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Journal : Cermin Dunia Kedokteran

Perspektif Medis, Sosial, dan Kebijakan dalam Memahami Infertilitas di Indonesia: Sebuah Tinjauan Naratif Sutanto, Reynardi Larope; Suskhan, Rizki Fauzi; Pratama, Satria Arief; Christian, Christopher; Putra, Elza Nur Warsa; Faruqi, Muhammad; Simanjuntak, Kevin Tadeus; Ali, Najma; Setyawan, Dhanis Adrianto; Suryoadji, Kemal Akbar
Cermin Dunia Kedokteran Vol 52 No 8 (2025): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i8.1598

Abstract

Introduction: Infertility is a reproductive health problem in various countries, including Indonesia, with a significant impact on population and community productivity. This study aims to assess the urgency of addressing infertility in the context of public health and population control in Indonesia. Methods: This research employs a literature review method, referencing relevant sources. Document searches were conducted through Google Scholar and manual searching using the keywords “(Infertility) AND (Indonesia).” Results: The review found 53 literatures consisting of scientific research, medical consensus, review papers, news, and legal products. Discussion: Infertility is a complex problem that requires a multidisciplinary approach. The discussion is organized into several multidisciplinary sections which include a discussion from the medical side in the form of etiology, risk factors, diagnosis flow, and management of infertility, a review of infertility as a public health problem, the impact of infertility on patients and society, sensitive public communication methods regarding infertility, and recommendations for management and policy regulation regarding infertility for government officials. Conclusion: Addressing infertility in Indonesia requires the support of various parties, including the government, health workers, and the community, to overcome its complex impact.
Kombinasi Alat Cardiac Contractility Modulation dan Terapi Sel Punca Hematopoetik CD34+CD133+ sebagai Terapi Gagal Jantung dengan Penurunan Fraksi Ejeksi Ridwan, Alifaturrasyid Syafatullah; Suryoadji, Kemal Akbar
Cermin Dunia Kedokteran Vol 49 No 10 (2022): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i10.309

Abstract

Gagal jantung merupakan penyebab morbiditas dan mortalitas di seluruh dunia dan di Indonesia. Seiring progresi penurunan fungsi kontraktilitas jantung, terapi farmakologis seringkali tidak cukup, sehingga terapi invasif seperti cardiac contractility modulation (CCM) merupakan alternatif. Terapi regeneratif dengan sel punca dewasa CD34+CD133+ juga menunjukkan manfaat memperbaiki perfusi miokard dan inhibisi kerusakan lanjut pasca-iskemia. Studi literatur ini mengevaluasi potensi gabungan modalitas terapi listrik CCM dengan terapi regeneratif sel progenitor CD34+CD133+ pada pasien gagal jantung kronis dengan penurunan fraksi ejeksi hingga <30% berdasarkan penelitian 10 tahun terakhir di database online PubMed, Scopus, dan EBSCO. Kombinasi CCM dengan infus sel punca terbukti meningkatkan kontraktilitas dan membatasi area fibrosis pasca-infark. Dapat disimpulkan bahwa terapi CCM untuk perbaikan kontraktilitas berpotensi dikombinasikan dengan terapi regeneratif sel punca CD34+CD133+ untuk memaksimalkan perbaikan kontraktilitas jantung pada pasien gagal jantung kronis dengan penurunan fraksi ejeksi berat. Heart failure is the leading cause of morbidity and mortality in general population both worldwide and in Indonesia. The progression of decreased cardiac contractility may result in inadequate pharmacological therapy, and invasive therapy such as cardiac contractility modulation (CCM) is an alternative. Regenerative therapy with adult stem cells CD34+CD133+ in various studies has also shown benefits for improving myocardial perfusion and inhibition of further post-ischemic damage. This literature study aims to evaluate the potential of combined cardiac contractility modulation (CCM) electric therapy and CD34+CD133+ progenitor cells regenerative therapy in chronic heart failure with a reduced ejection fraction to <30%. The literature study was compiled from studies of the last 10 years and registered in the online database of PubMed, Scopus, and EBSCO. This study found CCM can increase natural contraction of myocardium without increasing oxygen demand and also influences remodeling myocardium to increase its ejection fraction. Various clinical trials have also shown subpopulations of CD34+CD133+ progenitor cells from bone marrow play a role in enhancing perfusion in post-infarct myocardium, inducing myocardial repopulation and inhibiting further damage to ischemic myocardium. The combination of CCM with cell infusion has been shown to increase contractility and limit the area of post-infarct fibrosis. CCM and regenerative therapy with stem cells CD34+CD133+ may be potentially combined to maximize therapeutic cardiac contractility improvement in chronic heart failure patients with severe reduction of ejection fraction.
Perbaikan Pendengaran Pasien Otitis Media Efusi yang Autoinflasi: Laporan Kasus Berbasis Bukti Firmansyah, Ugiadam Farhan; Suryoadji, Kemal Akbar; Bashirudin, Jenny; Bramantyo, Brastho; Alviandi, Widayat
Cermin Dunia Kedokteran Vol 51 No 6 (2024): Cardiology
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i6.1024

