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Jonny Karunia Fajar
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Deka in Medicine
Published by PT. DEKA RESEARCH GROUP
ISSN : 30472024     EISSN : 30472024     DOI : https://doi.org/10.69863
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Deka in Medicine is the open-access journal of Deka Institute (PT. Deka Research Group), which is established to support open access and knowledge sharing among medical scientists. The journal publishes three highly informative issues every year (in April, August, and December) at the appropriate intervals to circulate research findings properly throughout the year. As a beacon of high standards in academics, Deka in Medicine observes very stringent measures in peer reviewing and kindly welcomes the contributions of world scholars and researchers with open arms. The journal aims to promote knowledge by being disseminated across the globe in English and further advocates for a platform that would enable scholars and researchers to carry on scientific discussion and collaboration within the discipline. The key objective of this journal is to serve as a medium through which clinical and basic research can be promoted in the varied medical sciences. The journal was noted for its broad material cover, embracing topics in different areas under the dominion of medical sciences—from clinical and basic medical sciences to medicine and applied medical sciences. It is through such comprehensive coverage that the journal hopes to provide an integrated view of the dynamic complexities within the sphere of medical sciences, from which the spread of new insights and innovations in clinical practices, research methodologies, and therapeutic interventions may emanate. It additionally aims to contribute to the development and improvement of medical knowledge and practices around the world. To address the wide range of interests of clinical practitioners and researchers, it is a leading forum whereby different scholars, intellectuals, and practitioners from diverse regions across the globe present their academic perspectives and research activities. These are intended to foster mutual intellectual interchange internationally, open up educational opportunities, and initiate collaborations. Deka in Medicine publishes diversified scholarly contributions, ranging from original research articles, review articles, brief reports, case studies, and case series elucidating enlightening editorial reports, and commentaries. The breadth of publication by the journal is an attempt to be more than just a vehicle for the dissemination of the latest research but aims to be a channel that allows for scholarly exchange, facilitates the distribution of knowledge, and advances medical sciences.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 8 Documents
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Search results for , issue "Vol. 2 No. 2 (2025): August 2025" : 8 Documents clear
Serum IL-18 as a predictive biomarker for acute kidney injury in sepsis patients Pratama, Satya; Sutanto, Heri; Samsu, Nur
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e643

Abstract

BACKGROUND: Sepsis is a syndrome that can result in multiorgan dysfunction, including acute kidney injury (AKI). AKI is a serious complication of sepsis, and its incidence ranges from 30% to 50%. Newer predictive biomarkers such as serum interleukin-18 (IL-18) are being evaluated as early diagnostic markers with potentially greater sensitivity than serum creatinine. OBJECTIVES: To evaluate the usefulness of serum IL-18 levels as a predictive biomarker for AKI in patients with sepsis. METHODS: The cross-sectional study was conducted at Dr. Saiful Anwar General Hospital and included 68 sepsis patients, 34 with AKI and 34 without AKI. The serum level of IL-18 was measured using the ELISA method. AKI diagnosis was made according to the KDIGO criteria. The Mann-Whitney test, Spearman correlation, and receiver operating characteristic (ROC) curve analysis were included in the statistical analysis. RESULTS: The results showed that serum IL-18 levels were significantly greater in the AKI group compared with the non-AKI group (49.88 ± 50.87 vs. 19.89 ± 10.40; p < 0.001). A significant positive correlation was observed between serum IL-18 levels and the risk of AKI (r = 0.505; p < 0.001). ROC analysis revealed an area under the curve (AUC) of 0.792 with 82.4% sensitivity and 64.7% specificity at a cut-off value of 23.81 pg/mL. Logistic regression revealed that with each 1-unit increase in serum IL-18, a 7.3% increase in the risk of developing AKI was observed. CONCLUSION: Serum IL-18 has good potential to serve as a predictive biomarker for AKI in sepsis patients, with reasonable diagnostic accuracy.
Association between esophageal varices severity and psychological distress in cirrhotic patients Mustika, Syifa; Fathoni, Alfan; Sopacua , Andre; Vianty , Liku
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e690

Abstract

BACKGROUND: Patients with liver cirrhosis are highly vulnerable to psychological disorders; however, the implications of these mental health issues on the severity of esophageal varices remain unclear. OBJECTIVES: This study aimed to investigate the correlation between the grading of esophageal varices and the occurrence of anxiety and depression in cirrhotic patients experiencing upper gastrointestinal bleeding. METHODS: This study was conducted on inpatients at Dr. Saiful Anwar General Hospital, Malang, who were diagnosed with liver cirrhosis and experienced upper gastrointestinal bleeding over a six-month period using a consecutive sampling method. The grading of esophageal varices from endoscopic data was categorized according to the First Baveno International criteria. Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was performed using the Chi-Square test with a significance level of p-value < 0.05. RESULTS: Out of 53 respondents, 46 had large-grade esophageal varices and 7 had small-grade varices. Based on HADS scores, 38 respondents exhibited symptoms of anxiety, 10 were within the normal range, and 5 exhibited symptoms of depression. A significant moderate correlation was found between the grading of esophageal varices and the presence of anxiety and depression in cirrhotic patients with upper gastrointestinal bleeding (p = 0.001; r = 0.445). CONCLUSION: There is a significant correlation between large-grade esophageal varices and the occurrence of anxiety in cirrhotic patients experiencing upper gastrointestinal bleeding.
Comparative study of SCFA and butyrate levels in chronic hepatitis versus cirrhosis patients Mustika, Syifa; Fachrurrezza, Mochammad; Rakhmadhan, Iraky; Adam, Adam; Reyhan , Muhammad
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e688

