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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 227 Documents
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LOW BACK PAIN MEKANIK PADA PASIEN DENGAN OBESITAS: PERAN PENURUNAN BERAT BADAN DALAM PERBAIKAN NYERI DI PUSKESMAS GERUNGGANG David Herryanto
The Indonesian Journal of General Medicine Vol. 28 No. 1 (2026): 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/trkgah58

Abstract

Pendahuluan: Low back pain (LBP) mekanik merupakan keluhan muskuloskeletal yang sering dijumpai di layanan kesehatan primer dan berkaitan erat dengan aktivitas fisik serta beban biomekanik pada tulang belakang. Obesitas menjadi faktor risiko yang semakin penting melalui peningkatan beban aksial, perubahan biomekanika, dan inflamasi kronik tingkat rendah. Penurunan berat badan diharapkan dapat memperbaiki keluhan nyeri dan fungsi pasien. Laporan Kasus: Seorang laki-laki usia 29 tahun, karyawan swasta dengan aktivitas dominan duduk lama, datang dengan keluhan nyeri tumit dan nyeri punggung bawah. Nyeri bersifat mekanik: memberat saat berdiri lama atau beraktivitas dan membaik dengan istirahat. Skala nyeri VAS 6–8, tidak disertai gejala neurologis. Pasien memiliki riwayat obesitas (BB 96–104 kg) dan hipertensi. Pemeriksaan fisik dalam batas normal, tanpa defisit neurologis. Pemeriksaan penunjang menunjukkan gula darah sewaktu 145–151 mg/dL, asam urat 4,9 mg/dL, kolesterol total 176 mg/dL. Penatalaksanaan meliputi edukasi perubahan gaya hidup, anjuran aktivitas fisik teratur (sepeda statis, renang), serta terapi farmakologis simptomatis. Pemantauan serial menunjukkan perbaikan intensitas nyeri meskipun berat badan masih berfluktuasi. Diskusi: Kasus ini menggambarkan LBP mekanik dengan faktor risiko obesitas dan postur kerja statis. Pendekatan komprehensif di layanan primer berfokus pada edukasi, modifikasi aktivitas, dan penurunan berat badan sebagai intervensi utama. Perbaikan klinis terjadi secara bertahap, menegaskan bahwa penatalaksanaan berkelanjutan di puskesmas efektif untuk memperbaiki nyeri dan fungsi pasien obesitas dengan LBP mekanik. Kesimpulan: Penurunan berat badan dan peningkatan aktivitas fisik berperan penting dalam perbaikan nyeri pada pasien LBP mekanik dengan obesitas. Pendekatan holistik dan berkesinambungan di layanan kesehatan primer merupakan kunci keberhasilan terapi. Kata kunci: low back pain mekanik, obesitas, penurunan berat badan, layanan kesehatan primer, aktivitas fisik
A Comprehensive Systematic Review of The Relationship Between Head Ultrasound Findings and the Risk of Cerebral Palsy in Premature Infants M. Faza Akroma; Leviani Mulia Primadani
The Indonesian Journal of General Medicine Vol. 28 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/55gryv67

