Jurnal Kedokteran (Unram Medical Journal)
Jurnal Kedokteran (Unram Medical Journal) publishes original research articles, review papers, and case studies across a broad range of topics relevant to medicine and health sciences. Focus and Scope The journal welcomes contributions in, but not limited to, the following areas: Biomedical Sciences Clinical Sciences Medical Education Public Health Allergy and Immunology Psychology Cancer and Stem Cells Dentistry Medical Technology Pharmacology Jurnal Kedokteran (Unram Medical Journal) is dedicated to advancing clinical practice, biomedical research, public health, and health policy with a particular focus on Indonesia and the broader Southeast Asian region. The journal aims to improve health outcomes both regionally and globally by supporting high-quality, context-relevant scientific research. We are committed to enhancing the visibility and impact of national and regional health research, including from resource-limited and rural settings. The journal is managed by an experienced editorial team based at the Faculty of Medicine and Health Sciences, University of Mataram, working in collaboration with national and international experts across the health sciences. Publication Schedule and Journal Management Jurnal Kedokteran (Unram Medical Journal) is published quarterly, with issues released in March, June, September, and December. Starting from Volume 12, Issue 1 (2023), the journal's management and publication platform transitioned from https://jku.unram.ac.id/ to its current site at https://journal.unram.ac.id/. Online ISSN: 2527-7154 Print ISSN: 2301-5977
<p style="box-sizing: border-box; line-height: 1.785rem; margin: 1.43rem 0px; color: rgba(0, 0, 0, 0.87); font-family: tahoma, geneva, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Authors who publish with Unram Medical Journal, agree to the following terms: <ol style="box-sizing: border-box; color: rgba(0, 0, 0, 0.87); font-family: tahoma, geneva, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC-BY License). This license allows authors to use all articles, data sets, graphics, and appendices in data mining applications, search engines, websites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in University of Mataram's Journal of Medicine. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). This journal is open access journal which means that all content is freely available without charge to users or / institution. Users are allowed to read, download, copy, distribute, print, search, or link to full text articles in this journal without asking prior permission from the publisher or author.
Narkosis Nitrogen : Penurunan Kesadaran Pada Penyelam
Abstract: Narkosis nitrogen adalah gangguan neurologis reversibel yang terjadi akibat peningkatan tekanan parsial nitrogen selama penyelaman dalam dengan scuba. Meskipun nitrogen merupakan gas inert yang menyusun sekitar 79% udara atmosfer, pada tekanan tinggi gas ini mudah larut ke dalam jaringan tubuh, terutama jaringan saraf yang kaya lemak, sesuai dengan hukum kelarutan gas. Kondisi ini dapat menyebabkan gangguan fungsi kognitif dan motorik, seperti euforia, penurunan kemampuan berpikir, reaksi lambat, hingga halusinasi atau hilangnya kesadaran pada kedalaman ekstrem. Tujuan tinjauan ini adalah untuk memberikan gambaran komprehensif mengenai mekanisme kerja, faktor risiko, manifestasi klinis, dan strategi pencegahan narkosis nitrogen. Pencegahan mencakup pembatasan kedalaman penyelaman, serta peningkatan pelatihan dan kesadaran penyelam. Upaya edukasi dan infrastruktur keselamatan yang memadai sangat penting untuk menurunkan risiko dan dampak fatal akibat narkosis nitrogen.
Hak Cipta (c) 2025 radi ansary https://creativecommons.org/licenses/by/4.0
Neurobiological, Psychosocial, and Digital Behavior Perspectives of Intermittent Explosive Disorder in Children and Adolescents: A Literature Review
Intermittent Explosive Disorder (IED) is a psychological disorder characterized by repetitive and disproportionate outbursts of anger, accompanied by verbal and physical aggression. This disorder sometimes appears in children and adolescents with gadget addiction accompanied with emotional disturbances, and negatively affects long-term emotional, social, and neurobehavioral aspect. The etiology of IED is multifactorial, including biological factors such as dysregulation of the serotonin system, dysfunction of the prefrontal-amygdala circuit, as well as genetic predisposition, which interact with environmental factors such as negative parenting, childhood trauma, and socioeconomic stress. The diagnosis of IED according to the DSM-5 emphasizes the presence of spontaneous impulsive aggressive outbursts, does not correspond to the level of provocation, and interferes with the functioning of daily life. Research also shows a significant correlation between gadget addiction and increased aggressive behavior in children and adolescents, especially when accompanied by low ego-resilience and less supportive parenting. The treatment of IEDs requires a multidisciplinary approach, with pharmacological therapies such as fluoxetine and anticonvulsants, as well as psychological therapies such as Cognitive Behavioral Therapy (CBT) proving to be effective. An in-depth understanding of the neuropsychological factors and mechanisms of IEDs is essential in designing holistic and evidence-based prevention and treatment strategies.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Aurellia Wongso Prawiro, Hadil Hudati Awwari Rameci, I Gusti Ketut Artha Jaya Kusuma, Nadine Aisyah Sultan Firdaus https://creativecommons.org/licenses/by/4.0
Comprehensive Study of Internet Gaming Disorder in Children and Adolescents: A Literature Review
