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All Journal Dinamika Hukum BALI MEDICAL JOURNAL (BMJ) Medicinus : Jurnal Kedokteran Eduvest - Journal of Universal Studies Magna Neurologica Lumina: Indonesian Journal of Neurology
Made Agus Mahendra Inggas
Department Of Neurosurgery, Universitas Pelita Harapan, Tangerang, Banten, Indonesia
Aerospace Engineering Computer Science & IT Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences

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MAXIMIZATION OF DNA DAMAGE TO MGMT(+) EGFR(+) GBM CELLS USING OPTIMAL COMBINATION OF TEMOZOLOMIDE-ANTI EGFR MONOCLONAL ANTIBODY NIMOTUZUMAB Inggas, Made Agus Mahendra; Wahjoepramono, Eka J.; Maliawan, Sri; Islam, Andi Asadul
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.158 KB)

Abstract

Background: Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adultswith dismal prognosis due to the unavailability of an effective therapy. Up to now, there had been no definitive studies published on EGFR inhibition therapy as a chemosensitizer for GBM therapy using Temozolomide (TMZ). This study aims to reveal the most effective method and timing to administer TMZ anti EGFR targeted therapy which causes maximal DNA damage on GBM cells. Methods: Various regimens of anti EGFR monoclonal antibody Nimotuzumab (NMZ) was administered in different combinations with TMZ, performed on U87MG MGMT(+) EGFR(+) cells. The effectiveness of the combinations were evaluated by measuring yH2AX levels which reflects the degree of DNA damage. One-way Anova and LSD tests were performed to determine the effects of each treatment with p
LEGALITAS ORGANISASI BARU DI LUAR WADAH TUNGGAL ORGANISASI PROFESI DOKTER DI INDONESIA DALAM TINJAUAN YURIDIS Made Agus Mahendra Inggas; Dian Ratu Ayu Uswatun Khasanah; Ronald Jolly Pongantung
Jurnal Ilmiah Dinamika Hukum Vol 24 No 2 (2023): Edisi Oktober 2023
Publisher : Universitas Stikubank

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35315/dh.v24i2.9647

Abstract

The Association of Indonesian Doctors has been formed and declared in a Decree of the Ministry of Law and Human Rights, Number AHU-003638.AH.01.07.2022. The Indonesian Doctors Association is no longer the sole forum for medical organizations in Indonesia. The study of the legality of this new association and the study of the organization of the Indonesian Doctors' Association have violated the right to associate and human rights because it is the sole forum for the medical professional organization which is the focus of the problem raised by the author. The study uses a normative juridical approach to seek answers with certainty and legal certainty through existing legal theories, norms and legislation. The conclusions obtained are that in order to protect patients, improve service quality, and ensure legal and statutory certainty, the medical professional association or organization must be one. Determination of quality and service, competency standards, and professional ethics must come from a professional organization. With a noble purpose, a single professional organization does not violate the law on association and human rights. The presence of a new medical society organization will not interfere with the position of the Indonesian Doctors Association as a professional organization. The suggestion from this study is that new organizations such as the Association of Indonesian Doctors must synergize and become the task force for the Indonesian Doctors Association in controlling the running of the organization while simultaneously providing a driving force for services to the Indonesian people. Key words: Professional organizations; Constitution; Medical practice
The Legal Protection for Doctors Regarding Medical Consent for Additional Medical Procedures Made Agus Mahendra Inggas; Markoni Markoni; I Made Kantikha; Nardiman Nardiman
Eduvest - Journal of Universal Studies Vol. 4 No. 3 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i3.1072

