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Agus Prima
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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. 1 (2026): January" : 5 Documents clear
Clinical Utility of Procalcitonin for Stratifying Severity in Sepsis Secondary to Pneumonia Saputra , Wachyoe Hadi; Prima, Agus; Wirdah, Wirdah
Journal of Society Medicine Vol. 5 No. 1 (2026): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i1.253

Abstract

Introduction: Procalcitonin (PCT) is a biomarker that reflects the systemic inflammatory response to bacterial infections and has been widely studied in the context of sepsis. In patients with pneumonia, early identification of the severity of sepsis is essential for appropriate clinical management and prognostic evaluation. This study aimed to assess the clinical utility of serum procalcitonin levels in stratifying sepsis severity in patients with pneumonia. Methods: This analytical cross-sectional study was conducted between February 2013 and March 2014 in the Emergency Department and Internal Medicine Wards of Dr. Zainoel Abidin General Hospital in Banda Aceh, Indonesia. Thirty patients diagnosed with pneumonia were enrolled in this study using quota sampling method. Serum procalcitonin levels were measured and categorized according to the severity of sepsis. Statistical analysis was performed using one-way analysis of variance (ANOVA), followed by the least significant difference (LSD) post-hoc test using the SPSS software. Statistical significance was set at P < 0.05. Results: Serum procalcitonin levels progressively increased with increasing severity of sepsis. The lowest PCT level was observed in patients with pneumonia without sepsis (0.091 ng/mL), followed by those with sepsis (0.686 ng/mL), severe sepsis (3.593 ng/mL), and septic shock (21.703 ng/mL). Significant differences in PCT levels were found across the severity groups (P < 0.05), indicating a strong relationship between elevated procalcitonin levels and worsening clinical severity. Conclusion: Serum procalcitonin levels correlate with the severity of sepsis in patients with pneumonia and may serve as a useful biomarker for sepsis severity stratification and clinical risk assessment.
Adjunctive Micronutrient Therapy in Sepsis: Associations with Inflammation and Organ Dysfunction Prima , Agus; Lubis , Bastian
Journal of Society Medicine Vol. 5 No. 1 (2026): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i1.256

Abstract

Introduction: Despite advances in supportive care, sepsis remains a major cause of morbidity and mortality among critically ill patients. Adjunctive therapies targeting inflammation and endothelial dysfunction, such as thiamine and ascorbic acid, have gained increasing attention in recent years. Matrix metalloproteinase-9 (MMP-9) and its inhibitor TIMP-1 are key biomarkers involved in inflammatory dysregulation and organ dysfunction in sepsis. Methods: This retrospective cohort study was conducted over 12 months at Haji Adam Malik General Hospital. A total of 147 adult patients with sepsis were initially enrolled and categorized into four groups: normal saline (control), thiamine, ascorbic acid, and thiamine–ascorbic acid combination therapy. Propensity score matching was applied to achieve comparable baseline characteristics, resulting in 25 patients in each group. Serum MMP-9 and TIMP-1 levels were measured at the Integrated Laboratory, Faculty of Medicine, Universitas Sumatera Utara. The clinical outcomes included incidence rates, MMP-9/TIMP-1 ratios, and Sequential Organ Failure Assessment (SOFA) scores. Results: Combination therapy did not significantly reduce the incidence rate (OR 1.19; 95% CI 0.37–3.80) or MMP-9/TIMP-1 ratio (OR 0.34; 95% CI 0.09–1.30) compared to the control. In contrast, a single administration of ascorbic acid and thiamine significantly reduced the incidence rates and improved the MMP-9/TIMP-1 balance. Combination therapy was not associated with improved SOFA scores (OR 2.66; 95% CI 0.85–8.36). Conclusion: Combined thiamine and ascorbic acid therapies did not confer any superior clinical or biomarker benefits. Single-agent thiamine or ascorbic acid therapy demonstrated favorable effects on the incidence rate, MMP-9/TIMP-1 ratio, and organ dysfunction in patients with sepsis.
Anesthetic Management of Cavernous Sinus Meningioma with Pre-existing Cranial Nerve Deficits: A Case Report Rahmadhona, Sri; Lubis , Bastian
Journal of Society Medicine Vol. 5 No. 1 (2026): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i1.257

