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Cermin Dunia Kedokteran
Published by PT. Kalbe Farma Tbk.
ISSN : 0125913X     EISSN : 25032720     DOI : 10.55175
Core Subject : Health,
Health Professions
Cermin Dunia Kedokteran (CDK) is a Medical Journal published since 1974 and affiliated with PT Kalbe Farma Tbk. CDK is intended to help accommodate scientific publications and help increase and disseminate knowledge related to the development of medical science, pharmacy, and public health. CDK covers the disciplines of medicine, pharmacy, and health with several types of articles, namely: 1. Research 2. Literature review 3. Case report 4. Evidence-based case report (EBCR), systematic review 5. Other scientific articles Based on the SK Kemendikbudristek Nomor 152/E/KPT/2023, CDK has obtained Rank 4 (SINTA 4) for Scientific Journals.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,371 Documents
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Penatalaksanaan Leukemia Mieloid Akut pada Dewasa Muda di Daerah Terpencil: Laporan Kasus: Laporan Kasus Gultom, Clarissa Nadia; Ansori, Said
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1853

Abstract

Introduction: Acute myeloid leukemia (AML) is an aggressive and rapidly progressing hematopoietic malignancy that originates from myeloid stem cells in the bone marrow. Case: An 18-year-old male presented with nausea and vomiting for 5 days, preceded by frequent fatigue and weight loss over the past month. Vital signs were within normal limits. Physical examination revealed anemic conjunctivae and palpable enlargement of the liver and spleen. Laboratory examination revealed extreme leucocytosis, severe anemia, and thrombocytopenia. The patient was diagnosed with acute myeloid leukemia. Management was symptomatic with blood transfusion, and referred for further treatment. Discussion: AML is generally characterized by nonspecific symptoms such as anemia, fever, bleeding, hepatosplenomegaly, as well as hematological abnormalities including leukocytosis, anemia, and thrombocytopenia. The diagnosis is made by examining peripheral blood and bone marrow, while the prognosis is influenced by the patient's age, subtype, and cytogenetic abnormalities. Conclusion: AML in young adults may present with nonspecific symptoms such as fatigue, nausea, vomiting, and weight loss, which can delay diagnosis. Marked hematologic abnormalities, including extreme leukocytosis, severe anemia, and thrombocytopenia, should raise suspicion for AML. Early recognition, appropriate supportive management, and timely referral from peripheral healthcare facilities are essential to improve patient outcomes and survival.
Dolikoektasia Serebral Multipel sebagai Faktor Potensial Penyebab Perdarahan Intrakranial dan Intraventrikular Selama Krisis Hipertensi: Laporan Kasus: Laporan Kasus Basja, Agnes Triana; Fikriyah, Lathifatul
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1899

Abstract

Introduction: Dolichoectasia (DE) represents an uncommon vascular anomaly of the brain, characterized by abnormal dilation and elongation of cerebral blood vessels. Its occurrence is relatively rare, with an estimated prevalence ranging from 0.05% to 0.06%. Although predominantly observed within the vertebrobasilar system, cases involving the anterior cerebral circulation have also been documented. Patients with DE are susceptible to intracranial and intraventricular hemorrhage. Case: A 54-year-old male with sudden extremity weakness, hypertensive crisis, and hyperlipidemia. CT imaging showed intracranial hemorrhage in the left thalamic and intraventricular hemorrhage in the posterior horn of the left ventricle with enlargement and tortuosity of the intracerebral artery and vertebrobasilar artery. These imaging findings led to a diagnosis of multiple cerebral dolichoectasia. The patient underwent conservative management with antihypertension and decompression therapy, leading to a gradual alleviation of symptoms. Discussion: Hypertension is considered the major risk factor for intracranial hemorrhage in this patient, while dolichoectasia may represent an associated vascular abnormality that potentially increases vessel wall vulnerability. Structural alterations in dolichoectatic vessels, including disruption of elastic fibers and remodeling of the tunica media, may contribute to reduced vascular integrity under severe hemodynamic stress. The coexistence of hypertensive crisis and multiple dolichoectasia may therefore increase susceptibility to hemorrhagic complications. Conclusion: CT imaging is essential for the diagnosis of dolichoectasia and the detection of associated complications, including intracranial and intraventricular hemorrhage. Early and accurate diagnosis may improve patient outcomes by enabling appropriate therapy.
Tantangan Diagnostik pada Leukemia Akut: Laporan Kasus tentang Hasil Pemeriksaan Sumsum Tulang yang Tidak Jelas dengan Adanya Sel Blast pada Sediaan Darah Perifer: Laporan Kasus Dewi, Putu Itta Sandi Lesmana; Dharmayudha, Tjokorda Gede
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1939

