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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 201 Documents
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Relationship Between Serum Vitamin D Levels  and Anxiety Severity in Elderly Patients at the Internal Medicinie and Psychiatry Clinic of RSUP Prof. dr. I.G.N.G Ngoerah Denpasar Helen Widiani; Tuty Kuswardhani
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/agbfxp34

Abstract

Serum vitamin D plays an important role in both physical and mental health. Decreased serum vitamin D levels in the elderly are often associated with anxiety. This study aims to determine the relationship between serum vitamin D levelsand anxiety severity in elderly patients. A cross-sectional analytical study was conducted and subjects were recruited using consecutive sampling at RSUP Prof. dr. I.G.N.G. Ngoerah. Serum vitamin D levels were measured using the human vitamin D Chemiluminescent Microparticle Immunoassay (CMIA), and anxiety severity were assessed using the Geriatric Anxiety Inventory (GAI). The median age of the participants was 66.5 years (range: 60–83 years). The most common anxiety severity observed was mild (40%) and the most prevalent vitamin D status was insufficient (40%). Statisticalanalysis showed no significant correlation between serum vitamin D levels and anxiety severity (p=0.816). The Spearman correlation test yielded a p-value of 0.214 with a correlation coefficient of -0.125. However, path analysis revealed thatvitamin D indirectly affects anxiety severity through inflammatory bowel syndrome (IBS), with an effect size of -0.06 (p=0.035).
Hubungan Status Gizi Terhadap Kejadian Dislipidemia pada Mahasiswa Program Pendidikan Dokter Spesialis Ilmu Penyakit Dalam RSUP Prof. dr. I.G.N.G. Ngoerah I Dewa Gede Agung Suta Ariwangsa; I Made Pande Dwipayana
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/sqn0k793

Abstract

Background: Nutritional status plays an important role in determining individual’s health. Obesity is closely associatedwith dyslipidemia, mainly through insulin resistance mechanisms and proinflammatory adipokines, which contribute tothe development of metabolic syndrome. However, recent evidence suggests that obesity‑related dyslipidemia does notfollow a single, uniform pathophysiological pattern; instead, its characteristics may vary across individuals. This studyaimed to examine the relationship between nutritional status and dyslipidemia among residents of the Internal Medicine Specialist Program at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. Methods: This cross‑sectional study was conducted in August 2023 at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar. The study subjects were residents of the Internal Medicine Specialist Program. Data were collected through measurements of body mass index (BMI) as an indicator of nutritional status and lipid profile examination as an indicator of dyslipidemia. The association between variables was analyzed using the Chi‑Square test, with statistical significance set at p<0.05. Results: A total of 115 subjects were enrolled in the study, with 60% men and 40% women and a mean age of 31.25 ± 3.82 years. Of these, 74 subjects (64,3%) were classified as obese, and 57 subjects had dyslipidemia. Forty‑six (46) subjects had presented with obesity and dyslipidemia, while 11subjects had dyslipidemia in the absence of obesity. Meanwhile, 30 subjects had neither obesity nor dyslipidemia, and 28 participants were obese without dyslipidemia. The Chi‑Square test showed a significant association between nutritional status and dyslipidemia (p<0,001). Conclusion: This study demonstrates a significant relationship between nutritional status and dyslipidemia. Further research is needed to explore specific factors that contribute to obesity and dyslipidemia among residents in specialist medical training programs.Keywords: nutritional status, obesity, dyslipidemia, resident physicians, PPDS
Ansietas pada Lansia: Prevalensi, Faktor Penanda, dan Penanganannya Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qefshn93

Abstract

Anxiety in older adults is a prevalent mental health issue, yet it is frequently underrecognized due to the overlap symptoms with physical illnesses and age-related psychosocial changes. This article reviews the global prevalence, key risk markers,and evidence-based management approaches. Numerous studies indicate that anxiety in older adults is associated with chronic medical conditions (including pain), functional gastrointestinal disorders such as irritable bowel syndrome (IBS),low level of physical activity, and unhealthy dietary patterns. Evidence regarding direct association between serum vitamin D levels and anxiety in older adults remains inconsistent; however, emerging evidence suggests an indirect associationmediated through the role of vitamin D in gastrointestinal health and inflammatory process. Management of anxiety in older adults is recommended to follow a biopsychosocial approach, prioritizing psychological interventions such as cognitive behavioral therapy (CBT) and lifestyle modification, and selective pharmacotherapy reserved for moderate to severe cases.
 Hepatic Encephalopathy in a Postpartum Patient with Chronic Hepatitis B: A Case Report  Priska Harsanti Devi; I Ketut Mariadi
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/7n0pqt23

