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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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Cervical Cancer with Bulky Tumor: A Case Report Hezron, Teuku Maizaldi; Hasanuddin, Hasanuddin
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.v4i5.211

Abstract

Introduction: Cervical cancer is a malignancy originating from the cervix and represents one of the most common cancers affecting women both globally and in Indonesia. Meanwhile, bulky tumor is defined as a lesion measuring ≥4 cm in diameter. Neoadjuvant chemotherapy followed by radical surgery (NACT-RS) has emerged as a viable treatment option for stages IB3 and IIA2 cervical cancer, especially in settings where radiotherapy resources are limited or unavailable. Case Report: A 28-year-old female was presented with abnormal vaginal bleeding persisting for four months. The bleeding was bright red and foul-smelling. The patient also reported postcoital bleeding beginning seven months prior to presentation. A cervical biopsy was performed, and histopathological analysis confirmed a diagnosis of non-keratinizing squamous cell carcinoma. Due to the large tumor size, the patient underwent three cycles of chemotherapy prior to radical hysterectomy as part of her treatment plan. Conclusion: In patients with bulky cervical tumors, neoadjuvant chemotherapy followed by radical hysterectomy can offer favorable perioperative outcomes and remains a critical treatment approach.
Management of Patients with Guillain-Barré Syndrome in the Intensive Care Unit Sani , Fahmi; 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.v4i5.212

Abstract

Introduction: Guillain-Barré Syndrome (GBS) is an autoimmune disorder that affects the peripheral nervous system, commonly presenting with tetraplegia with or without sensory disturbances. This condition manifests as progressive muscle weakness and areflexia, leading to respiratory muscle weakness in severe cases, which often requires mechanical ventilation. ICU complications such as nosocomial infections, hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and sepsis are commonly encountered in prolonged hospitalizations. Plasmapheresis therapy is a primary treatment option for GBS, alongside intravenous immunoglobulin (IVIG). Case Report: We report the case of a 42-year-old male patient diagnosed with GBS, who developed respiratory failure and was treated with plasmapheresis. The patient showed significant clinical improvement following three cycles of plasmapheresis, leading to earlier recovery. The patient was successfully weaned off mechanical ventilation after four days. Conclusion: GBS is an autoimmune disorder following infection, leading to nerve cell destruction. Severe muscle weakness can result in respiratory failure, necessitating mechanical ventilation therapy.
Management of Patients with Guillain-Barré Syndrome and Severe Community-Acquired Pneumonia in the Intensive Care Unit (ICU) Junaidi , Agus; Budipratama , Dhany
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.v4i5.213

Abstract

Introduction: Guillain-Barré Syndrome (GBS) is an immune-mediated polyneuropathy that leads to respiratory failure requiring mechanical ventilation. The neurological deficits in GBS, including airway obstruction, ineffective coughing, and difficulty swallowing, increase pneumonia risk, which worsens patient condition. Community-Acquired Pneumonia (CAP) is a lung infection contracted outside hospitals, and its severity relates to mortality. Appropriate antibiotic therapy is crucial for reducing treatment duration and mortality. Case Report: We report a case of a 20-year-old male who developed respiratory failure due to GBS complicated by severe CAP. The patient was admitted to the ICU, where he received plasmapheresis for GBS treatment, which led to gradual improvement. Due to respiratory failure, the patient required mechanical ventilation. Empirical antibiotic therapy was initiated, considering the severity of CAP and the potential for bacterial resistance. After 13 days of intensive care, the patient was successfully weaned off mechanical ventilation. Conclusion: This case highlights the importance of a timely and comprehensive approach to treating GBS and CAP in the ICU. Plasmapheresis for GBS and appropriate antibiotic therapy for CAP were key in the patient’s recovery. Early intervention and appropriate supportive care, including mechanical ventilation when necessary, are essential for improving patient outcomes. Further studies and refined treatment protocols are needed to optimize care for patients with complex conditions like GBS complicated by CAP.
Dandy Walker Malformation Prenatal Diagnosis and Postnatal Outcome in Multigravida: A rare Case Mustaqin, Mustaqin; Utami, Niken Asri; Dewi, Tgk. Puspa; Fandika, Bayu Azizka Putra
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.214

