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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 236 Documents
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Curcumin in Sepsis: Anti-Inflammatory Mechanisms, Nano-Formulations, and Evidence from Preclinical and Early Clinical Studies Yeni Puspawani; Gusbakti Rusip; Ali Napiah
Journal of Society Medicine Vol. 5 No. 5 (2026): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i5.280

Abstract

Introduction: Sepsis is driven by dysregulated host inflammation, cytokine amplification, endothelial injury, and oxidative stress, with nuclear factor kappa B signaling acting as a central regulatory axis. Curcumin, the principal bioactive compound of turmeric, has gained attention as a potential adjunctive therapy because of its pleiotropic anti-inflammatory, antioxidant, and immunomodulatory properties; however, its translational relevance in sepsis remains unclear. Methods: This narrative review synthesizes evidence from preclinical sepsis models, mechanistic studies, systematic reviews, meta-analyses, and early randomized or controlled clinical trials that evaluated curcumin, nano-curcumin, or curcumin-based formulations for sepsis and critical illness. Results: Preclinical evidence indicates that curcumin attenuates macrophage hyperactivation, suppresses TNF-α, IL-6, and IL-1β signaling, and modulates pyroptosis-related inflammatory pathways. In polymicrobial sepsis models, curcumin inhibited the HMGB1/TLR4/NF-κB pathway, reduced HMGB1 release, and limited NF-κB p65 nuclear translocation in polymicrobial sepsis models. Higher doses demonstrated stronger protection against multi-organ injury, partly through ferroptosis suppression via ACSL4/glutathione peroxidase 4 (GPX4) regulation and inhibition of protein lactylation via p300 downregulation. Early ICU trials suggest that enterally administered nano-curcumin may reduce inflammatory and endothelial biomarkers while enhancing antioxidant responses via Nrf2 signaling. Clinical signals include improved SOFA scores and reduced mechanical ventilation duration, although mortality and ICU length-of-stay remain inconsistent. Pooled evidence from critically ill populations also indicates modest improvements in organ dysfunction and selected hepatic and nutritional biomarkers. Conclusion: Curcumin demonstrates strong biological and translational plausibility in sepsis through multi-target modulation of inflammatory, oxidative, and cell death pathways. However, current clinical evidence remains limited and heterogeneous, underscoring the need for larger, well-designed trials with standardized formulations and clinically meaningful endpoints.
BRAF Mutation Status and Histopathological Differentiation Patterns in Non–Small Cell Lung Cancer: A Tertiary Referral Center Study in Indonesia Lela Khaibirunna A.P; Noni Novisari Soeroso; Desfrina Kasuma; Putri Eyanoer
Journal of Society Medicine Vol. 5 No. 5 (2026): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i5.281

Abstract

Introduction: Non-small cell lung cancer (NSCLC) is the most common subtype of lung cancer and a major cause of cancer-related mortality worldwide. BRAF mutations have emerged as clinically relevant molecular alterations associated with tumor behavior and targeted therapy responses. However, evidence regarding their relationship with histopathological differentiation remains limited, particularly in the Indonesian population. This study aimed to evaluate the association between BRAF mutation status and histopathological differentiation in patients with NSCLC at a tertiary referral center in Indonesia. Methods: This retrospective cross-sectional study included patients diagnosed with NSCLC at a tertiary hospital in Medan, Indonesia. Clinical and demographic data were obtained from patients’ medical records. Histopathological differentiation was classified as well-, moderately, or poorly differentiated. BRAF mutation analysis was performed using real-time polymerase chain reaction on formalin-fixed paraffin-embedded tissue samples. Statistical analyses were performed to determine the association between BRAF mutation status and histopathological differentiation. Results: Most patients were men (76.7%), aged >40 years, and had a history of smoking (74.2%). Adenocarcinoma was the predominant histological subtype (75%), and most patients were diagnosed at stage IVA (60%). BRAF mutations were identified in 3.3% of the patients. Histopathological evaluation revealed that 20.8%, 37.5%, and 41.7% of the tumors were well-, moderately-, and poorly differentiated, respectively. A significant association was observed between BRAF mutation status and histopathological differentiation (P = 0.001), with mutations being more frequently detected in poorly differentiated tumors. Conclusion: BRAF mutations were identified in a small proportion of NSCLC patients and were significantly associated with poor histopathological differentiation, suggesting a potential role in aggressive tumor biology.
Risk Factors For Recurrence In Epilepsy Patients Yudhisman Imran; Reza Naulla
Journal of Society Medicine Vol. 5 No. 6 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i6.282

