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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 1,288 Documents
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Tinjauan Atas Efikasi Asam Traneksamat Oral untuk Terapi Melasma Marinda Nur Triyanti
Cermin Dunia Kedokteran Vol 49 No 8 (2022): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i8.290

Abstract

Melasma adalah kondisi hipermelanosit didapat berupa makula tidak merata yang umumnya simetris. Kondisi ini biasanya terlokalisasi dan bersifat kronik-residif. Di antara banyak faktor kausatif yang berperan pada patogenesis melasma, salah satu yang dianggap penting adalah paparan sinar UV pada kulit. Pengobatan melasma penuh tantangan karena sering rekuren. Asam traneksamat adalah plasmin inhibitor yang melalui sistem plasmin-aktivator plasminogen berperan mencegah induksi pigmentasi oleh radiasi UV. Artikel ini bertujuan meninjau efikasi asam traneksamat oral pada terapi melasma. Melasma is an acquired hypermelanocyte condition; generally localized, symmetrical in regular macules form, and chronic-recidive. Many causative factors may play role in the pathogenesis of melasma, one that is considered important is UV exposure. Despite several treatments available, recurrences are common. Tranexamic acid as plasmin inhibitor acts mainly via the plasminogen activator-plasmin system to prevent UV radiation-induced pigmentation. This review discuss the efficacy of oral tranexamic acid for melasma treatment.
The Roles of Social Media in Hypertension Management Programs Pandit Bagus Tri Saputra; Sherly Yolanda; Dinda Dwi Purwati; Sulistiawati
Cermin Dunia Kedokteran Vol 49 No 8 (2022): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i8.291

Abstract

Hypertension is still one of the leading causes of morbidity and mortality globally. Complications of hypertension cause innumerable social, economic, and health cost burdens, reaching 131 million dollars per year in the United States. However, blood pressure control through lifestyle modifications and pharmacological intervention, achieving blood pressure targets is often unsatisfying. With its simple, cost-efficient, multifunctional, and enormous coverage characteristics, social media is promising to be utilized in health programs. Social media could provide massive information and accommodate the hypertension community to increase hypertension awareness. Incorporating social media in hypertension management improves patients’ lifestyles and pharmacological adherence more than conventional methods. The exact mechanism of how social media-based health programs increase treatment adherence is complex and has not been well-defined; raised awareness, bidirectional communication, and a qualified coach (physician) seem to be the essential factors. It should also be well aware that screen time duration and emotional alteration due to social media exposure could also potentially increase blood pressure. Hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Komplikasi hipertensi menimbulkan beban sosial, ekonomi, dan biaya kesehatan yang mencapai 131 juta dollar setiap tahun di Amerika Serikat. Kontrol tekanan darah melalui modifikasi gaya hidup dan intevensi farmakologis, hasilnya seringkali masih belum memuaskan. Media sosial dengan karakteristiknya yang simpel, murah, multifungsi, dengan cakupan sangat luas tampak menjanjikan untuk digunakan dalam program-program kesehatan. Media sosial dapat menyediakan berbagai informasi dan mengakomodasi komunitas untuk meningkatkan kesadaran terhadap hipertensi. Penggunaan media sosial dalam manajemen hipertensi tampak mampu memperbaiki pola hidup dan ketaatan farmakologi lebih baik daripada metode konvensional. Mekanisme pastinya bersifat kompleks dan masih belum dapat dijelaskan dengan baik; namun peningkatan kesadaraan, komunikasi dua arah, dan pendamping (dokter) terkualifikasi tampak sebagai faktor-faktor penting. Hal yang seharusnya juga diperhatikan adalah durasi screen time dan perubahan emosional karena saat menggunakan media sosial juga dapat berpotensi meningkatkan tekanan darah.
Pengaruh Ekstrak Etanol Daun Sirsak terhadap Histologi Tumor Payudara Tikus Putih Betina Sprague Dawley Teguh Rinjaya; Muhammad In’am Ilmiawan; Mardhia Mardhia
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.292

