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Smart Medical Journal
Published by Universitas Sebelas Maret
ISSN : 26211408     EISSN : 26210916     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Smart Medical Journal (SmedJour) is published by Faculty of Medicine Universitas Sebelas Maret. SMedJour publishes original research articles or article review in the basic medical sciences, clinic medical sciences, medical education and public health.
Arjuna Subject : -
Articles 94 Documents
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Choledochal Cysts in Female Adult: Diagnostic Pitfall and Conservative Therapy for Bile Leak Fuadhi, Singgih Annas; Barmawi, Agus; Sofii, Imam; Setyawan, Nurcahya; Handaya, Adeodatus Yuda
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.72426

Abstract

Introduction: Choledochal cysts that are accompanied by obstructive jaundice are a rare case. These cysts can cause intrahepatic or extrahepatic ductal dilatation. Their diagnosis is difficult, particulary in adults. Proper management can prevent further complications.Methods: A serial case report of a patient with a choledochal cyst.Results: 2 female patients aged 21 years and 22 years have a painful and fixed lump in the upper right abdomen. The first patient also complained jaundice. Laboratory results showed an increase in total bilirubin and direct bilirubin. The second patient didn’t complaint about jaundice or increased bilirubin, and she had a cholecystectomy when she was ten. The diagnosis was confirmed by a contrast abdominal CT scan, showing type 1A Todani choledochal cysts in both patients. Management of the first patient was cyst excision, cholecystectomy, and Roux n Y hepaticojejunostomy. In the second patient, adhesiolysis, cyst excision, and Roux n Y hepaticojejunostomy were performed. The second patient had no postoperative complications.Conclusion: Choledochal cysts are a rare congenital condition in adulthood. n both cases, two patients were manage surgically. Bile leakage complications can be manage conservatively. Diagnostic and management of choledochal cysts must be correct to prevent pitfall and complications.
The Correlation Between Physical Activity and Kidney Stone Formation: A Literature Review Hernawan, Budi; Gonzales, Nico
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.71483

Abstract

Background: Kidney stones or nephrolithiasis is a disease where crystals form in kidney due to increased excretion of stones-forming components such as calcium, oxalate, uric acid, cystine, xanthine, and phosphate, or reduced urine volume. In addition, poor eating and drinking habits along with lack of physical activity put individuals at a high risk of developing kidney stones. Previous studies showed that physical activity can both reduce and increase the risk of kidney stones.Purpose: This study aims to determine the relationship between physical activity and formation of kidney stones.Method: A literature review design was used by conducting a journal search through PubMed, Science Direct, and Google Scholar databases using the keywords ("kidney stone" OR nephrolithiasis OR urolithiasis OR "renal calculi") AND ("physical activity" OR exercise)".Results: The results showed a total of 15 articles that discussed correlation between physical activity and kidney stones formation. Ten articles explained that physical activity reduced kidney stones formation, while four reported no significant effect. The last article stated that physical activity increased kidney stones formation Conclusion: Kidney stones formation occurred through the exacerbation of hypercalciuria in the absence of physical activity. Moderate physical activity reduced formation of kidney stones by decreasing calcium excretion in the urine. Meanwhile, excessive physical activity increased the occurrence of kidney stones in the absence of adequate fluid intake.
A Decade of Breastfeeding Self-Efficacy Research: A Bibliometric Analysis using VOSviewer Luluk Fajria Maulida; Revi Gama Hatta Novika; Nurul Jannatul Wahidah; Rufidah Maulina; Siti Nurhidayati; Atriany Nilam Sari; Fadhila Tsania Richa
Smart Medical Journal Vol 8, No 2 (2025): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v8i2.106552

