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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 210 Documents
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The Relationship Between Low-Density Lipoprotein Cholesterol and Coronary Artery Calcium Score in Patients with Chronic Coronary Syndrome Without Diabetes Mellitus at RSUP Haji Adam Malik Medan Muslim, Suci Asriri Pradina; Lubis , Hilfan Ade Putra; Nasution , Ali Nafiah
Journal of Society Medicine Vol. 4 No. 3 (2025): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.203

Abstract

Introduction: Chronic Coronary Syndrome (CCS) is the most common symptom of ischemic heart disease and is a major cause of morbidity and mortality worldwide. One of the associated risk factors for coronary heart disease events is Low Density Lipoprotein Cholesterol (LDL-C) through the process of atherosclerosis. Computed Tomography Coronary Artery (CTCA) is an examination that can be performed to assess atherosclerotic plaques and Coronary Artery Calcium Score (CAC Score). This study was conducted to assess the relationship between LDL and CAC Score in CCS patients. Methods: This study is an observational analytical study involving 300 patients diagnosed with CCS during the period from March 1, 2023, to March 31, 2024, at RSUP H. Adam Malik Medan. All involved patients underwent LDL examination and CTCA examination as well as CAC Score measurement. Patient characteristics, disease history, and risk factors were also recorded. Results: There was a significant relationship between LDL levels and CAC Score (P value: 0.008; OR: 1.91 (CI: 1.184-3.1). Among the patient characteristics in this study, the strongest protective factor was female gender (P value: <0.01; OR: 0.228 (CI: 0.119-0.437)), and the strongest risk factor was patients with hypertension (P value: 0.017; OR: 1.97 (CI: 1.119-3.484). Conclusion: LDL can increase CAC Score in CCS patients.
The TIMI Risk Index as a Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention at Haji Adam Malik Hospital Medan Purba, Antonius Leonardo; Hasan, Refli; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.204

Abstract

Introduction: ST-segment elevation myocardial infarction (STEMI) is a severe cardiovascular condition requiring urgent treatment through Primary Percutaneous Coronary Intervention (PPCI). However, PPCI increases the risk of Contrast-Induced Nephropathy (CIN), a condition characterized by a significant rise in serum creatinine levels. To minimize the risk of CIN, identifying patients at high risk is essential. This study evaluates the TIMI Risk Index (TRI) as a predictor of CIN in STEMI patients undergoing PPCI at Haji Adam Malik Hospital, Medan. Methods: This observational analytical study employed a cross-sectional design, focusing on STEMI patients with symptoms lasting less than 12 hours who underwent PPCI between January 2023 and December 2024. Participants were selected according to inclusion and exclusion criteria. Bivariate analysis was used, with the chi-square test for normally distributed data and the Fisher exact test for non-normally distributed data, with a significance level of p < 0.05. Results: The results indicated that TRI effectively predicted CIN occurrence, with a p-value of 0.0001, an area under the curve (AUC) of 0.834, and a 95% confidence interval (CI) of 0.752–0.916. A TRI cut-off score of 23.47 demonstrated a sensitivity of 77.3%, specificity of 77%, a positive predictive value (PPV) of 47.05%, and a negative predictive value (NPV) of 91.8%. Conclusion: In conclusion, the TRI with a cut-off score of 23.47 is a reliable tool for predicting CIN in STEMI patients undergoing PPCI, offering high sensitivity, specificity, and NPV, which can help improve clinical outcomes by identifying at-risk patients.
The Relationship Between Platelet and Lymphocyte Ratios and Left Atrial Thrombus Formation in Patients with Severe Mitral Stenosis due to Rheumatic Heart Disease at Haji Adam Malik Hospital Medan Ramzi, Defriyan; Hasan, Harris; Raynaldo, Abdul Halim
Journal of Society Medicine Vol. 4 No. 3 (2025): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i3.205

