Medical Laboratory Technology Journal https://www.ejurnal-analiskesehatan.web.id/index.php/JAK <p style="text-align: justify;">Medical Laboratory Technology Journal, with registered number ISSN 2461-0879 (online) is a scientific journal published by <a href="http://poltekkes-banjarmasin.ac.id/">Poltekkes Kemenkes Banjarmasin</a> in cooperation with <a href="http://www.patelki.or.id/">PATELKI</a> with the <a href="https://drive.google.com/file/d/1dALYxFH0_Jlo6WLshTzh4ZaoSYkQHnyv/view?usp=sharing">MOU</a>. The aim of this journal publication is to disseminate the conceptual thoughts or ideas and research results that have achieved in the area of medical laboratory sciences. This Journal particularly focuses on the main problems in the development of the sciences of medical laboratory areas. It covers the parasitology, bacteriology, virology, hematology, clinical chemistry, toxicology, food and drink chemistry, and any sciences that cover sciences of medical laboratory area. 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The editors will only accept the manuscripts which meet the assigned format.</p> <p style="text-align: justify;">Medical Laboratory Technology Journal (MLTJ) has been reaccredited by Ministry of Research, Technology, and Higher Education of Republic of Indonesia since Vol. 4, No. 2, 2018 until Vol. 9, No. 1, 2023 with grade 2nd according to the <a href="https://drive.google.com/file/d/1lywSF4TnAs-inQnQ1UNO0qg9TnP8M-RI/view?usp=sharing" target="_blank" rel="noopener">decree No. 79/E/KPT/2023</a> and <a href="https://drive.google.com/file/d/1SzTHLtz_GwE12OmJUUICAan2P0-4YwEx/view?usp=sharing" target="_blank" rel="noopener">Official Certificate. </a></p> en-US <p style="text-align: justify;">Publishing your paper with <strong>Medical Laboratory Technology Journal (MLTJ)</strong> means that the author or authors retain the copyright in the paper. MLTJ granted an author(s) rights to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by MLTJ in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at private monetary gain or commercial advantage. <p style="text-align: justify;">MLTJ journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a<a href="https://creativecommons.org/licenses/by-sa/4.0/" target="_blank"> Creative Commons Attribution-ShareAlike 4.0 International License</a>. This license lets others remix, transform, and build upon the material for any purpose, even commercially. MLTJ journal Open Access articles are distributed under this<strong><a href="https://creativecommons.org/licenses/by-sa/4.0/" target="_blank"> Creative Commons Attribution-ShareAlike 4.0 International License</a> (CC BY-SA)</strong>. Articles can be read and shared for All purposes under the following conditions:</address><address style="padding-left: 30px;"><br /> <strong>BY:</strong> You must give <a href="https://creativecommons.org/licenses/by-sa/4.0/">appropriate credit</a>, provide a link to the license, and <a href="https://creativecommons.org/licenses/by-sa/4.0/" target="_blank">indicate if changes</a> were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</address><address style="padding-left: 30px;"><strong>SA:</strong> If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.</address> editormltj@gmail.com (Leka Lutpiatina) Apinaga53@gmail.com (Ricko Dharmadi Utama) Fri, 13 Jun 2025 07:20:02 +0700 OJS 3.2.1.4 http://blogs.law.harvard.edu/tech/rss 60 The Ability of Alum to Reduce Color in Sasirangan Home Industry Wastewater https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/608 <p>Water is the main need of living things in the world. Water determines the sustainability of living things. Humans, animals, and plants depend on water for their survival. Therefore, water should always meet the standards that have been set. Wastewater from the home-based sasirangan industry has distinctive characteristics in the form of the color of wastewater that has not been managed properly. The purpose of this study was to determine the ability of alum to reduce the color of home-based sasirangan industry wastewater. The type of