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Muhamad Thohar Arifin
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Muhamad Thohar Arifin MD. PhD. Faculty of Medicine, Diponegoro University Jl. Prof. Soedarto, Tembalang, Kec. Tembalang, Kota Semarang, Jawa Tengah 50275 Email: dimjoffice@gmail.com
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Diponegoro International Medical Journal (DIMJ)
Published by Universitas Diponegoro
ISSN : Without     EISSN : 27455815     DOI : https://doi.org/10.14710/dimj
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience
Diponegoro International Medical Journal (DIMJ) ISSN Number: 2745-5815 welcomes contributions which promote the exchange of ideas and rational discourse between practicing educators and medical researchers all over the world. DIMJ is an international, peer review, electronic, and open access journal. DIMJ is seeking an original and high-quality manuscript. Areas of interest in all aspects of medical and physiology include but are not limited to the following topics: Modelling of diagnose and cure of human diseases The scientific underpinning of medicine and pathophysiology Biochemistry and biology molecular solution Decision support systems Biomedicine Any experimental design and statistical analysis The application of new analytical and study methods (including biomolecular studies)
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 84 Documents
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Comparison of Intravenous Ephedrine Administration of 5 mg and 10 mg Doses on Post Spinal Anesthesia Hypotension in Caesarean Section at Dr. Kariadi General Hospital Semarang Alaydrus, Husein; Rayhan, Amar; Arifin, Johan; Satoto, Hari Hendriarto
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.26813

Abstract

Background: Hypotension after spinal anesthesia or combined epidural anesthesia in caesarean section (CS) causes adverse effects on the mother and fetus/neonatal. Hypotension often occurs therefore vasopressors could be used routinely and should be used as prophylaxisMethods: Simple randomized controlled trial study of 52 patients undergoing CS at RSUP dr. Kariadi Semarang. Subjects revealed two groups, namely intravenous ephedrine at a dose of 5 mg and a dose of 10 mg. Hemodynamic variables were measured every 3 minutes until the operation was completed.Results: In the comparison of mean arterial pressure (MAP) between the ephedrine 5 mg and ephedrine 10 mg groups, a statistically significant difference was obtained at 30 minutes (P < 0.05) while in the measurement of heart rate (HR) between the ephedrine 5 group mg and ephedrine 10 mg, a statistically significant difference was obtained from 3 to 15 minutes. Hypotension was obtained in 1 patient in the ephedrine 10 mg group and 3 patients in the ephedrine 5 mg group.Conclusion: 10 mg intravenous ephedrine as a prophylactic agent after spinal anesthesia for patients undergoing CS has better hemodynamic outcomes and complications than 5 mg intravenous ephedrine. Keywords: spinal anesthesia, ephedrine, SC, hypotension
Bacteria Patterns and Antibiotic Sensitivities in Patients with Preterm Premature Rupture of Membrane: Study of Patients with PPROM ≤ 6 Hours And > 6 Hours at General Hospital Kariadi Semarang Munthe, Rio Bornfry Haro; Pramono, Besari Adi; Kristiawan, Endy Cahyono; Poerwoko, Agoes Oerip; Cahyanti, Ratnasari Dwi
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.24649

Abstract

Background: Preterm premature rupture of membranes (PPROM) has multifactorial causes. Ascending bacterial invasion can cause intrauterine infection in up to 60% of cases with PPROM. Giving antibiotics at inadequate concentrations causes bacteria to grow exponentially, which is characterized by very fast growth.Objective: This study aims to determine bacteria patterns and antibiotic sensitivity in patients with PPROM at Dr. RSUP. Kariadi, Semarang.Methods: Observational analytical research with a cross-sectional design. The research subjects were 46 pregnant women aged 20-36 weeks 6 days who experienced PPROM. The selection of research subjects was carried out using the consecutive sampling method, namely the selection of research subjects based on research criteria and the subjects signed an agreement to participate in the research. The independent variables in this study were preterm PPROM ≤ 6 hours and > 6 hours, the dependent variables in this study were bacteria patterns and antibiotic sensitivity. The data that has been obtained is analyzed using the SPSS program. Results are significant if p<0.05.Results: Escherichia coli and Candida albicans are the most found pathogens. The antibiotics vancomycin, meropenem, and amphotericin B are effective in patients with PPROM. Women who experienced PPROM ≤ 6 hours and > 6 hours did not have significant differences in bacteria patterns and antibiotic sensitivity results.Conclusion: The gram-negative rod-shaped bacteria Escherichia coli and the fungus Candida albicans are the main pathogens that cause PPROM. The administration of vancomycin, meropenem, and amphotericin B has high effectiveness in PPROM patients at RSUP dr. Kariadi Semarang.
THE EFFECT OF DAYAK ONION (ELEUTHERINE PALMIFOLIA) EXTRACT CREAM APPLICATION ON SERUM INTERLEUKIN-6 LEVELS: AN EXPERIMENTAL STUDY IN UVB-INDUCED MALE WISTAR RATS Choirunnisa, Armadina Fitra; Afriliana, Liza; Damayanti, Galih Sari; Widyawati, Widyawati
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29701

