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Medicinus : Jurnal Kedokteran
  • Medicinus : Jurnal Kedokteran
  • Website
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
 39   40   41   42   43 
Isolated Hypoglossal Nerve Palsy Associated with Tuberculosis of the Atlantoaxial Joint: A Rare Case Report Situmeang, Rocksy Fransisca V; Gabriella, Nadia; Koesbandono
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10189

Abstract

Background: Venous thromboembolism (VTE) is the third most common cardiovascular disorder worldwide. While lower-extremity deep vein thrombosis and pulmonary embolism are typical presentations, thrombosis in atypical sites remains challenging to recognize and diagnose.   Case Description: A 27-year-old female flight attendant with history inflammatory bowel disease (IBD), tuberculosis and combined oral contraceptive (COC) use presented with an acute abdominal pain. Initial contrast-enhanced CT revealed thrombosis of the left renal and ovarian veins. Laboratory tests showed elevated hs-CRP and D-dimer, with positive ANA but negative antiphospholipid antibodies. She was treated with intravenous heparin followed by oral rivaroxaban, though adherence was inconsistent due to episodes of heavy vaginal bleeding. Repeat CT imaging eight months later demonstrated resolution of the initial thrombi but revealed a new thrombus in the inferior vena cava extending into the right common iliac vein, accompanied by recurrent elevation of D-dimer.   This case illustrates the interplay of multiple risk factors for VTE, including IBD, prolonged immobility during long-haul travel, COC use, tuberculosis, and rifampicin therapy. These overlapping chronic and transient triggers likely contributed to recurrent thrombosis despite ongoing treatment.   Conclusions: Recurrent VTE in unusual venous sites can occur particularly in patients with multiple risk factors. Early recognition, appropriate imaging, and anticoagulant therapy adherence are essential to preventing progression and recurrence.
The Hidden Clot: A Case of Recurrent Atypical Venous Thrombosis Highlighting the Need for Vigilant Diagnostic Evaluation Mangkuliguna, Gladys; Sutanto, Ratna; Violetta, Olivia; Kurniawan, Andree
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10592

Abstract

Background: Venous thromboembolism (VTE) is the third most common cardiovascular disorder worldwide. While lower-extremity deep vein thrombosis and pulmonary embolism are typical presentations, thrombosis in atypical sites remains challenging to recognize and diagnose.   Case Description: A 27-year-old female flight attendant with history inflammatory bowel disease (IBD), tuberculosis and combined oral contraceptive (COC) use presented with an acute abdominal pain. Initial contrast-enhanced CT revealed thrombosis of the left renal and ovarian veins. Laboratory tests showed elevated hs-CRP and D-dimer, with positive ANA but negative antiphospholipid antibodies. She was treated with intravenous heparin followed by oral rivaroxaban, though adherence was inconsistent due to episodes of heavy vaginal bleeding. Repeat CT imaging eight months later demonstrated resolution of the initial thrombi but revealed a new thrombus in the inferior vena cava extending into the right common iliac vein, accompanied by recurrent elevation of D-dimer.   This case illustrates the interplay of multiple risk factors for VTE, including IBD, prolonged immobility during long-haul travel, COC use, tuberculosis, and rifampicin therapy. These overlapping chronic and transient triggers likely contributed to recurrent thrombosis despite ongoing treatment.   Conclusions: Recurrent VTE in unusual venous sites can occur particularly in patients with multiple risk factors. Early recognition, appropriate imaging, and anticoagulant therapy adherence are essential to preventing progression and recurrence
Accuracy of Mammography and Ultrasonography in Differentiating Benign and Malignant Breast Lesions Based on Histopathology at MRCCC Siloam Semanggi Hospital Eben Haezer, Randi; Kusumaningtyas, Nungky; Muis, Mirna; Purwanto, Denni Joko; Lugito, Nata Pratama Hardjo; Supit, Nina ISH
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10725

