Jurnal Kedokteran (Unram Medical Journal)
Jurnal Kedokteran (Unram Medical Journal) publishes original research articles, review papers, and case studies across a broad range of topics relevant to medicine and health sciences. Focus and Scope The journal welcomes contributions in, but not limited to, the following areas: Biomedical Sciences Clinical Sciences Medical Education Public Health Allergy and Immunology Psychology Cancer and Stem Cells Dentistry Medical Technology Pharmacology Jurnal Kedokteran (Unram Medical Journal) is dedicated to advancing clinical practice, biomedical research, public health, and health policy with a particular focus on Indonesia and the broader Southeast Asian region. The journal aims to improve health outcomes both regionally and globally by supporting high-quality, context-relevant scientific research. We are committed to enhancing the visibility and impact of national and regional health research, including from resource-limited and rural settings. The journal is managed by an experienced editorial team based at the Faculty of Medicine and Health Sciences, University of Mataram, working in collaboration with national and international experts across the health sciences. Publication Schedule and Journal Management Jurnal Kedokteran (Unram Medical Journal) is published quarterly, with issues released in March, June, September, and December. Starting from Volume 12, Issue 1 (2023), the journal's management and publication platform transitioned from https://jku.unram.ac.id/ to its current site at https://journal.unram.ac.id/. Online ISSN: 2527-7154 Print ISSN: 2301-5977
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Therapeutic Potential of Nigella sativa in Chronic Rhinosinusitis: A Narrative Review of Experimental and Clinical Evidence
Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the nasal and paranasal sinus mucosa that significantly impairs quality of life. Although topical and systemic corticosteroids and endoscopic sinus surgery remain the standard of care, many patients still experience relapse and require repeated courses of treatment. Biologic therapies have shown promising outcomes; however, limited availability and high costs pose major barriers, particularly in low- and middle-income countries. Therefore, there is a need for an effective, safe, and affordable adjuvant treatment option. Nigella sativa, commonly known as black seed (alhabahat alsawda), contains bioactive compounds, notably thymoquinone, with antioxidant, anti-inflammatory, and immunomodulatory properties. This narrative review summarizes experimental and clinical evidence on Nigella sativa in CRS. In vitro studies suggest thymoquinone attenuates pro-inflammatory signaling, reduces fibroblast proliferation, and modulates epithelial barrier–related markers. In animal rhinosinusitis models, thymoquinone improves histopathology and decreases inflammatory cell infiltration. Limited clinical studies using nasal spray or oral extracts report improvements in validated symptom scores and quality-of-life measures with acceptable tolerability. Overall, Nigella sativa shows potential as an adjunctive therapeutic option in CRS, but the current evidence base is heterogeneous and small. Well-designed, adequately powered randomized controlled trials using standardized formulations, dosing regimens, and long-term follow-up are needed to confirm efficacy, safety, and clinical applicability.
Hak Cipta (c) 2026 Nurul Endah Ardianti https://creativecommons.org/licenses/by/4.0
Active and Second Hand Smokers as Influential Factors in Pulmonary Tuberculosis: A Descriptive Case Analysis
Pulmonary tuberculosis (TB) is a major global health problem, and Indonesia ranks second worldwide in TB incidence. Smoking has been identified as a key behavioral risk factor that increases susceptibility to Mycobacterium tuberculosis infection. This study aimed to describe the smoking behavior of pulmonary TB patients at RSI Surabaya Jemursari. A descriptive analytic study was conducted on 117 pulmonary TB patients registered in 2023. Data were collected from medical records and included demographic characteristics and smoking history. Smoking behavior was categorized into smoker type (active or passive), frequency (light or heavy), and duration (short-term or long-term). The results showed that most patients were active smokers (70.9%), the majority were light smokers (59.0%), and most had smoked for more than one year (76.9%). These findings confirm that smoking is highly prevalent among pulmonary TB patients and represents an important risk factor for TB in hospital-based settings. It is recommended that smoking cessation programs be integrated into TB management at both hospital and community levels to support improved treatment outcomes and contribute to national TB elimination efforts.
Hak Cipta (c) 2026 Dewi Masithah, Nanda Fadhilah Witris Salamy, Abdul Hakim Tsalis Sisyanto, Ain Darojah Siddiq Ramadhana https://creativecommons.org/licenses/by/4.0
Catheter-Related Bloodstream Infection Complicated by Infective Endocarditis in a Patient Undergoing Hemodialysis
Background: End-stadium kidney disease (ESKD) necessitates long-term hemodialysis, wherein the utilization of central venous catheters (CVCs) heightens the risk of catheter-related bloodstream infections (CRBSIs). The persistence of bacteremia has the potential to progress into infective endocarditis (IE), which is associated with significant morbidity and mortality. Case Presentation: We present a case of a 30-year-old female with a medical history of chronic kidney disease (CKD) stadium 5 undergoing regular hemodialysis. She presented with systemic symptoms including fever, chills, joint pain, and localized discomfort at the catheter insertion site. Notably, her clinical history included the placement of a jugular CVC followed by the insertion of a tunneled catheter prior to the creation of an arteriovenous shunt. Laboratory evaluations demonstrated severe anemia, leukocytosis, and advanced renal impairment. Blood cultures yielded multidrug-resistant Acinetobacter baumannii, with sensitivity limited to imipenem. Echocardiographic assessment revealed significant tricuspid regurgitation with a vegetation measuring 11 × 16 mm, indicative of right-sided IE. The patient was diagnosed with ESKD, CRBSI, and IE, and subsequently managed with hemodialysis, broad-spectrum antibiotic therapy (including meropenem), supportive measures, and a plan for catheter removal. Conclusion: This case underscores the complex interrelationships between CKD, CRBSI, and IE in hemodialysis patients with prolonged catheter utilization. Timely recognition and intervention, including appropriate antibiotic therapy tailored to culture sensitivities and vigilant vascular access management, are essential to mitigate morbidity and mortality associated with these conditions.