Abstract

Background: Indonesia receives intense ultraviolet B (UVB) exposure. Prolonged exposure to (UVB) radiation is a major environmental factor contributing to oxidative stress and skin inflammation through the overproduction of reactive oxygen species (ROS) and subsequent upregulation of pro-inflammatory cytokines, including interleukin-6 (IL-6). Eleutherine palmifolia, traditionally used in Indonesian herbal medicine, contains abundant flavonoids and phenolic compounds with documented antioxidant and photoprotective properties. Its ability to absorb UV rays and neutralizing ROS suggests potential efficacy as a topical agent for mitigating UVB-induced inflammatory responses. Objective: This study aimed to evaluated the effect of Eleutherine palmifolia extract cream at various concentrations (10%, 15%, 20%) on serum IL-6 levels in UVB-induced male Wistar rats. Methods: A true experimental design with post-test only control group was conducted using 36 male Wistar rats randomly assigned to four groups: control (placebo), P1 (10%), P2 (15%), and P3 (20%). The cream was applied 20 minutes before UVB exposure and again 4 hours after irridation, three times per week for 30 days. Serum IL-6 levels were measured using ELISA. Statistical analysis was performed using Shapiro–Wilk, Levene’s test, one-way ANOVA, and LSD post-hoc test. Results: Mean IL-6 levels (pg/mL): control 1.63; P1 1.59; P2 1.65; P3 1.57. ANOVA indicated a significant differences among groups (p = 0.047). Post-hoc analysis showing a significant difference only between P2 and P3 groups (p = 0.012). Conclusion: The 20% Eleutherine palmifolia cream showed the strongest anti-inflammatory effect, significantly lowering IL-6 compared with 15%, while other group differences were not significant.
The Relationship Between Childhood Trauma and Level of Resilience in Borderline Personality Disorder Atmaja, Diana; Hadiati, Titis; Wardani, Natalia Dewi
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.27515

Abstract

Background: Borderline personality Disorder (BPD) is a serious mental disorder characterized by instability in emotions, impulse control, interpersonal relationships and self-image. Childhood trauma such as physical emotional or neglect abuse, has been strongly linked to the development of mental disorders, including BPD. Resilience as a psychological capacity to adapt to adversity, has also been shown to vary among individuals with BPD and may relate to their history of childhood trauma.Objective: To determine the relationship between childhood trauma and resilience level in BPDMethods: This study was a cross-sectional study, with 41 subjects were patients who had been diagnosed with BPD. Childhood trauma and resilience levels were assessed using the Childhood Trauma Questionnaire (CTQ) and Connor Davidson Resilience Scale (CD-RISC).Results: The relationship between emotional abuse and resilience level obtained a p = 0.008, physical abuse p = <0.001, sexual abuse p = 0.002 so that there is a significant relationship between emotional abuse, physical abuse and sexual abuse with resilience level in BPD.Conclusion:There was a significant relationship between childhood trauma emotional abuse, physical abuse and sexual abuse with the level of resilience in BPD patients.
Prenatal–Postnatal Heavy Metal Exposure in Relation to Neurodevelopmental Disorder and ADHD: A Systematic Review Husodho, Gabriela Valencia Putri; Prasadah, Ichsan Marzuki; Kumalasari, Anatalya Diah Ayu; Listiyanti, Talitha Aristawati; Setiawan, Rivaldo Heru; Bakri, Saekhol
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29755

Abstract

Introduction: Susceptibility to environmental insults during fetal brain development has been linked to an increased risk of neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD). ADHD is a prevalent neurodevelopmental disorder in children and is influenced not only by genetics, but also by environmental factors, particularly prenatal exposure to heavy metals. Heavy metals, such as lead, mercury, cadmium, and arsenic, are known neurotoxins that can disrupt fetal brain development; however, evidence regarding their role in ADHD remains inconsistent.Methods: This systematic review followed PRISMA guidelines to evaluate the association between prenatal heavy metal exposure and the risk of ADHD in children. The PECO framework was used to define population, exposure, comparators, and outcomes. A comprehensive literature search was conducted across PubMed, ScienceDirect, and ProQuest, using relevant keywords. Eligible studies included human observational research (cohort, case-control, cross-sectional) between 2021 and 2025 assessing prenatal exposure to heavy metals, neurodevelopmental outcomes, and ADHD.Results: Several studies have reported that elevated prenatal levels of cadmium, lead, and manganese are associated with increased ADHD symptoms and reduced cognitive performance. The findings on mercury were mixed, potentially due to confounding factors, including fish intake and maternal nutrition. Selenium and copper demonstrate dual effects, being essential at low levels but harmful at high concentrations. Thallium exposure in the third trimester significantly impaired cognitive and psychomotor development. Some studies have highlighted sex-specific and nonlinear dose-response effects.Conclusion: Heavy metals have an inconsistent impact on neurodevelopment. While some studies have associated prenatal exposure to cadmium and lead with neurodevelopmental issues, others have not found such links. Both prenatal and postnatal exposure to heavy metals, particularly cadmium, mercury, and lead, are associated with childhood ADHD.Keywords: ADHD, prenatal exposure, heavy metals, neurodevelopment, environmental toxins
Incidence and Associated Factors of Occupational Contact Dermatitis in Wood Furniture Finishing Workers faustinawati, belinda; Malik, Diah Adriani; Afriliana, Liza
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.28408

