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The International Journal of Medical Science and Health Research

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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 589 Documents

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HYPOTHYROIDISM AS MANIFESTATION OF POSTPARTUM THYROIDITIS Putu Ayu Kevin Komala Dewi Mahayuna Putri; I Wayan Yuna Ariawan; I Wayan Eka Saputra
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): 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: 10.70070/50yept06

Introduction:Postpartum thyroiditis (PPT) is a destructive autoimmune inflammatory disorder of the thyroid gland that occurs within one year after delivery in women without a prior history of thyroid disease. The condition is caused by an autoimmune process that induces thyroid follicular damage and thyroglobulin proteolysis. Clinically, PPT typically presents with a triphasic pattern, beginning with a transient thyrotoxic phase, followed by hypothyroidism, and ultimately progressing toward recovery to a euthyroid state. Case Illustration: A 37-year-old woman presented with a gradually enlarging anterior neck swelling without associated pain. The patient had no previous history of thyroid disease or autoimmune disorders. Five months before clinical assessment, she had delivered her third child. Thyroid function tests revealed hypothyroidism, while thyroid ultrasonography demonstrated findings consistent with thyroiditis. The patient was subsequently treated with levothyroxine and scheduled for monthly follow-up evaluations. Following treatment, thyroid hormone levels returned to within normal limits, and the neck swelling gradually decreased. Discussion:The hypothyroid phase of postpartum thyroiditis (PPT) may occur due to depletion of thyroglobulin stores and cessation of the proteolytic process, resulting in decreased serum T3 and T4 levels. Patients with symptomatic hypothyroidism, as well as asymptomatic individuals with TSH levels >10 mU/L, are recommended to receive levothyroxine therapy at a dose of 50–100 mcg daily accompanied by periodic thyroid function monitoring. Most patients recover completely and return to a euthyroid state within one year. However, persistent hypothyroidism may develop in up to 50% of patients despite initial clinical improvement. Conclusion: The diagnosis of postpartum thyroiditis remains challenging because its clinical manifestations are often subtle and nonspecific. Therefore, a multidisciplinary approach is essential to ensure continuity of thyroid disorder management from pregnancy through the postpartum period.

EXTRAMAMMARY PAGET'S DISEASE WITH METHOTREXATE THERAPY: A CASE REPORT Anggreini Oktavia Trisno; Cindy Christella Chandra; Sukmawati Tansil Tan
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): 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/yahfap82

Introduction: Extramammary Paget's Disease (EMPD) is an uncommon intraepidermal adenocarcinoma that develops in regions containing apocrine glands, including the scrotum, inguinal folds, and perineum. It is most frequently observed in older adults and is often initially mistaken for benign conditions such as dermatitis or fungal infections due to its vague clinical appearance. Case Report: A 67-year-old man presented with a one-year history of erythematous, pruritic, and painful lesions located in the right groin and scrotal area. Physical examination revealed an erythematous patch with hyperpigmented macules, accompanied by erosion, scaling, and a plaque-like kissing lesion. Histopathological analysis confirmed the presence of characteristic Paget cells within the epidermis, leading to a definitive diagnosis of EMPD. The patient received therapy with topical methotrexate combined with topical gentamicin. Discussion: Diagnosing EMPD is challenging because its clinical features mimic those of common inflammatory skin disorders. Histopathology remains the diagnostic gold standard. Although surgical excision is the conventional treatment, topical methotrexate represents a promising non-invasive alternative, especially for limited disease or when surgery is not feasible. In the present case, marked clinical improvement was noted after four weeks of treatment, including reduced erythema and erosion, along with complete resolution of pruritus and pain. Conclusion: The combination of topical methotrexate and gentamicin produced favorable clinical results in this elderly patient with EMPD. This case supports the potential role of topical methotrexate as a safe, cost-effective, and well-tolerated therapeutic option for selected individuals with EMPD.