Abstract

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.
Perbandingan Efektivitas Leflunomide dengan Methotrexate untuk Terapi Artritis Rematoid Suryoadji, Kemal Akbar; Wibowo, Pramesti Kusumadini
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.1053

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Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by symmetrical joint involvement and extra-articular manifestations. Methotrexate and leflunomide are disease modifying anti-rheumatic drugs(DMARD) and use as treatment options for rheumatoid arthritis. This report aims to compare the effectiveness of leflunomide with methotrexate as therapy for rheumatoid arthritis. Methods: Literature search was carried out through three electronic databases: PubMed, Cochrane, and EBSCOHost with specific keywords based on PICO. Selection was in accordance with inclusion and exclusion criteria based on the clinical question. Selected literature was critically reviewed using an adapted instrument from the University of Oxford’s CEBM. Result: One systematic review and meta-analysis literature by Alfaro-Lara, et al, (2017) was obtained. The results showed a trend towards methotrexate in achieving response according to American College of Rheumatology (ACR20) (0.88 [95% CI: 0.74-1.06]; p = 0.18), reduction in joint swelling was greater with methotrexate (-0.82 [95% CI: 0.24-1.39]; p = 0.006), no significant difference in joint pain reduction (p>0.05). Liver enzyme elevations were more frequent with leflunomide (0.38 [0.27-0.53]; p = 0.007); gastrointestinal (GI) complaints were more frequent with methotrexate (1.44 [1.17-1.79]; p = 0.0007), no significant difference in the incidence of non-severe infections. Conclusion: Leflunomide has the same efficacy as methotrexate for RA therapy; more reduction of joint swelling with methotrexate. Leflunomide was associated with greater increases in liver enzymes, but fewer GI complaints.
Dampak Merokok terhadap Kesehatan Lingkungan: Sebuah Tinjauan Naratif Suryoadji, Kemal Akbar; Sutanto, Reynardi Larope; Christian, Christopher; Putra, Elza Nur Warsa; Faruqi, Muhammad; Simanjuntak, Kevin Tadeus; A’yun, Ilham Qurrota; Ali, Najma
Cermin Dunia Kedokteran Vol 51 No 3 (2024): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i3.1064

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Introduction: Smoking, which involves tobacco as the primary material, has extensive impacts on environmental and human health. This study incorporates literature and research related to the environmental impacts of smoking. Methods: This research uses the literature review method, referencing relevant sources. Document searches were conducted through Google Scholar and manual searching using the keywords “(Smoking) AND (Environmental Health).” Results: The environmental impacts of smoking are highly complex, including air pollution, littering from cigarette butts, and the effects of tobacco processing and production on land and water. Regulatory issues pose challenges in controlling the negative environmental impacts of smoking. Discussion: Air pollution resulting from smoking includes a significant increase in carbon dioxide emissions and a substantial contribution to climate change. Littering cigarette butts leads to the accumulation of harmful plastic waste in marine ecosystems and human health. Tobacco production also carries serious consequences, including deforestation, agrochemical use, and pollution. Controlling tobacco and cigarette use requires comprehensive measures, including cost regulation, advertising bans, and strict monitoring. Stronger regulations and collaborative efforts are needed to address the environmental impacts of smoking effectively. Conclusion: Smoking has significant impacts on environmental health, including air pollution, littering pollution, and the effects of tobacco production. Further efforts are necessary to control these negative impacts through effective regulations and raising public awareness of the environmental consequences of smoking.
Hubungan antara Bersepeda dan Infertilitas Pria: Tinjauan Sistematis dari Penelitian Saat Ini: Analisis Suryoadji, Kemal Akbar; Ridwan, Alifaturrasyid Syafaatullah; Fauzi, Ahmad; Sini, Kieran Pasha Ivan; Taher, Akmal
Cermin Dunia Kedokteran Vol 52 No 5 (2025): Kardiologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i5.1241