Abstract

Introduction: Prematurity remains a leading cause of long-term neurodevelopmental disability, with cerebral palsy (CP) being one of the most severe motor outcomes. Cranial ultrasound (cUS) is a primary, non-invasive neuroimaging tool in the neonatal intensive care unit for detecting brain injuries prevalent in preterm infants, such as intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL). Establishing the strength and consistency of the relationship between specific cUS findings and subsequent CP risk is critical for prognosis, early intervention, and guiding clinical management (Romero-Guzman & López-Muñoz, 2017; O’Shea, 2016). Methods: This systematic review synthesized evidence from 80 studies, including cohort studies, case-control studies, and meta-analyses. The population comprised premature infants (<37 weeks gestation). Studies were included if they involved cUS examination, assessed CP diagnosis with clear criteria, and included follow-up to at least 12 months corrected age. Data extraction focused on premature population characteristics, specific cUS abnormalities, CP assessment methods, quantitative ultrasound-CP associations, and confounding factors (Linsell et al., 2016). Results: The analysis revealed a strong, hierarchical association between cUS abnormalities and CP risk. Cystic PVL showed the strongest association (Odds Ratio [OR] up to 70.9), followed by non-cystic PVL (Relative Risk [RR] 9.27), and severe IVH (Grade III-IV; OR 3.1-3.4). A normal cUS had a high predictive value (99%) for a normal or mildly abnormal MRI. Key risk factors like chorioamnionitis, lower gestational age, and postnatal dexamethasone exposure were significantly linked to both cUS abnormalities and CP. Intervention studies indicated that early treatment for post-hemorrhagic ventricular dilatation (PHVD) and antenatal corticosteroids improved neurodevelopmental outcomes (Gotardo et al., 2019; Hirtz et al., 2015; Cizmeci et al., 2020). Discussion: The heterogeneity in effect estimates across studies is attributable to population differences (e.g., extremely preterm vs. late preterm), timing and technique of cUS assessment, variations in CP outcome definitions, and methodological quality. The evidence confirms that cUS is a valuable prognostic tool, particularly for severe white matter injury and hemorrhage. However, its predictive accuracy is context-dependent, being highest in the most vulnerable infants. The mediating role of cUS-detectable injury in treatment effects (e.g., magnesium sulfate) underscores its importance in understanding pathways to CP (Guillot et al., 2020; Villamor-Martínez et al., 2019). Conclusion: Specific cUS findings, especially cystic PVL and high-grade IVH, are significant predictors of CP risk in preterm infants. Serial cUS screening, particularly at ~1 week and term-equivalent age, is recommended for high-risk infants. Prognostic counseling should consider both the strong reassurance offered by a normal scan and the nuanced interpretation of abnormal findings, acknowledging other contributing risk factors. Future research should prioritize standardized imaging protocols, longitudinal designs with long-term follow-up, and the integration of cUS with advanced imaging modalities for improved prediction.
A Comprehensive Systematic Review of The Relationship Between Excessive Analgesic Use and Migraine Chronicity Achmad Deddy Fatoni; An Nur Rahmad Nugroho
The Indonesian Journal of General Medicine Vol. 29 No. 1 (2026): 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/dp0kjq46

Abstract

Introduction: Medication overuse headache (MOH) is a significant complication in migraine management, where excessive use of acute analgesics paradoxically leads to increased headache frequency and chronicity. Understanding the bidirectional relationship between analgesic overuse and the transformation from episodic to chronic migraine (CM) is crucial for developing effective treatment strategies. This systematic review synthesizes evidence on this relationship and evaluates the efficacy of various interventions. Methods: A systematic methodology was employed to screen and extract data from 80 relevant studies. Inclusion criteria focused on adult migraine populations, clear definitions of analgesic overuse and migraine chronicity, quantitative outcome data, and studies with adequate sample sizes. Data extraction covered study design, definitions of key constructs, population characteristics, evidence of the analgesic-overuse-chronicity relationship, effects of interventions, and moderating factors. Results: Analgesic overuse is highly prevalent (40-78%) in CM populations, with triptans, combination analgesics, and NSAIDs being most commonly overused. Evidence strongly supports a causal relationship from overuse to chronicity, demonstrated by significant improvements following medication withdrawal. Detoxification combined with preventive treatment achieved the highest success rates (up to 96.8% MOH cure). Anti-CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab) showed consistent efficacy in reducing both migraine days and acute medication use, with 55-61% of patients reverting from overuse without formal detoxification. OnabotulinumtoxinA, gepants (e.g., atogepant), topiramate, and behavioral interventions (mindfulness, CBT) also demonstrated significant benefits. Outcomes varied by medication type overused, with triptan overuse associated with better prognosis, and were moderated by patient factors such as psychological comorbidities and pain catastrophizing. Discussion: The findings highlight a complex, bidirectional relationship where overuse perpetuates chronicity through mechanisms like central sensitization and altered pharmacokinetics, while effective preventive treatment reduces the need for acute medication. The evidence supports stratified treatment approaches: combined withdrawal and prevention for amenable patients, anti-CGRP therapies for those intolerant to withdrawal or with prior treatment failures, and integrated behavioral-pharmacological strategies for those with psychological comorbidities. Conclusion: Excessive analgesic use is a key modifiable risk factor in migraine chronicity. A multimodal, patient-centered approach is essential, prioritizing medication withdrawal where feasible, leveraging the efficacy of newer preventive therapies like anti-CGRP agents, and addressing psychological moderators. Future research should focus on long-term outcomes, personalized medicine based on overuse medication type, and the neurobiological mechanisms underlying the overuse-chronicity cycle.
A Comprehensive Systematic Review of The Relationship between Fluid Restriction Management and The Prevention of Complications in Dengue Hemorrhagic Fever in Children Ongku Saripa Hasibuan
The Indonesian Journal of General Medicine Vol. 29 No. 1 (2026): 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/vwh5m563