The Comprehensive Systematic Review of Use of Benzoyl Peroxide as Monotherapy or Combination Therapy for Acne Auliani Deby Veronica; Deriel Elka Hidayat
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): 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/htwn1y81

Introduction: Acne vulgaris is a prevalent inflammatory skin condition. Benzoyl peroxide (BPO) is a first-line topical agent, but the comparative efficacy of monotherapy versus combination regimens remains to be systematically defined. This review evaluates the significant positive clinical outcomes of BPO as monotherapy or combination therapy. Methods: A systematic screening of randomized controlled trials and vehicle-controlled studies was performed. Inclusion criteria: patients with acne vulgaris, BPO as active intervention, comparator group, and quantifiable outcomes. Data extraction focused on lesion count reductions, treatment success rates, safety, and comparative effectiveness. Results: From 80 included studies (29,592 participants), BPO monotherapy demonstrated significant superiority over vehicle: inflammatory lesion reduction 52.1% vs 34.7% and total lesion reduction 44.3% vs 27.8% (p<0.001) (1). Adapalene 0.1%/BPO 2.5% combination showed significant synergy, achieving 78.4% total lesion reduction vs BPO 52.6% (p<0.05) (8). The triple combination clindamycin phosphate 1.2%/adapalene 0.15%/BPO 3.1% (CAB) yielded treatment success rates of 51.3% vs adapalene 0.3%/BPO 2.5% 32.9% (p<0.001) (13). Inflammatory lesion reductions exceeded 75% with CAB (11,38). Adapalene 0.3%/BPO 2.5% reduced atrophic scar count by 21.7% at week 24 (p<0.0001 vs vehicle) (65). Safety profile showed mild-to-moderate local reactions; no serious BPO-related adverse events. Discussion: BPO monotherapy provides significant efficacy in mild-to-moderate acne. Combination therapies, particularly with adapalene or clindamycin, yield superior outcomes due to synergistic mechanisms. The triple combination CAB gel represents a significant advance for moderate-to-severe acne. However, most CAB evidence comes from industry-sponsored trials. Conclusion: BPO monotherapy is effective for mild acne. Combination therapy, especially with retinoids or antibiotics, is significantly more effective for moderate-to-severe disease. The triple combination offers the highest efficacy.

The Comprehensive Systematic Review of Effectiveness of Salicylic Acid in Chemical Peeling Procedures for Comedonal Acne Auliani Deby Veronica; Deriel Elka Hidayat
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): 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: 10.70070/1btjx557

Background: Comedonal acne is characterized by open and closed comedones and often requires effective keratolytic agents. Salicylic acid (SA), a lipophilic beta-hydroxy acid, is widely used in chemical peels, but comprehensive systematic evidence focusing specifically on comedonal outcomes is limited. Methods: This systematic review analyzed 52 studies, including randomized controlled trials, and comparative cohort studies. The primary outcome was comedone-specific reduction following SA chemical peels. Secondary outcomes included overall acne improvement, safety, tolerability, and comparison with other peeling agents. Results: Six biweekly sessions of 30% SA peels achieved consistent comedone reductions of 88–90% (p<0.001) (1,2). The salicylic-mandelic acid combination (20% SA + 10% mandelic acid) produced 90.2% comedonal clearance, significantly superior to 35% glycolic acid (35.87%) (5). SA 30% was significantly more effective than Jessner’s solution for non-inflammatory lesions (p=0.04) (4) and superior to 25% TCA in one study (69% vs. 60% reduction, p<0.001) (11), though another found equivalence (6). Combination therapies enhanced outcomes: SA peel plus pulsed dye laser showed greater improvement than SA alone (p=0.003) (7); adding SA peels to oral isotretinoin increased clearance from 73.4% to 92.5% (9). Safety was favorable: transient burning and erythema were common but self-limiting; no serious adverse events were reported. SA peels showed better tolerability than TCA and mandelic acid peels (6,16,40). Discussion: The lipophilic property of SA enables deep follicular penetration, explaining its superior comedolytic effect. Protocol variations (session frequency, outcome measurement) explain the reported heterogeneity (54–90%). The 6-session biweekly regimen appears optimal. Conclusion: Thirty percent salicylic acid peels administered biweekly for six sessions are highly effective, safe, and well-tolerated for comedonal acne, achieving approximately 90% comedone reduction. SA is superior or equivalent to most superficial peeling agents for comedones.

