Cermin Dunia Kedokteran

Antibacterial Activity Test of the Combination of Binahong Leaf Extract (Anredera cordifolia (Ten.) Steenis) and Moringa Leaf Extract (Moringa oleifera Lam.) against Propionibacterium acnes, the Bacteria that Causes Acne

2025-10-15T19:27:58+07:00

Introduction: Acne is a skin disease that is often found in many teenagers to young adults. Propionibacterium acnes is one of the causes of acne infection with a prevalence of 12.9%. As long-term inappropriate use of antibiotics can cause resistance, traditional medicine using natural ingredients can act as an alternative. The secondary metabolite compounds from binahong (Anredera cordifolia (Ten.) Steenis) leaves and moringa (Moringa oleifera Lam.) leaves are believed to have antibacterial activity. This study aims to determine the antibacterial activity of a combination of binahong leaves and moringa leaves in inhibiting the growth of acne-causing bacteria, Propionibacterium acnes. Methods: This quantitative experimental research study tested the antibacterial properties of binahong leaves and moringa leaves against
Propionibacterium acne with random design (RAL) of 11 treatments with 3 repetitions. Bacterial test used paper disc diffusion with a single concentration of 20%, 40%, 60% and a combination of 20%:20%, 40%:60%, and 60%:40%, with clindamycin as positive control and sterile aquadest as negative control. Results: The phytochemical screening results were that binahong leaves and moringa leaves contained alkaloids, tannins, saponins, and flavonoids while the results of the antibacterial activity test were that the 60%:40% combination was more effective in inhibiting the growth of Propionibacterium acnes with an inhibition zone diameter of 26.7 mm ± 2.0 (strong). Conclusion: Binahong leaves and Moringa leaves contain secondary metabolite compounds of tannins, alkaloids, saponins, and flavonoids, and have antibacterial activity. Binahong leaves and moringa leaves can inhibit the growth of bacterium Propionibacterium acnes with a strong inhibition zone category.

Private Practitioners' Perceptions of the Tuberculosis Case Reporting System in Pontianak City in 2020

2025-06-16T18:57:52+07:00

Introduction: In reality, many tuberculosis (TB) patients don’t receive proper treatment. One contributing factor is the high number of unreported tuberculosis cases. This study aims to understand the perception of independent practice doctors regarding tuberculosis case reporting in Pontianak City in 2020. Method: This research uses a qualitative approach with a case study design. The research sample consists of 12 independent practice doctors from each district in Pontianak City, as well as TB program managers. The sample was determined using purposive sampling technique, and qualitative data were analyzed using content analysis. Results: The study results indicate a lack of knowledge and understanding in the private sector regarding the Minister of Health Regulation Number 67 of 2016 related to the case reporting system. Conclusion: Key factors in the underreporting of TB cases to independent practitioners include public health centers serving as the primary referral for TB patients. Additionally, there is limited knowledge and understanding of the Minister of Health Regulation Number 67 of 2016 and its implementation, a lack of coordination and socialization from the government, both directly and indirectly, to general practitioner, and uncooperative patients in TB case management.

Quality of Life of Elderly Patients with Low Back Pain at Ulin General Hospital Banjarmasin

2025-10-16T10:29:23+07:00

Introduction: Low back pain can change the daily life and quality of life of the elderly. This study aims to determine the quality of life of elderly patients with and without low back pain at Ulin General Hospital Banjarmasin. Methods: This study used an analytical observational approach with a cross‑sectional design. Sampling was through a purposive sampling approach according to the inclusion criteria. The study population was 100 patients aged 60 and over, half of the population with low back pain. The Indonesian versions of the WHOQoL‑BREF and SF‑36 questionnaires were used as a research instrument. Results: The results showed significant differences in the quality of life in the elderly patients with low back pain in 4 domains, namely physical functioning (p = 0.006), role limitations due to physical health (p = 0.023), social functioning (p = 0.009), and general health (p < 0.001), with median of each domain in order are 62,5 (0–100), 50 (0–100), 75 (0–100), and 50 (4–100). No significant differences in other domains in the WHOQoL-BREF and SF-36 questionnaire. Conclusion: Low back pain affects the life of elderly patients at Ulin General Hospital Banjarmasin, which was different in 4 aspects, namely physical functioning, role limitations due to physical health, social functioning, and general health.