Abstract: Internet Gaming Disorder (IGD) is excessive use of the internet to play games so that it interferes daily life function. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of IGD can be made if 5 or more of the following 9 symptomatic criteria are found: (1) preoccupation; (2) withdrawal symptoms; (3) tolerance; (4) control failure; (5) loss of interest in other activities; (6) playing games without considering the risks; (7) lying about the time spent playing; (8) using online games as an escape; and (9) daily functional impairment. Some risk factors for IGD include gender, community membership, playtime, and presence in offline community. IGD lead mental health problems such as anxiety disorders and depression. In addition, IGD also affect the behavior of children and adolescents, such as school refusal, aggressive behavior, and even suicide. IGD prevention and management requires a multidisciplinary approach. Collaboration of various parties is needed to handle IGD cases, including family, school, doctors, psychologists and therapists.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Hasna Tazkia Aghni, Panji Sena Ramadhan, Aisah Aliyyu https://creativecommons.org/licenses/by/4.0
Nomophobia pada Anak dan Remaja sebagai Tantangan Psikososial di Era Digital : Suatu Tinjauan Literatur
Perkembangan teknologi yang semakin canggih, khususnya dalam penggunaan gadget atau gawai, telah membawa dampak signifikan terhadap kehidupan sosial di era modern, salah satunya adiksi gawai pada anak dan remaja. Penggunaan berlebihan dari gawai dapat menimbulkan masalah psikologis, salah satunya adalah nomophobia (no-mobile-phone phobia). Studi ini merupakan tinjauan literatur sistematis dengan mengumpulkan pustaka dari beberapa database terkemuka mengenai fenomena nomophobia. Ketakutan akan kehilangan kontak dengan gawai yang disebut nomophobia, dipengaruhi oleh berbagai faktor risiko terkait kepribadian dan temperamen individu. Selain itu penggunaan gawai yang berlebihan, kecemasan tinggi, dan keterampilan emosional yang rendah juga berkontribusi pada peningkatan nomophobia. Nomophobia berdampak signifikan terhadap kondisi psikologis, fisik, sosial, dan akademik anak dan remaja, serta berhubungan dengan meningkatnya stres, kesepian, gangguan tidur, serta disfungsi regulasi emosi. Penanganan nomophobia memerlukan pendekatan multidimensi melalui edukasi, intervensi psikologis, serta upaya meningkatkan interaksi sosial langsung antara anak dan remaja dengan orang tuanya untuk membentuk pola penggunaan teknologi yang lebih sehat.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Alisha Chaerani Zubaedi, Romy Healthy Mikailla, Baiq Remtaya Mikailla https://creativecommons.org/licenses/by/4.0
Transverse Myelitis pada Anak Perempuan Usia 11 tahun: Sebuah Laporan Kasus
Abstract: Transverse myelitis (TM) is a rare inflammatory disease that causes injury to the spinal cord resulting in clinical manifestations of weakness, sensory changes, and autonomic dysfunction.This disease can attack all age groups, but the highest age range is 10-19 years and 30-39 years.This disease is acute, and shows dominant clinical neurological abnormalities.The cause of this condition is still unknown, and the diagnosis of TM can be assessed from clinical examination, neurological examination, radiology and laboratory. Case presentation: An 11-year-old female child patient came to the West Nusa Tenggara Provincial Hospital with complaints of weakness of the limbs felt since 4 days before admission accompanied by inability to urinate, abdominal bloating and pain. The patient then underwent further examination and the patient was diagnosed with transverse myelitis, and received drug management and medical rehabilitation Conclusion: Based on this case, the patient experienced sudden weakness in all four limbs which was idiopathic and diagnosed as Transverse myelitis. Although this condition is rare, it requires immediate management and appropriate rehabilitation to maximize the patient's motor, sensory and autonomic functions, to prevent permanent disability.
Hak Cipta (c) 2025 Rika Fitria, Tristina Wardani https://creativecommons.org/licenses/by/4.0
Peran Fast Food Terhadap Jerawat : Tinjauan Literatur
Acne vulgaris was a prevalent dermatological condition commonly observed in adolescents and young adults. This condition can significantly impact one's quality of life and has psychological effects, including a decrease in self-confidence. One of the contributing factors to the development of acne was dietary habits, particularly the consumption of fast food. Fast foods, such as pizza, burgers, fried chicken, french fries, and ice cream, are high in saturated fats, sugars, salts, and preservatives, which may induce inflammation and exacerbate skin conditions. Furthermore, lifestyle factors, such as inadequate sleep, stress, and the use of inappropriate skincare products, may aggravate the condition. Therefore, adopting a balanced diet and regulating fast food intake emerges as an effective strategy to mitigate the risk of acne in adolescent and young adults.
Hak Cipta (c) 2025 saki yora, Fikri Ash Shadiq Ramadhani, Tamara Jevani, LH. Putri Puspa Sari, Muhammad Fiqry Hakim, Vernonia Yora Saki https://creativecommons.org/licenses/by/4.0
Review Artikel : Pemanfaatan Sumber Alami Asam Linoleat dalam Formulasi Sediaan Kosmetik
Linoleic acid is an essential fatty acid that cannot be synthesized by the human body and is abundantly found in various natural sources such as candlenut, sunflower seeds, almonds, and chia seeds. This compound is known to possess significant biological activities, including anti-inflammatory, antioxidant, anti-aging properties, as well as supporting skin regeneration and hair growth. This review aims to explore the potential of linoleic acid as an active ingredient in the formulation of body care and skincare products. Literature searches were conducted through Google Scholar, PubMed, and ScienceDirect using relevant keywords, with inclusion criteria encompassing the chemical properties, pharmacological benefits, and cosmetic applications of linoleic acid. The results of the review indicate that linoleic acid has been utilized in various dosage forms, including hair tonics, anti-acne creams, hand body lotions, lip balms, emulgels, facial serums, masks, and hair emulsions to support the hair growth process. Its effectiveness is highly influenced by the concentration of the active ingredient and the formulation type used. This review supports the utilization of linoleic acid as a promising and sustainable natural active ingredient in the modern cosmetic industry. Further research is needed to optimize formulations and comprehensively evaluate the safety of these preparations.
