Garuda - Garba Rujukan Digital

Article Per Year (5 Year)

All

The International Journal of Medical Science and Health Research

ijmhsr
Website

Published by International Medical Journal Corp. Ltd.

ISSN : 30481376 EISSN : 30481368 DOI : -

Core Subject : Health,

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

The International Journal of Medical Science and Health Research, published by International Medical Journal Corp. Ltd. is dedicated to providing physicians with the best research and important information in the world of medical research and science and to present the information in a format that is understandable and clinically useful. Committed to publishing multidisciplinary research that spans the entire spectrum of healthcare and medicine access, The American Journal of Medical Science and Health Research aims at an international audience of pharmacists, clinicians, medical ethicists, regulators, and researchers, providing an online forum for the rapid dissemination of recent research and perspectives in this area.

Arjuna Subject : Kedokteran - Review dan Referensi, Kedokteran

Articles 529 Documents

32 33 34 35 36

Risk Factors for Hearing Loss at Birth in Newborns with Congenital Cytomegalovirus Infection: A Comprehensive Systematic Review Della Reyhani Putri; Ilham Priharto
The International Journal of Medical Science and Health Research Vol. 17 No. 7 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kz1nzb87

Introduction: Congenital cytomegalovirus (cCMV) infection is the foremost non-genetic etiology of sensorineural hearing loss (SNHL) in the pediatric population, representing a significant global public health challenge (Pignataro et al., 2024). The clinical presentation of cCMV is markedly heterogeneous, ranging from asymptomatic infection to severe, multi-system disease. The early identification of newborns at the highest risk for congenital SNHL represents a significant clinical challenge, as hearing loss can be present at birth or have a delayed onset (Goderis et al., 2014). This systematic review aims to comprehensively identify, appraise, and synthesize the existing evidence on maternal, neonatal, and diagnostic risk factors that are predictive of SNHL present at birth in newborns with confirmed cCMV. Methods: A systematic literature search was conducted across the PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library databases for cohort, case-control, and cross-sectional studies published through 2024. Studies were deemed eligible for inclusion if they investigated specific risk factors for congenital SNHL in newborns with virologically confirmed cCMV infection within the first 21 days of life (Rawlinson et al., 2017). The methodological quality and risk of bias of included non-randomized studies were rigorously assessed using the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool. Data were extracted and narratively synthesized, categorized by the specific domain of the risk factor. Results: A total of 17 studies, encompassing over 3,000 newborns with cCMV, met the inclusion criteria. The synthesis of evidence revealed several consistent and significant predictors of congenital SNHL. Key risk factors included maternal primary infection occurring within the first trimester of pregnancy (De Cuyper et al., 2022; Foulon et al., 2019), the presence of symptomatic disease at birth, particularly with evidence of central nervous system (CNS) involvement (Pignataro et al., 2024; Rivera et al., 2002), and specific abnormalities on neonatal neuroimaging, such as periventricular cysts on magnetic resonance imaging (MRI) (De Cuyper et al., 2022) and temporal-pole white matter abnormalities (Fink et al., 2024). The clinical finding of petechiae at birth also emerged as a strong independent predictor of congenital SNHL (De Cuyper et al., 2022). In contrast, the predictive utility of neonatal viral load measurements was found to be inconsistent across the analyzed studies (Boppana et al., 2005; Walter et al., 2008). Discussion: The synthesized evidence strongly indicates that the risk of congenital SNHL is not uniformly distributed among all newborns with cCMV. A distinct risk gradient exists, which is powerfully linked to the timing of maternal infection and the degree of viral impact on the neonatal central nervous system (Rivera et al., 2002). Neuroimaging, particularly brain MRI, emerges from this review as a paramount prognostic instrument for early risk stratification, capable of identifying specific lesions that confer a high risk of adverse outcomes (Fink et al., 2024; Manara et al., 2021). Conclusion: Maternal primary infection in the first trimester, clinical signs of CNS involvement at birth, specific neuroimaging findings, and the presence of petechiae are significant and clinically relevant risk factors for congenital SNHL in newborns with cCMV. These identified factors can be effectively utilized for early risk stratification, guiding targeted audiological surveillance, and facilitating informed parental counseling (De Cuyper et al., 2022).

