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Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Published by Universitas Indonesia
ISSN : -     EISSN : 28284070     DOI : https://doi.org/10.69951/proceedingsbookoficeonime
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience Public Health
This proceeding book encompasses various themes within the realm of general medicine. Selected articles from the International Conference and Exhibition of The Indonesian Medical Education Research Institute undergo peer review and editorial management before being published as an open-access digital proceeding book. The published articles include original pieces, case reports, case series, systematic reviews, narrative reviews, and technical notes.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 54 Documents
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Platelet-Rich Plasma as a Pharmacopuncture Agent in Cervical Myofascial Pain Nareswari, Irma; Kamal, Achmad Fauzi; Mihardja, Hasan; Yunus, Reyhan Eddy; Jusuf, Ahmad Aulia; Harahap, Alida Roswita; Wahyuni, Luh Karunia; Werdhani, Retno Asti; Handayani, Selfi; Rukmindar, Dion
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.310

Abstract

Chronic cervical myofascial pain (CMP) is a prevalent musculoskeletal disorder characterized by persistent neck pain, inflammation, functional impairment, and altered pain processing. Conventional treatments, including pharmacological therapy and physical rehabilitation, often provide limited and temporary relief. Increasing evidence suggests that chronic CMP involves not only peripheral nociceptive input but also nociplastic pain mechanisms driven by sustained neuroimmune dysregulation and central sensitization. Pharmacopuncture, combining acupuncture point stimulation with localized injection of therapeutic agents, has evolved with the introduction of regenerative biologics such as platelet-rich plasma (PRP). PRP contains concentrated platelets and bioactive growth factors, including VEGF, PDGF, and TGF-β, which exert anti-inflammatory and tissue-reparative effects. Emerging data indicate that PRP pharmacopuncture may reduce pro-inflammatory cytokines (e.g., IL-1β and TNF-α), modulate regulated cell death pathways (e.g., apoptosis and pyroptosis), and promote the restoration of myofascial tissue homeostasis. These mechanisms may contribute to both peripheral tissue repair and attenuation of nociplastic pain processing. This narrative review synthesizes current clinical and experimental evidence on the biological mechanisms and therapeutic potential of PRP pharmacopuncture in chronic CMP. Available studies report meaningful improvements in pain intensity and functional outcomes compared with conventional acupuncture or pharmacotherapy alone. However, substantial methodological heterogeneity may arise from PRP preparation protocols, acupoint selection, and outcome measures, limiting the ability to draw definitive conclusions. High-quality randomized controlled trials incorporating standardized protocols and mechanistic biomarkers are required to establish PRP pharmacopuncture as an evidence-based integrative treatment for chronic CMP.
The Dual Effect of Tolvaptan on Diuresis and Azotemia in a Case of Acute Kidney Injury with Furosemide Resistance After Coronary Artery Bypass Grafting: A Case Report Supriyadi, Eddo; Karseno Dibyosubroto, Iradewi; Sugiarto, Adhrie
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.313

Abstract

Background: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) affects up to 30% of patients, increasing morbidity and mortality. Increasing Furosemide dose, by blocking sodium, potassium, and chloride reabsorption, paradoxically increases urea reabsorption to maintain medullary osmolarity. This increased urea retention reduces Furosemide’s effectiveness and can elevate urea levels. Tolvaptan, a V2 receptor antagonist, indirectly inhibits Urea Transporter A1 (UT-A1), potentially opposing this effect. Case Presentation: A 67-year-old man post-CABG developed inadequate diuresis despite high-dose Furosemide (20 mg/hour). Post-extubation, he experienced worsening dyspnea, positive fluid balance, elevated Central Venous Pressure (CVP), and a sharp rise in creatinine (0.97 to 4.74 mg/dL). Dialysis was planned on Day 3 but deferred for observation after initiating Tolvaptan. Following Tolvaptan administration, diuresis improved, CVP decreased, and Creatinine fell to 2.11 mg/dL. The patient recovered without further events. Discussion: This case describes the potential use of Tolvaptan as an adjunct to Furosemide to improve diuresis and decrease urea reabsorption. Furosemide improves diuresis by blocking electrolyte reabsorption, but this effect is often counteracted by a compensatory increase in urea reabsorption to maintain peritubular tissue osmolarity, which lowers the overall potency of the diuretic. This water retention, coupled with increased sodium chloride in the tubule, triggers the macula densa and juxtaglomerular feedback, thus lowering GFR. Conclusion: Tolvaptan's potential to augment diuresis and improve urea removal is beneficial to reduce the need for dialysis. Further study is needed to confirm this theoretical application in other clinical settings.
Comparative Study of Antioxidant and Cytotoxic Activities of Abrus precatorius Extracts from the Biofarmaka Herbal Garden and the Materia Medica Garden Batu Christy, Chika Lovenia; Rani Wardani Hakim
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.315