Hak Cipta (c) 2026 Tazkiyah Arafah Amatullah, I Gede Yasa Asmara https://creativecommons.org/licenses/by/4.0
Termination of Pregnancy with Fetal Congenital Anomalies: Moral and Bioethical Considerations
Termination of pregnancy due to fetal congenital anomalies presents a complex issue that entails moral, ethical, and legal dilemmas. Numerous studies have shown that decisions to terminate such pregnancies are influenced not only by medical considerations, but also by cultural values, religious beliefs, and prevailing legal norms. The importance of a professional ethical approach in prenatal diagnosis and decision-making lies in balancing patient autonomy with the physician’s moral responsibility. Emotional distress experienced by parents and the need for ethically sensitive support are also crucial factors. In Indonesia, termination of pregnancy in cases of severe fetal anomalies is strictly regulated and often shaped by interpretations of religious values and social norms. Islamic perspectives and Indonesian law emphasize the protection of life, while allowing room for termination under specific circumstances. Diverse views among the public and healthcare professionals highlight the need for open dialogue that respects value pluralism. The provision of abortion services must be safe, respectful, and grounded in human rights principles. This review concludes that policies and practices regarding termination of pregnancy for congenital anomalies must be developed with careful consideration of core bioethical principles—autonomy, beneficence, non-maleficence, and justice—as well as sensitivity to local moral and cultural contexts.
Hak Cipta (c) 2026 Muhammad Freddy Candra Sitepu, Eva Hikmatul Damayanti, Siti Rosidah, Resna Hermawati, Arfi Syamsun, Lenny Herlina https://creativecommons.org/licenses/by/4.0
Hubungan Pola Asuh Orang Tua dengan Gangguan Mental Emosional pada Remaja SMAN 15 Kota Tangerang
The mental health of adolescents is a critical issue influenced by multidimensional interaction between parenting styles, neurobiological mechanisms and psychosocial environments. This study comprehensively examined the relationship between parental styles (democratic, authoritarian, permissive) and adolescent mental health issues at SMAN 15 Kota Tangerang through an integrated neuropsychological approach. The cross-sectional design involved 291 students aged 16-17 years, using the Parenting Styles and Dimensions Questionnaire (PSDQ) and the Self-Reporting Questionnaire-20 (SRQ-20) as screening instruments. The results indicated that 175 respondents (60.1%) were raised with a democratic parenting style, followed by 70 respondents (24.1%) with an authoritarian style, and 46 respondents (15.8%) with a permissive style. The study also revealed that 170 respondents (58.4%) experienced emotional mental health issues, while 121 respondents (41.6%) exhibited symptoms of mental disorders such as anxiety, depression, and somatic disorders. The Chi-Square statistical test showed a significant relationship between parenting styles and adolescent mental health (χ²=177.199, p < 0.001; p < 0.05). These findings emphasize the importance of parenting education programs that integrate neuroscience principles to optimize adolescent brain development. The study concludes that optimal parenting styles can support adolescent mental health and reduce the risk of emotional mental disorders in the future.
Hak Cipta (c) 2025 Nessa Suci Amalia, Alya Dwiana https://creativecommons.org/licenses/by/4.0
Diagnosis of Acute Rheumatic Fever in an 8-Year-Old Child: A Case Report
Abstract: Acute Rheumatic Fever (ARF) is a serious autoimmune disease caused by a Group A Streptococcus (GAS) infection. In genetically susceptible people, the immune system mistakenly attacks its own tissues, a process called molecular mimicry. This can lead to inflammation of the joints and permanent heart valve damage, known as Rheumatic Heart Disease (RHD). Diagnosing ARF is challenging as symptoms are varied and there is no single test. A diagnosis relies on the Jones Criteria, which combine clinical signs with evidence of a prior GAS infection. Case Illustration : An 8-year-old boy presented with migratory arthritis in his hands and feet, following a week of a sore throat and intermittent fever. Residing in a densely populated area, the patient had an environmental risk factor for bacterial spread. Lab tests confirmed a preceding Streptococcus infection with an elevated anti-streptolysin O (ASTO) titer of 800 IU/mL and a C-Reactive Protein (CRP) level of 41 mg/L. The diagnosis of Acute Rheumatic Fever was established, as the patient met one major criterion (arthritis) and two minor criteria (fever and elevated CRP) based on the Jones Criteria. Conclusion : An 8-year-old boy was diagnosed with Acute Rheumatic Fever (ARF), an autoimmune disease triggered by a Group A beta-hemolytic Streptococcus infection. The main symptoms were migratory arthritis and intermittent fever, preceded by a sore throat. The diagnosis was confirmed using the Jones Criteria, as the patient met one major criterion (arthritis) and two minor criteria (fever and elevated C-Reactive Protein or CRP). Evidence of the prior infection was supported by an increased anti-streptolysin O (ASTO) titer of 800 IU/mL.
Hak Cipta (c) 2026 Fitri Nazilinly, dr. Yudhi Kurniawan, Sp. A (K) https://creativecommons.org/licenses/by/4.0
Interaksi Protein-Protein Hormon Anti-Müllerian (AMH) dan Perannya dalam Patofisiologi Sindrom Ovarium Polikistik (PCOS): Pendekatan Bioinformatika
Abstract: A key biomarker in the context of ovarian dysfunction in PCOS is anti-Müllerian AMH. In women with PCOS, serum AMH levels are elevated 2–3-fold compared to normal women. This increase reflects changes in the expression and molecular function of AMH and its receptor (AMHR2), which may disrupt ovarian hormonal homeostasis. Although experimental studies have demonstrated the involvement of AMH in the pathophysiology of PCOS, understanding the molecular interactions of AMH with other proteins in the context of human PCOS remains limited. Therefore, bioinformatics approaches can be used to identify and map the AMH protein interaction network in PCOS and evaluate the involvement of relevant molecular pathways. This study was conducted using a bioinformatics approach to explore protein interactions. The analysis process included collecting datasets of proteins related to AMH and PCOS, modelling protein-protein interaction (PPI) networks, and functional analysis using KEGG pathways and Gene Ontology (GO). The protein interaction shows that AMH plays a central role in PCOS through its influence on follicular development, hormonal regulation, and cellular signalling pathways. The association between AMH in PCOS involves the ovarian steroidogenesis pathway bioinformatically which is targeted in SMAD and TGF B signalling.