Abstract

Introduction: Rheumatic heart disease is an immune disease condition that often causes damage to the structure of the heart valves, such as mitral stenosis. One of the complications of severe mitral stenosis is thrombus in the left atrium. This condition is closely related to inflammation, so inflammatory cells such as lymphocytes and platelets are closely related to their severity and complications. Therefore, this study aims to see the ability of mitral platelet and lymphocyte ratios to the incidence of left atrial thrombus. Methods: This study is an analytical descriptive study with a cross-sectional research design, conducted at the Integrated Heart Center of Haji Adam Malik Hospital, from November 2024. The parameters of echocardiography, blood laboratory, as well as thrombus in the left atrium data were acquired. A statistical analysis test will be was done to assess the difference in the average ratio of platelets and lymphocytes based on the presence of thrombus in the left atrium, as well as the ability of the predictor of the ratio. Statistical analysis was carried out using SPSS software, a P value of < 0.05 was considered significant. Results: There are a total of 175 samples in this study. A total of 45 (25.7%) of the sample had thrombus in the left atrium. The median value and interquartile range of the Platelet/Lymphocyte Ratio (PLR) were higher in the thrombus group in the left atrium compared to the group without thrombus in the left atrium (P = 0.0001). The ROC curve analysis showed PLR parameters, with P = 0.0001, AUC 0.713, and 95% CI 0.620 – 0.806. The threshold value of PLR 132.5 has a sensitivity of 71.1% and a specificity of 61.0% has the ability to predict the presence of thrombus in the left atrium. Conclusion: The PLR ratio has a significant association with the occurrence of thrombus in the left atrium, in the condition of severe mitral stenosis due to rheumatic heart disease
The Effect of Providing Digital Education Through Smartphone Applications on Control Level of Asthma Patients at Outpatient Clinic University of North Sumatra Hospital Medan Pohan, Indah Triana Sari; Tarigan, Amira Permatasari; Pandiaman, Pandia; Erna, Mutiara
Journal of Society Medicine Vol. 4 No. 4 (2025): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.199

Abstract

Introduction: Asthma is a chronic airway disease where achieving and maintaining asthma control is the main goal of management. Effective asthma control requires good patient self-management, including the ability to recognize symptoms and take appropriate action. This study aimed to assess the effect of digital education through the Paru Sehat smartphone application on asthma control levels in patients at the Outpatient Clinic of the University of North Sumatra Hospital, Medan. Method:This study used a quasi-experimental within-subject (pre-post) design. Asthma control levels were measured using the Asthma Control Test (ACT) before and after the use of the Paru Sehat application. Data analysis was conducted using a paired t-test for normally distributed data and the Wilcoxon test for non-normal data. A p-value <0.05 was considered statistically significant. Results: Before the intervention, 56% of patients had partially controlled asthma, 40% were uncontrolled, and only 4% were fully controlled. After using the Paru Sehat application, the proportion of fully controlled patients increased to 20%, partially controlled decreased to 48%, and uncontrolled cases reduced to 32%. However, this improvement was not statistically significant (p = 0.058). Conclusion: The use of the Paru Sehat application showed a trend toward improved asthma control, but the change was not statistically significant. Further research with a larger sample size and longer intervention duration may be needed to determine its effectiveness.
Comparison of C2HEST and MC2HEST Scores as Predictors of New-Onset Atrial Fibrillation in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention at Haji Adam Malik Hospital Medan Hanifah, Putri Vidya; Nasution , Ali Nafiah; Putra , Hilfan Ade
Journal of Society Medicine Vol. 4 No. 4 (2025): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.201

Abstract

Introduction: To evaluate whether the C2HEST and mC2HEST scores have good ability as predictors of new-onset atrial fibrillation in patients with acute coronary syndrome undergoing percutaneous coronary intervention at HAM Hospital Medan. Method: This study is a retrospective cohort study. Retrospective data were collected by total sampling from all medical records of ACS patients at Adam Malik Hospital from January to September 2024. Prospective data were collected consecutively until the minimum sample size was met. Samples included in the research analysis were those that met the inclusion criteria without exclusion criteria. Results: As a predictive method, the mC2HEST score is as good as the C2HEST score, with AUCs of 0.713 and 0.728, respectively. The cut-off point obtained is the same for both scores, which is >3. The C2HEST score has a sensitivity of 73.7%, specificity of 52.6%, while the mC2HEST score has a sensitivity of 78.9%, specificity of 55.1%. The total number of samples that met the criteria was 108 patients. Patients with new-onset atrial fibrillation numbered 19 (17.6%). The youngest patient was 30 years old and the oldest was 81 years old. The average age in patients with new-onset atrial fibrillation was 67 years and without new-onset atrial fibrillation was 57 years. This study also yielded a new scoring system as an alternative predictive method. Conclusion: The mC2HEST score is as good as the C2HEST score as a predictor of new-onset atrial fibrillation in patients with acute coronary syndrome undergoing percutaneous coronary intervention at HAM Hospital Medan.
Relationship Between D-Dimer Levels and Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Deep Vein Thrombosis Patients Lubis, Maisyarah Farhati; Heny Syahrini Lubis; Gatot , Dairion
Journal of Society Medicine Vol. 4 No. 4 (2025): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.202