Abstract

Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal electrical activity in the brain. It remains a significant global health concern, particularly in low- and middle-income countries (LMICs). The recurrence of seizures in patients with epilepsy is influenced by multiple clinical and nonclinical factors involved in epileptogenesis. This literature review aims to summarize the risk factors for recurrent seizures in patients with epilepsy based on recent scientific evidence. The literature was obtained from PubMed, Google Scholar, and manual searches and included articles published in English and Indonesian between 2010 and 2026. The study designs included meta-analyses, systematic reviews, cohort studies, case-control studies, cross-sectional studies, and case reports. The findings indicate that seizure recurrence is associated with the etiology of epilepsy (structural, genetic, infectious, metabolic, immunological, and idiopathic), as well as with lifestyle and behavioral factors such as sleep deprivation, psychological stress, alcohol consumption, smoking, and non-adherence to antiepileptic drugs. Abnormal MRI findings also increase the risk of disease recurrence. Furthermore, neuroinflammatory mechanisms, particularly microglial activation and proinflammatory cytokine release, contribute to increased neuronal excitability. In conclusion, recurrent seizures in epilepsy result from complex interactions among biological, clinical, and behavioral factors. Early identification and management of these risk factors are essential to reduce seizure recurrence and improve the quality of life of patients.
Bronchoscopy, Ultrasound, and Video Laryngoscopy as Guidelines for Percutaneous Dilatation Tracheostomy (PDT) in Patients with Difficult Airway Suspected of Laryngeal Tumor Sutan Syarif Muda Dalimunthe; Edi Daramawan; Rizki Taufiqurrahman; Bastian Lubis; Andriamuri Primaputra Lubis; Rommy Fransiscus Nadeak; Dis Bima Purwaamidjaja; Ferdinand Chandra
Journal of Society Medicine Vol. 5 No. 6 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i6.283

Abstract

Introduction: Percutaneous dilatational tracheostomy (PDT) is the preferred technique for elective tracheostomy in critically ill patients. However, a laryngeal or cervical mass is a relative contraindication because landmark puncture is unreliable, bleeding risk increases, and the airway may be lost when the endotracheal tube is withdrawn. Evidence on the safe extension of PDT to such airways is limited. Case Description: A 72-year-old man was admitted to H. Adam Malik General Hospital, Medan, Indonesia, with decreased consciousness after being struck by a motorcycle. Tracheal intubation was unexpectedly difficult and required a video laryngoscope and bougie. After eight days of ventilation, weaning failed, and tracheostomy was indicated. Pre-procedural neck ultrasound showed peritracheal soft-tissue thickening suspicious for a laryngeal tumor without compression of the tracheal lumen and identified a puncture interspace free of large vessels. Open tracheostomy was initially considered because of anticipated bleeding; however, bedside PDT was performed under triple guidance: ultrasound for site selection, video laryngoscopy to inspect the larynx and confirm endotracheal tube position, and flexible bronchoscopy through the tube for continuous intraluminal vision during needle puncture, guidewire passage, dilatation with the Ciaglia Blue Rhino system, and cannula insertion. The correct position was confirmed bronchoscopically before fixation. Conclusion: Combined ultrasound, video laryngoscopic, and bronchoscopic guidance eliminated every blind step and converted a tracheostomy that would conventionally have been performed openly into a controlled bedside intervention. This strategy may be considered an adjunct to standard PDT in selected high-risk patients provided adequate equipment and at least two trained operators are available.
The Role of Bronchoscopy as a Diagnostic and Therapeutic Modality in Critically Ill Patients with Respiratory Failure and Pneumonia in the Intensive Care Unit: A Descriptive Observational Study Edi Darmawan; Rizki Taufiqurrahman; Sutan Syarif Muda Dalimunthe; Septian Adi Permana; Arie Zainul Fatoni; Teuku Yasir; Andriamuri Primaputra Lubis; Rommy Fransiscus Nadeak; Bastian Lubis
Journal of Society Medicine Vol. 5 No. 5 (2026): May
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i5.284