Abstract

Introduction: Acute leukemia is a hematologic malignancy characterized by the proliferation of immature leukocytes that disrupt normal hematopoiesis, leading to cytopenias and systemic symptoms. Diagnosis typically relies on bone marrow evaluation. Peripheral blood findings may be critical when marrow results are inconclusive. Case: A 23-year-old male with melena, severe anemia, generalized weakness, and a two-week history of back pain. Physical examination revealed pallor and splenomegaly. Initial laboratory findings showed severe macrocytic anemia, leukocytosis, and thrombocytopenia. A peripheral blood smear revealed 63% blasts with a high nuclear-to-cytoplasmic ratio and prominent nucleoli. Despite these findings, the diagnosis of acute leukemia, bone marrow aspiration was inconclusive. Elevated lactate dehydrogenase indicated a high tumor burden. Discussion: Peripheral smear evaluation, supported by cytogenetic and flow cytometry studies, is vital for early diagnosis. Acute leukemia must remain a differential consideration even in the absence of definitive bone marrow findings. Conclusion: This case highlights the diagnostic challenge of acute leukemia with inconclusive initial bone marrow findings. Peripheral blood smear detection of circulating blasts was crucial in establishing the diagnosis. Early recognition through integrated diagnostic evaluation remains essential for the timely initiation of treatment.
Indikasi CT Scan pada Tata Laksana Trauma Kepala pada Anak: Tinjauan Pustaka Agus, Aurelia Michelle Calista
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1951

Abstract

Head injury is an emergency case, including in the pediatric population. Pediatric head injury is a common cause of mortality and morbidity in the pediatric population. Head computed tomography (CT) scan is used as the gold standard in traumatic brain injury diagnosis, allowing for fast and accurate diagnosis. However, there are often constraints like limited facilities, uncooperative children, and risk of malignancy due to radiation exposure. Moreover, most pediatric head trauma cases are mild and only < 10% require neurosurgical intervention. Several algorithms and clinical decision protocols have been formulated to assist clinicians in determining the need for performing a CT scan, especially for children with minor head injury. The three most frequently used clinical decision rules are PECARN (Pediatric Emergency Care Applied Research Network), CATCH (Canadian Assessment of Tomography for Childhood Head Injury), and CHALICE (Children's Head Injury Algorithm for the Prediction of Important Clinical Events). Implementing these clinical decision rules may reduce unnecessary CT scans and minimize radiation exposure in children. Furthermore, these predictive algorithms can support faster, more effective, and safer clinical decision-making in the emergency management of pediatric head trauma.
Penyakit Moyamoya Tahap III menurut Klasifikasi Suzuki pada Orang Dewasa: Diagnosis dan Penatalaksanaan Konservatif — Laporan Kasus: Laporan Kasus Candrayuni, Ni Made Ayu; Riyadi, Marsya Julia; Wardhana, I Made Edwin Alberty
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1980

Abstract

Introduction: Moyamoya disease (MMD) is a rare, progressive cerebrovascular condition, predisposing patients to ischemic or hemorrhagic strokes—particularly among Asian populations. Case: A 38-year-old male with a prior ischemic stroke in 2023 presented with acute left lower limb weakness lasting two days. MRI showed an acute and chronic ischemic lesion, and an acute lacunar infarct in the right superior frontal gyrus. MRA and cerebral angiography confirmed Suzuki stage III MMD, with A1 right anterior cerebral artery (ACA) occlusion and collateral flow from the left posterior cerebral artery (PCA). Cerebral angiography revealed occlusion of the proximal A1 segment of the right ACA and a characteristic “puff of smoke” appearance from abnormal collateral vessels in the distal branches of the right middle cerebral artery (MCA). The patient was managed conservatively with cilostazol, rosuvastatin, and antiplatelet therapy, alongside physical rehabilitation, resulting in functional improvement. Discussion: MMD is a progressive vasculopathy that may cause recurrent cerebrovascular events due to impaired cerebral perfusion. Cerebral angiography remains essential for diagnosis and Suzuki staging. Although revascularization surgery is the standard treatment to improve cerebral blood flow and reduce stroke risk, conservative management may be considered in selected patients based on clinical stability, collateral circulation, and treatment indications. In this case, conservative therapy combined with rehabilitation was associated with clinical improvement, although continuous monitoring is required due to the progressive nature of the disease. Conclusion: Early diagnosis of MMD through advanced neuroimaging is crucial for preventing recurrent stroke and guiding treatment decisions. This case highlights that individualized conservative management may provide clinical benefits in adult Suzuki stage III MMD when surgical intervention is not immediately performed, while long-term follow-up remains essential.
Diagnosis Miokarditis yang Tertunda Setelah Trauma Tumpul Abdomen: Sebuah Laporan Kasus Langka: Laporan Kasus Kaiba, Astrid Carolinn Valleriana; Kuntadi, Putu Aditya Darmawan; Athoillah, Nabil
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.2015