Abstract

Background: Breast cancer is the most common malignancy in women. Early detection improves survival. Mammography is the gold standard for women over 40, while ultrasonography is commonly used in younger women with dense breasts. To compare the diagnostic accuracy of mammography and ultrasonography in differentiating benign and malignant breast lesions using histopathology as the Gold standard.   Methods: This cross-sectional analytic study included 91 patients who underwent mammography, ultrasonography, and histopathological confirmation at MRCCC Siloam Semanggi Hospital. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) were calculated. Statistical analysis used McNemar’s test and ROC curve analysis based on Hanley & McNeil’s method, with p < 0.05 considered significant.   Result: Ultrasonography demonstrated higher sensitivity (98.4%) and NPV (92.3%) than mammography (96.7% and 88.9%), indicating better ability to rule out malignancy. Mammography showed higher specificity (53.3% vs. 40.0%) and PPV (80.8% vs. 76.9%), reflecting better performance in identifying benign lesions. Overall accuracy was slightly higher for mammography (82.4%) compared to USG (79.1%). The AUC for mammography was 0.750 (95% CI: 0.630–0.870), while USG had an AUC of 0.692 (95% CI: 0.565–0.819). Overlapping confidence intervals indicated no statistically significant difference in diagnostic accuracy between the two modalities (p > 0.05).   Conclusions: Mammography and ultrasonography both demonstrated high diagnostic performance with complementary strengths. Mammography provided higher specificity and PPV, while USG offered superior sensitivity and NPV. Given the small difference in accuracy and overlapping AUC confidence intervals, no significant difference was found between the two modalities. Combined use of mammography and USG may improve diagnostic accuracy in clinical practice.
Diagnostic Accuracy of Coronary Artery Calcium Scoring in Detecting Significant Coronary Artery Stenosis Compared with Invasive Coronary Angiography Erico, Adelbertus; Muljadi, Rusli; Yuniarti, Mira; Pardede, Ingrid Maria; Kurniawan, Andree; Jorizal, Patricia
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10757

Abstract

Background: Coronary artery disease (CAD) remains a leading cause of mortality, emphasizing the importance of early non-invasive diagnostic strategies. This study evaluated the diagnostic accuracy of coronary artery calcium scoring (CACS) in detecting significant coronary stenosis, using invasive angiography as the reference standard.   Methods: Sixty-three patients who underwent both CACS and quantitative coronary angiography were retrospectively analyzed. The mean total CACS was 684.1 ± 1030.8, and significant stenosis (≥70%) was most prevalent in the left anterior descending artery (92.1%).   Result: Spearman’s analysis revealed positive correlations between CACS and angiographic stenosis in the right coronary artery (ρ = 0.338, p = 0.007), left anterior descending artery (ρ = 0.492, p = 0.001), and left circumflex artery (ρ = 0.314, p = 0.012). Receiver operating characteristic (ROC) analysis demonstrated moderate-to-good diagnostic performance, with area under the curve (AUC) values of 0.699 for RCA, 0.769 for LAD, and 0.690 for LCX.   Conclusions: These findings indicate that CACS can serve as a reliable, low-cost, and non-invasive modality for preliminary screening and risk stratification of CAD, particularly in identifying patients who may benefit from invasive coronary angiography.
Diagnostic Performance of PI-RADS v2.1 for Clinically Significant Prostate Cancer in Indonesian Patients Undergoing MRI Fusion Prostate Biopsy Sindunata, Nyoman Aditya; Tarigan, Vera Nevyta; Jorisal, Patricia; Murtala, Bachtiar; Sugiono, Marto; Sungono, Veli
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10777

Abstract

Background: Prostate cancer is the second most common malignancy among men and one of the leading causes of cancer-related death. MRI evaluation using prostate imaging and data system (PI-RADS) v2.1 is widely applied to detect clinically significant prostate cancer (csPCa). However, data on its diagnostic performance in Indonesian population remain limited.   Methods: An analytical observational study with retrospective cross-sectional design was conducted on patients with PI-RADS category 3-5 who underwent MRI fusion prostate biopsy at Siloam Hospitals Kebon Jeruk between 2021 and 2025. Sensitivity, specificity, predictive values, and accuracy of PI-RADS v2.1 were evaluated against histopathological findings. Statistical analyses include Chi-Square and Mann-Whitney U test.   Result: A total of 75 patients were included, with a median age of 71 years (range: 49-84). The csPCa detection rates for each PI-RADS category were 14.29% for PI-RADS 3, 48.28% for PI-RADS 4 and 89.74% for PI-RADS 5. Histopathology confirmed csPCa in 50 patients (66.67%) and non-csPCa or benign lesions in 25 patients. The sensitivity of PI-RADS v2.1 at a cutoff ≥4 was 98% (95% CI 89.35–99.95), specificity 24% (95% CI 9.36–45.13), positive predictive value (PPV) 72.06%, negative predictive value (NPV) 85.71%, and overall accuracy 73.33% (95% CI 61.86–82.89). Bivariate analysis showed that older age, higher PSA, larger lesion size, PSA density ≥0.15 ng/ml2, and PIRADS 4/5 category were significantly associated with csPCa.   Conclusions: PI-RADS v2.1 demonstrates very high sensitivity and good NPV for excluding csPCa but has low specificity, resulting in moderate overall accuracy (73.33%).
Association Between Gender, Coronary Artery Dominance and Severity of Coronary Artery Stenosis on Computed Tomography Angiography Kurniawan, Yohanes Chandra; Muljadi, Rusli; Koesbandono; Lukito, Antonia Anna; Lugito, Nata Pratama Hardjo; Yuniarti, Mira
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10780

