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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. 33 No. 2 (2020): MEDICINUS" : 6 Documents clear
Neuroproteksi Otak Janin pada Persalinan Preterm dan Pertumbuhan Janin Terhambat Bachnas, Adrianes
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.174 KB) | DOI: 10.56951/medicinus.v33i2.45

Abstract

Exalted obstetrics not merely fulfill the obligation to deliver babies safely but beyond, to deliver babies on their most optimal condition to grow up and to be a noble person. Neuroprotection should be implemented in daily practice. Brain, as the central part of the human body, plays an extremely important role for all of the human cells, tissue, organs, and systems activities. Any kind of physiological process in human body is related to brain control. There would be no human in optimal condition without optimal brain function. Preterm delivery and fetal growth restriction are two of the many pathologic conditions in pregnancy that could potentially injure fetal brain. Injured brain would result in major lifelong neurological deficits. There isn’t any cure for these, so prediction and prevention are barely necessary. Neuroprotection is a concept which all efforts are given to minimize the insult to the fetal brain due to such pathologic problems as mentioned before. Preterm birth, either spontaneously or iatrogenic, puts the risk for fetus to get brain damage. Hypoxic situations in the early minutes after birth lead to inflammation and apoptosis process, causing neuronal injury, neuronal death, and demyelination. Antenatal magnesium sulfate administration has found to give significant aid to hinder this condition and in the end showing a substantial reduction in the number of cerebral palsy cases. Fetal growth restriction remains an unsolved dilemma in maternal-fetal medicine. It is mostly related with placental insufficiency that causes chronic hypoxia and nutrition deprivation. Low dose aspirin in the first trimester soon as the poor placentation is known to be happen remains the solid evidence exists. Nutritional intervention such as a balanced intake of protein and calory, also micronutrients supplementation are somehow still worthy enough to accompany the timely decision of terminating pregnancy.
Lymphedema Diagnosis dan Terapi Primasari, Medisa
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (154.944 KB) | DOI: 10.56951/medicinus.v33i2.46

Abstract

Lymphedema merupakan kondisi akibat gangguan transportasi aliran limfa yang menyebabkan terjadinya akumulasi cairan limfatik di ruang interstitial. Gangguan transportasi aliran limfa dapat disebabkan oleh kelainan kongenital ataupun yang didapat, seperti akibat trauma, infeksi, keganasan, dan pascatrombosis vena. Tindakan yang dapat dilakukan untuk mencegah komplikasi dan progresi penyakit berupa terapi non-operatif dan terapi operatif. Terapi konservatif yang dilakukan berupa edukasi perawatan kulit, manual lymphatic drainage (MLD), kompresi dengan short-stretch bandage, serta latihan ringan. Adapun terapi pembedahan dilakukan pada kondisi berat dan mengalami gangguan fungsional yang tidak membaik dengan terapi non-operatif. Pada lymphedema derajat awal, terapi yang dapat dilakukan adalah metode fisiologis seperti lympholymphatic bypass, lymphovenous bypass serta transfer kelenjar limfa; sedangkan pada lymphedema berat dengan jumlah jaringan fibroadiposa yang tinggi, digunakan metode reduksi yang terdiri dari eksisi langsung atau liposuction.
Congenital Analbuminemia Santosa, Putu Adi; Widijanti, Anik; Susianti, Hani; Intanwati, Sherly; Meilani, Rossy
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.628 KB) | DOI: 10.56951/medicinus.v33i2.50

Abstract

Congenital analbuminemia (CAA) is a rare autosomal recessive disorder, characterized by the absence or very low level of serum albumin (human serum albumin/HSA) as a result of defect on chromosome 4 which encodes albumin. It is defined as albumin level <1 g/l with normal liver function and the absence of protein loss.1,2 Estimated CAA prevalence is less than 1 in 1 million.A 10-year-old boy suffered from generalized edema that got worsened since last month. The patient had been misdiagnosed with nephrotic syndrome 2 years earlier, and then became protein-losing enteropathy. Neither cough nor diarrhea were reported. The patient had history of food allergy. Physical examination showed moderately ill condition, Glasgow Coma Scale (GCS) score E4 V5 M6, blood pressure 90/50 mmHg, pulse 120 x/min, respiratory rate 30x/min, palpebral edema, shifting dullness, undulation (+), with nonpitting edema on the extremities. Laboratory findings: leukocytosis (neutrophilia), peripheral blood smear showed hypochromic microcytic anisositosis erythrocyte. AAT serum 246 mg/dl, GGT serum: 88 U/l, iron serum 28 µg/dl, TIBC 411 µg/dl, transferrin saturation 7%, total IgE 775,90 U/ml. Serum Protein Electrophoresis (SPE) results were hypoalbuminemia (1,4 g/dl), hypogammaglobulinemia (0,21 g/dl), and total protein 2,91 g/dl. Chest X-ray showed pneumonia with minimal right pleural effusion. Overestimation of serum albumin level was caused by alpha and beta globulin that were detected as albumin in bromocresol green (BCG) methods. CAA aggravated with by allergy caused malnutrition in this patient. These data support the diagnosis of CAA with sepsis and iron deficiency anemia. Suggestion for the management consist of blood culture, procalcitonin level measurement, inguinal lymph node biopsy, DNA sequence analysis, also analysis of pleural and ascites fluid.
Patofisiologi dan Manajemen Terapi Sindrom Stevens-Johnson(SSJ) dan Nekrolisis Epidermal Toksik (NET) Diana, Rina; Eko Irawanto, Muhammad
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (467.986 KB) | DOI: 10.56951/medicinus.v33i2.53