Hak Cipta (c) 2025 Firda Asma'ul Husna, Luluk Hermawati, Nur Bebi Ulfah Irawati, Hilizza Awalina Zulfa, Ghea Farmaning Thias Putri , Yuda Nabella Prameswari https://creativecommons.org/licenses/by/4.0
Microorganisms Causing Diarrhea in Food Served at Islamic Boarding Schools: A Descriptive Study in Surabaya, Indonesia
Diarrhea remains one of the leading public health problems in Indonesia, particularly among children. Contaminated food with pathogenic microorganisms such as Escherichia coli, Salmonella spp., Shigella spp., Staphylococcus aureus, and Vibrio cholerae is a major contributor. Boarding school environments, where sanitation is often suboptimal, increase the risk of foodborne contamination. This study aimed to identify the presence of diarrhea-causing microorganisms in food consumed by students at one of islamic boarding school in Surabaya and to examine the potential risk factors for contamination. A descriptive observational study with a cross-sectional design was conducted. Food samples were purposively collected from three food stalls frequently visited by students. Microbiological analysis was performed using selective media: EMBA for E. coli, SSA for Salmonella and Shigella, MSA for Staphylococcus aureus, and TCBS for Vibrio cholerae. Data were analyzed descriptively and compared with standards from the Indonesian Ministry of Health and the National Agency of Drug and Food Control (BPOM). For the result, Laboratory examination revealed no contamination with E. coli, Salmonella spp., Shigella spp., Staphylococcus aureus, or Vibrio cholerae in the food samples. However, several behavioral and environmental risk factors were observed, including poor handwashing practices, improper food storage at room temperature, and inadequate personal hygiene among food handlers and students. In conclusion, although laboratory findings showed no contamination by major diarrheagenic microorganisms, the risk of diarrhea remains due to poor hygiene and sanitation practices. Strengthening food hygiene education and sanitation practices within boarding schools is crucial for preventing diarrheal disease.be avoided, but if essential they must be defined at their first mention in the abstract itself.
Hak Cipta (c) 2026 Diah Retno Kusumawati, Yardan Aggie Priambodo, Yuriske Agnovianto https://creativecommons.org/licenses/by/4.0
The Relationship Between Body Mass Index and Human Sperm Motility
Approximately 17.5% of the adult population has experienced infertility, and this can cause significant stress, stigma from the community, disrupt financial capabilities, and affect mental health and psychosocial relationships in general. Sperm motility plays a crucial role in the fertilization of an egg by sperm. A fit body contributes to good sperm motility. A healthy body is supported by an ideal weight and height, as reflected in the body mass index (BMI). This study aims to determine the relationship between BMI and human sperm motility. This study used a cross-sectional method with a correlational analytical approach. Subjects were obtained through secondary data, including weight, height, and sperm motility data from infertile patients visiting the Duta Sehat Mataram Pharmacy. A total of 60 subjects were recruited, of which 16 cases were excluded, four with azoospermia and 12 with varicocele. The data were analyzed using the Spearman correlation test. In this study, 70.4% of cases were overweight, 27.3% were normal, and 2.3% were underweight from 44 data sets that met the inclusion criteria. Based on data analysis, there was no significant relationship between body mass index and human sperm motility. The Spearman correlation test showed p = 0.338 (p>0.05) and a correlation coefficient of -0.148. This study evaluated the relationship between men's body mass index and sperm motility, with results showing a weak trend and no statistically significant association.
Hak Cipta (c) 2025 I Nyoman Bagus Aji Kresnapati, Gede Wira Buanayuda https://creativecommons.org/licenses/by/4.0
Beauty Beyond Knowledge: Skincare Product Selection from Social Media Among Adolescents in Islamic Boarding School
Skincare has become a growing trend among adolescents, strongly influenced by social media platforms. However, limited knowledge regarding the safe selection of skincare products may increase the risk of harmful or illegal product use. This study aimed to analyze the relationship between knowledge and skincare product selection from social media among adolescents in an Islamic boarding school. This cross-sectional study was conducted from February to July 2024 at one of islamic boarding school in Madura. A purposive sampling technique was applied, and 44 adolescents who used skincare products participated. Data were collected using structured questionnaires and analyzed using the Fisher Exact Test. Results showed that the most respondents were female (65.9%), aged 16 years (36.4%), and in grade X (52.3%). Although most students had good knowledge (82.7%), the Fisher Exact Test showed no significant relationship between knowledge and skincare product selection (p=0.461). The main reasons for using skincare were to maintain skin health and protection from sun exposure (44%), with TikTok being the primary source of information (59%). In conclusion, knowledge alone does not significantly influence skincare selection among adolescents, as choices are shaped by multiple cultural, personal, and psychological factors. Strengthening health education and critical evaluation of social media content are essential to promote safe skincare practices among adolescents.
