Cermin Dunia Kedokteran

The Relationship between Dietary Patterns and the Quality of Sunscreen Use (SPF ≥ 30) and the Incidence of Acne Vulgaris among Generation Z University Students

2026-01-19T09:26:08+07:00

Introduction: Acne vulgaris (AV) is an inflammatory disorder of the pilosebaceous follicles that commonly affects adolescents and young adults. AV is influenced by multiple factors, including diet and the use of cosmetic products such as sunscreen. This study aimed to analyze the association of dietary patterns and the quality of SPF ≥ 30 sunscreen use with AV among Generation Z university students. Methods: This analytical observational study used a cross-sectional design and included 108 eligible respondents. Data were collected using questionnaires on dietary patterns and quality of sunscreen use, as well as a clinical examination for AV. Bivariate analysis was performed using Fisher’s exact test. Results: Dietary patterns among Generation Z were not significantly associated with the presence of acne vulgaris (p = 0.609). The quality of SPF ≥ 30 sunscreen use was also not significantly associated with the incidence of acne vulgaris (p = 0.441). Conclusion: Neither dietary patterns nor the quality of SPF ≥ 30 sunscreen use showed a statistically significant association with the incidence of acne vulgaris in the study sample. Further studies with larger populations and multivariable analyses are needed to evaluate other potential confounding factors.

Prevalence and Risk Factors Associated with Computer Vision Syndrome Symptoms Among Schoolchildren During the COVID-19 Pandemic

2026-05-19T15:40:41+07:00

Introduction: The COVID-19 pandemic has led to major changes in the education system through the implementation of the school-from-home policy since March 16, 2020. This condition led to a significant increase in the intensity of gadget use among students, potentially triggering eye health problems such as computer vision syndrome (CVS). This study aimed to determine the prevalence of CVS and the factors influencing its occurrence among students at a private senior high school in Central Jakarta during the online learning period. Methods: A cross-sectional study using random sampling was conducted, and data were collected via online questionnaires completed by students. Results: Out of a total of 166 respondents, 74.7% of students experienced CVS symptoms. The most commonly reported complaints included itchy eyes (78.9%), watery eyes (69.3%), and headaches (63.9%). Most of these complaints were associated with prolonged gadget use, namely, more than 6 hours per day. Conclusion: The duration of digital device use during online learning and refractive error were important factors contributing to the prevalence of CVS among students. Promotive and preventive efforts are needed to reduce the risk of CVS through education on healthy gadget use during distance learning.

Profile of Rabies Vaccination Administration for Patients Bitten by Dogs at the Natarandang Community Health Centre, Wolomeze Sub-district, East Nusa Tenggara, Indonesia

2025-07-18T14:32:57+07:00

Introduction: Rabies is a viral disease that is almost always fatal once clinical symptoms appear, with dogs being the primary source of transmission. This study aims to describe the rabies vaccination profile of dog bite patients at Natarandang Health Center, Wolomeze District. Methods: A retrospective descriptive study on 32 patients who received rabies vaccination after dog bites between January 2022 and February 2023. Data were collected from medical records and analyzed descriptively. Results: Most patients were male (65.6%), with the most common bite locations in the calf (34.4%) and hand (28.1%). The most frequent first aid measures included checking the dog's infection history and seeking medical attention (34.4% each). The most commonly administered rabies vaccine was PCECV (81.3%). Delayed medical care was associated with fever (65.6%) as the predominant symptom. Conclusion: Most dog bite patients at Natarandang Health Center were male, with the most common bite locations in the calf and hand. The most frequently reported first aid were checking the dog’s history and seeking medical attention. The predominant rabies vaccine administered was PCECV. Fever was the most common symptom.

