginal bleeding.
Introduction: Congenital Adrenal Hyperplasia (CAH) is a rare autosomal recessive disorder, most commonly caused by 21-hydroxylase deficiency, leading to impaired cortisol and aldosterone synthesis and excess androgen production. It manifests with varying degrees of virilization, salt-wasting crises, or ambiguous genitalia. Early diagnosis and multidisciplinary management are crucial to improving patient outcomes and quality of life. Case Presentation: A 17-year-old female presented with primary amenorrhea and mild virilization, including facial hair growth and underdeveloped breast tissue. Physical examination and Tanner staging confirmed the ambiguous genitalia and incomplete secondary sexual development. Elevated testosterone levels (3.01 ng/mL; normal: 0.1–0.9), normal imaging of internal genitalia and observed during laparoscopy within normal limit were consistent with non-classical CAH, likely due to 21-hydroxylase deficiency. Discussion: Non-classical CAH, caused by a mild 21-hydroxylase deficiency due to CYP21A2 mutations, is characterized by late-onset hyperandrogenic symptoms such as hirsutism, amenorrhea, and mild virilization. Diagnosis requires a combination of clinical evaluation, laboratory testing, and imaging, with 17-hydroxyprogesterone measurement as the diagnostic standard. Management includes glucocorticoid therapy to suppress androgen excess, along with genetic counseling, fertility support, and psychosocial care. Conclusion: This case emphasizes the diagnostic challenges of non-classical CAH, particularly in resource-limited settings. A multidisciplinary approach, including medication, hormonal therapy and psychosocial support, is essential for enhancing the physical and psychosocial well-being of affected individuals.
Introduction: Envenomation is common in developing countries, more than 2600 reports of mortality following scorpion envenomations being reported per year. It also can produce a variety of clinical presentations, from minimal to life threatening, including neurological disorder. There are some brain ischaemic infarct cases following scorpion bite reported in India and some African country but there is no official data reported in Indonesia. Case Presentation: A 56-year-old female patient with controlled Diabetic who was stung by a small yellowish white scorpion in the morning on the tip of her right finger felt pain and found a small redness bump on it. She also vomited twice and got epigastric pain. In the afternoon, she came to ED with chief complain of spinning sensation, weakness of her left arm and slurred speech when getting up from bed. This symptom are appropriate to the three stages of scorpion envenomation. Discussion: The neurological examination indicates lessions in the sub cortex and the dizziness suggests cerebellum lesion. The results of a head CT also showed signs of infarction in the pons which direct us to multiple site infarct as what has been reported that infarct in scorpion envenomation tend to be multiple and predominant in parietooccipital, cerebellar and capsuloganglionic regions. Conclusion: This case report is meant to remind us regarding mortality and morbidity caused by scorpion sting which tend to be underestimated in Indonesia. We recommend to observe (at least for 12 hours) the scorpion sting patient who show symptoms of envenomation.
Introduction: Asthma is a chronic inflammatory airway disorder that may persists into adulthood, especially in people with a genetic predisposition and comorbidities like obesity and allergic rhinitis. Optimal management requires a holistic, patient-centered approach that extends beyond pharmacologic intervention. This case report describes managing chronic asthma holistically with family medicine principles, focusing on biopsychosocial assessment and multidisciplinary care. Case Presentation: We report a case of a 24-year-old male with a history of bronchial asthma, complicated by grade I obesity and allergic rhinitis. The patient reported recurrent dyspnea, triggered by allergen exposure and physical exertion. He also had episodic hypertension and poor medication adherence. Physical examination showed bilateral wheezing on auscultation and a BMI of 29.49 kg/m². Psychosocial evaluation using the Family APGAR and SCREEM tools indicated high family functionality and resource availability, but long-term economic stability and poor medication adherence were noted. A multidisciplinary, patient-centered care plan was implemented, which included pharmacologic therapy, respiratory rehabilitation, dietary counselling, and family-centered health education. Follow-up assessments demonstrated improved clinical outcomes and functional capacity. Discussion: This case highlights the challenges of managing chronic asthma in young adults with coexisting metabolic and atopic disorders. The integration of family medicine principles, such as biopsychosocial assessment, structured education, and environmental modifications, proved essential in improving treatment adherence and quality of life. Conclusion: A holistic, family-centered, multidisciplinary management strategy improves asthma outcomes in adult patients with comorbidities. Tailored interventions that account for psychosocial and environmental factors should be prioritized in long-term care of individuals with respiratory diseases.