Abstract

Introduction : A mother’s confidence in her ability to breasfeed, known as breastfeeding self efficacy (BSE) is a key predictor of exclusive breastfeeding duration. This study aimed to analyze the development of BSE research and provide insights for researchers and policymakers to improve future studies.Method : This bibliometric analysis was conducted using data from the Scopus database, one of the largest sources of peer reviewed literature. Articles were retrieved on August 7, 2024, using the keywords “Breastfeeding” AND “Self” AND “Efficacy.” A total of 1,006 documents were identified. After applying inclusion criteria (English language, article or review type, published between 2014 and 2023, open access, and final publication stage), 413 documents were selected for analysis. Data were analyzed using VOSviewer version 1.6.20 based on publication year, journal source, author, country of origin, and keywords.Results : Research on BSE has shown a consistent upward trend over the past decade, with the highest number of publications in 2023 (82 articles). The United States was the most productive country, followed by Brazil, Canada, the United Kingdom, China, and Indonesia. Most articles were published in journals focusing on lactation physiology, breastfeeding challenges, and evidence based interventions. The most cited studies emphasized the importance of partner support, coparenting, and breastfeeding safety during the COVID-19 pandemic. Keyword analysis revealed several underexplored areas, particularly the role of midwives, formula use, and BSE in mothers of preterm infantsConclusion : This study highlights the growing global attention to breastfeeding self-efficacy as a key factor in improving maternal and child health, and points to the need for further research on underexplored areas, including the role of midwives and the impact of alternative feeding practices, to support more effective interventions and policies.
Validity And Reliability of The Indonesian Version of Reflux Symptoms Score (RSS) and Reflux Sign Assessment (RSA) Kandhi, Putu Wijaya
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.78463

Abstract

Introduction: Laryngopharyngeal reflux (LPR) symptoms are unspecific and make it difficult for clinicians to make a diagnosis. Several types of questionnaires have been developed to diagnose LPR such as the reflux symptoms score (RSS) and reflux sign assessment (RSA) questionnaires. However, the use of these questionnaires in Indonesia is still experiencing obstacles because there is no Indonesian version that has been tested for validity and reliability. This study aims to evaluate the validity and reliability of the Indonesian versions of RSS and RSA.Methods: This study was an observational analytic study with a cross-sectional design involving 40 patients with LPR during January-March 2023. Questionnaire validity was assessed using external and internal validity methods, while reliability was assessed using internal consistency and test-retest reliability.Results: The Indonesian versions of the RSS and RSA had good internal consistency with Cronbach's α values of 0.734-0.831 and 0.743-0.809 respectively. Test-retest reliability for RSS and RSA was also good with rs of 0.930 and 0.842 respectively with p<0.001 for both questionnaires. The Indonesian versions of RSS and RSA also proved to have good validity with high correlations between RSS with reflux symptoms index (RSI) and RSA with reflux finding score (RFS) with p<0.001 for both questionnaires).Conclusion: The Indonesian versions of the RSS and RSA questionnaires were found to be valid and reliable for the assessment of symptoms and diagnosis of LPR.
A 58-Years Old Women Underwent Triple Arthrodesis for Adult Acquired Flatfoot Deformity Grade IV with Posterior Tibial Tendon Insufficiency Post Failed Reconstruction: A Case Report Bagus Jati Nugroho; Mahardika Frityatama
Smart Medical Journal Vol 7, No 3 (2024): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i3.88653

Abstract

Background: Adult acquired flatfoot (AAFD), formerly known as posterior tibial tendon dysfunction (PTTD), involves the gradual collapse of the foot arch, leading to ongoing deformity. The posterior tibial tendon, crucial for foot stability, is often implicated. A lack of comprehensive epidemiological data exists, but the condition is prevalent, especially among the elderly and those with chronic vascular diseases. Dysfunction of the posterior tibial tendon causes instability in the foot, leading to lateral displacement of forces and subsequent deformities. Triple arthrodesis is an effective treatment for correcting foot deformities, offering pain relief and stability, particularly in cases of arthrosis and neuromuscular diseases. This case report highlights a Grade IV AAFD with failed reconstructive surgery, contributing to the literature on surgical intervention outcomes.Case report: We present the case of a 58-year-old woman with progressively worsening pain and discomfort in her left foot. The patient underwent a triple arthrodesis procedure for adult acquired flatfoot deformity grade IV with posterior tibial tendon insufficiency. the patient has a history of failed reconstructive surgery with medial displacement calcaneal osteotomy and flexor digitorum longus to posterior tibial tendon transfer. Physical examination findings revealed presence of surgical scars on the left pedis region consistent with prior interventions. There is evidence of hindfoot valgus and medial arch collapse, justifying the need for further surgical intervention in radiology finding.Discussion: Stage IV acquired flatfoot deformity results from weakened deltoid ligament and Posterior Tibial Tendon Dysfunction (PTTD), leading to hindfoot valgus and abduction. Surgical options include medializing calcaneal osteotomy (MCO) and tendon transfers like flexor digitorum longus (FDL). Triple arthrodesis is preferred for rigid deformities, but whether to include the calcaneocuboid joint depends on examination findings. Exclusion may cause arthrodiastasis, with limited evidence of improved outcomes. Double arthrodesis has higher nonunion rates but doesn't impair correction.Conclusion: Individuals with rigid foot deformities, triple arthrodesis, fusing the talonavicular, subtalar, and calcaneocuboid joints, improves pain relief and function. The decision to include the calcaneocuboid joint depends on its condition. Excluding it may cause unintended joint movement, but its distraction doesn't necessarily improve outcomes. After talonavicular fusion, calcaneocuboid joint motion is minimal. Double arthrodesis for rigid planovalgus deformity shows higher nonunion rates and lower patient scores compared to triple arthrodesis, but it doesn't impair deformity correction. This case contributes to the growing evidence supporting triple arthrodesis as a salvage procedure for advanced flatfoot deformities and serves as a valuable reference for managing similar challenging cases.
Advancing Surgical Oncology: Short-Term Outcome of Laser-Assisted Pulmonary Metastasectomy: A Case Series Mada Ilham Bawono; Darmawan Ismail
Smart Medical Journal Vol 9, No 1 (2026): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v9i1.115101