Hak Cipta (c) 2026 Maria Ulfa, Meidyta Sinantryana, Yuriske Agnovianto https://creativecommons.org/licenses/by/4.0
the Antipyretic Effect of Ethanolic Extract of Bilimbi Fruit (Averrhoa bilimbi L.) in DPT Vaccine-Induced Male Wistar Rats (Rattus norvegicus)
Organisasi Kesehatan Dunia (WHO), memperkirakan sekitar 50.000 individu kehilangan nyawa setiap harinya akibat penyakit infeksius. Salah satu reaksi sistemik fisiologis yang umum terjadi sebagai respons terhadap infeksi adalah hipertermia atau demam. Masyarakat Indonesia sering menggunakan pengobatan alternatif seperti fitofarmaka, termasuk penggunaan buah belimbing wuluh, yang diketahui mengandung senyawa bioaktif seperti saponin, alkaloid, dan flavonoid dan memiliki potensi penurun demam. Penelitian ini bertujuan untuk mengevaluasi daya kerja antipiretik serta mengidentifikasi dosis paling optimal dari ekstrak etanol buah belimbing wuluh. Rancangan yang digunakan dalam studi ini adalah True Experimental dengan pendekatan Pretest-Posttest Control Group Design. Sebanyak tiga puluh ekor hewan coba jenis tikus dialokasikan secara acak ke dalam enam gugus perlakuan, yang terdiri atas: kelompok normal, kontrol negative (aquadest), kelompok kontrol positif (parasetamol), serta tiga kelompok perlakuan (ekstrak etanol buah belimbing wuluh takaran bertingkat, yakni 875, 1750 dan 3500 mg/kgBB. Induksi demam injeksi intramuskular vaksin DPT sebanyak 1 ml/kgBB, IM. Pengamatan pada tiga fase waktu, yakni sebelum proses induksi demam, dua jam pasca penyuntikan vaksin, serta secara periodik setiap 30 menit hingga menit ke-180 usai pemberian perlakuan. Hasil menunjukkan bahwa ekstrak etanol dari buah belimbing wuluh (Averrhoa bilimbi L.) memperlihatkan potensi farmakologis sebagai agen antipiretik.(p<0.05). Uji Post Hoc Bonferroni memperlihatkan bahwa kelompok yang memperoleh dosis menengah (1750 mg/kgBB) maupun dosis tinggi (3500 mg/kgBB) memberikan respons antipiretik yang sepadan dengan kelompok kontrol positif yang diberi parasetamol. Kesimpulan untuk dosis optimal yang memberikan efikasi paling tinggi terletak pada takaran 1750 mg/kgBB.
Hak Cipta (c) 2026 christin nayoan, Nuurkholisha Nuurkholisha, Nur Syamsi Nur Syamsi, Andi Alfia Muthmainnah Tanra, Rahma, IPFI White, Haerani Harun https://creativecommons.org/licenses/by/4.0
Maternal Knowledge and Attitudes in Relation to Childhood Stunting Risk in Sekotong, West Lombok
The prevalence of stunting in Sekotong Sub-district, West Lombok, remains above the maximum threshold established by the government despite the implementation of various intervention approaches. One contributing factor is the low level of knowledge and awareness among the community regarding stunting. This study aimed to assess the relationship between maternal knowledge and attitudes toward stunting among mothers with children at risk of stunting. A cross-sectional study design was employed involving 33 female respondents aged over 18 years who had children identified as being at risk of stunting. The results indicated a moderate and statistically significant correlation (r = 0.498; p = 0.003) between the mothers’ level of knowledge and their attitudes towards stunting. Demographic data revealed that the majority of mothers had only completed secondary education; however, they demonstrated good knowledge (>8) and positive attitudes (>18) regarding stunting, at 78.78% and 100%, respectively.
Hak Cipta (c) 2025 Candra Eka Puspitasari, Gusti Ayu Eka Radha Ardinia, Baiq Hawarikatun, Nachwa Humaira Alhidayah, Bakhraeni, Siti Hamida Rahayu Tsania https://creativecommons.org/licenses/by/4.0
Narkosis Nitrogen : Penurunan Kesadaran Pada Penyelam
Abstract: Narkosis nitrogen adalah gangguan neurologis reversibel yang terjadi akibat peningkatan tekanan parsial nitrogen selama penyelaman dalam dengan scuba. Meskipun nitrogen merupakan gas inert yang menyusun sekitar 79% udara atmosfer, pada tekanan tinggi gas ini mudah larut ke dalam jaringan tubuh, terutama jaringan saraf yang kaya lemak, sesuai dengan hukum kelarutan gas. Kondisi ini dapat menyebabkan gangguan fungsi kognitif dan motorik, seperti euforia, penurunan kemampuan berpikir, reaksi lambat, hingga halusinasi atau hilangnya kesadaran pada kedalaman ekstrem. Tujuan tinjauan ini adalah untuk memberikan gambaran komprehensif mengenai mekanisme kerja, faktor risiko, manifestasi klinis, dan strategi pencegahan narkosis nitrogen. Pencegahan mencakup pembatasan kedalaman penyelaman, serta peningkatan pelatihan dan kesadaran penyelam. Upaya edukasi dan infrastruktur keselamatan yang memadai sangat penting untuk menurunkan risiko dan dampak fatal akibat narkosis nitrogen.
Hak Cipta (c) 2025 radi ansary https://creativecommons.org/licenses/by/4.0
Update on Patophysiology and Management of Complication in Children With Haemophilia: A Literature Review from 2020-2025
Background: The high prevalence of death in children with haemophilia is often associated with its complications. The complications can worsen the quality of life of children and pose a high economic threat. This emphasizes the need for earlier detection and good management of complications. Aim: This literature review aims to discuss the pathophysiology and management of complications that can present in paediatric patients with haemophilia. Method: A literature search of original research, case reports, systematic reviews, and meta-analyses was conducted through Google Scholar, ProQuest, and Wiley. The included articles met the following criteria: year of publication 2020-2025, in English or Indonesian, and at least accompanied by a complete abstract. Results & Discussion: The total number of articles reviewed was 20 articles. The types of complications that often occur in paediatric patients with haemophilia are haemophilic arthropathy, inhibitor, bleeding, and psychosocial disorders. Management options given for each complication vary, but in general consist of prophylactic transfusion of coagulation factor replacement, physical rehabilitation therapy, pain management, surgery, bypassing agents, gene therapy, and monoclonal antibodies. Each type of management has its own goals and procedures, and modifications to the mode of therapy administration have the potential to provide better outcomes for the severity and disability of the patient. Summary: Complications of haemophilia in children require more attention from health workers. Acute therapy and prophylaxis remain the main options, with a number of new regimens being developed that are expected to be more widely used and available for people from various social strata.