Hak Cipta (c) 2025 Wahyu Haryanto, Intan Alfizahara, Abdul Hamid Muktiali, Bq Aisya Adinda, Putri Syerin Salsabila, Irma Hapinatunnisa, Baiq Mia Ramadhani Rahadian, Rahmah Dara Ayunda https://creativecommons.org/licenses/by/4.0
Myasthenic Crisis in Thymoma : A Clinical Case Report
Thymoma is an anterior mediastinal tumor commonly associated with paraneoplastic syndromes, notably myasthenia gravis. This case report describes a 40-year-old man presenting with progressive dysphagia, cranial and limb muscle weakness, and severe dyspnea. Thoracic imaging revealed an anterior mediastinal mass suspected to be thymoma. The patient developed a myasthenic crisis requiring intubation and mechanical ventilation. Treatment included intravenous anticholinesterase, intravenous immunoglobulin, and thymectomy. Prompt radiological assessment and clinical diagnosis are crucial in managing such cases to prevent life-threatening respiratory complications.
Hak Cipta (c) 2025 Rab sanjani, Novia Andansari Putri, Moulid Hidayat, Triana Dyah Cahyawati, Stevia Ariella Pasande https://creativecommons.org/licenses/by/4.0
Radiologic Multimodality Approach in a Case of Pancoast Tumor with Bone Lytic Lesions
Lung cancer was the second most common malignancy and the leading cause of cancer-related mortality worldwide in 2020, accounting for 1.8 million deaths. Delayed diagnosis often leads to advanced-stage presentation and poor long-term survival. Pancoast tumors, a rare subset of superior sulcus lung cancers, may present with atypical neurologic signs. We report a 55-year-old man with a 6-month history of right chest pain and progressive dyspnea. Physical examination was unremarkable apart from mild right eyelid ptosis without a full Horner’s syndrome. Chest X-ray and contrast-enhanced CT demonstrated an apical mass in the right upper lobe with lytic lesions of the first and second ribs. Bronchoscopic biopsy confirmed non–small cell lung carcinoma consistent with a Pancoast tumor. The patient underwent surgical resection of the apical mass with regional lymphadenectomy, followed by platinum-based chemotherapy. Postoperative imaging revealed residual disease, prompting additional chemotherapy cycles. At six-month follow-up, the patient experienced marked pain relief and partial resolution of ptosis, with no new metastatic foci on imaging. High clinical suspicion and a multidisciplinary radiologic and histopathologic approach are essential for early diagnosis and optimal management of Pancoast tumors.
Hak Cipta (c) 2025 Rab sanjani, Prima Belia Fathana, Novia Andansari Putri, I Bona Manik, Triana Dyah Cahyawati https://creativecommons.org/licenses/by/4.0
Spinal Cord Stimulation for Chronic Pain: A Literature Review
The high prevalence and significant impact of chronic pain on patients' quality of life is important as a major public health issue. The condition is particularly concerning due to the high proportion of chronic pain cases that are refractory to conventional treatment. Spinal cord stimulation (SCS) has emerged as an effective neuromodulation technique for patients with refractory chronic pain, demonstrating superior outcomes compared to pharmacological treatments, including in reducing opioid consumption. Patient selection is crucial for optimizing outcomes following SCS and various factors, including substance abuse, smoking, opioid use, and psychological distress, may adversely affect the success of the treatment. These complications can be classified into device-associated and biologically mediated complications. Despite these recognized risks, neuromodulation through SCS is considered a safe intervention, with a low risk of mortality.
Hak Cipta (c) 2025 Kadek Adi Sagita Reka Baya, Muhammad Arismunandar https://creativecommons.org/licenses/by/4.0
Prevalence of Wrist Tendinitis Among Computer Users, Office Workers, and Manual Laborers in Egypt
Tendinitis is a common musculoskeletal disorder that affects individuals engaged in repetitive tasks, including computer users, office workers, and manual laborers. Understanding the relationship between occupational activities and tendinitis can help develop preventive strategies. The study design is a retrospective cohort study, which enables us to examine the prevalence of tendinitis among different occupational groups by analyzing medical records of diagnosed cases and assessing their work histories. A random sample of 371 participants. We reviewed their occupational history and assessed potential associations between work-related activities and the risk of tendinitis. Statistical analysis, including incidence rate calculations and logistic regression models, was used to determine the association between job type and tendinitis risk. we found that People who frequently perform hand-intensive writing or typing tasks are likely to report a higher incidence of repetitive hand pain due to overuse, strain injuries, and tendinitis. Among the participants, who were all engaged in repetitive hand-intensive tasks, 18% were diagnosed with tendinitis. The incidence was highest among office workers, indicating a significantly higher risk compared to other job types. The ergonomic conditions were also found to influence the likelihood of developing tendinitis. Jobs that require repetitive movements and sustained postures also increase the risk of musculoskeletal disorders. Therefore, it is essential to transition from paper-based tasks to digital alternatives and incorporate modern technology in the workplace. Implementing ergonomic interventions, modifying the nature of office and manual work, and integrating technology and artificial intelligence into workplace tasks will help reduce the incidence of tendinitis.