Abstract

Introduction: Dengue Hemorrhagic Fever (DHF) in children remains a significant global health challenge, with fluid management being a cornerstone of treatment. However, the optimal fluid strategy—restrictive versus liberal—remains controversial, particularly in preventing complications such as shock, organ dysfunction, and mortality (Wills et al., 2005). Methods: A systematic review was conducted following PRISMA guidelines. Studies were screened based on predefined criteria including pediatric population (0–18 years), restrictive fluid intervention, comparison groups, and outcomes related to DHF complications. Data extraction covered study characteristics, fluid protocols, complication outcomes, and clinical context.Results: A total of 53 studies were included, predominantly from dengue-endemic regions. Restrictive or protocol-driven fluid management was consistently associated with reduced mortality, shorter ICU and hospital stays, and lower incidence of respiratory complications and fluid overload compared to liberal strategies (Ranjit et al., 2005; Tang, 2017; Naorungroj et al., 2025).Discussion: The effectiveness of fluid management depends on clinical setting, disease phase, and resource availability. In well-monitored ICU settings, aggressive early resuscitation followed by de-escalation is beneficial, whereas in resource-limited settings, minimal or restrictive approaches may be safer (Ford et al., 2012; Liyanarachchi et al., 2022). Conclusion: A tailored, context-sensitive fluid management strategy—incorporating adequate initial resuscitation, vigilant monitoring, and timely de-escalation—is essential to optimize outcomes in pediatric DHF. Future studies should standardize definitions and protocols across diverse healthcare settings.
HUBUNGAN USIA DENGAN KEJADIAN PTERIGIUM DI RUMAH SAKIT MATA KOTA MAKASSAR TAHUN 2025 Syarifa Trya Nur Nahdiah; Marlyanti Nur Rahmah Akib; Ratih Natasha Maharani; Tiradewi Bustami; Azizah Anoez; Diah Tantri Darkuthni
The Indonesian Journal of General Medicine Vol. 29 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/8mz7pk97

Abstract

Latar belakang: Gangguan kesehatan mata merupakan masalah kesehatan global, dengan sekitar 285 juta orang mengalami gangguan penglihatan menurut World Health Organization (WHO). Pterigium adalah salah satu penyakit mata yang sering ditemukan di wilayah tropis dan subtropis dan dapat menurunkan kualitas penglihatan. Usia dan jenis kelamin diduga berperan dalam kejadian pterigium. Penelitian ini bertujuan untuk mengetahui hubungan usia dan jenis kelamin dengan kejadian pterigium di Rumah Sakit Mata Kota Makassar tahun 2025. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain deskriptif menggunakan data sekunder rekam medis pasien Poliklinik Mata RS Mata Makassar tahun 2025. Sampel diambil dengan teknik total sampling sesuai kriteria inklusi. Variabel independen adalah usia yang dikelompokkan menjadi dewasa muda (18–44 tahun), dewasa (45–59 tahun), dan lanjut usia (≥60 tahun), sedangkan variabel dependen adalah kejadian pterigium. Analisis data dilakukan secara univariat dan bivariat menggunakan uji Chi-Square dengan tingkat kemaknaan p<0,05. Hasil: Dari total 8.663 pasien, sebanyak 748 pasien (8,6%) terdiagnosis pterigium. Kelompok usia lanjut (≥60 tahun) merupakan kelompok dengan jumlah kasus terbanyak (43,2%). Analisis bivariat menunjukkan adanya hubungan yang bermakna antara usia dan jenis kelamin dengan kejadian pterigium (p<0,05), dengan proporsi lebih tinggi pada laki-laki dan meningkat seiring bertambahnya usia. Kesimpulan: Usia dan jenis kelamin berhubungan secara bermakna dengan kejadian pterigium, dengan risiko tertinggi pada kelompok usia lanjut dan pasien laki-laki, sehingga diperlukan upaya promotif dan preventif yang lebih terarah pada kelompok berisiko.
The Comprehensive Systematic Review of Vasoactive-Inotropic Score as a Predictor of Outcome in Pediatric Critical Care Mohamad Fadli; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 30 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/29yj3207