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Introduction: Cycling is a popular sport and also has various health benefits. However, cycling carries health risks, including fertility problems. This research aims to explore the association between cycling and infertility in men. Methods: This systematic review was conducted according to a PROSPERO protocol (ID: CRD42024509255) and PRISMA guidelines using the PubMed, Cochrane, and ScienceDirect databases. Keywords “(Bicycle) AND (Infertility)” are used. The risk of bias was assessed based on the Cochrane risk of bias tool for cohort studies. Results: The final two cohort studies were included with a total of 487 cyclists. Regular cycling of more than 1.5 hours/week was associated with 34% (95% CI 4-55%) lower sperm concentration compared to control. Regular cycling of more than 5 hours/week was associated with lower sperm concentration (OR 1.92, 95% CI 1.03-3.56) and lower total sperm motility (OR 2.05, 95% CI 1.19-3.56) compared to the control group. Conclusion: There is a relationship between cycling and male infertility; a decrease in sperm concentration in men who cycle at least 1.5 hours/week and lower sperm motility in men who cycle for at least 5 hours/week. The direct efect of cycling on the incidence of infertility as a consequence needs to be explored further.
Prognosis Mortalitas Pasien Tuberkulosis dengan Komorbid Diabetes Melitus Tipe 2: Analisis Suryoadji, Kemal Akbar; Fauzi, Ahmad; Ridwan, Alifaturrasyid Syafaatullah; Putra, Abdul Hafiidh Surya; Wisnu, Wismandari
Cermin Dunia Kedokteran Vol 52 No 2 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i2.1248

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Introduction: Indonesia ranks 3rd in tuberculosis (TB) cases in the world, and data from the Ministry of Health in 2020 showed that 10%-15% of TB sufferers had diabetes mellitus (DM). TB is one of the important causes of death, and DM affects the immune system which can increase the severity and mortality of the disease. This evidence-based case report was conducted to examine the mortality risk of tuberculosis patients with DM comorbidity. Methods: An article search was conducted to answer research questions based on 3 databases: PubMed, Cochrane, and ScienceDirect with the keywords “((Tuberculosis) AND (DM type 2) AND (Mortality))”. The search was based on inclusion and exclusion criteria and a critical review was conducted according to the guidelines for prognostic studies. Result: Tuberculosis patients with type 2 DM comorbidities have a 1.51 times higher risk of mortality compared to tuberculosis patients without type 2 DM comorbidities. Conclusion: Study by Huangfu, et al, (2019) can be the best choice to answer the clinical question that the risk of death of tuberculosis patients with comorbid DM increases by 1.51 times compared to patients without DM.
Profil Sosiodemografi Wanita Hamil dengan Infeksi Saluran Kemih: Sebuah Tinjauan Sistematis dari Penelitian Saat Ini: Analisis Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Kadarusman, Adib Kamil Putra; Binathara, Geraldus Sigap Gung; As’syifa, Salsa Billa; Hakim, Surahman
Cermin Dunia Kedokteran Vol 52 No 1 (2025): Obstetri & Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i1.1250

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Introduction: Untreated UTIs during pregnancy can lead to complications for both the mother and the fetus, highlighting the importance of appropriate management. Understanding the sociodemographic profiles of pregnant women with UTIs can aid in tailored interventions and care. Methods: This systematic review followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024507145). Cohort cross-sectional studies focusing on the sociodemographic profiles of pregnant women with UTI were systematically searched and selected from databases such as ScienceDirect, Cochrane, Scopus, and PubMed. Eligibility criteria included relevance to sociodemographic profiles, clear extraction and statistical analysis methods, and publication in English. Data extraction and study selection were conducted independently by six researchers, with any discrepancies resolved through discussion. Results: Three studies met the inclusion criteria and were included in the systematic review. The studies conducted in the United States, Cameroon, and Bangladesh, which included 46,398 pregnant women, revealed diverse sociodemographic factors associated with UTI risk among pregnant women. Factors such as low educational attainment, low household income, and racial/ethnic disparities were identified as significant contributors to UTI prevalence in the United States. In Cameroon, although a high UTI prevalence was observed, no significant risk factors were identified. In Bangladesh, maternal undernutrition, primiparity, and low paternal education were significant risk factors for UTIs among pregnant women. Antibiotic sensitivity was varied, indicating the complexity of UTI management. Conclusion: The systematic review emphasizes the importance of considering sociodemographic factors in understanding and addressing UTI risk among pregnant women. Socioeconomic status, cultural disparities, and health-related factors play significant roles in UTI prevalence and management. An intervention to target specific sociodemographic characteristics may be necessary to effectively prevent and manage UTIs in pregnant women across different geographical and socioeconomic contexts.