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The Indonesian Journal of General Medicine
Published by International Medical Journal Corp. Ltd.
ISSN : -     EISSN : 3048104X     DOI : -
Core Subject : Health,
Dentistry Health Professions Medicine & Pharmacology Public Health Veterinary
ims: The Indonesian Journal of General Medicine aims to advance the field of medicine by disseminating high-quality research findings that are accessible to a broad audience of healthcare professionals, researchers, and policymakers. The journal is committed to supporting the development of medical knowledge and practice in Indonesia and globally, fostering innovative research and evidence-based clinical practices. Scope: The journal covers a wide range of topics within the general medical field, including but not limited to: Clinical studies in various medical disciplines Epidemiological research and public health issues Innovations in diagnostic techniques and treatments Reviews on current practices and emerging trends in medicine Case studies and clinical trials Health policy and medical education The Indonesian Journal of General Medicine welcomes submissions from all areas of medicine, particularly those that have significant implications for patient care, public health, and policy-making. The journal encourages submissions that offer new insights, propose novel approaches, or address challenges pertinent to the Indonesian and international medical communities.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 3 Documents
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Search results for , issue "Vol. 17 No. 4 (2025): The Indonesian Journal of General Medicine" : 3 Documents clear
Diagnostic Accuracy of Artificial Intelligence-Assisted Phonocardiography for Pathological Heart Murmurs and Congenital Heart Disease in a Pediatric Population: A Systematic Review and Meta-Analysis Meicyana Nona Pita; Vanessa C. Gunawan; Subhika Laksmi
The Indonesian Journal of General Medicine Vol. 17 No. 4 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ze98pw33

Abstract

Background: Congenital heart disease (CHD) is a major global health concern, and early detection is critical for preventing adverse outcomes. Cardiac auscultation, the primary screening method, suffers from high inter-observer variability and modest accuracy, leading to both missed diagnoses and unnecessary specialist referrals. Artificial intelligence (AI)-assisted phonocardiography has emerged as a promising solution, but its overall diagnostic performance has not been quantitatively synthesized. Methods: Following the PRISMA 2020 guidelines, a systematic literature search was conducted across PubMed, Cochrane CENTRAL, and Google Scholar to identify studies evaluating the diagnostic accuracy of AI-assisted phonocardiography in pediatric populations (≤18 years). Eligible studies used echocardiography as the reference standard and provided sufficient data to construct a 2x2 contingency table. The methodological quality of included studies was assessed using the QUADAS-2 tool. A bivariate random-effects model was employed to calculate pooled sensitivity, specificity, likelihood ratios, and the diagnostic odds ratio (DOR), which were visualized using forest plots and a Summary Receiver Operating Characteristic (SROC) curve. Results: The selection process yielded 16 studies for inclusion in the meta-analysis. The pooled analysis demonstrated a summary sensitivity of 91.7% (95% CI: 87.3–94.7) and a summary specificity of 95.3% (95% CI: 91.8–97.4) for the detection of pathological murmurs or CHD. The positive likelihood ratio was 19.7 (95% CI: 10.8–35.6), the negative likelihood ratio was 0.087 (95% CI: 0.055–0.136), and the DOR was 226.6 (95% CI: 89.8–571.5). Methodological quality assessment revealed that nearly half of the studies (43.8%) had a high risk of bias in the patient selection domain, primarily due to the use of case-control designs. Conclusion: AI-assisted phonocardiography exhibits high diagnostic accuracy for detecting pathological heart murmurs and CHD in children, significantly surpassing the performance of conventional auscultation. However, its effectiveness is reduced for subtle acoustic signals, and the evidence base is partly limited by methodological issues in primary studies. With further validation in large-scale prospective trials, this technology holds transformative potential as a scalable, cost-effective screening tool to improve health equity in pediatric cardiac care globally.
Sacroiliac Joint Fusion vs. Conservative Management for Chronic Sacroiliac Joint Pain: A Systematic Review of Pain and Functional Outcomes I Made Wahyu Adi Putrawan; I Gusti Ngurah Paramartha Wijaya Putra
The Indonesian Journal of General Medicine Vol. 17 No. 4 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ab9b1d81