Abstract

Background: Occupational contact dermatitis (OCD) is a prevalent skin disease caused by workplace exposure to exogenous agents. Wood furniture finishing workers are at high risk due to significant contact with allergens and irritants, yet specific research on this group remains limited.Objective: To determine the incidence rate of OCD and analyze its associated factors among wood furniture finishing workers.Methods: An observational analytical study with a cross-sectional design was conducted involving 36 wood furniture finishing workers. Data on potential risk factors were collected using a modified Nordic Occupational Skin Questionnaire (NOSQ)-2002. The diagnosis of OCD was established using the Mathias criteria. A patch test was performed with four common industrial allergens (Formaldehyde 1%, Isothiazolinone 0.2%, Cobalt Chloride 1%, and Colophony 20%) to identify specific sensitisations. Data were analyzed using Mann-Whitney, Fisher's exact, and logistic regression tests.Results: The incidence rate of OCD was 58.3% (21 of 36 subjects). Positive patch test results were found in 20 subjects (55.5%), with Cobalt Chloride 1% being the most frequent sensitizer (44.4%), followed by Colophony 20% (30.5%), Formaldehyde 1% (19.4%), and Isothiazolinone 0.2% (13.8%). Univariate analysis identified younger age (p=0.012), shorter length of work (p=0.001), and a history of atopic dermatitis (p<0.001) as significant risk factors. Multivariate logistic regression analysis confirmed that younger age was the strongest predictor for OCD (OR 1.086; 95% CI 1.018–1.158; p=0.012).Conclusion: Wood furniture finishing workers exhibit a high incidence of OCD. Younger age, shorter work duration, and a history of atopic dermatitis are significant associated factors. These findings highlight the need for targeted preventive strategies, including worker education and improved safety measures in the furniture finishing industry.
Internet Addiction and Its Association With Sleep Problems Among Early Adolescents in a Peri-Urban Area Maharani, Aidza Ajrina; Rahmadi, Farid Agung; Mulyono, Mulyono; AS, Widodo Sarjana
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29774

Abstract

Background: The use of the internet among adolescents increases rapidly, particularly since COVID-19 pandemic, due to the necessity of online learning. Excessive internet use may progress to internet addiction, which has been identified as a risk factor for sleep disturbances. Sleep disorders that occur in adolescents may persist into adulthood, can result in sustained detrimental effects on health, especially in individuals aged 10-12 years, as they are still on critical period of growth and neurodevelopment. Data from Demak show that 30% from 40,000 students from elementary to high school have been addicted to online games, which represents a major subtype of internet addiction. Objective: To determine the relationship between internet addiction and sleep disorders among adolescents aged 10-12 years. Methods: A cross-sectional, analytical observational study was conducted. Data were obtained using the Internet Addiction Diagnostic Questionnaire questionnaire and the Sleep Disturbance Scale for Children (SDSC) questionnaire, administered to four grades and five grades at Bintoro 5 Elementary School in Demak, recruited through purposive sampling. Statistical analysis was performed using chi-square tests and multivariate logistic regression to control the confounding variables such as physical activity, obesity, and co-sleeping. Results: Among 81 respondents, the prevalence of internet addiction was 35.8% (n=29), and the prevalence of sleep disorders was 61.7% (n=50). Bivariate analysis using chi-square test demonstrated a significant relationship between internet addiction and sleep disorders P<0.05 (0.008). After controlling for confounding factors with logistic regression, the result remained statistically significant P<0.05 (0.006). Conclusion:Internet addiction is significantly associated with sleep disorders in adolescents aged 10-12 years, even after controlling for confounding factors.
Erythrocyte Indices for Beta-thalassemia Trait (BTT) Screening in Indonesia: A Scoping Review Mutmainah, Iffa; Kemuning, Asri Ragil; Nugraha, Widya Eka; Hanif, Aisyah Amanda; Mauludyani, Anna Vipta Resti
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.27771

