Healthy Tadulako Journal (Jurnal Kesehatan Tadulako)

The Influence of Parenting Patterns on Stunting Incidence Among Toddlers at Puskesmas Pantoloan, Palu City

Ketut Suarayasa Ketut — 2025-04-30

Background: Poor parenting in the family is one of the causes of inadequate nutritional intake, contributing to stunting. Stunting is a chronic malnutrition condition occurring in the first 1000 days of life, leading to delays in brain and physical development. According to the Ministry of Health, stunting is defined as a z-score less than -2SD and severe stunting as less than -3SD. Objectives: To determine the influence of parental parenting on the incidence of stunting in toddlers at the Pantoloan Community Health Center, Palu City. Methods: This case-control study involved 144 toddlers (72 stunting cases and 72 non-stunting controls) selected through purposive sampling. The total population was 947 toddlers. Data were analyzed using the Chi-square test. Results: There was no significant relationship between the type of parenting style and stunting incidence (P = 0.335, OR = 1.600). Similarly, no significant relationship was found between parenting methods and stunting incidence (P = 0.085, OR = 1.183). Conclusions:
Parental parenting style and methods were not significantly associated with stunting incidence among toddlers at the Pantoloan Community Health Center, suggesting the need to explore other contributing factors.

The Influence of Self-Care Management on Blood Pressure Control in Hypertensive Patients: A Literature Review

Syarifah Nurul Yanti Rizki Syahab Asseggaf — 2025-04-30

Background: Hypertension, often referred to as the "silent killer," is a chronic condition characterized by systolic blood pressure >/140 mmHg and diastolic blood pressure >/90 mmHg. It is a major contributor to cardiovascular morbidity and mortality. One key factor affecting blood pressure control is adherence to antihypertensive medication, which is closely linked to self-care management. Objective: This literature review aims to analyze the influence of self-care management on blood pressure control in patients with hypertension. Methods: An integrative literature review was conducted by collecting references from electronic databases. Six journal articles that met the inclusion criteria were analyzed using descriptive analysis techniques. Results: The review found a strong correlation between effective self-care management and improved blood pressure control. Various factors were identified as influencing self-care capacity, including age, duration of illness, presence of comorbidities, self-efficacy, perception, and health literacy. These factors play a critical role in determining a patient's ability to manage their condition. Conclusion: Self-care management is essential in supporting medication adherence and achieving blood pressure control in hypertensive patients. Both intrinsic and extrinsic factors contribute to the effectiveness of self-care strategies and should be considered in hypertension management programs

Analysis of Potential Hazards with Job Safety Analysis Techniques at Filling Stations and Transportation of Bulk LPG – PT. Tambang Yokodelta North Sulawesi

Aprillya Arikalang — 2025-04-30

Background: The LPG Bulk Filling and Transportation Station (SPPBE) at PT. Tambang Yokodelta Matungkas, North Minahasa, is a high-risk environment due to the flammable and pressurized nature of LPG. Identifying potential hazards is essential to ensure worker safety and prevent accidents. Objective: This study aims to analyze potential hazards and assess occupational risks using the Job Safety Analysis (JSA) method at the SPPBE of PT. Tambang Yokodelta. Methods: This qualitative research involved interviews and observations with eight informants, including the SPPBE manager, HSE head, technicians, and operators. Data were collected through interviews, field observations, and document review, and analyzed descriptively. Results: The study identified hazards classified into four risk levels: Low, Medium, High, and Extremely High. Low-risk activities, such as minor injuries, can be controlled with personal protective equipment (PPE). Medium risks, like falling during LPG handling, require additional PPE. High risks, including fire hazards during gas filling, need engineering controls. Extremely high-risk activities, such as gas explosions, require immediate management action and substitution measures. Conclusion: Workers at PT. Tambang Yokodelta face various risks. Effective control measures, including PPE, SOP compliance, engineering controls, and management commitment, are crucial for ensuring occupational safety.