Abstract

Informed Consent is a prerequisite before a medical procedure can be considered legally valid and provide legal protection. Additional medical procedures can raise ethical, medical, and legal issues. There is no specific legislation focusing on legal protection for doctors regarding these additional medical procedures, but general principles of Indonesian law provide room for doctors to defend themselves if they have served patients professionally in accordance with professional standards and professional ethics. The research aims to analyze the procedures for obtaining consent for additional medical procedures and the legal protection for doctors providing these services to patients. The research method is conducted using a normative juridical approach with conceptual and case approach. The research results indicate that the purpose of obtaining consent for medical procedures is to protect patients from medical procedures performed without their knowledge and to provide legal protection for doctors from unforeseen and negative consequences. In the case of additional medical procedures, there must be renewed consent, and the procedure for obtaining consent depends on the availability of family members, either during or after the procedure. Doctors must comply with all medical standards and maintain complete medical records. In conclusion, the procedure for obtaining consent for additional medical procedures should be conducted during the procedure if family members are present or after the procedure if family members are absent, and legal protection for doctors in additional medical procedures is ensured through renewed written consent, maintaining complete medical records, and adhering to professional standards.
Pharmacoresistant Temporal Lobe Epilepsy Controlled by Bilateral Anterior Thalamic Nuclei Thalamotomy Made Agus Mahendra Inggas; Retno Jayantri Ketaren; Vivien Puspitasari; Julianta Wahyoepramono
Eduvest - Journal of Universal Studies Vol. 5 No. 1 (2025): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i1.50815

Abstract

Introduction: Several potential targets have been suggested for the treatment of pharmacoresistant epilepsy, including medial parts of temporal lobes, caudate nucleus, cerebellum, centromedian nucleus of the thalamus, subthalamic nucleus and anterior thalamic nucleus (ATN). The effectiveness of bilateral ATN thalamotomy as treatment option for pharmacoresistant temporal lobe epilepsy is a considerable approach in this recent advances. Method: Case report. Result: A 24-year old male patient presented with unknown onset of generalized tonic clonic seizures and serials of drop attacks since 4 years of age. He was also diagnosed with Attention Defcit Hyperactivity Disorder (ADHD) and a history of febrile seizures. Brain MRI was normal. He has been treated with so many combination of antiepileptic drugs (AEDs) with last combination were Valproic acid 500 mg twice daily, Clonazepam 2 mg thrice daily and Zonisamide 100 mg twice daily. Despite all polytherapy AEDs given, he was still having recurrent seizures. Vagal Nerve Stimulation (VNS) was then conducted and seizures were slightly better. After maximal VNS voltage given, seizures became more frequent. ATN bilateral thalamotomy was done five years after, where seizure was better controlled. Levetiracetam 500mg twice daily and phenobarbital 15 mg once was given in concordance to the surgery, and the patient is doing well until now. Conclusion: In pharmacoresistant temporal lobe epilepsy where AEDs and VNS showed no signifcant improvement, ATN bilateral thalamotomy is considered to be a compelling treatment option. As we know, this is a first case report for ATN thalamotomy for epilepsy in south east asia region.
Lactate Dehydrogenase as A Potential Prognostic Biomarker in Subarachnoid Haemorrhage: A Systematic Review Yang Yang Endro Arjuna; Alexander Erick Purnomo; Jeremiah Hilkiah Wijaya; Mary Christina Elsa; Yusak Mangara Tua Siahaan; Made Agus Mahendra Inggas; Randra Frits Christopher; Michelle Gloria Setiawan; Haddiyya Wardhani Nugroho
Lumina : Indonesian Journal of Neurology Vol. 1 No. 1 (2025): April : Lumina : Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v1i1.9861