Abstract

Background: Thalassemia is a monogenic disorder that ranks fifth among the catastrophic diseases in Indonesia. Thalassemia screening plays an important role in preventing the birth of individuals with thalassemia major. Numerous erythrocyte indices have been used as first-line screening methods for beta-thalassemia trait, preceding definitive analysis using hemoglobin electrophoresis.Objective: This study aimed to conduct a literature review comparing the most frequently used erythrocyte indices in Indonesia with hemoglobin electrophoresis.Methods: A systematic search was conducted using PubMed, Scopus, EBSCO, and Google Scholar databases in July 2024. This study included full-text articles in Indonesian or English that compared erythrocyte indices and hemoglobin electrophoresis for thalassemia screening.Results: Six articles were included in this review. Two of the six articles analyzed the compatibility of erythrocyte indices and hemoglobin electrophoresis using kappa statistics. The remaining articles calculated the diagnostic values.  Among the ten erythrocyte indices, the Mentzer index was the most frequently assessed, appearing in six studies, followed by the indices of Shine & Lal and Sirdah, each evaluated in three studies. The Green-King, England & Fraser, and Srivastava indices were each examined in two studies. Additionally, Ehsani, Matos and Carvalho, RDW, and MCV and/or MCH indices were each assessed in one study.Conclusion: The compatibility between erythrocyte indices and hemoglobin electrophoresis, based on two studies, was fair indicating that hematological indices alone are insufficient for a definitive diagnosis. This finding aligns with the conclusions of four other studies, which also suggested that no single erythrocyte index is definitive. Among the indices, the Green-King Index demonstrated the highest reliability; however, further studies are needed to support this finding, while hemoglobin electrophoresis remains essential for an accurate diagnosis.
Effect of Topical Dayak Onion (Eleutherine palmifolia) Cream on Epidermal Thickness in UVB-Exposed Male Wistar Rats: An Experimental Study Setyanegari, Aditya Putri; Damayanti, Galih Sari; Afriliana, Liza; Karlowee, Vega
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29621

Abstract

Background: Exposure to ultraviolet B (UVB) radiation, particularly in tropical regions like Indonesia, can cause skin damage characterized by increased epidermal thickness due to keratinocyte hyperproliferation, contributing to photoaging. Natural photoprotective agents rich in antioxidants such as Dayak onion (Eleutherine palmifolia) extract are expected to mitigate these effects. Objective: This study aims to evaluate the effect of applying Dayak onion extract cream at varying concentrations on epidermal thickness of UVB-induced male Wistar rat skin. Methods: This study was a true experimental study with a post-test only control group design. A total of 36 male Wistar rats were randomly divided into four groups: a control group (given placebo cream) and three treatment groups given Dayak onion extract cream at concentrations of 10%, 15%, and 20%. UVB exposure was carried out every two days for 30 days, along with application of the cream before and after UVB radiation. Epidermal thickness was analyzed through histopathological examination using Hematoxylin-Eosin staining and observed under 400x magnification. Results: Statistical analysis showed significant differences (p < 0,05) in epidermal thickness between the control group and the treatment groups. The mean epidermal thickness in the treatment groups was lower than that of the control group, with the greatest reduction observed in the 20% concentration group, followed by the 15% and 10% groups. There was no significant difference between the 15% and 20% concentrations. Conclusion: Application of Dayak onion extract cream is effective in reducing epidermal thickness, with a concentration of 20% providing optimal protective effects. These findings support the potential of Dayak onion as a natural photoprotective agent.Keywords: Dayak onion, Eleutherine palmifolia, epidermal thickness, photoaging, antioxidant
Spontaneous Pneumothorax after Physical Exertion on Adolescets with Vaping History in Diponegoro National Hospital Semarang: A Case Report Qolby, Qonita Nur; Wilastono, Muzaki; Balqis, Hanifa Amalia; Hadi, Hadi; Alwi, Luqman
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.30130

Abstract

Background: Vaping is now a trend for a tobacco-smoking alternative. However, studies and regulations regarding the side effects of vaping are limited. Recently, vaping-associated spontaneous pneumothorax cases were reported. Pneumothorax, when air accumulates in the pleural cavity, could progress to an emergency case. It is rarely related to physical exercise.Case Presentation: We found two spontaneous pneumothorax cases in Diponegoro National Hospital that presented with chest pain and cough post-exercise in vaping adolescents. The diagnosis was established based on medical history, physical examination, and chest X-ray. Both patients were treated with water-sealed drainage (WSD) and intensive care.Conclusion: Pneumothorax is an important diagnosis to consider in vaping patients, resulting in long stay and high-cost hospitalization. Vaping-associated spontaneous pneumothorax cases in active adolescents should receive special attention for conducting electronic cigarette studies and regulations in Indonesia.

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