Case Report: 60-Year-Old Female with Ischemic Stroke, Type 2 Diabetes Mellitus, and Hypertension

Husnawati Husnawati — 2025-04-30

Background: Ischemic stroke remains a leading cause of death and disability worldwide, with increasing incidence each year. Patients with comorbidities, such as Type 2 diabetes mellitus (DM), pose additional treatment challenges due to a higher risk of drug-related problems (DRPs), particularly drug interactions. Objective: This study aims to describe pharmaceutical care in female patients diagnosed with ischemic stroke and Type 2 DM, with a focus on identifying and evaluating DRPs. Method: A descriptive case study was conducted. Data were collected through medical records and patient monitoring, focusing on the identification and analysis of potential DRPs in the context of pharmaceutical care. Results: The study found drug interactions as the most prominent DRP. An interaction between potassium slow-release (KSR) and candesartan was identified as requiring monitoring. Additionally, moderate interactions were found between atorvastatin and clopidogrel, as well as atorvastatin and amlodipine. These interactions have the potential to influence therapeutic outcomes. Conclusion: The prescribed medication regimen was generally appropriate for the patient's condition. Nevertheless, the presence of DRPs highlights the importance of regular monitoring and dose adjustments. Optimizing pharmaceutical care through early detection and management of DRPs is essential to ensure treatment safety and effectiveness in patients with complex conditions.

The Relationship Between Fruit and Vegetable Consumption with The Incidence of Anemia Among Adolescent Girls in Three High Schools In Central Maluku

Damara Herlis Mailera — 2025-04-30

Background: Anemia is a global health problem common in both developed and developing countries, often caused by nutritional deficiencies, including low intake of fruits and vegetables. Adolescent girls are particularly at risk due to monthly menstrual blood loss. Objective: This study aimed to analyze the relationship between fruit and vegetable consumption and the incidence of anemia among adolescent girls in three high schools in Central Maluku in 2024. Methods: This was a quantitative analytical study using a cross-sectional design. The population consisted of students from SMA Negeri 15, SMA Negeri 44, and SMA Negeri 48 Central Maluku. A total of 102 respondents were selected using a total sampling technique. Anemia status was measured using the Hemocue device, and data on fruit and vegetable consumption were collected using the Commcare application. Data analysis was performed using the Spearman test. Results: The prevalence of anemia among respondents was 36.3%. Meanwhile, 63.7% reported regularly consuming fruits and 55.9% regularly consumed vegetables. Conclusion: There was no statistically significant relationship between fruit (p = 0.504) and vegetable (p = 0.587) consumption and the incidence of anemia in adolescent girls in the selected Central Maluku high schools in 2024.

The Characteristics of Conjunctivitis Patients at the Eye Hospital Makassar: A Recent Analysis of January – December 2023 Records

A Alya Amaliah M — 2025-04-30

Background: Conjunctivitis is an inflammation of the conjunctiva caused by viruses, bacteria, fungi, or allergies, with varying prevalence based on etiology, age, gender, and season. Objectives: This study aims to determine the characteristics of conjunctivitis patients at the Makassar Eye Hospital from January to December 2023. Methods: This research employed a descriptive method with a retrospective approach using patient medical record data. The study included 118 conjunctivitis patients as the sample. Results: The most affected age group was 18–65 years (72%), followed by children (16.9%) and the elderly over 65 years (11%). Conjunctivitis was more prevalent in females (60.2%) than males (39.8%). The most common etiology was allergy (39%), followed by bacterial (31.4%) and viral causes (29.7%). Allergic conjunctivitis was primarily treated with artificial tears (30.4%) and antihistamines. Bacterial conjunctivitis was mainly managed with a combination of antibiotics, steroids, and artificial tears (43.2%). Viral conjunctivitis was also most frequently treated with the same combination therapy (40%). Conclusions: Conjunctivitis is most prevalent among individuals of productive age (18–65 years) and more common in females. Allergic conjunctivitis is the most frequent type, with artificial tears being the primary treatment.

Effects of Pear Juice on Weight Loss in Obese Adolescents

Yulia Purnamasari — 2025-04-30

Background: Adolescents are highly vulnerable to nutritional problems, with obesity recognized as a global epidemic by the World Health Organization (WHO). In Indonesia, around 13.5% of individuals over 18 are overweight, and 28.7% are obese. Objective: This study aimed to examine the effect of pear juice consumption on weight loss among obese adolescents. Methods: A quasi-experimental study with a pre-test and post-test control group design was conducted. Participants were divided into intervention and control groups, each with 34 obese adolescents selected through purposive sampling. Data were analyzed using Paired t-Test and Independent t-Test at a significance level of </ 0.05. Results: Most respondents were male (55.9%), 75.0% were classified as obese based on BMI, and 60.3% had a genetic predisposition to obesity. The intervention group showed an average weight loss of 1.91 +/ 0.332 kg, while the control group had an average weight gain of 1.79 +/ 0.155 kg. Although weight loss in the intervention group was significant, the difference between groups was not statistically significant. Conclusion: Pear juice may help reduce weight in obese adolescents, possibly due to its fiber content that supports calorie regulation. Further studies with larger samples are recommended.

