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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Biomedical Journal of Indonesia Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) SRIWIJAYA JOURNAL OF MEDICINE Majalah Patologi Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Sriwijaya Journal of Surgery JURNAL KESEHATAN: JURNAL ILMIAH MULTI SCIENCES Indonesian Community Empowerment Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Ophthalmologica Indonesiana Indonesian Journal of Pharmacology and Therapy Journal of Medicine and Health
Theodorus
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Religion Humanities Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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High Improved Glasgow Prognostic Score (iGPS) Predicts Increased Postoperative Mortality in Stage I-III Colorectal Cancer: A Kaplan-Meier Survival Analysis Gerry Armando; Efman Manawan; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 1 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i1.130

Abstract

Introduction: Colorectal cancer (CRC) represents a formidable cause of cancer-related mortality globally. Accurate prognostication that extends beyond conventional TNM staging is imperative for optimizing patient management. The Improved Glasgow Prognostic Score (iGPS), an inflammation-based biomarker derived from C-reactive protein (CRP) and albumin, has demonstrated considerable promise; however, its clinical utility has not been extensively validated in Southeast Asian populations. This study was therefore designed to investigate the association between preoperative iGPS and postoperative mortality among patients with non-metastatic CRC in an Indonesian tertiary care center. Methods: This study employed an ambispective cohort design, enrolling 33 patients with stage I-III CRC who underwent surgical resection at Dr. Mohammad Hoesin Hospital, Palembang. Preoperative serum CRP and albumin concentrations were utilized to calculate each patient's iGPS, which was then stratified into three risk categories: score 0 (low), 1 (medium), or 2 (high). The primary endpoint was all-cause postoperative mortality. The prognostic significance of iGPS in relation to survival was evaluated using the Kaplan-Meier method and log-rank test. Results: The patient cohort was predominantly composed of individuals aged ≥40 years (90.9%), with a median age of 59. Stage 3B was the most frequently observed pathological stage (39.4%). The overall mortality rate during the observational period was 57.6%. A robust association was identified between iGPS and survival outcomes. The survival probability for patients with iGPS 0 was 100%. Conversely, survival was substantially diminished in patients with iGPS 1 (33.3%) and iGPS 2 (42.1%). Kaplan-Meier analysis revealed a statistically significant divergence in survival distributions (p < 0.05), with higher iGPS scores correlating with markedly inferior survival. Conclusion: The preoperative iGPS is a potent and significant predictor of postoperative mortality in this Indonesian cohort of patients with non-metastatic CRC. Its utility as an accessible, cost-effective, and objective instrument for risk stratification is substantial. The integration of iGPS into routine clinical practice could enhance prognostic accuracy and aid in therapeutic decision-making.
Counseling of the Use of Herbal Medicines for Health Care to the Community Parisa, Nita; Kamaluddin, M. T.; Theodorus; Saleh, Mgs. Irsan; Lusiana, Evi; Tamzil, Nia Savitri; Wicaksono, Bonanza Abi; Nashif, Arkan Abdullah
Indonesian Community Empowerment Journal Vol. 2 No. 2 (2022): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v2i2.21

Abstract

Herbal medicine is growing quite rapidly, especially in every area that has traditional medicine using natural ingredients that are believed to treat disease. In addition, the use of herbal medicines is believed to have fewer side effects compared to conventional medicine. WHO also recommends the use of traditional and herbal medicines in efforts to maintain health, as well as prevent and treat diseases ranging from mild to chronic diseases. Based on the various problems faced, the purpose of implementing community service is to increase public knowledge and understanding of medicinal plants, independent health screening, and self-medication, and the role of supplements (vitamins and herbs) in health care and disease prevention efforts.
Integrating the Colon Leakage Score (CLS) and Serum Albumin to Predict Anastomotic Leakage in Colorectal Cancer Surgery: A Diagnostic Accuracy Study in an Indonesian Cohort Muhammad Rizqi Firyal; Muhammad Hafidh Komar; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.132