Abstract

Breast cancer remains the leading cause of cancer incidence and mortality among women. Doxorubicin is a mainstay in breast cancer therapy; however, its use is limited by toxicity and adverse effects. Abrus precatorius (APC) contains bioactive compounds with antioxidant and anticancer potential, though variations in growing conditions may influence its activity. This study compared the antioxidant and cytotoxic activities of 70% ethanol leaf extracts of APC from the Biofarmaka Garden (Bogor, West Java) and the Materia Medica Garden (Batu, East Java). Qualitative phytochemical screening was performed to identify secondary metabolites. Antioxidant activity was evaluated using the DPPH assay with vitamin C as the positive control, while cytotoxic activity was assessed against MCF-7 cells using the MTT assay with doxorubicin as the positive control. IC₅₀ values were calculated and analyzed using independent t-test and Mann–Whitney test. Both extracts contained saponins, flavonoids, tannins, alkaloids, and steroids. Antioxidant activity was moderate with IC₅₀ values of 175.70 ± 0.69 µg/mL (Bogor) and 173.07 ± 0.07 µg/mL (Batu) (p = 0.021). Cytotoxic activity was weak with IC₅₀ values of 264.51 ± 8.11 µg/mL (Bogor) and 257.35 ± 33.92 µg/mL (Batu) (p = 0.513). Both extracts showed similar phytochemical profiles, with moderate antioxidant and weak cytotoxic activities against MCF-7 cells. Keywords: Abrus precatorius, antioxidant, cytotoxic, MCF-7, IC50
Association between Musculoskeletal Status and Genetic Mutations in Patients with Hemophilia A Primacakti, Fitri; Wahidiyat, Pustika Amalia; Sjarif, Damayanti R.; Chozie, Novie Amelia; Candini, Naura Anindya; Prihartono, Joedo; Sukartini, Ninik; Ramadhani, Nadhifa Tazkia; Lubis, Bidasari
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.316

Abstract

Introduction: Hemophilia A is an inherited bleeding disorder caused by mutations in the factor VIII (FVIII) gene. These mutations result in either reduced FVIII synthesis (null variants) or loss of FVIII function (non-null variants). Null variants are typically associated with more severe FVIII deficiency and recurrent joint bleeding, which may adversely affect musculoskeletal health.  Objective: To evaluate the relationship between musculoskeletal status and genetic mutations in patients with hemophilia A. Methods: A cross-sectional study was conducted at the Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital from June 2024 to March 2025. Genetic analysis was performed at the Human Genetic Research Center using inverse-shifting PCR and Sanger sequencing. Mutations were classified as null variants (intron-22 inversion, intron-1 inversion, large deletion, and nonsense mutations) and non-null variants (missense and non-conserved splice mutation). Musculoskeletal status was assessed by the presence of target joints and the Hemophilia Joint Health Score (HJHS), which evaluates global gait and joint function of the elbows, knees, and ankles. Higher HJHS scores indicate worse joint health.  Results: Sixty patients were included in this study, of which 39 had severe, 15 had moderate, and the remaining 6 had mild hemophilia A. The median age was 9.5 years (range 2-18). Null variants were identified in 45/60 patients and non-null variants in 15/60 patients. The most common target joints were the knees in patients with null variants and the ankles in those with non-null variants. The median HJHS was 4 (Q1-Q3: 2-13.5) in the null variant group and 2 (Q1-Q3: 1-11) in the non-null variant group. No significant association was observed between the target joint and the HJHS and genetic mutations. Further subgroup analysis showed no difference in HJHS between mutation groups among patients receiving prophylaxis (p=0.366) or on-demand treatment (p=0.458). Conclusion: No association was found between genetic mutation type and musculoskeletal status in patients with Hemophilia A. HJHS did not differ between mutation groups regardless of treatment regimens.  
Application of The JMF 10 Warning Signs for Early Detection of Primary Immunodeficiency among Children with Recurrent Infections in Indonesia Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Wati, Ketut Dewi Kumara
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.318