Introduction: Pneumonia is an acute inflammation of lung parenchymal due to pathogen infection (bacterial, viral, fungal, and parasitic) but not including specific parenchymal lung inflammation caused by mycobacterium tuberculosis. Fungal pneumonia is a rare disease and difficult to diagnose, this disease could lead to misdiagnosis with antibiotic resistant bacterial pneumonia. Case Presentation: We present a 53 years old woman with comorbid hepatocellular carcinoma and low lymphocyte level who was suspected with fungal pneumonia and bacterial pneumonia as differential diagnosis who failed with adequate antibiotic regimen. We use fluconazole as a drug of choice due to lack of diagnostic tools to identify the causing microorganism, and limited source of medication. Discussion: Fungal pneumonia is a rare disease and difficult to diagnose due to wide range of symptom. Presence of risk factor and inability to treat with antibiotic should be make a suspicion to fungal pneumonia. Radiograph finding of ground-glass opacity could help to make the diagnosis, followed with microbiologic examination. The treatment should be considered causative agent and patient conditions. Conclusion: Antibiotic unresponsive pneumonia with risk factor, clinical and radiologic suggestive finding should be considered as fungal pneumonia as differential diagnosis, adequate treatment and examination including radiographic and microbiology should be performed.
Introduction: The Maternal Mortality Rate (MMR) is indicated as one of Nation’s health performance which is noted 189 per 100,000 live births in Indonesia at 2020. Maternal death can prevented by maintaining good quality of antenatal care (ANC) to identify the modifiable risk factors include Chronic Energy Deficiency (CED). Objective: To analyze IHS 2023 data in order to determine the factors associated with the prevalence of chronic energy deficiency (CED) in Indonesian pregnant women. Methods: This study uses a cross-sectional study design with secondary data sourced from the 2023 Indonesian Health Survey (IHS) and the population of all women aged 10-45 years. Descriptive analysis was conducted to summarize the characteristics of the respondents. Bivariate analysis was performed using chi-square tests and a simple logistic regression test. Multivariate analysis was performed with multiple logistic regression. Results: Research shows that 14% of pregnant women are in the condition of CED (LiLA 23.5 cm). Bivariate analysis showed that maternal age, parity, education, area of residence, supplementary feeding (PMT), and defecation behavior were related to CED in pregnant women (p-value: ≤0.05). Multivariate analysis, show the most dominant variables related to CED in pregnant women were age, area of residence, and supplementary feeding (PMT). Conclusion: The factors of CED in pregnant women tend to be complex. The results of this study are expected to contribute to increasing the preventive efforts of the government, health workers, and the community related to CED, especially for pregnant women in order to prepare for a healthy pregnancy and form quality human resources.
Introduction: Lung cancer is the second most frequent disease worldwide and the major cause of cancer deaths. Most lung cancer patients are already in the final stages of the disease by the time symptoms appear. Multiple studies have found that lung cancer patients experience significant symptom distress, particularly respiratory problems. Multiple symptoms can cause individuals severe discomfort and lower their quality of life and ability to function. Thus, effective respiratory treatment is crucial. Understanding the best management strategies in this field is essential for advancing knowledge and improving lung cancer patients' quality of life. Main Text: The respiratory symptoms reported in people with lung cancer can arise from various factors, including airway obstruction, involvement of the lung parenchyma and pleura, abnormalities in the vascular and neuromuscular systems, and side effects of the treatments delivered. The most commonly evaluated and documented symptoms included cough, dyspnea, hemoptysis, stridor, and pain in the chest. The optimal utilization of pharmacological and non-pharmacological interventions is crucial in reducing the burden of symptoms. Conclusion: Treating distressing respiratory symptoms in lung cancer is a complicated process. While significant advancements have been achieved in comprehending the symptoms linked to lung cancer, additional headway is required to reduce the morbidity associated with unmanaged symptoms. Specifically, there is a need for more research to enhance the management of symptoms in lung cancer patients to improve their quality of life and outcome.