Abstract

Introduction: Myocarditis is an inflammation of the myocardium that can lead to impaired heart function and sudden death. Most cases are caused by viral infections and are very rarely reported as a post-traumatic complication. Case: A 54-year-old male developed abdominal pain and vomiting after blunt abdominal trauma. The patient was initially diagnosed with colonic rupture and underwent exploratory laparotomy. Despite initial improvement, the patient experienced hemodynamic deterioration. Electrocardiography, cardiac biomarkers,and echocardiography evaluation revealed myocarditis with decreased ejection fraction. Despite supportive and pharmacological therapy, the patient fell into cardiogenic shock and passed away. Discussion: This case demonstrates that the diagnosis of myocarditis can besignificantly delayed in patients with atypical presentations and no obvious cardiac symptoms. Abdominal trauma accompanied by systemic infection, such as colonic rupture, may potentially cause secondary myocardial inflammation. Clinicians need to consider the possibility of myocarditis in patients with postoperative hemodynamic instability, even without a history of cardiac disease. Conclusion: This report highlights the urgency of improving diagnostic awareness of myocarditis and access to support facilities.
Pengaruh Vitamin D dalam Menurunkan Kadar Protein C-Reaktif pada Kolitis Ulserativa: Laporan Kasus Berbasis Bukti: Laporan Kasus Berbasis Bukti Batubara, Irawati Friana; Sonia, Steffi
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.2033

Abstract

Introduction: Ulcerative colitis (UC) is a chronic gastrointestinal inflammatory disease characterized by immune dysregulation. C-reactive protein (CRP) is used as a marker of inflammation and disease severity. Vitamin D has an immunomodulatory role, and low serum levels are associated with increased disease activity in UC. However, the effect of vitamin D supplementation on inflammatory markers in UC remains unclear. This study aims to evaluate the effect of vitamin D supplementation on CRP levels in patients with UC. Methods: A systematic literature search was conducted across three databases: PubMed, Scopus, and the Cochrane Library. The search strategy was developed based on the PICO approach, with filters for randomized controlled trials and meta-analyses. Duplicates were removed, and selection was carried out based on titles, abstracts, and full texts. The selected studies were critically appraised using the validity, significance, and applicability approach from the Centre for Evidence-Based Medicine. Results: Two studies met the criteria, one systematic review and meta-analysis, and one meta-analysis. Although both studies showed a significant reduction in CRP levels after vitamin D administration, the validity of these studies remains doubtful. Conclusion: Current evidence is insufficient to support a definitive recommendation for the use of vitamin D supplementation in patients with ulcerative colitis. High-quality randomized controlled trials are needed.
Perbandingan Fraksi Trombosit Imatur (IPF) dan Prokalsitonin (PCT) sebagai Penanda Biologis Tingkat Keparahan Infeksi dalam Hubungannya dengan Antigen NS1 pada Pasien Demam Berdarah Dengue (DBD) Baihaki, Ichwan; -, Mutmainnah; Nugroho, Heru Purwanto; Aprilicia, Gita
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.2035

