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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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Management of a P3A0 Postpartum Patient with Peripartum Cardiomyopathy (PPCM), Acute Decompensated Heart Failure (ADHF), Respiratory Failure Due to Acute Pulmonary Edema, and Community-Acquired Pneumonia (CAP) in the ICU Sulistiono, Paulus; Budipratama, Dhany
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.v4i7.224

Abstract

Introduction: Acute dyspnea following pregnancy is a rare condition often accompanied by significant comorbidities. Potential causes include pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration, pulmonary edema, and other critical conditions. Pulmonary edema, in particular, may occur during pregnancy or the postpartum period, associated with preeclampsia, peripartum cardiomyopathy (PPCM), pre-existing cardiac disease, tocolytic therapy, or fluid overload. This case report highlights a complex clinical scenario involving these factors. Case Description: We present the case of a 36-year-old woman, P4A0, who developed progressive acute dyspnea six days postpartum following a normal delivery. Her condition rapidly progressed to respiratory failure, necessitating admission to the intensive care unit (ICU) and mechanical ventilation. Physical examination and diagnostic workup revealed acute pulmonary edema secondary to peripartum cardiomyopathy, complicated by acute decompensated heart failure (ADHF) and community-acquired pneumonia (CAP). Following tailored medical therapy, the patient’s condition improved, and she was discharged from the ICU on the fifth day in a stable condition. Conclusion: This case underscores the importance of early recognition and multidisciplinary management of acute dyspnea in the postpartum period, particularly when linked to PPCM, ADHF, and CAP. Timely intervention with mechanical ventilation and targeted therapy can lead to favorable outcomes, emphasizing the need for heightened awareness among clinicians managing postpartum patients.
Management of a Critically Ill Post-Cesarean Section Patient with Antepartum Hemorrhage Due to Placenta Previa Totalis in a G2P1A0 at 27–28 Weeks Gestation with Severe Preeclampsia, HELLP Syndrome, Pulmonary Edema, Stage 2 Acute Kidney Injury, and Hypoalbuminemia Bernadeth, Bernadeth; Erlangga, Muchammad Erias
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.v4i7.225

Abstract

Introduction: Massive antepartum hemorrhage in pregnancy, particularly due to placenta previa totalis, poses life-threatening risks requiring intensive care unit (ICU) management. The ROSE (Resuscitation, Optimization, Stabilization, Evacuation) approach is critical in managing critically ill patients with massive bleeding, emphasizing fluid resuscitation, massive transfusion protocols, and coagulopathy management. This case report highlights the complex management of a patient with placenta previa totalis, severe preeclampsia, and HELLP syndrome, complicated by pulmonary edema, acute kidney injury (AKI), and hypoalbuminemia. Case Description: A 35-year-old woman, G2P1A0 at 27–28 weeks gestation, was admitted to the ICU following an emergency cesarean section due to antepartum hemorrhage from placenta previa totalis. She presented with hemorrhagic shock and severe preeclampsia complicated by HELLP syndrome. Initial resuscitation at a referring facility included 2000 cc Ringer’s lactate and 500 cc 0.9% NaCl. In the hospital, damage control surgery and massive transfusion (packed red blood cells, fresh frozen plasma, and platelets) were performed. Postoperatively, the patient required mechanical ventilation and vasopressor support in the ICU. On day 1, she developed volume overload, pulmonary edema, stage 2 AKI, and hypoalbuminemia, managed with furosemide. Extubation was achieved on day 3, and she was transferred to the high-care unit on day 4. Conclusion: In pregnant patients with trauma and massive hemorrhage, early diagnosis, damage control surgery, and appropriate massive transfusion management are critical interventions required to save the patient's life.
Management of Sepsis Patients Due to Community-Acquired Pneumonia in the Intensive Care Unit Ardiayuman , Ardiayuman; Budipratama, Dhany
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.v4i7.226

