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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 195 Documents
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Atypical Presentation of Cerebellopontine Angle Dermoid Cyst: A Case of Secondary Trigeminal Neuralgia Prima Budi Prayogi; Galih Indra Permana; Hanis Setyono; Ferry Wijanarko; Geizar Arsika Ramadhana; Muhammad Fauzan Jauhari
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.v5i4.753

Abstract

Dermoid cysts are rare congenital ectodermal inclusion cysts, accounting for a small percentage of all intracranial tumors. Their occurrence in the cerebellopontine angle (CPA) is infrequent, and presentation as isolated trigeminal neuralgia (TN) is considered atypical. This study underscores that rare congenital lesions like dermoid cysts can manifest with relatively common neurological symptoms, prompting clinicians to consider a broader differential diagnosis A 60-year-old female presented with a two-year history of paroxysmal, shock-like pain in the left cheek and intraoral area, triggered by light touch, consistent with trigeminal neuralgia. Neurological examination was otherwise largely unremarkable initially, though the pain significantly impacted her quality of life and nutritional intake, leading to weight loss. Magnetic Resonance Imaging (MRI) revealed an extra-axial lesion in the CPA, compressing the trigeminal nerve. The lesion exhibited characteristics suggestive of an epidermoid or arachnoid cyst initially, but with features also compatible with a dermoid cyst. The patient underwent a retrosigmoid craniotomy for microsurgical excision of the lesion. Intraoperatively, a cystic lesion with contents suggestive of a dermoid cyst was found adherent to the trigeminal nerve and surrounding structures. Histopathological examination confirmed the diagnosis of a dermoid cyst. Postoperatively, the patient experienced significant relief from her trigeminal neuralgia. In conclusion, CPA dermoid cysts, though rare, should be considered in the differential diagnosis of secondary trigeminal neuralgia, even in atypical presentations. MRI is crucial for diagnosis, and surgical excision aiming for maximal safe resection is the mainstay of treatment, offering potential for symptom resolution. Long-term follow-up is necessary due to the potential for recurrence if the residual cyst wall remains. This case underscores the importance of considering rare pathologies in common clinical presentations.
Vitamin D3 Supplementation as a Potential Therapeutic Strategy to Mitigate Inflammation in Chronic Kidney Disease: An NF-κB-Centric Preclinical Study Adly; Darmawan Ismail; Kristanto Yuli Yarsa
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.v5i4.754

Abstract

Chronic kidney disease (CKD) represents a global health burden, characterized by progressive loss of kidney function and a heightened state of chronic inflammation. Nuclear Factor-kappa B (NF-κB), a pivotal transcription factor, plays a central role in orchestrating this inflammatory cascade, contributing significantly to CKD progression and associated cardiovascular complications. Vitamin D deficiency is highly prevalent in CKD patients and is increasingly recognized for its potential role in exacerbating inflammation. This preclinical study aimed to investigate the therapeutic potential of Vitamin D3 supplementation in mitigating inflammation by modulating NF-κB levels in an experimental model of CKD. This study employed a post-test only control group design using 24 male albino Rattus norvegicus. CKD was induced, and animals were divided into three groups (n=8 each): a Control group (normal rats), a CKD group (rats with induced CKD receiving no treatment), and a CKD + Vitamin D3 group (CKD rats receiving Vitamin D3 supplementation for four weeks). Blood NF-κB levels were measured weekly for four weeks. Statistical analysis was performed using SPSS, including ANOVA and post-hoc Bonferroni tests, to determine significant differences between groups. NF-κB levels remained stable in the Control group. The CKD group exhibited a significant and progressive increase in blood NF-κB levels over the four-week period (mean at week 4: 657.50 ± 18.68 units/mL). Conversely, the CKD + Vitamin D3 group demonstrated a highly significant and time-dependent reduction in NF-κB levels, decreasing from a mean of 650.72 ± 24.92 units/mL at week 1 to 127.20 ± 4.46 units/mL by week 4 (p < 0.001 compared to the CKD group). Two-way repeated measures ANOVA revealed a significant interaction between treatment and time (p < 0.001). In conclusion, Vitamin D3 supplementation significantly attenuated the rise in blood NF-κB levels in this preclinical model of CKD in Rattus norvegicus. These findings suggest that Vitamin D3 holds promise as a therapeutic strategy to mitigate inflammation in CKD by targeting the NF-κB pathway. Further research is warranted to elucidate the precise molecular mechanisms and to translate these findings into clinical applications for human CKD patients.
Maternal Hypertension as a Dominant Predictor of Neonatal Respiratory Distress Syndrome: A Cross-Sectional Study in a Regional Indonesian Hospital Putu Ayu Prita Nandari Dewi; Putu Verita Wulandari
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.v5i4.756

