Indonesian Journal of Health Research and Development

Utilization of Nipa Palm (Nypa fruticans) Leaf Extract as a Natural Preservative for Salted Three Spot Gourami (Trichopodus trichopterus)

Agustin Maharani Khairunisa — 2026-06-23

Background: Salted three-spot gourami (Trichopodus trichopterus) is a traditional fish product that is susceptible to microbial spoilage and quality deterioration during storage. The use of plant-based bio-preservatives has been explored as an alternative to synthetic additives to improve product safety and shelf life.
Aims: This study aimed to assess the effectiveness of nipa palm (Nypa fruticans) leaf extract at different concentrations as a natural preservative for salted three-spot gourami.
Methods: The experiment was arranged in a Completely Randomized Design (CRD) with four treatments (0%, 10%, 15%, and 20%) and three replications. Parameters observed included moisture content, Total Plate Count (TPC), and organoleptic attributes (appearance, aroma, and texture).
Results: The application of nipa palm leaf extract significantly (P < 0.05) affected moisture content, microbial growth, and sensory quality during storage. The 15% treatment (P2) produced the lowest moisture content throughout storage, reaching 19.83% on day 30. Microbial counts in all extract-treated samples remained within the maximum permissible limit of the Indonesian National Standard (≤1 × 10⁵ CFU/g), with the 20% treatment (P3) showing the lowest microbial load (1.0 × 10⁵ CFU/g) on day 30. Sensory evaluation indicated that extract-treated samples maintained acceptable appearance, aroma, and texture throughout storage, with better sensory stability than the untreated control.
Conclusion: Nipa palm leaf extract effectively improved the storage quality of salted three-spot gourami. Although the 15% concentration (P2) achieved the greatest moisture reduction, the 20% concentration (P3) is recommended for practical application because it provided the strongest microbial inhibition while maintaining acceptable sensory quality during 30 days of storage.

Use of Dental Services and Oral Health-Related Quality of Life in Preschool Children

Keila Lais Carrera da Hora — 2026-06-30

Background: Oral health issues, particularly cavities, significantly impact children's eating, sleeping, speech, and overall well-being. The COVID-19 pandemic has worsened these problems by increasing disparities in access to dental care.
Aims: To analyse the use of dental services and their impact on oral health-related quality of life (OHRQoL) in preschool children in Salvador, identifying associated factors.
Methods: A cross-sectional study was conducted among 523 children aged 26 to 80 months enrolled in municipal public daycare centres in Salvador, BA. Oral health assessments and a caregiver questionnaire were used to collect sociodemographic data, dietary and oral health habits, and dental service use. OHRQoL was assessed using the B-ECOHIS. Descriptive and multivariate analyses were performed using linear regression at the 95% significance level.
Results: The prevalence of caries was 41.87%, and the use of dental services during the pandemic was low (13.58%). Age, family income, dental caries, and fear/anxiety were significantly associated with the B-ECOHIS, highlighting inequalities in access to services and in children's oral health-related quality of life (OHRQoL). There was no association between dental service use and OHRQoL.
Conclusion: The COVID-19 pandemic reduced preschoolers’ use of dental services, worsening OHRQoL and highlighting social inequalities and the need for equitable preventive oral health care.

Advancements and Emerging Strategies in Mechanical Ventilation: A Systematic Review of Innovative Modalities, Monitoring Technologies, and Prevention of Ventilator-Induced Injuries

Ravi Yadav — 2026-06-19

Background: Mechanical ventilation remains essential for patients with respiratory failure and during anesthesia for surgery. Despite technological progress, challenges persist regarding optimal ventilatory settings, transition strategies between non-invasive and invasive ventilation, and prevention of ventilator-induced lung injury and ventilator-induced diaphragm dysfunction.
Aims: To comprehensively review recent advances in mechanical ventilation, focusing on innovative ventilation modes, monitoring technologies, and strategies to prevent ventilator-induced complications.
Methods: A systematic review was conducted following PRISMA guidelines. Literature searches were performed in PubMed, EMBASE, and the Cochrane Library for studies published between January 2020 and October 2025. Clinical efficacy, safety, and patient outcomes across ventilation modalities were assessed. Thirty-five randomized controlled trials and high-quality observational studies were included for primary analysis, with fifteen additional studies supporting discussion findings.
Results: Significant progress was identified in several areas of mechanical ventilation. Neurally Adjusted Ventilatory Assist (NAVA) improved patient-ventilator synchrony and increased ventilator-free days compared with conventional modes (22 vs. 18 days, p = 0.016). Adaptive Support Ventilation demonstrated comparable efficacy to standard ventilation while reducing clinician workload. Proportional Assist Ventilation showed no significant advantage over pressure support ventilation in liberation time (7.3 vs. 6.8 days, p = 0.58). Artificial intelligence-based monitoring systems achieved >95% sensitivity in detecting patient-ventilator asynchronies. Lung-protective ventilation with low tidal volumes and plateau pressures <30 cmH₂O remained the cornerstone of ARDS management.
Conclusion: Novel ventilation modes may enhance synchrony and reduce workload, although major clinical benefits remain limited. Artificial intelligence shows promise for personalized ventilation strategies, while lung-protective ventilation remains critical for preventing VILI.

From Clinic to Policy: Advancing Sustainable Dentistry through Public Health Systems

Sanjida Haque — 2026-06-18

Background: Dentistry generates significant biomedical waste, utilizes energy-intensive resources, and employs materials harmful to the environment, such as dental amalgam. The concept of dental sustainability is in line with international targets like the UN Sustainable Development Goals (SDGs) and the Minamata Convention on Mercury.
Aims: This narrative policy review analyzes how dental associations and public health systems may lead policy, educate, advocate, and reform dentistry to make it more sustainable.
Methods: The study was performed based on peer-reviewed sources, as well as international policy and professional guidelines. PubMed, Scopus, Google Scholar, WHO, FDI, ADA, NHS, and national regulatory bodies were target sources of evidence. A synthesis of literature on the effects of the environment, sustainability programs, waste management, amalgam phase-down, digital dentistry, and governance of health systems was performed
Result: Worldwide efforts, including the FDI Sustainability in Dentistry Policy Statement (2021) and national strategies, including the NHS Net Zero Plan, show evidence of an ever-growing trend in favor of sustainability in the dental care sector. Nevertheless, lack of financial resources, poor awareness, poor management systems, and inconsistent implementation of policies hinder achievements. Clinical standards can be influenced by dental associations, and the wider change is enabled by the involvement of the regulation, reform of procurement, and development of the infrastructure by the public health systems.
Conclusion: The integration of sustainability in dentistry requires a collaborative effort from both professional associations and public health systems. Improving policy, education, innovation, and regulation can ensure that dentistry contributes positively to both oral health and environmental protection.