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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 208 Documents
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Obesity as a Risk Factor of Cancer Theodore Dharma Tedjamartono; Ketut Suastika
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/xjymmp28

Abstract

The prevalence of overweight and obesity continues to increase globally. These conditions are considered a serious public health concern due to its correlation with other diseases, such as type 2 diabetes mellitus, cardiovascular disease, andcancer. Obesity is defined as the accumulation of abnormal or excessive body fat that can impair health. Although obesity is not considered a major risk factor for cancer, it is associated with several types of cancer. One of the key mechanismsunderlying the relationship between obesity and cancer is chronic inflammation. In individuals with obesity, hypoxia can occur in adipose tissue, triggering alterations in leptin levels, dysregulation of adiponectin, macrophage infiltration, mitochondrial dysfunction, and an increased endoplasmic reticulum (ER) stress response. These changes collectively contribute to a state of chronic inflammation. Chronic inflammation is a mediator of cancer cell development, primarily by inducing changes in the tumor microenvironment and promoting the formation of cancer phenotypes (tumorigenesis). Other factors that explain the relationship between obesity and cancer in general will be explained in this literature review.
Triple-Threat Pregnancy: Navigating PPCM, Preeclampsia, and Thalassemia Major – A Holistic Reproductive Risk Assessment Post-Cesarean Delivery Arya Ady Nugroho; Yudianto Budi Saroyo; Dwiana Ocviyanti
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qdxs3625

Abstract

Background: Pregnancies complicated by multiple severe maternal conditions such as peripartum cardiomyopathy (PPCM), preeclampsia, and β-thalassemia major, pose significant risks to both mother and fetus. This case explores the challenges of managing a high-risk pregnancy, involving these conditions and highlights the importance of a multidisciplinary approach in high-risk pregnancy management.Case presentation: A 33-year-old pregnant woman with β-thalassemia major presented at 32+4 weeks of gestation with acute dyspnea, severe preeclampsia, and signs of PPCM. She was carrying dichorionic diamniotic twins and required emergency cesarean section after stabilization. Echocardiography revealed severe left ventricular systolic dysfunction with an ejection fraction of 35%. The patient underwent immediate postoperative management and received a trans-cesarean intrauterine device (IUD) insertion for long-term contraception. Both neonates were admitted to the neonatal intensive care unit (NICU) for prematurity care.Conclusion: This case underscores the critical need for a holistic, multidisciplinary approach in managing complex highrisk pregnancies, focusing on immediate maternal stabilization, neonatal care, and long-term reproductive planning.
Nanobubbles for Precision Oncology Zumratul Rabbani, Khadijah; Dwi Laksono, Pudjo Dwi Laksono; Anurogo, Dito
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/gsz6t860

Abstract

Nanobubbles (NBs) represent a unique class of sub-200 nm carriers that integrate deep tissue penetration with ultrasound (US)-responsive functionality, offering opportunities for simultaneous imaging, oxygenation, and therapeutic delivery in solid tumors. This review synthesizes the physicochemical principles governing NB stability with translational designconsiderations, including interfacial charge, free-lipid content, bubble spacing, and zeta (ζ)-potential as determinants of uptake and cytotoxicity. Particular emphasis is placed on gas-based payloads: oxygen nanobubbles for alleviating tumor hypoxia and carbon monoxide-releasing molecules (CO-RMs), nitric oxide (NO), and hydrogen sulfide (H₂S) for redoximmunometabolicmodulation within hormetic dose windows. Preclinical data demonstrate that oxygen nanobubbles enhance radiotherapy and chemotherapy responses by reversing hypoxia-induced resistance, while CO, NO, and H₂Sdonors—delivered in biphasic, dose-sensitive ranges—enable immunomodulation and reprogramming of the tumor microenvironment. We further distill case-level evidence (e.g., IR780–docetaxel nanobubbles in pancreatic cancer) intopractical design rules and discuss engineering levers such as shell composition, crosslinking chemistry, and acoustic parameterization. Finally, this review outlines translational roadmaps covering scalable manufacturing, imaging-guideddosimetry, and early-phase clinical strategies. Collectively, nanobubble-based, gas-augmented, ultrasound (US)-triggered systems represent an emerging precision platform with the potential to transition from experimental prototypes towardcontrolled clinical evaluation in oncology.
The Association between Thyroid Function with Bone Mineral Density in Hyperthyroid Patients at The Diabetic Center Clinic of RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar Katrin Wilentina Siahaan; Made Ratna Saraswati
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/6h1hgs76