Abstract

Kanker payudara merupakan kasus kanker tertinggi pada wanita di seluruh dunia dan penyebab kematian terbesar akibat kanker. Salah satu tanaman yang diketahui dapat bersifat sebagai anti-kanker adalah daun sirsak. Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak etanol daun sirsak terhadap histologi sel tumor payudara pada tikus betina galur Sprague Dawley. Penelitian eksperimental dengan desain post-test only control group. Proses induksi tumor payudara dengan pemberian 7,12 dimetilbenz(α)antracene (DMBA) dan estrogen. Total subjek penelitian adalah 30 ekor tikus betina galur Sprague Dawley yang dibagi menjadi 6 kelompok, yaitu normal, kontrol negatif (DMSO 5%), kontrol positif (tamoxifen per oral 50 mg/kgBB/hari), perlakuan I (ekstrak daun sirsak per oral 75 mg/kg/hari), perlakuan II (ekstrak daun sirsak per oral 150 mg/kgBB/hari), dan perlakuan III (ekstrak daun sirsak per oral 300 mg/kgBB/hari); perlakuan diberikan selama 9 hari. Uji statistik Fischer exact test menunjukkan tidak terdapat perbedaan gambaran jaringan histologi secara bermakna antar kelompok perlakuan. Ekstrak etanol daun sirsak dosis 300 mg/kgBB/hari tidak memengaruhi histologi tumor payudara.   Breast cancer is the most frequent cancer and cause of cancer death in women worldwide. Soursop leaf has been known to have anti-cancer properties. This study aimed to determine the effect of soursop leaf ethanol extract on the histology of breast tumor in female Sprague Dawley rats. This is an experimental study with a post-test only control group design. Breast tumor was induced by 7,12 dimethylbenz(α)anthracene (DMBA) and estrogen injection. The total subjects were 30 female rats Sprague Dawley divided into 6 groups: normal, negative control (DMSO 5%), positive control (tamoxifen oral 50 mg/kgBW/day), treatment I (soursop leaf extract oral 75 mg/kgBW/day, treatment II (soursop leaf extract oral 150 mg/kgBW/day), and treatment III (soursop leaf extract oral 300 mg/kgBW/day). Each treatment was for 9 days. Analysis with Fischer exact test resulted in no significant difference in histological characteritics among the treatment groups. Ethanol extract of soursop leaves at a dose of 300 mg/kgBW/day did not affect the histology of breast tumor.
Manajemen Pasien Sirosis Hepatis saat Pandemi COVID-19 Guruh Dirga Saputra
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.293

Abstract

Penyakit coronavirus (COVID-19) mengakibatkan keadaan darurat kesehatan manusia secara global, tak terkecuali pasien penyakit hati, seperti sirosis hepatis yang dianggap lebih rentan terinfeksi virus karena respons imun yang terganggu. Kerusakan hati terkait COVID-19 berhubungan dengan sitotoksisitas virus langsung, aktivasi sistem kekebalan sistemik, kerusakan hati terkait penggunaan obat, reaktivasi penyakit hati yang sudah ada, dan hepatitis, sehingga tingkat morbiditas dan mortalitas terkait COVID-19 pada pasien sirosis relatif lebih tinggi. Hingga saat ini, masih belum ada pengobatan farmakologis yang terbukti efektif dan aman untuk pasien sirosis dengan COVID-19. Fokus utama tata laksana adalah mencegah perburukan dan menangani komplikasi.   Coronavirus disease (COVID-19) is a global human health emergency, and patients with liver diseases such as liver cirrhosis are considered more susceptible to viral infections due to an activation of the systemic immune system. COVID-19-associated liver damage is associated with direct viral cytotoxicity, activation of the systemic immune system, drug-associated liver damage, reactivation of pre-existing liver disease, and hepatitis. Most evidences suggest a relatively higher rate of COVID-19-related morbidity and mortality in cirrhotic patients. An effective and safe pharmacological treatment for cirrhotic patients with COVID-19 has not been determined. The main focus is to prevent worsening course and manage complications.
Patofisiologi Spinal Cord Injury Kartini Ciatawi; Tiffany
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.294

