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Medical and Health Journal
Published by Universitas Jenderal Soedirman
ISSN : -     EISSN : 28073541     DOI : https://doi.org/10.20884/1.mhj.2023.2.2.8053
Core Subject : Health,
Medicine & Pharmacology
Medical and Health Journal (EISSN. 2807-3541) is containing various articles/ manuscripts in the forms of research article, systematic reviews, case reports in the field of medicine focusing on basic medicine, clinical medicine, biomedical sciences, medical biotechnology, and public health. This journal is published by Universitas Jenderal Soedirman, Purwokerto, Indonesia.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 188 Documents
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Clinical Improvement in an Adolescent with Severe Multivalvular Rheumatic Heart Disease During Conservative Management: A Case Report Windy Oliviany; Andhika Bagus Pradhipta
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22211

Abstract

Rheumatic heart disease (RHD) remains an important cause of cardiovascular morbidity in children and adolescents, particularly in developing countries. Severe multivalvular involvement, especially severe mitral regurgitation (MR) accompanied by severe aortic regurgitation (AR), may result in substantial hemodynamic burden and frequently requires evaluation for definitive valve intervention. However, the clinical course of selected adolescents with severe multivalvular RHD managed conservatively remains insufficiently described. Case Report: A 14-year-old boy presented with fever, progressive dyspnea, chest pain, palpitations, and migratory joint pain with swelling, preceded by recurrent sore throat and episodes of migratory arthralgia. Laboratory investigations demonstrated elevated C-reactive protein, erythrocyte sedimentation rate, and antistreptolysin O titer. The clinical presentation was consistent with acute rheumatic fever, with carditis and polyarthritis fulfilling major Jones criteria and fever fulfilling a minor criterion, supported by evidence of preceding streptococcal infection. Echocardiography demonstrated severe MR, severe AR, and mild tricuspid regurgitation, with preserved left ventricular systolic function and low probability of pulmonary hypertension. The patient received medical treatment consisting of benzathine penicillin G, prednisone, aspirin, furosemide, and captopril, followed by regular secondary prophylaxis with benzathine penicillin G and clinical follow-up. During follow-up, the patient's fever, dyspnea, chest pain, palpitations, and migratory joint symptoms resolved, and he was able to perform light physical activities without symptoms. Serial echocardiography showed improvement of AR from severe to moderate, while severe MR persisted. At the latest follow-up, left ventricular ejection fraction remained preserved at 71%. Conclusion: This case demonstrates sustained clinical and functional improvement in an adolescent with severe multivalvular RHD during individualized conservative management and secondary antibiotic prophylaxis. However, clinical improvement did not indicate resolution of structural valvular disease, as severe MR persisted despite improvement of AR and preservation of left ventricular systolic function. Conservative management should therefore not be considered a substitute for definitive valve intervention but may provide clinical stability in selected patients while the indication and timing of intervention are reassessed through close clinical and echocardiographic follow-up.
Chronic Wet Cough as a Warning Sign of Bilateral Cystic Bronchiectasis in an Adolescent: A Case Report RR Wening Gelar Praditina; Agus Fitrianto; Desi Yulyanti
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22216