Abstract

Hyperthyroidism is a pathological condition caused by an excess of thyroid hormones synthesized and secreted by thyroid gland. The prevalence of hyperthyroidism remains significant worldwide. Hyperthyroidism affect both the resorption and formation phases by stimulating the activity of osteoblasts and osteoclast, shortening the bone remodeling time, and consequently leading to bone loss characterized by a decrease in bone mineral density (BMD). Identifying the risk of osteoporosis and fractures in the hyperthyroid population requires research on the phenomenon of low bone mineral density values in hyperthyroid patients. Therefore, this study seeks to examine the association between thyroid function (TSHs and FT4) with BMD values in hyperthyroid patients. The observational analytic study with a cross-sectional design was conducted on hyperthyroid patients undergoing outpatient treatment at the Diabetic Center Clinic at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from January to May 2024, based on the inclusion and exclusion criteria, aged 18-50 years. This study evaluated TSHs and FT4 levels against BMD using dual-energy x-ray absorptiometry (DEXA) bone scans on the femur and lumbar regions, expressed in Z-scores. Data were analyzed using SPSS v.23.0 through univariate and bivariate analysis. The analysis used Spearman correlation with p<0.05 considered significant. The median age of hyperthyroid patients in this study was 34 years (19-50) years, with 84.4% being women. The TSHs level was 0.22 ± 0.45 mIU/L and the FT4 level was 3.22 ± 3.16 ng/dL. Spearman correlation showed no correlation between TSHs levels (r=0.138; p=0.452) and a negative correlation between FT4 levels (r=-0.426; p=0.015) with the average BMD (Z-score), indicating that the higher FT4 levels, then the bone mineral density value gets lower in hyperthyroid patients. This study demonstrates association between FT4 levels and bone mineral density in hyperthyroid patients, while TSHs levels showed no association with BMD in hyperthyroid patients.
Progressive Left Diaphragmatic Eventration Manifesting as Respiratory Failure in an Elderly Patient with Chronic Obstructive Pulmonary Disease: A Case Report Morris Lintong Barimbing; R.A. Tuty Kuswardhani
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/x60wst37

Abstract

Background: Diaphragmatic eventration (DE) is a rare condition characterized by the abnormal elevation of an anatomically intact hemidiaphragm. In adults, it is often asymptomatic. However, in elderly patients with significant pulmonary comorbidities such as chronic obstructive pulmonary disease (COPD), the progression of DE can precipitate acute, life-threatening respiratory decompensation.Case presentation: A 70-year-old man with COPD, hypertension, and chronic kidney disease presented with worsening dyspnea, cough, and gastrointestinal symptoms that were refractory to COPD therapy. Serial chest radiographs revealeddramatic progression from a previously asymptomatic elevated left hemidiaphragm to complete diaphragmatic eventration with visceral herniation, resulting in severe impairment of lung function. Surgical plication via video-assisted thoracoscopic (VATS) was advised; however, the patient developed acute psychological distress upon learning the surgical plan, followed by sudden cardiac arrest and death. This case illustrates the fatal convergence of structural respiratory compromise, chronic pulmonary disease, and acute emotional stress as a cardiac trigger.Conclusions: Progressive DE should be considered in the differential diagnosis of unexplained respiratory failure in COPD patients, especially when unresponsive to standard therapy. Serial imaging is crucial for diagnosis, and the management of psychological stress is a vital component in the care of critically ill geriatric patients.
Rekonseptualisasi Faktor Risiko dalam Kedokteran 2025 Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 1 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/2ejq6e75

Abstract

The term “new risk factors” in the medical literature of 2025 rarely refers to the discovery of previously unknown disease determinants; rather, it reflects an epistemic shift in how risk is defined, measured, and interpreted. This perspectivehighlights how advances in objective measurement technologies, large-scale cohort analyses, and genetics-based causal approaches have brought renewed attention to factors that were previously under recognized or oversimplified. By examining examples such as multidimensionally measured sleep irregularity, wildfire smoke exposure as a cardiovascular determinant, chlorpyrifos pesticide exposure in neurodegenerative disease, and debates surrounding immune-relateddisease causality which assessed through Mendelian randomization, this article demonstrates that the “novelty” of riskfactors more often lies in the breadth of disease spectra and the depth of biological inference rather than in the variables themselves. Obesity and cancer are used as a conceptual framework to illustrate how clinical redefinition can reshape riskstratification and preventive strategies. This perspective argues that progress in modern medicine should not be measured by the expansion of risk factor lists, but by the capacity of scientific systems to assess risk with greater precision, contextual awareness, and orientation toward clinically meaningful outcomes.
Dermatitis Kontak Alergi Akibat Plester Penutup Luka: Sebuah Laporan kasus Jarang dan Tinjauan Literatur Lukman Nur Rahman; Ilham Suripto Gani
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/ydackz21