Abstract

Spinal cord injury (SCI) dapat mengakibatkan defisit motorik, sensorik, dan autonom yang substansial, bahkan permanen. Saat spinal cord mengalami trauma, trauma awal akan menyebabkan kerusakan langsung; seiring waktu, proses inflamasi akut ditambah astrogliosis berkontribusi terhadap cedera sekunder. Berbagai modalitas evaluasi dan terapi SCI masih belum sepenuhnya berhasil memperbaiki fungsi neurologis. Hal ini diduga akibat kompleksitas patofisiologi SCI.   Spinal cord injury (SCI) can cause substantial motor, sensory, and autonomic deficits or even permanent loss of neurological function. The initial trauma causes direct damage to the spinal cord; the acute inflammatory process coupled with astrogliosis contributes to secondary injury. Various evaluation and treatment modalities for SCI are still mostly unsuccessful in improving neurological function. This is may be due to the complexity of the pathophysiology of SCI.
Sindrom Guillain-Barre sebagai Gejala COVID-19 dan Potensi Efek Samping Pasca-Vaksinasi COVID-19 Joanesa Della Felista; Budi Riyanto Wreksoatmodjo
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.295

Abstract

COVID-19 adalah penyakit infeksi virus SARS-CoV-2. Gejala umum COVID-19 adalah pada saluran pernapasan, namun dapat ditemukan gejala neurologis antara lain sindrom Guillain-Barré (GBS). Hingga saat ini prevalensi kasus GBS pada pasien COVID-19 sekitar 0,15%. Selain itu, GBS juga dapat merupakan salah satu efek samping setelah pemberian vaksin COVID-19. Insiden GBS lebih banyak pada penerima vaksin viral vector (0,38/100.000 dosis) dibandingkan penerima vaksin mRNA (0,18/100.000 dosis). Hingga saat ini belum ada laporan kasus GBS pasca-vaksinasi berbasis protein. Hampir semua kasus GBS baik yang menerima vaksin berbasis mRNA maupun viral vector menunjukkan respons baik terhadap terapi IVIg.   COVID 19 is primarily a respiratory viral infection, but there are reports of neurological symptoms among patients; one of the accompanying neurological symptoms is Guillain-Barré Syndrome (GBS). Its prevalence among COVID 19 patients is approximately 0.15%. GBS is also reported as a side effect after COVID vaccinations. Its incidence in greater among viral vector vaccine recipients (0.38/100.000 doses) as compared to mRNA vaccine recipients (0.18/ 100.000 doses). No GBS case was reported after protein-based vaccine administration. The majority of cases responded well after IVIg therapy.
Tata Laksana Ensefalitis Toksoplasma pada Penyandang HIV Fani Agusta Chandra
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.296

Abstract

Ensefalitis toksoplasma (toxoplasma encephalitis atau TE) adalah infeksi oportunistik intrakranial tersering pada penyandang HIV. Manifestasi TE akibat reaktivasi infeksi laten terjadi jika imunitas seluler menurun (CD4+ <100 sel/mm3). Diagnosis presumtif berdasarkan klinis (manifestasi lesi desak ruang dan defisit neurologis fokal progresif dengan awitan subakut), radiologis (lesi multipel fokal berbentuk cincin dengan edema di sekitarnya), dan respons klinis serta radiologis terhadap terapi empiris anti-toksoplasma dalam 2 minggu pertama. Terapi akut lini pertama adalah kombinasi pyrimethamine, sulfadiazine, dan leucovorin selama minimal 6 minggu. Terapi ARV (anti-retrovirus) biasanya dimulai 2 - 3 minggu setelah terapi akut dimulai, harus dilanjutkan dengan terapi rumatan sebagai profilaksis sekunder hingga kriteria penghentian dicapai.   Toxoplasma encephalitis is the most prevalent intracranial opportunistic infection amongst HIV population. TE manifestations are due to a reactivation of latent infection because of decreased cellular immunity (CD4+ <100 cells/mm3). Presumptive diagnosis is based on clinical syndrome (mass effect signs and symptoms and progressive focal neurological deficit with subacute onset), imaging (multiple focal ring-enhancing lesions with surrounding edema), and clinical and radiological response to anti-toxoplasma empiric therapy in the first 2 weeks of administration. The first line treatment for acute therapy is combination of pyrimethamine, sulfadiazine, and leucovorin for a minimum of 6 weeks. ART (anti-retroviral therapy) is usually started 2 - 3 weeks after acute therapy; followed by maintenance therapy as secondary prophylaxis until criteria for discontinuation it is fulfilled.
Primary Intraosseous Carcinoma, Not Otherwise Specified with Ameloblastic Carcinoma Features in a Middle-aged Woman Stephen Utama Candinegara; Dewa Gede Subawa; Renaningtyas Tambun
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.297