Abstract

Neonatal respiratory distress syndrome (RDS) remains a significant cause of morbidity and mortality in newborns, particularly in developing countries. While prematurity is a primary risk factor, other maternal and neonatal factors, including maternal hypertension, contribute to its incidence. This study aimed to identify the risk factors for RDS in neonates treated at a regional hospital in Tabanan, Indonesia, with a particular focus on the role of maternal hypertension. A cross-sectional study was conducted using secondary data from medical records of neonates treated at Tabanan Regional General Hospital (RSUD) from January 2023 to December 2024. The study included neonates diagnosed with RDS and a control group without RDS. Data on maternal factors (hypertension, diabetes mellitus) and neonatal factors (gestational age, birth weight, gender, mode of delivery) were collected. Bivariate analysis using Chi-square and Fisher's exact tests was performed to determine associations, with a p-value <0.05 considered statistically significant. A total of 220 neonates were included in this investigation, with 114 (51.8%) diagnosed with RDS and 106 (48.2%) without RDS. Maternal hypertension was found to be significantly associated with an increased risk of neonatal RDS (p=0.021; OR=1.5, 95% CI 1.1-2.0). No significant associations were found between RDS and gestational age (p=0.056), birth weight (p=0.839), gender (p=0.689), mode of delivery (p=0.072), or maternal diabetes mellitus (p=0.248) in this study. In conclusion, maternal hypertension emerged as a dominant predictor of neonatal RDS in this regional Indonesian hospital setting. This finding underscores the importance of vigilant antenatal care and management of hypertensive disorders during pregnancy to potentially mitigate the risk of RDS in newborns.
Head and Neck Cancer in Bali: A Retrospective Study on Patient Characteristics, Predominant Sites, and Histopathology at a Tertiary Referral Hospital Komang Soniananda Pradnyana Putri; I Gde Ardika Nuaba; I Ketut Suanda
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.v5i4.757

Abstract

Head and neck cancers (HNCs) represent a significant global health burden, with distinct epidemiological patterns observed across different geographical regions. In Indonesia, HNCs are among the leading malignancies, yet detailed regional data, particularly from areas like Bali, remain limited. This study aimed to delineate the characteristics of HNC patients at a tertiary referral hospital in Denpasar, Bali. A retrospective descriptive study was conducted using medical records of patients diagnosed with head and neck malignancies at Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar, between January 1st, 2021, and December 31st, 2023. Data collected included age, gender, occupation, primary tumor site, and histopathological findings. A total sampling method was employed. Descriptive statistics were used for analysis. A total of 290 patient records were analyzed. Males comprised 69% (n=201) of cases, and females 31% (n=89). The predominant age group was 45–65 years (63%, n=183). Farmers were the most common occupational group (27%, n=77). Nasopharyngeal cancer was the most prevalent malignancy, accounting for 80% (n=232) of cases. Nonkeratinizing squamous cell carcinoma was the most frequent histopathological diagnosis (80%, n=231). In conclusion, head and neck malignancies in this Balinese cohort predominantly affected middle-aged to elderly males, with farming being a common occupation. The strikingly high prevalence of nasopharyngeal cancer, primarily nonkeratinizing squamous cell carcinoma, underscores a significant regional health concern that warrants further etiological investigation and targeted public health strategies.
Surgical Approaches for Orbital Floor Fractures: A Meta-Analysis of Clinical Outcomes and Complication Rates Comparing Transconjunctival, Subciliary, and Endoscopic Techniques Disa Saraswati; Agus Rudi Asthuta
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.v5i4.761

