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All Journal Jurnal Anestesiologi Indonesia Althea Medical Journal Global Medical and Health Communication Universa Medicina JURNAL PENDIDIKAN JASMANI DAN OLAHRAGA Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Medika Malahayati Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Health and Medical Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan Jurnal Ilmiah Kesehatan Jurnal Prima Medika Sains Indonesian Journal of Cancer
Gunadi, Julia Windi
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Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Anesthetic Management Of Peritonitis And Septic Shock In Colorectal Cancer: A Case Report Rusli, Joseph; Sugiaman, Angela Mulyana; Gunadi, Julia Windi
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 9 (2025): Volume 12 Nomor 9
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i9.22461

Abstract

A 64-year-old male presented with signs of peritonitis, including severe abdominal pain, distension, and dehydration. Laboratory findings showed elevated inflammatory markers (leukocyte count: 19,500/mm³, C-reactive protein: 25 mg/dL), impaired renal function (serum creatinine: 2.1 mg/dL), and metabolic acidosis (pH: 7.25, lactate: 4.5 mmol/L). Imaging revealed a perforated rectal tumor with extensive peritoneal contamination. Emergency exploratory laparotomy was performed, involving tumor resection, colostomy formation, and peritoneal lavage. Hemodynamic instability due to septic shock was managed with norepinephrine to maintain blood pressure. Dobutamine was used to enhance cardiac output, while nitroglycerin supported coronary perfusion to prevent ischemic complications. Postoperatively, the patient required intensive care, including ventilatory support, fluid resuscitation, and tailored antibiotic therapy. Despite complications such as transient paralytic ileus, the patient was extubated on day five and discharged to the general ward by day ten. This case emphasizes the importance of early diagnosis, prompt surgical intervention, and personalized hemodynamic management in malignant-associated peritonitis. Multidisciplinary collaboration is critical to optimizing outcomes. Limitations of this case include its single-patient design. Further research should focus on advanced diagnostic tools and tailored resuscitation protocols to improve the management of similar cases.
The Differential Gene Expression of Squamous Cell Carcinoma Versus Basal Cell Carcinoma Highlights Oxidative Phosphorylation As A Potential Factor in Metastasis: A Single-Cell Gene Expression Analysis Study Soekmadji, Peter Nugraha; Sanjaya, Ardo; Tangano, Justin Javier; Gunadi, Julia Windi
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1264

Abstract

Background: Nonmelanoma skin cancer (NMSC) can be classified into basal (BCC) and squamous cell carcinoma (SCC). Combined, they rank 5th among the highest incidences of cancer in the world. Despite their low mortality rate, metastasis remains a significant concern. Basal cell carcinoma grows slowly and rarely metastasizes, unlike squamous cell carcinoma, which usually metastasizes when left untreated. However, it is currently unknown what influences their metastatic potential.Method: This research uses single-cell RNA expression data from the Gene Expression Omnibus database. The data will be preprocessed, normalized, and integrated before differential expression and enrichment analyses. Additionally, the 5 most upregulated genes in basal cell carcinoma compared to squamous cell carcinoma and vice versa will be discussed.Results: 165 genes highly expressed in BCC were identified and enriched, with the most significant enrichment for genes promoting apoptosis. We also identified 143 genes highly expressed in SCC, which had the most significant enrichment for genes involved in oxidative phosphorylation. The top 5 upregulated genes in BCC were KRT17, CXCL8, RPS17, CCL20, and IER3, and in SCC were KRT1, LY6D, FABP5, S100A8, and KRT10.Conclusion: We identified differentially expressed genes, including those related to oxidative phosphorylation and cell multiplication, which may help explain the varying behaviors of these cancers, particularly the higher metastatic potential of SCC. However, further research is needed to examine the effects of oxidative phosphorylation on these cancer cells.
Comparison of Global Rating Assessment Between Examiners and Simulated Patients on Communication Skills with OSCE Scores: Perbandingan Penilaian Global Rating Antara Penguji dan Pasien Simulasi Pada Keterampilan Komunikasi Dengan Nilai OSCE Waty, Wenny; Hutagalung, Albert Rodney; Tih, Fen; Sanjaya, Ardo; Gunadi, Julia Windi
Jurnal Ilmiah Kesehatan Vol 17 No 1 (2025): Jurnal Ilmiah Kesehatan
Publisher : Universitas Mohammad Husni Thamrin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37012/jik.v17i1.2303