Abstract

Introduction: Respiratory failure remains a major cause of intensive care unit (ICU) admission and is associated with substantial morbidity and mortality worldwide. Pneumonia frequently results in respiratory failure requiring invasive mechanical ventilation. Bronchoscopy enables direct airway visualisation and bronchoalveolar lavage (BAL), providing important diagnostic and therapeutic benefits in critically ill patients. This study evaluated the role of bronchoscopy in ICU patients with pneumonia-associated respiratory failure. Methods: This descriptive observational study was conducted in the adult ICU of RSUP H. Adam Malik Medan, Indonesia. Adult patients with pneumonia-associated respiratory failure requiring invasive mechanical ventilation who underwent bronchoscopy during ICU treatment in December 2025 were included. Data were obtained from medical records, bronchoscopy reports, laboratory investigations, and radiological examinations. Outcomes included chest radiographic findings, leukocyte count, neutrophil-to-lymphocyte ratio (NLR), and BAL culture results. Results: Eighteen patients were included. Radiological improvement was observed in 13 patients (72%), whereas 5 patients (28%) demonstrated deterioration. Leukocyte count improvement occurred in 16 patients (89%), and NLR improvement was identified in 15 patients (83%). BAL cultures predominantly revealed Acinetobacter baumannii, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Conclusion: Bronchoscopy provides important diagnostic and therapeutic benefits in ICU patients with pneumonia-associated respiratory failure by facilitating airway clearance, improving inflammatory parameters, and supporting targeted antimicrobial therapy.
Lymph Node Enlargement as a Manifestation of Systemic Venous Congestion in Patients with High VExUS Scores: A Case Series Rizki Taufiqurrahman; Edi Darmawan; Sutan Syarief Muda Dalimunthe; Bastian Lubis; Andriamuri Primaputra Lubis; Rommy Fransiscus Nadea; Septian Adi Permana
Journal of Society Medicine Vol. 5 No. 6 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i6.285

Abstract

Introduction: Fluid overload in critically ill patients increases central venous pressure (CVP) and induces systemic venous congestion, a recognized contributor to organ dysfunction. The Venous Excess Ultrasound Score (VExUS) is a bedside ultrasonographic method that grades venous congestion by integrating inferior vena cava (IVC) diameter with hepatic, portal, and renal venous Doppler patterns. Because the major lymphatic vessels drain into the central venous circulation through the thoracic duct, sustained elevation of CVP may also impede lymphatic outflow and cause reactive enlargement of regional lymph nodes. To describe supraclavicular lymph node enlargement as a clinical manifestation of systemic venous congestion in critically ill patients with high VExUS scores. Methods: This case series included five mechanically ventilated patients with respiratory failure and fluid overload admitted to the intensive care unit of H. Adam Malik General Hospital, Medan. Bedside ultrasonography assessed the IVC diameter and hepatic, portal, and renal venous Doppler to determine the VExUS grade, together with the evaluation of the subclavian vein and supraclavicular lymph nodes. Results: The five patients (aged 57–77 years) had a mean IVC diameter of 2.14 ± 0.21 cm. Four patients had a VExUS grade of 3, and one had a grade of 2. All patients demonstrated supraclavicular lymph node enlargement (10.3–17.6 mm), with larger nodes tending to occur in patients with higher VExUS grades. Conclusion: Supraclavicular lymph node enlargement may represent a reactive manifestation of systemic venous congestion in critically ill patients with high VExUS scores and could serve as an adjunctive parameter for assessing fluid overload in the intensive care unit setting.
Thoracic Spinal Anesthesia in a Patient with Peritoneal Tuberculosis with Massive Ascites and Bilateral Pleural Effusion for Laparotomy Dwi Lunarta Docterina Sutanti Siahaan; Jadeny Sinatra; Ronald T.H. Tambunan; Agus Prima
Journal of Society Medicine Vol. 5 No. 6 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i6.286