Abstract

Nekrolisis epidermis (NE) adalah sindrom reaksi mukokutan akut yang ditandai dengan nekrosis dan pengelupasan epidermis yang luas serta dapat menyebabkan kematian. Lesi awal berupa makula eritematosa, kemudian berkembang secara progresif menjadi lesi lepuh kendur dan selanjutnya terjadi pengelupasan epidermis. Berdasarkan luas permukaan tubuh yang terlibat, NE diklasifikasikan menjadi tiga kategori, yaitu sindrom Stevens-Johnson (SSJ) jika luas lesi <10%, overlap SSJ-nekrolisis epidermal toksik (SSJ-NET) jika luas lesi 10–30%, dan nekrolisis epidermal toksik (NET) jika luas lesi >30%. Patofisiologi NE belum diketahui dengan jelas hingga saat ini. Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksik (NET) merupakan kondisi yang dapat menyebabkan kematian, oleh karena itu memerlukan penanganan yang cepat dan tepat. Mengidentifikasi kemungkinan penyebab dan memberikan perawatan yang diperlukan di rumah sakit diharapkan mampu meminimalisasi kejadian fatal akibat kondisi ini. Penanganan utama pada SSJ-NET adalah dengan menghentikan penggunaan substansi yang dicurigai sebagai penyebab. Terapi lain yang dapat diberikan masih cukup kontroversial, seperti pemberian corticosteroid, IVIG, plasmapheeresis, dan ciclosporin.
Clinical and Epidemiological Characteristics of Severe and Very Severe Pneumonia in Infants Mustiko MD, Hedi; Setyoningrum MD, Retno Asih
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.149 KB) | DOI: 10.56951/medicinus.v33i2.55

Abstract

Background: Childhood pneumonia is a leading cause of mortality and morbidity in developing countries. World Health Organization (WHO) stated that pneumonia is the cause of mortality of around 1.2 million children under 5 years per year. The high incidence of very severe pneumonia cases with preventable risk factors become the background of this study.Purpose: The aim of our study was to describe clinical and epidemiological characteristics of severe and very severe pneumonia in infants and children.Methods: This is a descriptive cross-sectional study. The study were conducted from January 2017 to December 2018. We obtained clinical and demographic data of each patient based on medical records.The diagnosis of pneumonia was made clinically based on the Indonesian Ministry of Health criteria. Prematurity was defined as babies born with gestational age less than 37 weeks, low birth weight was defined as babies with birth weight less than 2500 grams. The nutritional status of children is clinically and anthropometrically evaluated using 2006 WHO curve of weight-by-age. Results: A total of 465 patients were diagnosed with pneumonia during 48 months study. 212 patients were excluded and 253 pneumonia patients met the inclusion criteria, 140 patients with very severe pneumonia and 113 patients with severe pneumonia. Among 253 patients, 141 were boys. 125 patients were 2-5 months of age. 71 patients were born with low birth weight and 62 patients had history of preterm birth. There were 86 patients receiving exclusive breastfeeding and 138 patients with complete immunization status. There were 131 patients with moderate and severe malnutrition, and 127 patients with comorbidity factors. 94 patients developed pneumonia with suspected bacterial causative agents.Conclusion: Lower age, prematurity, low birth weight, poor nutritional status, exclusive breastfeeding, comorbidities, and suspected bacterial causative agents are common characteristics of severe and very severe pneumonia in infants and children in Dr. Soetomo Surabaya.
Serum Level of 25-Hydroxyvitamin D in Children with Epilepsy Receiving Long-Term Antiepileptic Treatment Ismail, Chasan; Irawan, Roedi; Saharso, Darto
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (88.621 KB) | DOI: 10.56951/medicinus.v33i2.59

Abstract

Background: Long-term treatment with antiepileptic drugs (AED) requires monitoring of potential side effects, one of them is the decreasing in serum vitamin D level. Low serum vitamin D level is also a global health problem in healthy children. There are conflicting results regarding the low serum vitamin D level in epileptic children due to treatment with AED. Purpose: This study aimed to compare serum vitamin D level between healthy children and children with epilepsy receiving long-term AED treatment in Soetomo General Hospital. Methods: This was a cross-sectional study conducted in the pediatric neurology clinic of Soetomo general academic hospital from August 2018 to July 2019. Subjects are children ages 2-18 years with epilepsy receiving AED treatment for over 6 months (n=22), with healthy children as control (n=22). Peripheral serum 25-hydroxyvitamin D level were measured using enzyme-linked fluorescence assay (ELFA) method. The differences of those groups were analyzed by comparing the mean of 25-hydroxyvitamin D level of both groups using Anova and T-test (95% CI). Results: Low serum vitamin D level were identified in 27% children with epilepsy and 13% healthy children. The mean of serum 25-hydroxyvitamin D level in children with epilepsy and healthy children was 21.5 ng/ml (SD 8.41) and 34.3 ng/ml (SD 10.09), respectively. There was a significant difference between groups (p<0.05). Conclusion: Children with epilepsy receiving long-term AED treatment have lower level of serum 25-hydroxyvitamin D than healthy children.

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