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Rachmat Hidayat
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INDONESIA
Open Access Indonesian Journal of Medical Reviews
Published by HM Publisher
ISSN : -     EISSN : 28076257     DOI : https://doi.org/10.37275/oaijmr
Core Subject : Health,
Health Professions Medicine & Pharmacology
Open Access Indonesian Journal of Medical Reviews (OAIJMR) is a bi-monthly, international, peer-review, and open access journal dedicated to various disciplines of medicine, biology and life sciences. The journal publishes all type of review articles, narrative review, meta-analysis, systematic review, mini-reviews and book review.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 193 Documents
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Unusual Presentation of Malignant Melanoma: A Case of Giant Amelanotic Involvement of the Hand Gargarin Nabalah; Henky Agung Nugroho
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.716

Abstract

Malignant melanoma, a cancer originating from melanocytes, typically presents as a pigmented lesion. Amelanotic melanoma, a subtype lacking pigmentation, poses diagnostic challenges due to its varied clinical appearance. Acral amelanotic melanoma (AAM), occurring on the palms, soles, and subungual areas, is particularly rare. This case report describes an unusual presentation of a giant amelanotic malignant melanoma on the left hand, highlighting the diagnostic and management complexities. A 45-year-old male presented to the surgical oncology clinic with a three-year history of a progressively enlarging lump on his left hand. Initially small, the lesion rapidly grew in the past year, accompanied by ulceration and bleeding. Physical examination revealed an 8 cm x 6 cm x 4 cm rough-shaped, skin-colored mass with crusting and easily bleeding sores on the left palm. No axillary lymphadenopathy was noted. Histopathological examination of a biopsy sample indicated amelanotic malignant melanoma, which was confirmed by positive HMB-45 staining on immunohistochemistry. Magnetic Resonance Imaging (MRI) revealed a large soft tissue mass infiltrating the muscles of the left hand and causing bone marrow replacement in the 4th and 5th metacarpal bones. The patient subsequently underwent wrist disarticulation. Postoperative follow-up at one and six months showed good recovery without recurrence. In conclusion, this case underscores the importance of considering amelanotic melanoma in the differential diagnosis of unusual hand lesions, even in the absence of typical pigmentation. Proper histopathology and immunohistochemistry are crucial for accurate diagnosis and to rule out other malignancies. This report contributes to the limited literature on giant AAM of the hand and highlights the surgical management of this rare entity.
Rare Presentations of Male Breast Cancer: A Case Series Highlighting Diagnostic and Therapeutic Challenges Chandra Budi Hartono; Widyanti Soewoto
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.717

Abstract

Male breast cancer (MBC) is a rare disease with a rising incidence, accounting for less than 1% of all breast cancer cases. It typically presents in older men and outcome-based studies in adolescent and young adult (AYA) males are scarce due to its rarity. This case series aims to highlight the diagnostic and therapeutic challenges encountered in two rare presentations of MBC. The first case involved an 18-year-old male who presented with left chest pain and a rapidly growing breast mass. Histopathological analysis revealed invasive ductal carcinoma (IDC) NST grade III with positive margins, staged as cT2N0M0. He also presented with anemia and elevated transaminase enzymes. The second case was a 59-year-old male with a history of mucinous adenocarcinoma of the right breast who presented with the right arm and shoulder pain and a supraclavicular mass. Imaging revealed extensive metastatic disease in the lungs, liver, and bones, and he was diagnosed with cT2N3cM1. Both patients underwent different treatment approaches based on their disease stage and presentation. In conclusion, MBC, especially in AYA patients, presents unique diagnostic and therapeutic challenges due to its rarity and potential for aggressive behavior. These cases underscore the importance of considering MBC in differential diagnoses, even in younger males, and the need for tailored treatment strategies based on the specific clinicopathological features and stage of the disease. Early detection, comprehensive nodal evaluation, and adherence to established treatment guidelines are crucial for improving outcomes in MBC patients. Further research is warranted to better understand the biological characteristics and optimal management of MBC in rare presentations and younger populations.
Neutrophil-Lymphocyte Ratio as a Predictor of Ulcer Severity in Type 2 Diabetes Prima Budi Prayogi; Prima Kharisma Hayuningrat; Suharto Wijanarko; Hari Wujoso
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.718