Abstract

Introduction: In the field of medical education, the evaluation process of communication and clinical skills training is known as Objective Structured Clinical Examination (OSCE). OSCE can be assessed using the global rating method, which is a method of subjective evaluation by examiners and standardized patients of student performance. Objective: The study aims to examine the relationship between the subjectivity of examiners and standardized patients in OSCE scores using the global rating method. Methods: The study involved 985 students from the Faculty of Medicine at Maranatha Christian University who participated in the Local OSCE from December 2021 until January 2022. Secondary data were analyzed using logistic regression in SPSS software and presented in tables and multivariate analysis. Results: The global rating assessment by examiners showed a significant relationship with OSCE scores (p<0.001), while the global rating assessment by standardized patients did not show a significant relationship with OSCE scores (p>0.05). This indicates that the evaluation by examiners has a greater influence on OSCE results compared to the assessment by standardized patients. Recommendations: More comprehensive training is needed for standardized patients in conducting assessments using the global rating method to minimize bias. Furthermore, future research is recommended to explore other factors that may influence OSCE assessments to improve the validity and reliability of the evaluation.
EFEK TERAPI ADJUVAN METFORMIN PADA KANKER KOLOREKTAL Pratono, Dono; Fidelia, Catrinne; Sanjaya, Ardo; Jasaputra, Diana Krisanti; Gunadi, Julia Windi
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 4 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Kanker kolorektal adalah suatu keganasan yang terjadi pada kolon, rektum, atau keduanya. Angka kejadian kanker kolorektal menempati posisi ketiga dan menjadi penyebab kematian tersering kedua pada semua jenis kelamin. Pengobatan kanker kolorektal dengan agen kemoterapi tunggal, yaitu 5-fluorourasil atau kombinasi dengan oksaliplatin dan avastin dapat memberikan perbaikan penyakit, namun memberikan beberapa efek samping. Tujuan dari artikel ini yaitu untuk mengetahui mekanisme kerja obat metformin sebagai terapi adjuvan dalam menghambat pertumbuhan sel pada pasien kanker kolorektal. Metode yang digunakan oleh penulis dalam artikel ini adalah metode telaah pustaka, dengan mengumpulkan beberapa sumber tertulis melalui pencarian data yang di akses melalui Google scholar, Pubmed, Mendeley, dan Science direct. Hasil telaah pustaka menunjukkan bahwa terdapat beberapa mekanisme kerja obat metformin dalam menghambat proliferasi dan pertumbuhan sel, antara lain dengan aktivasi jalur AMPK, menurunkan jumlah insulin dan IGF, serta menurunkan ekspresi Inhibin βA (INHBA) yang pada akhirnya dapat menghambat mitosis sel. Simpulan dari telaah pustaka ini adalah metformin dapat dipilih menjadi terapi adjuvan dalam pengobatan kanker kolorektal karena banyaknya efek yang ditimbulkan dalam menghambat pertumbuhan sel kanker. Melalui telaah pustaka ini diharapkan metformin dapat dimanfaatkan sebagai terapi adjuvan pasien kanker kolorektal baik pada saat ini maupun di kemudian hari. Kata kunci : kanker kolorektal, metformin, proliferasi sel DOI : 10.35990/mk.v7n4.p410-419
EFEK COVID-19 TERHADAP LARING Mangape, Hiro Salomo; Sihotang, Sharon Kolose; Sanjaya, Ardo; Gunadi, Julia Windi; Edwin, Christian
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 1 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) merupakan virus yang memiliki selubung single stranded Ribonucleic Acid (ss-RNA) yang menjadi penyebab penyakit Corona Virus Disease 2019 (COVID-19). Laring merupakan perbatasan saluran pernapasan dan saluran pencernaan sehingga mudah terkena infeksi COVID-19. Gangguan pada laring juga dapat terjadi akibat tindakan intubasi atau trakeostomi pada kasus COVID-19 derajat berat. Tujuan tinjauan pustaka ini adalah mempelajari mekanisme terjadinya infeksi COVID-19 pada laring baik infeksi secara langsung maupun akibat tindakan intubasi atau trakeostomi. Pencarian dilakukan melalui PubMed dan google scholar dengan kata kunci “COVID-19”, “laring”, “intubasi”, dan “komplikasi pada laring”. Hasil tinjauan Pustaka menunjukkan bahwa laring memiliki reseptor terhadap trans-membrane protease serine 2 (TMPRSS2) dan angiotensin converting enzyme 2 (ACE2). Infeksi laring terjadi ketika ACE2 berikatan pada permukaan luminal epitel saluran napas sehingga dapat menyebabkan gejala edema laring, sesak napas, stridor, dan disfonia. Penatalaksanaan pada kasus laring disesuaikan dengan etiologi dan manifestasi yang dihasilkan. Kesimpulan yang dapat diambil adalah kasus COVID-19 memang jarang bermanifestasi pada laring, namun komplikasi pada laring dan setelah penggunaan post-intubasi sangat mungkin terjadi. Oleh karena itu, komplikasi COVID-19 terhadap laring tetap harus dipantau. Kata kunci : ACE2, COVID-19, laring, TMPRSS2 DOI : 10.35990/mk.v7n1.p101-111
Literature Review: Pengaruh Zinc Terhadap Diabetes Gestasional Saiman, Erik Dwikurnia; Kwan, Clarissa; Sanjaya, Ardo; Gunadi, Julia Windi
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 4 (2025): Volume 12 Nomor 4
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i4.18155

