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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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Correlation Between HbA1c Levels and Chronic Complications in Patients with Type 2 Diabetes Mellitus at UNS Hospital Prasasti Probowirasmi; Coana Sukmagautama; Siti Munawaroh
Smart Medical Journal Vol 8, No 1 (2025): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v8i1.94924

Abstract

Introduction: Diabetes mellitus has been a burden for global health with 422 million patients. Complication in diabetes patients increase the cost of patient care. This research was conducted to determine the correlation between HbA1c levels and chronic complications of type 2 diabetes mellitus in UNS hospital. Furthermore, the HbA1c predictive threshold and the incidence of chronic problems linked to type 2 diabetes mellitus are also explained in this paper.Methods: This study used a retrospective cross-sectional design based on 133 inpatient medical records from 2022. Data were collected using a purposive sampling method that adjust the inclusion and exclusion criteria. Data analysis using SPSS 23 software with logistic regression.Results: (1) There is a significant correlation of HbA1c levels and chronic complication of type 2 diabetes mellitus patients in UNS Hospital. (2) HbA1c score of 6.5% or above is best cutoff to use for determining whether type 2 diabetes mellitus was developing chronic problems. (3) The prevalence of the organ with the most involvement in complication is cardiovascular (51,4%).Conclusion: There is a significant correlation of HbA1c levels and chronic complication of type 2 diabetes mellitus in UNS Hospital with cardiovascular as the organ with the most involvement.
The Correlation Between Interleukin-6 (IL-6) Levels and the Extent of Coronary Lesions Based on SYNTAX Scores in Patients with Acute Coronary Syndrome (ACS) Siallagan, Delpiana; Loesnihari, Ricke; Hasan, Refli
Smart Medical Journal Vol 7, No 1 (2024): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i1.80649

Abstract

Introduction: Atherosclerosis plays an important role in the pathogenesis of acute coronary syndrome (ACS). Inflammation plays a causal role in atherosclerosis. There are many inflammatory markers related to ACS, including C-reactive protein (CRP), homocysteine, matrix metal loproteinases, interleukin (IL)-6, IL-8, and IL-27. IL-6 is the sign of synthesis of acute phase proteins. Recently, the clinical trials related to ACS showed that IL-6 may be an indicator of increased risk for ACS.  An Interleukin-6 (IL-6) examination is can be used  to assess risk factors for acute coronary syndrome (ACS). Interleukin-6 is a marker of local inflammation of coronary plaque and peripheral blood circulation which increases the occurrence of coronary heart disease causing plaque instability and rupture. The SYNTAX scoring system has   correlation assessed through angiography assessing the complexity of the severity of coronary artery stenosis. This study aims to determine the between Interleukin-6 (IL-6) levels and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome (ACS).Methods: This is a cross-sectional study of 45 patients with acute coronary syndrome (ACS) who were treated at H. Adam Malik General Hospital, Medan (February 2023 – May 2023). IL-6 levels were examined using the Electrochemiluminescent Immunoassay (ECLIA) method using Cobas e 411. The extent of the coronary lesion was calculated based on the SYNTAX score from coronary angiography which was calculated by two invasive cardiologist as suggested before using an online calculator. We used the Spearman correlation test and Mann Whitney test to analyze the data.Results: There were 39 male subjects (86.7%) total.  The mean age of the subjects was 54.89 ± 10.3 years old. Most of the subjects experienced STEMI in total 28 people (62.2%). The Median IL-6  levels was  19.22 pg/mL  while the median of SYNTAX score level was 13.00. By using cross-sectional study and the spearman correlationa test, there is a significant correlation between IL-6 and the SYNTAX score with the correlation value obtained r = 0.343 (p = 0.021).Conclusion: There is a significant relationship between IL-6 and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome. 
A Systematic Review of Cassia alata Extract as an Anticancer Agent in Human Breast Cancer Cell Lines from In Vitro Studies Fasha Putri Arkhan; Faithu Arthuvachivo; Siti Munawaroh
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.v8i3.109304