Abstract

Background: Dengue hemorrhagic fever (DHF) is an infectious disease caused by the dengue virus (DENV) and transmitted by the Aedes aegypti and Aedes albopictus mosquito vectors. This disease remains a major global health problem, particularly in tropical regions such as Indonesia. Clinical indicators of DHF severity include thrombocytopenia and shock, which are associated with high viremia levels and an increase in dengue NS1 antigen in the vascular system. This study compares immature platelet fraction (IPF) and procalcitonin (PCT) levels as biomarkers of infection severity in relation to DENV NS1 antigen positivity. Methods: This study included 35 patients with DHF and 35 healthy controls. IPF values and PCT levels were measured. Differences between the two groups were analyzed using an independent t-test. Results: p-values for both IPF and PCT were < 0.05, indicating statistically significant differences between DHF patients and healthy controls. These findings suggest that higher IPF values are associated with thrombocytopenia, whereas elevated PCT levels may reflect more severe infection, including dengue shock syndrome. Conclusion: There are significant differences in IPF and PCT levels between DHF patients and controls, depending on dengue NS1 antigen positivity. IPF may serve as an indicator of thrombocytopenia, while PCT may be a marker of infection severity, including dengue shock syndrome, in patients with dengue hemorrhagic fever.
Tinjauan Kebijakan pada Rencana Aksi Nasional Eliminasi Kanker Leher Rahim sebagai Pencegahan Primer Kanker Serviks di Indonesia: Perspektif Vaksinasi HPV berdasarkan Rekomendasi Pusat Pengendalian dan Pencegahan Penyakit: Tinjauan Pustaka Kusuma, Fitriyadi; Suryoadji, Kemal Akbar
Cermin Dunia Kedokteran Vol 53 No 07 (2026): Juli 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i07.1675

Abstract

Introduction: Cervical cancer is the second most prevalent cancer among women in Indonesia and ranks third globally. It accounts for 7.5% of cancer-related deaths worldwide, with a notable impact in developing nations like Indonesia. The primary cause is high-risk Human Papillomavirus (HPV); however, the risk can be lowered through vaccination. This review aims to evaluate Indonesia's policy for implementing a national HPV vaccination program targeting school-aged children and assess its conformity with CDC guidelines. Methods: The study involved an extensive review of literature, as well as international and Indonesian policy documents. Results: The CDC recommends HPV vaccination for individuals aged 9-26, ideally beginning at 11 or 12 years old. In line with this, Indonesia has included the HPV vaccine in its national immunization schedule. The Indonesian Ministry of Health intends to require HPV vaccination for school-aged children, aiming for full national implementation by 2023. This reflects Indonesia's strong commitment to a comprehensive cervical cancer prevention strategy. The policy's alignment with CDC recommendations emphasizes the country's dedication to primary prevention through HPV vaccination. Conclusion: By enforcing HPV vaccination for school-aged children, Indonesia aims to substantially decrease the incidence and mortality rates associated with cervical cancer. This policy represents a significant advance in the fight against cervical cancer in Indonesia and could serve as a model for other countries contending with similar public health issues.
Skor TriAge+ sebagai Alat Diagnostik Klinis Awal Vertigo Sentral pada Stroke Serebelum – Laporan Kasus: Laporan Kasus Vidyarni, Kurnia Elka; Irawati, Dyah
Cermin Dunia Kedokteran Vol 53 No 07 (2026): Juli 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i07.1706

Abstract

Introduction: Vertigo is a common complaint in the emergency department (ED); however, differentiating central from peripheral vertigo remains challenging. More than 4.4 million patients present to the emergency department annually with dizziness or vertigo, and approximately 5% are diagnosed with stroke. Early identification of central vertigo is crucial to prevent adverse neurological outcomes. Case: A 63-year-old male presented with severe swaying dizziness accompanied by nausea, rendering him unable to walk. The TriAge+ score was 9, indicating high risk for stroke. On the fourth day of hospitalization, the patient developed weakness in the right extremities and impaired sensory function in the bilateral cranial nerve V distribution. Non-contrast head CT revealed a subacute ischemic cerebral infarction affecting the pons, right corona radiata, and bilateral basal ganglia, with signs of brain atrophy. The patient was diagnosed with central vertigo due to cerebellar infarct stroke. Discussion: The TriAge+ score demonstrates high sensitivity for detecting central vertigo in the ED. In resource-limited settings where neuroimaging is not immediately available, this bedside clinical tool can facilitate early risk stratification and timely referral for definitive diagnostic workup and stroke-specific care. Conclusion: The TriAge+ score, as an early clinical diagnostic tool in the ED, is essential for detecting central vertigo in order to reduce morbidity and mortality associated with cerebellar stroke.

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