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The Journal of Society Medicine (JSOCMED)
Published by PT. CoinReads Media Prima
ISSN : -     EISSN : 29645565     DOI : https://doi.org/10.47353/jsocmed.v2i1
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
The Journal of Society Medicine (JSOCMED) | ISSN (e): 2964-5565 is a leading voice in the Indonesia and internationally for medicine and healthcare. Published continuously, JSOCMED features scholarly comment and clinical research. JSOCMED is editorially independent from and its The Editor-in-Chief (EIC) is Prof. dr. Aznan Lelo, PhD, SpFK. JSOCMED offers many attractive features for authors, including free online access to all research articles, online publication ahead of print, and online responses to articles published as Quick Comments. In addition, as befitting a publication of the Journal of Society Medicine, JSOCMED implements best practice in scientific publishing with an open peer review process, declarations of competing interests and funding, full requirements for patient consent and ethical review, and statements of guarantorship, contributorship, and provenance.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 5 Documents
 1 
Search results for , issue "vol. 5 no. 7 (2026): july" : 5 Documents clear
Effect of Intraoperative Lung-Protective Ventilation on Postoperative Pulmonary Complications in Non-ARDS Surgical Patients: A Prospective Multicenter Cohort Study Ali Rezaei; Hossein Karimi; Zahra Mohammadi
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.288

Abstract

Introduction: Postoperative pulmonary complications (PPCs) are among the most frequent adverse events after major surgery and drive substantial morbidity, prolonged hospitalization, and mortality. Although lung-protective ventilation (LPV) is well established in patients with acute respiratory distress syndrome (ARDS), its perioperative role in non-ARDS surgical patients remains incompletely defined. We evaluated the association between intraoperative LPV and PPCs in non-ARDS patients who underwent general anesthesia. Methods: In this prospective multicenter cohort study, adults undergoing elective non-thoracic, non-cardiac surgery were managed intraoperatively with LPV (tidal volume 6–8 mL/kg predicted body weight, PEEP 5–8 cmH₂O, selective recruitment maneuvers) or conventional ventilation (tidal volume 10–12 mL/kg, minimal PEEP). The primary outcome was the incidence of PPC within 7 postoperative days. Secondary outcomes included pneumonia, respiratory failure, length of stay, and 30-day mortality. Multivariable logistic regression was used to adjust for relevant confounders. Results: Of 1,000 patients, 500 received LPV and 500 conventional ventilation, with well-balanced baseline characteristics. PPCs occurred in 75 (15.0%) LPV patients versus 110 (22.0%) conventional patients (p=0.006). LPV was independently associated with lower PPC odds (adjusted odds ratio 0.60, 95% CI 0.42–0.85; p=0.004). Pneumonia was less frequent (6.0% vs. 10.0%, p=0.02) and hospital stay was shorter (median 5 days vs. 6 days, p=0.02). The ICU stay and 30-day mortality did not differ significantly. Conclusion: Intraoperative LPV was independently associated with fewer PPCs in non-ARDS surgical patients, alongside lower pneumonia rates and shorter hospitalization. These findings support the broader perioperative adoption of lung-protective ventilation to improve respiratory outcomes after surgery.
Regional Anesthesia Strategy Using Thoracic Paravertebral Block in a Patient with Tuberculosis-Related Pyopneumothorax: A Case Report T Arfi Sulaiman; Rahendra Rahendra
Journal of Society Medicine Vol. 5 No. 7 (2026): July
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.296

Abstract

Thoracic surgery in patients with severe pulmonary disease poses significant anesthetic challenges. General anesthesia with positive pressure ventilation may exacerbate ventilation–perfusion mismatch and worsen air leakage in the presence of a bronchopleural fistula. Regional anesthesia techniques that preserve spontaneous ventilation may offer a safer alternative in selected high-risk patients. We report a case of a 68-year-old male with tuberculosis-related right-sided pyopneumothorax complicated by bronchopleural fistula, severe chronic obstructive pulmonary disease with a restrictive component, atrial fibrillation with normal ventricular response, and hepatic insufficiency (ASA physical status III), who was scheduled for an open pleural window procedure. Given the high risk of general anesthesia and mechanical ventilation, ultrasound-guided unilateral thoracic paravertebral block (TPVB) was selected as the primary anesthetic technique, combined with dexmedetomidine sedation. The block was performed at T5–T7 using ropivacaine, achieving adequate dermatomal anesthesia. Sedation was titrated to preserve spontaneous ventilation and patient cooperation. The procedure was completed without conversion to general anesthesia. The patient remained hemodynamically stable, with preserved spontaneous breathing and adequate oxygenation throughout the surgery. No vasopressors, rescue opioids, or airway interventions were required. Postoperative pain was minimal, and no block-related or respiratory complications occurred. Thoracic paravertebral block combined with dexmedetomidine sedation provided effective anesthesia and favorable perioperative stability for open pleural window surgery in a high-risk pulmonary patient. This case highlights the potential role of regional anesthesia-based strategies as an alternative to general anesthesia in carefully selected thoracic surgical patients where preservation of spontaneous ventilation is desirable.
Response-Guided Low-Temperature Radiofrequency Ablation Without Escalation Above 60°C for Trigeminal Neuralgia: Two Case Reports Rizky Ramadhana; Rahendra Rahendra
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.301