Efficacy and Safety of Dupilumab in Adolescents with Uncontrolled Atopic Dermatitis: Systematic Review

2026-05-20T18:04:44+07:00

Introduction: Up to 24.6% of young adults worldwide suffer from atopic dermatitis. Dupilumab was originally intended for adults with uncontrolled moderate to severe atopic dermatitis. As of March 2019, it has been approved by the US Food and Drug Administration (FDA) for use in adolescents aged 12 to 17. This article aims to evaluate the efficacy and safety of dupilumab in adolescents with uncontrolled moderate to severe atopic dermatitis compared to standard therapy. Methods: A literature search was conducted in June 2020 across Cochrane, EBSCO, and PubMed using specific medical subject heading (MeSH) terms. Inclusion and exclusion criteria were applied. Only relevant articles were selected and appraised using the Center for Evidence-based Medicine (CEBM) tools. Results: Two articles were selected: 1 RCT and 1 cohort study, with 251 and 40 subjects, respectively. Both studies showed statistically significant reductions across all parameters evaluated with Investigator Global Assessment (IGA), Eczema Area and Severity Index (EASI), and Pruritus Numerical Rating Scales. The effectiveness of dupilumab is positively correlated with dosage, frequency, and treatment duration. In both studies, the 4 mg per kg body weight group compared to the 2 mg per kg body weight group, and the every 2 weeks’ protocol compared to the every 4 weeks’ protocol showed better effectiveness. The most common side effects include conjunctivitis, skin infections, and local reactions due to injections. Conclusion: Dupilumab is effective for treating uncontrolled atopic dermatitis in adolescents. The IGA, EASI, and pruritus NRS parameters showed significant reductions. Side effects associated with dupilumab are minimal and well-tolerated.

Onychomycosis Caused by Kodamaea ohmeri in a Patient with Human Immunodeficiency Virus (HIV) – A Case Report

2026-05-22T12:36:12+07:00

Introduction: Onychomycosis is a fungal nail infection usually caused by dermatophytes. Kodamaea ohmeri is a rare fungus that has been reported as a pathogen capable of causing onychomycosis and systemic infections. This yeast-like fungus is often misidentified as Candida sp. A complete identification is required for accurate results. Case: A 40-year-old male with HIV presented with yellow and brittle fingernails for 2 months. KOH examination of nail scrapings was performed, followed by fungal culture. The isolate was identified in parallel using the Integral System Yeast Plus, Vitek-2, MALDI-TOF (Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry), and sequencing, and the result was Kodamaea ohmeri. The patient received oral itraconazole and topical ketoconazole. Discussion: Onychomycosis in HIV patients is caused by low immunity, high viral load, and low CD4 values. In this case, K. ohmeri was successfully identified using Vitek-2, MALDI-TOF, and ITS (Internal Transcribed Spacer) area sequencing, while the Integral System Yeast Plus misidentified the isolate as Candida tropicalis. There was clinical improvement in the nail after treatment. Conclusion: Onychomycosis in HIV patients can be caused by Kodamaea ohmeri. Identification can be done with Vitek-2 and MALDI-TOF.

Wide Excision and Flap Reconstruction for Basal Cell Carcinoma in the Right Frontal Region: A Case Report

2024-11-21T09:10:43+07:00

Introduction: Basal cell carcinoma is a type of non-melanoma skin cancer characterized by basaloid cells that form lobules, columns, bands, or strands. The primary goal of basal cell carcinoma treatment is to completely remove the tumor while preserving function and physical appearance as much as possible. Case: A 70-year-old man with basal cell carcinoma of the right frontal region-superior eyelid OD. Diagnosis was made based on physical examination and histopathological findings. The procedure included wide excision and frozen-section analysis of the surgical margins in the superior eyelid region and the medial canthus, with positive margins; reconstruction was performed with a rotational flap and a skin graft. Anatomical pathology results showed well-differentiated infiltrating basal cell carcinoma. The most effective therapy is surgery. Discussion: In this case, a diagnosis of mixed nodular and pigmented BCC was established based on clinical and histopathological findings, followed by surgical excision and reconstruction using an advancement flap appropriate for the defect in the frontal region. This approach yields a high cure rate; however, long-term follow-up remains necessary given the risk of recurrence and the emergence of new BCC lesions. Conclusion: Basal cell carcinoma generally grows slowly, often developing locally without spreading or metastasizing. Appropriate management can improve quality of life and life expectancy.