Abstract

Introduction: Anastomotic leakage (AL) is a devastating complication in colorectal surgery, associated with high rates of morbidity and mortality. Accurate preoperative risk stratification is essential for guiding clinical decision-making. This study aimed to evaluate the diagnostic accuracy of a synergistic model combining the clinical Colon Leakage Score (CLS) with the biochemical marker of preoperative serum albumin for predicting AL in an Indonesian patient cohort. Methods: A retrospective diagnostic accuracy study was conducted at a single tertiary care center. The study included 60 patients who underwent resection and primary anastomosis for colorectal cancer between January 2022 and June 2024. Patients who received a diverting stoma were excluded. A "high-risk" status was defined by a composite criterion: a CLS > 11 and a preoperative serum albumin level < 3.5 g/dL. The primary outcome was clinically significant AL. Following the identification of inconsistencies in the initial analysis, a complete data re-analysis was performed. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and overall accuracy, with 95% confidence intervals (CI), were calculated. Results: The incidence of AL was 21.7% (13/60 patients). A striking 71.7% of the cohort presented with preoperative hypoalbuminemia. The analysis revealed that the combined model demonstrated poor sensitivity of 46.2% (95% CI: 19.2% - 74.9%) but excellent specificity of 97.9% (95% CI: 88.7% - 99.9%). The model yielded a high PPV of 85.7% (95% CI: 42.1% - 99.6%) and a robust NPV of 86.8% (95% CI: 75.0% - 94.6%). The overall accuracy was 86.7%. Conclusion: The combined CLS-albumin model functions as a highly specific "rule-in" test, not a general screening tool. While it fails to identify more than half of the patients who will leak, a positive result correctly identifies a small subset of patients at extremely high risk for anastomotic leakage. The findings also highlight a profound baseline burden of malnutrition in this population, which warrants further investigation and clinical attention.
The Lung Organ Failure Score (LOFS) as an Early Predictor of Mortality in Blunt Thoracic Trauma: A Preliminary Validation Study in a Southeast Asian Cohort Charita Ulfah Widyawan; Arie Hasiholan Lumban Tobing; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.133

Abstract

Introduction: Blunt thoracic trauma is a leading cause of trauma-related mortality. Early and accurate risk stratification is essential for optimizing outcomes, yet many prognostic scores lack validation in diverse populations. This study aimed to perform a preliminary evaluation of the prognostic value of the lung organ failure score (LOFS) for predicting in-hospital mortality in patients with blunt thoracic trauma in an Indonesian tertiary trauma center. Methods: This retrospective, single-center, exploratory cohort study included adult patients (≥18 years) admitted with blunt thoracic trauma to Dr. Mohammad Hoesin General Hospital from January 2023 to January 2025. Data on demographics, injury characteristics, initial physiological parameters, and clinical outcomes were collected. The LOFS was calculated for each patient. The primary outcome was in-hospital mortality. Statistical analyses included bivariate comparisons, Kendall's Tau correlation, and Receiver Operating Characteristic (ROC) curve analysis. Results: A total of 32 patients were included. The overall in-hospital mortality rate was 21.9% (n=7). The non-survivor group had a significantly higher mean LOFS than the survivor group (21.00±5.29 vs. 14.16±3.92, p=0.001). LOFS demonstrated a moderate, positive correlation with mortality (Kendall's Tau r=+0.568, p=0.001). ROC analysis showed that LOFS had excellent discriminative ability for mortality, with an Area Under the Curve (AUC) of 0.840 (95% CI: 0.685–0.995, p=0.001). An optimal cut-off score of ≥18 yielded a sensitivity of 85.7% and a specificity of 80.0%. Conclusion: In this preliminary study, LOFS was strongly associated with in-hospital mortality and demonstrated excellent discriminative performance. The findings suggest LOFS is a promising and simple tool for early risk stratification in this high-risk population. However, the study's small sample size precluded a reliable assessment of its independence from other risk factors. Further validation in larger, prospective multicenter studies is essential to confirm these findings.
Determinants of In-Hospital Mortality Following Pelvic Ring Fractures: A 4.5-Year Analysis from a Developing Country's Trauma Center Jaya Ndaru Prasetio; Ismail Bastomi; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.135