The Relationship Between Fat Intake and Pocket Money with The Incidence of Overweight in Teenagers at SMA Negeri 1 Toroh

Ulfia Fitriyani — 2025-04-30

Background: Overweight is a prevalent nutritional issue among adolescents and increases the risk of future health problems such as cardiovascular disease and diabetes mellitus. Key contributing factors include high fat intake and the amount of pocket money, which can influence dietary habits. Objective: This study aimed to analyze the relationship between fat intake and pocket money with the incidence of overweight in adolescents at SMA Negeri 1 Toroh. Method: A cross-sectional design was used with a sample of 90 students was selected using proportionate stratified random sampling. Data collection involved a 3x24-hour food recall to assess fat intake, a questionnaire on pocket money, and anthropometric measurements to determine overweight status. The Pearson product moment test was used to analyze the relationship between fat intake and overweight, while the Spearman rank test assessed the relationship between pocket money and overweight. Results: Most respondents had a deficient fat intake (41.1%), medium-level pocket money (38.9%), and a 41.1% prevalence of overweight. Statistical analysis revealed a significant relationship between fat intake and overweight (p = 0.001) and between pocket money and overweight (p = 0.017). Conclusion: Both fat intake and pocket money are significantly associated with the incidence of overweight among adolescents.

The Relationship Between Physical Activity and Fiber Intake with The Incidence of Overweight in Teenagers at SMA Negeri 1 Toroh

Kinanti Eka Farizma — 2025-04-30

Background: Overweight is a common issue among adolescents, with 9.5% of Indonesian teenagers classified as overweight in 2018. Low physical activity and inadequate fiber intake are significant contributing factors.
Objective: This study aimed to analyze the relationship between physical activity and fiber intake with overweight incidence among students at SMA Negeri 1 Toroh. Methods: This descriptive quantitative study used a cross-sectional design involving 90 students from grades X, XI, and XII, selected through proportionate stratified random sampling. Physical activity was measured using a 7x24 hour activity form, fiber intake was assessed with the Sq-FFQ, and overweight status was determined based on BMI calculations. Data were analyzed using the Spearman rank correlation test. Results: Most respondents had low physical activity (81.1%) and inadequate fiber intake (88.9%). A total of 41.1% were classified as overweight. The analysis showed no significant relationship between physical activity and overweight status (p = 0.543; rs = -0.065). However, fiber intake was significantly associated with overweight status (p = 0.033; rs = 0.225).
Conclusion: There is no significant association between physical activity and overweight status, but fiber intake is significantly related to overweight status among students at SMA Negeri 1 Toroh.

The Relationship Between Viral Load Levels and CD4+ Count with the Incidence of Opportunistic Infections in HIV/AIDS Patients at Ibnu Sina Hospital Makassar

Nur Ramahdani Daud — 2025-04-30

Background: HIV/AIDS is a global health problem that continues to be a challenge, especially in developing countries. One important aspect in the management of HIV/AIDS is the monitoring of viral load and CD4+ levels which serve as indicators of the patient's immune status. As the disease progresses, HIV/AIDS patients are at high risk of opportunistic infections that can worsen health conditions and shorten life expectancy. Objective: To determine the relationship between viral load and CD4+ levels in HIV/AIDS patients at Ibnu Sina Hospital. Method: Analytic observational research method with cross sectional approach, the research subjects were 10 subjects for viral load examination and 32 subjects for CD4+ examination. Results: The highest percentage of opportunistic infections was in oral candidiasis infection as many as 16 people (50%). The chi-square test showed a significant relationship between CD4+ levels and opportunistic infections in HIV/AIDS patients at Ibnu Sina Hospital Makassar with a p-value of 0.000 while for viral load could not be determined because secondary data were incomplete. Conclusion: There is a significant relationship between CD4+ levels with opportunistic infections in patients with HIV/AIDS at Ibnu Sina Hospital Makassar.

