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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 31 Documents
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The role of parathyroid and bone scintigraphy in detecting multiple parathyroid adenomas with fibrous dysplasia: A case report Khairunnisa, Alifina; Budiawan, Hendra; Affandi, Erwin; Kartamihardja, Achmad
Deka in Medicine Vol. 2 No. 1 (2025): April 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e576

Abstract

BACKGROUND: Primary hyperparathyroidism is the leading cause of hypercalcemia, usually caused by a parathyroid adenoma and potentially leading to metabolic bone disorders. Fibrous dysplasia is a rare skeletal disorder that can coexist with hyperparathyroidism, although it is rarely found without McCune-Albright syndrome. CASE: A 31-year-old woman with a history of hemodialysis presented with progressive swelling of the upper and lower jaw over the past two years, accompanied by bone pain and fatigue. Laboratory tests revealed elevated parathyroid hormone levels, serum creatinine, and hypocalcemia. Magnetic resonance imaging (MRI) of the neck identified an isointense lesion in the left thyroid gland but failed to localize the parathyroid adenoma. 99mTc-Sestamibi parathyroid scintigraphy showed multiple adenomas in the lower poles of both thyroid lobes. 99mTc-MDP bone scintigraphy demonstrated a metabolic superscan pattern, leading to a diagnosis of primary hyperparathyroidism with polyostotic fibrous dysplasia. The patient underwent minimally invasive parathyroidectomy, which was histopathologically confirmed as bilateral inferior parathyroid adenomas. Postoperatively, the patient experienced significant symptom improvement, including reduced bone pain and improved quality of life. CONCLUSION: The coexistence of primary hyperparathyroidism and fibrous dysplasia without McCune-Albright syndrome is rare but important to recognize. Parathyroid and bone scintigraphy play a crucial role in diagnosis, assessing bone involvement, and planning appropriate therapy. A multimodal imaging approach enables early detection and more effective surgical strategies, improving clinical outcomes for patients.
Diagnostic challenges in assessing treatment responds of primary bone lymphoma: A case report Angelina, Arlene; Kusumahstuti, Kharisma; Darmawan, Budi; Hidayat, Basuki
Deka in Medicine Vol. 2 No. 1 (2025): April 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e570

Abstract

BACKGROUND: Primary Bone Lymphoma (PBL) is quite difficult to assess treatment responses because of limited access to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). Therefore, this study intends to highlight one case regarding alternative imaging modalities, such as technetium-99m methylene diphosphonate (99mTc-MDP) and technetium-99m methoxyisobutyl isonitrile (99mTc-MIBI), for activity assessment in tumors as well as their involvement in the marrow. CASE: A 17-year-old male with persistent pain and swelling in the left knee over one month underwent a bone biopsy that confirmed the diagnosis of Diffuse Large B-Cell Lymphoma (DLBCL) in the tibia. The patient was subjected to chemotherapy using cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), followed by radiotherapy. PET/CT was unavailable; therefore, metabolic tumor evaluation was performed through 99mTc-MDP and 99mTc-MIBI scintigraphy for tumor activity and bone marrow involvement assessment. Bone scintigraphy with 99mTc-MDP showed increased tracer uptake in the proximal left tibia and distal left femur, indicating ongoing tumor activity. These findings were reinforced by the further assessment with 99mTc-MIBI, which confirmed high metabolic activity in these areas. Subsequently, a bone marrow biopsy evidenced infiltrative lymphoblasts constituting 24.8 percent infiltrating the involved marrow space, thus confirming the bone marrow being infiltrated. Hence, this patient received additional rituximab treatment to enhance treatment outcome. CONCLUSION: This case portrays the difficulties one faces while evaluating the treatment response in Primary Bone Lymphoma (PBL), as well as the role of 99mTc-MDP and 99mTc-MIBI scintigraphy as alternative metabolic imaging modalities in the absence of PET/CT.
The impact of assisted living facilities on hospitalization, length of stay, and mortality rates among the elderly: A systematic review and meta-analysis Sopacua, Andre; Haryanto, Ahmad; Soenarti, Sri
Deka in Medicine Vol. 2 No. 1 (2025): April 2025
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2025.e514

Abstract

BACKGROUND: With 21.3% of the global population aging, the demand for assisted living facilities (ALFs) for individuals with complex medical conditions has surged. However, residing in ALFs may be associated with higher hospital admission rates, longer hospital stays, and increased mortality compared to living at home. The exact relationship between ALFs and these adverse health outcomes remains unclear. OBJECTIVES: To determine the correlation between ALFs—including nursing homes (NH), home care (HC), and residential care (RC)—and hospitalization rates, length of hospital stay, and mortality compared to community-dwelling individuals. METHODS: A literature search was conducted across five databases, focusing on risk ratios for hospitalization and mortality, as well as mean changes in hospital duration. This study compared interventions involving NH, HC, and RC with community dwelling. Quality appraisal was performed using the Newcastle-Ottawa Scale (NOS), and a forest plot was generated using a random-effects model with 95% confidence intervals (CI). RESULTS: Community-dwelling individuals had a 1.21 times higher likelihood of hospitalization compared to those in ALFs (RR 1.21, 95% CI: 0.97–1.51, I²=100%, p=0.10). Subgroup analysis showed that individuals receiving HC and NH had lower hospitalization rates than those in community settings, while RC residents had a higher risk. Additionally, ALF residents experienced longer hospital stays compared to the control group [MD: -1.21 (95% CI: -3.06 to 0.65, I²=99%, p=0.20)]. Mortality rates were 2.83 times higher among community dwellers than ALF residents (RR 2.83, 95% CI: 1.43–5.61, I²=100%, p=0.003). Subgroup analysis also indicated lower mortality risks among individuals receiving RC, NH, and HC compared to those in community settings. CONCLUSION: ALFs are associated with an increased risk of hospitalization and mortality, as well as a shorter length of hospital stay.
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.

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