Abstract

The optimal surgical pathway for the remediation of orbital floor fractures persists as a topic of considerable deliberation among ophthalmic and maxillofacial surgeons. The primary surgical modalities—transconjunctival, subciliary, and endoscopic techniques—each present a unique profile of advantages and inherent limitations with respect to surgical exposure, aesthetic outcomes, and the incidence of postoperative complications. This meta-analysis was undertaken to conduct a comparative evaluation of the clinical outcomes and complication rates associated with these three principal surgical approaches employed in the repair of orbital floor fractures. A meticulous and systematic search of prominent medical databases, including PubMed, Embase, and the Cochrane Library, was performed to identify relevant comparative studies published between January 2014 and December 2024. These studies were required to evaluate transconjunctival, subciliary, and/or endoscopic techniques for the repair of orbital floor fractures. Data from seven heterogeneous comparative studies were ultimately synthesized for this analysis. The primary outcome measures assessed were the incidence of postoperative persistent diplopia and the occurrence of significant enophthalmos, defined as globe retrodisplacement of 2 mm or greater. Secondary outcomes encompassed a range of complication rates, specifically including infraorbital nerve (ION) hypoesthesia, lower eyelid malpositions such as ectropion and entropion, and postoperative surgical site infections. Pooled odds ratios (ORs) or risk ratios (RRs) with their corresponding 95% confidence intervals (CIs) were calculated, employing a random-effects model to account for inter-study variability. The analysis incorporated seven studies, comprising a total of 850 patients who underwent surgical correction for orbital floor fractures. The distribution of patients across the surgical modalities was as follows: 300 patients were managed via a transconjunctival approach, 350 patients via a subciliary approach, and 200 patients via an endoscopic approach. The findings indicated that the transconjunctival approach was associated with a statistically significant lower rate of postoperative ectropion (OR 0.25, 95% CI 0.10-0.65) when compared to the subciliary approach. No statistically significant differences were observed in the rates of persistent diplopia (Transconjunctival vs. Subciliary: OR 0.90, 95% CI 0.55-1.48; Transconjunctival vs. Endoscopic: OR 1.10, 95% CI 0.60-2.01) or significant enophthalmos among the three surgical groups. Endoscopic approaches demonstrated a trend towards lower rates of new or worsened ION hypoesthesia (OR 0.60, 95% CI 0.30-1.19 vs. combined transcutaneous approaches), although this did not achieve statistical significance. In conclusion, this meta-analysis suggests that the transconjunctival approach may offer a superior lower eyelid cosmetic outcome by substantially reducing the risk of ectropion relative to the subciliary approach. All three evaluated techniques demonstrated comparable efficacy in addressing the primary functional objectives of resolving diplopia and correcting enophthalmos. The selection of an appropriate surgical approach should, therefore, be an individualized decision, meticulously considering surgeon experience and expertise, the specific characteristics and complexity of the fracture, and pertinent patient-related factors and preferences. There remains a compelling need for further high-quality, large-scale randomized controlled trials to definitively establish the potential superiority of one approach over the others across a broader range of outcomes.
Giant Pulmonary Bullae Complicated by Hospital-Acquired Pneumonia in Chronic Obstructive Pulmonary Disease: A Multidisciplinary Approach to Successful Bullectomy Hendra Rohmana; Darmawan Ismail
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.v5i4.763

Abstract

Giant pulmonary bullae (GPB), particularly in patients with chronic obstructive pulmonary disease (COPD), present significant management challenges due to compromised lung function. The development of hospital-acquired pneumonia (HAP) further complicates the clinical picture, increasing morbidity and mortality. This report details a case of GPB with HAP in a COPD patient. A 65-year-old male, a heavy former smoker with moderate COPD and a history of dust and wood smoke exposure, presented with progressive dyspnea and productive cough. Investigations revealed right-sided giant bullae occupying over 30% of the hemithorax, consolidation, and leukocytosis. Sputum culture grew Candida albicans, and intraoperative cultures later confirmed Streptococcus viridans HAP. Following initial medical stabilization with antibiotics, bronchodilators, and corticosteroids, he underwent an exploratory thoracotomy with bullectomy on day 14. In conclusion, the surgical intervention was successful, with no major complications. Post-operatively, the patient showed significant improvement in respiratory symptoms and lung expansion. This case highlights the efficacy of a multidisciplinary approach, combining intensive medical therapy with timely surgical bullectomy, for managing complex presentations of GPB, HAP, and COPD, leading to favorable outcomes.
When the Lung Deceives: Spindle Cell Carcinoma Manifesting as an Aggressive Posterior Mediastinal Mass – A Multimodal Imaging Case Report Anggita Putri Kantilaras
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.v5i4.764