Abstract

Introduction: The Vasoactive-Inotropic Score (VIS) quantifies cardiovascular support in critically ill children by aggregating vasoactive medication doses into a single numerical value. Despite widespread clinical use, a comprehensive synthesis of VIS as a predictor of pediatric outcomes across diverse populations is lacking. This systematic review aimed to evaluate the predictive value of VIS for mortality and morbidity in pediatric critical care populations. Methods: A systematic review was conducted following PRISMA guidelines. We screened studies based on predefined criteria: pediatric population (0-18 years), explicit VIS calculation using standard formulas, reporting of clinical outcomes, and statistical analysis examining VIS-outcome relationships. Studies were excluded if limited to adult populations, case reports, conference abstracts, or editorials. Data extraction included population characteristics, VIS calculation methods, predicted outcomes, predictive performance metrics, and key findings. Results: Eighty-seven studies published between 2010-2025 met inclusion criteria, encompassing 29,920 patients across diverse settings (PICU, cardiac ICU, NICU). Post-cardiac surgery populations were most frequently studied (n=34), followed by septic shock (n=18) and neonatal populations (n=15). VIS demonstrated strong mortality prediction across populations: septic shock (AUROC 0.779-0.976), neonatal cardiac surgery (AUROC 0.83), congenital diaphragmatic hernia (AUROC 0.925), and extremely low birth weight preterm infants (AUROC 0.816-0.92). Optimal thresholds varied substantially from VIS >5 in preterm infants to >70 in myocarditis. Maximum VIS in the first 24-48 hours showed strongest associations with outcomes. VIS predicted prolonged mechanical ventilation (OR 5.20, 95% CI 3.78-7.16) and composite poor outcomes (OR 6.5-8.1). The Vasoactive-Ventilation-Renal (VVR) score outperformed VIS alone in cardiac surgery populations (AUC 0.87-0.98 versus 0.68-0.78). Discussion: VIS demonstrates consistent predictive validity across pediatric critical care populations, with performance comparable or superior to established scoring systems. Threshold heterogeneity reflects population-specific severity, age-related physiologic differences, and condition-specific considerations. Serial VIS monitoring provides incremental prognostic information beyond single measurements. Conclusion: VIS is a valid, readily calculable predictor of mortality and morbidity in pediatric critical care. Population-specific thresholds and integration with multi-organ dysfunction scores enhance predictive utility. Future research should focus on prospective validation of thresholds and implementation of VIS-guided clinical decision support.
The Comprehensive Systematic Review of Fluid Overload and Mortality in Critically Ill Children Mohamad Fadli; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 30 No. 1 (2026): 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/bz9f0f42

Abstract

Introduction: Fluid overload (FO) is a common complication in critically ill children associated with adverse outcomes. However, heterogeneity in definitions, measurements, and study populations has created gaps in understanding the true magnitude of this association. This systematic review aims to comprehensively synthesize evidence on the association between FO and mortality in critically ill children, examining definitions, measurement methods, and population-specific effects. Methods: A systematic review of observational studies, randomized controlled trials, and meta-analyses examining FO and mortality in critically ill children (0-18 years) admitted to PICUs, NICUs, or cardiac ICUs was conducted. Studies were screened based on predefined criteria including pediatric population, FO exposure with clear definition, mortality outcomes, and adequate sample size. Data extraction encompassed study characteristics, FO definitions, mortality outcomes, confounding adjustments, secondary morbidity outcomes, and methodological quality. Results: Sixty-five studies were included, comprising over 45,000 patients across general PICUs, cardiac ICUs, and specialized populations (sepsis, CRRT, ECMO, ARDS, TBI). FO definitions varied considerably, with percentage FO calculated as (fluid intake—output)/reference weight × 100 being most common. Thresholds ranged from ≥5% to ≥20%, with reference weights including admission, preoperative, or dry weight. Meta-analyses demonstrated significantly increased mortality with FO (pooled OR range: 4.34-5.06). A dose-response relationship was consistently observed, with 3-6% increased mortality odds per 1% FO increase. Mortality rates were consistently higher across FO thresholds: 29.4% vs. 65.6% for <10% vs. ≥20% FO in CRRT patients; 46% vs. 26% for >10% FO in sepsis. However, 4 studies found no independent association after multivariable adjustment. Secondary outcomes including prolonged mechanical ventilation, longer PICU/hospital stays, and AKI were consistently associated with FO. Discussion: This review demonstrates a consistent, dose-dependent association between FO and mortality across diverse pediatric critical care populations, though with important population-specific variations. The strongest associations were observed in sepsis, CRRT, ECMO, and post-cardiac surgery patients, while TBI showed inconsistent findings. The timing of FO assessment emerged as critical, with later-onset FO (>48-72 hours) showing stronger mortality associations. Methodological heterogeneity in FO definitions and measurement remains a significant limitation. Conclusion: Fluid overload is independently associated with increased mortality and morbidity in critically ill children, with evidence supporting a dose-response relationship. Standardized FO definitions and measurement protocols are urgently needed. Future research should focus on randomized trials of fluid management strategies and risk-stratified approaches.
HUBUNGAN JUMLAH KUNJUNGAN TERAPI INJEKSI TRIAMSINOLON ASETONID DENGAN RESPONS KLINIS KELOID: STUDI RETROSPEKTIF ANALITIK DI RSUD SUMBAWA Ketut Kwartantaya Winaya; Ida Ayu Agung Kirana Komalasari
The Indonesian Journal of General Medicine Vol. 30 No. 1 (2026): 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/thzabg62

