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INDONESIA
MEDICINUS
Published by PT Dexa Medica
ISSN : 1979391X     EISSN : 29638399     DOI : 10.56951
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Tujuan penerbitan jurnal Medicinus adalah untuk meningkatkan wawasan dan menambah khasanah pengetahuan para praktisi medis dan farmasis di bidang kedokteran dan kefarmasian. Ruang lingkup dari jurnal ilmiah ini adalah publikasi artikel-artikel ilmiah yang bisa disajikan dalam bentuk penelitian (research), laporan kasus (case report), teknologi dan klinis kefarmasian, serta ulasan literatur medis.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 72 Documents
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Peran Kalsium dan Magnesium pada Kehamilan Rima Irwinda
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.631 KB) | DOI: 10.56951/medicinus.v33i1.1

Abstract

Mikronutrien memiliki peran penting dalam outcome kehamilan. Defisiensi mikronutrien berhubungan dengan outcome perinatal yang buruk serta berdampak pada kualitas kesehatan di masa yang akan datang. Di antara berbagai jenis mikronutrien, mineral kalsium dan magnesium diketahui bersifat esensial dalam masa kehamilan. Kalsium dan magnesium memiliki peran fisiologis yang luas, di antaranya berperan dalam proses pembentukan tulang, metabolisme energi, sekresi hormon, komunikasi antarsel, dan fungsi homeostasis lainnya. Beberapa penelitian menunjukkan adanya hubungan antara defisiensi kalsium dengan risiko preeklamsia yang lebih tinggi, oleh karena itu perlu diperhatikan kecukupan kalsium dalam masa kehamilan, serta komponen nutrisi lain yang dapat mengoptimalkan absorpsi kalsium, seperti magnesium dan vitamin D3.
Tingkat Keberhasilan Reposisi Tertutup pada Fraktur Antebrachii di RS Bethesda Yogyakarta pada Tahun 2007-2013 Johan Budiman; Sudharmadji; Hariatmoko; Rizaldy Taslim Pinzon
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (239.253 KB) | DOI: 10.56951/medicinus.v33i1.2

Abstract

Forearm fracture defined as fracture that occurs in the forearm, where the radius and ulna bones are both broken. Forearm fracture is the most common type of fracture that occurs in children and adults. Traffic accident is one of the cause of this fracture. The initial approach in non-complicated forearm fracture is closed reduction with cast immobilization (conservative therapy). The aim of this study is to analyze the success rate of closed reduction of the forearm fracture at Bethesda Hospital of Yogyakarta. The study also examines the relationship between the type of fracture and the related success rate of closed reduction on forearm fracture as well as the distribution of forearm fracture at Bethesda Hospital, Yogyakarta. This is a descriptive study with cross-sectional design. Radiographs and medical records of patients with forearm fracture at Bethesda Hospital, Yogyakarta were analyzed retrospectively in the period of 2007-2013. The measured variables are the change in the degree of angulation, apposition changes, gap occurrences, and the presence of overlap between radiological examinations before and after closed reduction. Medical records are also analyzed after reduction is done. Data is statistically analyzed using Chi-Square method. The result shows that closed reduction of forearm fracture performed by emergency team of Bethesda Hospital Yogyakarta during the period of 2007-2013 was quite successful and there is a significant relationship between the type of fracture with the success rate of closed reduction of forearm fracture (p=0.003). Thus, closed reduction is a mainstay initial approach in the patients with forearm fracture. If it is not successful, then surgery can be performed.
Smoking, COPD, Infection and Lung Cancer: How Are They Interconnected? Benjamin J. Tanuwihardja
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (855.169 KB) | DOI: 10.56951/medicinus.v33i1.3