Abstract

Introduction: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is associated with activation of coagulation and inflammation. In DVT, the coagulation process is often accelerated by inflammatory mediators, causing fibrinolytic disruption and increasing D-dimer levels. D-dimer testing, with its high negative predictive value, is commonly used as a screening tool for thromboembolic events. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inflammatory markers that can be easily calculated from routine blood tests and may assist in the early detection of DVT. This study aims to evaluate the relationship between D-dimer levels and both NLR and PLR in DVT patients at Adam Malik Hospital. Method: This analytical observational study used a cross-sectional design. Secondary data were collected from medical records of DVT patients treated at Adam Malik Hospital between June 2022 and June 2024. NLR and PLR were the independent variables, while D-dimer level was the dependent variable. Data were analyzed using Spearman’s rho correlation test. Results: Among 100 patients, 38% were aged over 59 years, with equal gender distribution. The most common comorbidity was infection (71%), and 62% had hospital stays longer than 7 days. A significant positive correlation was found between D-dimer levels and NLR (p = 0.001, r = +0.350). However, there was no significant correlation between D-dimer levels and PLR (p = 0.610, r = –0.052). Conclusion: There is a significant association between D-dimer levels and NLR, but no significant relationship between D-dimer levels and PLR in DVT patients.
Factors Related to Obstructive Sleep Apnea in Patients with Heart Failure and Atrial Fibrillation Masyab, Nadiah; Lubis , Anggia Chairuddin; Raynaldo , Abdul Halim
Journal of Society Medicine Vol. 4 No. 4 (2025): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.207

Abstract

Introduction: Obstructive sleep apnea (OSA) causes cardiovascular disturbances due to intermittent hypoxia, oxidative stress, systemic inflammation, excessive negative intrathoracic pressure, sympathetic activation, and increased blood pressure. These factors can impair myocardial contractility, leading to the development of heart failure and atrial fibrillation (AF). Epidemiological studies have shown a significant independent association between OSA, heart failure, and AF. This study aims to identify factors associated with obstructive sleep apnea (OSA) in patients with heart failure accompanied by atrial fibrillation. Method: This study was conducted on patients diagnosed with heart failure and atrial fibrillation hospitalized at the Integrated Heart Center of Adam Malik Hospital. Data collection began in August 2023 and continued until the required sample size was reached. This is an observational analytic study with a cross-sectional design. Results: A total of 51 patients participated in this study. The majority of respondents were male (66.7%), with most being aged between 60-69 years. The study found that the degree of OSA in heart failure patients with AF was predominantly mild (30.8%), followed by moderate (25.0%) and severe (17.3%). The average AHI value was 16.78 with a standard deviation of 14.359. Multivariate analysis identified two significant variables: smoking history and functional capacity (NYHA Class) (p > 0.05). Conclusion: A significant association was found between gender and smoking history with the occurrence of OSA in patients with heart failure and atrial fibrillation. The multivariate analysis also highlighted the significance of smoking history and functional capacity (NYHA Class) (p > 0.05).
Breastfeeding and Its Protective Role Against Breast Cancer: A Meta-Analysis of Surgical and Non-Surgical Cases Murti, Krina; Juliandra , Windy; Tua, Sampe
Journal of Society Medicine Vol. 4 No. 4 (2025): April
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i4.208

