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INDONESIA
MEDICINUS
Published by PT Dexa Medica
ISSN : 1979391X     EISSN : 29638399     DOI : 10.56951
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Tujuan penerbitan jurnal Medicinus adalah untuk meningkatkan wawasan dan menambah khasanah pengetahuan para praktisi medis dan farmasis di bidang kedokteran dan kefarmasian. Ruang lingkup dari jurnal ilmiah ini adalah publikasi artikel-artikel ilmiah yang bisa disajikan dalam bentuk penelitian (research), laporan kasus (case report), teknologi dan klinis kefarmasian, serta ulasan literatur medis.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 6 Documents
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Search results for , issue "Vol. 38 No. 11 (2025): MEDICINUS" : 6 Documents clear
Steroid Therapy on Cholestasis: A Case Report Rendi Aji Prihaningtyas; Bagus Setyoboedi; Sjamsul Arief; Prihaningtyas, Rendi Aji
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/mp7wkf03

Abstract

Introduction: Cholestasis is a pathological condition associated with immune-mediated processes that interfere with bile flow, thus requiring early diagnosis and prompt treatment to ensure optimal outcomes. The use of steroid therapy in the treatment of cholestasis has not been previously reported. Case: A 2-month and 9-day-old male infant presented with jaundice beginning at one week of age, followed by pale stools and tea-colored urine. Physical examination revealed jaundice, hepatomegaly, and splenomegaly. Laboratory investigations showed elevated liver enzymes: aspartate aminotransferase (AST) 292 U/l, alanine transaminase (ALT) 187 U/l, gamma-glutamyl transferase (GGT) 312.7 U/l, and alkaline phosphatase (ALP) 882 U/l), along with elevated bilirubin level (total bilirubin 7.9 mg/dl and direct bilirubin 6 mg/dl). Cytomegalovirus (CMV) IgG was reactive. A two-phase abdominal ultrasound examination revealed a preprandial gallbladder size of 0.65 x 0.33 x 1.91 cm, a postprandial size of 0.37 x 0.29 x 0.73 cm. Liver biopsy revealed chronic hepatitis and mild fibrosis (F1). The patient was treated with methylprednisolone, which was gradually tapered off. Following steroid therapy, liver enzyme and bilirubin levels normalized, gallbladder size increased, and stool color darkened. Posttreatment gallbladder size showed an increase (preprandial 3.05 x 0.96 x 0.72 cm, postprandial 2.45 x 0.72 x 0.82 cm). Conclusions: Steroids may improve bile flow and prevent further liver damage. Targeting immune mechanisms could represent a promising approach for future cholestasis treatments.
Diagnostic Dilemma in Massive Cellular Leiomyoma with Cystic Degeneration Arya Ady Nugroho; Riyan Hari Kurniawan; Aprilia Asthasari Siregar
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qkhd0b31

Abstract

Background: Uterine leiomyomas, commonly known as fibroids, are prevalent benign tumors in women of reproductive age. While often asymptomatic, they can become symptomatic when they enlarge or when degenerative changes occur. Cystic degeneration, which occurs in approximately 4% of leiomyomas, presents a diagnostic challenge, as it can mimic malignancy on imaging due to its solid-cystic appearance on imaging. This case report aims to highlight the diagnostic dilemma posed by large leiomyomas with cystic degeneration and to emphasize the importance of advanced imaging as well as histopathological examination in confirming benign diagnoses and excluding malignancy. Case Presentation: A 27-year-old woman presented with progressive abdominal distension and intermittent lower abdominal pain over thepast year. Imaging revealed a large, solid-cystic mass in the uterine fundus, raising suspicion of malignancy. Further diagnostic workup, including magnetic resonance imaging (MRI) and histopathological examination, confirmed the massas a benign leiomyoma with cystic degeneration. The patient underwent a laparotomy myomectomy, and intraoperative findings confirmed a well-circumscribed subserosal mass with cystic degeneration. Histopathology examination alsoconfirmed a benign leiomyoma, ruling out malignancy. Conclusion: This case underscores the diagnostic challenges of differentiating large leiomyomas with cystic degeneration from malignancies. Advanced imaging, particularly MRI, along with histopathological examination, plays a crucial role in establishing an accurate diagnosis and subsequently, guiding appropriate management.
Cedera Ginjal Akut akibat Glomerulonefritis Akut Pasca-Steptococcus pada Kehamilan  I Dewa Gede Agung Suta Ariwangsa; Nyoman Paramita Ayu
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/kt004z43