Abstract

Tingginya kadar gula darah merupakan ciri dari diabetes, suatu kondisi metabolik. Ketika diabetes muncul pertama kali saat kehamilan, maka tipe spesifik ini disebut diabetes gestasional. Diabetes gestasional berefek buruk baik pada ibu maupun janin yang sedang dikandung. Kadar zinc pada pasien diabetes gestasional menurun dibandingkan wanita hamil yang sehat. Pemberian suplementasi zinc dipercaya dapat memperbaiki kondisi pasien diabetes gestasional. Studi pustaka ini bertujuan untuk membahas mengenai efek suplementasi zinc terhadap pasien diabetes gestasional. Metode yang digunakan adalah literature review dengan mencari artikel dengan kata kunci diabetes gestasional, kehamilan dan zinc dengan kriteria inklusi meliputi artikel dalam 10 tahun terakhir, akses teks lengkap, dalam bahasa Inggris. Ditemukan 5 penelitian yang membahas mengenai suplementasi zinc pada pasien diabetes gestasional. Studi pustaka ini menyimpulkan bahwa pemberian suplementasi zinc 30mg/hari selama 6-8 minggu dapat memperbaiki kondisi pasien diabetes gestasional, meskipun tidak semua penelitian menunjukkan adanya penurunan glukosa darah.  
Anesthetic Management for Sternotomy in a Patient with Anterior Mediastinal Tumor: A Case Report Rusli, Joseph; Kurniawan, Arfian Pascalis; Hapdijaya, Indra; Gunadi, Julia Windi
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.72407