Abstract

Introduction: Pelvic ring fractures are calamitous injuries with high mortality. While clinical risk factors are well-defined in high-income countries, there is a scarcity of data from low- and middle-income countries (LMICs), where socioeconomic factors may critically influence survival. This study sought to explore the sociodemographic and clinical factors associated with in-hospital mortality following pelvic fractures at a tertiary trauma center in Indonesia. Methods: A retrospective cohort study was performed on all patients (N=31) admitted with traumatic pelvic fractures to Dr. Mohammad Hoesin General Hospital between January 2021 and June 2025. Data on patient demographics, socioeconomic variables, injury mechanisms, and clinical management were analyzed. The primary outcome was in-hospital mortality. Given the exploratory nature of the study and the small sample size, bivariate analysis using Pearson's Chi-Square and Fisher’s Exact tests was conducted to identify potential associations. Results: The overall in-hospital mortality rate was 9.7% (3 of 31 patients). The cohort was primarily young adults (61.3% aged 20-59 years) injured in traffic accidents (87.1%). The only variable found to have a statistically significant association with mortality was occupation. All three fatalities occurred in patients from the informal employment sector, corresponding to a 37.5% mortality rate within this subgroup (p=0.008). No significant association was found for established clinical predictors, including Young-Burgess fracture classification (p=0.736), a finding likely attributable to the study's limited statistical power. Conclusion: This study, though limited by its sample size, identified a powerful association between informal sector employment and mortality after pelvic fracture. This finding generates the critical hypothesis that in an LMIC setting, socioeconomic vulnerability is a paramount driver of poor outcomes, likely mediated through delays in care and presentation with more severe physiological derangement. These results underscore the need for a socio-clinical approach to trauma care and highlight a crucial area for future, more definitive research.
A Preliminary Retrospective Analysis of the Blunt Abdominal Trauma Scoring System (BATSS) in a High-Prevalence Cohort: A Single-Center Indonesian Experience Akbar Rizky Wicaksana; Alsen Arlan; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.136

Abstract

Introduction: The triage of blunt abdominal trauma (BAT) is a critical challenge, and the utility of clinical scoring systems like the blunt abdominal trauma scoring system (BATSS) requires validation in diverse clinical settings. This study aimed to provide a preliminary, critical appraisal of the BATSS's diagnostic performance and the behavior of its individual components in a unique, high-risk cohort at a tertiary Indonesian trauma center. Methods: A retrospective analysis was conducted on 37 BAT patients who underwent definitive diagnostic evaluation (CT scan or laparotomy) between July 2021 and July 2025 in Palembang, Indonesia. The cohort was noted to have a significant selection bias, with an intra-abdominal injury (IAI) prevalence of 91.9% (34 injured, 3 uninjured). A component-level analysis of the seven BATSS variables was performed alongside a standard diagnostic accuracy assessment using an ROC curve to determine the optimal cut-off. Results: The cohort was predominantly young males injured in traffic accidents. The ROC analysis demonstrated poor discriminatory power (AUC = 0.525). At an optimal cut-off of 8.5, BATSS showed a sensitivity of 82.4% and a statistically unstable specificity of 33.3% (95% CI: 0.8% to 90.6%). The PPV was 93.3%, while the NPV was critically low at 14.3%. Component analysis revealed that sensitivity was primarily driven by high-point variables like a positive FAST scan, while low specificity was associated with non-specific signs like abdominal tenderness. Conclusion: In this high-prevalence, pre-selected cohort, BATSS failed to perform as a reliable triage tool. Its poor specificity and dangerously low NPV render it unsuitable and unsafe for ruling out IAI. The score's apparent sensitivity was driven by variables that already indicate a high-risk patient, suggesting the score adds little value to standard clinical assessment. This preliminary study highlights the critical need for robust, large-scale validation before clinical adoption and suggests BATSS may be inappropriate for settings with a high pre-test probability of injury.
Elevated Serum Lactate as an Indicator of Neurometabolic Derangement and its Independent Correlation with Clinical Outcomes in Traumatic Brain Injury Satya Agusmansyah; Anugerah Onie Widhiatmo; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.137

