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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
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Indirect Right Inguinal Hernia in a Six-Year-Old Girl: A Case Report and Literature Review Pratama P, Gusti Putu Agung
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.v15i2.10968

Abstract

Background: Pediatric inguinal hernia is a common surgical problem, yet direct hernias in girls account for fewer than 1.5% of childhood groin defects. Although often painless and reducible, the cumulative risk of incarceration approaches 6%, warranting early repair. Case Description: A healthy six-year-old girl presented with a two-month history of an intermittent, painless right-groin bulge that appeared with crying or coughing. Physical examination revealed a 2.5 × 2 cm fully reducible mass; ultrasonography confirmed a fat-containing herniation medial to the inferior epigastric vessels, consistent with a reducible direct inguinal hernia. After optimization, she underwent an open high ligation herniotomy. The hernia sac was dissected to the internal ring and securely ligated without mesh. Operative time was 25 minutes and blood loss were negligible. The patient was discharged the same day, resumed unrestricted activity within one week, and remained asymptomatic at six-month follow-up with no evidence of recurrence. Conclusions: This case illustrates that open high ligation provides safe, durable closure for the exceedingly rare direct inguinal hernia in pediatric females, mirroring success rates above 98% reported for indirect defects. Early elective repair eliminates the risk of incarceration, avoids mesh-related morbidity, and allows rapid return to normal activity.
The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital Bora, Fivilia Anjelina; Dewi, Dewa Ayu Mas Shintya; Kurniyanta, I Putu; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Suarjaya, Putu Pramana; Aribawa, I Gusti Ngurah Mahaalit; EM, Tjahya Aryasa; Parami, Pontisomaya; Labobar, Otniel Andrians
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.v15i2.10969

Abstract

Background: We assessed whether preoperative anxiety is associated with postoperative pain severity, opioid requirement, neutrophil-to-lymphocyte ratio (NLR), and blood glucose after gynecologic laparotomy. Methods: Prospective cohort at Ngoerah Hospital (May to June 2025). Anxiety was measured preoperatively with APAIS and categorized as non-anxious, mild, moderate, or severe. Outcomes were NRS pain at 6, 12, and 24 hours, total fentanyl in the first 24 hours, and NLR and blood glucose at 6 hours postoperatively. Multivariable analysis used MANCOVA (99% confidence intervals). Result: Fifty-four patients were included (mean age 41.78 ± 10.58 years). Anxiety distribution was 46.3% non-anxious, 25.9% mild, 24.1% moderate, and 3.7% severe. Higher anxiety was associated with higher NRS at 6 hours (B 0.842; 99% CI 0.475 to 1.209; p < 0.001), 12 hours (B 0.381; 0.247 to 0.515; p < 0.001), and 24 hours (B 0.158; 0.048 to 0.269; p = 0.048). Anxiety was associated with higher 24-hour fentanyl requirement (B 147.8 microg; 99% CI 124.062 to 171.651; p < 0.001), higher postoperative NLR (B 4.31; 99% CI 0.609 to 8.027; p = 0.024), and higher postoperative blood glucose (B 19.4 mg/dL; 99% CI 7.912 to 30.912; p = 0.001). Conclusions: Higher preoperative anxiety was independently associated with worse pain, greater opioid requirement, and higher postoperative NLR and blood glucose after gynecologic laparotomy.
Impact of Socioeconomic Inequalities on the Incidence of Type 2 Diabetes Mellitus: A Systematic Review Sasongko, Calvin; Adrya, Jessica; Varsha, Srigita; Fatchurrahman, Sony A.; Hermawan, Galih Muchlis; Dhika, Veriantara Satya; Tjahyanto, Teddy
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.v15i2.10972

