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All Journal The International Journal of Medical Science and Health Research The Indonesian Journal of General Medicine
Wahyu Agus Prastyo
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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A Comprehensive Literature Review of Histopathology of Squamous Cell Carcinoma Wahyu Agus Prastyo; Artha Investari Nugraheni
The Indonesian Journal of General Medicine Vol. 7 No. 3 (2024): 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/h70hva33

Abstract

Background: The literature on the histopathology of squamous cell carcinoma (SCC), particularly cutaneous squamous cell carcinoma (cSCC), has evolved significantly over the past decade, revealing a complex interplay of histopathologic features, molecular markers, and clinical outcomes.  Literature Review: The work by (K. El-Mofty, 2014) explores histopathologic risk factors associated with oral and oropharyngeal SCC variants, particularly those related to HPV. The identification of distinct morphological characteristics shared among keratinizing neoplasms is essential for accurate diagnosis and treatment planning. The article highlights the unique behaviors of HPV-related variants, which may exhibit either favorable prognoses or aggressive metastatic potential, thus necessitating careful evaluation. The role of immunohistochemical markers in the diagnosis and staging of cSCC is further elaborated by (Bălășescu et al., 2022), who identify key characteristics that predict disease progression. Their findings suggest that immunohistochemical markers can enhance diagnostic accuracy, particularly in poorly differentiated cases, thereby informing treatment strategies. Finally, (Gabriel Cocuz et al., 2022) provide a scientometric analysis of current research directions, highlighting the sustained interest in histopathology and immunohistochemistry of cSCC. Their work suggests an ongoing recognition of the importance of personalized diagnostics and targeted therapies to improve patient outcomes. Conclusion: In conclusion, the reviewed literature underscores the complexity of cSCC histopathology and the critical need for accurate diagnosis and staging. The integration of histopathological features with molecular markers and the continual evolution of diagnostic techniques are essential for refining our understanding of SCC behavior and enhancing treatment efficacy. Ongoing research is necessary to address existing challenges and optimize patient management strategies.
A Comprehensive Literature Review of Histopathology of Renal Cell Carcinoma Wahyu Agus Prastyo; Artha Investari Nugraheni
The Indonesian Journal of General Medicine Vol. 7 No. 3 (2024): 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/g4852n71

Abstract

Background: The histopathology of renal cell carcinoma (RCC) encompasses a diverse array of subtypes, each characterized by distinct morphological and genetic features that have significant implications for clinical outcomes and treatment strategies. The evolution of our understanding of RCC has been reflected in a series of pivotal studies over the years, which have contributed to the molecular and histological classification of this malignancy. Literature Review: The exploration of ancillary techniques by (Pradhan et al., 2009) further enriched the discourse on RCC by emphasizing the significance of integrating histomorphology with molecular and cytogenetic analyses. This multifaceted approach is vital for improving diagnostic accuracy and tailoring treatment plans to individual patient needs ((Pradhan et al., 2009)). The comprehensive molecular characterization conducted by The Cancer Genome Atlas ((J. Ricketts et al., 2018)) revealed distinct genetic drivers associated with various RCC subtypes, emphasizing the importance of understanding these alterations for developing effective treatment strategies ((J. Ricketts et al., 2018)). Recent advancements in digital pathology, as discussed by (Zhu et al., 2020) and (Abu Haeyeh et al., 2022), highlight the potential of deep learning techniques to enhance diagnostic accuracy and streamline the classification of RCC subtypes, thus improving clinical outcomes ((Zhu et al., 2020); (Abu Haeyeh et al., 2022)). Conclusion: The analysis of papillary renal cell carcinoma by (S. Chawla et al., 2023) underscores the unique biological characteristics of this subtype and the challenges in advancing therapeutic strategies compared to clear cell RCC ((S. Chawla et al., 2023)). The literature collectively illustrates the dynamic and evolving nature of RCC histopathology, emphasizing the need for ongoing research to refine classification systems and enhance understanding of tumor biology, ultimately aiming to improve patient outcomes.
A Comprehensive Literature Review of Histopathology of Hepatocelullar Carcinoma Wahyu Agus Prastyo; Artha Investari Nugraheni
The Indonesian Journal of General Medicine Vol. 7 No. 3 (2024): 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/xhcvh622