Correlation of TG/HDL Ratio and LDL/HDL Ratio with The Incidence of Coronary Artery Disease (CAD) at General Hospital of Buleleng Regency Gupta Arya Gumilang P; Susila IK; Kiki Wulandari P; Raka Mahasadu IGA
The International Journal of Medical Science and Health Research Vol. 17 No. 7 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/4ayzrm93

Background: CAD is a leading cause of death in both industrialised and developing nations, primarily affecting the younger generation. Triglycerides (TG) to high-density lipoprotein (HDL) cholesterol ratios (TG/HDL) and low-density lipoprotein (LDL) to HDL ratios (LDL/HDL) have been linked to cardiovascular disease. Objective: The objective of this research is to ascertain the relationship between the incidence of CAD and the TG/HDL and LDL/HDL ratios. Method: Analytical observational study with a cross-sectional approach conducted on 210 CAD patients at General Hospital of Buleleng Regency in 2024-2025. Data analysis was performed using the SPSS. Determination of the cut-off value was carried out using the Receiver Operating Characteristic (ROC) curve, then followed by chi-square analysis and logistic regression. Results: Average age of the sample was 60.53 ± 12.647 years and the majority were <65 years old (67.6%). Based on the ROC curve, the cut-off value for the TG/HDL ratio was 2.84 (AUC= 0.45; 95%CI (0.302-0.508); p<0.07) and LDL/HDL ratio was 2.38 (AUC= 0.503; 95%CI (0.398-0.608); p<0.96). Based on the chi-square test, there was no significant relationship between the TG/HDL ratio (OR=1.71; 95%CI=0.92-3.17; p=0.08) or the LDL/HDL ratio (OR=0.94; 95%CI=0.52-1.70; p=0.85) with the incidence of CAD. Based on multivariate analysis, a significant relationship was obtained between a high TG/HDL ratio and the incidence of CAD (AOR=0.42; 95%CI=1.88-0.979; p=0.04). Conclusion: There is a significant relationship between a high TG/HDL ratio and the incidence of CAD.

A Case Report of Well-Differentiated Liposarcoma Presenting as a Primary Inguinal Mass: Diagnostic Challenges and Management Komang Budhi Pradnya Wibawa; Gede Bayu Wedanta Netra
The International Journal of Medical Science and Health Research Vol. 17 No. 8 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ara09857

Introduction: Liposarcoma (LPS) is the most common soft tissue sarcoma in adults, yet its presentation as a primary mass in the inguinal region is exceedingly rare. This atypical location poses a significant diagnostic challenge, as the clinical signs often mimic more common benign conditions such as inguinal hernia or lipoma, which can lead to delayed diagnosis or inadequate initial management. This report details a case of well-differentiated liposarcoma (WDLS) in the inguinal canal, highlighting the clinical, radiological, and pathological nuances critical for accurate diagnosis and definitive treatment. Case Illustration: A 49-year-old male presented with a one-month history of a right inguinal lump that had rapidly enlarged over the preceding week, accompanied by intermittent pain. Physical examination revealed a mobile, tender mass measuring approximately 2x3 cm. Ultrasound imaging was pivotal, identifying a solid, heterogeneous, vascularized lesion, which raised the suspicion of a neoplasm beyond a simple lipoma. The patient subsequently underwent a wide excisional biopsy.Histopathological examination revealed a tumor composed of mature adipocytes with scattered atypical, hyperchromatic stromal cells and neoplastic lipoblasts, confirming the diagnosis of well-differentiated liposarcoma. A notable and potentially misleading feature was the presence of a prominent "chicken wire" vascular pattern within the stroma, a finding more classically associated with myxoid liposarcoma.1 Discussion: This case underscores the importance of maintaining a high index of suspicion for malignancy in patients presenting with atypical inguinal masses. Preoperative imaging, particularly ultrasound with Doppler, is invaluable for identifying features suggestive of sarcoma, thereby guiding appropriate surgical planning toward a wide excision rather than a simple enucleation. The finding of a "chicken wire" vascular pattern within a WDLS represents a significant diagnostic pitfall, emphasizing the need for comprehensive morphological assessment and, in equivocal cases, ancillary molecular testing to avoid misclassification and subsequent inappropriate adjuvant therapy. Wide surgical excision with negative margins remains the cornerstone of treatment for localized WDLS. Conclusion: Well-differentiated liposarcoma is an essential, albeit rare, differential diagnosis for solid inguinal masses. Optimal patient outcomes are contingent on a multidisciplinary approach encompassing astute clinical suspicion, appropriate imaging, meticulous pathological evaluation, and definitive surgical management. Given the high risk of local recurrence and the potential for dedifferentiation into a more aggressive sarcoma, a structured protocol of long-term, lifelong surveillance is mandatory following initial treatment. Keywords: Liposarcoma, Well-Differentiated Liposarcoma, Inguinal Tumor, Spermatic Cord, Soft Tissue Sarcoma.

