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Medicinus : Jurnal Kedokteran
  • Medicinus : Jurnal Kedokteran
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Published by Universitas Pelita Harapan
ISSN : 19783094     EISSN : 26226995     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Medicinus: Jurnal Kedokteran is an official journal of the Faculty of Medicine, Universitas Pelita Harapan launched in the year 2007. Medicinus is a peer-reviewed and open-access journal that covers basic, translational, or clinical aspects of health and medical science. Medicinus accepts original research articles, review articles, and also interesting case reports. Medicinus: Jurnal Kedokteran is published three times a year in February, June, and October.
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Articles 10 Documents
 1 
Search results for , issue "Vol. 14 No. 2 (2025): February" : 10 Documents clear
The Profile of P63 Expression and Epstein-Barr-Encoded RNA (EBER) Distribution in Primary Central Nervous System Lymphoma: A Retrospective Bi-Center Study Kristiani, Erna; Marisca, Stephanie; Suharyani, Sally; Dermawan, Kevin; Widodo, Stephanie T.; Ham, Maria F.; Harahap, Agnes S.; Susanto, Eka; Tjahjadi, Hartono; July, Julius
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9545

Abstract

Background : Primary central nervous system lymphoma (PCNSL) is a type of lymphoma occurring around 0.5 – 1.2% of all intracranial neoplasms. However, recent epidemiological research shows a threefold increase in the number of cases. The Epstein-Barr virus (EBV) and PCNSL are both associated with the condition of immunosuppression or immunodeficiency, which often found to have a significant relationship with each other. Moreover, the TP63 mutation is associated with a poor prognosis. Methods : This is a descriptive study to assess the expression of TP63 and EBER on PCNSL, and present the characteristics of the disease. The study was conducted on 25 cases from two health centers with the most cases of brain tumors in Indonesia, Siloam Hospital Lippo Village and Cipto Mangunkusumo Hospital (CMH) from 2014 to 2018, the P63 expression and EBER-1 examinations were done by 4 pathologists. A total of 25 patients, 13 (52%) patients were male, ranging from age 30 – 79, with average 57,6 years old, located mostly in the frontal lobe in 8 patients (30.9%). Result : From the research results obtained positive P63 results in 20 cases (80%), while the EBER test was negative for all 25 patients. Further analysis with software SPSS 25 proving that P63 expression is not associated with germinal center B-cell type (GCB) or non-GCB type (p-value 0,87). Neither, P63 have any association with Ki67 with p-value of 1.00. Conclusions : This study concludes that there is a possibility that PCNSL cases in Indonesia are not associated with Epstein-Barr virus infection, but most of the cases will have a poor prognosis as indicated by P63 expression.
The Influence of the Severity of Obstructive Sleep Apnea on the Incidence of Hypertension Tjandra, Marchella; Moningkey , Shirley Ivonne; Lim , Hendyono
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9546

Abstract

Background : Hypertension is a condition where systolic blood pressure reaches 140 mmHg, and diastolic blood pressure reaches 90 mmHg. According to the Ministry of Health of Republic Indonesia, hypertension ranks third as a cause of death in Indonesia. Secondary hypertension arises from identifiable causes such as obstructive sleep apnea, renal vascular disease, hormonal contraceptives, endocrine disorders, stress-induced hypertension, pregnancy, burns, renal parenchymal disease, polycystic ovarian syndrome, preeclampsia, and specific medications like NSAIDs and antidepressants. Previous studies have recorded 83% Hypertension patients had OSA. Despite these findings, there are still contradictions in the literature (7), indicating the need for further research to explore the relationship between OSA and hypertension, as well as the impact of different types of OSA on hypertension. Methods : This research is an observational analytic study using a cross-sectional method. Medical status data and polysomnography results were collected from February to April 2024 at Siloam Hospitals Lippo Village. Data were processed using SPSS 23.0 and analyzed using the chi-square method. Significant variables will be further analyzed using logistic multivariate analysis. Result : There was an influence of the severity of Obstructive Sleep Apnea on the incidence of hypertension at Siloam Hospitals Lippo Village (OR=15.4, 95%CI 3.477 – 68.216; p-value=0.001). Besides the influence of the severity of Obstructive Sleep Apnea, other variables such as gender, BMI ≥ 23 kg/m², and a history of diabetes mellitus also affected the incidence of hypertension. Conclusion : The influence of the severity of Obstructive Sleep Apnea on the incidence of hypertension found in Siloam Hospitals Lippo Village.
COX-2 Expression and Its Prognostic Implications in Uterine Leiomyosarcoma: A Systematic Review and Meta-Analysis Suherman, Levita Dyah Kartika; Sungkarto, Kenny; Ellyamurti, Devanti Octavia; Tarigan, Tiara Namora; Negara, Puspa; Tjahyanto, Teddy; Wijaya, Jeremiah Hilkiah
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9547

