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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 179 Documents
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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.
Correlation Between CD4 Level and The Severity of Pneumocystis Pneumonia in Patients with Human Immunodeficiency Virus at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali Aries Hasan Basri; I Made Susila Utama
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/3b8w1665

Abstract

Pneumocystis jirovecii is an opportunistic fungal pathogen that causes life-threatening cases of pneumocystis pneumonia (PCP) in immunodeficient patients. In patients with human immunodeficiency virus (HIV), the risk of developing PCP increases when the CD4 count <200 cells/μl. This study aimed to determine the correlation between the CD4 level and the degree of severity of pneumocystis pneumonia in HIV patients at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali. A retrospective analysis was conducted on HIV patients diagnosed with PCP between 2020 to 2022 period. The researchsubjects were all PCP-PCR positive patients who were hospitalized at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. The results of the study showed a total of 120 subjects, including 28 (23.3%) male subjects with severe PCP and 11 (9.2%)female subjects with severe PCP. The highest number of cases was found in the age range ages 20‒40 years, with 20 (16.6%) subjects having severe PCP. Regarding treatment status, 23 (19.2%) subjects with severe PCP were pre-HAART(highly active antiretroviral therapy) while 16 (13.3%) subjects were on HAART. The highest proportion of severe PCP cases was found in subjects with a CD4 count of less than 50 cells/μl, totaling 32 subjects (26.6%). The Kruskal-Wallistest was applied to assess the association between the CD4 count categories and PCP severity in HIV patients. The study concluded that there is a significant correlation between CD4 levels and the severity of pneumocystis pneumonia in HIVpatientsat RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar.
The Gut-Brain Axis in Type 2 Diabetes: A Review of Microbial Mechanisms and Clinical Implications Goenadi , Emmanuel Adrian; Pramudito, Ignatius Aditya Haryo; Saputra, Petra Heinson Handoyo; Bararinda, Pradipta Putramachristy; Priskila, Loury
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/g87wm568

Abstract

The understanding of Type 2 Diabetes Mellitus (T2DM) is evolving beyond traditional risk factors to recognize the Gut Microbiota (GM) as a pivotal player in its pathogenesis. This narrative review illuminates the critical role of the Gut-Brain Axis (GBA), detailing how microbial dysbiosis—characterized by a loss of butyrate-producing bacteria—drives the systemic inflammation and insulin resistance central to T2DM. This paper provides an overview of microbiota-based interventions (probiotics, prebiotics, FMT) and explore the synergistic impact of physical activity, which not only enhances insulin sensitivity but also beneficially modulates the GM. The evidence indicates that an integrated approach, combining targeted microbial modulation with regular physical activity, represents a powerful therapeutic strategy for improving glucose homeostasis in T2DM.
NAUSICAA Compression Suture of The Lower Uterine Segment in Morbidly Adherent Placenta Previa Case Arya Ady Nugroho; Sri Pudyastuti; Tri Apriliawan Bendarto Rahardjo
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/gna3c076

Abstract

Background: Placenta accreta spectrum or morbidly adherent placenta occurs mostly on a previous cesarean scar when placenta fails to detach due to abnormal invasion of placenta in to the uterine wall. The incidence of morbidly adherent placenta increased in the past decade from 0.8 per 1000 deliveries to 3 per 1000 deliveries.1 The increase in the incidence is attributed to increase in cesarean deliveries from 1 in about 2500 births to 1 in 500 births.2  A recent retrospective study reported that the rate of accreta for previous 1, 2, 3, 4, and 5 cesarean deliveries was found to be 26.7%, 43.5%, 65.5%, 55.6%, and 66.7%, respectively.3 Case presentation: In this study, We present a case of thirty-one year-old gravida III para II, 36 weeks of gestasional age, presented to the outpatient clinic and diagnosed with adhesive total placenta previa on US exam. Patient underwent c-section continued with nausicaa uterine compreesion suture, intraoperative bleeding was 1100 cc, there was no complication. Conclusion: Fertility-sparing surgery for women with morbidly adherent placenta could be one of the options to be considered. Nausicaa suture is a simple and feasible alternative to hysterectomy in patients suffering from major PPH.
Karakteristik Pasien dan Tata Laksana Infeksi Malaria di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar Tahun 2019-2023 I Dewa Gede Agung Suta Ariwangsa; Harris Hardian; I Made Susila Utama
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/1xmve570

