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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 6 Documents
 1 
Search results for , issue "vol. 5 no. 8 (2026): august" : 6 Documents clear
Antibiotics versus Surgery for Uncomplicated Acute Appendicitis in Adults: A Meta-Analysis of Randomized Controlled Trials Heri Gunanti Surbakti; Atikah Najla Rodhiah
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.287

Abstract

Introduction: Appendectomy has been used to treat appendicitis for a century, but randomized controlled trials (RCTs) have challenged its efficacy in uncomplicated disease. We performed a meta-analysis to quantify 1-year antibiotic-first efficacy and compare complications with appendectomy in adults. Methods: Following PRISMA 2020, MEDLINE, Embase, CENTRAL, and trial registries were searched to June 2026 for RCTs comparing antibiotics with appendectomy in adults (≥16 years) with imaging- or clinically diagnosed uncomplicated appendicitis. The co-primary outcomes were overall treatment-related complications (risk ratio [RR], random-effects DerSimonian–Laird model) and pooled 1-year efficacy of antibiotics (proportion avoiding appendectomy, logit-transformed model). Heterogeneity (I²), leave-one-out sensitivity analyses, subgroup analysis by diagnostic modality, and Egger’s test were performed; bias was assessed with RoB 2. Results: Eight RCTs (3,202 participants) were included. Pooled 1-year efficacy of antibiotics was 70.9% (95% CI 65.3–76.0%; I²=43%), consistent across imaging-confirmed (71.4%) and clinically diagnosed (70.0%) appendicitis. For complications, the pooled RR was 0.91 (95% CI 0.19–4.48; I²=90%), with very high heterogeneity explained by trial design: omitting the single trial using open appendectomy reversed the estimate and removed heterogeneity (RR 2.25, 95% CI 1.39–3.64; I²=4%), indicating that antibiotics do not reduce, and may increase, complications versus contemporary laparoscopic surgery, particularly with an appendicolith. Conclusion: An antibiotics-first strategy allowed seven of ten adults to avoid appendectomy at one year and is reasonable for uncomplicated appendicitis. However, it does not reduce complications compared to laparoscopic appendectomy and carries recurrence. Shared decision-making, appendicolith exclusion, and follow-up are essential.
Prophylactic Antibiotic Efficacy and Factors Associated with Surgical Site Infection in Complicated Appendicitis Undergoing Appendectomy: A Systematic Review and Meta-Analysis Herdi Gunanta Syaiful; Amir Fajar; Ahmad Muhtadi
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.289

Abstract

Introduction: Surgical site infection (SSI) is the leading preventable complication after appendectomy for complicated (gangrenous, perforated, or abscess-forming) appendicitis. Perioperative antibiotic prophylaxis is established; however, whether prolonging postoperative antibiotics adds benefit and which patient- and operation-related factors drive SSI remain contested. We synthesized the efficacy of prolonged versus short-course prophylaxis and the factors associated with SSI. Methods: Following PRISMA 2020, we searched MEDLINE, Embase, and CENTRAL to July 2026 for studies of patients undergoing appendectomy for complicated appendicitis that reported SSI. Randomized and cohort studies comparing short versus extended postoperative antibiotics were pooled as risk ratios (RR); adjusted odds ratios (OR) for factors associated with SSI were pooled by inverse-variance random-effects (DerSimonian–Laird) models. Heterogeneity (I²), prediction intervals, leave-one-out analyses, and Egger's test were assessed. Results: Eleven studies (4,135 patients) were included in the analysis. Prolonging antibiotics beyond a short course did not reduce incisional SSI (randomized trials: RR 1.91, 95% CI 0.90–4.03; all studies: RR 1.12, 95% CI 0.54–2.36, I²=34%) or intra-abdominal abscesses (RR 1.00, 95% CI 0.71–1.42, I²=0%). Three factors were independently associated with SSI: complicated/perforated pathology (OR 4.75, 95% CI 2.81–8.04), open versus laparoscopic approach (OR 2.41, 95% CI 1.22–4.77), and prolonged operative duration (OR 2.68, 95% CI 1.75–4.11). Conclusion: Prophylaxis is essential in complicated appendicitis, but it need not be prolonged; extending beyond a course does not reduce SSI or intra-abdominal abscesses, supporting stewardship. The SSI burden reflects disease severity, open approach, and prolonged operations, guiding risk-adapted prevention over longer courses.
Bullous Pemphigoid Suspected to Be Caused by COVID-19 Vaccine: A Case Report Cut Putri Hazlianda; Rinda C. Risanti Risanti
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.290

Abstract

Introduction: Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease caused by autoantibodies against hemidesmosomal proteins, BP180 and BP230. Although usually idiopathic, BP has increasingly been reported following COVID-19 vaccination, and early recognition of this association is clinically important. Case Description: A 64-year-old man developed widespread tense bullae over erythematous skin with pruritus and pain, sparing the face, two days after the first dose of an inactivated (Sinovac) COVID-19 vaccine. He had no history of drug or food allergy, prior skin disease, or relevant comorbidities. Dermatological examination revealed multiple tense bullae with papular and vesicular lesions over erythematous macules and plaques on the extremities and trunk, with erosions, excoriations, and crusts; Nikolsky’s sign was negative. Histopathology demonstrated subepidermal bullae with acanthosis and an inflammatory infiltrate rich in eosinophils, lymphocytes, and neutrophils, confirming BP suspected to be vaccine-induced. The patient was treated with systemic and topical corticosteroids, oral antibiotics, antihistamines, and supportive care. After one week, the lesions improved markedly, with no new bullae, and corticosteroids were gradually tapered. Conclusion: Bullous pemphigoid may develop shortly after COVID-19 vaccination. Although a causal relationship cannot be firmly established, clinicians should remain aware of this potential association, particularly in elderly patients presenting with new-onset blistering eruptions after vaccination, as early recognition enables prompt management and favorable outcomes.
Bullous Pemphigoid in a Young Female: A Case Report Cut P. Hazlianda; Elza Wahyuni
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.291