Abstract

Introduction: Breast cancer is a leading cause of morbidity and mortality among women worldwide. Epidemiological studies have suggested that breastfeeding may reduce the risk of breast cancer, but evidence has been inconsistent. This meta-analysis aims to evaluate the association between breastfeeding and breast cancer risk, focusing on the effect of breastfeeding duration and menopausal status at the time of diagnosis. Methods: We conducted a systematic review of case-control and cohort studies published between 2020 and 2025 that assessed the relationship between breastfeeding and breast cancer risk. Studies were included if they provided data on breastfeeding history and its association with breast cancer risk, and if odds ratios (ORs) with 95% confidence intervals (CIs) were available or could be derived. Statistical analysis was performed using fixed and random-effect models to calculate pooled ORs, and subgroup analyses were conducted based on menopausal status and breastfeeding duration. Results: The meta-analysis included 10 studies with a total of 18,000 participants. The pooled OR for the association between ever breastfeeding and reduced breast cancer risk was 0.87 (95% CI: 0.80–0.94), indicating a modest reduction in risk. The protective effect was more pronounced in pre-menopausal women (OR = 0.75, 95% CI: 0.67–0.84), while the effect in post-menopausal women was less significant (OR = 0.95, 95% CI: 0.88–1.03). Duration of breastfeeding was associated with a non-linear reduction in breast cancer risk, with the greatest reduction observed in women who breastfed for 6 to 12 months (OR = 0.75, 95% CI: 0.64–0.87). Conclusion: This meta-analysis supports the hypothesis that breastfeeding is associated with a modest reduction in breast cancer risk, particularly for pre-menopausal women and those who breastfed for longer durations. Although the effect size is small compared to other established risk factors, breastfeeding remains an important modifiable risk factor for breast cancer prevention. Further research is needed to clarify the mechanisms underlying this association and to determine whether breastfeeding duration has a cumulative effect beyond 12 months.
Management of Autoimmune Encephalitis with Refractory Status Epilepticus Saputra, Rangga; Oktaliansah, Ezra
Journal of Society Medicine Vol. 4 No. 5 (2025): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i5.209

Abstract

Introduction: Autoimmune encephalitis (AE) is a leading cause of non-infectious encephalitis. Its diagnosis remains challenging due to the often non-specific clinical presentation and difficulties in confirming antibody-negative cases. Comprehensive evaluation is essential to establish the diagnosis of AE. Case Report: We report a 25-year-old male presenting with decreased consciousness and seizures, accompanied by behavioral changes over the preceding 10 days. Electroencephalography (EEG) showed normal waveforms, and cerebrospinal fluid (CSF) analysis did not suggest infection. Brain CT scans were unremarkable, and serologic tests for herpes simplex virus (HSV) IgG and IgM were non-reactive. Notably, anti-NMDAR antibodies were positive. The patient was managed in the ICU with mechanical ventilation, sedated with propofol, and administered phenytoin for seizure control. Empirical treatment with acyclovir was given for 10 days, with no clinical improvement. First-line immunotherapy with methylprednisolone (1g/day for 5 days) was initiated but failed to produce neurological recovery. On day 14, CSF analysis indicated autoimmune etiology; plasma exchange was performed over three days, resulting in clinical improvement. Conclusion: Diagnosing and managing antibody-negative AE remains challenging. Clinical judgment, supported by the exclusion of differential diagnoses and the absence of characteristic radiological and immunological findings, can justify the initiation of immunosuppressive therapy or plasma exchange, which may lead to significant clinical improvement.
Management of Acute Pulmonary Edema in Kidney Transplant Patients in the ICU Ginting, Muhammad Aldi Rivai Ginting; Suwarman, Suwarman
Journal of Society Medicine Vol. 4 No. 5 (2025): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i5.210

Abstract

Introduction: Kidney transplantation is the standard treatment for end-stage renal disease (ESRD), significantly improving survival rates and quality of life. However, pulmonary complications are a leading cause of morbidity and mortality post-transplant. Case Report: This case report presents a 50-year-old male with chronic kidney disease (CKD), diagnosed five months prior and undergoing regular hemodialysis. He had a history of hypertension and diabetes mellitus. The patient underwent a 9-hour kidney transplant surgery without complications. Post-operatively, urine output was minimal (5 mL), prompting vasopressor support to elevate the mean arterial pressure above 150 mmHg, which improved renal function. On days one and two post-surgery, the patient developed respiratory distress, with a chest X-ray revealing pulmonary edema. Continuous furosemide infusion was initiated to manage fluid overload, leading to improvement in the patient’s respiratory status. By day four, the patient was stable and transferred from the ICU to a regular room. Pulmonary complications, including pulmonary edema, affect up to 80% of kidney transplant recipients in the first year post-transplant and contribute to high morbidity and mortality. Conclusion: This case emphasizes the importance of early recognition and management of pulmonary edema through fluid management and vasopressors. Timely intervention, including diuretic therapy, is crucial for stabilizing kidney transplant recipients and improving patient outcomes. The report highlights the need for further research to establish evidence-based guidelines for fluid management in kidney transplant patients. Effective management is essential for enhancing post-operative recovery and quality of life in transplant recipients.

Page 16 of 21 | Total Record : 210

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