Hak Cipta (c) 2025 Ni Wayan Puspa Wijaya Suryantarini https://creativecommons.org/licenses/by/4.0
Pre-Referral Management, Maternal and Perinatal Outcome of Preeclampsia Patients with Severe Feature In Coastal Region
Preeclampsia (PE) with severe features, as one of the hypertensive disorders in pregnancy, often becomes a problem in health services for pregnant women. West Nusa Tenggara or Nusa Tenggara Barat (NTB) Province is in the Eastern part of Indonesia with archipelagic characteristics. Sea transportation is the main transportation used to refer patients live in coastal area and small islands. Travel distance, limited facilities on ships and weather conditions are challenges for the referral system in this province. This study aims to determine the characteristics of pre-referral management in cases of preeclampsia with severe features and type of maternal and perinatal outcomes. This study found a total of 60 subjects. Of the four pre-referral treatments for preeclamptic pregnant women, administration of MgSO4 is the most common therapy. There were 80% (n=48) of subjects receiving antihypertensives. 21 subjects (35%) were given steroids. Only one subject with a history of taking aspirin. As many as 30% of patients experienced eclampsia, 6.7% with HELLP syndrome, 20% with severe hypertension and one with CVA. The majority of babies born with APGAR scores <7 at one and five minutes, 10% with RDS and 21.7% in the NICU for >3 days. Our findings show pre-referral care needs to be better, especially for patients living on the coast as it takes more challenges due to extreme weather and distance. The provision of low-dose aspirin in groups at high risk of preeclampsia needs to be improved.
Hak Cipta (c) 2025 I Dewa Ayu Risna Jayanthi, Agus Rusdhy Hariawan Hamid, Yoga Pamungkas Susani https://creativecommons.org/licenses/by/4.0
Neurobiological, Psychosocial, and Digital Behavior Perspectives of Intermittent Explosive Disorder in Children and Adolescents: A Literature Review
Intermittent Explosive Disorder (IED) is a psychological disorder characterized by repetitive and disproportionate outbursts of anger, accompanied by verbal and physical aggression. This disorder sometimes appears in children and adolescents with gadget addiction accompanied with emotional disturbances, and negatively affects long-term emotional, social, and neurobehavioral aspect. The etiology of IED is multifactorial, including biological factors such as dysregulation of the serotonin system, dysfunction of the prefrontal-amygdala circuit, as well as genetic predisposition, which interact with environmental factors such as negative parenting, childhood trauma, and socioeconomic stress. The diagnosis of IED according to the DSM-5 emphasizes the presence of spontaneous impulsive aggressive outbursts, does not correspond to the level of provocation, and interferes with the functioning of daily life. Research also shows a significant correlation between gadget addiction and increased aggressive behavior in children and adolescents, especially when accompanied by low ego-resilience and less supportive parenting. The treatment of IEDs requires a multidisciplinary approach, with pharmacological therapies such as fluoxetine and anticonvulsants, as well as psychological therapies such as Cognitive Behavioral Therapy (CBT) proving to be effective. An in-depth understanding of the neuropsychological factors and mechanisms of IEDs is essential in designing holistic and evidence-based prevention and treatment strategies.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Aurellia Wongso Prawiro, Hadil Hudati Awwari Rameci, I Gusti Ketut Artha Jaya Kusuma, Nadine Aisyah Sultan Firdaus https://creativecommons.org/licenses/by/4.0
Comprehensive Study of Internet Gaming Disorder in Children and Adolescents: A Literature Review
Abstract: Internet Gaming Disorder (IGD) is excessive use of the internet to play games so that it interferes daily life function. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a diagnosis of IGD can be made if 5 or more of the following 9 symptomatic criteria are found: (1) preoccupation; (2) withdrawal symptoms; (3) tolerance; (4) control failure; (5) loss of interest in other activities; (6) playing games without considering the risks; (7) lying about the time spent playing; (8) using online games as an escape; and (9) daily functional impairment. Some risk factors for IGD include gender, community membership, playtime, and presence in offline community. IGD lead mental health problems such as anxiety disorders and depression. In addition, IGD also affect the behavior of children and adolescents, such as school refusal, aggressive behavior, and even suicide. IGD prevention and management requires a multidisciplinary approach. Collaboration of various parties is needed to handle IGD cases, including family, school, doctors, psychologists and therapists.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Hasna Tazkia Aghni, Panji Sena Ramadhan, Aisah Aliyyu https://creativecommons.org/licenses/by/4.0
Nomophobia pada Anak dan Remaja sebagai Tantangan Psikososial di Era Digital : Suatu Tinjauan Literatur
Perkembangan teknologi yang semakin canggih, khususnya dalam penggunaan gadget atau gawai, telah membawa dampak signifikan terhadap kehidupan sosial di era modern, salah satunya adiksi gawai pada anak dan remaja. Penggunaan berlebihan dari gawai dapat menimbulkan masalah psikologis, salah satunya adalah nomophobia (no-mobile-phone phobia). Studi ini merupakan tinjauan literatur sistematis dengan mengumpulkan pustaka dari beberapa database terkemuka mengenai fenomena nomophobia. Ketakutan akan kehilangan kontak dengan gawai yang disebut nomophobia, dipengaruhi oleh berbagai faktor risiko terkait kepribadian dan temperamen individu. Selain itu penggunaan gawai yang berlebihan, kecemasan tinggi, dan keterampilan emosional yang rendah juga berkontribusi pada peningkatan nomophobia. Nomophobia berdampak signifikan terhadap kondisi psikologis, fisik, sosial, dan akademik anak dan remaja, serta berhubungan dengan meningkatnya stres, kesepian, gangguan tidur, serta disfungsi regulasi emosi. Penanganan nomophobia memerlukan pendekatan multidimensi melalui edukasi, intervensi psikologis, serta upaya meningkatkan interaksi sosial langsung antara anak dan remaja dengan orang tuanya untuk membentuk pola penggunaan teknologi yang lebih sehat.
