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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 11 Documents
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Approaches for identifying and managing publication bias in meta-analysis Jonny Fajar
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.1

Abstract

The consequences of publication bias in meta-analysis pose significant risks, potentially leading to erroneous conclusions within the meta-analytic framework. The objective of this article was to explore the methodologies for identifying publication bias and approaches for mitigating its effects. The techniques employed to detect publication bias can generally be distinguished into two major categories: graphical and statistical methodologies. Graphical approaches utilize techniques such as funnel plots and meta-plots, which visually depict the distribution of effect sizes and standard errors across studies. Statistical methods encompass various computations, including Fail-Safe N, rank correlation, Egger regression, tests for excess significance (TES), and selection models tailored for evaluating publication bias through quantitative analyses. The combination of these methods is recommended for a more comprehensive assessment, rather than relying on individual approaches. Methods for addressing publication bias include the trim and fill (T&F) method, Publication Error and True Effect Size Estimation (PET-PEESE) method, and the Weight-Function Model, each offering unique strategies for adjusting effect size estimates. The selection of these methods should consider the specific characteristics of the meta-analysis under consideration, ensuring the most appropriate approach is employed. Publication bias poses a significant risk in the field of meta-analysis, and selecting methods for its identification and mitigation requires comprehensive consideration
Successful resolution of mesenteric tuberculosis and HIV co-infection following 6 months of anti-tuberculosis therapy: a case report Novita Maulidiyah; Ramadi Wicaksono; Aisyah Retnowulan; Budi Santoso; Aries Subianto; Latifah Mashudi; Fajar Kurniawan
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.2

Abstract

BACKGROUND: Mesenteric tuberculosis (TB), a rare extrapulmonary variant of TB, poses diagnostic and therapeutic challenges in its management. Therefore, discussing a case of mesenteric TB is both intriguing and informative for gaining insights into its clinical presentation and optimal treatment strategies. CASE PRESENTATION: A 50-year-old male presented symptoms of blackish stools three days post-gallstone surgery, accompanied by approximately two months of abdominal discomfort, described as squeezing or stabbing, alleviated temporarily by analgesics, alongside abdominal distension, rigidity, decreased appetite, and afternoon fevers. Physical examination revealed normal vital signs, with pale conjunctiva and asymmetrical chest wall movement, dull percussion, and decreased breath sounds in the lower left hemithorax. Abdominal inspection indicated distension, postsurgical signs, and ascites. Following laboratory investigations, chest and abdominal radiographs, and tissue biopsies, the patient was diagnosed with HIV co-infection along with pulmonary and mesenteric TB. Treatment comprised an intensive phase of four fixed-dose combinations (FDC) of anti-TB drugs, followed by a continuation phase of two FDC tablets, alongside first-line antiretroviral (ARV) therapy and cotrimoxazole prophylaxis. By the sixth month follow-up, clinical improvement was observed, with resolution of symptoms and weight gain to 56 kg. CONCLUSION: This case highlights the effective management of mesenteric TB and HIV co-infection, emphasizing the importance of comprehensive care and collaborative efforts between TB and HIV/AIDS control programs.
The impact of administering vitamin D supplements on handgrip strength and performance in the timed-up-and-go test in frail elderly individuals: A meta-analysis involving randomized controlled trials Erdilian Pratama; Chrisandi Rizqiansyah; Wahyu Firmansah; Sri Soenarti
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.3