Perforated Appendicitis with Generalized Peritonitis in a Patient with Situs Inversus Totalis: A Case Report and Literature Review Thomas Anggara
The International Journal of Medical Science and Health Research Vol. 17 No. 8 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/3173ry21

INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital condition characterized by the mirror-image transposition of thoracic and abdominal organs. Its co-occurrence with acute appendicitis, one of the most common surgical emergencies, presents a significant diagnostic challenge due to the atypical, left-sided clinical presentation. This can lead to diagnostic delays and an increased risk of complications. CASE ILLUSTRATION: A 40-year-old male presented to the emergency department with a three-day history of generalized abdominal pain that originated in the left lower quadrant (LLQ). Physical examination revealed tachycardia and signs of generalized peritonitis. Laboratory investigations showed marked leukocytosis. A chest radiograph incidentally revealed dextrocardia, raising suspicion for situs inversus. A subsequent abdominal ultrasound confirmed the transposition of visceral organs and identified findings suggestive of acute appendicitis in the LLQ. An emergency exploratory laparotomy was performed, which confirmed a perforated, gangrenous appendix located in the left iliac fossa, with approximately 200cc of purulent fluid in the peritoneal cavity. An appendectomy was performed, and the patient experienced an uneventful post-operative recovery. DISCUSSION: The patient's initial presentation with LLQ pain is a classic "mirror image" of typical appendicitis, highlighting the critical importance of considering anatomical variations in the differential diagnosis of abdominal pain. The diagnostic pathway, initiated by the serendipitous finding of dextrocardia, underscores the pivotal role of basic and advanced imaging in unmasking the underlying condition and facilitating timely surgical intervention, thereby preventing further morbidity. CONCLUSION: Although exceedingly rare, left-sided appendicitis in patients with situs inversus must be included in the differential diagnosis for patients presenting with LLQ pain. A high index of clinical suspicion, coupled with prompt and appropriate imaging, is paramount to avoiding diagnostic delays and reducing the risk of severe complications such as perforation and generalized peritonitis.

Evaluating the Evidence for a Link Between Glycemic Control and Keratosis Pilaris in Type 2 Diabetes: A Systematic Review Gede Agus Indra Pramana; Rona Nisrina Ananda
The International Journal of Medical Science and Health Research Vol. 17 No. 8 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/eh4b9m05