Introduction: Soil-transmitted helminths (STH) represent a common group of parasitic infections that commonly contract humans as their definitive hosts. This parasite has been declared the third most prevalent neglected tropical diseases (NTDs) globally. The intricate interplay between these parasites and the host immune response necessitates a comprehensive exploration of the immunological dynamics governing the response to STH for prospective insights. Main Text: This review aims to elucidate the immunological facets of STH during host infection, delving into the intricate pathologic interactions underscored by the multifaceted involvement of adaptive and acquired immune responses. This immune interaction produces two major outcomes, chronic infection and worm expulsion depending on immune predominant response (type 1 versus type 2 immunity). Type 1 immunity is notable for its function against intracellular pathogens yet unsuitable for parasitic infection. Meanwhile, type 2 immunity is typical for macro parasite. However, attention recently has been dragged towards the study of the immunomodulatory properties inherent to STH, as recent reports leverage this characteristic to discern immune responses and functions against various parasitic diseases. Immunomodulation properties of STH are primarily mediated by the presence of Excretory/secretory proteins (ESPs) and soluble products (SPs) which act as a double-edged sword, enhancing parasitic invasion yet blunting immune response. Conclusions: Understanding the immunological aspects of STH is imperative for fostering comprehension and effective management in the contemporary era, as the goal of eradicating STH as a neglected tropical disease remains distant. In addition, its immunomodulation properties bring several implications, particularly to the advancement of treating other diseases, such as autoimmune diseases.
Introduction: Dysthymia, or persistent depressive disorder (PDD), is a state of chronic depressive mood that currently does not meet the criteria for depressive disorder and occurs all the time or persists for at least 2 years. Management of dysthymia is a combination of antidepressants and psychotherapy. Transcranial magnetic stimulation (TMS) is referred to as adjuvant therapy for depression. However, there have been no studies that specifically provide TMS for dysthymia. Case Presentation: A 27-year-old male, came to the Psychiatric Poly of regional mental hospital with complaints of not having the spirit of life for 8 years. The total Beck Depression Inventory (BDI) score starts at 10. This patient received rTMS 20 times with a frequency of 5 Hz, a motor threshold of 60%, and the dorsolateral prefrontal left cortex (DLPFC) improved, as evidenced by the BDI score being 4. Discussion: Dysthymia conditions affect neuron cells and make them less active, so neurotransmitter instability is not achieved, especially with serotonin, norepinephrine, and dopamine. So, it can provide stimulation to reactivate neuron cells and help neurotransmitters reach their balance point. This patient has been given 20 rTMS. The reason for giving a frequency of 5 Hz is because a high frequency is excitatory, so it can provide stimulation to activate neuron cells again. The location at DLPFC is because it adapts to previous research that the location has been linked to depressive states and plays a role in a person's executive function. Stimulation using motor threshold is 60% because it is the average human intensity. Conclusion: rTMS is effective for improving the symptoms of patients with dysthymia
Introduction: Tocilizumab is a potential therapeutic agent for modulating cytokine storms, a known cause of multiorgan failure and mortality in severe COVID-19. However, recent studies present conflicting results regarding its outcome and effectiveness. This study aims to assess the outcomes of severe COVID-19 patients treated with tocilizumab. Objective: We report the mortality rate of patients with severe COVID-19 after tocilizumab administration. Methods: A case series study involving 11 patients was conducted in the intensive care unit. Data on demographics, medical history, length of hospital stay, vital signs, laboratory and radiology examination, and drugs administered were collected. Statistical analysis used IBM SPSS version 17. Results: The patient mortality rate reached 72.7%, with a median of two and 4.5 days of tocilizumab administration in patients who recovered and died, respectively. Comorbidities included hypertension (27.3%), type 2 diabetes mellitus (45.5%), and obesity (63.6%). Other therapies co-administered with tocilizumab include antibiotics, vasopressors, convalescent plasma, and remdesivir. Despite promising changes in laboratory parameters in almost every patient, radiological improvement was found in only 28.58% of patients. Conclusion: This study highlights that tocilizumab administration in severe COVID-19 has a good safety profile, with no serious adverse effect observed, although a high mortality rate was observed even after tocilizumab administration in patients with severe COVID-19.