Abstract

BACKGROUND: Ongoing debates continue regarding the specific effects of vitamin D intake on the timed-up-and-go test and handgrip strength. OBJECTIVES: To assess the impact of vitamin D supplementation on handgrip strength and performance in the timed-up-and-go test. METHODS: Between May and June of 2023, a systematic review and meta-analysis were undertaken to assess the effects of vitamin D intake on handgrip strength and performance in the timed-up-and-go test. A comprehensive search was performed on Google Scholar, Web of Science, and PubMed to search for relevant articles published until June 2023. The analysis exclusively incorporated randomized controlled trials (RCTs) available in English publications, with a specific emphasis on evaluating the impact of vitamin D supplementation on both handgrip strength and performance in the timed-up-and-go test. Inverse variant meta-analysis was employed to evaluate the impact of vitamin D intake on the timed-up-and-go test and handgrip strength. RESULTS: A total of 21 appropriate studies were incorporated into the systematic review. Our findings revealed a favorable impact of vitamin D administration on enhancing performance in the timed-up-and-go test. Conversely, we could not ascertain any advantageous effects of vitamin D intake on handgrip strength. Despite the notable enhancement observed in the timed-up-and-go test, our analysis did not yield statistically significant evidence supporting the impact of vitamin D intake on handgrip strength based on the included studies. CONCLUSION: Our study findings reveal that vitamin D is an essential component in improving the timed-up-and-go test.
The association between albumin levels, platelet-to-albumin ratio, and the likelihood of peritonitis occurrence in individuals undergoing peritoneal dialysis Mazen Mazen; Achmad Rifai; Atma Gunawan
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.4

Abstract

BACKGROUND: Since albumin and platelet had been reported to govern the risk of infection, their impact in the case of peritoneal dialysis (PD) – related peritonitis should be investigated. OBJECTIVES: To assess the association between albumin levels and platelet – to – albumin ratio and the risk of PD-related peritonitis. METHODS: We conducted a retrospective study in Saiful Anwar General Hospital, Malang, Indonesia during July 2019 and July 2021. Data related to albumin levels and platelet – to – albumin ratio as well as the incidence of PD-related peritonitis were collected from medical record using a standardized pilot form. The association between the albumin levels and platelet – to – albumin ratio and the risk of PD-related peritonitis was analyzed using multiple logistic regression. RESULTS: We included 123 PD patients during study period. Of them, 20 patients were PD-related peritonitis. Our study found that lower albumin levels were associated with increased risk of PD-related peritonitis with the mean difference was -0.30 (MD: -0.30; 95%CI: [-0.55], [-0.05]). We also found that platelet – to – albumin ratio was observed higher in PD-related to peritonitis compared to control (MD: 14420.10; 95%CI: 832.08, 28008.12). However, the role of albumin levels and platelet – to – albumin ratio had weak association to the risk of PD-related peritonitis with the area under curve were 61% and 59%, respectively. CONCLUSION: Our study provides the preliminary data regarding the potential role of albumin and platelet – to – albumin ratio for predicting the risk of PD-related peritonitis. However, further large – scale study should be performed to reclarify our findings.
Assessing corticosteroid utilization and mortality risk in septic shock: insights from network meta-analysis Wibowo Sutrisno; Volodymyr Dzhyvak
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.5

Abstract

BACKGROUND: Despite current guidelines recommending corticosteroid administration in septic shock management, there is ongoing controversy regarding their impact on mortality rates and the most effective corticosteroid type. OBJECTIVES: To assess corticosteroid use and mortality risk in septic shock via network meta-analysis. METHODS: A comprehensive network meta-analysis was undertaken by retrieving articles from PubMed, Embase, and Scopus databases. Pertinent data encompassing baseline characteristics of articles, definitions of sepsis, types of corticosteroids employed, and mortality rates were systematically extracted from each article. The Manthel Hanzhel method alongside a network meta-analysis approach was employed to evaluate the influence of corticosteroid administration on mortality risk among individuals diagnosed with septic shock. RESULTS: Our analysis comprised a total of 50 articles. While indirect comparison failed to yield statistically significant results regarding the reduction in mortality risk, direct comparison indicated that corticosteroid administration was linked to a decreased risk of mortality among septic shock individuals (OR: 0.80; 95%CI: 0.68, 0.93; p Egger: 0.0550; p Heterogeneity: 0.0010; p: 0.0040). Furthermore, among all the types of corticosteroids analyzed, only the hydrocortisone and fludrocortisone combination demonstrated an association with reduced mortality risk in septic shock patients. Individuals receiving this combination therapy exhibited decreased likelihood of mortality compared to those receiving a placebo (OR: 0.78; 95%CI: 0.64, 0.96; p Egger: 0.3082; p Heterogeneity: 0.8570; p: 0.0190). CONCLUSION: Our study emphasizes the significance of corticosteroid therapy, particularly highlighting the hydrocortisone and fludrocortisone combination, for septic shock management.
Investigating the connection between age progression and erectile dysfunction incidence in chronic kidney disease patients undergoing hemodialysis Dandi Widiaputro; Heru Suwito; Helsa Eldatarina; Wahyu Firmansah; Muhamad Akbar; Rosmince Wattimury; Ketut Rahardja; Dheni Haryanto; Atma Gunawan
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e210