Abstract

Background: The literature surrounding hepatocellular carcinoma (HCC) reveals a complex interplay of histopathological features, molecular genetics, and clinical implications that shape the understanding and management of this prevalent malignancy. Literature Review: The molecular and genetic markers associated with HCC are explored by (El-Nakeep, 2022), who address the high mortality rates associated with HCC and the complex relationship between cirrhosis and HCC development. This discussion emphasizes the necessity for further investigation into the molecular pathways underlying HCC progression. The role of imaging in diagnosis and management is reinforced by (Chartampilas et al., 2022), highlighting the importance of dynamic imaging techniques in accurately staging HCC and assessing treatment responses. Moreover, localized studies, such as that by (Sweed et al., 2022), contribute to the understanding of HCC's heterogeneous nature, emphasizing morpho-molecular classifications that guide diagnosis and treatment. The immune landscape, as discussed by (Gryziak et al., 2022), introduces the implications of immune cell interactions within the tumor microenvironment, suggesting that immune profiles should be considered alongside histopathological features in tailoring treatment strategies. The mutational landscape of HCC and the potential for precision medicine are examined by (Gorji et al., 2023), advocating for personalized therapeutic strategies that account for the genetic diversity of HCC. Finally, (Hyuk Choi & N. Thung, 2023) synthesize recent advancements in histological and molecular classification, emphasizing the importance of accurate pathological classification for effective management and prognostication. Conclusion: In conclusion, the literature collectively underscores the critical integration of histopathological analysis with molecular insights and clinical practices to enhance the understanding of HCC. This multifaceted approach is essential for improving diagnosis, treatment, and patient outcomes in the context of this complex malignancy.
Diagnostic and Surgical Outcomes for Congenital Diaphragmatic Hernia in Neonates : A Literature Review Wahyu Agus Prastyo; Artha Investari Nugraheni
The International Journal of Medical Science and Health Research Vol. 10 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/2yz5w656

Abstract

Introduction: The literature surrounding congenital diaphragmatic hernia (CDH) in neonates has evolved significantly over the past decade, reflecting advances in both diagnostic and surgical approaches. Literature Review : Chaudhary et al. (2019) further contribute to understanding prognostic factors associated with CDH, identifying critical indicators that correlate with survival outcomes. Their retrospective audit highlights the variability in survival rates among healthcare centers, underscoring the need for standardized protocols in managing CDH. Similarly, Raitio et al. (2021) systematically review the impact of hernia sac presence on survival outcomes, revealing that the presence of a hernia sac may confer physiological advantages, thereby improving prognosis. Long-term outcomes for CDH survivors remain a critical concern, as highlighted by Yamoto et al. (2022), who report that while survival rates have improved, these patients are at risk for various long-term complications. Cimbak and Buchmiller (2024) reinforce this by advocating for long-term follow-up clinics to manage the complex health issues that arise in CDH survivors. Their work emphasizes the necessity of a structured approach to longitudinal care that adapts to the evolving needs of this patient population. Conclusion: In conclusion, the literature reflects a multifaceted understanding of the diagnostic and surgical outcomes for congenital diaphragmatic hernia in neonates. Continued research, collaboration among healthcare professionals, and comprehensive care strategies are essential for optimizing outcomes and addressing the long-term challenges faced by CDH survivors.
Diagnostic and Surgical Outcomes for Pediatric Hernias : A Literature Review Wahyu Agus Prastyo; Artha Investari Nugraheni
The International Journal of Medical Science and Health Research Vol. 10 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/j1zcty48

Abstract

Introduction: The literature on pediatric hernias and their surgical management has seen significant advancements, particularly in the comparison between laparoscopic and traditional open repair techniques. Literature Review : Research has highlighted various advantages of laparoscopic repair, such as shorter recovery times and reduced postoperative pain (Namgoong et al., 2014). However, concerns regarding recurrence rates and operational costs persist, prompting further investigation into the nuances of different surgical approaches (Min Lim et al., 2020). A retrospective study reinforced the notion that while laparoscopic techniques offer enhanced visibility and potential cosmetic benefits, open repair remains a reliable standard due to its simplicity and established success rates (N. Al-Taher et al., 2021). The growing body of literature underscores the importance of minimally invasive surgery (MIS) in pediatric settings, with bibliometric analyses indicating a trend towards laparoscopic techniques, particularly in cases of bilateral hernias and recurrences (Shu et al., 2022). Recent contributions have advocated for personalized surgical approaches that prioritize patient recovery and safety, reflecting an evolution in hernia repair methodologies.  Conclusion: Collectively, the literature illustrates a robust discourse surrounding pediatric hernia repair, where the ongoing evaluation of laparoscopic techniques against traditional methods is paramount. The findings indicate that while laparoscopic approaches are gaining traction, a balanced perspective that considers both the potential benefits and the established efficacy of open repair is essential for informed surgical decision-making in pediatric patients.
Management Protocols and Surgical Outcomes for Pediatric Intussusception : A Literature Review Wahyu Agus Prastyo; Artha Investari Nugraheni
The Indonesian Journal of General Medicine Vol. 10 No. 2 (2025): 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/mv2gc364