Introduction: Type 2 Diabetes Mellitus (T2DM) is a systemic metabolic disorder frequently associated with a wide spectrum of cutaneous manifestations, which often reflect the underlying degree of glycemic control. Keratosis pilaris (KP), a common benign disorder of follicular keratinization, has been anecdotally linked to metabolic disturbances such as obesity and insulin resistance. However, a direct, evidence-based correlation between glycemic control, measured by glycated hemoglobin (HbA1c), and the severity of KP in the T2DM population has not been systematically evaluated, representing a significant gap in the literature. Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library databases were searched for observational studies published up to October 2024. The primary search sought studies directly correlating HbA1c levels with KP severity in adult T2DM patients. Due to the absence of such studies, the search was broadened to include studies assessing KP in populations with related metabolic conditions (obesity, metabolic syndrome, insulin resistance). The Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool was used for quality assessment. Results: The systematic search yielded no studies that directly investigated the correlation between HbA1c levels and KP severity in patients with T2DM. The review of broadened search results included 16 observational studies. These studies demonstrated a high prevalence of KP in populations with metabolic dysregulation, with rates of 42% to 64.7% reported in obese cohorts. Crucially, one study identified a statistically significant association between KP and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score in obese adolescents (). Other studies, however, did not find a significant link between KP and insulin levels, highlighting inconsistencies in the existing indirect evidence. Discussion: The principal finding of this review is the definitive lack of direct evidence on the topic, which constitutes a critical research gap. Despite this, a strong biological rationale for a positive correlation is proposed, synthesized from indirect clinical and basic science evidence. Pathophysiological pathways involving hyperglycemia-induced Advanced Glycation End Products (AGEs) are known to impair keratinocyte differentiation and skin barrier function. Concurrently, compensatory hyperinsulinemia in T2DM can activate Insulin-like Growth Factor-1 (IGF-1) receptors on follicular keratinocytes, promoting hyperproliferation—a key pathological feature of KP. This dual mechanism suggests that poor glycemic control could both initiate and exacerbate the follicular hyperkeratosis characteristic of KP. Conclusion: While direct clinical evidence is currently absent, a compelling, mechanistically plausible link exists between poor glycemic control in T2DM and the severity of Keratosis Pilaris. This review highlights the urgent need for well-designed observational studies to investigate this association. If confirmed, KP could serve as a readily observable cutaneous marker for underlying insulin resistance or deteriorating glycemic control, prompting earlier clinical intervention.

A Giant Retroperitoneal Dedifferentiated Liposarcoma: A Case Report and Comprehensive Review of Multidisciplinary Management Mohammad Jathy Oktariansyah; Nurudin Syahadat; Fifa Yuniarmi
The International Journal of Medical Science and Health Research Vol. 18 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/2hnts243

Introduction : Retroperitoneal liposarcoma (RLPS) is a rare mesenchymal malignancy characterized by large tumor size at diagnosis and a high propensity for local recurrence. Giant RLPS, particularly the high-grade dedifferentiated subtype, presents formidable diagnostic and therapeutic challenges. Case Illustration : We present the case of a 64-year-old male with a one-year history of progressive abdominal distension. Physical examination revealed a massive, firm abdominal mass. Contrast-enhanced computed tomography (CT) identified a 35 x 25 x 20 cm heterogeneous retroperitoneal mass with both fatty and large non-lipomatous components, consistent with dedifferentiated liposarcoma. The patient underwent an exploratory laparotomy with a successful en bloc compartmental resection, which included the tumor, the right kidney, the right adrenal gland, and a segment of the ascending colon. The resected specimen weighed 10.4 kg. Histopathology confirmed a grade 3 dedifferentiated liposarcoma arising from a well-differentiated liposarcoma, with negative surgical margins (R0). The patient had an uneventful postoperative recovery and is undergoing surveillance. Discussion : This case highlights the central role of radical surgical resection as the only potentially curative modality for primary RLPS. The discussion provides a comprehensive review of the diagnostic utility of cross-sectional imaging, the principles of compartmental surgery to achieve negative margins, and the current, evolving landscape of adjuvant therapies. We critically analyze the results of the landmark EORTC-STRASS trial, which failed to show an overall benefit for preoperative radiotherapy but suggested a potential benefit in the liposarcoma subgroup, creating an ongoing clinical controversy. The limited role of systemic therapy outside of the advanced or metastatic setting is also reviewed. Conclusion : The management of giant RLPS is complex and necessitates a multidisciplinary approach at a specialized sarcoma center. Complete surgical resection remains the cornerstone of treatment, while the role of neoadjuvant therapies continues to be refined through histology-specific clinical trials.