Hak Cipta (c) 2025 Nour Hatem, Reham Mahmoud, Najah Elmounedi, Abdelrahman Mahmoud https://creativecommons.org/licenses/by/4.0
Correlation Between Blood Glucose and Hemodialysis Adequacy in Routine Hemodialysis Patients at West Nusa Tenggara General Hospital
Progressive kidney function decline to a GFR < 15 mL/min/1.73 m² is defined as stage 5 chronic kidney disease (end stage) or end-stage renal failure. In this condition, patients require renal replacement therapy, such as hemodialysis. Effective dialysis indicates a longer life expectancy and lower mortality rates. The effectiveness of the hemodialysis process or hemodialysis adequacy is measured by the Kt/V value, which reflects the urea clearance during each hemodialysis session. Blood sugar levels before hemodialysis are one of the predictors of hemodialysis adequacy. This study used an analytic observational method on 34 samples that met the inclusion and exclusion criteria to find correlation between blood glucose and hemodialysis adequacy in routine hemodialysis patients at West Nusa Tenggara General Hospital. Data collection was carried out at the HD Unit 2 of the Provincial General Hospital of West Nusa Tenggara. In this study, the average age of the respondents was 50 years, consisting of 64.7% male and 35.3% female. The results of the correlation analysis using the Pearson test showed no significant relationship between blood glucose levels and hemodialysis adequacy, with p=0,478 and r=-0,126. However, the Fisher exact test revealed a statistically significant relationship between gender and hemodialysis adequacy, with p<0,001. In conclusion, blood glucose levels were not associated with hemodialysis adequacy, while gender showed a statistically significant association with hemodialysis adequacy.
Hak Cipta (c) 2025 Carolina Janicca Winda Manafe, I Gede Yasa Asmara, I Gede Supartha https://creativecommons.org/licenses/by/4.0
Correlation between Reticulocyte Hemoglobin Equivalent (Ret-HE) and Iron Profile in Routine Hemodialysis Patients at West Nusa Tenggara General Hospital
Abstract: Chronic kidney disease (CKD) is a dysfunction occurs in the kidneys that causes the body's inability to maintain homeostasis through controlling blood volume/composition and kidney replacement therapy is needed, one of which is hemodialysis. Hemodialysis process and CKD itself can cause complications, especially iron deficiency anemia (IDA). This research aim to find out the correlation between standard iron deficiency anemia diagnostic examinations (serum iron, transferrin saturation, TIBC) and Ret-HE. This study uses an analytical observation method on 50 research subjects fulfill the research criteria. Data collection was carried out at the Hemodialysis Unit of the NTB Provincial Hospital using consecutive sampling method. The study result showed 42 subject (84%) have normal Ret-HE (≥ 29 pg). There was a statistically significant correlation between Ret-HE and iron profile in routine hemodialysis patients (P < 0.05) with weak correlation using Pearson correlation test (r = 0,2-0,399). Keywords: CKD, iron deficiency anemia, iron profile, Ret-HE, routine hemodialysis, serum iron, stage V, TIBC, transferrin saturation.
Hak Cipta (c) 2025 Atina Rizki Putri, I Gede Yasa Asmara, Triana Dyah Cahyawati https://creativecommons.org/licenses/by/4.0
A Case Report of Mediastinal Tumor: Limfoma Non-Hodgkin
Mediastinal tumors in adults are predominantly located in the anterior mediastinum, commonly presenting as lymphoma or thymoma. Non-Hodgkin lymphoma (NHL) is a group of malignant neoplasms originating from lymphoid tissues, primarily the lymph nodes. These lymphomas are not confined to the anterior mediastinum but may also occur in the middle and posterior mediastinal compartments. The average age of onset for this disease ranges between 28 and 35 years. Blood tests, radiological imaging, and histopathological examination are essential for establishing a definitive diagnosis. The treatment approach is determined by the type, stage, histopathological characteristics, and presenting symptoms. A 39-year-old female presented to the surgical oncology clinic with an MSCT scan of the head and neck, revealing a solid anterior mediastinal mass measuring 68 mm (suspected lymphoma). The patient reported an initial complaint of headache accompanied by a neck lump. Physical examination showed normal vital signs but revealed multiple lymphadenopathies in the bilateral submandibular, cervical, and supraclavicular regions. Blood tests and contrast-enhanced thoracic MRI were performed, with MRI findings indicating an anterior mediastinal mass infiltrating the ascending aorta, suggestive of lymphoma. A biopsy confirmed the diagnosis of Non-Hodgkin lymphoma, specifically large B-cell lymphoma, through immunohistochemical analysis. Chemotherapy was recommended as the primary treatment. The signs and symptoms of mediastinal tumors vary widely and are often nonspecific. Asymptomatic masses are usually benign, whereas symptomatic patients often present with underlying malignancies. The tumor’s location is crucial for establishing clinical suspicion and planning biopsies and surgical procedures. The staging of NHL follows the Lugano classification, with chest, abdominal, and pelvic CT scans often required for imaging. Management of lymphoma typically involves chemotherapy alone or in combination with radiotherapy. The location of a mediastinal tumor plays a vital role in narrowing the differential diagnosis and planning biopsies and surgical procedures. Non-Hodgkin lymphoma is not confined to the anterior mediastinum and may occur in other compartments. Radiological and histopathological evaluations are essential for confirming the diagnosis and guiding treatment decisions