Abstract

Introduction: Radiofrequency ablation (RFA) is an established interventional treatment for trigeminal neuralgia refractory to pharmacotherapy. Conventional protocols often escalate the temperature stepwise to 70–80°C; however, higher temperatures increase the risk of sensory complications. Whether selected patients can achieve pain control without escalation above 60°C remains clinically relevant. Case Description: We report two patients with idiopathic trigeminal neuralgia of the mandibular (V3) division treated using a response-guided, low-temperature, fluoroscopy-guided RFA strategy. A 58-year-old man (baseline Numeric Rating Scale [NRS] 8) received two lesions at 50°C for 60 seconds each; a 63-year-old woman (baseline NRS 10) received two lesions at 60°C for 60 seconds each. Both had persistent pain despite paracetamol and pregabalin. Needle placement through the foramen ovale toward Meckel's cave was confirmed fluoroscopically, with sensory and motor testing. Both patients achieved complete pain relief immediately after the procedure (NRS 0), sustained at the three-month follow-up, without corneal complications, dysesthesia, motor deficits, or other adverse events. Conclusion: Response-guided low-temperature RFA without escalation above 60°C may provide effective short-term pain relief in selected patients with idiopathic trigeminal neuralgia while minimizing unnecessary thermal exposure to healthy tissues. Prospective studies are needed to define the optimal patient selection, temperature, and long-term durability.
The Benefit of Application-Based Education Using the Healthy Lungs Version 2.0 on Inhaler Adherence Among Patients with Chronic Obstructive Pulmonary Disease at RS Prof. Dr. Chairuddin P. Lubis Muhammad Pany Al-A’raf; Amira Permata Sari Tarigan; Andika Pradana
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.305

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Inhalation therapy is central to management; however, suboptimal adherence and incorrect inhaler technique contribute to poor disease control and recurrent exacerbations. Application-based education provides continuous, standardized, accessible instruction that may improve adherence to inhaler therapy. The Healthy Lungs application 2.0 was developed in the Philippines for COPD patients to evaluate its educational effectiveness on inhaler adherence at RS Prof. Dr. Chairuddin P. Lubis, University of North Sumatra, Indonesia. Methods: An analytical study with a case–control approach enrolled 50 patients with COPD selected by consecutive sampling. Inhaler adherence was assessed with a structured questionnaire before and after the application-based intervention. Normality was examined with the Kolmogorov–Smirnov test, and pre- versus post-intervention adherence was compared using the Wilcoxon signed-rank test, with significance set at p < 0.05. Results: The respondents were predominantly elderly (43%) and male (58%). Before the intervention, low adherence predominated (50%); afterwards, the proportion with high adherence rose to 42%, with most respondents improving and few declining. The Wilcoxon test demonstrated a significant difference in adherence before and after the intervention (Z = –3.196; p = 0.001), with a large effect size (Cohen's d = 1.05). Conclusion: Education delivered through the Healthy Lungs app significantly improved inhaler adherence among patients with COPD, supporting its use as an adjunct to conventional inhaler counseling.
The Impact of Recurrent Seizures on Cognitive Functions in Epilepsy: A Literature Review Yudhisman Imran; Ainaya Az Zahra
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.309

Abstract

Epilepsy is among the most prevalent chronic neurological disorders, affecting more than 50 million people worldwide and contributing substantially to the global burden of neurological disease. Beyond the seizures themselves, recurrent epileptic activity is increasingly recognized as a driver of progressive cognitive decline; however, cognitive comorbidity remains under-addressed in routine clinical management. This literature review synthesizes current evidence on the mechanisms, clinical manifestations, and assessment of cognitive impairment associated with recurrent seizures. Recurrent seizures arise from an imbalance between excitatory (glutamate) and inhibitory (GABA) neurotransmission, producing neuronal hyperexcitability and hypersynchronization. During and after seizure episodes, cyclooxygenase-2–dependent cerebral vasoconstriction induces localized hypoperfusion and hypoxia; when repeated, these events accumulate, causing structural and functional brain injury. The hippocampus, essential for memory, is particularly vulnerable to hypoxic-ischemic damage, whereas temporal- and frontal-lobe involvement disrupts memory, language, attention, and executive function. Approximately 60–70% of patients with chronic epilepsy experience cognitive impairment, the severity of which is modulated by age at onset, seizure frequency, duration, and antiepileptic drug use. Practical screening tools such as the Montreal Cognitive Assessment (MoCA), including its validated Indonesian version (MoCA-Ina), demonstrate higher sensitivity than the Mini-Mental State Examination for detecting mild impairment, while brain-derived neurotrophic factor represents a promising biomolecular marker of cognitive dysfunction. Collectively, the evidence indicates that epilepsy management should extend beyond seizure control to incorporate routine cognitive surveillance. Early detection through sensitive screening instruments enables comprehensive, individualized treatment planning and may ultimately improve the long-term quality of life for people living with epilepsy.

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