Abstract

A case of an elderly ex-smoker chronic obstructive pulmonary disease (COPD) patient with controlled type 2 diabetes mellitus (T2DM) as comorbid was followed-up for 10 years. His stable COPD in the course of time slowly declined to multiple acute exacerbation (AE)-COPD and multiple hospital admissions. High-dose systemic corticosteroids given during AE-COPD with prolonged oral steroids continuation led to depressed immunity that ended with severe immunosuppression, causing sepsis and chronic heart failure (CHF) with non-ST elevated myocardial infarction (NSTEMI) and worsening of COPD in his ninth year follow-up. This immunosuppression also triggered the emergence of lung cancer by allowing malignant cell to evade immune surveillance. Fortunately patient is survived and recovered to stable COPD.
A Rare Presentation of Penile Abscess Involving the Corpus Spongiosum and Anterior Urethra Gede Janardana; I Wayan Suarsana
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.595 KB) | DOI: 10.56951/medicinus.v33i1.4

Abstract

Penile abscess is an urological condition rarely described in literature. Multiple etiologies of penile abscess has been reported including idiopathic, complication of endourology procedure such as cavernosography, penile injection, penile instrumentation, trauma, gonorrhea complication, tuberculosis, priapism, as well as hematological spread of distant infection. A 42-year-old circumcised male presented for 2 days history of redness and painful swelling of the mid-distal ventral penile shaft and fever of 39°C. The patient had a history of a urethral catheterization 4 days before presentation as he had a problem of progressing difficulty to urinate since 7 days before. 600cc gross hematuria was observed at the initial catheterization. Physical examination showed edema, induration, and tenderness in the mid-distal ventral penile shaft. Skin break was found at the ventral side of coronal sulcus, excreting brownish-red discharge with pus. Laboratory examination showed normal WBC (7,720/mm3), normal random blood sugar (106 mg/dl). Urine analysis showed pyuria (15–16 WBC/hpf) and hematuria (4–5 RBC/hpf). The patient was treated with incision and drainage of the abscess, necrotomy, and systemic antibiotics for ten days. The remaining viable urethral tissues were stitched to the surrounding penile shaft skin in accordance to the “First stage of Johanson procedure” urethroplasty. Percutaneous cystostomy was also performed for urinary diversion. Most reported penile abscesses are cavernosal abscesses. In this patient, the abscess occurred in the corpus spongiosum in anterior urethra region, possibly caused by prior urethral instrumentation. Penile abscess after catheterization is an uncommon condition. Prompt drainage of purulent material and evacuation of necrotic area were the treatment goals. Surgical evacuation remains the first-line treatment.
Perkembangan Pemeriksaan Interferon-Gamma Release Assay (IGRA) dengan Metode T-SPOT.TB serta Aspek Klinis Pelaporan Hasil Juliani Dewi
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (440.107 KB) | DOI: 10.56951/medicinus.v33i1.5

Abstract

Latent tuberculosis infection (LTBI) screening and its treatment play important role in controlling tuberculosis (TB). Healthcare workers are known to be at high risk of latent TB infection. CDC suggests that every healthcare service should have TB controlling program. CDC recommends IGRA test for people who have history of contact with atypical mycobacteria patiens, screening in pregnancy, healthcare worker screening, and serial evaluation for Mycobacterium tuberculosis (MTB) infection. IGRA test kits that are commercially available are QFT and T-SPOT.TB. Term “indeterminate” is used as a borderline value in QFT, but in T-SPOT.TB, it means the result is invalid. Term "borderline zone" is used in T-SPOT.TB, but not in QFT. T-SPOT.TB uses borderline zone which is designed to reduce uncertainty result in narrow range around single cut-off point. There are still no recommendations to use IGRA test for therapeutic monitoring.
Ekokardiografi pada Gagal Jantung Nia Dyah Rahmianti; Ni Putu Alit Trisna
MEDICINUS Vol 33 No 1 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (202.248 KB) | DOI: 10.56951/medicinus.v33i1.6