Postoperative Quality of Life after Gastrectomy : The Systematic Review of Randomized Controlled Trial Agem Tarhimul Mushlih; Isidora Galuh Parahita; Adi Chandra Perwira
The International Journal of Medical Science and Health Research Vol. 48 No. 1 (2026): 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/mdt6a717

Introduction: Gastrectomy is the cornerstone of curative treatment for gastric cancer but significantly impacts postoperative quality of life (QoL). Evidence synthesis from randomized controlled trials (RCTs) is essential to identify surgical and perioperative strategies that optimize QoL. Methods: This systematic review included 80 RCTs evaluating postoperative QoL after gastrectomy. Studies were screened for adult patients (≥18 years) undergoing elective gastrectomy with ≥30 days follow-up, using validated QoL instruments. Data extraction focused on gastrectomy details, QoL assessment methods, comparative effectiveness, and factors affecting QoL. Results: Function-preserving surgeries showed superior outcomes: pylorus-preserving gastrectomy achieved better hemoglobin preservation (+0.01 vs -0.76 g/dL, P<0.001) and lower gallstone formation (2.33% vs 8.66%, P=0.026) (2). Stomach-preserving surgery (SENORITA trial) demonstrated significantly better physical function (P=0.002), less eating restriction, and higher BMI (23.9 vs 22.1, P<0.001) at 1 year (3,26). Roux-en-Y reconstruction after distal gastrectomy provided durable global health benefits at 5 years (96.4±5.6 vs 90.9±13.7, P=0.010) versus Billroth-I (5). Vagus nerve preservation reduced diarrhea at 12 months (P=0.048) and gastroparesis (0.8% vs 7.6%) (4,21). Individualized nutritional counseling significantly improved global health, fatigue, dysphagia, and reflux (all P<0.05) (12). Multimodal prehabilitation reduced 90-day complications by 60% (RR 0.40, 95%CI 0.24-0.66) (13). Electro-acupuncture during adjuvant chemotherapy improved QoL (FACT-Ga TOI-AUC 5678±1229 vs 4735±1233, P<0.001) and disease-free survival (HR 0.47) (17). Psychological resilience training combined with nutritional support improved 2-year disease-free survival (79.3% vs 64.2%, P<0.001) (20). Discussion: Function-preserving and vagus-sparing techniques offer significant QoL advantages with acceptable oncological trade-offs in early-stage disease. Roux-en-Y reconstruction is superior for reflux control. Intensive face-to-face interventions are more effective than digital-only programs. Conclusion: Surgical technique, reconstruction method, and perioperative support significantly influence post-gastrectomy QoL. Function-preserving approaches, Roux-en-Y reconstruction, nutritional counseling, prehabilitation, and acupuncture yield substantial positive QoL benefits.

The Comprehensive Systematic Review of Management of Hypertensive Emergencies with Neurological Involvement Aulia Olviana
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): 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/sejybj42

