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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.
Arjuna Subject : -
Articles 429 Documents
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Predictive Value of Optic Nerve Sheath Diameter in Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Tjahyanto, Teddy; Suryakanto, Milani
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9240

Abstract

Introduction : Optic nerve sheath diameter (ONSD) is a promising non-invasive marker for elevated intracranial pressure (ICP), potentially aiding in the prognostication of subarachnoid hemorrhage (SAH) outcomes. This study aimed to evaluate the predictive value of ONSD for poor outcomes in SAH patients, defined by the Glasgow Outcome Scale (GOS). Methods : A systematic review and meta-analysis were conducted, including studies from 2010 to 2021 that examined the relationship between ONSD and outcomes in SAH patients. A total of 615 patients were analyzed, with mean ages ranging from 54.1 to 58.8 years, and a predominance of males (38.2%). SAH severity was stratified using the Hunt and Hess classification, ranging from Grade 1 to Grade 5. The QUADAS-2 tool assessed the risk of bias, and the GRADE framework evaluated evidence certainty. Results : The pooled analysis revealed moderate predictive accuracy for ONSD in determining poor outcomes, with a pooled proportion of 0.70 (95% CI: 0.61–0.78). Significant heterogeneity (I² = 77.4%, p = 0.004) was observed, likely due to variability in ONSD thresholds, measurement techniques, and timing. Funnel plot analysis suggested potential publication bias, although further statistical testing is needed. Conclusions : ONSD demonstrates potential as a non-invasive tool for predicting poor outcomes in SAH patients. However, significant heterogeneity and moderate accuracy highlight the need for standardization of ONSD thresholds and measurement protocols. Further multicenter studies are required to validate its clinical utility and integrate it into comprehensive prognostic models.
Bereavement as A Risk Factor for Depression in The Elderly: An Evidence Based Case Report Andoko, Dewanto; Handoko, Marshel Timotius; Cipta, Darien Alfa
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9242

Abstract

Background: Depression disorder among the elderly population is a serious issue that is often underdetected and undertreated. Depression can lead to functional impairments, which are comparable to or even worse than those in individuals with chronic conditions such as heart and lung diseases. Bereavement is believed to be one of the risk factors for depression in the elderly. This literature search aims to explore bereavement as an etiology of depression in the elderly. Method: A structured search was conducted using the PubMed, Cochrane, and Science Direct databases, using tailored keywords aligned with the clinical question to obtain relevant results. Results: The search and selection process yielded one selected article that was deemed relevant to the case. This article provided a summary of evidence concerning the relationship between bereavement and the emergence of depression diagnosis in the elderly. Conclusion: The results of this systematic review and meta-analysis indicate that bereavement increases the risk of depression in the elderly. However, further studies are still needed to elucidate the mechanisms underlying depression in the elderly.
Clivus Chordoma: Case Report and Current Considerations on Endoscopic Endonasal Trans-Sphenoid Surgery with Neurosurgeon-Otolaryngologist Collaboration Lekatompessy, Michael; Widyakrisna, Albertus Boyke Raditya; July, Julius
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9245

Abstract

Chordomas, infrequent malignancies primarily located along the craniospinal axis, showcase gradual growth and localized bone destruction, with the clival region involved in approximately 25-35% of cases. Headaches accompanied by neurological deficits are the typical clinical presentations. Complete surgical resection is the mainstay, with recent collaborative efforts between otorhinolaryngologists and neurosurgeons leading to a positive shift from traditional craniotomic procedures to endoscopic endonasal approaches, fostering minimally invasive techniques and utilizing endoscopy for primary visualization across the neuraxis. Furthermore, the concept of team surgery has been introduced, involving simultaneous contributions from ENT surgeons and Neurosurgeons at all stages of the procedure, including the approach, resection, and reconstruction phases. This report presents a series of two successful cases of clival chordomas managed using the endoscopic endonasal approach at Siloam Hospital Lippo Village This indicates its potential as a viable surgical choice, particularly within medical centers that possess the necessary specialties. Successful implementation is notably enhanced through collaborative efforts between otolaryngologists and neurosurgeons, underscoring the significance of interdisciplinary teamwork.
Identification and Interpretation of Spinal Cord Injuries in Robbery Victims: A Forensic Review Kusumaningrat, Donald Rinaldi; Wahjoepramono, Eka Julianta; Purnamasari, Dewi
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9247

Abstract

Robbery is intrinsically a violent crime and is defined as the original criminal plan of the perpetrator by committing robbery, by force committed on occasion or with the pretext of robbery. Strangulation by ligature occurs when an external force is applied to the neck causing various traumatic pathologies. If the injury is severe enough, cerebral perfusion and oxygen delivery are compromised and can lead to asphyxia and rapid neuronal death. These injuries can be encountered in a variety of clinical scenarios and may be present in suicide attempts, sports injuries, motor vehicle trauma, and may have implications in the fields of criminology and forensic pathology. In this case, a 66-year-old woman who was a victim of a robbery suffered a neck injury. After examination, there was a fracture in the cervical spine and was diagnosed with spinal cord trauma. As a result of this injury, the victim suffered permanent paralysis. The perpetrators of the robbery are threatened with criminal penalties under 364 KUHP and/or Article 351 No 3 KUHP.
Superficial Spreading Cervical Squamous Cell Carcinoma to Endometrium: A Rare Case Report Limanto, Jennifer Jesse; Prasetiyo, Patricia Diana; Djohansjah, Alexy Oktoman; Chandra, Shally
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9250

Abstract

Introduction: Squamous cell carcinoma (SCC) was the most common variant of cervical cancer with metastases potential to many organs, commonly parametrium and vagina, but in a rare condition can also spread to endometrium. Further evaluations are needed since superficial spreading of cervical SCC are related to poorer outcomes. Case Presentation: A 62 y.o, post-menstrual, P3A0 women came with complaint of vaginal discharged mixed with blood since 6 months ago. Pap smear result suggestive of malignancy so the patient undergo guided biopsy from endocervix that revealed finding similar to carcinoma intraepithelial (CIN) 3. The patient underwent TAH-BSO operation. Microscopic examination from cervix showed tumor cell with round nuclei, prominent nucleoli, pleomorphic, hyperchromatic, increased nuclear-cytoplasm ratio in whole epithelial layer. Microscopic examination from endometrium showed epithelial squamous cell proliferation in almost 98% endometrial tissue and atypical cell nuclei, consistent with tumor founded in cervix. The final diagnosis was superficial endometrial spreading SCC with moderate differentiation. Immunohistochemistry (IHC) assay with p16 showed positive result in endometrium. Patient then consulted to gynecologist – oncology specialist for further treatment and evaluation. Conclusion: Superficial spreading of cervical SCC to endometrium was a rare finding. Detection of SCC in endocervix can be considered as predictor for proximal spreading of cervical SCC so further examination like endometrial curretage are suggested to assist the early detection. IHC assay with p16 resulted positive in our patient suggesting that endometrial SCC in this patient was correlated with HPV infection that commonly find in cervical cancer.
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.

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