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with increasing global prevalence, frequently complicated by foot ulcers. These ulcers present a significant burden, often leading to amputation and increased mortality. The neutrophil-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has emerged as a potential prognostic indicator in various diseases. This study investigated the correlation between NLR and the severity of foot ulcers in patients with T2DM. A retrospective, cross-sectional study was conducted, analyzing data from 60 patients with T2DM and foot ulcers admitted to Dr. Moewardi General Hospital, Surakarta, between January 1st, 2022, and December 31st, 2023. NLR was calculated from routine complete blood counts. Ulcer severity was graded using the Meggitt-Wagner classification. Statistical analysis included Spearman's rank correlation and Kruskal-Wallis tests. Our study found a significant correlation observed between NLR and ulcer severity (ρ = 0.524, p < 0.001), with NLR values increasing with ulcer grade. Amputation was significantly associated with ulcer severity (p=0.009). In conclusion, NLR is a valuable and readily available biomarker for assessing the severity of foot ulcers in patients with T2DM. Elevated NLR is associated with more severe ulcers and a higher likelihood of amputation. Incorporating the assessment of NLR into the routine evaluation of patients with diabetic foot ulcers can aid in risk stratification and guide clinical management.
Rare Presentation of Emphysematous Cystitis with Culture-Proven Urosepsis in a Geriatric Female: A Case Report Maharsi, Chiendo Yurinda; Ali Husein
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.719

Abstract

Emphysematous cystitis (EC) is a rare and potentially life-threatening infection of the bladder wall characterized by the presence of gas. It predominantly affects elderly females with diabetes mellitus. While the clinical presentation can vary, it commonly involves symptoms of urinary tract infection. This case report describes an unusual presentation of EC in a geriatric female complicated by culture-proven urosepsis. A 66-year-old female with a history of type 2 diabetes mellitus presented to the emergency department with fever, dyspnea, and tachypnea. She reported suprapubic pain, dysuria, and foul-smelling, murky urine for two days. Initial laboratory findings revealed leukocytosis, hyperglycemia, and elevated procalcitonin levels, indicating sepsis. Computed tomography (CT) of the abdomen and pelvis revealed air foci within the bladder wall, consistent with EC. Blood and urine cultures grew Escherichia coli resistant to multiple antibiotics but susceptible to amikacin and gentamicin. The patient was treated with intravenous amikacin and showed significant clinical improvement, with subsequent negative urine cultures. In conclusion, our study highlights a rare presentation of emphysematous cystitis complicated by culture-proven urosepsis in a geriatric female with multidrug-resistant Escherichia coli. Prompt diagnosis using CT imaging and appropriate antibiotic therapy based on culture sensitivities led to a successful outcome. This case underscores the importance of considering EC in elderly diabetic patients presenting with sepsis and urinary symptoms, even with atypical features.
Efficacy of Green Mussel Shell-Derived Hydroxyapatite as a Bone Graft Substitute in Rabbit Femoral Defects: An In Vivo Study Rafika Syah Putra; Najatullah; Selamat Budijitno
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.721