Introduction: Hypertensive emergencies with neurological involvement, particularly intracerebral hemorrhage (ICH), present a therapeutic challenge where rapid blood pressure (BP) reduction must balance hematoma expansion prevention against cerebral ischemia risk. This review synthesizes evidence on management strategies. Methods: A systematic screening of sources identified 80 studies meeting predefined criteria: adult populations with hypertensive emergency and acute neurological symptoms, examining pharmacological or surgical interventions with clinical outcome reporting. Included studies comprised randomized controlled trials, cohort studies, and post-hoc analyses of major trials (INTERACT2, ATACH-2). Results: Intensive systolic BP (SBP) reduction to <140 mmHg reduced hematoma expansion but showed divergent functional outcomes: INTERACT2 demonstrated ordinal benefit (OR 0.87, p=0.04) while ATACH-2 was neutral. Pooled analysis revealed a J-shaped relationship: SBP reduction of 55-85 mmHg within 2 hours optimized outcomes, while reductions >70 mmHg reversed benefit (OR for unfavorable outcome increased) and increased acute kidney injury (OR 2.00, p<0.05). In patients with initial SBP ≥220 mmHg, intensive reduction caused excess neurological deterioration (15.5% vs. 6.8%, p=0.04). Minimally invasive surgery (endoscopy/aspiration) achieved superior 6-month functional outcomes (mRS 0-2: 33.3% and 32.7% vs. 22.2% for craniotomy, p=0.017). Urapidil produced greater BP reduction and better 1-month neurological scores than nitroprusside (p<0.05). Discussion: The apparent INTERACT2-ATACH-2 discrepancy is explained by differential baseline SBP, reduction magnitude crossing into harmful J-curve territory, and agent-specific effects. Optimal management requires individualized SBP reduction targets (55-85 mmHg range) with avoidance of excessive hypotension, particularly in severe ICH or extremely elevated SBP. Conclusion: Intensive BP reduction is beneficial when magnitude is titrated to baseline SBP, with an optimal reduction of 55-85 mmHg. Minimally invasive surgery improves outcomes in deep hemorrhages. Urapidil shows superior efficacy.

Arthroscopic Fixation of a Posterior Cruciate Ligament Avulsion Fracture: A Case Report I Made Wahyu Adi Putrawan; I Komang Mahendra Laksana Mendra
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): 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/vk427b75

Introduction: Avulsion fractures of the posterior cruciate ligament (PCL) are relatively uncommon injuries, particularly in the adolescent population. These injuries involve detachment of the ligament from its tibial insertion and may result in persistent posterior knee instability if not properly managed. Accurate diagnosis and appropriate fixation are essential to restore normal knee kinematics and prevent long-term complications. Case Illustration: This report presents the case of a 16-year-old female patient with a 3-month history of left knee pain and instability following a fall during training. Clinical examination revealed positive posterior drawer and valgus stress tests. Magnetic Resonance Imaging (MRI) confirmed a displaced tibial avulsion fracture of the PCL (Meyers-McKeever Type III) and a concomitant full-thickness MCL tear. The patient underwent a single-stage procedure: arthroscopic suspensory button fixation for the PCL avulsion and an anatomic reconstruction of the MCL. Discussion: Surgical management is superior to non-operative treatment for displaced PCL avulsions, citing improved union rates and better objective stability (Gopinatth et al., 2023). The rationale for selecting an arthroscopic suspensory fixation technique (Kan et al., 2020) over traditional open or arthroscopic suture methods is discussed, highlighting its minimally invasive nature, robust fixation, and avoidance of complications associated with other techniques (Hu et al., 2025). Conclusion: Arthroscopic suspensory fixation represents an effective and reliable treatment option for displaced PCL tibial avulsion fractures in adolescents. This technique enables stable fixation, supports early rehabilitation, and contributes to satisfactory restoration of knee stability, even in chronic cases.

MRI Manifestations in Isolated Ulnar Collateral Ligament Injury of the Thumb (Gamekeeper's Thumb) : A Systematic Review Hafid Septian Nugroho; Anas Khoeruluman; Lely Sabariyah; Imam Mustika
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): 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/bq4wks30

