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Journal of International Surgery and Clinical Medicine
Published by Universitas Syiah Kuala
ISSN : -     EISSN : 28077008     DOI : https://doi.org/10.51559/jiscm
Core Subject : Health,
Health Professions Medicine & Pharmacology
Journal of International Surgery and Clinical Medicine; peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the field. JISCM publishes articles that encompass basic research/clinical studies related to Surgical Oncology, Digestive Surgery, Vascular Surgery and Endovascular, Pediatric Surgery, Urology, Neurosurgery, Orthopedics, Plastic Surgery. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship and encourage a vigorous dialogue between medical scholars and practitioners.
Arjuna Subject : Kedokteran - Pembedahan
Articles 55 Documents
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The Effects of Prednisone and Aspirin Administration on Pregnancy Outcomes in Mothers with RhD Isoimmunization and a History of Recurrent Pregnancy Loss: A Case Report Susanty, Devi; Marhadisony, Regina; Indirayani, Ima; Aditya, Rizka; M Fuad
Journal of International Surgery and Clinical Medicine Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v5i2.83

Abstract

Introduction: Rhesus incompatibility arises when an Rh-negative mother becomes sensitized to the D antigen of an Rh-positive fetus, triggering the production of anti-D antibodies, a process known as isoimmunization. This condition is associated with severe obstetric complications, including Recurrent Pregnancy Loss (RPL) and Hemolytic Disease of the Fetus and Newborn (HDFN). Clinical management remains challenging, as no single therapeutic modality can comprehensively eliminate the adverse effects of isoimmunization. A targeted and integrated management approach is therefore imperative to optimize pregnancy outcomes. Emerging evidence suggests that corticosteroids combined with aspirin may confer beneficial effects in patients with rhesus incompatibility. Case Presentation: A 27-year-old woman, G5P0A4, with RhD-negative status, experienced recurrent pregnancy loss and was managed with prednisone (10 mg/day), aspirin, and Rh immunoglobulin (RhIg) at appropriate gestational intervals. The patient successfully carried the pregnancy to 36 weeks and six days, resulting in the birth of a healthy neonate. Discussion: Rhesus incompatibility is a clinically significant condition in which Rh-negative mothers develop isoimmunization following exposure to Rh-positive fetal blood, producing antibodies against fetal red blood cell antigens. This immunological response contributes to adverse pregnancy outcomes, most notably RPL and HDFN, both carrying substantial maternal and neonatal morbidity. Effective management continues to pose considerable clinical challenges due to limited therapeutic interventions capable of mitigating the immunological consequences of isoimmunization. Evidence from published case reports indicates that combined prednisone and aspirin administration may represent a promising adjunctive therapeutic strategy alongside RhIg prophylaxis. Conclusion: The integrated management incorporating RhIg prophylaxis as the cornerstone of therapy alongside adjunctive prednisone and aspirin was associated with a successful pregnancy outcome in this RhD-negative mother with a history of RPL. The relative contribution of each therapeutic component cannot be determined from a single case report. Further prospective studies with larger sample sizes are needed to evaluate the independent efficacy of corticosteroids and aspirin in this clinical context.
The Relationship Between Risk Factors and Cervical Cancer Stage at the Gynecologic Oncology Polyclinic of RSUDZA Alfarah, Tasya Dafa; Ishak, Saifuddin; Hasanuddin
Journal of International Surgery and Clinical Medicine Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v5i2.88

Abstract

Introduction: Cervical cancer remains a major global health problem, particularly in developing countries such as Indonesia. Most deaths from cervical cancer are caused by delayed diagnosis, resulting in patients being detected at advanced stages. Although many studies examine risk factors for cervical cancer incidence, studies linking these same factors to the stage at diagnosis are limited representing a research gap this study addresses. This study aimed to determine the relationship between five cervical cancer risk factors and cancer stage at diagnosis at the Gynecologic Oncology Polyclinic of RSUDZA Banda Aceh. Methods: Observational analytic cross-sectional study using secondary data (medical records). A non-probability total sampling technique was applied (N = 54; n = 52 after exclusion). Bivariate analysis used Fisher's Exact and Mann–Whitney tests (95% CI, α = 0.05). Ethical approval was obtained from the Health Research Ethics Committee FK USK RSUDZA (No. 221/EA/FK-RSUDZA/2021, 26 July 2021). Results: No significant relationship was found between age at marriage (p = 1.000), parity (p = 0.595), education (p = 0.894), income (p = 0.102), or oral contraceptive use (p = 1.000) and cervical cancer stage. Conclusion: Stage at diagnosis is more strongly determined by access to and uptake of early-detection services and health-seeking behavior than by these demographic or reproductive risk factors. Strengthening community-based screening (VIA, Pap smear) and HPV vaccination is essential to reduce the proportion of patients diagnosed at advanced stages.
Proximal Transverse Vaginal Septum In Women With Primary Infertility : A Rare Case Report Rauzatul Jannah; Yusra Septivera; Rusnaidi Rusnaidi; Sarah Nainggolan
Journal of International Surgery and Clinical Medicine Vol. 6 No. 1 (2026): Available online : 1 June 2026
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v6i1.78