Abstract

Background: Anterior mediastinal masses (AMMs) pose significant anesthetic challenges, risking airway obstruction, cardiovascular collapse, and hemodynamic instability, especially in the supine position. Preoperative assessment, including imaging and cardiopulmonary evaluation, is crucial. Anesthetic management prioritizes spontaneous ventilation (SV), airway patency, and hemodynamic stability, often employing awake intubation, inhalational induction, and neuromuscular blockade avoidance. A multidisciplinary, individualized anesthetic management of the sternotomy approach optimizes outcomes.Case: 50-year-old male with anterior mediastinal tumor (AMT) scheduled for elective sternotomy. The patient experienced chest pain and a persistent cough with displacement and indentation of the aorta and inferior vena cava as observed on contrast-enhanced computed tomography (CT) scan, indicating high surgical risk. Anesthesia induction involved fentanyl, midazolam, atracurium, and propofol, followed by intubation with a left-sided double-lumen tube (DLT) for one-lung ventilation.Discussion: Mediastinal masses pose significant anesthetic risks, primarily due to the potential for mediastinal mass syndrome (MMS). Preoperative imaging and symptom-based risk stratification are critical. Anesthetic goals include maintaining SV and avoiding neuromuscular blockade when possible, as loss of SV is often linked to MMS onset. However, in procedures like sternotomy requiring deep anesthesia and muscle relaxation, airway control may necessitate neuromuscular agents. In such cases, preparedness for difficult ventilation is essential. We utilized a left-sided DLT to facilitate one-lung ventilation and surgical access. Postoperative intensive care unit (ICU) monitoring is advised for high-risk patients.Conclusion: This case's importance lies in the complex anesthetic management of sternotomy for anterior mediastinal mass resection, requiring meticulous planning to prevent airway and cardiovascular compromise. A multidisciplinary approach and early diagnosis are key to optimizing patient safety and outcomes.
ANALYSIS OF THE EFFECTIVENESS OF DUAL PI3K/mTOR INHIBITORS IN INHIBITION OF PI3K/AKT/mTOR SIGNALING PATHWAY IN BREAST CANCER Susanto, Andi; Subardin, Dian Aryanti; Gunadi, Julia Windi; Sanjaya, Ardo
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 8 No 4 (2025): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Breast cancer is a malignancy originating from breast cells, ducts, and tissues that can occur due to genetic mutations due to DNA damage in normal cells. The PI3K/Akt/mTOR pathway is an intracellular pathway that plays an important role in regulating basic cell functions such as cell growth, movement, survival, metabolism, and angiogenesis. Some examples of PI3K/mTOR pathway inhibitor drugs on the market and often used are dactolisib, samotolisib, voxtalisib, and so on. These drugs are more effective than single-pathway inhibitors. This article was prepared using the literature review method. The data used in this article were obtained from the PubMed and Google Scholar using the keywords breast cancer, PI3K/Akt/mTOR inhibitor, and PI3K/AKT/mTOR signaling pathway. Several studies suggest that the PI3K-AKT-mTOR pathway is critical in mediating the proliferation and migration of breast cancer cells. Because of the importance of the PI3K-AKT-mTOR pathway in the pathogenesis of breast cancer, it is often used as a target for breast cancer therapy. PI3K/mTOR dual ATP competitive inhibitors can directly act on the main target proteins of PI3K and mTOR, thereby more efficiently inhibiting the PI3K/AKT/mTOR signaling pathway and effectively preventing other factors that can activate the PI3K pathway, and reducing the resistance and side effects produced by single inhibitors. Keywords: breast cancer, dual inhibitor, PI3K-AKT-mTOR DOI : 10.35990/mk.v8n4.p434-445
Effects of Moderate-Intensity Treadmill Training on Cardiac Mitochondrial Mitophagy and Dynamics in Young and Aged Wistar Rats Gunadi, Julia Windi; Ramadhan, Difa Hidayat; Safira, Bernike Tirsa; Ramadhan, Andra Alifya; Wahyudianingsih, Roro; Limyati, Yenni; Goenawan, Hanna; Lesmana, Ronny
Althea Medical Journal Vol 13, No 1 (2026)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v13n1.4553

Abstract

Background: Cardiac aging is closely associated with mitochondrial dysfunction and impaired quality control mechanism. Exercise has been shown to modulate mitochondrial homeostasis, however, its effects on cardiac mitophagy and mitochondrial dynamics during aging remain unclear. This study investigated the effects of moderate-intensity treadmill training on mitochondrial maintenance-related gene expression in the hearts of young and aged Wistar rats.Methods: Young and aged rats were divided into four groups: young control, young exercise, aged control, and aged exercise (n=6 per group). Exercise groups performed treadmill running at 20 m/min for 30 minutes/day, 5 days/week for 8 weeks. Cardiac gene expression levels of Pink1, Parkin, Mfn1, Mfn2, Opa1, Drp1, and Fis1 were analyzed using semi-quantitative polymerase chain reaction (PCR). Data were analyzed using one-way ANOVA or Kruskal–Wallis test followed by appropriate post hoc analyses.Results: Exercise significantly increased Mfn2 expression in aged exercise rats compared with aged controls (p=0.029), suggesting partial restoration of age-related decline. Expression of Mfn1 and Drp1 varied among groups but showed no significant pairwise differences. Expression levels of Opa1, Fis1, Pink1, and Parkin remained unchanged. These results indicate that moderate exercise selectively enhances mitochondrial fusion capacity while maintaining balanced fission and basal mitophagy activity.Conclusion: Moderate-intensity treadmill training promotes mitochondrial  fusion-related adaptation in aging cardiac tissue. Regular moderate exercise may represent a potential non-pharmacological strategy to support mitochondrial function and mitigate cardiovascular aging.  
Effect of Muay Thai training frequency on VO2 max and muscle endurance in non-athletic adults: a randomized clinical trial Putra, Al Husni Hadi Pasca; Gunadi, Julia Windi; Limyati, Yenni; Adhika, Oeij Anindita
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.46-58