Abstract

Introduction: Limited awareness and diagnostic resources contribute to delayed recognition of primary immunodeficiency (PID). The Jeffrey Modell Foundation (JMF) 10 warning signs have been widely used for screening. However, their diagnostic performance has not been validated in Indonesia. Objective: To evaluate the diagnostic performance of the JMF 10 warning signs for early detection of PID among children with recurrent infections in Indonesia. Methods: This multicentre cross-sectional study was conducted across 10 hospitals in Jakarta involving 254 children aged 0–18 years who met the severe, persistent, unusual, and recurrent (SPUR) infection criteria. The diagnosis of PID was established based on clinical diagnosis by the European Society for Immunodeficiencies (ESID) Registry Working Definitions. Analysis was performed to determine the sensitivity, specificity, predictive values, and accuracy of the JMF 10 warning signs. Results: Diagnostic performance for PID improved with the number of warning signs, with overall accuracy increasing from 15% (1 sign) to 86.2% (≥5 signs). A total score of ≥3 signs was associated with higher occurrence of PID (PR 2.63; 95% CI 1.23–5.60; p = 0.008), providing an optimal balance of 75.7% sensitivity and 48.9% specificity. The two most specific indicators were recurrent severe sinus infections (99.5%) and ear infections (95%). All PID subjects required IV antibiotics. Conclusion: The JMF warning signs remain a valuable clinical screening tool for early detection of PID among Indonesian children. A threshold of three or more warning signs provides reasonable accuracy for screening and referral of PID in resource-limited settings.
Relationship between Emergency Department Triage Data and 24- and 48- Hour Mortality in an Academic Teaching Hospital Aviesena Zairinal, Ramdinal; Amanah, Salma Rizqi
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.319

Abstract

Introduction: Triage data plays an essential role in the initial assessment and prioritization of emergency patients. However, the association between triage parameters and short- term mortality remains underexplored. Evaluating 24-hour and 48-hour mortality may serve as an indicator of the effectiveness of triage and early resuscitation efforts. Objectives: To determine the relationship between emergency department triage parameters and short-term mortality (24-hour and 48-hour) among patients treated at an academic teaching hospital. Methods: A retrospective cohort study was conducted on all patients admitted to the emergency department from January to February 2024. Demographic and clinical data obtained during triage were analyzed. Bivariate and multivariate binary logistic regression analyses were performed to identify factors associated with 24-hour and 48-hour mortality. Results: A total of 1,976 patients were included. The 24-hour and 48-hour mortality rates were 1% and 5%, respectively. Significant predictors of 24-hour mortality were triage category (OR = 4.42; 95% CI 1.93–10.09), respiratory rate (OR = 1.09; 95% CI 1.02–1.16). Predictors of 48-hour mortality included age (OR = 1.02; 95% CI 1.008–1.036), triage category (OR = 3.23; 95% CI 2.23–4.67), respiratory rate (OR = 1.08; 95% CI 1.03–1.13), systolic blood pressure (OR = 0.98; 95% CI 0.97–0.99), and mental status (OR = 3.58; 95% CI 2.11–6.07). Conclusion: Several routinely collected data during initial admission to the emergency unit are independently associated with both 24-hour & 48-hour mortality. These results highlight that triage data can serve as meaningful predictors of early mortality and may support rapid risk stratification, resource allocation, and operational decision-making in the Emergency Department.
A Neuroscience Approach to a Virtual Reality (VR) Based Accommodation–Convergence Intervention for Evaluating Intra-Individual Mental Fatigue during Nearwork: A Crossover Experimental Study Concept Hartono, Riyadi; Pasiak, Taufiq Fredrik; Thadeus, Maria Selvester
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.320

Abstract

Introduction: Prolonged nearwork is associated with increased mental fatigue, a neurocognitive state marked by slower processing, reduced accuracy, and diminished executive performance. This condition affects up to 60–70% of students and office workers worldwide. Objective: Analyzing the effect of a VR-based Accommodation–Convergence Intervention on intra-individual mental fatigue parameters during nearwork from a neuroscience perspective. Methods: A crossover experimental study was developed involving 20 healthy male participants (18–25 years) to perform identical 60-minute Pauli test under two conditions: (1) 2D screen-based and (2) 3D VR based (reduce accommodation–convergence by projecting visual object at optical infinity). Mental fatigue was assessed using several biomarkers, including Pauli test performance, P300 amplitude and latency, and EEG Alpha–Theta PSD. Intra-individual differences between conditions were analyzed using a within-subject. The conceptual framework  was supported by a synthesis of 100 peer-reviewed studies (2014–2024) establishing mental fatigue indicators biomarker. Results: Hypothetically, comparisons between 2D screen and 3D VR-based demonstrated improvement in endurance, reflected by a higher Pauli test performance slope, attenuating the increase in P300 latency-amplitude as well as changes in EEG Alpha–Theta indicative of mental fatigue. The results showed a trend of VR exposure across multiple biomarkers, although the confidence intervals were wide in this small-sample pilot study. Conclusion: This study illustrated a neuroscience-based framework demonstrating that accommodation–convergence intervention via VR may influence indicators of mental fatigue. By integrating EEG, P300, and the Pauli test, the approach provides an objective model for assessing intra-individual cognitive endurance.
Hyperbaric Oxygen Therapy for Traumatic Brain Injury: A Review Of History, Development, Current Techniques, and Future Directions Wiwoho, Yudi Yuwono; Sadikin, Abdul Halim; Jusuf, Ahmad Aulia; Mulyawan, Wawan; Mudjihartini, Ninik; Ibrahim, Nurhadi; Jusman, Sri Widia A.; Sadikin, Mohamad
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.321