Abstract

Heart failure (HF) is a leading cause of cardiovascular morbidity and mortality worldwide. Clinical diagnosis of HF is often challenging because the symptoms and signs of HF are either too nonspecific or too infrequent. Echocardiography, given its safety, easy availability, and the ability to permit a comprehensive assessment of cardiac structure and function, is an indispensable tool in the evaluation and management of patients with heart failure (HF). It can also detect and define the hemodynamic and morphologic changes in HF over time and might be equivalent to invasive measures in guiding therapy. The early detection of heart failure has been facilitated by the assessment of global longitudinal strain, which is also useful in later heart failure for the assessment of left ventricular synchrony.The use of echocardiography has been associated with favorable outcomes, probably onthe basis of facilitation of appropriate therapy. Although the guidelines emphasize that no singletest satisfies all imaging requirements in heart failure, and other modalities can provide additional information about specific questions (especially tissue characterization), echocardiography is indispensable in the management of heart failure.
Neuroproteksi Otak Janin pada Persalinan Preterm dan Pertumbuhan Janin Terhambat Adrianes Bachnas
MEDICINUS Vol 33 No 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.174 KB) | DOI: 10.56951/medicinus.v33i2.45

Abstract

Exalted obstetrics not merely fulfill the obligation to deliver babies safely but beyond, to deliver babies on their most optimal condition to grow up and to be a noble person. Neuroprotection should be implemented in daily practice. Brain, as the central part of the human body, plays an extremely important role for all of the human cells, tissue, organs, and systems activities. Any kind of physiological process in human body is related to brain control. There would be no human in optimal condition without optimal brain function. Preterm delivery and fetal growth restriction are two of the many pathologic conditions in pregnancy that could potentially injure fetal brain. Injured brain would result in major lifelong neurological deficits. There isn’t any cure for these, so prediction and prevention are barely necessary. Neuroprotection is a concept which all efforts are given to minimize the insult to the fetal brain due to such pathologic problems as mentioned before. Preterm birth, either spontaneously or iatrogenic, puts the risk for fetus to get brain damage. Hypoxic situations in the early minutes after birth lead to inflammation and apoptosis process, causing neuronal injury, neuronal death, and demyelination. Antenatal magnesium sulfate administration has found to give significant aid to hinder this condition and in the end showing a substantial reduction in the number of cerebral palsy cases. Fetal growth restriction remains an unsolved dilemma in maternal-fetal medicine. It is mostly related with placental insufficiency that causes chronic hypoxia and nutrition deprivation. Low dose aspirin in the first trimester soon as the poor placentation is known to be happen remains the solid evidence exists. Nutritional intervention such as a balanced intake of protein and calory, also micronutrients supplementation are somehow still worthy enough to accompany the timely decision of terminating pregnancy.
Lymphedema Diagnosis dan Terapi Medisa Primasari
MEDICINUS Vol 33 No 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (154.944 KB) | DOI: 10.56951/medicinus.v33i2.46

Abstract

Lymphedema merupakan kondisi akibat gangguan transportasi aliran limfa yang menyebabkan terjadinya akumulasi cairan limfatik di ruang interstitial. Gangguan transportasi aliran limfa dapat disebabkan oleh kelainan kongenital ataupun yang didapat, seperti akibat trauma, infeksi, keganasan, dan pascatrombosis vena. Tindakan yang dapat dilakukan untuk mencegah komplikasi dan progresi penyakit berupa terapi non-operatif dan terapi operatif. Terapi konservatif yang dilakukan berupa edukasi perawatan kulit, manual lymphatic drainage (MLD), kompresi dengan short-stretch bandage, serta latihan ringan. Adapun terapi pembedahan dilakukan pada kondisi berat dan mengalami gangguan fungsional yang tidak membaik dengan terapi non-operatif. Pada lymphedema derajat awal, terapi yang dapat dilakukan adalah metode fisiologis seperti lympholymphatic bypass, lymphovenous bypass serta transfer kelenjar limfa; sedangkan pada lymphedema berat dengan jumlah jaringan fibroadiposa yang tinggi, digunakan metode reduksi yang terdiri dari eksisi langsung atau liposuction.
Congenital Analbuminea Putu Adi Santosa; Anik Widijanti; Hani Susianti; Sherly Intanwati; Rossy Meilani
MEDICINUS Vol 33 No 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.628 KB) | DOI: 10.56951/medicinus.v33i2.50