Abstract

Introduction: Dandy Walker malformation (DWM) is a rare congenital anomaly characterized by cerebellar vermis hypoplasia, posterior fossa expansion, and fourth ventricle enlargement, often associated with hydrocephalus and chromosomal abnormalities like Trisomy 18 (Edwards syndrome). This case report describes the prenatal diagnosis and postnatal outcome of DWM in a multigravida patient. Case: A 43-year-old multigravida woman at 29–30 weeks’ gestation presented to Dr. Zainoel Abidin General Hospital with suspected fetal anomalies. Obstetric examination revealed a transverse fundal height of 23 cm, estimated fetal weight of 1,500 grams, fetal heart rate of 140 beats/min, and maternal hypertension (160/90 mmHg). Ultrasound identified DWM (absent cerebellar vermis, enlarged fourth ventricle), bilateral hydronephrosis, and undescended testes. The patient had a history of poorly controlled hypertension and reported owning a cat for one year but denied alcohol or smoking. Following counseling, pregnancy termination was performed, resulting in the delivery of a 1,400-gram male infant (length: 36 cm, Apgar score: 4–5). Postnatal phenotypic examination revealed undescended testes, low-set ears, overlapping digits, respiratory distress, small stature, and hypotonia. Karyotyping confirmed Trisomy 18. Conclusion: This case underscores the importance of prenatal ultrasound in detecting DWM and associated anomalies, enabling informed decision-making. The coexistence of DWM and Trisomy 18 highlights the need for genetic testing in such cases. Despite termination, the poor postnatal outcome reflects the severe prognosis of Trisomy 18. This report contributes to the limited literature on DWM in multigravida patients.
Patch Test Analysis of Channa Striata Extract Biopolymer Dalimunthe, Dina A; Lubis, Flora Marita; Hazlianda, Cut Putri; Sinaga, Riana Miranda; Dhillon, Jesryn; Hutagalung, Patricia; Berlian, Guntur
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.217

Abstract

Introduction: Wound healing involves complex interactions between cells and mediators that occur immediately after the wound occurs and depends on nutritional factors and wound closure. Snakehead murrel fish (Channa striata) extract has been extensively researched to speed up the wound healing process because of its high amino acid content. Patch tests were carried out to assess the allergen potential of the Channa striata extract biopolymer in the form of wound dressings. Methods: Experimental study of 40 subjects who had admit patch test with various consentration of Channa striata extract biopolymer. The patch test materials divided of 5 grups. They were aquadest solution, Eucheuma cottonii biopolymer, Channa striata extract biopolymer concentrations of 5.4 g/mL, 10.8 g/mL, and 21.6 g/mL. All subjects had been assessed for skin reactions that occured after 48 hours, 72 hours, and 96 hours. Results: A total of 40 subjects met the inclusion criteria and completed informed consent.  There was minimum allergen reaction (+) in slight subject in all grups except aquadest grup after 48 hours. The allergic reaction dissolve in 72 and 96 hours. An irritant reaction (IR) occurred in among all grups but indicated to the  hypafix plaster. Conclusion: Patch test containing biopolymer Channa striata extract showed a minimal allergic reaction
The Relationship Between Elevated Systemic Immune-Inflammatory Index (SII) and the Severity of Coronary Lesions in Chronic Coronary Syndrome (CCS) Patients Undergoing Coronary Angiography at Haji Adam Malik Hospital Medan Fatraya, Qien Jovan; Safri , Zainal; Lubis , Anggia Chairuddin
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.219

Abstract

Introduction: This study examines the correlation between Systemic Immune Inflammation Index (SII) and coronary lesion severity in Chronic Coronary Syndrome (CCS) patients using the SYNTAX score. Inflammatory markers, including neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR), are associated with atherosclerosis and CAD. Methods: This retrospective observational study analyzed correlation between SII values and coronary lesion severity in CCS patients who underwent coronary angiography. Data were collected between June and August 2024. Patients were categorized based on the SYNTAX score, which evaluates coronary lesion severity. The study used statistical tests including mean tests, multivariate logistic regression, Spearman correlation, and ROC curve analysis to assess SII's sensitivity and specificity in predicting lesion severity. A p-value <0.05 was considered significant. Results: The study subjects were 115 samples with an average age of 59.41 ± 9.45, with 78 male samples (67,8%). It was found that the SII value has a strong correlation with the SYNTAX score, specifically with a mild SYNTAX score of 365.7 (183.45 - 853.91), a moderate SYNTAX score of 695.52 (534.83 - 1838.57), and a severe SYNTAX score of 1026.7 (413.57 - 3813.83; p value <0.001). Conclusion: The study found a significant relationship between SII value and coronary lesion severity, measured by SYNTAX score. Higher SII values were associated with more severe coronary lesions, suggesting SII can serve as an effective predictor of lesion severity in CCS patients.
The Left Atrioventricular Coupling Index as a Predictor of Major Cardiovascular Events in Chronic Heart Failure Patients at Adam Malik Hospital Medan Alfuadi , Rifki Mirza; Lubis , Anggia Chairuddin; Ade Putra , Yuke Sarastri-Hilfan
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.220

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.
Relationship between Coronary Artery Calcium Score (CACS) and Diastolic Dysfunction in Patients with Stable Coronary Heart Disease at Adam Malik General Hospital Medan Putra, Muhammad Hafiz Mahruzza; Hasan, Refli; Sitepu, Andika; Hasan, Harris; Ketaren, Andre Pasha; Andra, Cut Aryfa; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi
Journal of Society Medicine Vol. 4 No. 6 (2025): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i6.221