Abstract

Acute post-Streptococcal glomerulonephritis (APSGN) is an inflammation of the glomeruli due to immunologic mechanism caused by group A β-hemolytic Streptococcus infection. The clinical triad of APSGN includes are gross or microscopic hematuria, edema (mostly periorbital), and arterial hypertension. This condition is generally self-limiting and is recommended to be managed symptomatically. APSGN rarely occurs in pregnancy, with estimated incidence of 1:40,000.This report discusses a rare case of stage III acute kidney injury due to APSGN in a 36-year-old pregnant woman at 9 weeks of gestation. The patient presented with fever, oliguria, hypertension, and a history of sore throat. Kidney function tests revealed elevated serum creatinine (12.49 mg/dl) and low glomerular filtration rate (GFR) (3.62 ml/minute/1.73 m2). Urinalysis showed proteinuria, microscopic hematuria, leukocytes, and granular cast. No microorganisms were found in the throat swab culture, however the anti-Streptolysin O (ASO) titer was found elevated. A chest X-ray revealed findings consistent with pneumonia. The patient received supportive treatment, including fluid resuscitation, intravenous antibiotic for pneumonia, and underwent several sessions of hemodialysis. On the seventh day of treatment, her kidney functionimproved, and she was discharged five days later. Several previous case reports on APSGN in pregnancy have also indicated a favorable prognosis for both the mother and fetus.
Karakteristik Kelainan Hematologi Pasien Systemic Lupus Erythematosus di RSUP Prof. Dr. I.G.N.G. Ngoerah di Poli Rawat Jalan Rematologi Satwika Hadipratama; Gede Kambayana
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/zh899c89

Abstract

Systemic lupus erithematosus (SLE) is one of the leading causes of death among young women. Hematological abnormalities are common manifestations of SLE, and can affect various types of blood cell, with severity ranging from mild to life-threatening. The main hematological manifestations of SLE include anemia, leucopenia, thrombocytopenia, lymphadenopathy, and/or splenomegaly. This study aims to explore the characteristics of hematological disorders in SLEpatients. Methods: This was a retrospective descriptive study using a cross-sectional data collection method. The subjects were patients diagnosed with SLE who received treatment at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, during the period of July–August 2023. Results: A total of 72 subjects participated in this study, with a mean age of 35.9 years (range: 18–72 years). The majority were female (90.3%) and were within the 18–50 year age group (87.5%). Laboratory tests showed the following mean values: hemoglobin 11.8 g/dl, platelets 299.5×10³/μl, white blood cells (WBC) 13.5×10³/μl, lymphocytes 1.7×10³/μl, and erythrocyte sedimentation rate (ESR) 32.6 mm/hour. The mean neutrophil-to-lymphocyte ratio (NLR) was 3.92. The mean values of renal function and metabolic parameters were as follows: blood urea nitrogen (BUN) 13.3 mg/dl,serum creatinine (SC) 1.19 mg/dl, estimated glomerular filtration rate (eGFR) 100 ml/minute/1.73 m², protein-to-creatinineratio (PCR) 1.03, and calcium level 9.2 mg/dl. Bone mineral density measurements revealed that 6.9% of subjects had osteopenia and 9.7% had osteoporosis. Conclusion: This study provides a better understanding of the clinical, laboratory,and comorbidity profile of patients with SLE. These findings offer valuable insights for appropriate clinical management and intervention strategies.
Peran Bromhexine dalam Tata Laksana Gangguan Pernapasan: Mekanisme dan Efektivitas Klinis Fariz Nurwidya
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/zb6m9p23

Abstract

Bromhexine hydrochloride is a mucoactive agent that has been used for more than five decades. Although primarily known as a mucolytic agent, recent evidence indicates a more complex mechanism of action as well as broader potentialtherapeutic applications. This literature review aims to synthesize the latest scientific evidence regarding the mechanism of action, clinical efficacy, and safety of bromhexine in the management of various respiratory tract diseases. A literaturesearch was conducted using the PubMed and Scopus databases with the keywords “bromhexine”, “bromhexin”, “mucolytic”, “COPD”, “bronchitis”, “respiratory tract infection”, and “COVID-19”. Selected articles included clinical trials,in vitro/in vivo studies, reviews, and metaanalysis published up to 2025. The review found that bromhexine acts through several mechanisms, including mucin depolymerisation via disulfide bonds cleavage, stimulation of alveolar type II cellssurfactant production, enhancement of ciliary system activity, as well as anti-inflammatory and antioxidant activities. Bromhexine has demonstrated effectiveness as an adjuvant therapy in acute and chronic bronchitis, chronic obstructivepulmonary disease (COPD), asthma, and bronchiectasis, by reducing sputum viscosity and improving productive cough symptoms. In conclusion, bromhexine shows good efficacy and safety for the management of mucus production and transport disorders in various pulmonary diseases, owing to its mucolytic and surfactant-stimulating properties. These mechanisms remain relevant in the modern era of respiratory disease management.
Mengembalikan Makna Bernapas Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/rvt1y058

Abstract

The management of lower respiratory tract diseases, such as bronchitis, chronic obstructive pulmonary disease (COPD), and bronchiectasis, poses a significant challenge, particularly in countries with high levels of air pollution, smoking habits, and high prevalence of infections. Cough, as one of the primary symptoms, serves as a protective mechanism of the body to maintain airway hygiene as well as unobstructed breathing. Therefore, cough should be managed appropriately to ensure efficient mucus expectoration, one way being through the use of mucolytic agents such as bromhexine. Themodern approaches to respiratory infection management emphasize the combination of pharmacological interventions and physiological support. Pharmacological therapy focuses on restoring respiratory function using rational treatment, including control of inflammation, managing mucus drainage, and the rational use of antibiotics. Physiological interventions such as pulmonary rehabilitation and smoking cessation have a substantial long-term impact on improving patients’ quality of life.

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