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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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Search results for , issue "Vol. 14 No. 3 (2025): June" : 10 Documents clear
Coverage and Knowledge Regarding Human Papillomavirus Vaccination Among Female Medical Students at Pelita Harapan University Lukman, Leni
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10148

Abstract

Background: Cervical cancer is the fourth most common cancer among women worldwide. Human papillomavirus (HPV) is the primary cause of cervical cancer. One of the key preventive measures to reduce the incidence of cervical cancer is immunization. According to the data from the World Health Organization year 2020, the national HPV vaccination coverage in Indonesia was only 5% for the complete dose and 6% for the first dose. Lack of knowledge is one of the contributing factor of HPV vaccination coverage. Methods: This study was conducted with cross-sectional design. This study used primary data which was collected using questionnaires. The questionnaire has been tested for validity and reliability in previous study. The subjects were female students of Faculty of Medicine University of Pelita Harapan. Results: Our of 770 subjects with mean age of 20.3 years old, 490 subjects (63.6%) never got HPV vaccination, 102 subjects (13.3%) were not fully vaccinated and 178 subjects (23.1%) were fully vaccinated. Age at first dose of HPV vaccination was 9-14 years old in 123 subjects (43.9%) and > 15 years old in 157 subjects (56.1%). From all of the HPV vaccinated subjects, 18 subjects (6.4%) got bivalent vaccine, 52 subjects (18.6%) got quadrivalent vaccine and 64 subjects (22.9%) got nonvalent vaccine. Majority of the subjects (354 subjects, 46%) had good knowledge regarding HPV vaccination, 271 subjects (35.2%) had sufficient knowledge and 145 subjects (18.8%) had poor knowledge. Conclusions: Despite sufficient knowledge regarding HPV vaccination among majority of female medical students at Pelita Harapan University, HPV vaccination coverage remained suboptimal.
The Impact of Attitude and Knowledge on Consent Decisions for Cataract Surgery: A Study at Siloam Hospitals Lippo Village, Building B Wibisono, Atria Puspitaloka; Irma, Josiah; Rizki, Saraswati Anindita
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10149

Abstract

Introduction: Cataracts account for 77.7% of blind cases in Indonesia, indicating that many cataract patients have not had surgery. Low levels of knowledge, attitude, and decision-making among cataract patients regarding surgery may limit the number of procedures performed in Indonesia. Therefore, this study aims to assess cataract patients’ knowledge, attitude, and decision-making concerning surgery at Siloam Hospitals Lippo Village in Tangerang. Objective: To determine the relationship between knowledge, attitude, and decision-making regarding cataract surgery among Siloam Hospitals Lippo Village Building B patients. Methods: This cross-sectional study involves 64 cataract patients visiting Siloam Hospitals Lippo Village Building B. The collected data were analysed using SPSS Statistics bivariate analysis. Results: Out of the 64 respondents, 7 (10.9%) demonstrated low knowledge, 4 (6.3%) displayed a negative attitude, and 4 (6.3%) indicated unwillingness to undergo surgery. A significant relationship exists between knowledge and attitude, attitude and decision, and knowledge and decision regarding cataract surgery, with a p-value of 0.000 as determined by the Pearson Chi-Square test. Conclusion: A significant relationship exists between knowledge, attitude, and the decision to undergo cataract surgery.
The Relationship of Body Mass Index with Length of Stay in Symptomatic Cholelithiasis Patients Who Have Undergoing Open Cholecystectomy at RSUS Lippo Village Karawaci Hospital Alvionitan, Chellya Fanny; Sudirman, Taufik
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10150

Abstract

Background: Gallstones, also known as cholelithiasis, are hardened deposits of digestive fluids that develop in the gallbladder. A serious medical condition called cholelithiasis is frequently managed with general surgery. One of the treatments for cholelithiasis is an open cholecystectomy. It will take some time to recover from this surgical procedure at the hospital. The period of hospitalization will depend on the patient's weight. Numerous research findings continue to conflict with this study. As a result, this study was carried out to examine the connection between BMI and the length of hospital stay in the open cholecystectomy technique. Methods: This study used a cross-sectional study design with a sample population of cholelithiasis patients at Siloam Hospital. The sample size of 51 was selected using a purposive sampling technique. Data is taken from the patient's medical record and the data collected will be analyzed using Mann-U Whitney. Result: From 51 samples, the mean length of stay for subjects with BMI < <23 kg/ m2 was 3 days, with the lowest value being 1 day and the highest value was 5 days. Meanwhile, the mean length of stay for subjects with BMI > 23 kg/ m2 was 3 days with the lowest value was 2 days and the highest value was 6 days. From the Mann-U Whitney test, it was found that the results of the comparison were not significant (p> 0.05). Conclusions: This study shows there is no relationship between BMI and duration of hospitalization in cholelithiasis symptomatic patients undergoing open cholecystectomy surgery.
Anesthetic Management in Obese Patients Undergoing Laparoscopic Cholecystectomy: A Case Report Pakardian, Insan Aqid; Dewi, Dewa Ayu Mas Shintya
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10152