research is a true experiment, with the population being all home-based sasirangan industry wastewater in Atun Sasirangan Cempaka. The sample is part of the wastewater. The wastewater was put into 25 containers for 5 treatments of alum addition with concentrations of 40%, 80%, 160%, 240%, and 320%. Each treatment was repeated 5 times. The results showed that the average value of wastewater color after treatment ranged from 140.5 to 179.2 Pt-Co. The lowest average value was in the treatment of adding alum with a concentration of 160%. It is concluded that alum is able to reduce the color of home-based sasirangan industry wastewater. It is recommended that the handling of wastewater color problems in the sasirangan fabric home industry use alum as a coagulant in the treatment method.</p> Abdul Khair, Noraida Noraida Copyright (c) 2025 Noraida Noraida, Abdul Khair http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/608 Fri, 13 Jun 2025 00:00:00 +0700 Differential Leukocyte Count Responses Post Injection of Duffy-binding-like Domain-2β of PfEMP1 Recombinant Protein in Wistar Rat https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/628 <p>Malaria due to <em>Plasmodium falciparum</em> causes a high mortality rate, and vaccination is a valuable approach to control it. One malaria vaccine candidate is <em>Plasmodium falciparum</em> erythrocyte membrane protein-1 (PfEMP1), specifically Duffy binding-like 2β (DBL2β) domain (DBL2β-PfEMP1), which has a vital role in severe malaria pathogenesis. The DBL2β-PfEMP1 recombinant protein is immunogenic. This study aimed to investigate the immune response of DBL2β-PfEMP1 protein by analyzing the differential leukocyte count. Twenty-three rats were randomly divided into control and five treatment groups. Rats were injected on days 0, 21, and 42 with a physiological solution of 0.9% NaCl, adjuvant, DBL2β-PfEMP1 protein, and each mixture of DBL2β-PfEMP1 protein with doses of 150, 300, and 450 µg/200gBW and adjuvant. Blood was collected on day 56 and prepared for differential leukocyte count examination with a visual microscopic examination by two expert observers. The results showed that DBL2β-PfEMP1 recombinant protein and adjuvant increased the eosinophils and neutrophils but decreased monocytes and lymphocytes and did not affect the basophils. Statistical analysis showed significant differences between groups for eosinophils (between control and DBL groups; Adj and DBL groups; DBL and other groups except DBL150+adj) and monocytes (between control and all doşe groups with adjuvant; DBL and all doşe groups with aduvant), but not for basophils, neutrophils, and lymphocytes. In conclusion, the serial injection of DBL2β-PfEMP1 recombinant protein showed different responses in each leukocyte cell type. Further analysis by time-series differential leukocyte count examination will be essential to determine the responses of each type of leukocyte to support the research on malaria vaccine development.</p> Zahniar Zahniar, Erma Sulistyaningsih, Sheilla Rachmania, Rosita Dewi, Irawan Fajar Kusuma Copyright (c) 2025 Zahniar Zahniar, Erma Sulistyaningsih, Sheilla Rachmania, Rosita Dewi, Irawan Fajar Kusuma http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/628 Fri, 13 Jun 2025 00:00:00 +0700 Impact of Lead (Pb) Exposure on Hematological Parameters, hs-CRP, Ferritin, and Oxidative Stress (MDA) in Battery Factory Workers https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/629 <p>Exposure to lead in the workplace is common, with most employers and workers unaware of its adverse health effects. This study examines the relationship between blood lead levels in battery factory workers and health examination results such as Hematology profile (Hemoglobin level, Leukocyte count, Hematocrit Level, Platelet count, Erythrocyte Count, MCV, MCH, and MCHC), malondialdehyde (MDA), ferritin, and hs-CRP. The samples of this study were 25 blood samples of battery factory employees in Jakarta who were older than 40 years and had worked for more than 1 year. Workers' blood samples were collected using vacuum