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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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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.
Comprehensive Management of Septic Shock Secondary to Intra-Abdominal Infection Complicated by Acute Respiratory Distress Syndrome: A Case Report Sahat , David; Kestriani , Nurita Dian
Journal of Society Medicine Vol. 5 No. 2 (2026): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.263

Abstract

Introduction: Septic shock is a life-threatening complication frequently encountered after major abdominal surgery and is associated with substantial morbidity and mortality in the intensive care unit (ICU). Intra-abdominal infection following laparotomy is a common precipitating source of sepsis that may rapidly progress to circulatory failure. The development of acute respiratory distress syndrome (ARDS) further exacerbates disease severity and necessitates early recognition and coordinated multidisciplinary management. Case Description: We report the case of a 65-year-old man who developed septic shock secondary to postoperative peritonitis following a laparotomy. The patient had previously undergone low anterior resection for rectal carcinoma. On intensive care unit (ICU) admission, the patient presented with severe hemodynamic instability requiring aggressive fluid resuscitation, vasopressor support, and invasive mechanical ventilation. On ICU day three, the patient developed ARDS, characterized by persistent fever, marked leukocytosis, worsening hypoxemia, and bilateral pulmonary infiltrates on chest radiography. Management included early goal-directed resuscitation, vasopressor therapy, and empiric broad-spectrum antibiotics (meropenem and levofloxacin). Lung-protective ventilation strategies were implemented in close collaboration with intensivists, surgeons, and anesthesiologists. The patient showed gradual clinical improvement and was successfully extubated on ICU day ten. Conclusion: This case underscores the critical importance of rapid recognition and meticulous management of septic shock secondary to intra-abdominal infection complicated by ARDS. Optimal outcomes depend on timely resuscitation, appropriate empiric antimicrobial therapy, early identification of ARDS, implementation of lung-protective ventilation, and a coordinated multidisciplinary approach to critical care management.
Pharmacologic Management of Hypertensive Disorders of Pregnancy and Postpartum Hypertension: Current Evidence and Clinical Implications Tona , Azwar Iwan
Journal of Society Medicine Vol. 5 No. 2 (2026): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.264

Abstract

Hypertensive disorders of pregnancy remain a major cause of preventable maternal morbidity and mortality worldwide, encompassing a spectrum of conditions from chronic and gestational hypertension to severe hypertensive crises associated with preeclampsia and eclampsia. Severe elevations in blood pressure (systolic ≥160 mmHg and/or diastolic ≥110 mmHg) markedly increase the risk of stroke, cardiovascular complications, and adverse perinatal outcomes, underscoring the need for prompt and appropriate pharmacological intervention. This review synthesizes contemporary evidence regarding treatment thresholds, target blood pressure goals, and the comparative efficacy and safety of commonly used antihypertensive agents, including labetalol, nifedipine, hydralazine, and methyldopa, in both antepartum and postpartum settings. Emerging randomized trials and meta-analytic data supporting earlier intervention in non-severe chronic hypertension are discussed, along with clinical considerations unique to the postpartum period, during which blood pressure instability and stroke risk remain elevated. Therapeutic decision-making must balance maternal cardiovascular protection with fetal and neonatal safety, considering placental drug transfer and the relative scarcity of long-term outcome data. An individualized, evidence-based, and multidisciplinary approach throughout the antepartum and postpartum continuum is essential to prevent severe hypertension, minimize end-organ injury, and improve immediate and long-term maternal cardiovascular outcomes.
Zero Prevalence of Soil-Transmitted Helminth Infections among Students with Disabilities and Symptoms of Attention-Deficit/Hyperactivity Disorder in Bengkulu City, Indonesia Gunasari, Lala Foresta Valentine; Mufra, Rizki Nurul Hidayah; Sudjatmoko, Andri; Triana, Dessy; Nurmansyah, Dian
Journal of Society Medicine Vol. 5 No. 2 (2026): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.274