Abstract

Decompensated liver cirrhosis in the postpartum period is rarely reported, particularly in association with chronic hepatitisvB infection. We presented the case of a 33-year-old woman who developed decreased level of consciousness one day afterdelivery. She had no prior history of chronic illness, although her father had passed away from complications of hepatitisvB. Clinical findings included jaundice, ascites, and hepatic encephalopathy. Laboratory results revealed reactive HBsAg, hypoalbuminemia, elevated liver enzymes, hyponatremia, hypokalemia, and markedly elevated total bilirubin. Abdominalultrasound demonstrated cirrhosis with splenomegaly and ascites. The patient was diagnosed with Child-Turcotte-Pughclass C cirrhosis with grade II ascites, grade II hepatic encephalopathy, chronic hepatitis B, and esophageal varices. She received supportive treatment including lactulose, albumin transfusion, and antiviral therapy with tenofovir, resulting inclinical and biochemical improvement after one month. This case highlighted the importance of early screening for hepatitis B during pregnancy to prevent potentially fatal postpartum hepatic decompensation.
"Steakhouse Syndrome" pada Pasien Dewasa di RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar Ni Made Ayu Dwipayanti; I Ketut Mariadi
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/tvmwhd73

Abstract

Esophageal obstruction by foreign body is a common emergency condition, third rank after upper and lower gastrointestinal bleeding. This condition may be life-threatening, depending on the type of ingested object, the location of the obstruction, the patient’s condition, and the time interval from the incident until the treatment is given. The annual incidence has been reported to be 13 per 100,000 of the general population. We report the case of a 30-year-old female patient who presented with difficulty swallowing for two days prior to hospital admission after eating beef steak. This complaint was accompanied by chest pain and a burning sensation. Examination revealed a patent airway, with no complications such as hematemesisor abnormal breath sounds. Upper gastrointestinal endoscopy showed a food blockage (a mass of insufficiently chewed steak) in the esophagus, located 20 cm from the teeth, with erosion of the surrounding mucosa. This location is consistentwith previous studies showing that, in adults, about 68% of obstructions occur in the distal esophagus, between the aortic arch and the lower esophageal sphincter (LES). In this case, no medications were administered to relax the smooth muscles of the LES. The steak was pushed from the esophagus into the stomach using endoscopy. The obstruction was successfully removed, and the patient’s symptoms resolved. In conclusion, the patient’s symptoms were caused by an acute steak mass, known as “steakhouse syndrome”.
Progressive Supranuclear Palsy–Parkinsonism Predominant (PSP-P): A Case Report Ida Bagus Oka Garbhajana Sirinatha; D.P.G. Purwa Samatra; Sri Yenni Trisnawati
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/25yggq62

Abstract

Background: Progressive supranuclear palsy (PSP) is the most common form of atypical parkinsonism syndrome, presenting with signs and clinical features similar to Parkinson’s disease. The global incidence of PSP is estimated to be 0.005% of the world’s population, with 5% of those having parkinsonian symptoms or signs. PSP is a complex clinical disorder with a wide range of clinical manifestations that can lead to delayed diagnosis. Key symptoms of PSP include early postural instability, vertical saccadic eye movements, and vertical gaze palsy. Although no cure exists, early and accurate diagnosis is essential to optimize symptomatic management. Case: A 47-year-old female patient presented to the neurology clinic with stiffness throughout her body. The symptoms reportedly appeared suddenly 2 years ago and have worsened in the last 3 months. The patient also complained of slowed movement. Neurological examination revealed bradykinesia, postural instability, bidirectional nystagmus, and a decrease in cognitive function. The patient was diagnosed with progressive supranuclear palsy. The patient was managed with levodopa/carbidopa/entacapone (Stalevo®) 1 tablet every 12 hours and pramipexole 0.375 mg every 24 hours orally. Conclusion: A case of PSP–parkinsonism predominant (PSP‑P) in a 47-year-old female has been reported. The comparison with the existing literature supports the clinicalpresentation being consistent with PSP‑P.
Potensi Patogenik Infeksi Entamoebacoli dengan Komplikasi Syok Sepsis: Sebuah Laporan Kasus Atipikal saputera, christina; Christina Saputera
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/wv237d49

Abstract

Background: Entamoeba coli is a commensal protozoan that lives in the human intestinal lumen (nonpathogenic protozoan). There have been no reports of severe Entamoeba coli-related infections in patients with good nutritional andimmune status. The natural phagocytic properties of Entamoeba coli are are contributed to severe infections with rare complications, including septic shock. Diagnosis is generally established by microscopic stool analysis; positive resultsindicate the presence of Entamoeba coli cysts. Case: A 65-year-old female patient with symptoms of colitis, namely abdominal pain, abdominal cramps accompanied by diarrhea 4 hours before coming to the emergency room, the frequencyof diarrhea 6 times per day with watery, greenish yellow stool, accompanied by mucus. Physical examination showed signs indicating septic shock with positive microscopic stool analysis results for Entamoeba coli. Initial management in theform of broad-spectrum antibiotics plus the amebicidal agent metronidazole and comprehensive management of septicshock provided good outcomes in patient without complications. Conclusions: Although categorized as a nonpathogenic protozoan, the phagocytic ability of Entamoeba coli can trigger a severe systemic inflammatory response, including sepsis.High clinical vigilance is required to detect Entamoeba coli in stool examinations, as well as to ensure early diagnosis and appropriate management to prevent serious systemic complications.
Hubungan antara Asam Traneksamat dan Insiden Kejang pada Pasien dengan Perdarahan Subaraknoid Fitria, Dian Rizki; Dian Rizki Fitria; I Wayan Widyantara
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/4p5c2188