Abstract

Background : Uterine leiomyosarcoma (ULMS) is a rare, aggressive malignancy with high recurrence and poor survival, necessitating prognostic biomarkers and therapeutic targets. Cyclooxygenase-2 (COX-2), implicated in tumorigenesis and angiogenesis, remains understudied in ULMS. This systematic review and meta-analysis assessed COX-2’s prognostic role in ULMS. Methods : Following PRISMA guidelines, six studies (n=185) were retrieved from PubMed, EMBASE, and Scopus (2001–2024). Inclusion criteria required ULMS cohorts with COX-2 expression data and survival outcomes. Risk of bias was assessed using QUADAS-2, and evidence certainty via GRADE. A random-effects meta-analysis calculated pooled effect estimates with 95% confidence intervals (CIs), while heterogeneity was evaluated using I² statistics. Result : COX-2 expression correlated moderately with epithelial components (pooled effect: 0.51, 95% CI: 0.26–0.77) and weakly with mesenchymal components (0.26, 95% CI: 0.06–0.45). High heterogeneity (I² = 89.5% and 82.2%) reflected differences in study design, tumor subtypes, and COX-2 measurement thresholds. QUADAS-2 indicated a low risk of bias, and GRADE confirmed high evidence certainty. Stronger epithelial correlations were observed in Asian cohorts, highlighting geographic variability. Conclusions: COX-2 plays a more significant role in epithelial-driven ULMS carcinogenesis. Despite heterogeneity, robust methodologies support these findings. Future studies should standardize COX-2 assessment, expand cohort sizes, and integrate multi-omics approaches to refine prognostic and therapeutic applications.
Hypoalbuminemia as a Predictor of Outcomes in Acute Myeloid Leukemia: A Systematic Review and Meta-Analysis Jacobs, Christin Yosefin; Nugroho, Fajar Prianto; Amelia, Sesa; Pannaausten, Davin; Almaszahra, Annisa Naufal; Prayogo, Andi Bagus; Jessica; Pranata, Jimmy Angga
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9548

Abstract

Background : In acute myeloid leukemia (AML), hypoalbuminemia has been observed at diagnosis and during treatment, often correlating with poor clinical outcomes such as reduced remission rates, increased treatment-related toxicity, and shorter overall survival (OS). This systematic review and meta-analysis aim to investigate the prognostic value of hypoalbuminemia in patients with AML. Methods : A comprehensive literature search was conducted across PubMed, EMBASE, and Scopus to identify relevant studies published up to January 5, 2025. The search strategy included a combination of Medical Subject Headings (MeSH) terms and keywords such as “hypoalbuminemia,” “acute myeloid leukemia,” “AML,” “serum albumin,” “prognosis,” and “outcomes.” Boolean operators (AND, OR) were applied to refine the search. Result : This systematic review and meta-analysis included 10 studies with a total sample size of 4,105 participants, of which 2,134 were male, comparing normal albumin levels to hypoalbuminemia across diverse populations. The meta-analysis comparing OS between AML patients with hypoalbuminemia and normal serum albumin levels shows a pooled HR of 1.08 (95% CI: 0.81–1.44). Conclusions : While this meta-analysis suggests a potential association between hypoalbuminemia and poorer OS and DFS in AML patients, the lack of statistical significance and high heterogeneity caution against definitive conclusions.
The Use of Proton Pump Inhibitors in Managing Preeclampsia: A Systematic Review Avensia, Taura; Bahardiani, Dinda Tsania
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9551