Characteristics of Tonsillopharyngitis Patients at Ibnu Sina Hospital Makassar from January 2023 to May 2024

Nur Suci Hikma — 2025-04-30

Background: Upper respiratory tract infections in children often lead to tonsillopharyngitis, which is caused by viruses (such as adenovirus and rhinovirus) or bacteria, especially Group A beta-hemolytic streptococcus (GABHS). Predisposing factors include poor oral hygiene, consumption of certain foods, and inadequate treatment. Objective: To determine the characteristics of age, gender, type of food, clinical manifestations, laboratory results, and management provided to tonsillopharyngitis patients at Ibnu Sina Hospital, Makassar. Results: Of the 86 tonsillopharyngitis patients recorded at Ibnu Sina Hospital, Makassar, between January 2023 and May 2024, the majority of patients were female (60.47%), aged 20-44 years (46.51%). Most patients consumed regular food (74.42%), and the most common clinical symptoms were fever (87.21%), sore throat (75.58%), and hyperemia of the tonsils and pharynx (100%). Laboratory examination showed leukocytosis in 53.49% of patients, and the most common antibiotic treatment was ceftriaxone (55.81%), followed by cefixime (25.58%) Conclusion: The study at Ibnu Sina Hospital, Makassar, concluded that the majority of tonsillopharyngitis patients are female, aged 20-44 years, and consumed regular food. Most patients experienced hyperemia of the tonsils and pharynx, leukocytosis, and were treated empirically with the antibiotic ceftriaxone based on clinical manifestations.

A Rare Case of Aplastic Anemia in Toxic Typhoid Fever

Mutiara Putri Novita — 2025-04-30

Background: Typhoid fever is a prevalent febrile illness in tropical regions where public health infrastructure and sanitation are limited. Pancytopenia resulting from hemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of typhoid fever that can be fatal without proper management. Objective: This case report aims to describe the clinical presentation, management, and outcome of a typhoid fever patient who developed pancytopenia, altered consciousness, and speech impairment. Methods: A comprehensive evaluation was conducted, including the patient’s medical history, physical examination, and various diagnostic tests. Laboratory workups revealed pancytopenia, positive TUBEX IgM for Salmonella, lymphadenopathy, and bone marrow aplasia. Differential diagnoses were considered and ruled out to confirm HLH as the underlying mechanism. Results: The patient responded positively to a regimen including ceftriaxone, steroids, and supportive care. The presence of pancytopenia in this typhoid fever case was linked to HLH. Conclusion: Early diagnosis and appropriate antibiotic therapy are critical for managing severe typhoid fever cases with complications such as HLH, helping prevent further complications and improving patient outcomes.

Comparison Of Self Directed Video And Simulation Methods On Hand Only CPR Skill

Nanda Putri Nur Azizah — 2025-04-30

Background: Current data shows that most cases of cardiac arrest occur outside the hospital, the mortality rate is almost 90%. Indonesia is in second place in the Asian continent after the Philippines with 317,000 people suffering from heart disease.Objective: The purpose of this study was to determine the effect of providing education and simulation of hand-only CPR on the level of skills through the self-Directed Video method and simulation in students of SMA Muhammadiyah Tambak-Banyumas.Method: The method used is Quasi Experimental with a pre-test and post-test control group design approach. The instrument used in this study was an observation sheet to measure the level of skills about hand-only CPR.Result: The results of the study showed the effect of differences in the comparison of the self-directed video and simulation methods on hand-only CPR skills with a posttest value of self-directed video 79.00 and simulation 70.00. Conclusion: This shows that training using the self-directed video method has a greater effect on hand-only CPR skills compared to the simulation method in students of SMA Muhammadiyah Tambak-Banyumas.

