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Jurnal Kedokteran Meditek
Published by Universitas Kristen Krida Wacana
ISSN : 26861437     EISSN : 26860201     DOI : https://doi.org/10.36452/jkdoktmeditek
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Jurnal Kedokteran MEDITEK merupakan jurnal ilmiah yang mempublikasikan artikel-artikel dalam lingkup bidang kedokteran dan biomedik secara open access. Proses publikasi artikel melalui proses penelaahan oleh pakar sebidang (peer-review) secara double-blind. Jurnal Kedokteran Meditek berafiliasi pada Fakultas Kedokterandan Ilmu Kesehatan Universitas Kristen Krida Wacana, dengan misi mendorong penyebarluasan perkembangan ilmu kedokteran & biomedis di Indonesia maupun secara global dengan menerbitkan 3 edisi dalam setahun, yaitu: Januari, Mei dan September.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 5 Documents
 1 
Search results for , issue "Vol 31 No 6 (2025): NOVEMBER" : 5 Documents clear
Penatalaksanaan Gagal Napas pada Poliautoimun Multipel Sklerosis dengan Krisis Miastenia Octavia, Eva; Halimi, Radian Ahmad; Sitio, Nurita Dian Kestriani Saragi
Jurnal Kedokteran Meditek Vol 31 No 6 (2025): NOVEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i6.4000

Abstract

Introduction: Polyautoimmune involving multiple sclerosis (MS) and myasthenia gravis (MG) is rare, with overlapping clinical manifestations due to shared immunopathogenic mechanisms. The main challenge in such patients is the high risk of ventilator weaning failure, especially when complicated by ventilator-associated pneumonia (VAP). This report highlights the rarely reported success of ventilator weaning through a multidisciplinary and comprehensive management approach in MS-MG polyautoimmunity. Case Illustration: A 39-year-old female with relapsing-remitting MS and MG developed a myasthenic crisis requiring mechanical ventilation. Therapeutic plasma exchange (TPE) was initiated on the second day of treatment and continued for five cycles. Ventilator weaning was performed gradually in accordance with clinical improvement, but was hindered by VAP, necessitating tracheostomy. High-protein enteral nutrition support and early mobilization were initiated on the second day of treatment. After 24 days of intensive care, the patient was successfully weaned from the ventilator with stable respiratory function and improved muscle strength. She was discharged ten days later with tracheostomy care instructions and was able to perform independent active mobilization. Discussion: MS-MG polyautoimmunity presents complex immunological mechanisms that require a multidisciplinary approach. Evidence-based comprehensive management that integrates immunomodulatory therapy, treatment of VAP complications, high-protein enteral nutrition, mobilization, and progressive pulmonary rehabilitation significantly improved respiratory function and accelerated weaning from the ventilator. Conclusion: An evidence-based, comprehensive approach through multidisciplinary collaboration can enhance ventilator weaning and improve clinical outcomes and quality of life in patients with MS-MG polyautoimmunity.  
Analysis of D-Dimer Levels Based on Histopathological Grading of Breast Cancer Devita, Yessi; Digambiro, Reza Aditya; Hastuty, Dewi
Jurnal Kedokteran Meditek Vol 31 No 6 (2025): NOVEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i6.3974

Abstract

Background: Breast cancer is the most common malignancy among women worldwide. Systemic activation of coagulation, reflected by elevated D-dimer levels, has been associated with advanced stage, metastasis, and poor prognosis in breast cancer. However, it remains unclear whether D-dimer also correlates with histopathological grade as an indicator of intrinsic tumor aggressiveness, particularly among patients with invasive breast cancer in Indonesia. Objective: To evaluate the association between plasma D-dimer levels and histopathological grading of invasive breast cancer. Methods: This cross-sectional study included 180 untreated female patients with primary invasive breast cancer, comprising 60 cases each of Grade I, Grade II, and Grade III tumors. Plasma D-dimer levels were measured using a latex-enhanced immunoturbidimetric assay, and histological grading was determined according to the Nottingham system. Data were analyzed using the Kruskal–Wallis test, ANOVA on log-transformed values, post-hoc tests, and ANCOVA with adjustment for age, body mass index (BMI), clinical stage, C-reactive protein (CRP), lymphovascular invasion, and molecular subtype. Receiver operating characteristic (ROC) analysis was performed to distinguish Grade III from lower grades. Results: Median D-dimer levels increased progressively from Grade I (501.7 ng/mL) to Grade II (831.0 ng/mL) and Grade III (1312.9 ng/mL), with a statistically significant overall difference (p < 0.001). ROC analysis for identifying Grade III yielded an AUC of 0.960 with an optimal cut-off of 965.5 ng/mL FEU (sensitivity 91.7%, specificity 90.0%). Conclusion: Plasma D-dimer levels are significantly associated with histopathological grade in invasive breast cancer, independent of potential confounders. These findings suggest that D-dimer testing may help identify patients with high-grade tumors at an early stage, thereby refining risk stratification, informing more intensive treatment planning, and raising vigilance for thromboembolic complications, particularly in resource-limited settings.. ctice.
Efek Ekstrak Etanol Kulit Batang Rhizophora apiculata terhadap Kadar Kolesterol Total Darah pada Rattus norvegicus Jantan yang Diinduksi Deksametason Iswara, Karisma Kasih; Andisari, Hendrata Erry; Handajani, Fitri; Puspita, Angela
Jurnal Kedokteran Meditek Vol 31 No 6 (2025): NOVEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i6.3533