Abstract

The new surgical method of laser-assisted pulmonary metastasectomy enables surgeons to perform exact lung tissue removal while they maintain the ability to operate on multiple metastatic tumors. This study describes our experience and short-term outcomes of laser-assisted pulmonary metastasectomy.We present two patients who underwent laser-assisted pulmonary metastasectomy for pulmonary metastases. The first patient was a 19-year-old woman with a history of osteosarcoma, in whom asymptomatic pulmonary metastases were detected during routine surveillance. The second patient was a 50-year-old woman with a history of right-sided bronchoalveolar carcinoma who presented with chronic cough, while imaging tests showed suspected metastatic lesions in her left lung. The two patients received laser-assisted pulmonary metastasectomy which involved the removal of one to three metastatic nodules. Both patients had mild hemoptysis as their only postoperative symptom while they experienced no other major health issues. Short-term outcomes were favorable, with operative times ranging from 1–2 hours, blood loss of 30–50 mL, chest tube duration of 4-5 days and a length of stay of 4–6 daysThis preliminary experience indicates the technical applicability of laser-assisted pulmonary metastasectomy for resecting pulmonary metastases. The initial results showed positive short-term results, but researchers needed to conduct larger prospective studies to determine how effectively and safely the technique performed against standard procedures.
Gallstone Ileus Managed with One-Stage Laparotomy : A Rare Case Report Dorothy Eugene Nindya Wiharjanto; Ida Bagus Budhi Surya Adnyana; Afrizal Tri Heryadi
Smart Medical Journal Vol 8, No 2 (2025): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v8i2.103110

Abstract

Introduction: Gallstone ileus is defined as a mechanical intestinal obstruction due to impaction of one are more gallstones within the gastrointestinal tract. Gallstone ileus has shown a constant incidence of 30-35 cases/1000000 admissions over a 45-year period. Most of the symptoms and signs of gallstone ileus are nonspecific. Case Presentation: A 61-year-old man presented with abdominal pain and vomiting 3 days prior to hospital admission. The abdominal pain was felt on all of the regions of the abdomen and did not subside with rest. The patient has a history of having gallstones on November 2021. On 3 views abdominal x-ray, it showed high-grade ileus. Exploratory laparotomy with ileal enterotomy were performed incidentally to evacuate the gallstones and continued with cholecystectomy. The patient’s condition had improved after receiving surgery. We also provided post-operative pain management and maintained the fluid, electrolyte, and metabolic balances for the patient. Discussion: Gallstone ileus is a rare complication of cholelithiasis. Its intermittency of symptoms could also interfere the diagnosis. Therefore, it is associated with relatively high rates of morbidity and mortality. The main therapeutic goal of gallstone ileus is a relief of intestinal obstruction by evacuating the gallstones.Conclusion: Because of nonspecific signs and symptoms, the diagnosis of gallstone ileus is often delayed. It is mostly an incidental finding during abdominal procedures. Therefore, it should be considered in patients presenting with bowel obstruction and known gallstone disease.
Thyroid Crisis and Diabetic Ketoacidosis in Uncontrolled Diabetes Putri, Desy Puspa; Prabowo, Nurhasan Agung; Hermawati, Berty Denny
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.66806