Hak Cipta (c) 2025 Titi Pambudi Karuniawaty, Alisha Chaerani Zubaedi, Romy Healthy Mikailla, Baiq Remtaya Mikailla https://creativecommons.org/licenses/by/4.0
Pterygium is a triangular fibrovascular growth that usually originates from the nasal conjunctiva and extends onto the cornea, potentially impairing vision if it reaches the visual axis. This condition is more prevalent in tropical regions, such as Indonesia, and is associated with various etiological factors, including environmental exposure, chronic ocular irritation, and age-related changes. The pathogenesis of pterygium involves limbal stem cell damage, activation of matrix metalloproteinases, P53 gene alterations, and chronic inflammatory processes, all of which contribute to uncontrolled fibrovascular proliferation. Common symptoms include foreign body sensation, ocular redness, and visual disturbances such as induced astigmatism or decreased visual acuity. Diagnosis is primarily established through clinical evaluation and slit-lamp biomicroscopy. Management strategies for pterygium encompass preventive measures, medical therapy to control inflammation, and surgical intervention in progressive, visually significant, or recurrent cases. A comprehensive understanding of etiological factors, prompt diagnosis, and appropriate management is essential to prevent disease progression and optimize visual outcomes.
Hak Cipta (c) 2026 ali ramzi https://creativecommons.org/licenses/by/4.0
Transverse Myelitis pada Anak Perempuan Usia 11 tahun: Sebuah Laporan Kasus
Abstract: Transverse myelitis (TM) is a rare inflammatory disease that causes injury to the spinal cord resulting in clinical manifestations of weakness, sensory changes, and autonomic dysfunction.This disease can attack all age groups, but the highest age range is 10-19 years and 30-39 years.This disease is acute, and shows dominant clinical neurological abnormalities.The cause of this condition is still unknown, and the diagnosis of TM can be assessed from clinical examination, neurological examination, radiology and laboratory. Case presentation: An 11-year-old female child patient came to the West Nusa Tenggara Provincial Hospital with complaints of weakness of the limbs felt since 4 days before admission accompanied by inability to urinate, abdominal bloating and pain. The patient then underwent further examination and the patient was diagnosed with transverse myelitis, and received drug management and medical rehabilitation Conclusion: Based on this case, the patient experienced sudden weakness in all four limbs which was idiopathic and diagnosed as Transverse myelitis. Although this condition is rare, it requires immediate management and appropriate rehabilitation to maximize the patient's motor, sensory and autonomic functions, to prevent permanent disability.
Hak Cipta (c) 2025 Rika Fitria, Tristina Wardani https://creativecommons.org/licenses/by/4.0
Peran Fast Food Terhadap Jerawat : Tinjauan Literatur
Acne vulgaris was a prevalent dermatological condition commonly observed in adolescents and young adults. This condition can significantly impact one's quality of life and has psychological effects, including a decrease in self-confidence. One of the contributing factors to the development of acne was dietary habits, particularly the consumption of fast food. Fast foods, such as pizza, burgers, fried chicken, french fries, and ice cream, are high in saturated fats, sugars, salts, and preservatives, which may induce inflammation and exacerbate skin conditions. Furthermore, lifestyle factors, such as inadequate sleep, stress, and the use of inappropriate skincare products, may aggravate the condition. Therefore, adopting a balanced diet and regulating fast food intake emerges as an effective strategy to mitigate the risk of acne in adolescent and young adults.
Hak Cipta (c) 2025 saki yora, Fikri Ash Shadiq Ramadhani, Tamara Jevani, LH. Putri Puspa Sari, Muhammad Fiqry Hakim, Vernonia Yora Saki https://creativecommons.org/licenses/by/4.0
Review Artikel : Pemanfaatan Sumber Alami Asam Linoleat dalam Formulasi Sediaan Kosmetik
Linoleic acid is an essential fatty acid that cannot be synthesized by the human body and is abundantly found in various natural sources such as candlenut, sunflower seeds, almonds, and chia seeds. This compound is known to possess significant biological activities, including anti-inflammatory, antioxidant, anti-aging properties, as well as supporting skin regeneration and hair growth. This review aims to explore the potential of linoleic acid as an active ingredient in the formulation of body care and skincare products. Literature searches were conducted through Google Scholar, PubMed, and ScienceDirect using relevant keywords, with inclusion criteria encompassing the chemical properties, pharmacological benefits, and cosmetic applications of linoleic acid. The results of the review indicate that linoleic acid has been utilized in various dosage forms, including hair tonics, anti-acne creams, hand body lotions, lip balms, emulgels, facial serums, masks, and hair emulsions to support the hair growth process. Its effectiveness is highly influenced by the concentration of the active ingredient and the formulation type used. This review supports the utilization of linoleic acid as a promising and sustainable natural active ingredient in the modern cosmetic industry. Further research is needed to optimize formulations and comprehensively evaluate the safety of these preparations.