Abstract

Congenital analbuminemia (CAA) is a rare autosomal recessive disorder, characterized by the absence or very low level of serum albumin (human serum albumin/HSA) as a result of defect on chromosome 4 which encodes albumin. It is defined as albumin level <1 g/l with normal liver function and the absence of protein loss.1,2 Estimated CAA prevalence is less than 1 in 1 million.A 10-year-old boy suffered from generalized edema that got worsened since last month. The patient had been misdiagnosed with nephrotic syndrome 2 years earlier, and then became protein-losing enteropathy. Neither cough nor diarrhea were reported. The patient had history of food allergy. Physical examination showed moderately ill condition, Glasgow Coma Scale (GCS) score E4 V5 M6, blood pressure 90/50 mmHg, pulse 120 x/min, respiratory rate 30x/min, palpebral edema, shifting dullness, undulation (+), with nonpitting edema on the extremities. Laboratory findings: leukocytosis (neutrophilia), peripheral blood smear showed hypochromic microcytic anisositosis erythrocyte. AAT serum 246 mg/dl, GGT serum: 88 U/l, iron serum 28 µg/dl, TIBC 411 µg/dl, transferrin saturation 7%, total IgE 775,90 U/ml. Serum Protein Electrophoresis (SPE) results were hypoalbuminemia (1,4 g/dl), hypogammaglobulinemia (0,21 g/dl), and total protein 2,91 g/dl. Chest X-ray showed pneumonia with minimal right pleural effusion. Overestimation of serum albumin level was caused by alpha and beta globulin that were detected as albumin in bromocresol green (BCG) methods. CAA aggravated with by allergy caused malnutrition in this patient. These data support the diagnosis of CAA with sepsis and iron deficiency anemia. Suggestion for the management consist of blood culture, procalcitonin level measurement, inguinal lymph node biopsy, DNA sequence analysis, also analysis of pleural and ascites fluid.
Patofisiologi dan Manajemen Terapi (SSJ) dan Nekrolisis Epidermal Toksik (NET) Rina Diana; Muhammad Eko Irawanto
MEDICINUS Vol 33 No 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (467.986 KB) | DOI: 10.56951/medicinus.v33i2.53

Abstract

Nekrolisis epidermis (NE) adalah sindrom reaksi mukokutan akut yang ditandai dengan nekrosis dan pengelupasan epidermis yang luas serta dapat menyebabkan kematian. Lesi awal berupa makula eritematosa, kemudian berkembang secara progresif menjadi lesi lepuh kendur dan selanjutnya terjadi pengelupasan epidermis. Berdasarkan luas permukaan tubuh yang terlibat, NE diklasifikasikan menjadi tiga kategori, yaitu sindrom Stevens-Johnson (SSJ) jika luas lesi <10%, overlap SSJ-nekrolisis epidermal toksik (SSJ-NET) jika luas lesi 10-30% dan nekrolisis epidermal toksik (NET) jika luas lesi >30%. Patofisiologi NE belum diketahui dengan jelas hingga saat ini. Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksik (NET) merupakan kondisi yang dapat menyebabkan kematian, oleh karena itu memerlukan penanganan yang cepat dan tepat. Mengidentifikasi kemungkinan penyebab dan memberikan perawatan yang diperlukan di rumah sakit diharapkan mampu meminimalisasi kejadian fatal akibat kondisi ini. Penanganan utama pada SSJ-NET adalah dengan menghentikan penggunaan substansi yang dicurigai sebagai penyebab. Terapi lain yang dapat diberikan masih cukup kontroversial, seperti pemberian corticosteroid, IVIG, plasmapheeresis, dan cyclosporine.

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