Abstract

Background: Obesity is associated with various complications during general anesthesia, including apnea, hypoventilation, and challenges in intubation. In obese patients, these factors increase the anesthetic risks associated with laparoscopic cholecystectomy, a minimally invasive surgery performed to remove the gallbladder. This procedure is often indicated for gallstones causing inflammation, pain, or infection. Laparoscopic cholecystectomy involves small incisions, allowing most patients to recover quickly, return home the same day, and resume normal activities shortly thereafter. Compared to open cholecystectomy, the laparoscopic approach offers advantages such as faster recovery, reduced postoperative pain, and lower risk of complications. Methods: A 43-year-old female patient with a body weight of 120 kg, height of 155 cm, and a BMI of 49.9 kg/m² (classified as obesity) was initially scheduled for an open cholecystectomy. However, intraoperative evaluation by the surgeon led to a decision to switch to laparoscopic cholecystectomy. Anesthesia was induced using a propofol syringe pump, fentanyl (150 mcg), and atracurium (40 mg) as a muscle relaxant. Intubation was performed with video laryngoscopy, using an endotracheal tube (ETT) with a cuff size of 7. Result: During the operation, the patient's end-tidal CO2 (ETCO2) levels increased to 40 mmHg due to CO2 insufflation, leading to worsening respiratory acidosis. Complications such as these are common during laparoscopic procedures in obese patients and require timely management to prevent further deterioration. Conclusions: The patient’s condition was stabilized by employing specific intraoperative strategies, including positioning in reverse Trendelenburg, mild hyperventilation, and applying positive end-expiratory pressure (PEEP). These measures successfully reduced ETCO2 levels, demonstrating the importance of tailored anesthetic and ventilatory management in obese patients undergoing laparoscopic cholecystectomy.
Forensic Examination in a Homicide Case Due to Suffocation: A Case Report Kusumaningrat, Donald Rinaldi; Yapiter, Jesslyn Alvina
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10153

Abstract

Background: Smothering is a form of death due to asphyxia which is caused by obstruction of air flow from the mouth and nose which can be caused by various things such as hands, air-tight paper or textiles. Homicide smothering often occurs in infants, children, vulnerable adults and individuals with limited mobility. Smothering will cause a person to die from suffocation. Case Description: The body of a 4 year 9 months old female was found smothered. On external examination, bruises resembling grips were found on both left and right upper arms, bruises resembling grips were also found on both left and right thighs. There were blackish purple bruises on the back. On internal examination, petechial bleeding was found in the heart. Discussion: Smothering is a form of asphyxia caused by obstruction of the external respiratory opening, either by hand or by other means. Apart from that, it can also be caused by blockage of the nasal and oral cavities due to the entry of foreign objects. Based on the facts obtained from the examination, injuries were found due to blunt force in the form of bruises on the upper and lower lips, back area, upper and lower arms. So it can be concluded that the victim died from suffocation due to the closure of the respiratory tract. Conclusions: External examination and autopsy of the body are very important things to do, especially in crucial cases where there is done to help seek justice for the victim.
Perioperative Management of Craniotomy for Clipping Aneurysm: A Case Report Taopan, Damatus Try Hartanto; Suarjaya, I Putu Pramana
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10154