Abstract

Introduction: Traumatic brain injury (TBI) is a primary cause of global death and disability, where early and accurate prognostication is critical but remains a clinical challenge. Serum lactate is emerging as a biomarker of the complex neurometabolic derangement following TBI, extending beyond its traditional role as a marker of hypoxia. This study aimed to determine if serum lactate is an independent predictor of outcomes in TBI patients. Methods: We conducted a prospective, single-center observational study of 33 TBI patients at Dr. Mohammad Hoesin General Hospital. Serial venous serum lactate levels were measured at admission, 24, and 48 hours. The primary outcome was unfavorable functional status (Glasgow Outcome Scale [GOS] 1-3) at hospital discharge. Multivariate logistic regression was used to assess lactate as an independent predictor of unfavorable outcome, controlling for age and initial Glasgow Coma Scale (GCS) score. Survival was analyzed using Kaplan-Meier curves and a Cox proportional hazards model. Results: The cohort (N=33) was predominantly male (63.6%) with a mean age of 37.91 years. Higher admission lactate was strongly associated with worse GOS categories (p=0.002). After adjusting for age and initial GCS score, admission serum lactate remained a significant independent predictor of unfavorable outcome at discharge. For every 1 mmol/L increase in lactate, the odds of an unfavorable outcome increased by over twofold (Adjusted Odds Ratio: 2.15; 95% CI: 1.12-4.13; p=0.021). Similarly, lactate was an independent predictor of in-hospital mortality in the Cox proportional hazards model (Adjusted Hazard Ratio: 1.78; 95% CI: 1.05-3.01; p=0.032). Conclusion: Elevated admission serum lactate is a strong, independent predictor of unfavorable in-hospital functional outcome and mortality in TBI patients. As a readily available biomarker, it reflects the severity of the underlying neurometabolic crisis and provides crucial prognostic information beyond initial clinical and demographic assessments, aiding in early risk stratification.
Dissecting the Triad of Distress: A Multivariate Analysis of Clinical, Surgical, and Sociodemographic Determinants of Quality of Life in Indonesian Breast Cancer Patients Undergoing Chemotherapy Muhammad Yufimar Riza Fadilah; Mulawan Umar; Theodorus
Sriwijaya Journal of Surgery Vol. 8 No. 2 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i2.138

Abstract

Introduction: The assessment of health-related quality of life (HRQoL) is a paramount outcome in breast cancer survivorship, yet the interplay of disease-specific, treatment-related, and patient-level factors is not fully understood in Southeast Asian populations. This study aimed to comprehensively model the predictors of HRQoL and fatigue by simultaneously evaluating clinical, surgical, and sociodemographic variables among Indonesian breast cancer patients. Methods: A cross-sectional study was conducted with 102 female breast cancer patients undergoing chemotherapy at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Data on clinical variables (AJCC stage, chemotherapy cycles, treatment intent), surgical procedures (breast and axillary surgery type), and sociodemographic characteristics were collected. HRQoL was assessed using the validated Indonesian versions of the Functional Assessment of Cancer Therapy-General (FACT-G) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaires. Bivariate correlations and a hierarchical multivariate linear regression analysis were performed to identify significant independent predictors of FACIT-F scores. Results: The cohort was characterized by advanced disease (Stage III/IV: 62.7%) and aggressive surgical management (Mastectomy: 75.5%; Axillary Lymph Node Dissection: 68.6%). In the multivariate analysis, several factors emerged as significant independent predictors of poorer HRQoL. These included advanced cancer stage (β = -0.41, p < 0.001), having undergone a mastectomy versus breast-conserving surgery (β = -0.28, p = 0.002), having had an axillary lymph node dissection versus sentinel node biopsy (β = -0.25, p = 0.005), and a higher number of chemotherapy cycles (β = -0.19, p = 0.018). The final model explained a substantial portion of the variance in HRQoL (Adjusted R² = 0.58). In contrast, sociodemographic factors including age, income, and education were not significant predictors in the final model (p > 0.05). Conclusion: HRQoL in this cohort is not determined by a single factor but by a triad of distress: the biological burden of the disease (stage), the physical and psychological morbidity of surgical treatment, and the cumulative toxicity of chemotherapy. These treatment-related realities powerfully override the influence of sociodemographic characteristics. These findings mandate a paradigm shift towards an integrated supportive care model that proactively addresses surgical morbidity alongside systemic side effects from the point of diagnosis.
Efek Ekstrak Daun Kersen (Muntingia calabura L.) terhadap Kadar TNF-α pada Tikus Wistar Model Gout Artritis Akut Parisa, Nita; Tantoro, Valyn T; Adenina, Masayu S; Prananjaya, Bintang A; Saleh, Masagus I; Theodorus
Journal of Medicine and Health Vol 7 No 1 (2025)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v7i1.8629