Physical Exercise for Reducing Intraocular Pressure in Glaucoma

2024-09-14T13:50:48+07:00

Introduction: Glaucoma is a common eye condition that poses a risk to vision, as it involves elevated intraocular pressure (IOP) and can lead to vision impairment. Elevated intraocular pressure (IOP) and inadequate ocular perfusion are the basic theories of glaucoma development and progression. Methods: Literature within the last 10 years was searched through PubMed and Google
using the specified keywords: “Glaucoma” (title), “Intraocular Pressure (IOP)” (all fields), and “Physical Exercise” (all fields). The PRISMA method is used to process journal selection. Results: Dynamic exercises such as cycling and jogging have been shown to significantly reduce intraocular pressure (IOP), particularly in patients with glaucoma, whereas isometric activities like weightlifting or head-down yoga poses temporarily increase IOP. Breathing exercises such as yogic pranayama can lower IOP by stimulating parasympathetic activity and improving aqueous humor outflow without elevating ocular venous pressure. Conclusion: The decrease in IOP and increase in OPP after dynamic exercises such as cycling and jogging were related to the intensity of the exercise. No cure is available; management is to prevent further damage and vision loss. Physical exercise influences the IOP, ocular perfusion, neuroprotection, and mental health in patients with glaucoma. This article discusses the benefits of physical exercise in reducing IOP and its potential risks in glaucoma patients.

Efficacy of Efepoetin Alfa for Chemotherapy-Induced Anemia in Breast Cancer Patients: Case Series

2025-05-30T09:23:49+07:00

Introduction: Anemia is a common complication among cancer patients and substantially reduces quality of life (QOL) through symptoms such as fatigue and cognitive impairment. This case evaluates the use of efepoetin alfa to treat chemotherapy‑induced anemia (CIA) in late‑stage breast cancer patients in Indonesia. Case: Six Asian women aged 43–59 years with stage III breast cancer receiving docetaxel‑doxorubicin chemotherapy developed moderate anemia (mean baseline hemoglobin [Hb] 9.5 g/dL). Patients received subcutaneous efepoetin alfa (generally 0.3 mg/0.3 mL once); Hb was reassessed at an average of 8 days after the last injection. Discussion: Post‑treatment mean Hb rose to 12.1 g/dL (mean ΔHb ≈ 2.6 g/dL). No serious adverse events were observed during the short follow‑up. Conclusion: In this case, efepoetin alfa was associated with rapid increases in Hb and improved patient‑reported outcomes; however, a confirmatory larger study, standardized dosing and monitoring, and longer follow‑up are required to define efficacy and long‑term safety.

Survivors of Extremely Low Birth Weight (ELBW) Premature Infants at Type C Regional General Hospitals: Case Reports