The Relationship Between Family Income and Mother's Education Level and the Incidence of Stunting in Toddlers (Aged 24–59 Months) in the Working Area of Purwodadi 1 Public Health Center

Lena Siswanto Putri — 2025-04-30

Background: Indonesia faces a triple burden of nutritional problems, including stunting, wasting, obesity, and micronutrient deficiencies such as anemia. Malnutrition occurs when individuals do not receive adequate intake of protein, energy, vitamins, and minerals, which can lead to stunting. Objective: This study aims to determine the relationship between family income and maternal education level with the incidence of stunting in toddlers in the working area of Purwodadi Community Health Center 1. Method: This observational study with a cross-sectional design involved 116 respondents. Data on family income and maternal education were collected through questionnaires and interviews, while toddler nutritional status was assessed through anthropometric measurements. Results: The majority of respondents had sufficient family income (54.3%), and most mothers had higher education levels (49.1%). Statistical analysis showed no significant relationship between family income and the incidence of stunting (p = 0.495). However, there was a significant relationship between maternal education level and the incidence of stunting (p = 0.006). Conclusion: Family income is not significantly associated with stunting incidence in toddlers, but maternal education level plays an important role in reducing stunting risk.

Relationship of Health Belief Model with Medication Adherence in RW 11, Bangetayu Kulon Village, Semarang

Mutiara Putri Novita — 2025-04-30

Background: Hypertension cases in Indonesia are on the rise annually. Identifying risk factors is crucial for prevention. Risk factors include non-modifiable elements and modifiable ones. The Health Belief Model (HBM) is widely used to understand patient adherence to antihypertensive treatment adherence. Objective: This study aimed to pinpoint key patient adherence to antihypertensive treatment in RW 11, Bangetayu Kulon Village, Semarang. Methods: A cross-sectional quantitative design. Independent variables included perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action, while the dependent variable was adherence to antihypertensive medication. The sample comprised 33 hypertensive patients selected through purposive sampling. Data collection involved a validated questionnaire administered via interviews. Statistical analysis was conducted using SPSS version 27, with chi-square for bivariate analyses, and logistic regression for multivariate analysis. Results: Bivariate analysis indicated that perceived susceptibility, benefits, severity, and self-efficacy significantly correlated with treatment adherence. Multivariate analysis revealed that perceived severity and self-efficacy were the strongest predictors of adherence, with self-efficacy being the most dominant factor (PR 33.67, 95% CI 2.937–385.989, p = 0.005). Conclusion: The Health Belief Model effectively predicts medication adherence among hypertensive patients. Interventions aimed at improving self-efficacy and emphasizing perceived severity of hypertension could enhance patient adherence to treatment.

Effectiveness of Clinical Pharmacy Interventions in Medication Adherence for Geriatric Patients: Literature Review

Febrian Dzikri Ilham — 2025-04-30

Background: Medication adherence in geriatric patients is a major challenge as polypharmacy increases the risk of drug-related problems (DRPs). The role of clinical pharmacy is important in addressing these issues through evidence-based approaches. Objective: To review the effectiveness of various clinical pharmacy interventions in improving medication adherence in geriatric patients. Methods: This article used a systematic review of 13 literature selected from 934 articles based on inclusion criteria in the last 10 years, using PubMed and Google Scholar databases. The focus of the analysis included education, monitoring, and the use of tools such as pill cards and medication reminder charts. Results: Clinical pharmacy interventions, such as the use of Beers and STOPP/START criteria, counseling, and educational programs using tools, were shown to improve adherence in geriatric patients. Programs such as pill boxes increased adherence by 83.33%. However, some tools such as medication reminder charts had limited effectiveness. Conclusion: A collaborative approach, including patient and family education, monitoring, and clinical criteria-based therapy adjustments, is essential to improve medication adherence in geriatric patients, which directly improves their quality of life.

Analysis of complications in type 2 diabetes mellitus patients at Ibnu Sina Hospital in 2023

Dewi Sri Handayani — 2025-04-30

Background: Type 2 Diabetes Mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia due to decreased insulin secretion or insulin resistance. T2DM can lead to microvascular complications, such as neuropathy, nephropathy, and retinopathy, as well as macrovascular complications, including heart disease, stroke, and peripheral vascular disease. Objective: This study aimed to determine the relationship between age, gender, HbA1c levels, and the duration of T2DM with the complications experienced by T2DM patients at Ibnu Sina Hospital Makassar. Method: This was a descriptive observational study with a cross-sectional design involving 40 T2DM patients. Data were collected using secondary patient records. Results: The most common complication found was diabetic neuropathy, affecting 19 patients (47.5%). Statistical analysis using the chi-square test showed a significant relationship between age and complications (p = 0.002) and between HbA1c levels and complications (p = 0.004). Gender showed no significant relationship with complications. The duration of T2DM could not be analyzed due to incomplete data. Conclusion: Age and HbA1c levels are significantly associated with the occurrence of complications in T2DM patients at Ibnu Sina Hospital in 2023. Regular monitoring and strict glycemic control are essential to minimize the risk of complications.