Abstract

Background: Ruptured cerebral aneurysm is the most common cause of spontaneous subarachnoid hemorrhage (SAH). Anesthesiologists play a critical role in recognizing these complications to ensure thorough pre-anesthetic evaluation and appropriate perioperative management. However, there remains a limited number of case reports detailing the perioperative care of patients undergoing craniotomy for aneurysm clipping. Case Description: We present the case of a 66-year-old woman diagnosed with acute non-communicating hydrocephalus, pan-ventricular intraventricular hemorrhage, and subarachnoid hemorrhage involving the basal cistern, bilateral sylvian fissures, and temporal lobes following ventriculoperitoneal (VP) shunt placement. The hemorrhage was attributed to a ruptured aneurysm. A craniotomy for aneurysm clipping was planned, and the procedure was performed under general anesthesia. Intraoperatively, the patient's hemodynamic parameters were successfully maintained within stable limits. Postoperatively, the patient was closely monitored in the intensive care unit, where no neurological deficits or major complications were observed during the hospital stay. Discussion: This case highlights the complexity of managing patients with aneurysmal subarachnoid hemorrhage, particularly those presenting with multiple complications such as hydrocephalus and intraventricular extension of bleeding. Conclusions: The successful management of this case demonstrates that a well-structured perioperative plan is crucial in the surgical treatment of ruptured aneurysms. Despite the high-risk nature of subarachnoid hemorrhage and its associated complications, favorable outcomes can be achieved with careful preoperative preparation, intraoperative vigilance, and postoperative monitoring. Further case reports and studies are needed to expand the evidence base and refine best practices in the perioperative management of patients undergoing craniotomy for aneurysm clipping.
Tuberculoma With Visual and Vestibular Symptoms in A β-Thalassemia Patient: A Case Report Suryawijaya, Evlyne Erlyana; Ariarini, Ni Nengah Rida; Diafiri, Dinda; Dewati, Eva; Sitorus, Freddy
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10163

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which can affect the lungs (pulmonary TB) as well as other organs (extrapulmonary TB), including the central nervous system (CNS). The number of TB cases in Indonesia remains high, with 969,000 cases reported in 2021. Tuberculoma is a manifestation of TB in the CNS, presenting as an intracranial mass due to the spread of TB from other organs. It is a rare and serious form of CNS TB infection. The presence of congenital β-thalassemia adds complexity to the pathogenesis, diagnosis, and treatment of tuberculoma. Case Description: A 25-year-old female with a history of β-thalassemia HbE intermedia with a major phenotype presented with the main complaint of blurred vision in the lower right visual field. The patient also experienced vertigo, headache, and a history of seizures. Examination revealed inferior right quadrantanopia, anemia, leukopenia, and thrombocytopenia. Imaging and CSF analysis supported a diagnosis of intracranial tuberculoma. The patient was treated with anti-TB medication and intravenous dexamethasone. Discussion: Patients with thalassemia may have an increased risk of TB infection, including CNS TB. Tuberculoma involves granuloma formation in the brain, often in the meninges and cerebrum. Its manifestations vary and can include headaches and seizures. Diagnosis is based on clinical history, radiological findings, and laboratory results. The patient’s symptoms and imaging findings supported a diagnosis of tuberculoma, for which anti-TB and neurorestorative therapy was administered. Conclusions: Tuberculoma, as a manifestation of CNS TB, presents with variable and non-specific symptoms. Visual field disturbances can be one of the presenting symptoms that aid in diagnosis. Clinical, radiological, and laboratory evaluations are necessary for prompt and accurate diagnosis. Treatment involves anti-TB therapy and dexamethasone. This case highlights the importance of early diagnosis and comprehensive management of complex extrapulmonary TB infections.
Comparative Effectiveness of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Heart Failure: A Systematic Review Putri, Evira Agustina; Putri, Adinda Wafdani; Andreago; Welliangan, Ariyani Sudhamma; Guantoro, Vincent; Mardiah, Harisa
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10164

Abstract

Background: Heart failure (HF) affects over 64 million individuals globally and is associated with high morbidity and mortality, particularly in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging therapies with reported cardiovascular benefits. However, their comparative efficacy in HF-specific outcomes remains unclear. This systematic review aimed to assess and compare the safety and efficacy of SGLT2 inhibitors and GLP-1 RAs in patients with HF. Methods: We systematically searched PubMed, EMBASE, and Scopus up to 1 May 2025 for randomized controlled trials (RCTs) evaluating SGLT2 inhibitors or GLP-1 RAs in adults with HF. Primary outcomes included all-cause and cardiovascular mortality; secondary outcomes included HF hospitalization and major adverse cardiovascular events (MACE). Risk of bias was assessed using the Cochrane RoB 2 tool and certainty of evidence with the GRADE approach. Result: Fourteen RCTs comprising 30,867 patients (52.2% female; 63.2% with T2DM) were included. SGLT2 inhibitors significantly reduced cardiovascular mortality (RR: 0.85, 95% CI: 0.78–0.93, p < 0.001, I² = 14%), all-cause mortality (RR: 0.88, 95% CI: 0.81–0.95, p = 0.002, I² = 21%), and HF hospitalizations (RR: 0.72, 95% CI: 0.67–0.77, p < 0.001, I² = 0%). GLP-1 RAs did not demonstrate significant effects on these outcomes. Overall risk of bias was low to moderate; GRADE certainty ranged from moderate to high. Conclusions: SGLT2 inhibitors provide consistent reductions in mortality and hospitalization in HF patients across glycemic statuses. GLP-1 RAs showed limited benefit in HF-specific outcomes, supporting the preferential use of SGLT2 inhibitors in HF treatment strategies.
The Therapeutic Potential of Neural Stem Cell in Ischemic Stroke: A Systematic Review Periyanto, Toni; Putri, Evira Agustina; Romano, Sultan Adhitya; Riantiarno, Chairizia; Kamal, M. Aulady Rifki; Aulia, Indri Noer; Sugianto, Michael Aquilar
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10165