The Association of Valacyclovir Prophylaxis with the Suppression of Recurrent Genital Herpes: A Systematic Review Indra Hadi Rapmartua Ompusunggu; Desty Friska Kurnia
The International Journal of Medical Science and Health Research Vol. 18 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/kvmk6m02

Introduction : Recurrent genital herpes (RGH), a chronic condition primarily caused by Herpes Simplex Virus type 2 (HSV-2), represents a significant global health concern, imposing a substantial clinical and psychosocial burden on affected individuals (Fife et al., 2007; Romanowski, Marina and Roberts, 2003). Valacyclovir, a prodrug of acyclovir with enhanced oral bioavailability, is a cornerstone of pharmacological management (Baker et al., 1999). This systematic review aims to critically evaluate and synthesize the evidence from randomized controlled trials (RCTs) regarding the efficacy and safety of valacyclovir prophylaxis for the suppression of RGH. Methods : A systematic search of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov was conducted to identify relevant RCTs. Studies were included if they evaluated daily suppressive valacyclovir therapy against placebo, another antiviral, or a different valacyclovir dose in adults with RGH. The study selection process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data on study design, participant characteristics, interventions, and predefined outcomes were extracted. The methodological quality of each included study was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool (Sterne et al., 2019). Results : Seventeen RCTs met the inclusion criteria. The evidence consistently demonstrates the superiority of valacyclovir over placebo in suppressing RGH. A network meta-analysis showed a significantly lower risk of having at least one clinical recurrence with valacyclovir versus placebo (Le Cleach et al., 2014). Suppressive therapy reduces the frequency of genital herpes recurrences by 70%-80% (Centers for Disease Control and Prevention, 2021). It also potently reduces total genital HSV shedding by up to 78% (Martens et al., 2009) and decreases the risk of HSV-2 transmission to susceptible heterosexual partners by approximately 48% (Corey et al., 2004). Compared to acyclovir, valacyclovir offered comparable clinical efficacy with the convenience of less frequent dosing (Reitano et al., 1998; Public Health Agency of Canada, 2024). In specific populations, valacyclovir prophylaxis initiated at 36 weeks of gestation significantly reduced recurrences at delivery (Hollier and Wendel, 2008), and a twice-daily regimen was found to be most effective for HIV-coinfected individuals (DeJesus et al., 2003; Warren, Harris and Brennan, 2004). Patient-reported outcomes strongly favored suppressive therapy over episodic treatment, with significant improvements in quality of life and treatment satisfaction (Romanowski, Marina and Roberts, 2003). The long-term safety profile of valacyclovir was favorable and comparable to placebo (Brown et al., 2005; Reitano et al., 1998). Discussion : The synthesized evidence confirms the high efficacy of valacyclovir prophylaxis, which stems from its advantageous pharmacokinetic profile (Baker et al., 1999). The enhanced bioavailability of valacyclovir allows for a simplified once-daily dosing regimen, which improves patient adherence and overall quality of life (Romanowski, Marina and Roberts, 2003). The potent suppression of virologic shedding is the key mechanism underlying both the reduction in clinical recurrences for the individual and the significant public health benefit of reduced sexual transmission (Corey et al., 2004; Martens et al., 2009). The evidence supports an individualized dosing strategy based on recurrence frequency and host immune status (Reitano et al., 1998; Warren, Harris and Brennan, 2004). Conclusion : Valacyclovir prophylaxis is a highly effective, safe, and well-tolerated first-line intervention for the management of recurrent genital herpes. It significantly reduces clinical and virologic manifestations of the disease, improves patient quality of life, and serves as a critical tool for reducing sexual transmission.

What are the clinical and quality of life outcomes for patients 5 years after coronary artery bypass grafting surgery? : A Systematic Review Nizar Fathurrohman; Hari Agung Asari
The International Journal of Medical Science and Health Research Vol. 18 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/c9s84163