Abstract

Background: Subarachnoid hemorrhage (SAH) accounts for 2–7% of all strokes but contributes disproportionately to morbidity and mortality due to severe complications such as rebleeding, delayed cerebral ischemia, and seizures.Tranexamic acid (TXA) is used to prevent rebleeding in SAH; however, the association between TXA use and seizure riskremains controversial.Methods: A systematic literature review was conducted to identify clinical studies reporting seizure incidence in adult patients with SAH who received TXA. Randomized controlled trials, cohort and case-control studies were included as primary studies. Data were synthesized narratively, with limited quantitative analysis performed when feasible.Results: Five studies met the inclusion criteria. Most studies demonstrated a signal toward an increased risk of seizuresor adverse neurological effects in patients receiving TXA compared with control groups. Safety data suggests that seizure risk tends to increase with total TXA doses exceeding 2 g per day, whereas low-to-moderate doses administered for a shortduration were not consistently associated with an increased incidence of seizures.Conclusion: TXA use in patients with SAH may be associated with an increased risk of seizures, particularly at higher doses. Although TXA provides benefits in reducing rebleeding, careful risk–benefit assessment and appropriate dose selection are essential, especially in patients with neurological vulnerability.
Dysphagia as the Predominant Symptom in Chronic Tonsillopharyngitis with Acute Exacerbation: A Case Report Dzaka Ogan Amirudin Lutfi; Indera Istiadi; Deoni Daniswara
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/kkdmv851

Abstract

Introduction: Chronic tonsillopharyngitis typically presents with sore throat, fever, and enlarged tonsil. However, dysphagia as the predominant symptom in chronic tonsillopharyngitis with acute exacerbation is rarely reported and can have a significant impact on a patient’s quality of life. Case: A 25-year-old male presented to the emergency department with a three-day history of odynophagia, dysphagia, fever, and voice changes. Oropharyngeal examination revealed enlarged, hyperemic tonsils with dilated crypts containing debris. Laboratory findings showed marked leukocytosis with neutrophil predominance, suggesting bacterial infection. Oropharyngeal swab culture identified Streptococcus pyogenes,which was sensitive to multiple antibiotics including ceftriaxone and penicillin. The patient was diagnosed with chronic tonsillopharyngitis with acute exacerbation and treated with intravenous ceftriaxone, dexamethasone, ranitidine, andsupportive dietary modifications. Clinical improvement was observed, and the patient was discharged with oral medications and scheduled outpatient follow-up. Tonsillectomy was discussed but was declined by the patients. Conclusion: Thiscase highlights dysphagia could be a potential primary symptom in acute exacerbation of chronic tonsillopharyngitis, underscoring the importance of comprehensive evaluation and culture-guided antimicrobial therapy. Early recognition andappropriate management are crucial to prevent complications, reduce symptom severity, and improve patient outcomes.
Comprehensive Approach to Acute Pulmonary Embolism in a Patient with History of Cervical Cancer: Clinical Challenges and Therapeutic Strategies Arya Wiradarma; Putu Andrika
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/8nxexq93

Abstract

Pulmonary embolism (PE) is a life-threatening medical emergency that requires prompt diagnosis and treatment, particularly in patients with significant risk factors such as a history of cancer. This case report discusses a 45-year-old female with a history of stage IIIA cervical cancer who presented with acute onset dyspnea and hemodynamic instability. The patient’s prior cancer treatments, including chemotherapy and radiotherapy, increased the patient’s risk for venous thromboembolism (VTE), leading to acute pulmonary embolism. The diagnosis was confirmed by computed tomography pulmonary angiography (CTPA), which revealed a substantial thrombus obstructing the left pulmonary artery. Laboratoryfindings showed markedly elevated D-dimer levels. Further assessment with echocardiography (echo) revealed right ventricular (RV) dysfunction, a critical marker of hemodynamic stress caused by the embolism. The echo findings included RV hypokinesis, an increased right ventricle/left ventricle (RV/LV) ratio, and possible tricuspid regurgitation, all of which indicated severe right heart strain. These findings serve as key prognostic indicators in acute PE, correlating with a higher risk of mortality and guiding therapeutic decision-making. The comprehensive management approach for this patient highlights the importance of rapid diagnosis, risk stratification, and aggressive therapeutic interventions in highriskPE. Echocardiographic findings played a crucial role in determining the disease severity and informing the need for potential reperfusion therapies, such as thrombolysis or surgical embolectomy. This case emphasizes the importance of integrating clinical, imaging, and laboratory data to optimize patient outcomes. Echocardiography plays a pivotal role inmonitoring right ventricular function and adjusting treatment strategies in PE, particularly among oncology patients who are at increased risk.

Page 20 of 21 | Total Record : 201

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