Abstract

Peritoneal tuberculosis is an extrapulmonary form of tuberculosis with nonspecific clinical manifestations, such as ascites and abdominal pain, often leading to delayed diagnosis. In advanced conditions, massive ascites combined with bilateral pleural effusion may significantly impair respiratory function and increase perioperative risk. General anesthesia, commonly used for laparotomy, may further worsen pulmonary complications in such high-risk patients. We report a case of a 23-years-old female with peritoneal tuberculosis complicated by massive ascites and bilateral pleural effusion who underwent laparotomy under thoracic spinal anesthesia. The patient presented with abdominal distension, dyspnea, anemia, and hypoalbuminemia, indicating a compromised physiological status. Considering the risks associated with general anesthesia, thoracic spinal anesthesia was selected. The procedure was successfully performed with stable intraoperative hemodynamics and no significant respiratory complications. Thoracic spinal anesthesia is a feasible regional technique for abdominal surgery, offering better respiratory outcomes and recovery compared to general anesthesia. This case demonstrates its potential as a safe alternative in high-risk patients undergoing laparotomy.
Effect of Intraoperative Lung-Protective Ventilation on Postoperative Pulmonary Complications in Non-ARDS Surgical Patients: A Prospective Multicenter Cohort Study Ali Rezaei; Hossein Karimi; Zahra Mohammadi
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.288

Abstract

Introduction: Postoperative pulmonary complications (PPCs) are among the most frequent adverse events after major surgery and drive substantial morbidity, prolonged hospitalization, and mortality. Although lung-protective ventilation (LPV) is well established in patients with acute respiratory distress syndrome (ARDS), its perioperative role in non-ARDS surgical patients remains incompletely defined. We evaluated the association between intraoperative LPV and PPCs in non-ARDS patients who underwent general anesthesia. Methods: In this prospective multicenter cohort study, adults undergoing elective non-thoracic, non-cardiac surgery were managed intraoperatively with LPV (tidal volume 6–8 mL/kg predicted body weight, PEEP 5–8 cmH₂O, selective recruitment maneuvers) or conventional ventilation (tidal volume 10–12 mL/kg, minimal PEEP). The primary outcome was the incidence of PPC within 7 postoperative days. Secondary outcomes included pneumonia, respiratory failure, length of stay, and 30-day mortality. Multivariable logistic regression was used to adjust for relevant confounders. Results: Of 1,000 patients, 500 received LPV and 500 conventional ventilation, with well-balanced baseline characteristics. PPCs occurred in 75 (15.0%) LPV patients versus 110 (22.0%) conventional patients (p=0.006). LPV was independently associated with lower PPC odds (adjusted odds ratio 0.60, 95% CI 0.42–0.85; p=0.004). Pneumonia was less frequent (6.0% vs. 10.0%, p=0.02) and hospital stay was shorter (median 5 days vs. 6 days, p=0.02). The ICU stay and 30-day mortality did not differ significantly. Conclusion: Intraoperative LPV was independently associated with fewer PPCs in non-ARDS surgical patients, alongside lower pneumonia rates and shorter hospitalization. These findings support the broader perioperative adoption of lung-protective ventilation to improve respiratory outcomes after surgery.
Regional Anesthesia Strategy Using Thoracic Paravertebral Block in a Patient with Tuberculosis-Related Pyopneumothorax: A Case Report T Arfi Sulaiman; Rahendra Rahendra
Journal of Society Medicine Vol. 5 No. 7 (2026): July
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i7.296