Abstract

BACKGROUND: Cirrhosis is a common complication of chronic liver disease and exerts a profound influence on gut microbiota and metabolic function. Short-chain fatty acids (SCFAs), particularly butyrate, are crucial to intestinal integrity and immunomodulation. The relationship between SCFA levels and the progression of liver disease is not well understood. OBJECTIVES: The current study aimed to study the level of SCFAs and butyrate in fecal samples of patients with chronic hepatitis B, chronic hepatitis C, and compensated cirrhosis. METHODS: The research was conducted at Dr. Saiful Anwar General Hospital, Malang, Indonesia, from January to June 2023. Fecal samples were collected and measured for SCFA and butyrate concentrations by gas chromatography. The comparison was made statistically by the Mann-Whitney U test between groups. RESULTS: A total of 26 patients with chronic hepatitis B, chronic hepatitis C, or compensated cirrhosis were enrolled in the study. The overall mean SCFA level in the participants was 9.85 ± 4.78 mg/mL. The findings revealed no difference in the level of SCFA in chronic hepatitis patients and cirrhosis patients (p = 0.72). Likewise, there was no difference in butyrate levels between the two groups (p = 0.37). CONCLUSION: During the present study, SCFA and butyrate levels were not significantly different in chronic hepatitis patients compared to cirrhosis patients. SCFA synthesis and use may be affected by various factors such as dietary patterns, microbiota diversity, and metabolic differences among individuals. Further studies with larger populations and dietary control are necessary to delineate the role of SCFAs in the pathogenesis of liver disease and therapeutic applications.
Extreme thrombocytosis as a rare initial manifestation of chronic myeloid leukemia: A case report Brahmantya, Herwindo; Insanfadhil, Muhammad
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e651

Abstract

BACKGROUND: Severe thrombocytosis is a rare presentation of chronic myeloid leukemia (CML), but can be associated with rapid advancement of the disease and severe consequences. The aim of this case report is to describe the management of CML with severe thrombocytosis simulating essential thrombocythemia (ET). CASE: A 29-year-old male presented to emergency department with the symptoms of pain and swelling in left lower limb for four days. Swelling began in thigh and gradually spread to lower leg and was accompanied by pain on movement. Patient was diagnosed with CML in 2019 and on Imatinib 400 mg/day since then. Physical exam showed anemic conjunctiva, splenomegaly (Schuffner 1/8), and palpable mass of left gastrocnemius muscle. MRI revealed an intramuscular cystic mass suggestive of a lymphangioma. Laboratory results presented with severe anemia, leukocytosis, and spectacular thrombocytosis (6,143,000/µL). Bone marrow aspiration revealed elevated granulopoiesis and megakaryopoiesis, 10% myeloblasts, 5:1 myeloid-to-erythroid ratio, and positive platelet aggregation. Chronic-phase CML with transformation imitating ET was the diagnosis rendered. Treatment was with hydroxyurea, nilotinib, aspirin, intravenous fluids, and thrombocytapheresis. Two days after thrombocytapheresis, the patient complained of significant clinical improvement and was able to walk independently with minimal residual pain. CONCLUSION: CML with massive thrombocytosis is noteworthy to present specifically as it may mimic ET and carry a risk of thrombotic complications. Therapy by multimodal approach using TKI, cytoreduction, and thrombocytapheresis may be highly effective.
Chronic osteomyelitis in systemic lupus erythematosus: Diagnostic and therapeutic pitfalls Insanfadhil, Muhammad; Rahman, Perdana
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e667

Abstract

BACKGROUND: Chronic osteomyelitis is a recalcitrant and difficult-to-treat bone infection, particularly in immunocompromised individuals such as patients with Systemic Lupus Erythematosus (SLE). The coexistence of chronic osteomyelitis with SLE and malnutrition is clinically rare. This article aims to describe the diagnostic approach and conservative management of chronic osteomyelitis in a patient with SLE. CASE: A 19-year-old female presented with a two-week history of medial left knee pain, progressive swelling, and difficulty walking. The symptoms had recurred intermittently since November 2020, initially beginning with swelling and ulceration, and later developing into purulent discharge. Physical examination revealed swelling from the medial to posterior aspect of the left knee, tenderness, and reduced range of motion. Radiographic imaging demonstrated bone destruction in the proximal third of the left tibia, consistent with chronic osteomyelitis. A previous wound culture showed growth of antibiotic-sensitive bacteria. The patient was also diagnosed with SLE in remission, malnutrition (BMI <18), and an asymptomatic urinary tract infection. She was treated conservatively with oral antibiotics based on culture results, nutritional supplementation, and continued immunosuppressive therapy. Follow-up demonstrated clinical improvement without systemic infection or new local complications. CONCLUSION: Chronic osteomyelitis in malnourished patients with SLE can be successfully managed with a conservative treatment approach. Comprehensive evaluation and long-term follow-up are essential to minimize the risk of recurrence and complications.
The association of monocyte-to-lymphocyte and neutrophil-to-lymphocyte ratios with CIMT in HD and CAPD populations Baridwan, Fakhri; Samsu, Nur; Winoto, Eden
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e680