Abstract

BACKGROUND: Erectile dysfunction is frequently observed in patients with chronic kidney disease (CKD), especially in the elderly population. However, studies have presented diverse outcomes on this matter. OBJECTIVES: To assess the correlation between age progression and the prevalence of erectile dysfunction in chronic kidney disease patients receiving hemodialysis. METHODS: The study employed a retrospective design and was conducted at RSUD Dr. Saiful Anwar, Malang, during June-July 2022. Data collection involved retrieving age, the erection hardness score (EHS), and baseline characteristics from medical records. Statistical analysis focused on assessing the correlation between age and erectile dysfunction using linear regression. RESULTS: The study population consisted of 59 patients with erectile dysfunction and 61 patients without erectile dysfunction. The primary findings highlighted a substantial and moderately negative association between age and the EHS score, which serves as a key indicator of erectile function. The results suggested that as individuals aged, there was a noticeable trend towards a decrease in the EHS score, implying a decrease in erectile capacity. CONCLUSION: Our findings emphasize the crucial importance of age as a determining factor in the development of erectile dysfunction.
Prevalence of streptococcus pneumoniae in elderly with pneumonia: A meta-analysis and systematic review in Asia Sri Soenarti; Yannita Wijaya; Adhya Pratama; Aditya Nugraha; Agnes Seto; Alfan Fathoni; Ayu Sekarani; Gede Utama; Madya Juhandana; Putri Ardiyanti; Vidi Utomo; Zahra Safira; Zuhrotus Sholichah; Dimas Santoso
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e278

Abstract

BACKGROUND: There is currently insufficient study focusing on comprehensive studies that thoroughly assess the prevalence of Streptococcus pneumoniae specifically among elderly patients with pneumonia in Asia. OBJECTIVE: To analyze the prevalence of Streptococcus pneumoniae as a causative factor of pneumonia among elderly populations in Asian countries. METHODS: This meta-analysis was designed to systematically collect data from PubMed, Scopus, and Embase within the timeframe of January to February 2024. The study focused on gathering prevalence data of Streptococcus pneumoniae among elderly patients diagnosed with pneumonia in Asian countries. Statistical analysis employed a single-arm meta-analysis methodology to consolidate and evaluate the cumulative prevalence of Streptococcus pneumoniae in this specific population group. RESULTS: The total sample included in our study comprised 15 articles. Through our analysis, we found that the cumulative prevalence of Streptococcus pneumoniae among elderly patients diagnosed with pneumonia in Asia was 9% (Event rate: 0.09; 95% CI: 0.06, 0.12; Egger's test: p = 0.7047; p Heterogeneity < 0.0001; p < 0.0001). CONCLUSION: Streptococcus pneumoniae remains a plausible causative agent of pneumonia in elderly Asian populations.
Compartment syndrome as reperfusion injury following thrombectomy in acute limb ischemia: A case report Mokhammad Afifuddin; Novi Kurnianingsih; Dea Kurniawan
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e209