Abstract

The inflammatory condition, marked by pain, swelling, and elevated TNF-α levels, prompted the exploration of cherry leaves' flavonoids, known for their anti-inflammatory properties. An in vivo experimental study with a pre-and post-test control group design was conducted to compare the efficacy of cherry leaf extract (Muntingia calabura L.) in the Wistar rat model of acute gout arthritis. Five treatment groups (negative control (Na-CMC 0,5%), positive control (Colchicine), cherry leaf extract dose 200mg/kgBW, cherry leaf extract dose 400mg/kgBW, and cherry leaf extract dose 800mg/kgBW) were administered to Wistar rats to compare their ability in reducing TNF-α levels. Results revealed the extract's significant efficacy in reducing TNF-α levels at all doses compared to negative control. There is no significant difference among the three different doses compared to colchicine as a positive control. In conclusion, cherry leaf extract demonstrated significant efficacy as an anti-inflammatory agent by reducing TNF-α levels in acute gout arthritis rat models with the most efficient dose of 200mg/kg BW.
The Relationship between Thoracic Trauma Scoring and Mortality in Blunt Thoracic Trauma Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia Ahmat Umar; Marrantiza, Satria; Theodorus
Sriwijaya Journal of Surgery Vol. 6 No. 2 (2023): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v6i2.88

Abstract

Introduction: Closed thoracic trauma is frequently associated with rib fractures and pulmonary contusions. Thoracic trauma can be life-threatening if it is not treated immediately and properly. This study aimed to determine the relationship between thoracic trauma scoring and mortality in blunt thoracic trauma patients in sub-population Indonesia, especially at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Methods: This study is a cross-sectional observational study. A total of 70 research subjects participated in this study. Data analysis was carried out using SPSS in univariate and bivariate to determine the relationship between thoracic trauma scoring and mortality. Results: There is a significant relationship between CTS scores and mortality (p = 0.000). Patients with a CTS score ≥ 5 were significantly more at risk of dying than patients with a CTS score < 5 (p = 0.000). Conclusion: There is a relationship between CTS score and blunt trauma patient mortality thorax at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.
Co-Authors Abda Arif Adenina, Masayu S Agustian, Wisman Agustina Br Haloho Ahmat Umar Akbar Rizky Wicaksana Alsen Arlan Amanda Putri, Khairunnisa Rizqika Anak Agung Gede Sugianthara Anugerah Onie Widhiatmo Apriani Apriani Arie Hasiholan Lumban Tobing Ayeshah A Rosdah Bobi Wijaya Charita Ulfah Widyawan Citra Dewi Darwin, Nopriansyah Debby Handayati Harahap Dian Puspita Sari Eddy Mart Salim, Eddy Mart Efman Manawan Egha Eka Satyani Belina Evi Lusiana Fitrisyah, Aidyl Gerry Armando H.M.T. Kamaluddin Hardi Darmawan Hartanto, Kristian Ika Kartika Ika Kartika, Imanuddin, Kiagus Ahmad Ismail Bastomi Ismed, Yonis Jaya Ndaru Prasetio Jayawarsa, A.A. Ketut Jusuf Fantoni kurniati, nova Larasati, Veny M. T. Kamaluddin M.T. Kamaluddin Marrantiza, Satria Mezfi Unita Mgs. Irsan Saleh, Mgs. Irsan Mgs.Irsan Saleh Muhammad Hafidh Komar Muhammad Rizqi Firyal Muhammad Yufimar Riza Fadilah Mulawan Umar Nashif, Arkan Abdullah Nita Parisa Novi Triana Novianty Nurwany, Raissa Nyiayu Fauziah Kurniawati PATIYUS AGUSTIANSYAH, PATIYUS Prananjaya, Bintang A Putra, Chani Sinaro Qodir, Nur Ramzi Amin, Ramzi Rima Zanaria Rizal Sanif Roni Ferdi Rose Mafiana Rukmana, Cici Chintya Aulia Ruli Robi Ferli Saleh, Masagus I Salni Sastradinata, Irawan Satya Agusmansyah Sonata Daniatiek Sutomo Tanzil Syafei, Abdul Tantoro, Valyn T Wicaksono, Bonanza Abi Windi Astriana Yuniza Yuwono