Abstract

Introduction: Hyperlipidemia is an increase in blood lipid levels above normal limits, potentially leading to atherosclerosis and cardiovascular disease. Rhizophora apiculata contains flavonoids that have the potential to lower total blood cholesterol levels. Research on the hypolipidemic effects of R. apiculata is still limited, particularly in dexamethasone-induced animal models. Therefore, this study provides a new contribution to the use of mangrove biota as natural antihyperlipidemic agents. Purpose: This study aims to determine the effect of administering Rhizophora apiculata extract on total blood cholesterol levels in dexamethasone-induced Rattus norvegicus. Methods: This experimental study used a post-test only control group design with 40 male rats divided into four groups: negative control (K–), positive control (K+; induced by dexamethasone at 5 mg/kg BW for 7 days), prophylaxis group (KP; given R. apiculata extract at 56 mg/kg BW from day 8 until the end and induced by dexamethasone like K+), and therapy group (KT; given the extract simultaneously with dexamethasone induction). After treatment, total cholesterol levels were measured from intracardially drawn blood. Results: One-way ANOVA analysis showed a significant difference between groups (p < 0.001). However, post-hoc tests showed no significant difference between the positive control group and the prophylaxis (p = 0.435) or therapy (p = 0.397) groups. Conclusion: Although administration of Rhizophora apiculata extract as prophylaxis or therapy did not significantly reduce total cholesterol levels in dexamethasone-induced Rattus norvegicus, these findings suggest that further research is necessary to elucidate the mechanisms and potential efficacy of R. apiculata active compounds as natural antihyperlipidemic agents. Future studies should consider exploring different dosages, modes of administration, or alternative experimental models to better determine the therapeutic potential of this mangrove extract.
Paradoxical Reaction in Tuberculous Meningitis and Tuberculoma: Diagnostic Challenges Following Incomplete Treatment Situmeang, Rocksy Fransisca V; Gabriella, Nadia
Jurnal Kedokteran Meditek Vol 31 No 6 (2025): NOVEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i6.3856

Abstract

Introduction: Exacerbation of clinical or radiological findings in tuberculous meningitis (TBM) may result from a paradoxical reaction (PR), an immune-mediated response occurring in 6–30% of cases during or after anti-tuberculosis treatment (ATT). This case highlights the potential for PR to occur in the context of an incomplete ATT regimen. Case Illustration: A 20-year-old female presented with a 1-month history of headache, fever, double vision, nuchal rigidity, and bilateral abducens palsy. Cerebrospinal fluid analysis revealed pleocytosis and elevated protein, while brain MRI demonstrated leptomeningeal enhancement with multiple tuberculomas. She received standard ATT (RHZE), but discontinued therapy before completion due to symptom resolution and medication burden. One year later, she developed altered sensorium and behavioral changes; MRI showed new tuberculomas with edema despite negative serology. A diagnosis of PR was made, and high-dose intravenous corticosteroids were administered, resulting in clinical and radiological improvement. Discussion: PR remains a diagnostic challenge, often mistaken for microbiological relapse, drug resistance, or treatment failure. It arises from a distinct immune response to mycobacterial antigens, distinguishing it from relapse or drug resistance. Conclusion: Clinicians should suspect PR in worsening TBM cases, even in the setting of incomplete ATT, to prevent misdiagnosis and initiate prompt treatment.  
Comparison of Motoric Block Duration between 0.5% Hyperbaric Bupivacaine and 0.5% Levobupivacaine Cesarean Section Tanpomas, Irvan; Valentia, Clara; Suparto, Suparto; Wijaya, Monique Asby
Jurnal Kedokteran Meditek Vol 31 No 6 (2025): NOVEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i6.4022

Abstract

Introduction:The choice of anesthesia regimen affected each patient's recovery. Hyperbaric bupivacaine, a racemic mixture of S- and R-enantiomers, was more commonly used, while isobaric levobupivacaine, the S-enantiomer of bupivacaine, had fewer side effects. The anesthetic regimen chosen will determine postoperative recovery outcomes. Several studies have shown that the use of isobaric levobupivacaine accelerated postoperative motor recovery. Objectives: This study aims to compare the duration of motoric block from hyperbaric bupivacaine and isobaric levobupivacaine in pregnant women undergoing cesarean section with spinal anesthesia procedures. Methods: This quantitative analytical study was conducted on 52 cesarean section patients with spinal anesthesia procedures at Ukrida Hospital in 2024. The sample was randomly and equally divided into two groups, namely the Isobaric Levobupivacaine (IL) group of 26 people and the Hyperbaric Bupivacaine (HB) group of 26 people. Then the duration of motoric block will be assessed using the Bromage scale and observed every 30 minutes postoperatively until the patient reaches a Bromage score of 0 (can elevate the lower extremity). Results: The duration of motoric block was longer in the HB group than in the IL group (231.35 ± 16.944 versus 204.50 ± 38.472 minutes), with a significant difference (p < 0.001). Conclusion: Using the same technique and dosage, isobaric levobupivacaine with fentanyl offers faster relief of motoric block than hyperbaric bupivacaine with fentanyl.

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