Abstract

Bone grafting is a standard procedure in fracture management to enhance bone healing using osteogenic, osteoinductive, and osteoconductive materials. Bovine hydroxyapatite (HA) is a commonly used bone substitute, but its production can be expensive. Green mussel shells have emerged as a potential alternative source of HA due to their abundance and lower cost, particularly in Indonesia. This study aimed to evaluate the efficacy of HA derived from green mussel shells on bone healing in rabbit femoral defects through radiological examination. A post-test only experimental study was conducted on male New Zealand white rabbits (n=36) with surgically created femoral defects. The rabbits were randomly divided into three groups: a control group (K) with no treatment, a group (P1) treated with bovine HA, and a group (P2) treated with HA derived from green mussel shells. Bone healing was assessed radiologically at weeks 2, 4, and 6 post-surgery using the Radiographic Union Score for Tibial Fractures (RUST) score on femoral X-rays. Statistical analysis was performed to compare the RUST scores between the groups and across the different time periods, with a p-value of <0.05 considered significant. Significant differences in RUST scores were observed between the groups at week 2 (K: 1.33 ± 0.50, P1: 2.67 ± 0.50, P2: 2.78 ± 0.44; p<0.001) and week 4 (K: 2.22 ± 0.44, P1: 3.11 ± 0.33, P2: 3.33 ± 0.50; p=0.003). However, no significant difference was found between the P1 (bovine HA) and P2 (green mussel shell HA) groups at these time points (p>0.05). At week 6, no significant differences in RUST scores were detected among all three groups (p=0.087). In conclusion, the findings of this study suggest that the efficacy of HA derived from green mussel shells in promoting bone healing in rabbit femoral defects is comparable to that of bovine HA, as assessed by the RUST score. This highlights the potential of green mussel shells as a cost-effective and readily available alternative source for HA in bone graft applications.
Comparative Efficacy and Safety of Anti-VEGF Agents in Neovascular Age-Related Macular Degeneration: A Meta-Analysis Ramzi Amin; Siti Pradyta Phiskanugrah
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i1.723

Abstract

Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss in the elderly. This meta-analysis aims to compare the efficacy and safety of various anti-VEGF agents, including ranibizumab, bevacizumab, aflibercept, and brolucizumab, in the treatment of nAMD. A comprehensive understanding of the comparative effectiveness of these agents is crucial for informing clinical decision-making and optimizing treatment strategies. A meta-analysis was conducted using electronic databases, including PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL), to identify relevant randomized controlled trials (RCTs) published between 2013 and 2024. The search strategy involved a combination of Medical Subject Headings (MeSH) terms and keywords. Two independent reviewers extracted data from the included studies using a standardized form. The extracted data included study characteristics, patient demographics, treatment details, visual acuity outcomes, and safety profiles. Seven RCTs were included in the meta-analysis. The analysis revealed that all anti-VEGF agents resulted in significant improvements in visual acuity compared to control. Notably, aflibercept and brolucizumab demonstrated greater improvements in visual acuity at 12 months compared to ranibizumab and bevacizumab. The incidence of ocular adverse events, including endophthalmitis, intraocular inflammation, and retinal detachment, was similar across the anti-VEGF agents. All anti-VEGF agents are effective in improving visual acuity in nAMD. Aflibercept and brolucizumab may offer superior visual acuity outcomes compared to ranibizumab and bevacizumab. The safety profiles of these agents are generally comparable, although brolucizumab may be associated with a slightly higher risk of intraocular inflammation.
Comparison of Postoperative Outcomes in Colorectal Cancer Patients Undergoing Enhanced Recovery After Surgery (ERAS) vs Non-ERAS: A Retrospective Study Erdiansyah Reza Lesmana; Ida Bagus Budhi Surya Adnyana
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.724