Abstract

Introduction: As one of the leading causes of cancer-related deaths in women, breast cancer still poses major treatment challenges. Chemotherapy often causes toxicity and resistance, emphasizing the need for safer options. Cassia alata, rich in flavonoids like kaempferol shows potential anticancer effects through apoptosis induction. This review evaluated the in vitro evidence of C. alata against human breast cancer cell lines.Methods: This review followed the PRISMA 2020 guidelines. A total of 1,183 records were retrieved from six databases (PubMed, Scopus, ScienceDirect, ProQuest, EBSCOhost, and Google Scholar). After screening records, eight studies met the eligibility criteria. Eligible studies were in vitro experiments evaluating C. alata crude extracts, fractions, or derived formulations on human breast cancer cell lines (MCF-7, T47D, MDA-MB-231, and others). Data on interventions, concentrations, cytotoxicity assays, and molecular mechanisms were extracted. Quality assessment was performed independently by two reviewers using the ToxRTool, with discrepancies resolved through consensus. Inter-rater reliability was not applied due to small sample size and consensus scoring.Results: C. alata consistently reduced breast cancer cell viability, with reported IC₅₀ values ranging from 0.013 to 456 µg/mL depending on extract and cell line. Most studies showed dose-dependent cytotoxicity and apoptosis via caspase activation, nuclear fragmentation, and PI3K/AKT inhibition. Variations in extraction methods and assay conditions explained inter-study heterogeneity.Conclusion: Evidence from studies indicates that C. alata reduces breast cancer cell viability and promotes apoptosis. Further in vivo and clinical studies are required to validate efficacy and safety.
The Increase of HDL-C Levels using Ethanol Extract of Vernonia amygdalina Leaves in Wistar Rats Models of Metabolic Syndrome Pakha, Dyonisa Nasirochmi; Nurwati, Ida; Sunggoro, Agus Jati; Muthmainah, Muthmainah; Handayani, Selfi
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.v6i3.80480

Abstract

Introduction: Metabolic syndrome (MetS) is a cluster of metabolic factors, including low high-density lipoprotein cholesterol (HDL-C) levels. Vernonia amygdalina (VA) leaves have been documented for their anti-cholesterol properties. The purpose of this study to evaluate ethanol extract of VA leaves in rising HDL-C levels in the MetS model.Methods: An experimental study using pre-and post-test design was conducted using 30 male Wistar rats divided into five groups randomly. KN group served as the control group. KP group was the MetS model without ethanol extract administration. Meanwhile, P1, P2, and P3 were MetS models and were administered ethanol extract of VA leaves administration (50mg/kg, 100mg/kg, and 150 mg/kg) for 28 days. The data were analysed using paired t-test and one-way ANOVA (α=0,05).Results: This study discovered that administering the extract in P1, P2, and P3 significantly improved HDL levels. Furthermore, increasing the dose resulted in significantly greater HDL levels. VA leaves contain phytochemicals that have impacts on cholesterol levels in the blood. Flavonoids and tannin inhibit ester cholesterol formation. Terpenoid and flavonoid hinder HMG-CoA. Saponin contributes to free cholesterol transporter, reducing oxidative stress and increasing LDL receptors. Lastly, vitamin C raises catabolism levels and clearance LDL.Conclusion: There are increases in HDL levels in the MetS model group receiving ethanol extract VA leaves. 
Investigating Factors Influencing Treatment Outcomes of Pulmonary Tuberculosis: A Cross-Sectional Study Based on Community Health Center Registry in Surakarta Muhamad Rico Aldrian Renandri Bragastio; Suyatmi Suyatmi; Ahmad Farih Raharjo; Jatu Aphridasari
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.v7i3.88225

Abstract

Introduction: Pulmonary tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. The successful treatment of pulmonary TB can be influenced by several factors, namely gender, age, body mass index (BMI), and comorbid diseases. This study aims to investigate whether those factors influence the treatment outcome of pulmonary TB patients in Surakarta.Method: This study is an analytical observational study with a cross-sectional design. The research subjects were pulmonary tuberculosis patients treated in 2020-2022 at Ngoresan, Setabelan, and Sibela Community Health Center of Surakarta. The inclusion criteria was pulmonary TB patient over 15 years old. Patients suffering from other pulmonary diseases or with incomplete medical record were excluded.Results: This study involved 101 subjects. Multivariate analysis was conducted using the logistic regression test and bivariate analysis showed that there were not any significant effect of age, BMI, and comorbid diseases observed on treatment outcome with p=0.571, p=0.147, and p=0.13 respectively. Interestingly, gender was found to be significantly influencing the outcome of pulmonary TB treatment (p=0.020)Conclusion: Gender influencing the treatment outcome of pulmonary TB patients in Surakarta. Further study covering more cases across all Community Health Center of Surakarta is required.
The Role of Umbilical Cord–Derived Mesenchymal Stem Cell Secretome in Regulating Oxidative Stress and Inflammation in Skin Cells Fanni Yuniar; Endang Purwaningsih; Nunung Ainur Rahmah; Nenden Lilis
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.v9i1.115685