Introduction: Gamekeeper's thumb (acute ulnar collateral ligament injury of the thumb metacarpophalangeal joint) is a common sports-related injury. Accurate diagnosis, particularly differentiating Stener lesions from non-displaced tears, is critical for appropriate management. This systematic review synthesizes MRI manifestations and diagnostic performance for isolated thumb UCL injuries. Methods: A systematic literature screening identified studies involving living patients with isolated thumb UCL injury undergoing MRI evaluation. Data extraction focused on MRI techniques, imaging manifestations (ligament morphology, tear patterns, Stener lesions), diagnostic accuracy metrics, and classification systems. Results: The normal UCL demonstrates uniform hypointensity on all sequences with mean thickness 2.0-2.3 mm. Acute injuries show discontinuity, heterogeneous increased signal on fluid-sensitive sequences, and periligamentous edema. Distal insertion tears account for approximately 90% of ruptures. Partial tears demonstrate thickening (>7 mm) with <50% fiber involvement, while complete tears show full-thickness disruption. Stener lesions exhibit a characteristic "yo-yo on a string" appearance with the retracted ligament superficial to the adductor aponeurosis. Pooled MRI sensitivity for UCL tears is 99% (95% CI 92-100%) and specificity 100% (95% CI 87-100%). For Stener lesions, pooled sensitivity is 93% and specificity 98%. MRI significantly outperforms ultrasound for differentiating displaced from non-displaced tears (specificity 92% vs 72%, p<0.05). Discussion: MRI demonstrates exceptional diagnostic accuracy across the severity spectrum of thumb UCL injuries. The modality's superior soft tissue resolution enables direct visualization of the adductor aponeurosis interposition pathognomonic for Stener lesions. Coronal fluid-sensitive sequences provide optimal ligament visualization, while axial images are essential for assessing aponeurosis relationship. Chronic injuries with predominant scarring pose diagnostic challenges as edema is absent. MRI specificity for confirming UCL tears is significantly higher than clinical examination (100% vs 85%, p=0.04). Conclusion: MRI is a highly accurate, non-invasive imaging modality for thumb UCL injuries with pooled sensitivity and specificity exceeding 90%. It is particularly valuable for Stener lesion identification and surgical planning. Clinical examination with ultrasound serves as an efficient initial diagnostic pathway, with MRI reserved for ambiguous cases requiring definitive characterization.

Supraventricular Tachycardia in an Adolescent with Diabetic Ketoacidosis, Severe Hyperkalemia, and Pneumonia: A Case Report from a District Hospital in Indonesia Desty Fahriska; Muhammad Rahmatsyah Nasution; Nur Robbiyah
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): 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: 10.70070/3gfq7411

Introduction: Diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). Although electrolyte disturbances are common, life-threatening arrhythmias such as supraventricular tachycardia (SVT) are rarely reported, especially in resource-limited settings. This case illustrates the successful management of SVT triggered by severe hyperkalemia during DKA. Case Illustration: A 14-year-old girl with known T1DM presented with unconsciousness, Kussmaul breathing, and a three-day history of fever, cough, and vomiting. Initial assessment revealed Glasgow Coma Scale 9/10, heart rate 158 bpm, and blood pressure 113/64 mmHg. Laboratory findings showed blood glucose 425 mg/dL, pH 6.92, bicarbonate 3.4 mmol/L, and potassium 8.2 mmol/L. Serial electrocardiograms (ECG) showed peaked T-waves followed by narrow-complex SVT. Due to unavailability of adenosine, a vagal maneuver using an ice pack on the face was performed, along with intravenous calcium gluconate and insulin drip. The rhythm converted to sinus tachycardia within minutes. The patient also had bronchopneumonia and parotitis as DKA precipitants. Recovery was uneventful with no arrhythmia recurrence. Discussion: Hyperkalemia in DKA results from insulin deficiency, acidosis, and transcellular potassium shift. It can cause peaked T-waves and re-entrant arrhythmias including SVT. Vagal maneuvers are first-line for stable pediatric SVT. Calcium gluconate stabilizes cardiac membranes, while insulin and rehydration correct hyperkalemia. Conclusion: In DKA with hyperkalemia, early ECG monitoring is essential to detect arrhythmias. Vagal maneuvers can be effective even without adenosine. Stepwise management is life-saving.

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

Location Kota adm. jakarta selatan, Dki jakarta INDONESIA

Abstract

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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