Abstract

Background: Ischemic stroke remains a leading cause of disability and mortality worldwide, with over 12 million new cases annually and limited treatment options confined to narrow therapeutic windows. Neural stem cells (NSCs) have emerged as a promising therapeutic avenue due to their ability to self-renew, differentiate into all neural lineages, and exert paracrine effects that modulate inflammation and promote neurogenesis. Preclinical studies have demonstrated functional improvements of up to 60% in animal stroke models, but a systematic evaluation of these findings is needed to inform future clinical applications. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Databases searched included PubMed, EMBASE, and Scopus, covering literature up to May 8, 2025. Inclusion criteria comprised in vivo preclinical studies investigating NSC transplantation in animal models of ischemic stroke with at least one neurological, infarct, or histological outcome. Data extraction and risk of bias assessment (ROBINS-I) were independently performed by three reviewers. Due to study heterogeneity, a narrative synthesis was undertaken. Result: Eight studies met the inclusion criteria. NSC therapy improved neurological recovery in over 80% of cases, reduced infarct volume by up to 40%, and downregulated pro-inflammatory and apoptotic markers. Benefits were dose- and timing-dependent, with intracerebral and intravenous routes demonstrating variable efficacy. One study reported tumorigenicity, highlighting the need for safety profiling. Conclusions: Preclinical evidence supports the therapeutic potential of NSCs in ischemic stroke through neuroprotective and neurorestorative mechanisms. High-certainty findings justify continued investigation in clinical trials to refine dosing, delivery, and safety protocols.
Vaccine-Based Immunotherapy for Metastatic Colorectal Cancer: A Systematic Review Amelia, Sesa; Mathlubaa, Asya; Amly, Harzalina Zilfi; Jacobs, Christin Yosefin; Halim, Kurnia; Heriawan, Timotius Ivan; Guantoro, Vincent; Putri, Hesti Andika
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10166

Abstract

Background: Metastatic colorectal cancer (mCRC) remains a therapeutic challenge, particularly in microsatellite stable (MSS) tumors, which are largely unresponsive to current immunotherapy approaches. Vaccine-based immunotherapy offers a strategy to elicit tumor-specific immune responses in these immunologically “cold” tumors. However, clinical results have been mixed, and the efficacy and safety of cancer vaccines in mCRC remain to be clarified. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Randomized controlled trials (RCTs) evaluating vaccine-based immunotherapy in mCRC were identified from PubMed, EMBASE, and Scopus as of May 2, 2025. Eligible studies included human subjects with mCRC receiving vaccine therapy with or without additional treatments, compared to standard or placebo regimens. The primary outcomes were overall survival (OS) and progression-free survival (PFS); safety was assessed by the incidence of grade ≥3 treatment-related adverse events. Result: Five RCTs comprising 804 patients met inclusion criteria. Pooled analysis showed a trend toward improved OS with vaccine-based immunotherapy (HR 0.81; 95% CI, 0.65–1.00; p = 0.05; I² = 0%), and a modest, non-significant improvement in PFS (HR 0.80; 95% CI, 0.62–1.05; p = 0.07; I² = 0%). The incidence of severe adverse events was lower with vaccine-based therapies (RR 0.31; 95% CI, 0.02–6.09; p = 0.23; I² = 90%). Conclusions: Vaccine-based immunotherapy in mCRC demonstrates potential clinical benefit, particularly in prolonging survival with a favorable safety profile. Further biomarker-driven studies are needed to optimize patient selection and therapeutic combinations.

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