Abstract

Background: The literature on pediatric intussusception highlights the complexities of diagnosis and management, underscoring the need for timely intervention to optimize outcomes. The articles reviewed provide a multifaceted perspective on the condition, detailing diagnostic techniques, management protocols, and surgical outcomes. Literature Review: The initial article emphasizes the idiopathic nature of pediatric intussusception, linking it primarily to viral infections and the hyperplasia of Peyer's patches (Gupta et al., 2010). This foundational understanding is crucial as it sets the stage for the subsequent discussions on imaging and intervention strategies. The advocacy for ultrasonography as the primary diagnostic tool (Dadlani et al., 2020) reflects a shift towards non-invasive methods, aligning with contemporary pediatric practices that prioritize patient safety. The systematic review consolidates these insights, emphasizing the efficacy of non-surgical interventions and the necessity of surgical options when initial methods fail (Ali Attoun et al., 2023). It also discusses the role of adjunct therapies, such as dexamethasone, which reflects an evolving approach to treatment that integrates pharmacological support with traditional techniques. This distinction is critical for surgical planning, as it informs whether non-operative reduction or surgical intervention is warranted. The importance of timely diagnosis and intervention is further reinforced by the findings on idiopathic intussusception, where non-operative methods, such as pneumatic enemas, are shown to be effective (Alnamshan et al., 2023). Conclusion: In conclusion, the reviewed literature collectively underscores the critical importance of accurate diagnosis and timely intervention in managing pediatric intussusception. The evolution of management protocols, from non-invasive imaging to surgical interventions, illustrates a comprehensive approach that prioritizes patient outcomes. Continued research and the development of standardized management algorithms will be essential in further refining these protocols to enhance surgical outcomes for pediatric patients.
Management Strategies and Surgical Outcomes for Pediatric Appendicitis : A Literature Review Wahyu Agus Prastyo; Artha Investari Nugraheni
The Indonesian Journal of General Medicine Vol. 10 No. 2 (2025): 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/s2fazs37

Abstract

Background: The management of pediatric appendicitis has witnessed significant advancements, particularly with the introduction of non-operative strategies alongside traditional surgical approaches. Literature Review: The study by (GUANA et al., 2016) highlights the challenges of managing appendicitis in younger children, particularly under five years old, where atypical presentations can lead to complications such as perforation. The comparative analysis of laparoscopic and open surgical techniques underscores the benefits of minimally invasive surgery, including reduced postoperative pain and shorter recovery times, which are crucial in pediatric care. In contrast, the exploration of non-operative management by (Hall and Eaton, 2018) reveals that non-operative strategies, particularly antibiotic therapy, can be effective for uncomplicated appendicitis, with the potential to avoid surgery altogether. This perspective is supported by (Stulberg et al., 2018), who conducted a cost-effectiveness analysis demonstrating that antibiotic management yields better quality-adjusted life years and is less costly than surgical intervention. The systematic review by (Maita et al., 2019) further solidifies the efficacy of non-operative treatment for nonperforated appendicitis, indicating a significant success rate while acknowledging the need for careful patient selection to mitigate the risk of complications. The findings from (Yadao et al., 2022) and (Jumah and Wester, 2022) reinforce the potential of antibiotics as a first-line treatment for uncomplicated appendicitis, showcasing promising success rates and shorter hospital stays for non-surgical patients.  Conclusion: In conclusion, the literature presents a compelling case for the evolving management strategies for pediatric appendicitis, advocating for a balanced approach that incorporates both surgical and non-operative options. As non-operative management gains traction, it is critical for clinicians to consider individual patient characteristics and the associated risks of recurrence and complications when determining the optimal treatment pathway.
Laboratory Diagnosis of Lupus Anticoagulants: A Systematic Review of Assay Performance, Pre-analytical Challenges, and Clinical Utility Wahyu Agus Prastyo; Artha Investari Nugraheni; Mutia Ruliana Ayuningrum
The International Journal of Medical Science and Health Research Vol. 17 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/q03b8c43