Abstract

ckground: Type 2 diabetes mellitus (T2DM) is a rising global burden, and socioeconomic inequalities may shape risk through differential resources, environments, and access to prevention and care. We synthesised evidence on the association between socioeconomic position (SEP) and incident T2DM. Methods: We conducted a PRISMA 2020–guided systematic review of PubMed, EMBASE, and Scopus (inception to 18 January 2026). Observational studies of adults without diabetes at baseline that measured SEP (education, income, occupation and/or area deprivation) prior to diagnosis and reported incident T2DM were eligible. Random-effects meta-analyses pooled relative risks (RRs), treating hazard ratios as approximations. Risk of bias was assessed (NOS). Result: From 1,580 records, 25 studies met inclusion criteria and 23 contributed to quantitative synthesis. Studies were mainly prospective cohorts or nested case–control designs, largely from high-income countries, with follow-up from 3 to 34 years and participants aged 18–86 years. Lower education was associated with higher T2DM incidence (least vs most educated: RR 1.55, 95% CI 1.37–1.75). Lower occupational position was also associated with increased risk (lowest vs highest: RR 1.60, 95% CI 1.25–2.05). Income was not statistically conclusive (lowest vs highest: RR 1.37, 95% CI 0.94–2.01). Conclusions: Socioeconomic disadvantage, particularly lower education and occupational status, is consistently associated with higher risk of incident T2DM. Prevention and screening should incorporate SEP to better target upstream determinants.
Prognostic Significance of Hypoalbuminemia in Transcatheter Aortic Valve Implantation Patients: A Systematic Review and Meta Analysis of Diagnostic Test Accuracy Huvi, Destino; Adrya, Jessica; Sofyan, Nihal; Fauzi, Daffa Rizqi; Dharmasaputra, Alan; Varsha, Srigita; Wiyono, Putri Dhiya Prameswari
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.v15i2.10973

Abstract

ckground: Calcific aortic stenosis is common in older adults, and TAVR has expanded treatment to patients with high comorbidity and frailty. Serum albumin is an inexpensive marker that reflects inflammation, nutrition, and physiologic reserve, but its prognostic performance in TAVR needs clearer quantification. Methods: We performed a PRISMA/PRISMA-DTA–guided systematic review and diagnostic test accuracy meta-analysis of studies evaluating pre-procedural hypoalbuminemia in adults undergoing TAVR/TAVI. PubMed, Embase, and Scopus were searched from inception to 18 January 2026. Hierarchical models were used to pool sensitivity and specificity for 30-day mortality, and a random-effects model pooled hazard ratios for time-to-event mortality. Risk of bias was assessed using PROBAST. Result: Ten studies met inclusion criteria. Definitions of hypoalbuminemia varied (most commonly <3.3–3.5 g/dL). For predicting 30-day mortality, pooled sensitivity was 47.7% (95% CI 35.5–59.9) and pooled specificity was 76.0% (95% CI 62.9–89.2), indicating better rule-in than rule-out performance. Across studies reporting time-to-event outcomes, hypoalbuminemia was associated with higher mortality (pooled HR 1.15, 95% CI 1.03–1.29). PROBAST ratings were generally low risk for participants, predictors, and outcomes, with some concerns in the analysis domain. Conclusions: Pre-procedural hypoalbuminemia is a practical risk marker in TAVR patients, showing moderate specificity for early mortality and a consistent association with worse survival, supporting its use in peri-procedural risk stratification.
Platelet-Rich Plasma as a Novel Treatment for Hair Loss: A Systematic Review of Safety, Efficacy, and Patient Outcomes Limanda, Claudia Felicia; Hartanto, Ericko; Soewardy, Jeanny Megawati; Harahap, Alya Ihsani
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.v15i2.10974