tubes and placed in ice boxes to be sent to PT Petrolab Service Laboratory for blood lead level examination, Citama Hospital Laboratory Unit for blood profile examination, ferritin level, and hs-CRP value, and Prodia Jakarta Clinical Laboratory for MDA level examination. Bivariate analysis examined the relationship between lead levels, blood profile, ferritin levels, MDA levels, and hs-CRP values. Using the entered formula, multivariate analysis was used to test the relationship between lead levels and blood profile, ferritin levels, MDA levels, and hs-CRP values. The significance level used to test the significance of the relationship was &lt;0.05. The bivariate test results showed there was a correlation between blood lead levels and hs-CRP levels (P=0.000), MDA levels (P=0.000), ferritin levels (P=0.000), Hb levels (P=0.000), hematocrit levels (P=0.006), MCV value (P=0.000), and MCH value (P=0.004). In contrast, Multivariate analysis showed lead levels significantly correlated with MDA level (P=0.014), ferritin level (P=0.005), and MCV value (P=0.013). Blood lead levels should be controlled to reduce the risk of oxidative stress and its impact on health, and it is hoped that workers in contact with lead will place more emphasis on occupational safety and health.</p> Nur Siti Maryam, Indah Tri Susilowati, Kanti Rahayu, Rizki Alifah Nur Saputro Copyright (c) 2025 Indah Tri Susilowati, Nur Siti Maryam, Kanti Rahayu, Rizki Alifah Nur Saputro http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/629 Fri, 13 Jun 2025 00:00:00 +0700 Antibacterial Potential of Curcuma Mangga Kombucha: The Effect of Fermentation Duration on Activity Against Escherichia coli and Salmonella typhi https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/636 <p>Kombucha is a fermented beverage known for its various health benefits, including antibacterial activity. This study aims to evaluate the antibacterial potential of mango ginger (<em>Curcuma mangga</em>)-based kombucha against <em>Escherichia coli</em> and <em>Salmonella typhi</em>, as well as to analyze the effect of fermentation duration on the physicochemical properties of kombucha. Fermentation was conducted for 5, 7, 10, and 14 days, with total acidity, pH, and antibacterial activity measurements using the well diffusion method. The results showed total acidity increased as fermentation progressed, while pH decreased. Antibacterial tests demonstrated that mango ginger kombucha exhibited inhibitory activity against <em>Escherichia coli</em> and <em>Salmonella typhi</em>, with the largest inhibition zones observed on day 10 of fermentation (8.2 mm for <em>Escherichia coli</em> and 9.2 mm for <em>Salmonella typhi</em>). Although its inhibitory effect was moderate compared to the positive control (ciprofloxacin), these findings suggest the potential of mango ginger kombucha as a functional beverage with antibacterial properties. Further research is needed to identify the active compounds responsible for its antimicrobial activity and to optimize the fermentation process to enhance its effectiveness.</p> Ratna Ratna, Gemala Anjani, Diana Nur Afifah, Fitriyono Ayustaningwarno, Ninik Rustanti Copyright (c) 2025 Ratna, Gemala Anjani, Diana Nur Afifah, Fitriyono Ayustaningwarno, Ninik Rustanti http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/636 Fri, 13 Jun 2025 00:00:00 +0700 The Effects of Fermented Buffalo Milk (Dadih) Fortified with Red Dragon Fruit and Selenium on Adiponectin and Tumor Necrosis Factor-Alpha Levels in Obese Rats https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/639 <p>The increasing prevalence of obesity and its associated complications necessitates the exploration of functional foods as therapeutic interventions. This study aimed to analyze the effects of fermented buffalo milk (dadih) fortified with red dragon fruit (<em>Hylocereus polyrhizus</em>) and selenium on adiponectin and Tumor Necrosis Factor-Alpha (TNF-α) levels in obese rats. This experimental study employed a pretest-posttest control group design involving 20 Wistar rats divided into four groups: K1 (healthy control), K2 (obese control), P1, and P2 (obese intervention). K2, P1, and P2 were in obesity conditions induced by a high-fat-fructose diet (HFFD) for 28 days, and K1 was a healthy control group. Furthermore, dadih only and dadih fortified with red dragon fruit and selenium at 1.8 g/200 g body weight/day were administered to P1 and P2 groups, respectively. Treatment using dadih fortified with red dragon fruit and selenium significantly reduced weight gain (p=0.000) compared to K2 and P1. In addition, the P2 group showed increased adiponectin levels and decreased TNF-α levels (p=0.000) compared to the K2 and P1 groups. A strong negative correlation was found between adiponectin levels and TNF-alpha and body weight, while TNF-alpha and body weight showed a strong positive correlation. To conclude, fortifying dadih with red dragon fruit and selenium is more effective in improving the metabolic condition of obese rats compared to non-fortified dadih. This fortification significantly enhances adiponectin levels and reduces TNF-alpha levels. These findings suggest that functional food fortification could be a promising approach for managing obesity-related inflammation and metabolic disorders in humans, highlighting the potential application of dadih in dietary interventions.</p> Fitri Wulandari, Ninik Rustanti, Adriyan Pramono Copyright (c) 2025 Fitri Wulandari, Ninik Rustanti, Adriyan Pramono http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/639 Fri, 13 Jun 2025 00:00:00 +0700 Effect of Astaxanthin Cream on MMP-1 and SOD Expression in Wistar Rats Exposed to ultraviolet B https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/632 <p>Ultraviolet B (UVB) exposure is the main cause of skin damage leading to photoaging, increasing Reactive Oxygen Species (ROS) and triggering the production of Matrix metalloproteinase-1 (MMP-1) enzymes that play an important role in photoaging, describing clinical signs including wrinkles, thickening, dryness and pigmentation. Astaxanthin can inhibit ageing and reduce wrinkles, has strong antioxidant potential that can neutralize ROS, and suppress MMP-1 activity. The purpose of this study was to determine the effect of astaxanthin cream on the levels of MMP-1 and Superoxide Dismutase (SOD) enzyme production in mouse skin tissue exposed to short-term UVB light experimental research with a post-test-only control group design. The experimental animals used were 28 Wistar rats divided into 4 groups, namely group K1 (healthy), group KN exposed to short-term UVB and given base cream, group P1 exposed to short-term UVB rays and given 0.05% astaxanthin cream, and group P2 exposed to short-term UVB rays and given 0.1% astaxanthin cream. The treatment was carried out for 5 days, and on the 6th day, the levels of MMP-1 enzyme production in skin tissue and SOD were examined using the immunohistochemical method. Based on One-way ANOVA, there was a significant difference in the average levels of MMP-1 enzyme production in the skin tissue of all groups (p = 0.000). The highest MMP-1 production was found in the KN group, while in the P2 group, the levels were lower and not significantly different from the healthy group (K1). Significant differences in SOD expression were also observed among all groups (p = 0.000) using the Kruskal-Wallis test. The highest SOD expression was found in group P2 and was significantly different from groups P1 and KN. Topical astaxanthin cream administration affected MMP-1 enzyme production in skin tissue and SOD expression in Wistar rats exposed to short-term UVB radiation. Astaxanthin-based cream formulation has the potential to be developed as a topical agent to prevent skin damage caused by sun exposure, and these findings require further validation through studies on human skin models or early clinical trials.