Abstract

Spindle cell carcinoma (SpCC) of the lung is a rare and aggressive subtype of non-small cell lung carcinoma (NSCLC), characterized by a significant component of spindle-shaped tumor cells. Its radiological presentation is highly variable, typically appearing as peripheral or central lung masses. Presentation as a primary mediastinal mass is exceedingly uncommon, posing a considerable diagnostic challenge. A 47-year-old woman presented with a 4-month history of progressive lower limb weakness. Initial chest radiography revealed a left-sided mediastinal-appearing mass. Subsequent contrast-enhanced computed tomography (CT) of the thorax characterized a large, lobulated soft tissue mass in the left posterior mediastinum, measuring 5.25 × 4.74 cm. The mass exhibited homogeneous isodensity with peripheral calcification, caused 0.5 cm compression of the descending aorta, and showed erosion of the 4th thoracic vertebra with contrast enhancement. Fine needle aspiration (FNA) cytology, guided by CT, demonstrated atypical, polymorphic spindle-shaped cells within a fibroangiomatous stroma, consistent with spindle cell carcinoma. In conclusion, this case highlights an unusual presentation of pulmonary SpCC mimicking a posterior mediastinal tumor with aggressive features, including vascular compression and vertebral erosion. Despite its mediastinal appearance, subtle radiological signs such as the acute angle with the lung parenchyma, the epicenter of the mass, and the irregular tumor-lung interface suggested a pulmonary origin. This report underscores the importance of meticulous radiological evaluation and cytopathological correlation in diagnosing rare lung cancer variants that can masquerade as primary mediastinal neoplasms.
Mature Teratoma of the Mediastinum in an Adolescent: Clinical Camouflage as Meningioma with Hemoptysis and Pleural Effusion Adi Astron Prasetio; Darmawan Ismail
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (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.v5i5.765

Abstract

Mediastinal mature teratomas are relatively common germ cell tumors in adolescents, typically located in the anterior mediastinum. While often benign and slow-growing, they can cause symptoms like hemoptysis through compression or local invasion. The differential diagnosis can rarely include ectopic meningioma, posing significant diagnostic challenges. The aim of this report is to describe this unusual presentation of a mediastinal mature teratoma and to emphasize the importance of a comprehensive, multidisciplinary diagnostic workup for achieving an accurate diagnosis and guiding appropriate management in such complex cases of mediastinal pathology. A 17-year-old female presented with a two-month history of blood-streaked hemoptysis and intermittent central chest pain. She had no systemic symptoms such as fever or weight loss. Physical examination was largely unremarkable, though laboratory tests revealed mild anemia (Hb 9.2 g/dL). Imaging studies, including chest X-ray and contrast-enhanced thoracic multi-slice computed tomography (MSCT), identified a large, heterogeneous anterior to middle mediastinal mass. The mass was noted to compress the right main bronchus, causing right lower lobe atelectasis, and was associated with minimal right-sided pleural effusion and mediastinal lymphadenopathy. The MSCT findings were suggestive of a teratoma. A core biopsy of the mediastinal mass indicated a mature teratoma but also raised meningioma as a differential diagnosis. Bronchoscopy revealed mucosal hyperemia and hypervascularity in the tracheobronchial tree. A brain MRI was negative for intracranial metastasis. The patient was managed conservatively pending further comprehensive evaluation and multidisciplinary team discussion. In conclusion, this case underscores an atypical presentation of a mediastinal mature teratoma in an adolescent, characterized by hemoptysis, pleural effusion, and a rare histopathological differential of meningioma. It highlights the critical role of meticulous and comprehensive diagnostic evaluation, including advanced imaging and histopathology, along with a multidisciplinary approach, in accurately diagnosing and planning the management of such complex mediastinal masses, especially when faced with unusual clinical or pathological features.
A Rare Manifestation of Metastatic Breast Cancer: Cervical Esophageal Stenosis with Oropharyngeal Dysphagia Decades After Primary Treatment Made Gede Krisna Rendra Kawisana; I Wayan Sucipta; I Putu Santhi Dewantara
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (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.v5i5.767