Abstract

Background: Hair loss is common and clinically heterogeneous, and platelet-rich plasma (PRP) has emerged as a minimally invasive autologous therapy with potential effects on follicular cycling and the scalp microenvironment. This review evaluated PRP safety, efficacy, and patient outcomes across hair-loss conditions. Methods: PRISMA-guided systematic review and meta-analysis was conducted using PubMed, Embase, and Scopus (inception to 10 February 2026). Human clinical studies with extractable quantitative data on PRP for hair loss were included. Primary outcomes were hair density, hair thickness, hair count, and pulled hair number; safety and patient-reported outcomes were summarized. Risk of bias was assessed using ROBINS-I, and random-effects models were applied for pooling. Result: Eight studies met inclusion criteria. PRP was generally well tolerated, with mostly mild, transient procedure-related adverse events (e.g., injection-site pain, erythema/edema, pruritus, bruising) and no consistent signal of serious complications, although safety reporting was variable. Meta-analysis showed PRP increased hair density (pooled SMD = 3.39, 95% CI 2.27–4.52) and hair thickness (pooled SMD = 2.78, 95% CI 1.91–3.65) versus control, and reduced pulled hair number (pooled SMD = −3.75, 95% CI −5.59 to −1.92). Hair count was not clearly different from control (pooled SMD = −0.95, 95% CI −17.87 to 15.96). Most studies were at low-to-moderate risk of bias, with one at serious risk. Conclusions: PRP may improve hair density and thickness and reduce shedding-related measures in selected patients, but effects on hair count remain uncertain and outcomes are sensitive to protocol variability. Larger standardized randomized trials with longer follow-up are needed.
The Evolution of Biologic Therapies for Psoriasis and Atopic Dermatitis: A Systematic Review of Randomized Controlled Trial Limanda, Claudia Felicia; Hartanto, Ericko; Putri, Elisa; Primadani, Nurzanah; Hasnah, Multiyus
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.v15i2.10975

Abstract

ground: Psoriasis and atopic dermatitis are chronic, immune-mediated inflammatory skin diseases that cause a substantial, lifelong burden on patients globally. Over the past two decades, the therapeutic paradigm has shifted dramatically from broad immunosuppression to highly targeted biologic therapies designed to interrupt key cytokine pathways driving clinical disease activity. Methods: To comprehensively evaluate this transition, we conducted a systematic review of randomized controlled trials assessing the efficacy and safety of biologic treatments for moderate-to-severe psoriasis and atopic dermatitis. We systematically searched major electronic databases for peer-reviewed published trials, extracting data on targeted mechanisms, clinical efficacy outcomes, and safety profiles. Result: The evolution in psoriasis treatment progressed sequentially from early tumor necrosis factor inhibitors to highly specific interleukin (IL)-12/23, IL-17, and selective IL-23 blockades. These newer agents consistently demonstrate unprecedented rates of complete skin clearance and durable responses. Similarly, the atopic dermatitis landscape has been revolutionized by biologics targeting type 2 inflammation, particularly the IL-4 and IL-13 pathways. These interventions provide profound relief from intractable pruritus and persistent lesions in patients refractory to conventional therapies, while largely avoiding the off-target toxicities of older systemic agents. Conclusions: The advent and evolution of biologic therapies represent a watershed moment in dermatology. By enabling precision immunology, these targeted treatments have fundamentally transformed disease management, offering patients realistic expectations for sustained remission and significantly enhanced quality of life.
Evaluating the Effectiveness and Safety of a Shortened Rifapentine-Moxifloxacin Regimen in Treating Drug-Sensitive Pulmonary Tuberculosis: A Systematic Review Wicaksana, Luthfia Ayu; Sirait, Endy Amos Todo Hasudungan
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.v15i2.10976

Abstract

Background: Prolonged treatment duration remains a key challenge in managing drug-sensitive pulmonary tuberculosis (DS-TB), contributing to poor adherence and treatment failure. Recent evidence suggests that regimens incorporating rifapentine and moxifloxacin (RPT+MOX) may allow for effective 4-month treatment courses. Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines to evaluate the effectiveness and safety of shortened RPT+MOX regimens. PubMed, EMBASE, and Scopus were searched up to May 2025. Eligible studies included randomized trials or observational cohorts comparing shortened RPT+MOX regimens with standard 6-month therapies in patients with DS-TB. Outcomes included culture conversion at 8 weeks, relapse or treatment failure, and serious adverse events. Risk of bias was assessed using the ROBINS-I tool. Result: Five studies (three RCTs, two observational) met inclusion criteria. Pooled analysis showed no significant difference in risk for relapse or treatment failure (RR 0.79, 95% CI: 0.37–1.67), culture conversion (RR 1.16, 95% CI: 0.80–1.69), or serious adverse events (RR 0.92, 95% CI: 0.65–1.29) between RPT+MOX and standard regimens. Risk of bias ranged from minimal to moderate. The GRADE assessment supported high certainty of evidence. Conclusions: Shortened RPT+MOX regimens demonstrate comparable effectiveness and safety to standard 6-month treatment for DS-TB, supporting their use in appropriate settings. Further studies are warranted to assess long-term outcomes, real-world adherence, and feasibility across diverse populations.
Incidence and Risk Factors of Hernia Mesh-Related Infections: A Systematic Review and Meta-Analysis Kemala, Qanita Izza; Aisyah, Ghina Nabila; Najah, Nusaibah Hanina
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.v15i2.10977