Abstract

Primary Intraosseous Carcinoma, Not Otherwise Specified (PIOC, NOS) is an extremely rare neoplasm defined as squamous cell carcinoma in the mandible, presumably from the residue of odontogenic epithelium. The diagnosis is often challenging, and the prognosis is poor. The treatment of choice is surgical excision but usually declined for cosmetic reasons. A 41-year-old Melanesian woman with a mass in her right jaw since two years ago but rapidly growing in the last six months, accompanied with pain. Irregular hard mass was found in the right mandible. Radiology studies revealed lytic tumors, likely infiltrating. No metastasis was found. The first biopsy revealed acanthomatous ameloblastoma, and the second biopsy revealed pseudoepitheliomatous hyperplasia. Wide excision was then conducted with pathology results of PIOC and NOS with some features of ameloblastic carcinoma. This case may arise from a previous benign precursor. Further genetic information may be needed. The treatment of choice is surgical excision. The prognosis needs further follow-up.   Primary intraosseous carcinoma, not otherwise specified (PIOC, NOS) merupakan keganasan odontogenik yang langka. Diagnosisnya sulit dengan prognosis buruk. Tata laksana utama adalah bedah eksisi yang cenderung ditolak karena alasan estetik. Seorang perempuan ras Melanesia usia 41 tahun, mengeluh benjolan rahang kanan sejak dua tahun dan makin membesar terutama 6 bulan terakhir disertai nyeri. Massa tidak teratur dengan batas tidak jelas di mandibula kanan dengan ukuran 10 x 8 x 4 cm. Pemeriksaan radiologis menegaskan massa infiltratif, tetapi tidak menemukan anak sebar. Biopsi awal menunjukkan ameloblastoma, biopsi selanjutnya menunjukkan pseudoepitheliomatous hyperplasia. Eksisi luas dilakukan dan patologi menemukan PIOC, NOS dengan sebagian ciri ameloblastic carcinoma. Patologi dari tiga biopsi menunjukkan massa jinak odontogenik yang mengalami inflamasi kronis kemudian menjadi ganas. Prognosis masih belum bisa dipastikan.
Fisioterapi Kasus Cerebral Palsy Kuadriplegia Spastik Suharto; Dwi Rustianto; Siti Munirah
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.298

Abstract

Laporan ini membahas hasil fisioterapi kasus cerebral palsy di Yayasan Penderita Anak Cacat kota Makassar, Sulawesi Selatan, Indonesia. Diagnosis fisioterapi kasus ini adalah belum mampu merangkak, duduk, berdiri, dan berjalan mandiri, sehingga mengganggu aktivitas. Problematik fisioterapi meliputi body structure, activity limitation, participation restriction. Intervensi fisioterapi berupa massage, stretching, splint dan AFO, stimulasi elektrik, stimulasi taktil (stimulasi neurosensomotoris) dan proprioseptif, latihan aktivitas fungsional dan teknik Bobath, serta edukasi pada keluarga dan home program. Hasil fisioterapi pada spastisitas motorik kasar tidak mengalami perubahan, kemampuan hand support dan postural mengalami perubahan positif, pasien mampu duduk dengan baik dalam posisi tegak.   This paper reports the result of physiotherapy for cerebral palsy at the Foundation for Children with Disabilities in Makassar, South Sulawesi, Indonesia. The physiotherapy diagnosis is : not able to crawl, sit, stand, and walk independently, interfering with activities. Physiotherapy problems include body structure, activity limitations, participation restrictions. Physiotherapy interventions include massage, stretching, splints and AFO, electrical stimulation, tactile stimulation (neurosensomotor stimulation) and proprioceptive and functional activity exercises and Bobath techniques as well as family education and home program. The results of physiotherapy management on gross motor spasticity was not significant, but have positive changes on hand support and postural abilities; the patient is able to sit properly in upright position.
Efek Suplementasi Vitamin D terhadap Kejadian Dermatitis Atopik pada Anak Talita Clarissa Sinatra; Krisna Ariaputra; Ratna Mustika Sari
Cermin Dunia Kedokteran Vol 49 No 9 (2022): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i9.299

