Cermin Dunia Kedokteran

Students’ Perceptions of Cardiopulmonary Resuscitation Training Simulations Using Virtual Reality at the Faculty of Medicine, Wahid Hasyim University, Semarang, Indonesia

2025-09-09T19:49:58+07:00

Background: Cardiac arrest is a medical emergency requiring immediate action to prevent sudden death. Virtual Reality (VR) technology has been introduced to enhance the effectiveness of cardiopulmonary resuscitation (CPR) training. This study aims to evaluate students’ perceptions of using VR in CPR training simulations at the Faculty of Medicine, Wahid Hasyim University, Semarang. Methods: This study used a cross-sectional design with a descriptive quantitative approach. A total of 30 first-semester students were selected using a purposive sampling technique. Data were collected using a Likert-scale questionnaire based on the Technology Acceptance Model (TAM) that included Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Attitude Toward Using (ATU), and Behavioral Intention to Use (BIU), as well as variables of simulation effectiveness and VR technical difficulty. Data were analyzed descriptively. Results: The average PU score of 4.15 and PEOU score of 4.20 reflect positive perceptions of the added value and ease of use of VR. ATU scored 4.39, and BIU scored 4.08, indicating positive attitudes and strong intentions to continue using VR in CPR training. However, some students reported technical challenges, with an average score of 2.67. Conclusion: Students demonstrated positive perceptions of using VR in CPR training simulations, with high scores across all TAM aspects.

The Effect of Seminars on the Level of Knowledge of Diagnostic Tests for Infectious and Autoimmune Diseases Among Medical Students and Medical Laboratory Technology Students

2025-07-18T14:39:07+07:00

Introduction: Supporting examinations can aid in diagnosing infectious and autoimmune diseases. Conducting a health education seminar is essential to address the complexities of developing supporting examinations, particularly for future health professionals such as medical and medical laboratory students. This research aimed to analyze differences in knowledge levels regarding supportive examinations for infectious and autoimmune diseases before and after seminars for both programs' students. Methods: The research design was a quasi-experimental one-group pretest-posttest design with a total sample of 86 students from the University of Tanjungpura, Poltekkes Kemenkes Pontianak, and Poltekkes Aisyiyah Pontianak. Results: The Wilcoxon test revealed a statistically significant effect of the seminar (p < 0.005), as demonstrated by increased scores from pretest to posttest across all assessment items. Conclusion: There was an increase in the level of knowledge of supporting examinations before and after the seminar activities.

Parental Awareness of Smartphone-Based Applications for Visually Impaired and Blind Children in Yogyakarta, Indonesia

2025-06-16T18:39:58+07:00

Introduction: Smartphone-based applications (SBA) are currently available to help children with visual impairment (VI) and blindness progress to the next level of learning. This study aims to explore parental awareness of SBA to support the learning process of their visually impaired children. Methods: A cross-sectional study involving 27 children with VI and blindness. Parents were sent a questionnaire to be completed. The 20-item questionnaire measured the history of their children’s general and eye health, and SBA awareness and use, if any. Children were examined for general health and current eye conditions. Results: Blindness was 92.9%. The most common cause of blindness was retinopathy of prematurity. The majority went to a special school for the blind. Parents’ education level was mostly high school graduates. Only 22.2% parents were aware of the existence of SBA for children with VI and blindness. Conclusion: Parental awareness regarding smartphone-based applications (SBA) for children with VI and blindness was low.

Effectiveness of Lutein and Zeaxanthin Supplementation on the Progression of Geographic Atrophy and Visual Acuity in Age-Related Macular Degeneration: A Systematic Review Based on Clinical Trials

2026-03-31T07:35:41+07:00

Introduction: Geographic atrophy (GA) is an advanced form of dry age-related macular degeneration (AMD) that can cause severe central vision loss if its progression extends to the foveal area. Currently, therapeutic options for GA remain limited, with safety profiles requiring further evaluation. Lutein and zeaxanthin, as the main components of the Age-Related Eye Disease Study (AREDS2) formula, have become the focus of current research. Both are antioxidants concentrated in the macula, which exert protective effects on retinal structures and reduce oxidative stress. This systematic review aims to evaluate the effectiveness of oral lutein and zeaxanthin supplementation on GA progression and visual acuity in AMD patients. Methods: Literature searches were conducted across four biomedical databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A total of four studies met the inclusion criteria and were analyzed qualitatively. Results: The analysis showed that oral supplementation of lutein (10 mg/day) and zeaxanthin (2 mg/day) may reduce the progression of non-central GA and stabilize or improve visual acuity in patients with AMD. Lutein at doses of 10 mg and 20 mg demonstrated similar effectiveness in improving visual acuity through an increase in macular pigment optical density (MPOD). Conclusion: Based on the findings of this systematic review, oral supplementation with lutein (10 mg/day) and zeaxanthin (2 mg/day), as incorporated in the AREDS2 formulation, appears to slow the progression of non-central GA and preserve foveal integrity (foveal sparing). Further long-term studies are required to confirm the clinical benefits and long-term safety.