Abstract

Introduction: Chronic sacroiliac (SI) joint pain is a significant contributor to low back pain, affecting 15-30% of patients. While conservative management is the initial treatment, many patients fail to achieve lasting relief. Minimally invasive sacroiliac (MIS) joint fusion has emerged as a promising alternative. This systematic review aims to synthesize high-level evidence on the comparative efficacy of MIS fusion versus conservative management for chronic SI joint pain. Methods: Following PRISMA guidelines, a systematic search was conducted across multiple databases. Included studies were randomized controlled trials and cohort studies from the last decade that compared MIS fusion with non-operative care in adults with confirmed SI joint pain. The primary outcomes analyzed were pain reduction (e.g., VAS) and functional improvement (e.g., Oswestry Disability Index). Twenty-seven studies met the inclusion criteria. Results: The evidence consistently demonstrated that MIS fusion provides statistically significant and clinically meaningful improvements in pain and function compared to conservative management. Pain scores (VAS) were reduced substantially more in fusion groups, and functional (ODI) scores showed marked improvement. These benefits were shown to be durable at follow-ups of 24 months and beyond. A significant counterpoint was a sham-controlled trial that found no statistical difference between MIS fusion and a sham procedure. Revision rates for MIS fusion were low, typically 1-5%. Conclusion: For appropriately selected patients with chronic SI joint pain refractory to non-operative care, MIS fusion is a significantly effective and durable intervention that offers a high probability of improving pain, function, and quality of life. Its success is contingent upon rigorous diagnosis, and while the procedure is relatively safe, further research is needed to clarify its efficacy against placebo.
Pemfigoid Bulosa Ekstensif Atipikal dengan Keterlibatan Mukosa Genital pada Pria 31 Tahun: Laporan Kasus Langka dan Berat dari Bangka Belitung, Indonesia David Herryanto; Andriansyah Bonorusid
The Indonesian Journal of General Medicine Vol. 17 No. 4 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/72cfzc63

Abstract

Pendahuluan: Pemfigoid bulosa (PB) adalah penyakit autoimun bulosa subepidermal yang paling umum, secara klasik menyerang populasi lansia, biasanya pada dekade ketujuh hingga kedelapan kehidupan (Kridin, 2018; Schmidt et al., 2022). Patogenesisnya dimediasi oleh autoantibodi IgG yang menargetkan protein hemidesmosom BP180 dan BP230 (Dewi, 2017; Fuertes de Vega et al., 2014). Presentasi pada individu dewasa muda, terutama dengan manifestasi klinis yang parah dan keterlibatan mukosa genital, sangat jarang dilaporkan dan menimbulkan tantangan diagnostik serta terapeutik yang signifikan (Rocha et al., 2011; Al-Dhaheri et al., 2023). Laporan kasus ini bertujuan untuk mendokumentasikan secara komprehensif presentasi klinis yang sangat atipikal, dilema diagnostik yang kompleks, dan strategi penatalaksanaan awal pada kasus PB yang langka ini. Ilustrasi Kasus: Seorang pasien laki-laki berusia 31 tahun datang dengan keluhan lesi bula tegang yang luas dan progresif cepat selama satu bulan, menyebar di abdomen, punggung, dan area genital . Keluhan disertai pruritus berat dan nyeri. Pemeriksaan dermatologis menunjukkan bula multipel berdinding tegang dengan berbagai ukuran, erosi, dan krusta hemoragik di atas dasar kulit eritematosa. Lesi di perut tertutup krusta tebal akibat aplikasi obat oles ramuan tradisional yang tidak diketahui jenisnya (krusta medikamentosa). Kondisi ini diperparah oleh infeksi sekunder dan higiene personal yang buruk, di mana pasien sudah lama tidak mandi. Ditemukan pula erosi pada mukosa oral dan genital. Secara mengejutkan, ditemukan tanda Nikolsky dan tanda Asboe-Hansen yang positif, menciptakan sebuah paradoks klinis yang signifikan . Diagnosis kerja ditegakkan sebagai pemfigoid bulosa, dengan diagnosis banding utama sindrom Stevens-Johnson (SJS) dan pemfigus vulgaris (PV). Pasien dirawat inap dan diberikan terapi kortikosteroid sistemik intravena (deksametason), antibiotik spektrum luas, dan perawatan luka suportif . Diskusi: Kasus ini menyoroti beberapa penyimpangan utama dari gambaran klasik PB: usia onset yang sangat muda, tingkat keparahan penyakit yang ekstensif, dan keterlibatan mukosa genital yang langka, yang merupakan penanda penyakit yang lebih berat (Kridin et al., 2019). Adanya tanda Nikolsky yang positif, sebuah temuan yang secara klasik berasosiasi dengan pemfigus akibat akantolisis intraepidermal, menjadi anomali klinis yang paling menantang (Uzun & Durdu, 2016). Hipotesis yang diajukan adalah bahwa proses inflamasi yang sangat intens pada PB dapat menyebabkan kerusakan sekunder pada epidermis, menghasilkan fenomena "pseudo-Nikolsky" atau bahkan pelemahan kohesi epidermal basal yang menyerupai tanda Nikolsky sejati (Sardana & Garg, 2013). Temuan ini menekankan keterbatasan tanda klinis tunggal dalam diagnosis dan menggarisbawahi peran krusial pemeriksaan penunjang definitif seperti biopsi kulit dan imunofluoresensi direk (DIF) untuk diagnosis yang akurat (Murrell et al., 2021). Infeksi sekunder disebabkan oleh pengobatan tradisional. Kesimpulan: Pemfigoid bulosa dapat bermanifestasi pada dewasa muda dengan gambaran klinis yang parah dan atipikal, termasuk keterlibatan mukosa genital dan tanda klinis yang menyesatkan. Diperlukan kewaspadaan klinis yang tinggi dan pendekatan diagnostik yang sistematis, termasuk konfirmasi melalui pemeriksaan histopatologi dan imunopatologi, untuk memastikan penatalaksanaan yang tepat dan akurat pada kasus-kasus yang kompleks.

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