Abstract

Background: Bronchiectasis is a chronic respiratory disease characterized by irreversible bronchial dilatation resulting from structural damage to the bronchial walls. In children and adolescents, chronic wet cough is an important clinical warning sign that may indicate chronic suppurative lung disease and should prompt further evaluation, particularly when accompanied by recurrent respiratory infections or other signs of chronic pulmonary disease. Case Presentation: A 17-year-old girl presented with hemoptysis and intermittent dyspnea. She reported a chronic productive cough with yellowish sputum and blood, recurrent respiratory symptoms since childhood, difficulty gaining weight, and a smaller body size compared with her peers. She had repeatedly sought treatment at primary healthcare facilities for persistent cough without significant improvement. Physical examination revealed mild respiratory distress, mild intercostal retractions, fine basal crackles, and digital clubbing. Her body weight was 31 kg, height 141 cm, and body mass index 15.48 kg/m², indicating undernutrition. Laboratory investigations showed leukocytosis (16.62 × 10³/µL), thrombocytosis (549 × 10³/µL), neutrophilia, an elevated neutrophil-to-lymphocyte ratio (5.8), and increased C-reactive protein (11.1 mg/L). Chest radiography demonstrated bilateral lower-lobe infected bronchiectasis with a possible underlying pulmonary tuberculosis and bilateral pleural effusion. Contrast-enhanced chest computed tomography revealed bilateral cystic and infected bronchiectasis. Sputum molecular testing did not detect Mycobacterium tuberculosis. The working diagnosis was bronchiectasis with clinically suspected pulmonary tuberculosis. The patient received azithromycin, antituberculosis therapy, and prednisone, with clinical improvement during hospitalization. Conclusion: This case highlights the importance of recognizing chronic wet cough as an early warning sign of bronchiectasis in children and adolescents, particularly when accompanied by recurrent respiratory symptoms, hemoptysis, impaired growth, and digital clubbing. Chest computed tomography can confirm structural bronchial abnormalities and define disease distribution. When radiological findings suggest tuberculosis but microbiological testing is negative, the relationship between tuberculosis and bronchiectasis should be interpreted cautiously. Early recognition, appropriate radiological evaluation, and systematic assessment of underlying etiologies are essential to prevent further progression of structural lung damage
Management of Neonatal Hyperglycemia Through Glucose Infusion Rate Adjustment in an Extremely Low Birth Weight Preterm Infant: A Case Report Ariadne Tiara Hapsari; Anugrah Dimas Pratomo
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22245

Abstract

Background: Neonatal hyperglycemia is a common metabolic disturbance in preterm infants, particularly those with extremely low birth weight (ELBW). Immaturity of glucose homeostasis, critical illness, infection, and nutritional interventions may contribute to fluctuations in blood glucose levels. Appropriate glucose management is essential to prevent both hyperglycemia-related complications and inadequate nutritional intake. Case Presentation: We report the case of a female preterm infant born at 29 weeks and 4 days of gestation with a birth weight of 815 g (ELBW). The infant was admitted to the neonatal intensive care unit with severe respiratory distress and subsequently developed neonatal pneumonia and sepsis. Initial blood glucose was 44 mg/dL and increased to 128 mg/dL following a 10% dextrose bolus. Six hours after correction of the initial hypoglycemia, blood glucose increased to 201 mg/dL, indicating neonatal hyperglycemia. Glucose management was performed through serial blood glucose monitoring and individualized adjustment of the glucose infusion rate (GIR). The GIR was adjusted from 5.56 mg/kg/min on the first day to 6.94 mg/kg/min on the second day and 8.33 mg/kg/min on the third day. Blood glucose subsequently decreased to 122 mg/dL and 88 mg/dL, respectively, without insulin therapy. The infant received respiratory support, antibiotic therapy, nutritional management, and supportive care. During the subsequent hospitalization, respiratory status gradually improved. Endotracheal tube culture later confirmed ventilator-associated pneumonia caused by Serratia marcescens. Conclusion: This case highlights the dynamic nature of glucose dysregulation in an ELBW preterm infant with critical illness and infection. The transition from early hypoglycemia to hyperglycemia emphasizes the importance of serial glucose monitoring and individualized GIR adjustment. In this case, glucose levels were successfully controlled without insulin therapy, while maintaining adequate glucose delivery to support the nutritional requirements of a high-risk preterm infant. Integrated metabolic, nutritional, respiratory, and infectious monitoring is essential in the management of glucose disturbances in ELBW infants.
The Effect of Solvent Type and Extract Concentration of Binahong Leaves (Anredera cordifolia (Ten.) Steenis) on the In Vitro Antibacterial Activity against Cutibacterium acnes Sainal Edi Kamal; Wahyudin Wahyudin; Zufiah Zufiah; Andi Suriyanti; Viva Ratih Bening Ati
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22246