Abstract

Introduction: A transverse vaginal septum (TVS) represents an uncommon congenital malformation of female genital structures resulting from incomplete canalization where the urogenital sinus meets the distal portion of Müllerian ducts. This condition occurs in approximately 1 per 2,100 to 1 per 72,000 female live births. TVS manifests as either obstructive or non-obstructive variants and frequently correlates with infertility and painful intercourse. Surgical intervention is necessary to reestablish normal vaginal structure and enhance fertility potential. Case description: This report details a 28-year-old female presenting with inability to conceive following 18 months of consistent unprotected marital relations. Her complaints included painful sexual activity, reduced menstrual flow, and menstrual cramping. Physical examination identified a dense transverse membrane in the proximal vaginal third, measuring roughly 2 cm in thickness, positioned 5 cm beyond the introitus, containing a tiny opening that obscured cervical observation. Sonographic evaluation demonstrated unremarkable uterine and adnexal structures. Hysterosalpingography could not be completed due to septal blockage. Surgical management included vaginal septal excision combined with diagnostic laparoscopy and chromopertubation, demonstrating normal reproductive organs with open fallopian tubes and endometrial implants on the uterine surface that underwent ablation. Patient recovery proceeded without complications. Conclusion: A transverse vaginal septum constitutes a rare congenital malformation potentially presenting with fertility difficulties and dyspareunia during reproductive years. Surgical removal with vaginal restoration represents the preferred therapeutic approach to reestablish normal anatomy and maximize reproductive potential. Continued postoperative surveillance is crucial for detecting complications and assessing fertility outcomes.
Implant loosening after total knee replacement with pigmented villonodular synovitis: a case report Hajar Azizah Armarani Mallapasi; Fidelis Heru Wicaksono; Riza Aprizal
Journal of International Surgery and Clinical Medicine Vol. 6 No. 1 (2026): Available online : 1 June 2026
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v6i1.80

Abstract

Introduction: Aseptic loosening after total knee replacement (TKR) defined as prosthesis loosening from bone along with macrophage-induced inflammatory response without infection or trauma that may arises due to gradual mechanical loss of fixation while pigmented villonodular synovitis (PVNS) refers to a benign disease arises from synovium. Although the etiology of PVNS remains unclear and the underlying cause of PVNS occurrence following total knee replacement are limited in publication studies, a hypothesis of microtrauma causing recurrent hemorrhage may lead to PVNS. To date, there is no clear consensus on the primary treatment option for PVNS and surgery is generally the primary approach. Surgical excision with total synovectomy is considered to be the gold standard for PVNS. Case description: A 63-year-old woman with a history of left total knee replacement (TKR) 3 years prior came to our center with initial complaints of persistent pain and progressive impairment of daily activities. The patient later underwent a revision procedure along with open synovectomy due to suspected PVNS finding which confirmed with histopathological studies. Three months postoperatively, the patient showed marked improvement of left knee range of motion and quality of life measured with KOOS scoring of 78 out of 100. Conclusion: This case presenting an aseptic loosening after total knee replacement accompanied by PVNS finding confirmed by histopathologic studies. Implant loosening is thought to be related to loss of mechanical fixation or chronic inflammation, while PVNS occurrence following the implant loosening is likely triggered by microtrauma.
Persistent hydatidiform mole following incomplete evacuation mimicking post-molar gestational trophoblastic neoplasia successfully managed with repeat suction curettage: a case report Mala Hayati; Cut Meurah Yeni; Rizka Aditya
Journal of International Surgery and Clinical Medicine Vol. 6 No. 1 (2026): Available online : 1 June 2026
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v6i1.84

Abstract

Introduction: Hydatidiform mole is the most common form of gestational trophoblastic disease and may progress to post-molar gestational trophoblastic neoplasia (GTN). Persistent vaginal bleeding and elevated β-hCG levels following molar evacuation may indicate persistent trophoblastic disease and create diagnostic challenges, particularly when histopathological evaluation is unavailable. Case Report: A 27-year-old woman was referred with persistent vaginal bleeding five months after suction curettage for a hydatidiform mole. Histopathological examination was not performed during the initial evacuation because the anatomical pathology service was unavailable. Physical examination revealed uterine enlargement and active vaginal bleeding. Serum β-hCG was markedly elevated at 223,759 mIU/mL, and ultrasonography demonstrated an enlarged uterus with a heterogeneous honeycomb appearance suggestive of hydatidiform mole. The patient underwent repeat suction curettage, and histopathological examination demonstrated persistent hydatidiform mole without evidence of malignancy. Serial β-hCG monitoring showed progressive decline to <2 mIU/mL without chemotherapy. Discussion: Persistent trophoblastic disease following incomplete evacuation may clinically resemble post-molar GTN because of persistent bleeding, uterine enlargement, and markedly elevated β-hCG levels. Histopathological evaluation and serial β-hCG surveillance were essential in distinguishing persistent hydatidiform mole from malignant trophoblastic disease. Repeat suction curettage facilitated definitive diagnosis and complete remission in this patient. Conclusion: Persistent trophoblastic disease secondary to incomplete evacuation of a hydatidiform mole may mimic post-molar GTN. Repeat suction curettage may represent an effective management option in carefully selected low-risk patients with disease confined to the uterus.

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