Abstract

Latar Belakang: Dermatitis atopik (DA) merupakan kelainan kulit yang paling sering dijumpai pada bayi dan anak. Terapi konvensional memiliki efek samping dan komplians yang kurang baik, sehingga diperlukan terapi alternatif. Suplementasi vitamin D diperkirakan dapat memperbaiki luaran klinis DA pada anak karena adanya hubungan antara defisiensi vitamin D dan derajat DA anak serta peran vitamin D dalam memperbaiki sistem imunitas, fungsi barrier kulit, serta meregulasi proses inflamasi pada DA. Studi ini bertujuan untuk menganalisis efikasi suplementasi vitamin D terhadap penurunan derajat eksaserbasi DA pada anak dibandingkan dengan terapi konvensional tanpa vitamin D. Metode: Pencarian literatur di MEDLINE dan Cochrane berdasarkan pertanyaan klinis, kriteria inklusi dan eksklusi. Artikel terpilih ditelaah kritis untuk menilai validitas, kepentingan, dan penerapannya. Hasil: Dari 5 studi randomized control trial (RCT) dengan validitas sama, 3 studi menunjukkan bahwa suplementasi vitamin D mampu menurunkan skor derajat serangan DA pada anak dibandingkan kelompok plasebo, 2 studi lainnya menunjukkan penurunan nilai, namun tidak signifikan. Pada kelima studi tidak ditemukan efek samping atau komplikasi suplementasi vitamin D pada anak dengan dermatitis atopik. Simpulan: Suplementasi vitamin D dinilai dapat bermanfaat pada anak dengan dermatitis atopik yang merupakan kelompok risiko tinggi mengalami defisiensi vitamin D. Dosis vitamin D 500-1000 IU/ hari per oral selama 1-3 bulan aman untuk anak. Masih dibutuhkan penelitian lebih lanjut untuk menilai dosis dan durasi suplementasi vitamin D terbaik dengan efektivitas tinggi pada anak dengan DA.   Background: Atopic dermatitis (AD) is the most common skin disorder found in infants and children. Conventional therapy has major side effects and poor compliance, so alternative therapies are needed. Vitamin D supplementation is expected to improve the clinical outcome of AD in children because of the relationship between vitamin D deficiency and the severity of AD in children and the role of vitamin D in improving the immune system, skin barrier function, and regulating inflammatory processes in AD. This study aimed to analyze the efficacy of vitamin D supplementation in reducing the severity of AD exacerbation compared to children receiving conventional therapy without vitamin D. Methods: Literature search in MEDLINE® and Cochrane® based on clinical questions, inclusion and exclusion criteria. Selected articles were critically reviewed to assess their validity, importance and applicability. Results: Of the 5 randomized control trials (RCTs) with the same validity, 3 studies showed that vitamin D supplementation was able to reduce the severity of AD in children compared to the placebo group, the other 2 studies showed a decrease in scores, but not significantly. In the five studies, no side effects or complications of vitamin D supplementation were found in children with atopic dermatitis. Conclusion: Vitamin D supplementation is considered to be beneficial in children with atopic dermatitis who are a high-risk group for vitamin D deficiency. The dose of vitamin D is 500-1000 IU/day orally for 1-3 months is safe for children. However, further research is needed to assess the best dose and duration of vitamin D supplementation with high effectiveness in children with AD.

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