Introduction: Coronary Artery Bypass Grafting (CABG) is a crucial surgical intervention for complex coronary artery disease, with well-documented long-term clinical effectiveness. However, a significant gap exists in the literature regarding patient-centered outcomes, particularly long-term quality of life (QoL), which is inconsistently measured. This systematic review aims to comprehensively evaluate both the clinical and QoL outcomes for patients five years after undergoing CABG surgery. Methods: This review adhered to the PRISMA 2020 guidelines. A systematic search was conducted across multiple databases, including PubMed, Springer, Google Scholar, Semantic Scholar, and Wiley Online Library, using predefined inclusion criteria. Studies were required to have a minimum follow-up of five years and report on clinical outcomes or validated QoL measures. A total of 25 studies met the eligibility criteria for the final synthesis. Results: The synthesized data revealed robust clinical effectiveness, with five-year all-cause mortality rates ranging from 8.4% to 23.6% and Major Adverse Cardiac and Cerebrovascular Events (MACCE) rates between 22.6% and 31%. The use of arterial grafts and participation in cardiac rehabilitation were consistently associated with improved outcomes. In stark contrast, only two of the 25 included studies systematically measured QoL using validated instruments, highlighting a significant evidence gap. Discussion: While the clinical durability of CABG is well-established, the systemic failure to report on long-term QoL limits a holistic understanding of patient recovery. Key determinants of long-term success include strategic factors like arterial graft selection and diligent postoperative care, rather than the choice between on-pump and off-pump techniques. High-risk populations, including women and patients with anemia, were identified as having worse outcomes. Conclusion: CABG provides excellent and durable five-year clinical outcomes, particularly when arterial grafts and cardiac rehabilitation are utilized. However, there is an urgent need for future research to integrate standardized QoL metrics as primary endpoints. Shifting the focus from mere survival to ensuring patients thrive is essential for advancing patient-centered care in cardiac surgery.

The Association Between Parental Smoking Habits and the Incidence of Lower Respiratory Tract Infections in Children Under Five Years of Age: A Systematic Review Rahmi Annisa Syarli; Nurul Hikmah Amanatillah; Achmad Yudi Albari Pohan; Febi Alefiya
The International Journal of Medical Science and Health Research Vol. 18 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/xqf1f521

Introduction: Lower Respiratory Tract Infections (LRTI), including pneumonia and bronchiolitis, represent a leading cause of morbidity and mortality in children under five years of age globally. Parental smoking, leading to environmental tobacco smoke (ETS) exposure, is a significant and modifiable risk factor. This systematic review synthesizes and critically appraises the contemporary evidence examining the association between parental smoking habits and the incidence and severity of LRTI in this vulnerable population. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, Google Scholar, Semanthic Scholar, Springer, Wiley Online Library was conducted for observational studies (cohort, case-control, cross-sectional) published up to July 2024. The PICO framework guided the selection of studies investigating the association between parental smoking (prenatal or postnatal) and LRTI (pneumonia, bronchiolitis, bronchitis) in children under five. The methodological quality and risk of bias of included studies were assessed using the Cochrane Risk of Bias tool for non-randomised studies (ROBINS-I). Results: Seventeen observational studies met the inclusion criteria. The evidence consistently demonstrates a significant association between parental smoking and an increased risk of LRTI. Pooled data from meta-analyses indicate that smoking by any household member increases the overall risk of LRTI by approximately 54% (OR=1.54, 95% CI 1.40–1.69). Postnatal maternal smoking was identified as the most potent risk factor (OR=1.58, 95% CI 1.45–1.73), exceeding the risk from paternal smoking alone (OR=1.22, 95% CI 1.10–1.35). The association was strongest for bronchiolitis, with household smoking increasing the risk by 151% (OR=2.51, 95% CI 1.96–3.21). Furthermore, exposure was linked to increased disease severity, including a higher likelihood of hospitalization, intensive care unit admission, and need for mechanical ventilation. A clear dose-response relationship was observed, with risk escalating with the number of smokers in the household and the proximity of smoking to the child. Discussion: The consistency of findings across diverse geographical settings and study designs, supported by strong biological plausibility, substantiates a causal relationship. Prenatal exposure appears to impair lung development, creating a congenital vulnerability, while postnatal exposure acts as a direct inflammatory trigger, impairing mucociliary clearance and immune function. The disproportionately high risk associated with maternal smoking is likely attributable to the greater time mothers typically spend in close proximity to their infants. Conclusion: There is robust and conclusive evidence that parental smoking is a major preventable cause of LRTI incidence and severity in children under five. The findings underscore the urgent need for targeted public health interventions that promote smoking cessation among parents and establish completely smoke-free home environments to protect vulnerable children.