Hak Cipta (c) 2025 Wahyu Haryanto, Intan Alfizahara, Abdul Hamid Muktiali, Bq Aisya Adinda, Putri Syerin Salsabila, Irma Hapinatunnisa, Baiq Mia Ramadhani Rahadian, Rahmah Dara Ayunda https://creativecommons.org/licenses/by/4.0
Miller-Fisher Syndrome sebagai varian dari Guillain-Barré Syndrome
Guillain-Barré Syndrome (GBS) merupakan poliradikuloneuropati akut yang disebabkan oleh reaksi autoimun terhadap saraf perifer. Miller Fisher Syndrome(MFS) merupakan salah satu varian langka dari Guillain-Barré Syndrome (GBS) yang dicirikan dengan triad klinis oftalmoplegia, ataksia, dan arefleksia atau hiporefleksia. Patofisiologi pada MFS belum sepenuhnya dipahami. Hingga saat ini patofisiologi MFS dipercaya berkaitan dengan respon autoimun akut terhadap infeksi anteseden (seperti infeksi oleh Campylobacter jejuni, virus Epstein-Barr, Cytomegalovirus, atau Human Immunodeficiency Virus, Mycoplasma pneumonia, Haemophilus influenzae, dan virus influenza A) dan proses mimikri molekuler yang menyebabkan tubuh salah dalam mengenali gangliosida saraf perifer sebagai epitop dari antigen penyebab infeksi sehingga tubuh memproduksi antibodi (autoantibodi) anti-gangliosida yang bersirkulasi dalam darah dan menyerang sistem saraf perifer. Pada MFS, autoantibodi yang terbentuk adalah autoantibodi anti-gangliosida Q1b (anti-GQ1b). Diagnosis MFS ditegakkan berdasarkan terpenuhinya kriteria diagnostik GBS menurut National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) disertai triad gejala klinis khas pada MFS. Kriteria diagnositik lain yang juga umum digunakan adalah Kriteria Brighton sebagai alat bantu untuk mendiagnosis GBS dan membedakan antara pasien berisiko rendah dan berisiko tinggi. Pengobatan untuk GBS dan variannya mencakup perawatan suportif yang memadai, kontrol nyeri, bantuan pernapasan, dan imunoterapi.
Hak Cipta (c) 2025 Ni Putu Ayu Nindya Dewi Cahya Putri, Ilsa Hunaifi https://creativecommons.org/licenses/by/4.0
Myasthenic Crisis in Thymoma : A Clinical Case Report
Thymoma is an anterior mediastinal tumor commonly associated with paraneoplastic syndromes, notably myasthenia gravis. This case report describes a 40-year-old man presenting with progressive dysphagia, cranial and limb muscle weakness, and severe dyspnea. Thoracic imaging revealed an anterior mediastinal mass suspected to be thymoma. The patient developed a myasthenic crisis requiring intubation and mechanical ventilation. Treatment included intravenous anticholinesterase, intravenous immunoglobulin, and thymectomy. Prompt radiological assessment and clinical diagnosis are crucial in managing such cases to prevent life-threatening respiratory complications.
Hak Cipta (c) 2025 Rab sanjani, Novia Andansari Putri, Moulid Hidayat, Triana Dyah Cahyawati, Stevia Ariella Pasande https://creativecommons.org/licenses/by/4.0
Radiologic Multimodality Approach in a Case of Pancoast Tumor with Bone Lytic Lesions
Lung cancer was the second most common malignancy and the leading cause of cancer-related mortality worldwide in 2020, accounting for 1.8 million deaths. Delayed diagnosis often leads to advanced-stage presentation and poor long-term survival. Pancoast tumors, a rare subset of superior sulcus lung cancers, may present with atypical neurologic signs. We report a 55-year-old man with a 6-month history of right chest pain and progressive dyspnea. Physical examination was unremarkable apart from mild right eyelid ptosis without a full Horner’s syndrome. Chest X-ray and contrast-enhanced CT demonstrated an apical mass in the right upper lobe with lytic lesions of the first and second ribs. Bronchoscopic biopsy confirmed non–small cell lung carcinoma consistent with a Pancoast tumor. The patient underwent surgical resection of the apical mass with regional lymphadenectomy, followed by platinum-based chemotherapy. Postoperative imaging revealed residual disease, prompting additional chemotherapy cycles. At six-month follow-up, the patient experienced marked pain relief and partial resolution of ptosis, with no new metastatic foci on imaging. High clinical suspicion and a multidisciplinary radiologic and histopathologic approach are essential for early diagnosis and optimal management of Pancoast tumors.
Hak Cipta (c) 2025 Rab sanjani, Prima Belia Fathana, Novia Andansari Putri, I Bona Manik, Triana Dyah Cahyawati https://creativecommons.org/licenses/by/4.0
Spinal Cord Stimulation for Chronic Pain: A Literature Review
The high prevalence and significant impact of chronic pain on patients' quality of life is important as a major public health issue. The condition is particularly concerning due to the high proportion of chronic pain cases that are refractory to conventional treatment. Spinal cord stimulation (SCS) has emerged as an effective neuromodulation technique for patients with refractory chronic pain, demonstrating superior outcomes compared to pharmacological treatments, including in reducing opioid consumption. Patient selection is crucial for optimizing outcomes following SCS and various factors, including substance abuse, smoking, opioid use, and psychological distress, may adversely affect the success of the treatment. These complications can be classified into device-associated and biologically mediated complications. Despite these recognized risks, neuromodulation through SCS is considered a safe intervention, with a low risk of mortality.
Hak Cipta (c) 2025 Kadek Adi Sagita Reka Baya, Muhammad Arismunandar https://creativecommons.org/licenses/by/4.0
Prevalence of Wrist Tendinitis Among Computer Users, Office Workers, and Manual Laborers in Egypt
Tendinitis is a common musculoskeletal disorder that affects individuals engaged in repetitive tasks, including computer users, office workers, and manual laborers. Understanding the relationship between occupational activities and tendinitis can help develop preventive strategies. The study design is a retrospective cohort study, which enables us to examine the prevalence of tendinitis among different occupational groups by analyzing medical records of diagnosed cases and assessing their work histories. A random sample of 371 participants. We reviewed their occupational history and assessed potential associations between work-related activities and the risk of tendinitis. Statistical analysis, including incidence rate calculations and logistic regression models, was used to determine the association between job type and tendinitis risk. we found that People who frequently perform hand-intensive writing or typing tasks are likely to report a higher incidence of repetitive hand pain due to overuse, strain injuries, and tendinitis. Among the participants, who were all engaged in repetitive hand-intensive tasks, 18% were diagnosed with tendinitis. The incidence was highest among office workers, indicating a significantly higher risk compared to other job types. The ergonomic conditions were also found to influence the likelihood of developing tendinitis. Jobs that require repetitive movements and sustained postures also increase the risk of musculoskeletal disorders. Therefore, it is essential to transition from paper-based tasks to digital alternatives and incorporate modern technology in the workplace. Implementing ergonomic interventions, modifying the nature of office and manual work, and integrating technology and artificial intelligence into workplace tasks will help reduce the incidence of tendinitis.