Abstract

Colorectal cancer (CRC) represented a significant global health burden, contributing to approximately 10% of all cancer-related mortality worldwide. While surgery remained the primary treatment for resectable CRC, the postoperative period was often characterized by prolonged recovery and complications. Enhanced Recovery After Surgery (ERAS) protocols emerged as a multimodal approach to mitigate these challenges by attenuating surgical stress, optimizing nutritional status, minimizing opioid consumption, promoting early mobilization, and improving psychological well-being. This study aimed to compare the postoperative outcomes between colorectal cancer patients who underwent surgery with ERAS protocols and those who followed traditional non-ERAS recovery pathways. A retrospective cohort study was conducted at a single academic institution. The study population comprised 201 adult patients who underwent surgical resection for colorectal cancer between January 2020 and December 2024. Patients were categorized into two groups: the ERAS group (n=135), who were managed according to a standardized ERAS protocol, and the non-ERAS group (n=66), who received traditional postoperative care. Statistical analysis involved independent samples t-tests for continuous variables and chi-square tests for categorical variables, with a significance level set at p < 0.05. The ERAS group demonstrated a statistically significant reduction in the mean length of hospital stay compared to the non-ERAS group (7.67 days vs. 8.83 days, p < 0.001). While the ERAS group exhibited slightly higher mean hemoglobin levels postoperatively (11.29 g/dL vs. 11.14 g/dL, p = 0.56), this difference was not statistically significant. Notably, the incidence of postoperative complications was lower in the ERAS group (1 case) compared to the non-ERAS group (4 cases), with a p-value of 0.051, indicating a trend towards significance. In conclusion, the implementation of an ERAS protocol was associated with improved postoperative outcomes in colorectal cancer patients, specifically a significant decrease in the length of hospital stay and a trend towards a lower rate of complications. These findings supported the integration of ERAS pathways into the standard of care for colorectal cancer surgery to enhance patient recovery, potentially reduce healthcare costs, and improve overall patient outcomes.
Topical Fermented Lactobacillus acidophilus Lysate Accelerates Second-Degree Burn Healing: An In Vivo Study in Wistar Rats Kamilah, Lian; Kusumawardani, Arie; Widhiati, Suci; Dharmawan, Nugrohoaji; Ellistasari, Endra Yustin
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.725

Abstract

Second-degree burns, affecting the epidermis and dermis, constitute a major category of thermal injuries globally, presenting significant clinical challenges including pain, infection risk, and potential scarring. While standard treatments like silver sulfadiazine (SSD) exist, limitations including potential cytotoxicity and emerging resistance necessitate exploration of novel therapeutic strategies. Recent interest has focused on topical applications derived from probiotics, such as Lactobacillus spp., due to their suggested roles in modulating inflammation, combating oxidative stress, and providing antimicrobial activity to accelerate wound repair. This study investigated a fermented lysate derived from Lactobacillus acidophilus (L. fermented) as a potential topical agent for burn healing. This study aimed to evaluate the therapeutic efficacy of a 5% topical L. fermented ointment on the healing process of experimentally induced second-degree burns in a Wistar rat model, primarily by assessing the rate of wound closure compared to standard SSD treatment and an untreated control. A true experimental in vivo study utilizing a post-test only control group design was performed following ethical approval. Fifteen male Wistar rats were subjected to a standardized second-degree thermal burn injury on their dorsal aspect. The animals were then randomized (n=5 per group) to receive twice-daily topical applications of either 5% L. fermented ointment (Group A), SSD ointment (Group B), or no treatment (Control, Group C). Wound healing was quantitatively assessed by measuring the wound surface area (mm²) on days 1, 3, 7, and 14 post-injury using digital imaging and ImageJ software analysis. Statistical comparisons between groups were conducted using one-way ANOVA followed by LSD post-hoc tests, with statistical significance set at p<0.05. All treatment groups demonstrated a significant reduction in wound size over the 14-day observation period (p=0.001 within each group). Inter-group comparisons revealed significantly accelerated wound closure in Group A starting from day 3 onwards (p<0.005). At day 14, the mean wound area in Group A (17.5 ± 8.06 mm²) was significantly smaller than in Group B (119.22 ± 45.41 mm²) and Group C (305.18 ± 25.21 mm²) (p=0.001). Post-hoc analysis confirmed the superiority of L. fermented treatment over both SSD (mean difference 101.72 mm², p=0.001) and control (mean difference 287.68 mm², p=0.001). SSD treatment also resulted in significantly better healing than the control group (mean difference 185.96 mm², p=0.001). In conclusion, topical application of 5% fermented Lactobacillus acidophilus lysate significantly accelerated the closure of second-degree burn wounds in Wistar rats, demonstrating superior efficacy compared to both silver sulfadiazine treatment and no treatment. These findings highlight the potential of L. fermented lysate as a promising novel therapeutic agent for burn wound management.
Successful Management of Pediatric Todani Type IVa Choledochal Cyst with Roux-en-Y Reconstruction: Diagnostic and Surgical Insights Rizky Ratria Kusumawardhani; Thomas Aribowo
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.726