</p> Nita Rachmawati, Danis Pertiwi, Siti Thomas Copyright (c) 2025 Nita Rachmawati, Danis Pertiwi, Siti Thomas http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/632 Fri, 13 Jun 2025 00:00:00 +0700 Amino Acid Mutations of OprD Protein in Pseudomonas aeruginosa After Meropenem Exposure https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/646 <p><em>Pseudomonas aeruginosa</em> is a gram-negative pathogen associated with nosocomial infections and increased resistance to carbapenems, often linked to porin OprD inactivation. This study aimed to analyse amino acid substitutions in the OprD protein of two meropenem-sensitive <em>Pseudomonas aeruginosa</em> isolates (AK36 and AK237b) after 12 days of in vitro exposure to subinhibitory meropenem concentration (0.5 µg/mL). DNA was extracted at three time points (days 0, 5, and 12) and the <em>oprD</em> gene was sequenced using Sanger sequencing. Protein sequences were aligned and modelled using Swiss-Model to identify mutations and to assess structural changes. By day 12, AK36 had Gln67Lys and Gly68Ser substitutions, whereas AK237b had Glu169Lys. Structural modelling suggests these mutations may alter porin conformation and reduce membrane permeability. Despite no increase in the MIC, oprD expression was suppressed, indicating early adaptation. These findings support the hypothesis that prolonged meropenem pressure induces molecular changes that precede phenotypic resistance. This study highlights the importance of monitoring porin mutations as an early indicator of carbapenem resistance in clinical microbiology. This could help to improve antibiotic stewardship by identifying isolates at risk of developing resistance before it becomes clinically apparent.</p> Agus Evendi, Tiara Dini Harlita, Sresta Azahra Copyright (c) 2025 Agus Evendi, Tiara Dini Harlita, Sresta Azahra http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/646 Fri, 13 Jun 2025 00:00:00 +0700 The Isolatıon, Characterızatıon, and Antıfungal Assay of Lactıc Acıd Bacterıa Isolated from Green Glutınous Rıce Tape Agaınst Aspergillus flavus https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/645 <p>Green glutinous rice tape is a fermented food made from glutinous rice, katuk leaves (<em>Sauropus androgynus</em>), and yeast, originating from Tembilahan, Riau Province. This product can serve as a source of lactic acid bacteria (LAB) capable of producing antimicrobial compounds to inhibit pathogenic microorganisms, including <em>Aspergillus flavus</em>, a well-known spoilage fungus in food products. However, to date, no reports have explored the ability of LAB from green glutinous rice tape to inhibit the growth of <em>Aspergillus flavus</em>. This study aimed to isolate LAB from green glutinous rice tape, conduct macroscopic, microscopic, and biochemical characterizations, and evaluate the antifungal activity of the LAB isolates against <em>Aspergillus flavus</em> using the good diffusion method. The isolation process yielded four LAB isolates from Tembilahan green tape (TKHT-2, TKHT-3, TKHT-5, and TKHT-7), which were identified as members of the genus <em>Lactobacillus</em> sp., with antifungal activities of 25.50 ± 5.78 mm, 24.33 ± 0.62 mm, 22.16 ± 6.56 mm, and 18.66 ± 4.28 mm, respectively. The corresponding cell-free supernatants (CFS) from these isolates (TKHT-S2, TKHT-S3, TKHT-S5, and TKHT-S7) also demonstrated antifungal activity with inhibition zones of 19.83 ± 3.47 mm, 19.83 ± 4.24 mm, and 14.50 ± 3.26 mm, respectively. LAB cells and their cell-free supernatants partially inhibited <em>Aspergillus flavus</em>, indicating a fungistatic effect. These findings suggest the potential application of LAB from green glutinous rice tape as a natural preservative or antifungal agent in food products.