Hyperemesis Gravidarum-induced Encephalopathy, Kidney Injury, and Fetal Death – A Case Report

2026-05-18T10:22:01+07:00

Introduction: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy that can become life-threatening for the mother and fetus if not treated properly. Although most cases resolve with conservative management, rare instances progress to severe multisystem complications, including encephalopathy, acute kidney injury, and fetal demise. Case: A 22-year-old G1P0A0 woman at 13 weeks of gestation presented with decreased consciousness following four weeks of intractable vomiting since 8 weeks of pregnancy. The patient has been vomiting more than five times a day, and consciousness began to decrease over the last two days, with complaints of blurry vision and tremors. Physical examination revealed hypotension (blood pressure 80/45mmHg), tachycardia, and cold extremities. Laboratory findings demonstrated acute kidney injury (serum creatinine 8.1 mg/dL), severe electrolyte disturbances (sodium 115.7 mmol/L, potassium 2.07 mmol/L, chloride 77.8 mmol/L), and hepatocellular injury. Transabdominal ultrasound confirmed fetal demise at 13 weeks of gestation. Discussion: HG can precipitate life-threatening complications, including Wernicke's encephalopathy, acute kidney injury, and fetal loss through mechanisms of severe dehydration, malnutrition, and electrolyte imbalance. Early recognition with aggressive fluid resuscitation, electrolyte correction, and nutritional support is essential to prevent irreversible multisystem deterioration and improve maternal-fetal outcomes. Conclusion: Multisystem complications in HG are extremely dangerous for both mother and fetus. Appropriate preventive measures and early intervention must be taken to prevent worsening outcomes and reduce the risk of maternal and fetal mortality.

The TriAge+ Score as an Initial Clinical Diagnostic Tool for Central Vertigo in Cerebellar Stroke – A Case Report

2026-06-03T09:22:22+07:00

Introduction: Vertigo is a common complaint in the emergency department (ED); however, differentiating central from peripheral vertigo remains challenging. More than 4.4 million patients present to the emergency department annually with dizziness or vertigo, and approximately 5% are diagnosed with stroke. Early identification of central vertigo is crucial to prevent adverse neurological outcomes. Case: A 63-year-old male presented with severe swaying dizziness accompanied by nausea, rendering him unable to walk. The TriAge+ score was 9, indicating high risk for stroke. On the fourth day of hospitalization, the patient developed weakness in the right extremities and impaired sensory function in the bilateral cranial nerve V distribution. Non-contrast head CT revealed a subacute ischemic cerebral infarction affecting the pons, right corona radiata, and bilateral basal ganglia, with signs of brain atrophy. The patient was diagnosed with central vertigo due to cerebellar infarct stroke. Discussion: The TriAge+ score demonstrates high sensitivity for detecting central vertigo in the ED. In resource-limited settings where neuroimaging is not immediately available, this bedside clinical tool can facilitate early risk stratification and timely referral for definitive diagnostic workup and stroke-specific care. Conclusion: The TriAge+ score, as an early clinical diagnostic tool in the ED, is essential for detecting central vertigo in order to reduce morbidity and mortality associated with cerebellar stroke.

Odynophagia is Suspected to Be Due to Esophageal Stricture Caused by Low Volume Glyphosate-Surfactant Consumption

2025-03-14T23:28:46+07:00

Introduction: Glyphosate-surfactant is a non-selective, broad-spectrum systemic herbicide widely used in agriculture, forestry, and industry. It is frequently ingested in suicide attempt and depending on the ingested dose, may cause local caustic injury, systemic toxicity, or even death. Case: A 32-year-old man presented to the emergency department (ED) with throat pain and difficulty swallowing food for 2 days after ingesting approximately 5 mL of glyphosate-surfactant. Examination found hyperemic pharyngeal arch and oropharynx edema (Mallampati III). Laboratory results revealed leukocytosis, renal function, and electrolyte abnormalities. After gastric lavage, antibiotics, NSAIDs, and a liquid diet, the patient improved and was able to eat independently. Discussion: Even in small volumes (5 mL), glyphosate-surfactant, a caustic substance, can cause irritation and inflammation of the esophageal tract and progress to esophageal stricture. Conclusion: Small amounts of glyphosate-surfactant compound ingestion caused esophageal strictures, affecting the patient's ability to eat and causing discomfort, despite no kidney or respiratory damage.