Hak Cipta (c) 2025 Nour Hatem, Reham Mahmoud, Najah Elmounedi, Abdelrahman Mahmoud https://creativecommons.org/licenses/by/4.0
Correlation Between Blood Glucose and Hemodialysis Adequacy in Routine Hemodialysis Patients at West Nusa Tenggara General Hospital
Progressive kidney function decline to a GFR < 15 mL/min/1.73 m² is defined as stage 5 chronic kidney disease (end stage) or end-stage renal failure. In this condition, patients require renal replacement therapy, such as hemodialysis. Effective dialysis indicates a longer life expectancy and lower mortality rates. The effectiveness of the hemodialysis process or hemodialysis adequacy is measured by the Kt/V value, which reflects the urea clearance during each hemodialysis session. Blood sugar levels before hemodialysis are one of the predictors of hemodialysis adequacy. This study used an analytic observational method on 34 samples that met the inclusion and exclusion criteria to find correlation between blood glucose and hemodialysis adequacy in routine hemodialysis patients at West Nusa Tenggara General Hospital. Data collection was carried out at the HD Unit 2 of the Provincial General Hospital of West Nusa Tenggara. In this study, the average age of the respondents was 50 years, consisting of 64.7% male and 35.3% female. The results of the correlation analysis using the Pearson test showed no significant relationship between blood glucose levels and hemodialysis adequacy, with p=0,478 and r=-0,126. However, the Fisher exact test revealed a statistically significant relationship between gender and hemodialysis adequacy, with p<0,001. In conclusion, blood glucose levels were not associated with hemodialysis adequacy, while gender showed a statistically significant association with hemodialysis adequacy.
Hak Cipta (c) 2025 Carolina Janicca Winda Manafe, I Gede Yasa Asmara, I Gede Supartha https://creativecommons.org/licenses/by/4.0
Correlation between Reticulocyte Hemoglobin Equivalent (Ret-HE) and Iron Profile in Routine Hemodialysis Patients at West Nusa Tenggara General Hospital
Abstract: Chronic kidney disease (CKD) is a dysfunction occurs in the kidneys that causes the body's inability to maintain homeostasis through controlling blood volume/composition and kidney replacement therapy is needed, one of which is hemodialysis. Hemodialysis process and CKD itself can cause complications, especially iron deficiency anemia (IDA). This research aim to find out the correlation between standard iron deficiency anemia diagnostic examinations (serum iron, transferrin saturation, TIBC) and Ret-HE. This study uses an analytical observation method on 50 research subjects fulfill the research criteria. Data collection was carried out at the Hemodialysis Unit of the NTB Provincial Hospital using consecutive sampling method. The study result showed 42 subject (84%) have normal Ret-HE (≥ 29 pg). There was a statistically significant correlation between Ret-HE and iron profile in routine hemodialysis patients (P < 0.05) with weak correlation using Pearson correlation test (r = 0,2-0,399). Keywords: CKD, iron deficiency anemia, iron profile, Ret-HE, routine hemodialysis, serum iron, stage V, TIBC, transferrin saturation.
Hak Cipta (c) 2025 Atina Rizki Putri, I Gede Yasa Asmara, Triana Dyah Cahyawati https://creativecommons.org/licenses/by/4.0
A Case Report of Mediastinal Tumor: Limfoma Non-Hodgkin
Mediastinal tumors in adults are predominantly located in the anterior mediastinum, commonly presenting as lymphoma or thymoma. Non-Hodgkin lymphoma (NHL) is a group of malignant neoplasms originating from lymphoid tissues, primarily the lymph nodes. These lymphomas are not confined to the anterior mediastinum but may also occur in the middle and posterior mediastinal compartments. The average age of onset for this disease ranges between 28 and 35 years. Blood tests, radiological imaging, and histopathological examination are essential for establishing a definitive diagnosis. The treatment approach is determined by the type, stage, histopathological characteristics, and presenting symptoms. A 39-year-old female presented to the surgical oncology clinic with an MSCT scan of the head and neck, revealing a solid anterior mediastinal mass measuring 68 mm (suspected lymphoma). The patient reported an initial complaint of headache accompanied by a neck lump. Physical examination showed normal vital signs but revealed multiple lymphadenopathies in the bilateral submandibular, cervical, and supraclavicular regions. Blood tests and contrast-enhanced thoracic MRI were performed, with MRI findings indicating an anterior mediastinal mass infiltrating the ascending aorta, suggestive of lymphoma. A biopsy confirmed the diagnosis of Non-Hodgkin lymphoma, specifically large B-cell lymphoma, through immunohistochemical analysis. Chemotherapy was recommended as the primary treatment. The signs and symptoms of mediastinal tumors vary widely and are often nonspecific. Asymptomatic masses are usually benign, whereas symptomatic patients often present with underlying malignancies. The tumor’s location is crucial for establishing clinical suspicion and planning biopsies and surgical procedures. The staging of NHL follows the Lugano classification, with chest, abdominal, and pelvic CT scans often required for imaging. Management of lymphoma typically involves chemotherapy alone or in combination with radiotherapy. The location of a mediastinal tumor plays a vital role in narrowing the differential diagnosis and planning biopsies and surgical procedures. Non-Hodgkin lymphoma is not confined to the anterior mediastinum and may occur in other compartments. Radiological and histopathological evaluations are essential for confirming the diagnosis and guiding treatment decisions
Hak Cipta (c) 2025 Unram Medical Journal