Abstract

BackgroundUrban lifestyles have become increasingly sedentary, contributing to reduced physical fitness. Muay Thai, a high-intensity martial art, has been proposed as an effective exercise modality to improve aerobic capacity and muscle endurance. This study aimed to evaluate the effects of different weekly Muay Thai training frequencies on VO₂ max and muscle endurance in non-athletic adults. MethodsA randomized experimental study with a pre-test–post-test design was conducted involving 40 non-athletic adults (aged 20–25 years). Participants were randomly allocated into two groups: training twice weekly (MT2X) or four times weekly (MT4X) for eight weeks. Outcomes included VO₂ max and upper, abdominal, and lower body muscle endurance. Baseline characteristics were described descriptively. Between-group differences in post-intervention outcomes were analyzed using analysis of covariance (ANCOVA), with baseline values included as covariates. ResultsAt baseline, VO₂ max, abdominal, and lower body muscle endurance were higher in the MT4X group. After adjustment for baseline values using ANCOVA, the MT4X group demonstrated significantly higher post-intervention VO₂ max compared with the MT2X group (adjusted mean difference, p<0.001). Significantly greater improvements favoring the MT4X group were also observed for upper body muscle endurance (push-ups, p<0.001), abdominal muscle endurance (sit-ups, p<0.001), and lower body muscle endurance (squats, p=0.018). ConclusionA higher frequency Muay Thai training program is effective in significantly improving participants' aerobic capacity and muscle endurance. Practitioners are able to choose their training frequency preference, since both frequencies provide similar adaptation.
Co-Authors Albert Manggading Hutapea Andi Susanto Ardo Sanjaya Arief Budiono Astrid, Stephanie Camillo, Keyshia Valentine Daud, Fari Ananda Decky Gunawan, Decky Diana Krisanti Jasaputra Dominika, Katharina Ellen Edwin, Christian Fanny Rahardja Fen Tih Fidelia, Catrinne Gani, Irna Permanasari Ginting, Justin Hadi, Harry Tribowo Hanna Goenawan Hapdijaya, Indra Hutagalung, Albert Rodney Indah Kusuma Dewi, Indah Kusuma Indahwati, Dwiwahju Dian Indriany, Dini Ishak, Lani Jason, Daniel Jatnika, Danti Dja Kasnadi, Crystallica Luna Kastella, Faysal Kurniawan, Arfian Pascalis Kusmawan, Steven Zerin Putra Kwan, Clarissa Mangape, Hiro Salomo Miguna, Landry Natasia, Caroline Putri Nathania, Kezia Octavallen, Andri Octavia, Chitra Oeij Anindita Adhika Pamungkas, Raden Aprian Surya Putra Pangestuti, Balqist Sriprobo Permadi, Andieni Faqhira Pratono, Dono Putra, Al Husni Hadi Pasca Ramadhan, Andra Alifya Ramadhan, Difa Hidayat Ray, Hamidie Ronald Daniel Rizamena, Melya Ikbar Ronny Lesmana Roro Wahyudianingsih, Roro Rosali, Alexandrina Everdine Rudijanto, Yohanes Rumanti, Rizna Tyrani Rusli, Joseph Safira, Bernike Tirsa Saiman, Erik Dwikurnia Sihotang, Sharon Kolose Siringo Ringo, Nalaraty Wahyu Soekmadji, Peter Nugraha Subardin, Dian Aryanti Sugiaman, Angela Mulyana Surawijaya, Ade Kurnia Tangano, Justin Javier Tanuwijaya, Farrell Teresa Lucretia, Teresa Titing Nurhayati Valerie, Rachel Vita Murniati Tarawan Wahyudianigsih, Roro Waty, Wenny Wijayanto, Karen Regina Yenni Limyati Yumilia, Hoo Zecha, Rosa Nurul