Dengue fever is a major public health concern worldwide, especially in regions with warm temperatures. Dengue Virus (DENV) from Flaviviridae, which has 4 serotypes DENV-1, DENV-2, DENV-3, and DENV-4) caused Dengue. DENV can cause three different types of dengue fever: Classical DF, DHF, and DSS. To fight off DENV infection, the body will produce an immunological response. Neutralizing antibodies are one of the immune responses that play a role in preventing viral infections. However, antibodies can also contribute to DENV infection severity through a process called Antibody Dependent Enhancement (ADE). The amount of antibodies bound to virus particles is related to viral neutralization and ADE. Neutralization occurs when antibody concentrations exceed the stoichiometric threshold and when antibody concentrations are higher than the minimal amount that is required for stable attachment of virions to cells. ADE occurs in the presence of antibodies below the stoichiometric threshold for neutralization and less than the minimal amount required for stable attachment of viral particles to cells. Antibody binding stoichiometry is determined by the affinity of the antibody and the number of epitopes that can bind to the virion. According to scholarly discourse, it is commonly held that the balance between neutralizing antibodies and ADE can be influenced by two contexts, namely the affinity and amount of antibodies.
The number of COVID-19 instances involving children or adolescents is quite low. However, occurrences in children and adolescents are either not clinically identified or are modest due to silent infections. Multisystem Inflammatory Syndrome in Children (MIS-C) cases have been documented frequently throughout the past pandemic. MIS-C is an immune-mediated post-infectious process that develops autoantibodies and can be associated with many specificities. Increased levels of numerous plasma cytokines, such as IL-6, IL-8, IFN-γ, IL-17, TNF-α, and IL-10, as well as modifications to the interferon response pathway are present in patients with MIS-C. The majority of patients have a fever that lasts for more than 4 days, and typical symptoms include conjunctivitis, rash, and mucocutaneous symptoms like conjunctivitis, as well as neurologic abnormalities like headache, irritability, and encephalopathy. Management strategies based on particular symptoms, therapies for disorders with a similar presentation, such as Kawasaki disease, or recommendations for COVID-19 treatment in individuals over the age of 18. Patients who got corticosteroids together with IVIG recovered more quickly than patients who did not. Fewer MIS-C is self-limiting and may get better with just supportive treatment.
Introduction: Indonesia is facing a double burden of health problems: the increasing incidence of infectious diseases and an increased incidence of non-communicable diseases. The Posbindu (Integrated Health Post) for Non-communicable Disease (NCD), in Indonesian called as Posbindu – PTM, program is one of the Indonesian government's efforts to prevent and reduce the number of cardiovascular and other NCDs. Objective: This study explores the community's experience of visiting Posbindu -PTM. Methods: This phenomenological qualitative study was conducted through unstructured interviews with 17 patients visiting the Posbindu - PTM in several villages across Aceh Besar Regency in Indonesia. Results: Based on data analysis, we identified two themes related to their experience visiting the PTM Posbindu: the reasons for visiting the PTM Posbindu and the facilities available at the PTM Posbindu. There are 2 participant 2 participants visited Posbindu PTM because of personal experience, 9 participants visited Posbindu PTM because they experienced illness, and 2 participants visited Posbindu PTM because doctor's advice. Conclusion: The reason for visiting Posbindu PTM is because of personal experience, the pain felt, and doctors' advice. In the facilities available at Posbindu, PTM is found to be primarily based on patient expectations. However, a tiny number still do not meet patient expectations.