Abstract

Introduction: Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease, mediated by autoantibodies against hemidesmosomal proteins BP180 and BP230, which activate the complement system, recruit eosinophils and neutrophils, and produce subepidermal bullae. Although BP typically affects older adults, it can occasionally arise in young patients, and prompt recognition and objective monitoring of disease activity are important. Case Description: A 22-year-old woman presented with a two-week history of pruritic, fluid-filled tense bullae over the trunk, axillae, forearms, palms, and thighs, which were unresponsive to topical betamethasone and cetirizine. Examination revealed tense, clear, and hemorrhagic bullae on erythematous macules with a negative Nikolsky’s sign, and the initial Bullous Pemphigoid Disease Area Index (BPDAI) was 23 (moderate). Histopathological examination revealed subepidermal bullae with eosinophil- and neutrophil-rich infiltrates, confirming the BP diagnosis. Laboratory testing revealed thrombocytopenia underlying the hemorrhagic lesions, and oral mucosal involvement was observed during follow-up. She was treated with systemic and topical corticosteroids, an antihistamine, and supportive care. The BPDAI progressively decreased to 17 at two weeks and 7 at three weeks, with no new lesions. Conclusion: Oral and topical corticosteroids were effective in treating moderate bullous pemphigoid in this patient. Serial BPDAI scoring provides a practical and objective measure of treatment response and supports timely dose adjustment.
Gut-Origin Sepsis After Radical Cystectomy and Ileal Conduit: Early Intensive Care Unit Recognition and Targeted Management Leading to Rapid Recovery Ida Juita Halim; Vera Irawany
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.292

Abstract

Introduction: Gut-origin sepsis is an important but under-recognized source of postoperative systemic inflammation in critically ill patients. Disruption of the intestinal mucosal barrier after major surgery may facilitate bacterial translocation and trigger systemic inflammatory responses, even without overt intra-abdominal infection or positive blood culture. Early recognition remains challenging because clinical manifestations are often nonspecific, underscoring the value of simple, available biomarkers. Case Description: We report a 74-year-old man who developed early features suggestive of gut-origin sepsis after open radical cystectomy with ileal conduit for muscle-invasive bladder cancer. Despite stable macrocirculatory parameters and no vasopressor requirement, the patient exhibited persistent hyperlactatemia (6.1 mmol/L), lymphopenia (absolute lymphocyte count 711/µL), and an elevated neutrophil-to-lymphocyte ratio (NLR 16.9). Prompt admission to the intensive care unit and early targeted management—including optimized fluid resuscitation with albumin, broad-spectrum antimicrobial therapy, empirical antifungal coverage, and multimodal opioid-sparing analgesia—were followed by rapid clinical and laboratory improvement. Within 72 hours, serum lactate decreased to 2.8 mmol/L, the absolute lymphocyte count rose to 792/µL, and the NLR fell to 13.1. The patient was successfully extubated and discharged from the intensive care unit without progression to multiple organ dysfunction. Conclusion: This case underscores the clinical value of early intensive care recognition of gut-origin sepsis using simple, routinely available biomarkers, such as serum lactate, absolute lymphocyte count, and NLR. Optimal outcomes depend on a high index of suspicion and timely, physiology-based intervention delivered through a coordinated critical care approach in high-risk postoperative patients.
Fluid Balance Profile in Patients Admitted to the Intensive Care Unit (ICU) of Haji Adam Malik Central General Hospital, Medan, January–June 2025 Ahmad Yafiz Hasby; Muhammad Shiddiq
Journal of Society Medicine Vol. 5 No. 8 (2026): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i8.299

Abstract

Introduction: Fluid balance is a critical component of intensive care unit (ICU) patient management, and both positive and negative imbalances are associated with increased morbidity and mortality. Evidence regarding the cumulative fluid balance in Indonesian ICUs remains limited. To determine the fluid balance profile of ICU patients and its relationship with patient outcome and length of stay Methods: A descriptive-analytical observational study with a cross-sectional design was conducted at the ICU of Haji Adam Malik Central General Hospital, Medan, from January to June 2025. Of 222 patients screened, 64 adults (≥18 years) treated for ≥24 h were selected by total sampling from medical records. Cumulative fluid balance was categorized as positive or negative, and bivariate associations with outcome and length of stay were assessed using the chi-square test (p<0.05). Results: The majority of patients (59.4%) had a negative cumulative fluid balance. Negative balance predominated among patients aged 25–65 years, males, those with medical admissions, and obese patients, whereas positive balance predominated among those aged >65 years, females, those with surgical admissions, and underweight patients. Fluid balance was significantly associated with patient outcomes (p=0.003) and length of stay (p=0.001). Negative balance was associated with survival (79.3%) and a stay >7 days (80.5%), whereas positive balance was more frequent among deceased patients (57.1%) and those staying 1–3 days (81.8%). Conclusion: Negative cumulative fluid balance predominated and was associated with survival and a longer ICU stay. Close monitoring and individualized fluid management are essential for optimizing patient outcomes.

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