Hak Cipta (c) 2025 Unram Medical Journal
Terapi Noninvasive Brain Stimulation rTMS (Repetitive Transmagnetic Stimulation) Pada Pasien Penyakit Parkinson
Abstrak: Repetitive transmagnetic stimulation (rTMS) merupakan salah satu modalitas terapi stimulasi otak yang berkembang paling pesat sebagai terapi komplementer pemulihan fungsi neurologis termasuk penyakit degeneratif seperti Parkinson. Studi menunjukan stimulasi frekuensi tinggi rTMS di korteks motorik primer (M1), dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA) dan serebelum memberikan perbaikan fungsi motorik, kognitif dan gejala non motorik seperti depresi, gangguan tidur. Kata kunci: parkinson; motorik; kognitif; non motor; repetitive transmagnetic stimulation Abstract: Repetitive transmagnetic stimulation (rTMS) is one of the fastest growing brain stimulation therapy modalities as a complementary therapy for neurological function recovery including degenerative diseases such as Parkinson's. Studies show that high-frequency rTMS stimulation in the primary motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), supplementary motor area (SMA) and cerebellum provides improvements in motor function, cognitive and non-motor symptoms such as depression, sleep disorders. Keywords: parkinson; motor; cognitive, non-motor, repetitive transmagnetic stimulation
repetitive transcranial magnetic stimulation (rTMS)
Hak Cipta (c) 2025 Ni Nyoman Ayu Susilawati, Herpan Syafii Harahap, Jumraini Tammasse https://creativecommons.org/licenses/by/4.0
Obstructive Sleep Apnea (OSA) adalah gangguan tidur yang ditandai dengan episode berulang sumbatan pada saluran napas bagian atas saat tidur, yang menyebabkan gangguan pola tidur dan desaturasi oksigen. OSA pada anak-anak dapat menyebabkan efek samping yang penting pada perkembangan fisik dan kognitif, seperti morbiditas kardiovaskular, gangguan perilaku, serta penampilan di sekolah yang kurang baik. Tujuan dari tinjauan ini adalah untuk memberikan informasi terkini mengenai OSA pada anak-anak, epidemiologi, patofisiologi, manifestasi klinis, diagnosis, dan terapi. Literatur menunjukkan bahwa OSA terjadi pada 1-5% anak-anak, lebih sering terjadi pada anak-anak dengan dismorfia wajah kranial, obesitas, dan gangguan neuromuskular. Diagnosis OSA pada anak-anak terkadang sulit dilakukan, namun memerlukan penilaian multidisiplin dari riwayat medis untuk tidur, pemeriksaan fisik, dan polisomnografi. Modalitas pengobatan terdiri dari pembedahan dan medikamentosa. Review ini menarik perhatian pada nilai deteksi dini dan pengobatan OSA pada anak-anak untuk menghindari gejala sisa jangka panjang dan meningkatkan kualitas hidup.
Hak Cipta (c) 2025 Dita Mutia, Rifdah Amalia, Bayu Putra Wibowo, Nimas Resti, Muhammad Aulia Hikmah Romadoni https://creativecommons.org/licenses/by/4.0
Health profile of traditional diving fishermen in Guaeria Village West Halmahera
Fishermen are at risk of facing health issues such as eye and hearing disorders, unhealthy habits, and additional risks for traditional divers like ear barotrauma, thus requiring a health profile for a specialized approach to improving their health, which is different from the general population. This study aims to identify the health profile of traditional diving fishermen in Guaeria Village, West Halmahera, including factors that affect their health such as age, education, blood pressure, and other related health conditions. The design of this study is a descriptive cross-sectional with a total sample of 40 fishermen. The research results show that the majority of respondents were over 40 years old (75%) and had the highest level of education at the elementary school level (52.5%). Most of them experienced stage II hypertension (42.5%) and had a history of ear barotrauma (100%) with 45% of respondents experiencing tympanic membrane perforation. The vision condition of the respondents was mostly normal, but there were refractive errors and pterygium in some respondents. The fishermen's diving activities are quite intensive, with most of them diving at depths of more than 10 meters. This study concludes that traditional diving fishermen in Guaeria Village face health risks related to diving activities, such as ear barotrauma and hypertension, as well as vision conditions that require further attention.