Abstract

Background: Subarachnoid haemorrhage (SAH) lacks specific prognostic blood markers, but lactate dehydrogenase (LDH), linked to cellular damage, shows potential for predicting adverse outcomes in SAH patients. Elevated LDH levels may reflect anaerobic metabolism and tissue injury following SAH, providing insight into disease severity and complications. This review explores the relationship between lactate dehydrogenase levels and outcomes in SAH patients. Method: A systematic review was conducted using PubMed, Europe PMC, ScienceDirect, and Google Scholar, searching for terms like "Lactate Dehydrogenase," "LDH," "Subarachnoid Haemorrhage," and "Outcome" up to March 3, 2025. Studies comparing LDH levels with Modified Rankin Score (mRS) and secondary outcomes such as Hunt-Hess grade, Fisher grade, complications, and mortality were included. Result: Seven studies involving 5,985 participants met inclusion criteria. Higher LDH levels correlated with worse mRS scores, increased delayed cerebral ischemia (DCI), postoperative pneumonia, severe Hunt-Hess and Fisher grades, and higher mortality. Using the ROBINS-I tool, four studies showed low risk of bias, and three had moderate risk. Discussion: Elevated LDH levels predict adverse outcomes in SAH, highlighting its prognostic value. As a marker of cellular damage and anaerobic metabolism, LDH reflects tissue injury and hypoxia post-SAH, explaining its link to complications like delayed cerebral ischemia (DCI) and pneumonia. This physiological basis supports its role in risk stratification, aiding early identification of high-risk patients for targeted interventions and improved outcomes. Conclusion: Early measurement of LDH levels after SAH onset may help predict patient outcomes and complications, aiding clinical decision-making and improving patient management strategies.
Contributions of Nursing Professionals and Primary Care Physicians in Interdisciplinary Oncology Teams for Cancer Pain Management: An Analytical Review Henry Riyanto Sofyan; Anne Dina Soebroto; Eunike Novrilia; Ratu Novia Putri Aulia; Daniel Budi Utomo; Liliana Mangkuwerdojo; Erico Mulfiardi; Radja Buntal Sotarduga Simanjuntak; Made Agus Mahendra Inggas
Lumina : Indonesian Journal of Neurology Vol. 2 No. 1 (2026): April: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i1.10963

Abstract

Introduction: Cancer-related pain remains inadequately managed in a substantial proportion of oncology patients, despite established clinical protocols. Current systematic evidence indicates that up to 55% of patients experience undertreated pain.35 Interdisciplinary oncology teams — comprising nursing professionals and primary care physicians (PCPs) — are a critical organizational strategy for improving cancer pain management across the care continuum. Methods: A systematic narrative synthesis was conducted using 30 peer-reviewed sources identified through structured searches of the PubMed, CINAHL, Scopus, and Cochrane databases. Inclusion criteria encompassed studies, reviews, and guidelines published from 2002 to 2025 that addressed professional roles, team structure, barriers, and clinical outcomes in cancer pain management. Results: Nursing professionals contribute substantially to pain assessment and management through validated instruments, pharmacological and non-pharmacological interventions, patient self-management education, and interdisciplinary advocacy. PCPs facilitate care coordination, ensure analgesic prescribing continuity, and manage the primary–specialty interface. Effective interdisciplinary teams improve patient outcomes through structured communication, clear roles, and integrated care pathways. Persistent barriers include care fragmentation, professional role ambiguity, competency gaps, and regulatory constraints on opioid prescribing. Conclusions: Although current evidence supports the effectiveness of interdisciplinary approaches to improving cancer pain outcomes, significant gaps remain in comparative effectiveness data, implementation science, and health equity research. Enhanced clinical training, organizational investment, and policy reform are necessary to optimize collaborative cancer pain management across diverse healthcare settings. Keywords: Cancer Pain, Interdisciplinary Teams, Nursing Professionals, Primary Care Physicians, Collaborative Care, Palliative Care, Pain Mechanisms
Pediatric Epilepsy Surgery in A Drug-Resistant Epilepsy Patient Aggravated by SARS-CoV-2: A Case Report Edeline Samudra; Retno Jayantri Ketaren; Made Agus Mahendra Inggas
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1882