Abstract

Cavernous sinus meningioma poses significant neuroanesthetic challenges due to its skull base location, close proximity to critical neurovascular structures, and frequent association with pre-existing cranial nerve dysfunction. Optimal perioperative anesthetic management is essential for preserving cerebral perfusion pressure, maintaining optimal intracranial dynamics, and preventing secondary brain injury during complex skull base surgery. We report the perioperative anesthetic management of a 52-year-old woman with a right cavernous sinus meningioma who presented with a five-month history of progressive headache and multiple cranial nerve deficits, including ptosis, facial hypoesthesia, and deviation of the mouth and tongue, without limb motor weakness. The patient had long-standing poorly controlled hypertension and was classified as American Society of Anesthesiologists physical status III. Preoperative assessment demonstrated stable cardiopulmonary function, anisocoria, and preserved consciousness. Magnetic resonance imaging revealed a right cavernous sinus tumor measuring 2.4 × 1.7 × 1.9 cm. The patient underwent elective craniotomy and tumor removal under general anesthesia with endotracheal intubation. A comprehensive neuroprotective anesthetic strategy was implemented, including head-up positioning, controlled ventilation to maintain normocapnia, strict hemodynamic control to preserve cerebral perfusion pressure, and goal-directed fluid and blood management. The surgical procedure lasted six hours with an estimated blood loss of 1600 mL, managed with crystalloid, colloid, and blood component therapy. Postoperatively, the patient was managed in the intensive care unit with mechanical ventilation, adequate analgesia and sedation, osmotherapy, anticonvulsant prophylaxis, and close neurological monitoring. Despite transient metabolic acidosis, the patient remained hemodynamically stable, with preserved oxygenation and neurological improvement.
In Vitro Antibacterial Activity of Curcumin and Protocatechuic Acid Against Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae Isolated from Chronic Cough Sputum Hayati, Zinatul; Iwan Tona , Azwar; Prima , Agus
Journal of Society Medicine Vol. 5 No. 1 (2026): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i1.258

Abstract

Introduction: Curcumin and protocatechuic acid are naturally occurring phenolic compounds that have been investigated for their potential antimicrobial properties. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae is a major clinical concern because of the limited therapeutic options. This study aimed to isolate and identify K. pneumoniae ESBL from the sputum of patients with chronic cough and evaluate the antibacterial effects of curcumin and protocatechuic acid. Methods: A laboratory-based experimental study was conducted using sputum specimens from 100 patients with chronic cough. Bacterial isolation and identification were performed using standard microbiological procedures, followed by the confirmation of ESBL production. The antibacterial activities of curcumin and protocatechuic acid at 25 %, 50 %, and 75% concentrations were assessed using the disc diffusion method. Statistical analyses were performed using one-way analysis of variance (ANOVA) followed by post hoc testing. Results: Nine bacterial species were identified in the sputum samples. Klebsiella pneumoniae accounted for 27.5% of isolates, of which 7.5% were confirmed as ESBL-producing strains. Curcumin, at all tested concentrations, produced inhibition zones of approximately 6 mm, with no statistically significant differences between the concentrations tested. In contrast, protocatechuic acid demonstrated concentration-dependent antibacterial activity, producing mean inhibition zones of 20.6, 16.0, and 10.8 mm at 25%, 50%, and 75% concentrations, respectively, with statistically significant differences. The antibacterial effect of 75% protocatechuic acid was comparable to that of 10 µg meropenem. Conclusion: Curcumin showed no significant antibacterial activity against ESBL-producing K. pneumoniae, while protocatechuic acid exhibited significant and concentration-dependent inhibitory effects. These findings suggest that protocatechuic acid is a potential natural antibacterial agent against ESBL-producing K. pneumoniae.
Comprehensive Intensive Care Management of Sepsis Secondary to Submandibular Abscess Complicated by Ventilator-Associated Pneumonia Vonny, Vonny; Oktaliansah, Ezra; Erlangga , M. Erias
Journal of Society Medicine Vol. 5 No. 1 (2026): January
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i1.262

Abstract

Introduction: Phlegmon is an acute, rapidly spreading, suppurative inflammation of the connective tissue characterized by diffuse involvement without clear anatomical boundaries. When it affects the floor of the mouth, particularly the submandibular and sublingual spaces, it is referred to as Ludwig’s angina, a severe deep neck infection most commonly originating from odontogenic infections of the second or third mandibular molars. Ludwig’s angina is potentially life-threatening because of the risk of sudden airway obstruction and rapid progression to serious complications, including mediastinitis, pulmonary infection, sepsis, multiorgan failure, and death. Despite advances in antimicrobial therapy and surgical source control, airway compromise and infectious complications remain major challenges. Case Description: A 35-year-old man with bilateral submandibular abscesses who underwent incision, drainage, and tracheostomy at a referring hospital. Three days postoperatively, the patient developed pneumonia with purulent discharge from the tracheostomy site. Imaging revealed the extension of the infection into the parapharyngeal and retropharyngeal spaces, requiring repeat surgical debridement. Following surgery, the patient was admitted to the intensive care unit (ICU) and required mechanical ventilation. The ICU course was complicated by right-sided pleural empyema necessitating thoracotomy with decortication and chest tube placement, as well as ventilator-associated pneumonia caused by multidrug-resistant organisms. Management involved aggressive source control, advanced airway management, broad-spectrum antimicrobial therapy, optimized nutritional support and intensive respiratory physiotherapy. Conclusion: This case underscores the complexity of managing severe Ludwig’s angina complicated by sepsis and ventilator-associated pneumonia. Early recognition, prompt surgical intervention, meticulous airway management, and comprehensive multidisciplinary intensive care are crucial for improving outcomes in patients with extensive deep neck infections and critical respiratory complications.

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