Abstract

Introduction: Lupus Anticoagulants (LA) are a heterogeneous group of autoantibodies that paradoxically increase the risk of thrombosis despite prolonging in vitro phospholipid-dependent coagulation assays. As a key laboratory criterion for the diagnosis of Antiphospholipid Syndrome (APS), accurate LA detection is critical for patient management. However, the diagnostic process is fraught with challenges, including assay variability, pre-analytical errors, and significant interference from anticoagulant therapies. This systematic review synthesizes the current evidence on laboratory testing for LA to provide a comprehensive overview of best practices and persistent challenges. Methods: A systematic search of biomedical databases was conducted to identify studies evaluating the diagnostic accuracy of LA assays, the impact of pre-analytical and analytical variables, strategies for mitigating anticoagulant interference, and the correlation of LA positivity with clinical outcomes. Studies were selected based on predefined inclusion and exclusion criteria. The methodological quality of diagnostic accuracy studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Data on study design, patient populations, assays, and key outcomes were extracted and synthesized. Results: The review included 17 key studies. The evidence confirms that a dual-assay strategy using a dilute Russell's Viper Venom Time (dRVVT) and a sensitive activated Partial Thromboplastin Time (aPTT), such as the Silica Clotting Time (SCT), provides the highest diagnostic yield. The dRVVT demonstrates high specificity (>95%) and superior robustness to pre-analytical variations, whereas the SCT can offer greater sensitivity (up to 53.3% vs. 31.1% for dRVVT in one cohort). Pre-analytical variables, particularly platelet contamination, significantly risk false-negative results. Anticoagulant therapies, especially Direct Oral Anticoagulants (DOACs), cause profound interference, with rivaroxaban and apixaban leading to high rates of false-positive results (up to 92% for dRVVT). DOAC-adsorbent agents and alternative assays like the Taipan Snake Venom Time/Ecarin Time (TSVT/ET) have shown high efficacy in mitigating this interference. Persistent LA positivity is strongly associated with thrombosis (Odds Ratio up to 10.1 when co-present with other antiphospholipid antibodies) and adverse pregnancy outcomes (70% of pregnancies affected in one high-risk cohort). Discussion: The findings underscore the necessity of stringent, multi-step laboratory protocols for reliable LA detection. The differential performance and stability of dRVVT and SCT have important implications for assay selection, particularly in laboratory networks with sample transport. The management of anticoagulant interference has evolved from a strategy of avoidance to one of active mitigation, representing a significant advance in diagnostic capability and patient safety. The strong correlation between LA test results and severe clinical outcomes highlights the critical role of the laboratory in guiding therapeutic decisions, such as the choice between Vitamin K antagonists and DOACs in high-risk APS patients. Conclusion: Accurate LA detection is achievable but demands meticulous attention to pre-analytical, analytical, and post-analytical factors. Laboratories must implement robust protocols for sample processing and adopt validated strategies to manage anticoagulant interference. Clinicians must be aware of test limitations and the importance of confirming positive results. Continued efforts toward standardization, including the adoption of automated interpretation algorithms, are essential to reduce inter-laboratory variability and improve patient outcomes.
Estimating Glomerular Filtration Rate in Kidney Transplantation: A Systematic Review of the Diagnostic Accuracy of Creatinine and Cystatin C-Based Equations Wahyu Agus Prastyo; Artha Investari Nugraheni; Mutia Ruliana Ayuningrum
The International Journal of Medical Science and Health Research Vol. 17 No. 4 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/0nkfxa61

Abstract

Introduction: Accurate assessment of glomerular filtration rate (GFR) is paramount for monitoring allograft function and predicting outcomes in kidney transplant recipients (KTRs). Estimated GFR (eGFR) equations, based on endogenous biomarkers like serum creatinine (SCr) and cystatin C (CysC), are universally used, but their performance in the unique KTR population is variable. This systematic review synthesizes the evidence on the diagnostic accuracy of various eGFR equations in adult KTRs. Methods: A systematic search of PubMed, Scopus, and the Cochrane Library was conducted to identify diagnostic accuracy studies comparing eGFR equations to a measured GFR (mGFR) reference standard (e.g., inulin, iohexol, iothalamate, or radioisotope clearance) in adult KTRs. Data on study design, population characteristics, and performance metrics—including bias, precision, and accuracy (proportion of estimates within 30% of mGFR, P30)—were extracted. The methodological quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: Seventeen primary research studies involving over 20,000 KTRs were included. The evidence demonstrates that eGFR equations combining both SCr and CysC consistently outperform single-marker equations. The combined Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine-cystatin C equation achieved a P30 accuracy of 86.5% in a large cohort, superior to its creatinine-only (80.4%) and cystatin C-only (77.1%) counterparts. The recently developed, race-free, KTR-specific (KRS) equation showed high accuracy (P30 ranging from 73.0% to 91.3%) and outperformed the general population race-free CKD-EPI 2021 equation. Validation studies of the 2021 race-free CKD-EPI equations found their performance to be comparable to the previous 2009/2012 race-inclusive versions in KTRs, supporting their adoption in this population. Equations developed for specific subpopulations, such as the Berlin Initiative Study 1 (BIS-1) for the elderly, also demonstrated strong performance in older KTRs. Discussion: The superior accuracy of combined-marker equations is attributable to the mitigation of distinct non-GFR determinants associated with each biomarker. The development of the KRS equation marks a significant advancement, highlighting the benefit of population-specific formulas. The comparable performance of race-free equations alleviates concerns about compromising accuracy while promoting health equity. Conclusion: For the most accurate GFR estimation in KTRs, combined SCr-CysC equations are recommended. When only SCr is available, the KTR-specific KRS equation is the preferred choice over general population formulas. The transition to race-free equations is safe and appropriate in the kidney transplant setting.
Co-Authors Artha Investari Nugraheni Mutia Ruliana Ayuningrum