The Effect of Acupressure on Reducing the Intensity of Primary Dysmenorrhea Among Nursing Students at Tadulako University in Palu City

Andi Mariani — 2025-04-30

Background: Dysmenorrhea is a common condition characterized by menstrual pain experienced by adolescent girls, which can significantly affect their quality of life. Acupressure therapy is considered effective in alleviating pain intensity. This study aims to evaluate the impact of acupressure on reducing dysmenorrhea intensity among students of Akper Untad in Palu City. Objective: This research aims to analyze the effect of acupressure therapy on primary dysmenorrhea intensity in female students. Methods: This study employed a quasi-experimental design with a pre-test and post-test approach. A total of 47 female students participated as respondents. Pain intensity was measured using a 0-10 scale before and after acupressure treatment. Data analysis was performed using the Paired T Test. Results: The findings indicate that the average dysmenorrhea intensity before treatment was 7.77, which decreased to 3.00 after treatment. Statistical analysis revealed a p-value of 0.000, indicating a significant effect of acupressure on reducing dysmenorrhea intensity. Conclusion: Acupressure therapy is effective in reducing primary dysmenorrhea intensity among female students at Akper Untad in Palu City. This study provides evidence that acupressure can be a valuable non-pharmacological intervention for managing dysmenorrhea.

The Relationship of Emotional Intelligence with the Quality of Life of Diabetes Mellitus Patients in West Purwokerto Health Center

Catur Resti Oktaviani — 2025-04-30

Background: The quality of life of Diabetes Mellitus (DM) patients is an essential aspect that must be considered throughout the treatment process. Psychological factors significantly influence the quality of life and can be better managed if patients possess good emotional intelligence. Objective: This study aimed to determine the relationship between emotional intelligence and the quality of life of DM patients at the Purwokerto Barat Health Center. Methods: This quantitative study employed a correlational analytic design with a cross-sectional approach. A total of 115 DM patients were selected using proportionate stratified random sampling. Data were collected using the Emotional Intelligence Scale (EIS) and the Diabetes Quality of Life (DQOL) questionnaire. Data analysis was performed using the chi-square test. Results: The majority of DM patients were elderly (81.7%), female (65.2%), had a basic education level (51.3%), had an income below the regional minimum wage (90.4%), had an average disease duration of 77.41 months (6.2 years), and had no other complications (71.3%). Most patients had good emotional intelligence (92.2%) and good quality of life (93%). Conclusion: There is a significant relationship between emotional intelligence and the quality of life of DM patients at the Purwokerto Barat Health Center.

Analysis of the Side Effects of Long-Term Proton Pump Inhibitor (PPI) Use in Patients with Gastroesophageal Reflux Disease (GERD)

Zahra Nurhafidah — 2025-04-30

Background: Proton Pump Inhibitors (PPIs) are widely prescribed to manage gastrointestinal disorders, especially gastroesophageal reflux disease (GERD). However, long-term PPI use has been linked to serious side effects and potential complications. Objective: This study aims to analyze the side effects associated with prolonged PPI use in patients with GERD. Methods: A systematic review was conducted using Google Scholar and PubMed databases with relevant keywords. Article selection was carried out carefully based on inclusion and exclusion criteria to ensure the quality and relevance of the data. Additionally, a bibliometric analysis was performed to explore research trends related to the long-term use of PPIs. Results: The review found that prolonged PPI use is associated with various adverse effects, including an increased risk of dementia, progression of chronic kidney disease (CKD), gastric cancer, bone fractures, Frailty Syndrome, hypomagnesemia, iron deficiency, vitamin B12 deficiency, myocardial infarction, and esophageal cancer. The bibliometric analysis also indicated a growing trend of research focusing on the safety and complications of long-term PPI use. Conclusion: Long-term PPI therapy carries significant risks. Therefore, regular monitoring and appropriate discontinuation strategies are essential when using PPIs over extended periods to minimize potential harm.