Abstract

Pendahuluan: Keloid merupakan kelainan penyembuhan luka yang ditandai dengan proliferasi jaringan fibrosa yang melampaui batas luka asli. Kondisi ini sering kali menimbulkan keluhan subjektif berupa gatal, nyeri, serta gangguan kosmetik yang signifikan. Terapi standar yang paling efektif dan umum digunakan adalah injeksi kortikosteroid intralesi, khususnya triamsinolon asetonid. Efektivitas terapi ini sangat bergantung pada kepatuhan pasien dalam menjalani serangkaian kunjungan. Penelitian ini bertujuan untuk menganalisis hubungan antara frekuensi kunjungan terapi dengan perkembangan respons klinis pada pasien keloid di RSUD Sumbawa. Metode Penelitian: Penelitian ini menggunakan desain retrospektif analitik dengan mengambil data dari rekam medis pasien rawat jalan di Poliklinik Kulit dan Kelamin RSUD Sumbawa periode 2024-2025. Data mencakup 415 baris kunjungan yang dianalisis untuk mengidentifikasi profil demografis, pola kunjungan, diagnosis utama (ICD-10), dan diagnosis tambahan sebagai indikator respons klinis atau efek samping. Analisis data dilakukan secara deskriptif dan analitik untuk melihat keterkaitan jumlah sesi injeksi dengan stabilitas kondisi lesi. Hasil Penelitian: Hasil analisis menunjukkan bahwa mayoritas pasien ( > 95%) didiagnosis dengan hypertrophic scar atau keloid (L91.0). Terdapat variasi jumlah kunjungan yang lebar, mulai dari kunjungan tunggal hingga 14 kali kunjungan per pasien. Pasien dengan jumlah kunjungan yang lebih banyak ( > 6 kali) menunjukkan kecenderungan adanya diagnosis tambahan seperti hiperpigmentasi pasca-inflamasi (L81.0) dan xerosis kutis (L85.3), yang menandakan adanya respons kronis terhadap terapi. Sebagian besar pasien ( > 96%) menggunakan jaminan kesehatan BPJS, yang secara signifikan mendukung retensi kunjungan pasien. Diskusi: Injeksi triamsinolon asetonid bekerja dengan menekan mediator inflamasi dan menghambat aktivitas fibroblas. Frekuensi kunjungan yang rutin memungkinkan akumulasi efek farmakologis yang stabil untuk mendegradasi kolagen tipe I dan III. Di RSUD Sumbawa, ketersediaan dokter spesialis kulit dan kelamin (dr. YT, Sp.D.V.E) telah meningkatkan aksesibilitas layanan ini bagi masyarakat lokal, mengurangi angka rujukan ke luar daerah, dan memungkinkan manajemen kasus yang lebih komprehensif. Kesimpulan: Terdapat hubungan yang erat antara jumlah kunjungan dengan respons klinis keloid. Pasien dengan kunjungan rutin memiliki kemungkinan lebih besar untuk mencapai perataan lesi yang stabil dibandingkan pasien dengan kunjungan sporadis. Dukungan sistem pembiayaan kesehatan seperti BPJS sangat krusial dalam menjamin keberlangsungan terapi jangka panjang ini.
A Comprehensive Systematic Review of The Relationship between Vitamin E Consumption and the Risk of Preeclampsia Faizal Akbar Farid Musliem
The Indonesian Journal of General Medicine Vol. 31 No. 1 (2026): 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/pxp2vv33