Abstract

Esophageal metastasis from breast cancer is an infrequent occurrence, with cervical esophageal involvement being exceptionally rare. Presentation with oropharyngeal dysphagia, particularly decades after primary breast cancer treatment, poses a significant diagnostic challenge. This report details such a case, emphasizing the clinical course and diagnostic complexities. A 60-year-old female, with a history of primary breast cancer treated approximately two decades prior and subsequent treatment for a locoregional recurrence with surgery, chemotherapy, and radiotherapy in 2019, presented with progressive oropharyngeal dysphagia and aspiration over three months. Initial Fiberoptic Endoscopic Evaluation of Swallowing (FEES) suggested upper esophageal pathology with stenosis and extraluminal mass compression at the introitus esophagus. Esophagoscopy confirmed a high cervical esophageal stenosis impassable with the scope. Computed Tomography (CT) of the neck revealed a large heterogeneous solid mass at the C6-Th2 level, encasing the trachea and causing severe cervical esophageal stenosis with suspected wall infiltration, along with widespread metastatic disease including pulmonary and osseous metastases. In conclusion, this case highlights the critical importance of maintaining a high index of suspicion for metastatic breast cancer in patients presenting with new-onset oropharyngeal or esophageal dysphagia, even many years after their initial cancer diagnosis and treatment. Cervical esophageal metastasis, though rare, should be considered in the differential diagnosis. A multidisciplinary approach and comprehensive diagnostic evaluation, including advanced imaging, are paramount for accurate diagnosis and guiding appropriate palliative management.
Beyond Microcephaly: Semilobar Holoprosencephaly with Marked Macrocephaly due to Severe Congenital Hydrocephalus, Brachycephaly, and Hyponatremia – A Case Report Cynthia Cynthia; Edbert Wielim; Regina Suriadi; Putu Siska Suryaningsih
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (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.v5i5.768

Abstract

Holoprosencephaly (HPE) is a rare, complex brain malformation arising from incomplete prosencephalon cleavage, typically associated with microcephaly and facial dysmorphism. Coexisting severe hydrocephalus leading to macrocephaly in HPE, particularly the semilobar type, presents a distinct clinical picture. Hyponatremia often complicates neurological conditions involving increased intracranial pressure, potentially worsening prognosis. The aim of this case report is to meticulously describe the clinical presentation, diagnostic evaluation, management approach, and early outcomes of this rare and complex neonatal neurological disorder. A male neonate, born at 35+3 weeks gestation to a mother with severe preeclampsia, presented with marked macrocephaly (head circumference 50 cm), a prominent fontanel, and bilateral sunset eyes. Initial CT scan confirmed hydrocephalus. Subsequent evaluation and a repeat CT scan at one month revealed brachycephaly (cephalic index 98) and semilobar holoprosencephaly. Head circumference progressed to 64 cm by the time of ventriculoperitoneal (VP) shunt surgery at approximately 5 weeks of age. Laboratory investigations showed hyponatremia (120 mEq/L), hyperkalemia, and hypochloremia. At three months, the patient exhibited significant growth and developmental delays and malnutrition. In conclusion, this case highlights an unusual presentation of semilobar HPE characterized by severe congenital hydrocephalus causing marked macrocephaly, rather than microcephaly, complicated by brachycephaly and significant hyponatremia. Early, comprehensive diagnostic evaluation and multidisciplinary management are crucial in such complex neurodevelopmental disorders to address multifaceted challenges and attempt to optimize outcomes.

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