An Approach of Trigeminal Neuralgia for General Practitioner: A Literature Review
Abstract: Trigeminal neuralgia is a chronic neuropathic pain of the face caused by the dysfunction of the fifth cranial nerve (trigeminal). The characteristics of the pain are described as severe pain resembling an electric shock lasting from a second to minutes, mostly unilateral, with allodynia at the pain location corresponding to the trigeminal nerve innervation. The exact mechanism causing trigeminal neuralgia is still unknown. An appropriate diagnostic and management approach to trigeminal neuralgia is crucial for improving the quality of life of patients. Methods: This literature review uses various types of sources, such as articles in scientific journals and guidelines from government and related institutions. Article searches were conducted on online journal publication portals such as the National Center of Biotechnology Information (NCBI) (ncbi.nlm.nih.gov). Results: The diagnosis of trigeminal neuralgia is established based on clinical history and physical examination, particularly a thorough neurological examination. Supportive examinations such as MRI/angiography can be used to rule out differential diagnoses and determine the location of trigeminal nerve damage. The recommended pharmacological management for trigeminal neuralgia is the anticonvulsant medication carbamazepine. Other alternative therapies that can be performed include neuroleptic block therapy and surgery. Conclusion: An appropriate diagnostic and management approach in cases of trigeminal neuralgia can improve the quality of life for patients.
Moluskum Kontagiosum Pada Anak Dengan Penyakit Thalassemia
Pendahuluan: Moluskum kontagiosum adalah infeksi virus pada kulit yang disebabkan oleh poxvirus dan menginfeksi anak usia sekolah, orang dewasa, dan pasien dengan imunokompromais. Transmisinya dapat melalui kontak kulit langsung, otoinokulasi, atau melalui benda yang terkontaminasi, misalnya handuk, baju, dan kolam renang dengan masa inkubasi 2-8 minggu. Kasus : Seorang anak laki-laki berusia 16 tahun dengan keluhan timbul bentol pada tangan yang tidak gatal maupun nyeri. Manifestasi kulitnya berupa lesi papul multipel berwarna putih, berbentuk kubah dengan ukuran lenticular, terdapat lekukan pada tengah papul, berbatas tegas, susunan berkelompok dengan penyebaran bilateral dibagian ekstremitas atas. Penatalaksanaan pada kasus dengan pemberian terapi topikal berupa salep asam salisilat 10% 2x/hari pada daerah lesi dan pasien direkomendasikan untuk rutin memecahkan lesinya. Kesimpulan: Usia sekolah dan kondisi imunokompromais merupakan faktor resiko yang dapat menyebabkan lesi moluskum kontagiosum cenderung bertahan lebih lama dengan jumlah lesi yang banyak.
Hak Cipta (c) 2025 Muhammad Anthony Lalu, Dedianto Hidajat https://creativecommons.org/licenses/by/4.0
ProstaCard: Developing Novel Interactive Tools for Patient Education and Decision-Making in Benign Prostatic Hyperplasia Management
Introduction: Benign Prostatic Hyperplasia (BPH) presents significant challenges for patient comprehension and decision-making due to its intricate nature and the multitude of available treatment options. Educational interventions are increasingly acknowledged as effective means of addressing these challenges. This study focused on the development and assessment of ‘ProstaCard’, an interactive educational tool designed to enhance patient understanding of BPH and support informed decision-making in its management. Methods: The development of the tool involved a collaborative effort among urologists, game designers, and educators. The prototype was iteratively refined through an analysis of patient needs and feedback from healthcare professionals. To evaluate the tool’s efficacy in enhancing patient knowledge and decision-making skills, a preliminary pre-test/post-test design was utilized. Both quantitative and qualitative data were gathered from patients and healthcare providers to assess the tool's impact. Discussion: The results demonstrate that ‘ProstaCard’ substantially enhanced patients' understanding of BPH and their capacity to make informed decisions regarding treatment options. The tool successfully engaged participants in the educational process and facilitated dialogue between patients and healthcare providers. Nevertheless, additional research is required to investigate the long-term impact of the tool on patient outcomes and its potential integration into clinical practice. ‘ProstaCard’ shows potential as a novel educational tool for enhancing patient understanding and decision-making in the management of BPH. By offering an interactive and informative platform, the tool enables patients to engage more actively in their care, which may lead to improved treatment outcomes. Ongoing development and assessment of the tool are crucial to maximizing its effectiveness and applicability in clinical environments.
Hematoma Penoskrotal Masif Pasca Hernioplasti Terbuka akibat Penggunaan Jarum Cutting Edge
Operasi perbaikan hernia inguinalis merupakan prosedur operasi yang paling sering dilakukan di seluruh dunia. Hematoma inguinal pasca operasi perbaikan hernia inguinalis merupakan komplikasi yang jarang terjadi. Pasien laki-laki usia 51 tahun didiagnosis sebagai hernia inguinalis lateralis sinistra reponibilis, pada pasien dilakukan hernioplasti menggunakan polipropilen mesh yang difiksasi dengan benang polipropilen 2-0 dan jarum cutting edge. Delapan belas jam pasca operasi pasien mengalami hematoma yang meluas di kedua skrotum hingga penis. Dilakukan evakuasi hematoma dan pemasangan drain vakum di inguinal dan drain penrose pada kedua skrotum yang diikuti dengan perbaikan klinis. Resiko perdarahan pada kasus hematoma penoskrotal masif pasca hernioplasti dapat berasal dari faktor-faktor yang ditemukan sebelum operasi, selama dan setelah operasi. Terapi dengan evakuasi hematoma dan pemasangan drain memiliki prognosis yang baik.