Abstract

Acne is an inflammatory disorder of the pilosebaceous unit in which Cutibacterium acnes may contribute to disease-associated inflammation. Increasing antimicrobial resistance has encouraged the exploration of medicinal plants as potential sources of antibacterial agents, including binahong leaves (Anredera cordifolia (Ten.) Steenis). This study compared the in vitro antibacterial activity of 96% ethanol and ethyl acetate extracts of binahong leaves against C. acnes. A laboratory experimental study was conducted using 96% ethanol and ethyl acetate extracts at concentrations of 2%, 4%, and 6% w/v, with three replicates for each treatment. Antibacterial activity was assessed using a disk diffusion assay, with 1% Na-CMC and clindamycin 30 ppm as negative and positive controls, respectively. Inhibition zones were measured after incubation at 37 °C for 24 h. Data from the six extract groups were analyzed using two-way ANOVA followed by Tukey’s post hoc test. Both solvent type (p = 0.0002) and extract concentration (p < 0.001) significantly affected inhibition-zone diameter, whereas their interaction was not significant (p = 0.0878). Ethyl acetate extract produced larger inhibition zones than 96% ethanol extract at 4% and 6% concentrations (p = 0.017 for each comparison), whereas no significant difference was observed at 2% (p = 0.909). The largest inhibition zone among the extracts was observed with 6% ethyl acetate extract (18.33 ± 1.53 mm), although this remained lower than that of clindamycin (31.67 ± 0.58 mm). These findings indicate that ethyl acetate extract of binahong leaves has greater in vitro inhibitory activity against C. acnes than the 96% ethanol extract at higher concentrations tested. However, the findings should be considered preliminary and require confirmation using standardized anaerobic conditions, MIC/MBC determination, and chemical standardization of the extract.
Effect of Foeniculum vulgare Mill. Leaf Extract on Hemoglobin Levels in Mice with Experimental Malaria Dorojatun Krisna Sisputra; Suci Ihtiaringtyas; Lieza Dwianasari Susiawan; Mustofa Mustofa; Kamal Agung Wijayana
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22275

Abstract

Malaria is a parasitic disease caused by Plasmodium spp. and remains a major public health problem in tropical regions, including Indonesia. One of the clinical manifestations of malaria is anemia resulting from hemolysis, which leads to decreased hemoglobin levels. Although artemisinin-based combination therapy remains the first-line treatment for malaria, the emergence of drug resistance has prompted the search for alternative therapies to prevent malaria-associated anemia. This study aimed to evaluate the effect of Foeniculum vulgare Mill. leaf extract on hemoglobin levels in malaria model mice. A true experimental study with a pretest-posttest with control group design was conducted using 40 mice randomly assigned to eight groups: a negative control (DMSO), an extract control (400 mg/kgBW), a malaria control (Plasmodium berghei), and five treatment groups infected with P. berghei and administered F. vulgare leaf extract at doses of 50, 100, 200, 400, and 800 mg/kgBW. Hemoglobin levels were measured every 24 hours for five days using a hemoglobinometer. Data were analyzed using the Friedman test after the normality test indicated a non-normal distribution (p<0.05) and the homogeneity test showed homogeneous data (p>0.05). The analysis revealed no significant effect of F. vulgare leaf extract on hemoglobin levels in malaria model mice (p=0.216). In conclusion, Foeniculum vulgare Mill. leaf extract did not affect hemoglobin levels in malaria model mice.
Sleep Disorders in Stroke Patients: A Literature Review Khanza Ratualma Sauzan Anggestha; Gotot Puspitowigati; Suryo Bantolo
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22277