A Policy Review for National Cervical Cancer Elimination Plan as the Primary Prevention of Cervical Cancer in Indonesia: Perspective of HPV Vaccination Recommendations from the Centers for Disease Control and Prevention Recommendation

2024-10-25T23:42:57+07:00

Introduction: Cervical cancer is the second most prevalent cancer among women in Indonesia and ranks third globally. It accounts for 7.5% of cancer-related deaths worldwide, with a notable impact in developing nations like Indonesia. The primary cause is high-risk Human Papillomavirus (HPV); however, the risk can be lowered through vaccination. This review aims to evaluate Indonesia's policy for implementing a national HPV vaccination program targeting school-aged children and assess its conformity with CDC guidelines. Methods: The study involved an extensive review of literature, as well as international and Indonesian policy documents. Results: The CDC recommends HPV vaccination for individuals aged 9-26, ideally beginning at 11 or 12 years old. In line with this, Indonesia has included the HPV vaccine in its national immunization schedule. The Indonesian Ministry of Health intends to require HPV vaccination for school-aged children, aiming for full national implementation by 2023. This reflects Indonesia's strong commitment to a comprehensive cervical cancer prevention strategy. The policy's alignment with CDC recommendations emphasizes the country's dedication to primary prevention through HPV vaccination. Conclusion: By enforcing HPV vaccination for school-aged children, Indonesia aims to substantially decrease the incidence and mortality rates associated with cervical cancer. This policy represents a significant advance in the fight against cervical cancer in Indonesia and could serve as a model for other countries contending with similar public health issues.

Management of Age-Related Macular Degeneration (AMD) with AREDS2 Supplementation

2025-08-22T11:32:17+07:00

Age-related macular degeneration (AMD) is a degenerative disease of the macula that is the leading cause of blindness in the over-50 population. AMD is divided into non-exudative (dry) and exudative (wet) types, with the dry type accounting for 90% of cases. The main clinical features of dry AMD include drusen, hyperpigmentation or hypopigmentation of the retinal pigment epithelium (RPE), and geographic atrophy in advanced stages. Management of dry AMD focuses on preventing disease progression, one of which is through antioxidant supplementation based on the Age-Related Eye Disease Study (AREDS) and AREDS2 studies. AREDS2 supplementation, which contains vitamin C, E, zinc, copper, lutein and zeaxanthin, was shown to slow the progression of dry AMD by 55% over three years in cases of geographic atrophy beyond the fovea. In addition to nutritional supplementation, appropriate management includes early diagnosis, regular ophthalmic follow-up, and modification of risk factors such as smoking cessation and maintaining a healthy lifestyle to reduce the risk of disease progression. Early recognition and timely intervention are essential to preserve visual function and improve patients’ quality of life. This review aims to outline the pathophysiology, risk factors and management of AMD with an emphasis on the role of AREDS2 supplementation in preventing disease progression.

Prostate-Specific Antigen (PSA) Screening for Early Detection of Prostate Cancer: An Evidence-Based Analysis

2025-06-04T15:37:01+07:00

Introduction: Prostate-specific antigen (PSA) screening has transformed the early detection of prostate cancer, yet its widespread implementation remains controversial due to concerns over overdiagnosis, overtreatment, and questionable mortality benefit. This article evaluates the contemporary evidence regarding the benefits and harms of PSA-based screening, synthesizing findings from major clinical trials, cost-effectiveness analyses, and international guidelines. Methods: An evidence-based analysis using data from pivotal trials such as ERSPC, along with recent meta-analyses, biomarker advancements, MRI-based protocols, and national screening guidelines from the USPSTF, EAU, NCCN, and others. Results: PSA screening may reduce prostate cancer-specific mortality, particularly in men aged 55–69 years. It facilitates early detection, enhances access to curative therapies, and promotes broader health engagement. However, it carries significant risks, including overdiagnosis of indolent tumors, overtreatment-related morbidity, false positives, psychological distress, and economic burden. Mortality outcomes across studies remain inconsistent, prompting a shift toward personalized, risk-adapted screening guided by age, comorbidities, family history, biomarkers (e.g., PHI, 4Kscore), and multiparametric MRI. Conclusion: PSA screening should not be universally applied but rather employed through shared decision-making and individualized risk assessment. Continued research is warranted to optimize outcomes and inform equitable screening policies, particularly in resource-limited settings.