BRCA1 Expression Profile in Breast Cancer Patients in West Nusa Tenggara
Abstract: Breast cancer is still the highest case in Indonesia. The mortality ratio: incidence of breast cancer in various countries can be influenced by differences in the clinical and biological profiles of tumors like BRCA1 expression status. In addition, several parameters that can be reviewed based on breast cancer incidence such as age and domicile can also be associated with BRCA1 expression. BRCA1 is tumor suppressor gene. This protein works as a cell cycle regulator. Germline mutations of BRCA1 are the main cause of inherited breast cancer. Breast cancer with BRCA1 mutations only contributes 20-40% to breast cancer incidence, but this condition have adverse tumor characteristics with poor prognosis. The aim of this study is to determine the BRCA1 expression profile in breast cancer patients in West Nusa Tenggara based on age and domicile status. A 50 paraffin blocks of breast cancer tissue were examined for BRCA1 expression status using immunohistochemistry techniques. Samples and clinicopathological data were obtained from Pathology Anatomy Laboratory collection in NTB Provincial Hospital and medical records. BRCA1 expression profile in breast cancer patients will be analyzed descriptively using the frequency distribution of BRCA1 expression based on age and domicile. The negative BRCA1 expression is high at age <40 (59.1%) in Central Lombok and East Lombok districts (40%). Negative BRCA1 expression was found at age <40 years, found in two districts in NTB.
Hak Cipta (c) 2024 Unram Medical Journal
Oral Citicoline and Diabetic Retinopathy: Effects on Macular Ganglion Cell Layer Thickness
Diabetic retinopathy (DR) is the main cause of blindness at a productive age, especially in developing countries including Indonesia. Damage to the retinal neural unit occurs to precede vascular disorders and inflammation. Citicoline has been used widely as a neuroprotector and proven in vitro and in vivo to maintain the function of retinal ganglion cells (RGC) in glaucoma. The objective of the study is to measure the macular GCL thickness after administration of citicoline in patients with DR. All subjects with DR receive 500 mg citicoline administered orally once daily for 2 weeks. Before and after citicoline administration, all subjects undergo examinations of visual acuity, funduscopy, intraocular pressure (IOP), fundus photos, and measurements of retinal ganglion cells (GCL) thickness of the macula by ocular computed tomography (OCT). There are 13 subjects with DR, most of whom are female (69.2%), aged between 40-60 years (53.6%), and have bilateral DR (65%). Non-proliferative diabetic retinopathy- NPDR is found in 30.8% of subjects and macular edema in 53.8% of subjects. The average macular ganglion cell layer (GCL) thickness is 59.23 + 31.83 um. After citicoline administration, there is a GCL thickness increase significantly in subjects with proliferative diabetic retinopathy (PDR). The thinning of GCL is shown in subjects with DME. Citicoline may play a role in maintaining the neural unit of the retina, especially the ganglion cell layer. Further studies are needed to explore the effect of citicoline on each stage of diabetic retinopathy.
Kontrasepsi Implan: Farmakokinetik, Indikasi, Kontraindikasi
Abstrak Tingginya angka kehamilan yang tidak diinginkan dan tingkat kegagalan yang relatif tinggi dengan penggunaan metode kontrasepsi jangka pendek merupakan indikasi kuat akan perlunya metode kontrasepsi jangka panjang yang mudah digunakan dan sangat efektif. Kontrasepsi implan merupakan jawaban terhadap kebutuhan ini. Abtract The high number of unwanted pregnancies and the relatively high failure rate with the use of short-term contraceptive methods are strong indications of the need for long-term contraceptive method that is easy to use and highly effective. Contraceptive implants are the answer to this need.
The Correlation of Hyperglycemia, Leukocytosis, Hypernatremia, and Anemia with Mortality Rate and Length of Stay on Traumatic Brain Injury Patients in RSUD Provinsi Nusa Tenggara Barat
Traumatic Brain Injury (TBI) is a brain dysfunction caused by external force impacting the head that can lead to permanent or temporary cognitive, physical, and psychosocial dysfunction, with loss of consciousness. Hyperglicemia, leukocytosis, hypernatremia, and anemia can be caused by secondary damage, such as mitochondria dysfunction, free radicals, excitotoxicity, ion imbalance, excess NO, lipid peroxidase, energy failure, inflammation, axonal dysfunction, apoptotic cell death and necrosis, and ischemia, which contributes to mortalities and length of stay in hospital. This research using a retrospective study collecting medical records from surgery department that had met the inclusion criteria in RSUD Provinsi Nusa Tenggara Barat from 2018 to 2019. This study used the consecutive sampling method. There were 92 samples met the inclusion criteria. There was a statistically significant correlation between hyperglycemia and mortality rate (p=0.023), and also clinically significant due to the difference in proportions above 20% (Proportion difference = 25,8%). Researcher found a significant correlation between hyperglycemia and length of stay (p=0.032). Otherwise, there was no correlation between leukocytosis (p=1.000), hypernatremia (p=0.125), anemia (p=1.000) with mortality rate. There also no correlation between leukocytosis (p=0.763), hypernatremia (p=0.208), and anemia (p=0.41) with length of stay.