Abstract

Background: Maternal mortality remains a major global challenge, with preeclampsia (PE) as a leading cause after hemorrhage and infection. PE, a hypertensive disorder after 20 weeks of gestation, affects over. 4 million pregnancies annually, causing 50,000–70,000 maternal deaths. If untreated, it can lead to severe complications like eclampsia, HELLP syndrome, organ failure, and death. It also increases risks for the fetus, including low birth weight, preterm birth, and perinatal mortality. Early and effective management is crucial. Research suggests proton pump inhibitors (PPIs) may help by reducing sFlt-1 secretion, offering potential treatment options. Methods: A literature search was conducted in PubMed, ScienceDirect, Directory of Open Access Journals, and Cochrane Library, yielding 354 studies. Two studies meeting inclusion and exclusion criteria were included in this review. Result: Omeprazole and esomeprazole reduced sFlt-1 levels and increased PlGF levels in PE pregnancies, although the changes were not statistically significant. Esomeprazole increased sFlt-1 levels specifically in placental tissue. No adverse effects were reported with PPI use in the included studies. Conclusions: PPIs (omeprazole or esomeprazole 40 mg) show potential as safe therapies for managing preeclampsia, with minimal side effects, by reducing sFlt-1 levels and increasing PlGF levels. Further research is needed to confirm these findings.
The Association Between Smartphone Addiction, Learning Motivation Levels, and Cumulative Grade Point Average Among Students at the Faculty of Medicine, Pelita Harapan University Purushotama, Nyoman Bagus Satcitta Ananda; Nainggolan, Julita Dortua Laurentina
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9552

Abstract

Background: Cumulative Grade Point Average (CGPA) is a crucial metric in higher education. Achieving a good CGPA increases students' opportunities for career advancement or further education. Smartphones can aid learning by boosting motivation and academic achievement but may also cause addiction when used primarily for entertainment. Objective: To examine the relationship between smartphone addiction, learning motivation levels, and CGPA among preclinical students at the Faculty of Medicine, Pelita Harapan University. Methodology: This cross-sectional analytical study involved 103 students with a minimum sample size of 95. Data were analyzed using SPSS version 23 through bivariate analysis. Results: Among the respondents, 70 students were addicted to smartphone use, 94 achieved satisfactory CGPA scores, and 65 had high learning motivation. A significant relationship was found between smartphone addiction and CGPA (p = 0.029), smartphone addiction and learning motivation (p = 0.013), and learning motivation with CGPA (p = 0.000). Conclusion: There is a significant association between smartphone addiction, learning motivation levels, and CGPA among students at the Faculty of Medicine, Pelita Harapan University.
Addressing Uncontrolled Symptoms and Communication Gaps in a Patient with Metastatic Cholangiocarcinoma: Lessons from a Palliative Care Case Huang, Ian
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9553

Abstract

Background : Timely integration of palliative care is essential in managing advanced cancer patients, addressing both physical symptoms and psychosocial distress. Delayed communication of prognosis and inadequate symptom control can result in unnecessary suffering for patients and emotional distress for their families. Case Presentation : We report a 49-year-old male with metastatic cholangiocarcinoma, admitted with severe abdominal pain, nausea, and vomiting. He had undergone a Longmire procedure and gastrojejunostomy three weeks prior. Despite surgical intervention, his symptoms remained poorly controlled. Upon assessment, he expressed fear of death, while his wife struggled with the emotional burden of his prognosis, indicating a lack of prior communication regarding his terminal condition. Symptom management included oral morphine for pain and a combination of ondansetron, omeprazole, and haloperidol for nausea and vomiting, leading to improved symptom control. However, his condition deteriorated with pneumonia and respiratory failure, marking the transition to end-of-life care. He passed away peacefully 15 days after admission. Discussion : This case highlights the consequences of delayed prognosis disclosure and inadequate early symptom management. The absence of structured communication contributed to family distress, underscoring the importance of models like SPIKES in breaking bad news. The need for a multidisciplinary palliative care approach, including psychological support and optimized opioid management, was evident. Conclusions : Early palliative care involvement, proactive symptom control, and clear communication of prognosis are crucial in advanced cancer care. Establishing a dedicated palliative care team can improve quality of life, facilitate shared decision-making, and enhance end-of-life experiences for patients and families.
Exploring Joubert Syndrome: A Rare Case Study from Indonesia Siswanto, Johanes Edy; Tasmina; Prayudijanto, Muhammad I.; Daniswara, Boromeus A.; Pamungkas, Christophorus A. S.; Pratanu, Lydia
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9554