Abstract

Background: Coronary artery disease (CAD) is one of the leading causes of death worldwide. Several preliminary studies suggest that certain dominance patterns may be associated with the distribution and severity of stenosis, influencing the risk of cardiac complications and interventional strategies. However, the relationship of gender specific between coronary artery dominance patterns and the severity of stenosis remains poorly understood. This study designed to evaluate the relationship between gender specific, coronary artery dominance, and severity of coronary artery stenosis, number of stenosis vessels, stenosis location, and calcium score on CCTA examination.   Methods: A retrospective cross-sectional study with consecutive non-probability sampling was conducted over a one-year period with 1115 patients who underwent CCTA were analysed using the Chi-square test, Fisher’s exact test, and T-test according to the type of data.   Result: The result showed a strong association was found between non-right dominant coronary artery (non-RDCA) in females and significant coronary stenosis (p=0.009), with the most strongly associated location being the LCX (p=0.017).   Conclusions: These findings suggest the presence of gender- and dominance-specific patterns in coronary artery disease (CAD), warranting further investigation using prospective study designs and larger sample sizes.
Quantitative CT Attenuation Cut-off Values for Lesion Characterization: Enostoses in Patients Without Malignancy Versus Osteoblastic Metastases in Breast Cancer Pitri, Novita; Wulandari, Mathelda Diah; Nelwan, Dario Agustino; Jorisal, Patricia; Mulyanto, Ivana Dewi; Wijaya, Ratna Sari
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10792

Abstract

Background: Incidental osteoblastic bone lesions detected on CT scans, such as enostoses and osteoblastic metastases, often pose diagnostic challenges, especially in patients with or without a history of breast cancer. Hounsfield unit (HU) attenuation values have been proposed to differentiate these lesions non-invasively, however, variability in cut-off values exists in prior studies.   Methods: This observational analytic case-control study included adult patients who underwent CT and FDG PET-CT at MRCCC Siloam Semanggi Hospital, Jakarta from 2020 to 2025. Controls were patients with enostoses and no history of malignancy, while cases were breast cancer patients with PET/CT-confirmed osteoblastic metastases. Mean and maximum HU values were measured and analyzed to determine optimal cut-offs.   Result: Mean and maximum HU values were significantly higher in enostoses than in osteoblastic metastases (mean: 1025 ± 123.66 vs. 449.65 ± 106.93; maximum: 1167.77 ± 106.20 vs. 599.34 ± 134.78; p < 0.001). A mean HU cut-off of 692 achieved 100% sensitivity, 98.36% specificity, and an AUC of 0.992. A maximum HU cut-off of 860 showed 79.61% sensitivity, 100% specificity, and an AUC of 0.898.   Conclusions: Mean and maximum HU values on CT are highly effective for differentiating enostoses from osteoblastic metastases in breast cancer patients.
Association Between Ultrasound-Derived Fat Fraction (UDFF) Values and Metabolic Syndrome Laboratory Parameters in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Syahputra, Rheza Maulana; Jorisal, Patricia; Tarigan, Vera Nevyta; Lucas, Brian; Setiawan, Hardianto; Kurniawan, Andree
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10815

Abstract

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is highly prevalent worldwide and is strongly associated with metabolic syndrome and its related conditions such as diabetes mellitus and hypertension. Without early detection and intervention, hepatic steatosis can progress to hepatic inflammation, fibrosis, cirrhosis, and even hepatocellular carcinoma (HCC). This study aims to evaluate the relationship between ultrasound-derived fat fraction (UDFF) values and laboratory parameters of metabolic syndrome in MASLD, particularly liver enzymes, lipid profile, and glycemic profile, as well as to determine the optimal UDFF cut-off value for detecting metabolic syndrome risk in Indonesian patients.   Methods: A cross-sectional study was conducted on 96 patients who underwent UDFF and laboratory assessments including liver enzymes (SGOT/AST, SGPT/ALT), lipid profile (total cholesterol, HDL, LDL, triglycerides), and glycemic profile (HbA1c, fasting blood glucose). Data analysis included bivariate-multivariate correlation and ROC analysis.   Result: The distribution of UDFF (%) was as follows: normal ≤6% (27.1%; n=26), mild >6–15% (37.5%; n=36), moderate >15–25% (21.9%; n=21), and severe >25% (13.5%; n=13). UDFF showed a moderate positive correlation with SGPT (ρ=0.370; p<0.01) and triglycerides (ρ=0.380; p<0.01), and a weak negative correlation with HDL (ρ=−0.221; p<0.05). A UDFF threshold of 14% was able to predict abnormal SGPT levels and elevated triglycerides.   Conclusions: UDFF shows a significant correlation with laboratory parameters of metabolic syndrome in MASLD, confirming its potential as an accessible, effective, efficient, non-radiative, and non-invasive imaging modality. These findings support the central role of radiology in the early detection and therapeutic monitoring of MASLD and metabolic syndrome, as well as in preventing disease progression from hepatic steatosis to inflammation, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Large-scale multicenter validation is required to optimize these findings.
Relationship Between Electronic Device Usage with Asthenopia in Workers at Pelita Harapan University Lippo Karawaci Harlendo, Sachio; Josiah Irma; Saraswati Anindita Rizki; Ruth Syeela Widianty
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10828