Abstract

Hyperbaric oxygen therapy (HBOT) has gained increasing attention as a potential adjunctive treatment for traumatic brain injury (TBI) patients. This narrative review discusses the historical background, current preclinical and clinical studies, and explores its underlying mechanisms from biomolecular, histological, and clinical perspectives. HBOT promotes neural recovery by improving oxygenation, preserving mitochondrial integrity, enhancing neurotrophic support and synaptic connectivity, mitigating secondary injury pathways (including oxidative stress, inflammation, and apoptosis), and promoting angiogenesis and vascular stability. These mechanisms have demonstrated improvements of motor, cognitive, and memory functions both in preclinical and clinical studies, although outcomes and treatment protocols vary. However, challenges remain regarding optimal protocols, patient selection, and adverse effects. Further high-quality clinical trials are required to define the optimal HBOT regimen are required.
Chronic Lower Back Pain Among Hospital Workers: Effect of Ergonomic Chair Intervention on Quality of Working Life: A Literature Review Khairunnisa, Zulfa
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.322

Abstract

Abstract Chronic lower back pain (CLBP) is a prevalent occupational problem among hospital workers, primarily caused by prolonged sitting and poor ergonomic posture. This condition contributes to reduced productivity, discomfort, and diminished quality of working life. Ergonomic chair interventions have been introduced as a potential preventive and therapeutic strategy to alleviate pain and improve workplace well-being. A narrative literature review was conducted by searching PubMed, Scopus, and Google Scholar databases from 2015 to 2025 using the keywords low back pain, chair intervention, and hospital workers. Selected studies discussed ergonomic chair modifications, posture correction, and work-related health outcomes. Most reviewed studies demonstrated that ergonomic chair interventions reduced pain intensity and disability scores, while improving posture stability and job satisfaction. Enhanced comfort and reduced fatigue were associated with better concentration and productivity. However, inconsistencies in chair design, user compliance, and study methods remain as limitations. A chair which is pivot adjustable and has adjustable backrest can reduce the muscle activity and also decreases the inter-vertebral disc pressure. Therefore, there is some support that adjustability of the chair can be directly associated with the function of the musculoskeletal system. Ergonomic chair interventions provide a promising approach to reducing CLBP and improving the quality of working life among hospital workers. Further high-quality studies are needed to develop standardized ergonomic recommendations for healthcare workplaces. Keywords: ergonomic chair, hospital worker, low back pain, quality of working life
High Prevalence of Low Muscle Strength and Poor Physical Performance in Pre-Elderly and Elderly Communities in Rural Cirebon, Indonesia: A Public Health Measurement Initiative Safira, Nanda; Nasution, Lailan Safina
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.323

Abstract

Introduction: Sarcopenia, characterized by progressive muscle decline, threatens functional independence and global health sustainability. Early identification of low muscle strength is critical in community settings that lack advanced diagnostic tools. This cross-sectional study aimed to measure the prevalence of low muscle strength and identify key physical factors in a combined pre-elderly (45-59 years) and elderly (≥ 60 years) cohort, aligning with the concept of community-based physical fitness measurement. Methods: We conducted a cross-sectional study among 62 participants (67.7% female; 61.3% elderly) in Cirebon, Indonesia. Probable sarcopenia was screened using the Asian Working Group for Sarcopenia (AWGS 2019) criteria: Low Muscle Strength (handgrip < 28 kg for men, < 18 kg for women) and Low Physical Performance (≥ 12.0 sec chair stand). Analysis included non-parametric tests and a multivariate logistic regression adjusting for age and calf circumference. Results: Low muscle strength prevalence was high at 66.1% (n = 41). Strength was significantly higher in males (20.30 kg) than females (15.66 kg, p-value = 0.004). Physical performance was poor, with 80.6% of the population meeting the criteria for slowness (median = 13.98 sec). Multivariate analysis identified calf circumference as a significant independent protective factor for both low strength (AOR: 0.77; 95% CI: 0.62–0.92; p-value = 0.008) and poor performance (AOR: 0.77; 95% CI: 0.57–0.96; p-value = 0.043). Advanced age was a significant predictor specifically for low muscle strength (AOR: 4.41; 95% CI: 1.23–17.6; p-value = 0.026). No significant associations were found with body mass index (BMI), blood sugar, cholesterol, smoking, or job status (p-value > 0.05). Conclusion: The high prevalence of low muscle strength in this pre-elderly and elderly cohort, independently predicted by smaller calf circumference, signals a critical public health threat. This functional decline is primarily driven by physical and age-related factors, not socioeconomic status. Our findings demand urgent, community-based strength training programs to empower healthy aging and preserve functional independence.

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