Introduction: Vitiligo is a skin condition characterized by a lack of or damage to melanocytes, which results in depigmented lesions on the skin and mucosa. Objective: To describe the patients’ profile of vitiligo at the Dermatology and Venereology Clinic of dr. Zainoel Abidin General (RSUDZA) Hospital Banda Aceh. Methods: A retrospective observational descriptive study on vitiligo patients who were treated at the Dermatology and Venereology Clinic of RSUDZA Banda Aceh for the period January 2017 to June 2023. Results: A 6-year observation yielded a total of 2135 vitiligo patients. The year with the most vitiligo visitors was 202218 (5443 patients). Most cases were in women (536.2%), the majority of the age group 55 years (223%), age of onset 46-5517 years (16%), and only 21% had a family history of vitiligo. The most prevalent dermatological conditions were acrofacial vitiligo (24%), multiple lesions (838%), nummular lesions (289%), and the presence of head and neck lesions (201%). Topical steroids were given to the patient as topical therapy (976%). A total of 31% of patients had oral medication, while 294% received phototherapy.
Polycystic Ovarian Syndrome (PCOS) is the most common cause of anovulatory infertility, a hormonal condition that affects women of reproductive age and accounts for approximately 75% of infertility cases. World Health Organization (WHO) stated that around 116 million women globally were affected by PCOS. PCOS is the most common endocrine disease in reproductive-age women, with a prevalence of 5-10% of cases. The etiology of PCOS is unknown. There are several factors associated with PCOS, including genetic, environmental, lifestyle, and stress factors. PCOS presents with various complaints of hyperandrogenism (hirsutism, seborrhea, acne), menstrual cycle dysfunction, and overweight. Impairment of feedback between the hypothalamus-pituitary axis and ovary increases estrogen secretion, decreasing follicle-stimulating hormone (FSH). Patients with PCOS can lead to infertility. Infertility caused by PCOS is thought to be related to a dysfunction in developing mature follicles that causes anovulation. FSH and estrogen will be within normal laboratory limits. LH can be normal or increased. Delayed diagnosis often causes PCOS treatment to be inappropriate, which ends in infertility. PCOS is a chronic condition and cannot be cured, but treatments can improve symptoms. Management of subfertility associated with PCOS is often centered on lifestyle changes, pharmacotherapy, surgical treatment, and assisted reproductive technologies (ART).
Introduction: Paracetamol is a drug that is often used as an analgesic and antipyretic. However, the incidence of poisoning due to Paracetamol is still relatively high. Liver damage due to a lethal dose of Paracetamol causes an increase in liver serum enzymes and a decrease in albumin levels. Various plants have been extensively researched to act as hepatoprotectors. Temulawak (Curcuma xanthorrhiza) contains secondary metabolites, including xanthorrhizol and curcumin, which function as hepatoprotection by capturing free radicals, lipid peroxidase, and reducing hepatocyte apoptosis. Objective: This study aims to determine the effect of ginger extract on serum albumin levels induced by Paracetamol in Wistar rats. Methods: This research is an experimental study (pretest-posttest with control group). A total of 25 rats were divided into five groups: Group I (K1) was only given distilled water; Group II (K2) was given Paracetamol 2000 mg/kg BW; Group III (P1) given 800 mg/kgBW ginger extract on days 8-14 and Paracetamol 2000 mg/kgBW on day 19-21 for three days; Group IV (P2) given ginger extract 1600 mg/kgBW on day 8-14 and Paracetamol 2000 mg/kgBW on day 19-21 for three days; and group V (P3) given ginger extract 3200 mg/kgBW on day 8-14 and Paracetamol 2000 mg/kgBW on days 19-21 for three days. Serum albumin levels were measured before and after treatment. Results: Temulawak extract at 1600 and 3200 mg/kgBW had a better hepatoprotective effect than 800 mg/kgBW. Statistically, the difference is significant with a p=0.000 (p0.05). Conclusion: Ginger extract has a significant effect on changes in serum albumin levels in Wistar rats induced by toxic doses of Paracetamol.