Abstract

Thoracic surgery in patients with severe pulmonary disease poses significant anesthetic challenges. General anesthesia with positive pressure ventilation may exacerbate ventilation–perfusion mismatch and worsen air leakage in the presence of a bronchopleural fistula. Regional anesthesia techniques that preserve spontaneous ventilation may offer a safer alternative in selected high-risk patients. We report a case of a 68-year-old male with tuberculosis-related right-sided pyopneumothorax complicated by bronchopleural fistula, severe chronic obstructive pulmonary disease with a restrictive component, atrial fibrillation with normal ventricular response, and hepatic insufficiency (ASA physical status III), who was scheduled for an open pleural window procedure. Given the high risk of general anesthesia and mechanical ventilation, ultrasound-guided unilateral thoracic paravertebral block (TPVB) was selected as the primary anesthetic technique, combined with dexmedetomidine sedation. The block was performed at T5–T7 using ropivacaine, achieving adequate dermatomal anesthesia. Sedation was titrated to preserve spontaneous ventilation and patient cooperation. The procedure was completed without conversion to general anesthesia. The patient remained hemodynamically stable, with preserved spontaneous breathing and adequate oxygenation throughout the surgery. No vasopressors, rescue opioids, or airway interventions were required. Postoperative pain was minimal, and no block-related or respiratory complications occurred. Thoracic paravertebral block combined with dexmedetomidine sedation provided effective anesthesia and favorable perioperative stability for open pleural window surgery in a high-risk pulmonary patient. This case highlights the potential role of regional anesthesia-based strategies as an alternative to general anesthesia in carefully selected thoracic surgical patients where preservation of spontaneous ventilation is desirable.
Acute Exercise-Induced Hypoalgesia and Chronic Training Adaptations in Pain Perception Among Athletes: A Systematic Review, Meta-Analysis, and Meta-Regression Muhammad Aldi Rivai Ginting; Armansyah Maulana Harahap; Yulia Putri; Herviani Sari
Journal of Society Medicine Vol. 5 No. 6 (2026): June
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v5i6.300

Abstract

Introduction: Pain perception is a key determinant of athletic performance and injury rehabilitation. Acute exercise attenuates nociception via exercise-induced hypoalgesia (EIH), whereas sustained training elicits neuroplastic adaptations in pain modulation. Objective: To quantitatively appraise effects of acute and chronic exercise on experimentally evoked pain in athletes versus non-athlete controls and elucidate effect moderators. Methods: We systematically searched PubMed/MEDLINE, Scopus, Web of Science, SPORTDiscus, Cochrane, PsycINFO, and CINAHL from the publication dates to January 31, 2026, following the PROSPERO  CRD42025XXX) guidelines. We included studies that appraised pressure pain threshold (PPT), tolerance, intensity, or unpleasantness between athletes and controls, or within athletes, pre- and post-exercise. We conducted random-effects meta-analyses and yielded Hedges' g with 95% CIs; heterogeneity was indexed using I². We assessed the risk of bias using RoB 2 and ROBINS-I, and rated certainty using GRADE. Results: Forty-six studies (n = 2,418; 1,289 athletes and 1,129 controls) were included. Compared to controls, athletes showed elevated tolerance (g = 0.86, 95% CI: 0.62–1.10), heightened threshold (g = 0.42, 95% CI: 0.21–0.63), and attenuated intensity ratings (g = −0.72, 95% CI: −0.98 to −0.46). Acute exercise elicited moderate hypoalgesia in PPT (g = 0.52; 95% CI: 0.36–0.68). Endurance athletes showed superior tolerance gains over team-sport athletes (g = 1.04 vs. 0.71), and moderate-to-vigorous intensity protocols surpassed low-intensity protocols (g = 0.71 vs. 0.18). Training volume and competitive calibre were robust moderators. Conclusion: Athletes exhibit recalibrated pain perception, substantiating exercise as a non-pharmacological pain-modulatory strategy that warrants longitudinal investigation.

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