Abstract

Background: Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality. Early detection is crucial to improve survival outcomes. Mammography is considered the gold standard for screening women over 40 years, while ultrasonography (USG) is frequently used in younger women with dense breasts. However, diagnostic accuracy varies, and comparative studies in Indonesia remain limited. To compare the diagnostic accuracy of mammography and ultrasonography in differentiating benign and malignant breast lesions using histopathology as the Gold standard.   Methods: This cross-sectional analytic study included 91 patients who underwent mammography, ultrasonography, and histopathological confirmation at MRCCC Siloam Semanggi Hospital. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) were calculated. Statistical analysis used McNemar’s test and ROC curve analysis based on Hanley & McNeil’s method, with p < 0.05 considered significant.   Result: Ultrasonography demonstrated higher sensitivity (98.4%) and NPV (92.3%) than mammography (96.7% and 88.9%), indicating better ability to rule out malignancy. Mammography showed higher specificity (53.3% vs. 40.0%) and PPV (80.8% vs. 76.9%), reflecting better performance in identifying benign lesions. Overall accuracy was slightly higher for mammography (82.4%) compared to USG (79.1%). The AUC for mammography was 0.750 (95% CI: 0.630–0.870), while USG had an AUC of 0.692 (95% CI: 0.565–0.819). Overlapping confidence intervals indicated no statistically significant difference in diagnostic accuracy between the two modalities (p > 0.05).   Conclusions: Mammography and ultrasonography both demonstrated high diagnostic performance with complementary strengths. Mammography provided higher specificity and PPV, while USG offered superior sensitivity and NPV. Given the small difference in accuracy and overlapping AUC confidence intervals, no significant difference was found between the two modalities. Combined use of mammography and USG may improve diagnostic accuracy in clinical practice.
Environmental and Geographical Determinants of Nephrolithiasis: An Ecological Study in Kabupaten Kebumen Putra, Eka Asmara Juhan; Lubab, Muhammad Irbabul
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10967

Abstract

Background: Nephrolithiasis is a significant public health concern influenced by environmental, metabolic, and lifestyle factors. This study aimed to investigate the incidence of nephrolithiasis and its associated risk factors in karst and non-karst zones, focusing on demographic characteristics, water sources, comorbidities, and geographic variability. Understanding these determinants is crucial for developing targeted prevention strategies. Methods: A cross-sectional study was conducted from January 2025 to February 2025, involving 98 participants (35 from a karst zone and 63 from a non-karst zone). Data were collected through structured interviews, medical record reviews, and laboratory assessments, following the STROBE guidelines. Variables included age, gender, water source, daily water consumption, urinary habits, comorbidities, and occupational environment. Statistical analyses were performed using RStudio, with Mann-Whitney U tests for continuous variables and logistic regression for categorical variables. Nephrolithiasis incidence rates were calculated per 100,000 population and visualized using a heatmap. Result: District-specific incidence ranged from 10,989.0 (Ayah, karst; Karanganyar, non-karst) to 1,098.9 (Prembun, non-karst) per 100,000 population. Unadjusted risk-ratio (RR) estimates (95 % CI) included: female sex RR 1.52 (0.52–4.42); groundwater vs distilled water RR 1.65 (0.43–6.35); municipal vs distilled water RR 0.26 (0.03–2.12); fluid intake < 2,500 mL vs ≥ 2,500 mL RR 0.96 (0.32–2.81); urine retention RR 1.07 (0.38–3.03); outdoor vs indoor work RR 1.52 (0.52–4.42); scale present on boiling water RR 3.27 (0.88–12.24). None of the adjusted models reached statistical significance. Conclusions: This study underscores the multifactorial etiology of nephrolithiasis, emphasizing the role of geological, metabolic, and lifestyle factors. Targeted interventions, including community screening, dietary modifications, and improved water quality, are essential for reducing disease burden. Future research should explore causal relationships and refine preventive strategies through longitudinal studies and larger cohorts. These findings contribute to a deeper understanding of nephrolithiasis and inform region-specific public health measures.

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