Abstract

Stroke was a major cause of death and long-term disability and was frequently accompanied by sleep disorders that affected rehabilitation and quality of life. Post-stroke sleep disturbances could precede stroke as a risk factor or emerge afterward as a consequence of central nervous system damage and various accompanying factors. This literature review was conducted to discuss the definition, epidemiology, etiology, physiology, pathophysiology, classification, clinical manifestations, diagnosis, management, and prognosis of sleep disorders in stroke based on a search of the scientific literature through Google Scholar and PubMed. The spectrum of sleep disorders in stroke patients included sleep-disordered breathing, insomnia, excessive daytime sleepiness, hypersomnia, restless legs syndrome, periodic limb movement disorder, circadian rhythm disorders, and parasomnia, associated with damage to brain structures regulating sleep, respiratory disturbances, psychological factors, medical comorbidities, and environmental factors during care. Diagnosis was established through history taking, screening instruments such as the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale, and supporting examinations such as polysomnography and actigraphy. Management included non-pharmacological approaches such as cognitive behavioral therapy for insomnia and continuous positive airway pressure, as well as pharmacological therapy in certain conditions. Sleep disorders were associated with slower neurological recovery, reduced quality of life, cognitive impairment, and an increased risk of recurrent stroke. This review concluded that sleep disorders were common but frequently underdiagnosed non-motor complications of stroke, highlighting the importance of early identification and appropriate management as part of comprehensive stroke care to optimize recovery and long-term prognosis.
Type I Choledochal Cyst in a Pediatric Patient: A Case Report of Excision and Roux-en-Y Hepaticojejunostomy Novita Herowati
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22439

Abstract

Background: Choledochal cysts are relatively rare congenital anomalies of the biliary system but may lead to serious complications if not diagnosed and managed appropriately. Type I cysts are the most common form and generally require complete cyst excision followed by biliary reconstruction. Case: A 3-year-old girl was diagnosed with a type I choledochal cyst at Dr. Sardjito Hospital, Yogyakarta. The anatomy of the biliary system was assessed using intraoperative cholangiography. Based on the intraoperative findings, complete cyst excision was performed while preserving the surrounding anatomical structures, followed by biliary reconstruction using a Roux-en-Y hepaticojejunostomy. Postoperative evaluation showed that the patient remained clinically stable without significant complications. On postoperative day 10, the surgical wound was healing well, and the patient was discharged for outpatient follow-up. Conclusion: Type I choledochal cysts in children require accurate diagnosis and definitive management to prevent long-term complications. Complete cyst excision followed by Roux-en-Y hepaticojejunostomy resulted in a favorable early outcome in this case. Nevertheless, long-term follow-up remains necessary to detect potential complications following biliary reconstruction.
Ethanolic Extract of Butterfly Pea Flower (Clitoria ternatea L.) as an Antifungal and Antibiofilm Agent Against Candida albicans ATCC 10231 Setiawati Setiawati; Carrissa Alifia; Nia Krisniawati; Viva Ratih Bening Ati; M.M Rudi Prihatno
Medical and Health Journal Vol 6 No 1 (2026): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2026.6.1.22442

Abstract

Candida albicans is the leading cause of fungal infections worldwide, with mortality rates reaching up to 60%. Biofilm formation by C. albicans makes infections more difficult to treat and increases resistance to antifungal agents. The ethanolic extract of butterfly pea flower (Clitoria ternatea L.) has potential as an antifungal and antibiofilm agent, making it a promising alternative treatment. This study aimed to determine the antifungal and antibiofilm activity of butterfly pea flower ethanolic extract against C. albicans ATCC 10231. The research employed a true experimental method with a post-test only control group design. The antifungal assay used the microdilution method to determine the Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC), while the antibiofilm assay used the Microtiter Plate Assay to determine MBIC50 and MBRC50. The concentrations tested were 5, 10, 20, 40, and 80 mg/mL, with fluconazole 6.25 µg/mL as the positive control. The results showed an MFC value at 20 mg/mL. The MBIC50 and MBRC50 values were both at 10 mg/mL, with inhibition and reduction percentages of 72.28% and 65.18%, respectively. The ethanolic extract of butterfly pea flower exhibited better antifungal and antibiofilm activity than the positive control fluconazole at 6.25 µg/mL. The ethanolic extract of butterfly pea flower has the potential to be developed as an antifungal and antibiofilm agent.

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