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All Journal The Indonesian Journal of General Medicine
Ayub Quisa
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Dentistry Health Professions Medicine & Pharmacology Public Health Veterinary

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The Comprehensive Systematic Review of Neuroprotection with Hypothermia in Traumatic Brain Injury Ayub Quisa; Zakiul Ifkar Hamsi; Frederich Gabriel Xaverius Butar butar; Herfandi Dimas Anugrah
The Indonesian Journal of General Medicine Vol. 40 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kw23ce76

Abstract

Introduction: Traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Therapeutic hypothermia has been proposed as a neuroprotective strategy for decades, yet clinical trials have yielded conflicting results. Methods: This systematic review comprehensively analyzed 80 studies including randomized controlled trials, etc examining hypothermia for neuroprotection in TBI patients. Outcomes included functional neurological status (Glasgow Outcome Scale), mortality, intracranial pressure, biomarkers, and safety events. Results: Four major high-quality multicenter RCTs (POLAR n=511, Eurotherm3235 n=387, Hutchison et al. n=225, NABIS:H II n=232) demonstrated no benefit with hypothermia. POLAR showed no difference in favorable outcome (48.8% vs 49.1%; RR 0.99; P=0.94). Eurotherm3235 demonstrated harm (adjusted OR 1.53; P=0.04). However, significant positive signals emerged in specific subgroups: young patients (≤50 years) with evacuated mass lesions (77.8% favorable vs 33.3%; P=0.015) (15); acute subdural hematoma patients (75.0% vs 36.4%; P=0.045) (16); patients with initial ICP ≥30 mmHg (60.82% vs 42.71%; OR 1.861; P=0.039) (17); metabolic-targeted hypothermia (mortality 15.91% vs 34.09%; P=0.049) (25); pre-hospital initiation (65.1% vs 37.2%; P<0.05) (37); direct brain cooling (63.2% vs 15.4% good outcome; P=0.007) (55); and elderly patients (mortality 13.89% vs 30.56%; P=0.047) (13). Biomarker studies consistently demonstrated reduced NSE, S-100B, and oxidative stress markers with hypothermia (1-3,78). Discussion: The fundamental contradiction between large negative trials and numerous smaller positive Chinese single-center studies reflects critical differences in patient selection, injury subtypes, and cooling protocols. Diffuse injury may be harmed while focal evacuated lesions benefit. Conclusion: Prophylactic hypothermia for unselected severe TBI is not recommended. However, significant positive evidence supports hypothermia in young patients with evacuated mass lesions, acute SDH, refractory ICP ≥30 mmHg, and with metabolic-targeted or direct brain cooling approaches.
The Comprehensive Systematic Review of Platelet-rich Plasma Injections for Chronic Plantar Fascilitis Ayub Quisa; Zakiul Ifkar Hamsi; Frederich Gabriel Xaverius Butar Butar; Herfandi Dimas Anugrah
The Indonesian Journal of General Medicine Vol. 40 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/53r06d76

Abstract

Introduction: Chronic plantar fasciitis (PF) often fails conservative treatment. Corticosteroid (CS) injections provide rapid but temporary relief, while platelet-rich plasma (PRP) offers a regenerative approach. This systematic review compares the efficacy and safety of PRP versus other treatments for chronic PF. Methods: We systematically reviewed randomized controlled trials comparing PRP injections to any control for chronic PF (symptoms ≥3 months). Outcomes included pain (VAS), function (AOFAS), imaging changes, and adverse events. Results: From RCTs (>5,000 patients), and primary studies, a consistent temporal pattern emerged: CS provided faster pain relief at 2–6 weeks, but PRP demonstrated superior and sustained improvements from 3 to 24 months. Key significant positive findings include: at 6 months, PRP was superior to CS for pain (VAS 3.71 vs. 5.40, p<0.0001) (26) and at 24 months for function (AOFAS 92 vs. 56, p=0.001) (4). Meta-analyses confirmed PRP superiority at 3 and 6 months (p=0.01–0.02) (11). PRP produced greater plantar fascia thickness reduction (3.53 vs. 4.58 mm, p<0.001) (45). The safety profile markedly favored PRP (only temporary post-injection pain) versus CS (skin depigmentation, fat pad atrophy, infection) (23). PRP was comparable to surgery with faster recovery (14,15) and superior to extracorporeal shockwave therapy at 90 days (12), dry needling (62), and botulinum toxin (68). Discussion: PRP’s delayed but durable effect aligns with its regenerative mechanism (growth factor-mediated tissue remodeling), whereas CS provides only temporary anti-inflammatory suppression. Conclusion: For chronic PF, PRP provides superior, longer-lasting pain relief and functional improvement compared to CS, with an excellent safety profile. PRP should be preferred over repeated CS and considered before surgery.
Allergic Reactions to Residual Monomers in Acrylic Denture Bases: A Systematic Review of Randomized Controlled Trials and Primary Studies Junez Kanisa; Adethyan Wira Gama; Ayub Quisa
The Indonesian Journal of General Medicine Vol. 42 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/n8acfp80

Abstract

Introduction: Residual monomers — principally methyl methacrylate (MMA) and 2-hydroxyethyl methacrylate (2-HEMA) — persist in conventional polymethyl methacrylate (PMMA) denture bases following incomplete polymerization and are associated with a spectrum of adverse biological reactions, including Type IV contact hypersensitivity, allergic contact stomatitis, burning mouth syndrome (BMS), and occupational allergic contact dermatitis in dental personnel. Methods: he study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Two independent reviewers screened records using PRISMA 2020 methodology. Risk of bias was assessed with Cochrane RoB 2.0 and the Newcastle-Ottawa Scale. A minimum of 15 studies and 10 outcome domains were pre-specified. Results: Fifteen studies (n = 2,287 participants/specimens) met inclusion criteria. Autopolymerized resins harbored residual MMA of 2.2–7.5% w/w vs. 0.11–0.90% w/w for heat-cured PMMA and 0.02–0.12% w/w for CAD/CAM-milled PMMA. Patch-test positivity to MMA/2-HEMA among symptomatic denture wearers ranged from 4–27%. Ten pre-specified outcome domains were fully analyzed. GRADE certainty: HIGH for residual MMA quantification and cytotoxicity data; MODERATE for clinical sensitization prevalence and occupational exposure outcomes. Discussion: Evidence confirms a dose-dependent relationship between residual monomer elution and mucosal/immunological reactivity. Autopolymerized resins confer the greatest risk. Post-polymerization water immersion at 50°C for ≥60 minutes and use of CAD/CAM pre-polymerized PMMA substantially reduce allergenic burden. Conclusion: Residual monomers in acrylic denture bases constitute a clinically significant, preventable source of contact hypersensitivity. Clinicians should prioritize heat-cured or digitally fabricated PMMA, implement post-polymerization protocols, and employ standardized acrylate patch testing in symptomatic patients.
Co-Authors Adethyan Wira Gama Frederich Gabriel Xaverius Butar butar Herfandi Dimas Anugrah Junez Kanisa Zakiul Ifkar Hamsi