The Association of Surgical Complications with Glaucoma Surgery: A Systematic Review of Traditional and Minimally Invasive Procedures Ria Andini Sutopo; Natasha Rismayana Wijayanti; Irsad Sadri
The International Journal of Medical Science and Health Research Vol. 18 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/b3r13277

INTRODUCTION: Surgical intervention is a cornerstone in the management of moderate to advanced glaucoma, a leading cause of irreversible blindness worldwide. The surgical landscape has evolved from traditional incisional procedures, such as trabeculectomy and glaucoma drainage device (GDD) implantation, to a diverse array of minimally invasive glaucoma surgery (MIGS) techniques. This evolution reflects a continuous effort to balance the efficacy of intraocular pressure (IOP) reduction with the risk of surgical complications. This systematic review aims to comprehensively synthesize and compare the complication profiles associated with this full spectrum of modern glaucoma surgeries. METHODS: A systematic literature search was conducted in PubMed, Google Scholar, Semantic Scholar, Springer, Wiley Online Library for studies published between January 2000 and October 2024. The search included randomized controlled trials (RCTs), prospective and retrospective cohort studies, and large case series reporting on complications of trabeculectomy, GDDs, and various MIGS procedures. Two independent reviewers performed study selection and data extraction. The methodological quality of RCTs was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Data on over 15 distinct intraoperative, early postoperative, and late postoperative complications were extracted and narratively synthesized. RESULTS: A total of 22 studies, including 8 major RCTs and 14 cohort studies, met the inclusion criteria. Traditional surgeries were associated with higher rates of severe complications. The 5-year results of the Primary Tube Versus Trabeculectomy (PTVT) Study showed that early postoperative complications were significantly more frequent after trabeculectomy than tube shunts (34% vs. 19%, p=0.013), though rates of late and serious complications were similar by year five. Comparative trials of GDDs, such as the Ahmed Baerveldt Comparison (ABC) and Ahmed Versus Baerveldt (AVB) studies, demonstrated that non-valved Baerveldt implants had a higher incidence of hypotony-related complications compared to valved Ahmed implants, which were more prone to hypertensive phase and encapsulation. MIGS procedures demonstrated a markedly more favorable safety profile. The 5-year HORIZON trial found the cumulative risk of subsequent incisional surgery was significantly lower with the Hydrus microstent plus phacoemulsification compared to phacoemulsification alone (2.4% vs. 6.2%, p=0.027), with no long-term adverse safety signals. The most common complications for MIGS were transient hyphema and IOP spikes. DISCUSSION: The evidence confirms a distinct trade-off between surgical efficacy and safety. Traditional procedures offer the most substantial IOP reduction but carry a significant risk of vision-threatening complications like bleb-related endophthalmitis and refractory hypotony. MIGS procedures offer a safer alternative, particularly for mild-to-moderate glaucoma, primarily reducing medication burden with minimal risk of severe adverse events. The choice of surgery is therefore dependent on a nuanced assessment of the patient's disease severity, target IOP, and risk tolerance. The inconsistent reporting of complications across studies remains a significant barrier to direct meta-analytic comparison. CONCLUSION: Glaucoma surgery encompasses a spectrum of procedures with widely varying complication profiles. While traditional surgeries remain indispensable for advanced disease, MIGS has fundamentally improved the safety paradigm for patients with less advanced glaucoma. Future research must adopt standardized definitions and reporting protocols for complications to allow for more robust evidence synthesis and to better guide clinical decision-making.

Page 34 of 53 | Total Record : 529

32 33 34 35 36

Filter by Year

2022 2026

Filter By Issues

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

Phone
-

Journal Mail Official
pt.internationalmedicaljournal@gmail.com

Editorial Address
Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location
Kota adm. jakarta selatan,

Dki jakarta

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Indra Hadi

Contact Email profesionaljournalmedicine@gmail.com

Phone -

Journal Mail Official pt.internationalmedicaljournal@gmail.com

Editorial Address Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location Kota adm. jakarta selatan, Dki jakarta INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

Phone
-

Journal Mail Official
pt.internationalmedicaljournal@gmail.com

Editorial Address
Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location
Kota adm. jakarta selatan,

Dki jakarta

INDONESIA