Abstract

Introduction: Oxidative stress and inflammation are tightly interconnected processes that drive skin aging, impaired wound healing, and inflammatory skin disorders. Excessive reactive oxygen species (ROS) disrupt skin cell homeostasis, promote cellular senescence, and sustain inflammatory signaling, ultimately compromising skin regeneration. Umbilical cord–derived mesenchymal stem cell (UC-MSC) secretome has recently emerged as a promising cell-free therapeutic approach to modulate these pathological mechanisms.Methods: A narrative literature review was conducted using PubMed, Scopus, ScienceDirect, and Google Scholar to identify studies investigating the role of UC-MSC secretome in regulating oxidative stress and inflammation in skin cells. Search terms included combinations of “UC-MSC secretome,” “extracellular vesicles,” “exosomes,” “oxidative stress,” “inflammation,” “keratinocytes,” “fibroblasts,” and “wound healing.” studies relevant to skin biology were included based on biological relevance and mechanistic insight rather than strict methodological filtering.Results: The UC-MSC secretome, composed of soluble factors and extracellular vesicles enriched with bioactive proteins, cytokines, antioxidant enzymes, and regulatory microRNAs, consistently demonstrates antioxidant and anti-inflammatory effects in keratinocytes, fibroblasts, and melanocytes. Mechanistically, it reduces intracellular and mitochondrial ROS, activates endogenous antioxidant pathways such as Nrf2 and FOXO, preserves mitochondrial function, and NF-κB and MAPK. In vitro and in vivo studies show attenuation of UV-induced photoaging, enhanced wound healing, and protection of melanocytes from oxidative and immune-mediated damage.Conclusion: Current evidence supports UC-MSC secretome as a potent regulator of oxidative stress and inflammation in skin cells. Its cell-free nature offers advantages in safety, scalability, and therapeutic flexibility, highlighting strong translational potential for dermatology and regenerative skin medicine.
The Enablers and Barriers of Down-Scheduling Medicine Policies: A Systematic Review Ayu Candra Dewi; Andi Hermansyah; Umi Athiyah
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.v8i2.104493

Abstract

Introduction: Down-scheduling medicine policies aim to increase the availability of medicines by reclassifying certain prescription-only medicines to non-prescription classification. While these policies offer potential benefits, there is limited knowledge about the factors that enable or hinder their implementation.Methods: A systematic review of English language published literature from 2013-2024 was conducted. The literature was retrieved through web including PubMed, Scopus, Science Direct, Google Scholar, Cochrane, and Cinahl. The review focused on studies that explored the enablers and barriers to down-scheduling policies, with the keywords “drug reclassification" OR "medicine reclassification" OR "drug switching" OR "medicine switching" OR "drug down scheduling" OR "medicine down scheduling" OR "Rx-to-OTC".Results: A total of twenty-two eligible studies were identified. The analysis revealed that supportive policymakers, clear and transparent regulatory frameworks, positive perceptions of pharmacists, increased consumer awareness, and support from medical professionals are key enablers of successful down-scheduling policies. Conversely, risk-averse regulators and pharmacists' lack of confidence in self-medication emerged as significant barriers.Conclusion: Down-scheduling has been progressively implemented worldwide, enhancing consumer access to medicines and encouraging self-care. Nevertheless, regulatory challenges and concerns about safety and misuse continue to impede the broader adoption of such policies. Continuous evaluation, training, and regulatory clarity are essential for optimizing the benefits of down-scheduling policy. 
Overview of the Knowledge Level and Behavior of Contact Lens Use among Medical Students of Universitas Kristen Krida Wacana Pongtuluran, Regina; Mandalahi, Elisabeth Elida Elyus; Wangsa, Felix Jordan; Widyasa, Marni; Anugrahsari, Santi
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.v6i3.67738