Abstract

Introduction: Sepsis, a life-threatening response to infection, remains a critical global health issue, often triggered by community-acquired pneumonia (CAP) in vulnerable populations such as the elderly. This condition frequently requires intensive care unit (ICU) admission, necessitating adherence to evidence-based guidelines like the 2021 Surviving Sepsis Campaign (SSC) and Infectious Diseases Society of America (IDSA) recommendations. This case report highlights the application of these protocols in managing a complex sepsis case, emphasizing the role of early intervention and multidisciplinary care in improving outcomes.  Case Description: A 67-year-old male, Mr. U, presented with a 3-day history of dyspnea and 1-day history of altered consciousness. Initial assessment revealed respiratory distress (respiratory rate 32/min, oxygen saturation 88% on room air, Glasgow Coma Scale 10), with chest radiography confirming CAP. Laboratory results showed a lactate level of 4.2 mmol/L and leukocytosis (18,000/mm³), indicating sepsis. In the ICU, the patient received oxygen therapy, followed by intubation due to worsening respiratory failure. Blood cultures were obtained, and empirical antibiotics (meropenem) were initiated within 1 hour per SSC guidelines. Fluid resuscitation (30 mL/kg crystalloids) and norepinephrine were administered for persistent hypotension. Bronchoscopy revealed purulent secretions, aiding diagnosis and management. After 5 days of ventilatory support and adjusted antibiotics, the patient stabilized and was transferred to a general ward.  Conclusion: This case illustrates successful sepsis management due to CAP using SSC 2021 and IDSA guidelines. The integration of early antibiotics, fluid resuscitation, vasopressors, ventilation, and bronchoscopy underscores the efficacy of a multidisciplinary approach. Timely intervention in the ICU significantly improved survival and recovery, highlighting the need for further research to optimize protocols for such critical cases. 
Esophageal Varices in Pregnancy Secondary to Hepatic Cirrhosis: A Case Report Royda D, Syerli; Indirayani, Ima; Roziana, Roziana
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.218

Abstract

Introduction: Pregnancy complicated by liver disease is a rare but clinically challenging condition. Portal hypertension is one such liver disease that may occur in pregnant women, primarily caused by cirrhosis. Esophageal varices, a manifestation of portal hypertension, carry significant maternal and fetal mortality risks. Case Description: We present the case of a 22-year-old woman referred from the Internal Medicine-Gastroenterology Department with a diagnosis of grade IV esophageal varices and grade IV gastric fundal varices. At the initial referral to the Obstetrics and Gynecology clinic, her pregnancy was estimated at 5–6 weeks gestation. Despite the high morbidity and rarity of this case, the patient maintained the pregnancy until 34–35 weeks of gestation. She had a two-year history of esophageal varices, with previous hospitalizations for melena and hematemesis. Fetomaternal ultrasound revealed a singleton fetus in cephalic presentation, consistent with 34–35 weeks of gestation, with suspected intrauterine growth restriction (IUGR). Abdominal ultrasound suggested hepatic cirrhosis, and endoscopic evaluation confirmed grade IV esophageal and gastric fundal varices. Termination of pregnancy was performed via abdominal delivery. Conclusion: Preventing pregnancy complications, accurate diagnosis, and meticulous management that balances maternal and fetal risks are crucial in such cases to improve outcomes.
Triglyceride/High-Density Lipoprotein Ratio as a Predictor of Major Cardiovascular Events Within 6 Months Post-Treatment in Patients with Acute Myocardial Infarction and Type 2 Diabetes Mellitus at Haji Adam Malik General Hospital, Medan Taufik, Yasdika Imam; Hasan, Refli; Akbar, Nizam Zikri
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.227