Abstract

BACKGROUND: Chronic kidney disease (CKD) carries a high risk of cardiovascular complications due to atherosclerosis, which is exacerbated by chronic inflammation. The neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are emerging inflammatory markers with potential to predict atherosclerotic risk. OBJECTIVES: To evaluate the association between NLR and MLR values with carotid intima-media thickness (CIMT) in CKD patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). METHODS: This observational cross-sectional study was conducted at Dr. Saiful Anwar General Hospital, Malang, between July and December 2024. Data on baseline characteristics, laboratory results, and CIMT were obtained from medical records and carotid ultrasonography. Statistical analyses included t-tests, Mann-Whitney tests, and Pearson or Spearman correlation tests, depending on data distribution. RESULTS: A total of 97 CKD patients were included (45 on CAPD and 52 on hemodialysis). NLR values were significantly higher in the CAPD group compared to the hemodialysis group (p = 0.0253), while MLR did not differ significantly. CIMT was significantly higher in the hemodialysis group (p = 0.0035). In the CAPD group, MLR was significantly correlated with CIMT (r = 0.3543; p = 0.0169), whereas no significant correlation was observed in the hemodialysis group. NLR was not significantly associated with CIMT in either group. Subgroup and ROC analyses indicated that neither NLR nor MLR could accurately differentiate elevated CIMT from normal. CONCLUSION: MLR is associated with CIMT in patients undergoing CAPD, while NLR does not show a significant association with CIMT in either dialysis group.
Beyond the hype: Artificial intelligence at the service of clinical care Felipe, Vitor; Bersot, Carlos
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e634

Abstract

Artificial intelligence (AI) has generated significant expectation in the healthcare industry, particularly as a transformative factor in diagnosis, treatment, and patient care. Although its implementation continues to evolve, the majority of current AI applications remain limited to administrative and non-clinical functions, such as chatbots, computerized scheduling, and electronic triage systems. For AI to have a transformative impact on clinical practice, clinicians with first-hand knowledge of patient care dynamics and healthcare systems' real-world demands must lead the deployment of AI. In cardiovascular medicine, AI can make a considerable impact by integrating data from diverse sources—like wearable sensors, laboratory tests, and patient-reported outcomes—to detect early clinical changes and enable personalized follow-up. General public use of wearable devices provides an opportunity for continuous monitoring of patients, if the data thus created is filtered and interpreted through a clinically sound framework. Such a transformation helps develop adaptive and efficient models of follow-up that not only optimize resource use but also improve quality of care. The active engagement of doctors as designers of medical technology is imperative to make sure that digitalization is kept patient-centric and not focused on system efficiency only. If well integrated, AI has the potential to augment clinical responsiveness, enhance the doctor–patient relationship, and help create a more efficient, sustainable, and human-oriented healthcare system.
DEKA protocols for meta-analyses: Strengthening study transparency through a modified PRISMA approach Fajar, Jonny
Deka in Medicine Vol. 2 No. 2 (2025): August 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e669

Abstract

Meta-analysis has emerged as an increasingly vital method for synthesizing scientific evidence in support of data-driven decision-making. To maximize its contribution, meta-analysis manuscripts must be written in a systematic and informative manner. This article aims to provide a conceptual and technical guide on how to write a meta-analysis article that adheres to international scientific standards. In reporting meta-analyses, the title serves as a critical entry point for both readers and reviewers; therefore, it should clearly reflect the population, intervention, and outcome of interest, and include the phrase “a systematic review and meta-analysis” to facilitate indexing. An effective abstract should be concise and well-structured, encompassing the background, objective, methods, main findings, and conclusion, while maintaining clarity and self-sufficiency. The selection of keywords is equally important, as it significantly enhances article visibility in scientific databases; thus, the use of Medical Subject Headings (MeSH) is strongly encouraged. The introduction should present a logical framework that outlines the broader research issue and the specific covariates under analysis, along with clearly formulated objectives and hypotheses. The methods section must transparently describe the literature search strategy, inclusion and exclusion criteria, study quality appraisal, and statistical approaches, all aligned with PRISMA guidelines. Results should be reported systematically, with attention to heterogeneity, publication bias, and consistency of effects. The discussion should synthesize findings in relation to existing literature and theory, address study limitations, and identify directions for future research. The conclusion should highlight the clinical or scientific relevance of the main findings and outline opportunities for future exploration. When written in accordance with proper structure and scholarly principles, a meta-analysis article can achieve strong academic value and broad contributions to science and clinical practice.

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