Abstract

Background: Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality worldwide. Oxidative stress has been implicated in its pathogenesis, positioning vitamin E as a potential preventive agent due to its antioxidant properties. However, evidence regarding its efficacy remains conflicting. Methods: A comprehensive systematic review was conducted following PRISMA guidelines. We searched multiple databases for studies examining the relationship between vitamin E consumption and preeclampsia risk. Inclusion criteria encompassed randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies involving pregnant women. Data extraction included study characteristics, vitamin E exposure details, preeclampsia outcomes, biochemical markers, and confounding variables. Forty-six studies met inclusion criteria, comprising 12 RCTs, 8 cohort studies, 15 case-control studies, 13 cross-sectional studies, and 2 reviews. Results: RCTs demonstrated heterogeneous findings. While one trial using tocotrienol-rich fraction showed 97% risk reduction (aOR 0.030, 95% CI: 0.001-0.65; Aminuddin et al., 2021), large trials found no benefit (Poston et al., 2006; Beazley et al., 2005). The largest cohort study (n=73,317) identified a threshold effect at 7.3 mg/L serum vitamin E, with levels <5.5 mg/L associated with 29.56-fold increased risk (Shi et al., 2022). Observational studies consistently demonstrated lower vitamin E levels in preeclamptic women (Chaudhary et al., 2022; Aamir et al., 2021; Nnamdi et al., 2021). Dietary intake studies showed low intake was associated with increased risk (Rumbold et al., 2005; Masrikhiyah et al., 2016), but supplementation >100 mg/day in replete women was associated with harm (OR 1.68; Yang et al., 2025). Biochemical studies confirmed elevated oxidative stress markers and reduced antioxidant capacity in preeclampsia (Omar et al., 2019; Suhail et al., 2008; Begum et al., 2012). Discussion: The apparent contradiction between RCTs and observational studies is reconciled by baseline vitamin E status. The threshold effect at 7.3 mg/L explains why supplementation benefits deficient populations but not replete populations. Form of vitamin E (tocotrienols vs. alpha-tocopherol) and dose considerations are critical. Conclusion: Routine vitamin E supplementation is not supported in well-nourished populations. Targeted supplementation in vitamin E-deficient women (serum <7.3 mg/L) warrants further investigation.
HUBUNGAN DEPRESI DAN PROKRASTINASI AKADEMIK PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS MARANATHA BANDUNG ANGKATAN 2015 Fidi Kusuma; Cindra Paskaria; Ade Kurnia
The Indonesian Journal of General Medicine Vol. 31 No. 1 (2026): 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/yxb3z186

Abstract

Pendahuluan: Depresi merupakan suatu efek yang diakibatkan oleh peristiwa kehidupan yang menyebabkan stres berkepanjangan. Depresi merupakan gangguan mental yang umumnya ditandai dengan kesedihan yang berkepanjangan dan hilangnya minat terhadap aktivitas yang disukai, serta adanya ketidakmampuan melakukan aktivitas sehari-hari yang biasa dilakukan. Depresi yang dialami oleh mahasiswa dapat berpengaruh pada produktifitasnya terutama di bidang akademik. Prokrastinasi merupakan suatu perilaku menunda dalam hal melakukan ataupun merampungkan suatu pekerjaan demi melakukan aktivitas lain yang kurang berguna, sehingga kinerja menjadi terhambat, tugas tidak dapat selesai tepat waktu, dan tingginya frekuensi terlambat untuk menghadiri pertemuan-pertemuan. Prokrastinasi yang terjadi di lingkungan akademik disebut sebagai prokrastinasi akademik. Metode: Penelitian ini menggunakan subjek penelitian mahasiswa Fakultas Kedokteran Universitas Kristen Maranatha Bandung angkatan 2015 sebanyak 58 orang dengan metode pengambilan data menggunakan kuisioner depresi yang diadaptasi dari Beck Depression Inventory (BDI), dan alat ukur prokrastinasi akademik yaitu Skala Prokrastinasi Akademik yang telah dimodifikasi oleh Agam Anggoro. Hasil: Hasil dari penelitian ini menunjukkan adanya korelasi positif antara depresi dan prokrastinasi akademik (r=0.548, p=0.000). Diskusi: Hal ini menunjukkan bahwa semakin tinggi skor depresi seseorang maka semakin tinggi pula prokrastinasi akademik yang dilakukannya. Kesimpulan: Oleh karena itu dapat disimpulkan bahwa depresi dapat meningkatkan prokrastinasi akademik pada mahasiswa Fakultas Kedokteran Universitas Kristen Maranatha Bandung angkatan 2015.

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