Abstract

Introduction: Cardiovascular disease (CVD) remains the leading global cause of death, with coronary artery disease (CAD) and stroke contributing to 15 million deaths in 2016. Type 2 diabetes mellitus (DM) increases the risk of complex CAD, characterized by diffuse, calcified, and multivessel lesions. While the triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio is a potential independent predictor of CVD, its prognostic value for mortality in diabetic CAD patients undergoing statin therapy remains unclear. This study aimed to analyze the association between the TG/HDL-C ratio and cardiovascular and all-cause mortality in this population. Methods: This cross-sectional analytical study examined the relationship between the TG/HDL-C ratio and major cardiovascular events in non-ST-elevation acute coronary syndrome (NSTE-ACS) patients with type 2 DM receiving statin therapy. Data were collected through clinical observation and medical records. Statistical analysis utilized the Chi-square or Fisher’s Exact test to assess associations, with statistical significance defined as p <0.05. Results: The study included 72 patients (72.2% male; mean age 58.6±8.5 years) with type 2 DM (mean duration 10.5±3.9 years) and acute coronary syndrome (61.1% NSTEMI). Among participants, 61.1% were smokers, 48.6% had hypertension, and lipid profiles revealed 100% hypertriglyceridemia, 87.5% elevated LDL, and 33.3% low HDL. A high TG/HDL ratio was observed in 72.2% of subjects and was significantly associated with major adverse cardiovascular events (OR=3.32; p=0.025), indicating a 3.32-fold higher risk in the high TG/HDL ratio group. Conclusion: The TG/HDL-C ratio can serve as an effective parameter for estimating the risk of MACE in ACS patients with T2DM.
Determinants of Frailty Status in Elderly Patients with Permanent Pacemakers at Adam Malik Hospital, Medan Irawan, Raja Alfian; Ariestine, Dina Aprilia; Lubis, Anggia Chairuddin; Sungkar, Taufik; Nasution, Melati Silvanni
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.229

Abstract

Introduction: Frailty is highly prevalent among elderly patients following permanent pacemaker implantation, with rates exceeding 70%. The Comprehensive Geriatric Assessment (CGA) evaluates frailty through domains such as nutrition (Mini Nutritional Assessment, MNA), comorbidities (Charlson Comorbidity Index, CCI), functional status (Barthel Index), cognition (Mini Mental State Examination, MMSE), mood (Geriatric Depression Scale, GDS), quality of life, polypharmacy, and pacemaker implantation duration, alongside sociodemographic factors like age and sex. Identifying factors influencing frailty is essential for optimizing outcomes and quality of life in this population. Methods: This cross-sectional study included patients aged ≥60 years with permanent pacemakers attending the Arrhythmia Clinic at Adam Malik Hospital, Medan, from October to December 2024. Frailty was assessed using the CGA. Bivariate analyses employed Fisher’s exact test and chi-square tests to evaluate associations between frailty scores and variables including MNA, CCI, Barthel Index, MMSE, GDS, quality of life, polypharmacy, implantation duration, age, and sex. Multivariate logistic regression was used to identify significant predictors of frailty. Results: Of 62 participants, 62.9% were aged 60–74 years. Bivariate analysis revealed that 58.1% of malnourished patients (per MNA) were frail (p<0.008), and 94.1% of those on polypharmacy regimens were frail (p<0.001). Multivariate analysis identified polypharmacy as the only significant predictor of frailty (OR 14.0; 95% CI 2.186–89.675). Conclusion: Nutritional status and polypharmacy are associated with frailty in elderly pacemaker patients, with polypharmacy showing a significant independent effect. Targeted interventions addressing polypharmacy may improve frailty outcomes in this population.
Relationship Between Neutrophil-to-Lymphocyte Ratio and High-Density Lipoprotein with Major Cardiovascular Events in Acute Myocardial Infarction with ST-Segment Elevation Undergoing Primary Percutaneous Coronary Intervention at Adam Malik Hospital, Medan Adam, Faisal; Hasan, Harris; Haykal, T. Bob
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.231

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.
Hemoperitoneum in Pregnancy: A Case Series and Clinical Management Insights Purnama , Dean Reza; Aliah, Julyta; Indra , Indra
Journal of Society Medicine Vol. 4 No. 8 (2025): August
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.232