2024-11-01T15:47:55+07:00

Introduction: Low birth weight is defined by the World Health Organization as a birth weight of less than 2,500 grams, while extremely low birth weight is defined as a birth weight of less than 1,000 grams. Babies with low birth weight are 20 times more likely to experience complications and death compared to babies with normal birth weight. Case: A female infant, gestational age 28–29 weeks, birth weight 800 g, born spontaneously to a G3P1A1 mother with a history of premature rupture of membrane < 18 hours, urinary tract infection, and threatened preterm delivery. The infant cried immediately after birth, AS 7/9, and at 10 minutes appeared to be short of breath with a threat of respiratory distress. CPAP was administered, thermoregulation was performed, and intravenous antibiotics were given. Parenteral nutrition was given starting at 80 mL/kgBW/day and increased gradually. Breast milk was given on the second day starting at 20 mL/kgBW/day every 3 hours via OGT, increased by 10–20 mL/day according to tolerance. Complications during treatment included recurrent temperature instability, brown-colored vomit, and abdominal distension. The infant’s weight dropped to 700 g, and anemia (Hb = 10.6) developed. At 30 days of age, Kangaroo mother care, oral care, and physiotherapy were provided and taught to the parents. At 12 months of corrected age, the infant weighed 7.8 kg and was developing according to age milestones. Discussion: Early feeding plays a crucial role in the care of premature infants because it supports growth and gastrointestinal maturation. Enteral nutrition is better than total parenteral nutrition because it helps prevent problems from IV use, infections, side effects of total parenteral nutrition, and not eating. Conclusion: Prematurity is the leading cause of morbidity and mortality in neonates and children under 5 years of age. Proper management and good nutrition will support optimal growth, improve neurological outcomes, and reduce the incidence of sepsis and the possibility of retinopathy.

Multibacillary Leprosy with Type 2 Reaction in Young Adults: Case Report

2024-09-02T22:27:43+07:00

Introduction: Leprosy or Hansen’s disease, is a chronic granulomatous infection caused by Mycobacterium leprae, which affects the skin and peripheral nerves. The disease occurs more frequently in males and remains a significant public health issue in endemic countries such as Indonesia. Case: A 23-year-old male presented with swelling of both hands, feet, and ears, accompanied by numbness and radiating pain. Dermatological examination revealed multiple erythematous papules and nodules that were anesthetic and symmetrically distributed, accompanied by onychodystrophy. Enlargement of the auricularis magnus and posterior tibial nerves was observed, as well as sensory disturbance in the ulnar nerve area. Slit-skin smear examination of the left ear showed acid-fast bacilli (2+ bacilli per field of view). Discussion: The patient was diagnosed with multibacillary-type leprosy with a type 2 reaction (erythema nodosum leprosum). This reaction represents a complex immune response that can lead to permanent nerve damage if not promptly managed. Conclusion: Comprehensive management involving a combination of anti-leprosy drugs, corticosteroids, analgesics, vitamin B complex, and medical rehabilitation is essential to prevent disability progression and improve functional outcomes. Patient education and regular follow-up are crucial for treatment success. The main challenge in this case is to prevent disability progression and maximize remaining function through comprehensive rehabilitation.

Management of Ramp Lesion in Common Meniscus Lesion: Repair or Conservative

2024-10-08T14:55:13+07:00

Ramp lesions are the most frequent intra-articular injuries associated with anterior cruciate ligament (ACL) ruptures and are often missed during diagnosis. They occur at the meniscocapsular junction of the posterior horn of the medial meniscus and may compromise knee stability. Magnetic resonance imaging (MRI) can identify ramp lesions but has limited sensitivity; therefore, arthroscopy remains the diagnostic gold standard. Treatment options include conservative management for stable tears and surgical repair for unstable or type IV–V lesions. Recent studies show no significant difference in long-term knee stability between repaired and unrepaired lesions; however, repaired lesions demonstrate faster functional recovery. Repair is particularly advised for patients in their productive years, especially athletes or individuals with high physical-activity demands requiring optimal knee stability. Appropriate radiologic evaluation combined with structured postoperative rehabilitation improves clinical outcomes and reduces recurrence. This review summarizes current evidence on the epidemiology, diagnosis, classification, and management strategies for ramp lesions commonly found in association with ACL-related meniscal injuries.