Abstract

Introduction: Coronary artery calcium score (CACS) is a specific indicator of coronary atherosclerosis that plays a role in assessing the degree of calcification in atherosclerosis. Diastolic function is the first aspect of cardiac function to be impaired in ischemic heart disease. This study aims to determine the relationship between calcium scoring and diastolic dysfunction. Methods: This analytical observational study with cross-sectional design evaluated the relationship between coronary artery calcium score (CACS) and left ventricular diastolic function in patients with stable CAD. Data were collected retrospectively from medical records at RSUP H. Adam Malik Medan during Nov 2023-Nov 2024. CACS was assessed using coronary CT scan, while left ventricular diastolic function was measured by echocardiography. Data analysis used chi-square test, Mann-Whitney U test, and ROC curve analysis to evaluate CACS threshold in predicting diastolic dysfunction. Results: Among 158 analyzed samples, 113 patients had diastolic dysfunction. A calcium score ≥100 was found in 46.2% of patients, showing 1.318 times higher risk of diastolic dysfunction versus those with scores <100 (p = 0.006; 95% CI 1.083–1.605). ROC analysis showed CACS had moderate predictive ability for diastolic dysfunction with AUC of 0.647 (p = 0.004). A calcium score threshold of 45 had 65.5% sensitivity and 62.2% specificity in detecting diastolic dysfunction. Type 2 diabetes mellitus, urea, and creatinine levels were also significantly associated with diastolic dysfunction (p < 0.05). Conclusion: Calcium score shows a significant relationship with diastolic dysfunction in stable CAD patients and can predict diastolic dysfunction in patients undergoing coronary CT scan.
Management of Acute Hypercapnic Respiratory Failure (AHRF) in Patients with Obesity Hypoventilation Syndrome (OHS) in the Intensive Care Unit (ICU) Ningsih, Diana Fitria; Indriasari, Indriasari
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.222

Abstract

Introduction: Acute hypercapnic respiratory failure (AHRF) in patients with obesity hypoventilation syndrome (OHS) presents significant challenges in the intensive care unit (ICU), particularly when complicated by comorbidities such as community-acquired pneumonia and heart failure. Effective management requires a tailored approach addressing altered lung mechanics, infection control, and fluid balance. This case report highlights the multidisciplinary management of AHRF in a complex clinical scenario. Case Description: A 35-year-old female with OHS presented with progressive dyspnea for one month, worsening over the last two days. Initial assessment revealed type II respiratory failure with a pCO2 of 89 mmHg. Management included intubation and mechanical ventilation, initially with pressure control-assist control (PC-AC) mode, gradually transitioned to pressure support ventilation (PSV). Empirical antibiotics were administered, later adjusted based on sputum culture results. Fluid management involved furosemide to address concurrent heart failure. Adequate positive end-expiratory pressure (PEEP) was crucial to optimize lung mechanics. Despite an initial failed extubation, the patient was successfully extubated on day 7 with high-flow nasal cannula support and subsequently transferred to a step-down unit with nasal cannula oxygen therapy. Conclusion: This case underscores the importance of a multidisciplinary approach and dynamic therapy adjustments based on clinical response in managing AHRF in OHS patients with complex comorbidities. Early broad-spectrum antibiotics, careful fluid management, and gradual weaning from mechanical ventilation are critical for successful outcomes.
Management of Acute Respiratory Distress Syndrome Due to Transfusion-Related Acute Lung Injury and Pulmonary Contusion in a Patient with Moderate Head Injury Post-Craniotomy Decompression, Epidural Hematoma, and Posterolateral Rib Fractures 2-6 Hendro, Rachmad Try; Pison, Osmond Muftilov
Journal of Society Medicine Vol. 4 No. 7 (2025): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i7.223

Abstract

Introduction: Acute Respiratory Distress Syndrome (ARDS) is characterized by acute onset within seven days of an insult, leading to impaired gas exchange, respiratory distress not attributed to cardiac pump dysfunction, and diffuse bilateral opacities on chest X-ray (CXR). ARDS can result from direct lung parenchymal injury, such as pulmonary contusion, or indirect mechanisms, such as transfusion-related acute lung injury (TRALI), which triggers inflammatory mediator release, causing capillary leakage and damage to type I and II pneumocytes. Case Description: A 50-year-old male was admitted to the Intensive Care Unit (ICU) following a craniotomy evacuation. On the second day of ICU care, after receiving four units of packed red cell (PRC) transfusion and subsequent extubation, the patient developed dyspnea, increased respiratory rate, elevated work of breathing, and desaturation. Clinical examination revealed decreased consciousness, tachycardia, tachypnea, and desaturation. Diagnostic imaging showed diffuse bilateral opacities without cardiac abnormalities. The patient was re-intubated and connected to a ventilator using a lung protective strategy. Broad-spectrum antibiotics and adequate tissue perfusion support were administered. The patient showed improvement and was discharged from the ICU. Conclusion: ARDS, whether caused by direct insults like pulmonary contusion or indirect mechanisms like TRALI, requires a lung protective strategy to preserve healthy lung tissue. Early recognition and appropriate ventilatory management are critical for improving outcomes in such cases.

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