Abstract

Introduction: Malaria remains a major public health concern, affecting resident and travellers to endemic areas. Severemalaria is a complication of infection that can lead to poor outcomes when late to be diagnosed. The use of artemisininRESEARCH22 VOL. 38 ISSUE 12, DECEMBER 2025derivatives or artemisinin-based combination therapy (ACT) has been reported to improve outcomes and survival in malaria patients. Methods: This was a descriptive study. Data were collected retrospectively from medical records ofpatients treated at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar from 2019 to 2023. Descriptive analyses were conducted to summarize patient's characteristics, infection etiology, malaria severity, and treatment outcomes. Results: A total of37 malaria cases were treated at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar between 2019 and 2023. The mean age of patients was 29.85 years, and the majority were male (78.37%). Plasmodium vivax was identified as the most commonetiologic agent, in 19 cases (51.35%), followed by Plasmodium falciparum in 17 cases (45.94%), and Plasmodium malariae in 1 case (2.7%). Severe malaria was diagnosed in 9 cases (24.32%), predominantly caused by P. falciparum (7 cases,94.5%). Jaundice and renal dysfunction were the most frequent clinical findings in severe malaria, seen in 7 (77.77%) and 4 (44.44%) cases, respectively. The most common treatment regimens were 3-day dihydroartemisinin-piperaquine (DHP) plus 14-day primaquine in 10 patients (48.64%), and 3-day DHP plus 1-day primaquine in another 10 patients (27.02%).Intravenous artesunate followed by 3-day DHP and 3-day primaquine was administered to 7 patients (18.91%); artesunate followed by DHP and 1-day primaquine to 1 patient (2.7%), and artesunate followed by DHP alone to 1 patient (2.7%). Nodeaths were reported during treatment. Discussion: Severe malaria was identified in 9 out of 37 cases (24.3%), with P. vivax being the most common malaria species overall. Although severe malaria is typically associated with P. falciparumand P. vivax, this study also reported one severe case caused by P. malariae. Jaundice was the most common clinical presentation, often accompanied by renal impairment. All patients received artemisinin-based combination therapy andachieved complete recovery at the end of treatment. Conclusion: Severe malaria occurred in one-quarter of malariacases, with P. falciparum being the most frequent cause. Jaundice and renal dysfunction were the most common clinical manifestations. All patients recovered and were discharged from the hospital.
Tata Laksana Cairan Isotonis pada Pasien Hiponatremia Simptomatik Luh Putu Dea Sasmita Pralambari; Nyoman Paramita Ayu
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/3g1j1t90

Abstract

A case has been reported of a 66-year-old male patient presenting with decreased level of consciousness, suspected to be suffered from metabolic disorder — hyponatremia. In most cases of symptomatic hyponatremia, administrationof hypertonic fluids is often recommended. However, hypertonic fluid such as 3% NaCl carries a serious risk, the most severe of which is osmotic demyelination syndrome. Therefore, in cases of hypovolemic hyponatremia, some guidelinesrecommend correction with the administration of 0.9% NaCl isotonic saline solution. Precise administration of isotonic saline has been shown to adequately restore the sodium deficit caused by hypovolemia. In this case, following sodiumcorrection, the patient’s level of consciousness improved clinically, and serum sodium increased from 100 mmol/l to 106 mmol/l, and subsequently to 109 mmol/l within 24 hours. This 9 mmol/l increase was within the recommended target of an8–12 mmol/l over 24 hours. Based on these findings, sodium correction using isotonic fluids can be considered as a viable therapeutic option.
Skrining Fungsi Tiroid pada Pasien In Vitro Fertilization (IVF): Sebuah Pendekatan Klinis M. Adi Firmansyah
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/ef1gyv39

Abstract

The success of in vitro fertilization (IVF) programs is significantly influenced by hormonal balance, in which thyroid function plays a crucial role. Thyroid disorders, both hypothyroidism and hyperthyroidism, have been shown to decrease thechances of pregnancy and increase the risk of miscarriage, making screening as an essential step before commencing an IVF cycle. The primary assessment involves measuring thyroid-stimulating hormone (TSH) levels, with an ideal targetbelow 2.5 mU/l to create an environment conducive for embryo implantation. The clinical approach depends to the TSH results and thyroid peroxidase antibodies (TPO-Ab) test. The presence of positive TPO-Ab status increases the risk of implantation failure, often necessitating low-dose levothyroxine therapy. If TSH levels are above 4.5 mU/l (hypothyroidism) or low (hyperthyroidism), the IVF cycle should be postponed until thyroid function is controlled to avoid complications. Therefore, the optimization of thyroid function through TSH screening, TPO-Ab testing, and appropriate intervention is a key pillar of IVF preparation, requiring collaboration between fertility specialists and internists or endocrinologists to maximize the chances of pregnancy.
Mikrobiota–Usus–Otak sebagai Jaringan Metabolik dan Pengatur Kontrol Energi Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 12 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/fy2cd832

Abstract

This article examines the gut–brain axis in the pathophysiology of type 2 diabetes as a complex communication network that shapes glucose metabolism, systemic inflammation, gut hormone function, and eating behavior. By integratingevidence from metagenomic, neuroendocrine signaling, and modern pharmacotherapy studies, the article argues that type 2 diabetes is not merely a glycemic disorder, but also an internal ecological disruption involving microbiota interactions, theenteric nervous system, the vagus nerve, and metabolic regulatory centers in the brain. This perspective also highlights the clinical implications of emerging therapeutic agents such as GLP-1 agonists and dual GIP/GLP-1 agonists. This articleconceptualizes type 2 diabetes as an interorgan communication disorder that can be ameliorated through multilevel interventions including microbiota modulation, restoration of incretin, and precision nutrition strategies.

Page 18 of 18 | Total Record : 179

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