Abstract

Choledochal cysts (CC), or biliary cysts, are congenital dilatations of the biliary tree. Type IVa cysts, involving both intra- and extrahepatic ducts, present diagnostic and management challenges, particularly due to the risk of complications like cholangitis, pancreatitis, and long-term malignancy. Early diagnosis and complete surgical excision with biliary reconstruction are paramount. We report the case of a 4-year-old boy presenting with a six-month history of worsening intermittent upper abdominal pain, nausea, and vomiting. The initial ultrasound suggested a hepatic cyst. Magnetic Resonance Cholangiopancreatography (MRCP) confirmed multiple cystic dilatations involving the intra- and extrahepatic biliary ducts, consistent with a Todani Type IVa choledochal cyst. Laboratory findings showed elevated Gamma GT (179 U/L) but normal bilirubin levels. The patient underwent successful open surgery involving complete excision of the extrahepatic cyst and biliary reconstruction via Roux-en-Y hepaticojejunostomy. His postoperative course was uneventful, with discharge on day six. Follow-up revealed good clinical recovery without immediate complications. In conclusion, Todani Type IVa choledochal cysts are complex anomalies requiring meticulous diagnostic workup and tailored surgical management. This case highlights the utility of MRCP in delineating complex biliary anatomy and reaffirms Roux-en-Y hepaticojejunostomy following complete cyst excision as an effective treatment, offering favourable short-term outcomes in pediatric patients.
Beyond Awareness: Investigating the Disconnect Between Oral Health Knowledge and Caries Experience (DMF-T) in Indonesian Primary Schoolchildren Yona Ladyventini; Suci Rahmasari; Bobby
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.727

Abstract

Dental caries remains a significant public health problem among Indonesian children, impacting their quality of life and development. While oral health knowledge is considered crucial for prevention, its direct impact on caries experience, particularly in specific Indonesian contexts, requires further investigation. This study aimed to assess the relationship between oral health knowledge and caries experience (DMF-T index) among grade 2 students at an Islamic Integrated Primary School in Indonesia. A cross-sectional study was conducted involving 85 second-grade students selected via purposive sampling. Oral health knowledge was assessed using a validated, structured questionnaire covering topics like tooth brushing importance, frequency, caries causes, and prevention. Caries experience was measured using the DMF-T (decayed, missing, filled teeth) index through clinical examinations performed by trained dental personnel. Data were analyzed using descriptive statistics and the Chi-square test to determine the association between knowledge level (categorized as low or sufficient) and DMF-T status (categorized as low, moderate, or high), with significance set at p<0.05. The study included 45 (52.9%) female and 40 (47.1%) male students. The majority of students (80%, n=68) demonstrated sufficient oral health knowledge, with a mean knowledge score of 5.52 (SD=1.52) on a scale of 1-7. Despite this, the prevalence of dental caries was high, with a mean DMF-T score of 7.92 (SD=5.11). Overall, 61.2% (n=52) of students were categorized as having high DMF-T status, 18.8% (n=16) had moderate DMF-T, and 20% (n=17) had low DMF-T. The Chi-square analysis revealed no statistically significant association between the level of oral health knowledge and DMF-T status (p=0.920). High DMF-T prevalence was observed in both the low knowledge group (58.8%) and the sufficient knowledge group (61.8%). In conclusion, this study highlighted a significant disconnect between oral health knowledge and actual caries experience among primary schoolchildren in this Indonesian setting. While most students possessed sufficient knowledge, the prevalence and severity of dental caries remained alarmingly high, and knowledge level was not significantly associated with DMF-T status. These findings underscore the inadequacy of knowledge-based interventions alone and emphasize the need for comprehensive, multifaceted oral health promotion programs that address behavioral, practical, and environmental factors to effectively combat dental caries in children.

Page 15 of 20 | Total Record : 193

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