Determining the Amount of Blood Loss in Cases of Obstetric Hemorrhage

2024-11-04T11:51:23+07:00

Postpartum hemorrhage is a leading cause of maternal death worldwide and remains a serious health concern, particularly in developing countries such as Indonesia. Accurate estimation of blood loss is essential for early detection of emergencies and for implementing rapid and appropriate interventions for patients. This review discusses several methods used to determine the amount
of blood loss in obstetric cases, including visual estimation, quantitative measurement, and laboratory evaluation. The visual method is easily applied in primary health facilities but frequently underestimates blood loss due to lighting, fluid mixtures, and the experience of health providers. Quantitative methods, such as weighing blood-soaked materials or collecting blood in calibrated containers, are considered more objective and accurate. Laboratory assessment through hemoglobin concentration, hematocrit levels, and spectrophotometric analysis provides confirmation of clinical estimates. Combining quantitative and laboratory approaches can improve diagnostic accuracy, expedite clinical management, and ultimately reduce maternal morbidity and mortality associated with obstetric hemorrhage.

Potential of Licorice Root Extract (Glycyrrhiza glabra L.) for the Treatment of Hyperpigmentation

2025-07-05T12:44:35+07:00

Hyperpigmentation is a dermatological condition characterized by increased melanin production which is the pigment responsible for skin color. Melanin is synthesized by melanocytes through an enzymatic pathway regulated by the enzyme tyrosinase. This process can be triggered by various factors such as ultraviolet (UV) radiation, hormonal changes, skin inflammation, aging, and the use of certain medications. One therapeutic approach is the use of natural ingredients, including herbal plant extracts. Glycyrrhiza glabra L., commonly known as licorice root, has long been used in both traditional and modern medicine due to its active compounds such as glabridin, which possesses antioxidant and tyrosinase-inhibiting properties. This review aims to evaluate the potential of licorice root extract as a natural depigmenting agent in the treatment of hyperpigmentation. A literature review was conducted
using databases PubMed, Google Scholar, NCBI, and ResearchGate. The findings indicate that glabridin selectively inhibits tyrosinase activity without causing skin irritation and also exhibits anti-inflammatory and photoprotective effects. Licorice root extract shows
promise as a safe and effective natural therapeutic option for managing hyperpigmentation.

Length of Stay Less than Four Hours in the Emergency Room as an Indicator of Service Quality and Its Application in Indonesia

2025-04-26T01:16:22+07:00

The emergency department (ED) operates 24 hours in a day, 7 days, in a a week, to provide emergency medical care, but with the growing number of visits, delays in patient assessment and treatment can impact care quality. A common performance indicator used to measure ED efficiency is the length of stay (LOS) of less than four hours, reflecting both service quality and patient flow management. This target has been widely implemented in a few countries, such as the United Kingdom and Australia to enhance ED operations. In Indonesia, a similar target has been set for national referral hospitals, aiming for 90% compliance. However, initial evaluations show that only a small fraction of hospitals meet this target, raising concerns about its feasibility. Despite these challenges, the four-hour LOS remains a relevant quality indicator in EDs. Achieving this goal requires collaborative efforts from all
healthcare stakeholders to improve ED efficiency and patient care. This literature review explores the feasibility and challenges of this target in all parts of Indonesia.

Management of Neurogenic Bladder due to Spinal Cord Injury

2024-08-20T13:42:09+07:00

Neurogenic bladder is one of the most common complications of spinal cord injury (SCI), leading to impaired voiding function, recurrent urinary tract infections, and reduced quality of life. Determining the location, extent, and severity of the lesion is essential
to tailor management strategies to each patient’s neurological condition and functional status. Treatment includes non-surgical approaches such as intermittent catheterization, neuromodulation, and pharmacological therapy using anticholinergic drugs or 3-adrenergic agonists, which have been shown to reduce detrusor pressure. In cases unresponsive to conservative therapy,
surgical interventions such as bladder augmentation or sacral nerve stimulation may be performed to preserve renal function, prevent vesicoureteral reflux, and achieve urinary continence. The prognosis is generally favorable when patients undergo longterm rehabilitation combined with comprehensive education and regular renal function monitoring. Multidisciplinary collaboration among urologists, rehabilitation specialists, and nurses plays a vital role in improving patient quality of life, reducing complications, and ensuring sustainable, effective management.