Abstract

Introduction: Epilepsy is a manageable neurological disorder, but about one-third of cases are classified as drug-resistant epilepsy (DRE). DRE in pediatrics is more complex and may lead to cognitive function impairment, while surgery can offer seizure control in cases of focal DRE. Case: A 10-year-old male presented with a four-year history of recurrent seizures, thought to be caused by a left temporal cerebral cyst diagnosed five years earlier. During episodes, he experienced body stiffness, bilateral eye twitching, and drooling, with intact consciousness. After SARS-CoV-2 exposure, seizures became more frequent despite antiepileptic treatment, leading to partial resection of the left temporal lobe nine months later. Two years post epileptic surgery, he has become drug-responsive and achieved seizure control with symptomatic relief through medication. Discussion: Epilepsy is common in children, and DRE should be considered in cases of intractable epilepsy. Various factors can cause DRE, and in this patient, SARS-CoV-2 is thought to aggravate seizures by binding to ACE2 receptors in the central nervous system. This neural interaction may trigger reactive astrogliosis and neuroinflammation, disrupting the balance between glutamate and GABA levels. However, epilepsy surgery has been effective in improving the quality of life. Conclusion: Epilepsy surgery, either resective or non-resective surgery, is still rarely performed in Indonesia, while the management of DRE may require surgery. Although complete seizure freedom is not guaranteed, surgery can often convert DRE into a drug-responsive condition.
Efficacy and Safety of Stem Cell Therapy for Spinal Cord Injury in Adults: A Systematic Review and Meta-Analysis Anadya Rhadika; Sultan Adhitya Romano; Himawan Widyatmiko; Andrew Wilbert Tanuwijaya; Putu Surya Pradipta Hariantha Putra; Salma Rizqi Amanah; Abdelrahman Ramadan Elashry; Sarmad Javaid; Made Agus Mahendra Inggas; Jeremiah Hilkiah Wijaya
Medicinus Vol. 15 No. 1 (2025): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i1.10762

Abstract

Background: Despite encouraging early results, clinical outcomes remain inconsistent across trials. This study aimed to systematically evaluate the efficacy and safety of stem cell therapy in adults with spinal cord injury (SCI). Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. PubMed, EMBASE, and Scopus were searched until 18 October 2025. Eligible studies included adult SCI patients receiving stem cell therapy with measurable neurological outcomes. Data synthesis was performed using Review Manager 5.4 under a random-effects model, reporting pooled risk ratios (RR) with 95% confidence intervals (CIs). Risk of bias was assessed using ROBINS-I, and evidence certainty was graded via GRADE. Result: Thirteen studies involving 470 participants (286 intervention, 184 control) were included. Stem cell therapy significantly improved neurological recovery compared with controls (RR = 2.64; 95% CI 1.70–4.10; p < 0.0001; I² = 0%). Subgroup analyses showed consistent benefits across baseline AIS classifications (RR = 2.61; 95% CI 1.71–3.98) and cell doses (RR = 2.75; 95% CI 1.63–4.64). No major safety signals were identified. GRADE assessment rated the certainty of efficacy evidence as moderate. Conclusions: Stem cell therapy yields significant neurological improvement in adult SCI with a favorable safety profile. The findings support its regenerative potential through neuroprotective and remyelinating mechanisms. However, larger randomized controlled trials are required to validate efficacy, optimize protocols, and assess long-term safety.
Co-Authors Abdelrahman Ramadan Elashry Alexander Erick Purnomo Anadya Rhadika Andi Asadul Islam Andrew Wilbert Tanuwijaya Anne Dina Soebroto Daniel Budi Utomo Edeline Samudra Eka J. Wahjoepramono Erico Mulfiardi Eunike Novrilia Haddiyya Wardhani Nugroho Henry Riyanto Sofyan Himawan Widyatmiko I Made Kantikha Jeremiah Hilkiah Wijaya Jeremiah Hilkiah Wijaya Julianta Wahyoepramono Khasanah, Dian Ratu Ayu Uswatun Liliana Mangkuwerdojo Markoni Markoni Mary Christina Elsa Michelle Gloria Setiawan Nardiman Nardiman Putu Surya Pradipta Hariantha Putra Radja Buntal Sotarduga Simanjuntak Randra Frits Christopher Ratu Novia Putri Aulia Retno Jayantri Ketaren Retno Jayantri Ketaren Ronald Jolly Pongantung Salma Rizqi Amanah Sarmad Javaid Sri Maliawan Sultan Adhitya Romano Vivien Puspitasari Yang Yang Endro Arjuna Yusak Mangara Tua Siahaan