Abstract

Background: Joubert Syndrome is a rare autosomal recessive disorder characterized by midbrain-hindbrain malformation and multisystem involvement. This study aims to present a detailed case of Joubert Syndrome from Indonesia, emphasizing clinical presentation, diagnostic challenges, and management strategies in a resource-limited setting. Methods: This descriptive case study examines a newborn female referred for breathing difficulties and a skull tumor present since birth. Data were collected through clinical evaluations, imaging studies, laboratory tests, genetic analysis, and multidisciplinary consultations. A literature review was conducted to compare the findings with global data. Result: The first case involved a female infant with hydrocephalus, a posterior skull mass, and microcornea. Echocardiography showed a patent foramen ovale, while genetic analysis confirmed a normal 46,XX karyotype. The second case featured a male infant with posterior meningocele, seizures, and retinal dystrophy. EEG confirmed subclinical seizures, and genetic testing identified pathogenic TMEM237 mutations consistent with Joubert Syndrome type 14. Both infants received respiratory support, antibiotics, and targeted treatments, resulting in significant clinical improvement. Conclusions: These cases highlight the importance of multidisciplinary care and genetic testing in Joubert Syndrome diagnosis and management. Early recognition, advanced diagnostics, and consistent follow-up are crucial for optimizing outcomes, particularly in resource-limited settings.
Multifactorial Dermatitis in an Elderly Patient with Chronic Actinic Dermatitis: A Case Report Sunardi, Hendry Purnomo; Sutedja, Gina Triana
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9555

Abstract

Background : Chronic actinic dermatitis (CAD) is a rare, persistent photodermatosis triggered by UV and visible light, primarily affecting elderly individuals. With multifactorial etiologies, including genetic predisposition, environmental exposure, and comorbidities, CAD significantly impacts quality of life. This case report presents an elderly farmer with CAD, emphasizing the complexities of diagnosis and management in individuals exposed to high levels of sunlight due to occupational factors. Methods : A 70-year-old male farmer presented with a two-week history of pruritus and burning sensations on his face, exacerbated by sun exposure. He had a history of seborrheic dermatitis and hypertension. Physical examination revealed erythematous, hyperpigmented plaques on sun-exposed areas, with macular erythema, erosion, and lichenification. The working diagnosis was CAD, with actinic prurigo and cutaneous T-cell lymphoma as differentials. Management included methylprednisolone, cetirizine, and a compounded cream containing clobetasol propionate and gentamicin. Preventive measures, such as the use of moisturizers, sunblock, and UV avoidance, were also emphasized. The prognosis was favorable for life and function but uncertain for complete remission due to CAD's chronic nature. Conclusions : This case underscores the importance of an integrated approach combining pharmacological treatment and preventive strategies to manage CAD effectively. Tailored interventions addressing occupational and environmental risk factors are vital. Diagnostic limitations highlight the necessity for follow-up and the development of enhanced diagnostic tools. CAD management requires multidisciplinary collaboration to optimize patient outcomes.
The Palliative Role of Colchicine on Advanced Hilar Cholangiocarcinoma Patient with Socio-Economic Challenges: A Case Report Yanto, Theo Audi; Mulia, Nathania Raphaeli; Kusuma, Yordan
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9556

Abstract

Cholangiocarcinoma is a rare, slow-growing tumor that commonly presents beyond the point of resectability. Current guidelines recommend chemotherapy and radiotherapy for inoperable cases. However, palliative resources are not always accessible for patients with socio-economic barriers. Meanwhile, colchicine is a cost-effective drug and possesses anticancer effects. Here, we present a 53-year-old man with a 6-month history of painless jaundice, severe pruritus, recurrent fever, progressively growing abdominal mass, loss of appetite, and significant weight loss. He was incapable to perform adequate self-care and remained bedridden. Courvoisier sign was noted. Liver function tests show hyperbilirubinemia with elevated CA 19-9 level. Abdominal MRI 3T and MRCP showed hilar cholangiocarcinoma and obliteration of the hepatic vein. The patient and his family did not have health insurance and lived on a minimum income. Considered inoperable, the patient received daily colchicine 1 mg. Within four months, his symptoms have subsided, and he could perform several house chores. Bilirubin also showed a decreasing trend. In neoplastic cells, colchicine inhibits cell mitosis by perturbing tubulin formation. Being widely available, colchicine can be a palliative drug for terminally ill patients with socio-economic challenges. Although it improves patient performance status, we recommend further studies and close monitoring for the use of colchicine in advanced cholangiocarcinoma cases.

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