Abstract

BACKGROUND: Compartment syndrome following reperfusion in acute limb ischemia represents a rare but serious complication. Thus, documenting such cases is essential to enhance comprehension and management of this condition. CASE PRESENTATION: A 51-year-old man was referred from an urban hospital presenting with severe right leg pain persisting for 5 days prior to admission, accompanied by pulselessness, paresthesia, poikilothermia, and paralysis. The patient had underlying risk factors including uncontrolled diabetes mellitus and active smoking. Duplex ultrasound confirmed the diagnosis of acute limb ischemia, which was further supported by CT angiography revealing total occlusion from the right common iliac artery to the distal region. Intravenous heparin was administered, and the patient underwent emergency surgical thrombectomy. Following the intervention, the patient developed clinical signs of compartment syndrome as a manifestation of reperfusion injury, necessitating fasciotomy. Subsequent evaluation of the wound post-fasciotomy indicated it was not suitable for closure, and unfortunately, the patient passed away a few days later. CONCLUSION: This case illustrates acute limb ischemia necessitating thrombectomy and surgical fasciotomy due to compartment syndrome resulting from reperfusion injury, emphasizing the importance of rigorous monitoring.
Navigating heterogeneity in meta-analysis: methods for identification and management Muhammad Ilmawan
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e269

Abstract

Although meta-analysis is a powerful way to synthesize research findings from multiple studies, the problem of heterogeneity usually arises due to variation in study outcomes. Differences between studies regarding heterogeneity in results can arise from populations, interventions, outcome measures, and methodologies both within and between the studies. This article aims to provide an overview of the methods for identifying and dealing with heterogeneity in meta-analyses to ensure accurate and reliable conclusions. The article aims to describe the application of several statistical methods for detecting heterogeneity, namely the Q statistic and the I² statistic. The Q statistic is used to test whether observed variability in effect sizes exceeds chance expectations, while the I² statistic quantifies the proportion of variability due to heterogeneity. Other methods include the DerSimonian-Laird between-studies variance in random-effects models and the T and T² methods, which use both observed and expected information about effect size dispersion. Methods for dealing with heterogeneity are discussed, including choices between using fixed- versus random-effects models, and techniques for assessing and dealing with outliers using methods such as the Hedges technique. Additionally, the article explores methods to investigate sources of heterogeneity through subgroup analysis and meta-regression. Recognizing limitations such as residual heterogeneity, publication bias, and study quality is also important in making meta-analytical findings more robust. In conclusion, these methods enable researchers to more effectively address heterogeneity issues in meta-analyses, thereby providing more reliable and valid conclusions that contribute to evidence-based practice
Exploring a rare oncologic complication: alveolar rhabdomyosarcoma in HIV patient Dimas Santoso; Budi Santoso; Septian Kristyana; Didi Candradikusuma; Septalisa Natasia; Arde Evatta
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e277

Abstract

BACKGROUND: Alveolar rhabdomyosarcoma is one of the rare oncological complications in Human Immunodeficiency Virus (HIV) patients, but it has a serious impact. Therefore, case report study discussing case of alveolar rhabdomyosarcoma in HIV patient is very important. CASE: A 22-year-old man complained of pain and a growing lump behind his right knee for 9 months. The lump, initially small, became larger and more painful, affecting his ability to move his leg. The patient was diagnosed with HIV 3 years ago and also had leprosy. Additionally, the patient had a history of weight loss and a low body mass index (BMI). Physical examination revealed a 10x15x10 cm mass behind the right knee. Magnetic Resonance Imaging (MRI) of the right knee showed a complex cystic solid lesion involving several muscles and blood vessels. Fine Needle Aspiration Biopsy (FNAB) suggested a High-Grade Sarcoma. Open biopsy confirmed alveolar rhabdomyosarcoma with aggressive features and high mitotic activity. CONCLUSION: In conclusion, our study reported the first case of alveolar rhabdomyosarcoma in an HIV patient. Our study emphasizes the importance of thorough diagnosis for suspected malignancies in HIV patients.

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