Abstract

Introduction: Hemoperitoneum in pregnancy is a rare but life-threatening obstetric emergency characterized by intraperitoneal bleeding, often due to vascular rupture, uterine anomalies, or adnexal pathology. Its nonspecific symptoms, including acute abdominal pain and hemodynamic instability, complicate timely diagnosis, requiring rapid intervention to prevent severe maternal and fetal complications. Case Description: A 22-year-old primigravida at 28 weeks presented with acute abdominal pain, hypotension, and fetal distress on cardiotocography. Ultrasonography showed intraperitoneal free fluid, and emergency laparotomy revealed a ruptured uterine artery with 900 mL of blood. Surgical ligation and transfusion of two units of packed red cells achieved hemostasis, followed by cesarean delivery of a viable preterm neonate (1,200 g, Apgar 7/8). Nifedipine tocolysis stabilized the mother, discharged on day 7 with hemoglobin at 10.8 g/dL; the neonate required intensive care. The second case involved a 24-year-old primigravida at 28 weeks with hypotension (90/60 mmHg), tachycardia (120 beats/min), and similar ultrasound findings. Laparotomy showed a ruptured uterine vein with 800 mL blood, managed by ligation and transfusion of two packed red cell units. Nifedipine (20 mg every 6 h) prevented preterm labor, and pregnancy continued to term, delivering a healthy 3,200 g neonate (Apgar 8/9). The mother recovered well, with hemoglobin at 11.0 g/dL by day 7. Conclusion: This case highlights the critical need for swift ultrasonography and multidisciplinary management, including emergency surgery, to optimize outcomes in hemoperitoneum during pregnancy. Clinicians must maintain a high index of suspicion for acute abdomen with hypovolemia to prevent catastrophic maternal and fetal consequences.
Accuracy of the Moyers 75% Probability Table in Predicting Dental Arch Space in Batak Ethnic Students at the University Sumatera Utara Arifa , Silvia; Bahirrah, Siti; Yusuf , Muslim; Sofyanti, Ervina
Journal of Society Medicine Vol. 4 No. 9 (2025): September
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i9.233

Abstract

Introduction: Accurate prediction of dental arch space is crucial for effective orthodontic treatment planning, particularly in mixed dentition analysis. The Moyers prediction table at 75% probability is widely used to estimate space requirements for unerupted canines and premolars, but its accuracy varies across populations due to ethnic differences in tooth size and arch dimensions. This study evaluates the accuracy of the Moyers 75% probability table in predicting dental arch space among Batak ethnic students at Universitas Sumatera Utara (USU). Methods: A cross-sectional study was conducted on 60 Batak ethnic USU students (30 males, 30 females, aged 18–25 years) with normal occlusion and no history of orthodontic treatment. Dental casts were obtained, and mesiodistal widths of mandibular incisors, canines, and premolars were measured using digital calipers (accuracy 0.01 mm). Actual measurements were compared with predicted values from the Moyers 75% probability table. Discrepancies were analyzed, and accuracy was assessed as the percentage of predictions within ±1 mm of actual measurements. Results: The Moyers table overestimated canine-premolar space by an average of 1.2 mm in males and 0.9 mm in females. Accuracy within ±1 mm was achieved in 65% of cases, with significant differences between predicted and actual values (p<0.05). Sexual dimorphism was observed, with larger discrepancies in males. Conclusion: The Moyers 75% probability table shows moderate accuracy in Batak ethnic students, suggesting the need for population-specific adjustments. Further studies should explore ethnic variations to enhance orthodontic prediction models.
A Review of Non-surgical Strategies for Managing Chronic Rhinosinusitis Setiawan , Gunawan Wijaya
Journal of Society Medicine Vol. 4 No. 9 (2025): September
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i9.234

Abstract

Chronic rhinosinusitis (CRS) remains a significant public health challenge, characterized by persistent inflammation of the sinonasal mucosa lasting at least 12 weeks, leading to symptoms such as nasal congestion, facial pain, rhinorrhea, and olfactory dysfunction. Affecting an estimated 5-12% of the global population, CRS imposes considerable economic and quality-of-life burdens. While surgical options like functional endoscopic sinus surgery (FESS) are effective for refractory cases, non-surgical management is the initial and often primary approach, emphasizing symptom control, inflammation reduction, and prevention of disease progression. This comprehensive review synthesizes evidence from recent guidelines, clinical trials, and observational studies on non-surgical strategies, including nasal saline irrigation, intranasal and systemic corticosteroids, antibiotics, biologics, and adjunctive therapies. Key advancements include precision medicine via endotyping and the integration of biologics for type 2 inflammation-dominant phenotypes, particularly in CRS with nasal polyps (CRSwNP). Drawing from updated 2024-2025 literature, we highlight personalized treatment algorithms to optimize outcomes, minimize adverse effects, and reduce the need for surgery.

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