Abstract

Introduction: Soil-transmitted helminth (STH) infections remain a significant public health concern in Indonesia, particularly among children living in suboptimal sanitation environments. Children with disabilities, especially those exhibiting symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), are theoretically considered more vulnerable to STH infection because of behavioral factors that may interfere with personal hygiene. However, epidemiological data on STH infections in this population in Bengkulu City are limited. Methods: This descriptive cross-sectional study was conducted among students with disabilities enrolled in special schools (Sekolah Luar Biasa) in Bengkulu. A total of 70 students were selected using proportional stratified random sampling method. ADHD symptoms were assessed using the Indonesian Hyperactive Child Behavior Assessment Scale (SPPAHI), which was completed by parents or guardians. Stool samples were collected and examined for STH infections using the Kato–Katz technique. Results: All 70 stool samples examined were negative for STH infection, indicating a prevalence of zero. Based on the SPPAHI assessment, 56 students (80.0%) were identified as having ADHD symptoms, while 14 students (20.0%) were classified as suspected ADHD. Conclusion: No STH infection was detected among students with disabilities or ADHD symptoms in special schools in Bengkulu City. This zero prevalence may be associated with enhanced parental supervision, limited exposure to high-risk environments, and the effectiveness of the national mass drug administration deworming program in the country.
Open Surgical Repair of Adult Inguinal and Femoral Hernias: Contemporary Techniques and Clinical Outcomes Subhan , Nanda
Journal of Society Medicine Vol. 5 No. 2 (2026): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.265

Abstract

Groin hernias, particularly inguinal and femoral hernias, represent one of the most common conditions requiring surgical intervention in general surgery. Although minimally invasive approaches have gained increasing popularity, open surgical repair continues to play an essential role in contemporary practice, especially in patients with anatomical complexity, prior pelvic surgery, or contraindications to laparoscopic procedures. This review provides a comprehensive overview of the principles, anatomical considerations, indications, and operative techniques associated with open repair of adult inguinal and femoral hernias. A detailed understanding of groin anatomy, including the inguinal canal, Hesselbach’s triangle, and femoral ring, is fundamental to achieving an accurate diagnosis and ensuring safe surgical repair. Multiple operative techniques have been developed and can broadly be classified into mesh-based tension-free repairs and primary tissue repairs. Among mesh techniques, the Lichtenstein repair remains the most widely adopted approach owing to its technical simplicity, reproducibility, and consistently low recurrence rates. Open preperitoneal mesh repairs also provide effective coverage of the myopectineal orifice and may be particularly advantageous in femoral hernias. Non-mesh techniques, such as the Shouldice, Bassini, and McVay repairs, remain relevant in selected clinical scenarios, particularly when prosthetic material is contraindicated. Overall, open surgical repair remains a safe and effective strategy for the management of groin hernias, offering durable outcomes when performed with meticulous attention to anatomical landmarks and operative techniques. Appropriate patient selection and adherence to evidence-based surgical principles are critical for minimizing complications and reducing recurrence. This review aims to summarize current surgical principles, operative techniques, and clinical outcomes associated with open repair of inguinal and femoral hernias in adult patients.
Comparative Effectiveness of Antibiotic Class Strategies in the Management of Sepsis in India: Evidence from Real-World Clinical Data Gupta , Anil Kumar; Singh, Rakesh Kumar; Sharma, Priya
Journal of Society Medicine Vol. 5 No. 2 (2026): February
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i2.266

Abstract

Introduction: Sepsis remains a major cause of morbidity and mortality in intensive care units worldwide, particularly in low-and middle-income countries, where antimicrobial resistance is highly prevalent. In India, gram-negative pathogens dominate bloodstream infections and are frequently associated with high levels of carbapenem resistance, creating significant challenges in selecting appropriate empiric antibiotic therapy. However, comparative evidence regarding antibiotic class strategies in the Indian sepsis setting remains limited. Therefore, this study aimed to evaluate the comparative effectiveness of major antibiotic class strategies used in the management of sepsis in India using real-world clinical and surveillance data. Methods: A secondary analysis of publicly available real-world datasets was conducted. Evidence was synthesized from the multicenter SEPSIS INDIA prospective registry, national antimicrobial resistance surveillance data from the Indian Council of Medical Research (ICMR), and published Indian real-world cohorts evaluating novel β-lactam/β-lactamase inhibitor therapies. Data regarding empiric antibiotic exposure patterns, pathogen distribution, antimicrobial resistance profiles, clinical outcomes, and healthcare utilization were systematically analyzed to compare antibiotic class strategies used in sepsis management. Results: Approximately half of the ICU patients with sepsis had positive blood cultures, with gram-negative organisms accounting for nearly 80% of the isolates. Carbapenem-resistant pathogens were detected in approximately 57% of culture-positive cases. Empiric therapy was predominantly carbapenem-based, particularly meropenem (≈55%), followed by β-lactam/β-lactamase inhibitor regimens, such as piperacillin–tazobactam (≈22%). Polymyxins and glycopeptides were frequently used as adjunctive agents. Mortality was higher among infections caused by carbapenem-resistant organisms than among those caused by carbapenem-susceptible pathogens. Real-world cohorts evaluating ceftazidime–avibactam demonstrated encouraging microbiological success rates and acceptable clinical outcomes in infections caused by carbapenem-resistant gram-negative bacteria. Conclusion: Real-world evidence indicates that antimicrobial resistance substantially influences antibiotic effectiveness in the management of sepsis in Indian ICU patients. Optimizing empiric therapy through local antibiogram-guided strategies, antimicrobial stewardship, and rapid diagnostic integration is essential to improve outcomes and mitigate the growing impact of multidrug-resistant infections.
Emerging Antimicrobial Resistance in Gram-Negative Pathogens: Protocol for a Pragmatic Cluster-Randomized Controlled Trial Khan , Ahsan Raza; Iqbal , Mehwish
Journal of Society Medicine Vol. 5 No. 3 (2026): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i3.269