Abstract

Background: Prosthetic mesh lowers hernia‑recurrence rates but can precipitate infection; reported incidence and risk factors remain inconsistent. The objective of this systematic review and meta-analysis is to estimate the pooled incidence of hernia mesh infections and to identify the key risk factors associated with their development.Methods: A PRISMA 2020 search of PubMed, EMBASE and Scopus identified randomised, cohort and case‑control studies that reported mesh‑related infection incidence or risk factors ≥ 3 months after adult hernia repair. Two reviewers independently screened records, appraised bias (ROBINS‑I) and graded certainty (GRADE). Random‑effects meta‑analyses generated pooled proportions and risk ratio (RR).Result: Seven studies encompassing 57,653 repairs qualified. Infection incidence ranged 1.3 – 10.2 %; the pooled proportion was 4.9 % (95 % CI 2.6 – 7.4, I² = 87 %). Diabetes (RR 1.49, 95 % CI 1.13 – 1.97) and smoking (RR 1.43, 95 % CI 1.34 – 1.52) were consistent patient‑level risks, whereas obesity (RR 1.48, 95 % CI 0.68 – 3.22) and female sex (RR 1.08, 95 % CI 1.04 – 1.11) exerted smaller effects. Operative time > 2 h, emergency repair, large/PTFE or composite intraperitoneal meshes, and repeat surgery each roughly doubled infection odds. Certainty was low‑to‑moderate overall but high for diabetes and smoking; no publication bias was detected.Conclusions: Roughly one in twenty mesh repairs is complicated by infection. Optimising glycaemic control, enforcing smoking cessation, shortening operations and selecting macroporous meshes may meaningfully lower risk.
VEGF as a Marker of Wound Healing: Better High or Better Low? Sutanto, Kenny Wijaya; Lestari, Endang Sri; Prasetyo, Sigit Adi
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.v15i2.10978

Abstract

Background: Vascular Endothelial Growth Factor (VEGF) is a key regulator of angiogenesis and tissue regeneration in wound healing. However, the prognostic significance of VEGF expression remains controversial, with both high and low levels variably associated with good or impaired wound healing. This review aimed to clarify the prognostic implications of VEGF expression in wound healing, focusing on whether high or low levels better pred ict favorable outcomes. Methods: A systematic search was conducted in PubMed, EBSCOHost, Embase, and Google Scholar using PRISMA guidelines. Studies involving VEGF measurements in human or animal models of acute and chronic wounds were included. VEGF levels were correlated with healing parameters such as angiogenesis, re-epithelialization, inflammation, and overall wound resolution. Risk of bias was assessed using Cochrane RoB 2.0 and the Newcastle-Ottawa Scale. Result: 15 studies met inclusion criteria. High VEGF levels were oftenly associated with improved outcomes in early wound phases by enhancing angiogenesis. However, sustained high levels in chronic wounds often correlated with unresolved inflammation and fibrosis. In contrast, low VEGF expression indicates impaired angiogenesis. Conclusions: VEGF expression is related to the ongoing phase of wound healing. High levels are beneficial during the acute phase, but if sustained, it may exert negative effects. Clinical interpretation should consider wound type, timing, and VEGF source, rather than relying on absolute expression levels alone.

Page 43 of 43 | Total Record : 429

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