</p> Musyirna Rahmah Nasution, Nurliza Aulya, Rahma Dona, Yozi Fiedya Ningsih Copyright (c) 2025 Musyirna Rahmah Nasution, Nurliza Aulya, Rahma Dona, Yozi Fiedya Ningsih http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/645 Fri, 13 Jun 2025 00:00:00 +0700 The Effect of Jeruju Leaf Brew (Acanthus ilicifolius L) on HOMA-IR and TNF-α in White Rats Induce by STZ-NA https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/648 <p>The International Diabetes Federation (IDF) has reported a consistent global rise in the prevalence of type 2 diabetes mellitus (T2DM). Conventional T2DM treatments such as metformin, sulfonylureas, and insulin therapy are effective. Still, they can lead to side effects, including gastrointestinal disturbances, hypoglycemia, renal impairment, weight gain, and complications associated with injection procedures. The herbal remedies are considered a natural alternative with fewer adverse effects. <em>Acanthus ilicifolius</em> (Jeruju) contains antioxidant compounds such as flavonoids, alkaloids, and saponins and may serve as a complementary therapy. This study investigated the effect of jeruju leaf brew at 6 ml/kg/day and 12 ml/kg/day on tumor necrosis factor alpha (TNF-α) and homeostatic model assessment of insulin resistance (HOMA-IR) levels. Using a true experiment with a randomized post-test only with a control group design, 30 rats were divided into five groups (K0, K−, K+, P1, and P2). After 28 days of intervention, groups P1 and P2 showed significant reductions in TNF-α (7.80 pg/ml and 6.94 pg/ml, respectively) and HOMA-IR (3.75 and 3.28, respectively). These findings indicate that a higher dose of jeruju leaf brew results in greater reductions in TNF-α and HOMA-IR levels in T2DM rats.</p> Munifa Majdiyyah, Ade Chairina, Diana Nur Afifah, Ahmad Syauqy Copyright (c) 2025 Munifa Majdiyyah, Ade Chairina, Diana Nur Afifah, Ahmad Syauqy http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/648 Fri, 13 Jun 2025 00:00:00 +0700 Characteristics and Antioxidant Activity of Limau Kuit Peel (Citrus hystrix) Extract with Variation of Extraction Solvent https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/650 <p>Limau kuit (<em>Citrus hystrix</em>) has been traditionally utilized for its therapeutic properties, particularly the antioxidant potential of its peel. Extraction is preferred for medicinal use, with solvent selection playing a critical role in determining the yield and concentration of bioactive compounds. This study aimed to assess the characteristics and antioxidant activity (IC₅₀ value) of Limau Kuit peel extract extracted with three different solvents. The research methods, starting with sample preparation, were carried out by drying Limau Kuit peel, then extraction using three different solvents: distilled water, ethanol 70%, and ethanol 96%. Extraction with distilled water solvent used the infusion method, while the ethanol solvent used the maceration method. The third extract was then characterized based on the parameters of percent yield, organoleptic testing, phytochemical screening, chromatography profile, and determination of total flavonoid levels. Antioxidant activity testing on the third extract using the DPPH (2,2-diphenyl-1-picrylhydrazyl) method. The study results showed that the third extract had the same shape, color, aroma, taste, and compound content: flavonoids, phenolics, alkaloids, and terpenoids. The results of thin-layer chromatography also showed no difference in the third extract. The characteristic differences were found in the parameters of percent yield and total flavonoid content. The highest total flavonoid content of Limau Kuit (<em>Citrus hystrix</em>) peel extract was obtained using 70% ethanol (11.47% w/w), followed by 96% ethanol (6.39% w/w), and distilled water (2.82% w/w). Antioxidant activity, evaluated using the IC₅₀ value as the parameter, showed that the 70% ethanol extract exhibited the strongest activity (21.26 ppm, very strong), followed by the 96% ethanol extract (31.87 ppm, very strong), and distilled water extract (70.91 ppm, strong). This study concludes that 70% ethanol is the most effective solvent for extracting antioxidant-rich compounds from Limau Kuit peel, supporting its potential use in herbal formulations.</p> Muhammad Ikhwan Rizki, Ni Kadek Ayu Agustina, Anna Khumaira Sari , Satrio Wibowo Rahmatullah, Nazhipah Isnani Copyright (c) 2025 Muhammad Ikhwan Rizki, Ni Kadek Ayu Agustina, Anna Khumaira Sari , Satrio Wibowo Rahmatullah, Nazhipah Isnani http://creativecommons.org/licenses/by-nc-sa/4.0 https://www.ejurnal-analiskesehatan.web.id/index.php/JAK/article/view/650 Fri, 13 Jun 2025 00:00:00 +0700