Abstract

Introduction: Thyroid crisis is a medical emergency that causes damage to various organs of the body so that proper diagnosis and immediate treatment are needed. Excess thyroid hormone also affects blood sugar metabolism, especially in diabetic patients. The occurrence of thyroid crisis in conjunction with diabetic ketoacidosis (DKA) is rare, and the exact pathogenesis is still being investigated. We report a case of thyroid crisis in a DKA patient.Case Presentation: A 35-year-old woman was brought by her family to the ER due to a loss of consciousness since 6 hours before admission to the hospital. The patient was said to have complained of fever, shortness of breath, palpitations since the previous day. The patient has a history of uncontrolled Type 2 Diabetes Mellitus (DM) since 5 years ago. Physical examination showed somnolence, blood pressure 120/72 mmHg, pulse rate 126 beats per minute, irregular, respiratory rate 28 breaths per minute, fast and deep breaths. Investigations showed blood sugar 320 mg/dL, uncompensated metabolic acidosis, ketonuria. The patient received DKA therapy, but her consciousness and pulse rate had not improved. TSH levels was low with an increase in fT4 levels, with the Burch-Wartofsky score supporting a thyroid crisis. The patient then received treatment for thyroid crisis and her clinical condition showed significant improvement.Conclusion: The occurrence of thyroid crisis along with DKA is a life-threatening emergency. Untreated hyperthyroid induce severe hyperglycemia and causes acute condition in both organs.  
Centella asiatica Mitigates NMDA Receptor Antagonist-Induced Locomotor Enhancement in Zebrafish (Danio rerio) Cahayani, Wike Astrid; Masykur, Umar Jundullah; Putri, Dwi Sandhi Aulia Pramesti; Giri, Nyoman Deva Pramana; Sakinata, Naura Syifa; Rohmah, Afifatur
Smart Medical Journal Vol 7, No 2 (2024): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i2.85873

Abstract

Introduction: In exploring the complexities of the central nervous system and its disorders, animal models have proven indispensable for replicating human neurological conditions and investigating potential therapeutic interventions. Zebrafish, with their genetic and neurobiological similarities to mammals, have become a valuable model for studying neuroactive substances. This study aimed to assess the effects of Centella asiatica on MK-801 induced hyperactivity in zebrafish, bridging the gap between traditional herbal medicine and neuropharmacology. Methods: An experimental design was employed, utilizing adult zebrafish acclimatized under standard laboratory conditions, divided into three groups: a control group without any treatment, a group exposed to 5 µM of MK-801, and a group treated with 5 µM of MK-801 followed by Centella asiatica extract at a concentration of 10 µg/L. Swimming velocity served as the primary measure of locomotor activity, analyzed using Ethovision XT software.Results: The study found that MK-801 significantly increased swimming velocity in zebrafish, indicative of induced hyperactivity. Conversely, subsequent treatment with Centella asiatica notably reduced this hyperactivity, aligning swimming velocities closer to those observed in the control group.Conclusion: Centella asiatica demonstrated significant potential to mitigate MK-801 induced hyperactivity in zebrafish, underscoring its neuroprotective properties. This research highlights the therapeutic promise of natural compounds in neuropharmacology and the utility of zebrafish as a model organism in neuroscience research. Further investigation into Centella asiatica's mechanisms of action and its application in other models of neurological disorders is warranted.
From Campus to Community: Enhancing Science Awareness and Interest Through Anatomy Outreach Programme for Secondary School Students in Kelantan Shamsi Amalina Shamsuddin; Siti Fatimah Mukhtar; Zul Izhar Mohd Ismail; Mohd Asnizam Asari; Siti Nurma Hanim Hadie; Nurul Aiman Mohd Yusof; Mohamad Syabil Ikhwan Mohd Amin; Faizah Md Nawi; Nur Fasihah Mat Nawi
Smart Medical Journal Vol 8, No 3 (2025): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v8i3.110198

Abstract

Introduction: An Anatomy Outreach Programme (AOP) was conducted by the Department of Anatomy, Universiti Sains Malaysia at Falahiah Secondary School in Kelantan, Malaysia. The programme featured anatomical specimen exhibitions, interactive explanations, and a science-themed quiz aimed at enhancing science awareness and interest among secondary school students.Methods: The event, attended by 340 students from 9 schools, provided first-hand exposure to human anatomy, promoting student engagement with biology and related sciences. Pre- and post- programme questionnaires was developed, distributed and evaluated diligently.Results: Pre- and post-programme evaluations demonstrated significant improvements in students’ science interest and anatomical knowledge, including a 33% rise in science interest and a 31% increase in basic anatomy understanding. The initiative also positively influenced students’ motivation to pursue science-related studies in upper secondary levels.Conclusion: Despite minor logistical constraints, the programme was well received and has the potential for replication across similar educational settings. It demonstrates how university–community partnerships can address educational disparities and foster early interest in science among underserved populations.

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