Abstract

Introduction: The use of medical adhesives as postoperative wound dressings can lead to sensitization and subsequently trigger allergic contact dermatitis (ACD) due to exposure to various chemical components contained within these products.Case report: A 32-year-old woman presented with a reddish rash on the abdominal area surrounding her postoperative wound dressing, appearing approximately one week after undergoing laparotomy for a cystic ovarian neoplasm. The rashfirst developed two days after surgery, accompanied by burning, warmth, and pruritus. The lesions progressed into small fluid-filled vesicle-like eruptions. Clinical examination revealed erythematous macules with papules, milia-like vesicles and bullae, along with diffuse scaling that followed the outline of the surgical adhesive. The dressing used was Pharmafix®, which contains acrylate-based medical adhesive. Treatment consisted of cetirizine 10 mg, methylprednisolone 4 mg twice daily, and topical desoximetasone cream 0.25%.Discussion: The patient was diagnosed with ACD induced by acrylate-containing medical adhesives. The allergic reaction was triggered by chemical components within the adhesive, including diethyl-dithiocarbamate, tetrahydrofurfuryl acrylate,and 2-hydroxyethyl methacrylate. Acute management involved removal of the adhesive, gentle cleansing of the affected area, and short-term use of topical corticosteroid when indicated.
A Rare Case of Eisenmenger Syndrome Complicated by Dengue Hemorrhagic Fever Felly Moelyadi; Hendrata Erry Andisari
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/q2rncj89

Abstract

Background: Eisenmenger syndrome (ES) is a rare complication of congenital heart disease characterized by pulmonary hypertension and bidirectional or reversed shunt. Patients with ES are vulnerable to infections, including dengue virus(DENV), which can further aggravate cardiovascular compromise. Case: A 32-year-old woman with a history of congenital heart disease was admitted with shortness of breath, cyanosis, palpitations, and vomiting. During hospitalization, patientsdeveloped fever, rash, petechiae, and thrombocytopenia. Echocardiography demonstrated an atrial septal defect withbidirectional shunt and pulmonary hypertension, consistent with ES. Laboratory results confirmed dengue hemorrhagic fever (DHF) with hemoconcentration and severe thrombocytopenia. Management included cautious fluid resuscitation,platelet transfusion, corticosteroids, and supportive therapy with sildenafil citrate for pulmonary hypertension. Clinical improvement was achieved, and the patient was discharged after nine days of hospitalization. Conclusion: Thiscase illustrates the complex interaction between ES and DHF, in which increased vascular permeability, coagulation abnormalities, and chronic hypoxemia exacerbate hemodynamic instability. Currently, there are no standardized guidelines for managing dengue in patients with ES; therefore, therapy must be individualized with vigilant monitoring. Recognition of this rare comorbidity is important to prevent complications, optimize treatment, and improve survival.
Preeclampsia in the Modern Era: New Insights from Global Research and Implications for Practice in Indonesia Arya Ady Nugroho; Yudianto Budi Saroyo; Allan Taufiq Rivai
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/v8ne8639

Abstract

Preeclampsia (PE) remains a leading cause of maternal and neonatal morbidity and mortality worldwide, affecting 2–15% of pregnancies. This review synthesizes recent advancements in the understanding of PE pathophysiology, includingplacental dysfunction, endothelial impairment, and novel biomarkers such as angiogenic factors. Drawing on global studies published up to 2025, we explore predictive models for early detection before 11 weeks of gestation, innovativemanagement strategies including aspirin prophylaxis, and disparities in maternal and neonatal outcomes. In Indonesia, where PE contributes to 26–30% of maternal deaths, we highlight local epidemiology, risk factors such as anemia and obesity, and tailored interventions to improve screening and care in resource-limited settings. By emphasizing evidencebasedpractices, this article underscores the need for integrated approaches to reduce the burden of PE and provides actionable insights for clinicians in both global and Indonesian contexts.
Peran Manitol dalam Penanganan Peningkatan Tekanan Intrakranial pada Stroke Non-Hemoragik dengan Penyakit Jantung Bawaan: Laporan Kasus Putu Indah Mahardika Putri; I Wayan Widyantara
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/mfsfr250

Abstract

Background: Stroke is a condition of impaired cerebral circulation leading to brain tissue necrosis. It is the second leading cause of death worldwide after heart disease. Nonhemorrhagic stroke may result from thrombus formation or embolic occlusion. Congenital heart disease (CHD) is one of the risk factor for stroke, including tetralogy of Fallot (TOF). The incidence of stroke in CHD is approximately 1 in 11 males and 1 in 15 females. One of the complications of stroke is increased intracranial pressure (ICP). Mannitol is one of treatment that can be used to reduce elevated intracranial pressure (EICP). Case report: A 19-year-old male with a history of TOF presented with decreased consciousness and left-sided hemiparesis. A CT scan revealed a hypodense lesion suggestive of ischemic stroke. On the third day of hospitalization, the patient’s condition worsened, showing signs of increased ICP. A repeat CT scan showed hemorrhagic transformation accompanied by uncal herniation. Mannitol was administered for 3 days to manage the increased ICP, resulting in clinical improvement. Three days later, the patient was discharged with improved condition. Conclusion: The use of mannitol in stroke cases with CHD, such as TOF, showed favorable outcomes without causingadverse effects or worsening the underlying cardiac condition. Mannitol may be considered in patients with cardiac comorbidities.

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