Abstract

Introduction: Antimicrobial resistance among Gram-negative pathogens, including extended-spectrum β-lactamase (ESBL)-producing Enterobacterales and carbapenem-resistant Acinetobacter and Pseudomonas, is associated with high mortality and limited therapeutic options. Delayed initiation of effective antimicrobial therapy in bloodstream infections (BSIs) is consistently linked to adverse clinical outcomes. Although rapid diagnostic tests (RDTs) combined with antimicrobial stewardship (AS) improve the timeliness of therapy, high-quality evidence from resource-constrained settings remains limited. This study evaluates a pragmatic strategy integrating rapid diagnostics with stewardship to optimize early targeted therapy. Methods: This multicenter, parallel-group, pragmatic cluster randomized controlled trial includes 20 hospitals randomized to either an intervention bundle or standard care. The intervention comprises PCR-based pathogen and resistance gene identification, EUCAST rapid antimicrobial susceptibility testing (RAST), and a predefined stewardship algorithm for antibiotic optimization. Standard care includes routine culture, MALDI-TOF identification, and CLSI-guided susceptibility testing. Adult patients with confirmed Gram-negative BSIs are enrolled. The primary outcome is the proportion of patients receiving optimal targeted therapy within 24 hours of culture positivity. Secondary outcomes include time to effective therapy, 30-day mortality, hospital length of stay, adverse events, and antibiotic utilization. Analyses will follow an intention-to-treat approach using mixed-effects regression models. Results: As this manuscript presents a study protocol, no clinical outcome data are reported. Patient enrollment and trial implementation are ongoing across participating centers. Conclusion: This rigorously designed pragmatic cluster randomized trial will generate high-quality evidence on whether integrating rapid diagnostics with antimicrobial stewardship improves timely targeted therapy in Gram-negative BSIs, with direct implications for optimizing antimicrobial use and addressing global antimicrobial resistance.
Gut Microbiota as a Critical Modulator of Host Immune Responses in Severe Infections: Mechanistic Insights and Therapeutic Implications Chaiyasit, Anan; Wattanakul , Siriporn; Rattanapong , Kittisak
Journal of Society Medicine Vol. 5 No. 3 (2026): March
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i3.270

Abstract

Introduction: Severe infections, including sepsis and acute respiratory distress syndrome (ARDS), are the leading causes of morbidity and mortality worldwide, driven by dysregulated host immune responses. Emerging evidence has identified the gut microbiota as a critical regulator of systemic immunity; however, its mechanistic role in severe infection remains unclear. Methods: This narrative review synthesizes evidence from PubMed, Scopus, and Web of Science, focusing on mechanistic, translational, and clinical studies that evaluated microbiota–immune interactions in severe infections. Relevant studies were critically appraised and integrated to generate a mechanistic and clinically meaningful synthesis. Results: The gut microbiota maintains immune homeostasis through metabolites, such as short-chain fatty acids, bile acids, and tryptophan derivatives, which regulate epithelial integrity and T cell differentiation. In critical illness, dysbiosis, characterized by reduced diversity, loss of commensals, and pathogen overgrowth, disrupts these processes, leading to increased intestinal permeability, systemic inflammation, and organ dysfunction. Gut–organ axes, including gut–lung, gut–brain, and gut–kidney pathways, further amplify disease severity. Clinical evidence links dysbiosis to higher mortality and prolonged intensive care unit stays. Microbiota-targeted therapies, including probiotics, fecal microbiota transplantation, and precision interventions, show promise but remain limited by heterogeneity and insufficient high-quality evidence. Conclusion: Gut microbiota is a central modulator of host responses in severe infections, linking intestinal dysregulation and systemic immune dysfunction. Targeting microbiome-related pathways represents a promising strategy for precision critical care, although further mechanistic and clinical studies are required to establish effective therapies, improve patient outcomes in critical illness settings, and advance microbiome-based precision medicine.

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