Abstract

Introduction: Contact lenses are intended to treat refractive errors in the eye, as a diagnostic aid, and to support the personal appearance. A case study suggested that contact lenses cause eye diseases due to less knowledge and misbehavior when wearing contact lenses. This study was conducted to know the level of knowledge and behavior of using contact lenses among medical students of Universitas Kristen Krida Wacana (UKRIDA), intake 2016.Methods: It employed a descriptive analysis with a cross-sectional study. A total of 97 students who use contact lenses filled out a questionnaire in Google form.Results: The result demonstrated that 91 respondents (94%) had good knowledge about using contact lenses. Regarding behavior, 80 (93%) belonged to a good category.Conclusion: Their good knowledge and behavior towards using soft contact lenses might minimize their risk of red eye incidence upon using them. 
Correlation Of Cultural Beliefs and Chronic Energy Deficiency During Pregnancy with Stunting in Children Aged 0-24 Months in Jatipurno, Wonogiri Dewi, Annisa Puspa; Shabrina, Amalina; Aryoseto, Lukman
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.v7i2.89337

Abstract

Introduction: Stunting is a multifactorial issue that results in impaired growth and development in children. Maternal nutritional history, especially Chronic Energy Deficiency (CED), has an impact on child stunting. Infants with low birth weight are more likely to be stunted if their mothers have CED. The high rate of stunting in Jatipurno, Wonogiri is also influenced by culture beliefs in local community, which includes early supplemental feeding, dietary restrictions for pregnant mothers, and a high birth rate. This study aimed to see the correlation between CED during pregnancy and cultural beliefs (early complementary feeding, maternal food restrictions during pregnancy, and number of children) with stunting in children aged 0-24 months.Methods: This was an observational study with a retrospective case control approach. Purposive sampling based on the inclusion and exclusion criteria was used in this study. Subjects were children aged 0-24 months in Jatipurno, Wonogiri with normal and stunted nutritional status. Stunted children were allocated into case group (n=16) and normal children were allocated into control group (n=16). Statistical analysis performed with chi-square and multiple logistic regression using SPSS.Results: There was a significant relationship between CED during pregnancy with the incidence of stunting in children aged 0-24 months in the Jatipurno Health Center Working Area, with a p value of 0.008 (p<0.05) and OR value of 27.323.Conclusion: CED during pregnancy was a significant risk factor for stunting in children aged 0-24 months in Jatipurno, Wonogiri. There was no significant correlation between cultural beliefs (early complementary feeding, maternal food restrictions during pregnancy, and number of children) with stunting in children aged 0-24 months.
Prescribing Patterns of Antipsychotics in Schizophrenia Patients: A Study at Sikumana and Oesapa Primary Health Centers Reinaldo Erasmus Nesimnasi; Hanni Prihhastuti Puspitasari; Yulistiani Yulistiani
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.v8i3.109562

Abstract

Introduction: Schizophrenia is a chronic mental disorder with a rising prevalence, including in East Nusa Tenggara. Antipsychotics are the mainstay therapy, but prescribing patterns in primary care vary depending on patient condition and drug response. This study aimed to describe the prescribing patterns of antipsychotics among schizophrenia patients at Sikumana and Oesapa Primary Health Centers, Kupang City.Methods: A non-experimental descriptive design was applied using retrospective data from medical records of schizophrenia patients (ICD-X F20) during February–July 2025. Inclusion criteria consisted of patients who received antipsychotic therapy at both of two Primary Health Centers. Exclusion criteria included patients referred to higher-level facilities before receiving antipsychotic treatment.Results: A total of 42 patients with 129 visits were analyzed, dominated by males (52.4%) and the 25–44 age group (59.5%). Most were chronic patients (88.1%). Of 129 prescriptions, monotherapy predominated (57.4%), dominated by haloperidol (45 times) and risperidone (21 times). Combination therapy was also common (42.6%), particularly chlorpromazine + risperidone (29 times) and chlorpromazine + haloperidol (24 times). Trihexyphenidyl (103 times) was frequently prescribed as prophylaxis against extrapyramidal side effects, while diazepam (17 times) was used for anxiety or sleep disturbances. Several drugs were prescribed at lower doses than national and international guidelines, reflecting stable patient conditions in primary care, where lower doses remained effective while minimizing adverse effects.Conclusion: These findings highlight the dominance of typical antipsychotics and the limited variety of available drugs in primary care, underscoring the need for broader drug availability and more systematic monitoring of side effects.

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