Management of Bee Stings: A Review of Diagnostic Tools and Immunotherapy
Abstract: Insects from the order Hymenoptera, like bees, are essential to ecosystems but can cause severe allergic reactions through their venomous stings. Indonesia, with its high bee diversity, faces significant health risks from bee stings, especially to beekeepers, though epidemiological data is limited. This study reviews 19 relevant articles to discuss clinical presentations, including reactions from local inflammation to systemic anaphylaxis, diagnosed through skin tests, serum IgE antibodies, and baseline serum tryptase. Venom-specific immunotherapy (VIT), comprising an induction and maintenance phase, is the preferred treatment for allergic reactions, though its application depends on patient history and health conditions. Effective management and accurate diagnosis of bee sting allergies are crucial to preventing severe reactions.
As a malignancy with one of the highest fatality rate, esophageal cancer requires specific attention. The two etiologies of esophageal cancer which are squamous cell carcinoma and adenocarcinoma often does not show any specific symptoms in the early stage of the disease. However, as the disease progresses, patients can feel some clinical manifestations such as progressive dysphagia and unintentional weight loss. The process of establishing the diagnosis of esophageal cancer is carried out with a series of physical examinations and followed by endoscopy as the gold standard. However, due to the lack of specificity of the initial symptoms, diagnosis often only made when the cancer is already in an advanced stage which causes the cancer prognosis to be worse with a survival rate in 5 years of only around 20,9% and might cause some complications such as esophageal perforations, retropharyngeal abscesses, airway obstruction, and many other complications. Therefore, it is necessary to diagnose as early as possible through routine physical examinations to increase life expectancy and the effectiveness of the therapy. This literature review aims to further discuss the importance of establishing the diagnosis of esophageal cancer and the development of diagnostic instruments and means by searching the literature from various sources.
Tumor Stroma Gastrointestinal: dari Definisi hingga Prognosis – Literatur Review
Tumor stroma gastrointestinal (Gastrointestinal Stromal Tumor/GIST) adalah tumor ganas mesenkim yang berasal dari sel interstisial Cajal di saluran pencernaan, terutama pada lambung dan usus halus. GIST umumnya disebabkan oleh mutasi pada gen KIT atau PDGFRA, yang memicu proliferasi sel secara tidak terkendali melalui aktivasi jalur pensinyalan intraseluler. Ekspresi antigen CD117 (C-Kit) juga terkait dengan pertumbuhan tumor ini. Gejala GIST bervariasi, termasuk perdarahan, nyeri perut, dan obstruksi saluran cerna, yang sering menyebabkan keterlambatan diagnosis. Pendeteksian GIST biasanya dilakukan melalui pencitraan seperti CT scan atau MRI. Terapi utama terdiri dari pembedahan dan terapi target menggunakan imatinib mesylate untuk mengatasi mutasi spesifik. Prognosis GIST sangat bergantung pada ukuran tumor, lokasi, dan adanya metastasis, dengan deteksi dini berperan penting dalam memperbaiki harapan hidup pasien. Pemahaman yang lebih baik mengenai etiologi, patogenesis, dan terapi GIST sangat dibutuhkan untuk mendukung diagnosis dini dan manajemen yang lebih efektif.
Penyakit Obstruksi Usus: Atresia Duodenum
Atresia duodenum adalah kondisi kongenital yang ditandai dengan tidak berkembangnya bagian duodenum, yang mengakibatkan obstruksi total lumen usus. Atresia duodenum sering terjadi bersamaan dengan penyakit-penyakit lain seperti Down’s syndrome, penyakit jantung kongenital, dan atresia-atresia organ lainnya. Mekonium/feses pertama keluar sedikit atau tidak ada, perut membengkak, dan muntah berwarna kuning kehijauan (muntah bilous) dapat menjadi kecurigaan terhadap atresia duodenum. Hal ini kemudian dikonfirmasi dengan adanya double bubble sign pada hasil pemeriksaan radiologi. Penanganan untuk atresia duodenum meliputi dekompresi, resusitasi cairan, operasi duodenoduodenostomi, dan nutrisi parenteral. Keterlambatan penanganan dapat meningkatkan angka mortalitas akibat atresia duodenum. Penyusunan tinjauan pustaka ini menggunakan metode pencarian data melalui sumber-sumber data seperti Pubmed, Google Scholar, dan ScienceDirect. Pencarian data menggunakan kata kunci seperti ”atresia duodenum”, ”kelainan kongenital”, dan ”obstruksi usus”. Penelitian ini terfokus pada penyediaan informasi terkait atresia duodenum secara umum.
The Relationship Between Internet Addiction and Depression in Adolescents After the Covid-19 Pandemic
The Covid-19 pandemic has resulted in various major changes, one of which is in people's use of the internet. The total time people spend using the internet during the Covid-19 pandemic continues to increase significantly, increasing the risk of health problems related to internet addiction. Persistent internet addiction can cause various impacts that can lead to depression, especially in teenagers. This research aims to find out the relationship between internet addiction and depression in teenagers after the Covid-19 pandemic. This is an observational research with a cross-sectional design using KDAI to measure the level of internet addiction and CDI to screen for depression. Respondents were senior high school students aged 14 to 17 years (n = 115), taken using proportionate stratified random sampling. The study results showed that the incidence of internet addiction in teenagers after the Covid-19 pandemic was 27.8% and the risk of depression in teenagers after the Covid-19 pandemic was detected at 57.4%. Therefore, internet addiction has a significant relationship (p=0,001) with the tendency to develop depression in teenagers after the Covid-19 pandemic, with the risk increasing up to 4.1 times.