Cotrimoxazole Therapy for Toxoplasma Encephalitis in Patients with AIDS: A Case Report

2026-04-20T14:22:39+07:00

Introduction: Toxoplasma encephalitis (TE) is the most common opportunistic infection affecting the central nervous system in patients with HIV/ AIDS and is associated with high morbidity and mortality. In individuals with HIV, TE tends to be more severe and life-threatening. The first-line therapy for TE is a combination of pyrimethamine and sulfadiazine; however, the limited availability of these drugs in some healthcare settings makes cotrimoxazole a potential alternative to pyrimethamine. Case: A 50-year-old Balinese male, married, was brought to the emergency department with confusion lasting for two days prior to admission. Two weeks earlier, he had experienced headache, weakness, odynophagia, and weight loss of 8 kg within one month. The patient had a history of multiple sexual partners, frequent consumption of raw lawar, and occupational exposure as a pig farm worker. Physical examination revealed white plaques on the tongue and pharynx. Laboratory investigations showed a reactive HIV rapid test with a CD4 count of 11 cells/μL, positive anti-Toxoplasma gondii IgG antibodies, and contrast-enhanced cranial CT scan demonstrating multifocal ring-enhancing lesions in the right and left parietal regions with associated cerebral edema. The patient was diagnosed with stage IV HIV/AIDS, oropharyngeal candidiasis, and toxoplasma encephalitis, and was treated with cotrimoxazole 960 mg every 8 hours. Clinical improvement was observed after 11 days of treatment, and follow-up contrast-enhanced CT scan on day 18 showed radiological improvement with reduced perifocal edema and decreased number of lesions. Discussion: The diagnosis of toxoplasma encephalitis in patients with HIV/AIDS is established based on a combination of clinical manifestations, serological findings, and characteristic radiological features. In situations where pyrimethamine and sulfadiazine are unavailable, cotrimoxazole may serve as an effective alternative therapy. The favorable clinical and radiological responses observed in this case support the use of cotrimoxazole as an alternative treatment option for toxoplasma encephalitis. Conclusion: Cotrimoxazole may serve as an effective alternative therapy for toxoplasma encephalitis in patients with reactive HIV infection, particularly in settings where first-line therapy is unavailable, with favorable clinical and radiological outcomes.

Intensive Care Unit Management of Status Epilepticus with Central Nervous System Infection: A Case Report

2024-08-22T21:50:45+07:00

Introduction: Status epilepticus (SE) is a critical neurological emergency characterized by prolonged seizure activity that poses significant neurological risks and death, requiring immediate and effective management to prevent morbidity and mortality. SE can result from a variety of causes, including primary neurological disorders, metabolic disturbances, and iatrogenic factors. In the ICU, drug toxicity and electrolyte imbalances are common triggers, accounting for over 30%−35% of seizures. Understanding the underlying causes, such as central nervous system infections or autoimmune encephalitis, is crucial for targeted treatment and improving patient outcomes. Case: A 21-yearold male with SE complicated by a central nervous system (CNS) infection was managed in the intensive care unit (ICU). Seizure control was achieved using continuous infusions of midazolam and phenytoin. The treatment strategy also included supportive care, including mechanical ventilation and hemodynamic stabilization with norepinephrine. The patient's condition improved significantly. Discussion: This case demonstrates that favorable clinical outcomes in SE complicated by a CNS infection rely heavily on continuous sedation, the selection of antibiotics with adequate CNS penetration (such as linezolid), and meticulous hemodynamic monitoring in the intensive care setting. Conclusion: This case highlights the importance of early diagnosis, targeted treatment, and interdisciplinary collaboration.

Endometrial Carcinoma in a Patient with Type 2 Diabetes Mellitus: A Case Report

2023-08-09T19:37:18+07:00

Introduction: Endometrial cancer is often associated with obesity, type 2 diabetes mellitus (T2DM), insulin resistance, and hyperinsulinemia. Case: A 71-year-old woman with a history of T2DM, hypertension, and obesity (body mass index/BMI 32.08 kg/m²) presented with intermittent abdominal pain and vaginal bleeding. She had undergone a curettage procedure two weeks earlier. Ultrasound examination revealed a hyperechoic mass in the uterine corpus, and histopathological examination following staging laparotomy confirmed type 2 endometrial carcinoma (high-grade serous carcinoma) with omental metastasis. The diagnosis was stage IVB endometrial carcinoma. During hospitalization, the patient received intravenous ceftriaxone, insulin glargine, and oral antihypertensive medications (ramipril and nifedipine). She was scheduled to receive systemic chemotherapy with carboplatin and paclitaxel, the standard regimen for advanced-stage, aggressive non-endometrioid endometrial cancer. Discussion: Diabetes mellitus, particularly when accompanied by chronic hyperglycemia, insulin resistance, and hyperinsulinemia, is associated with an increased risk of various cancers, including endometrial cancer, as well as a poorer prognosis. Factors such as obesity, age, estrogen exposure, and insulin therapy may exacerbate this risk, while biomarkers such as IGF-2 and IGFBP-3 have the potential to be used for early detection and risk assessment of endometrial cancer. Conclusion: This case highlights the strong link between T2DM, obesity, and aggressive endometrial cancer, emphasizing the importance of early detection and comprehensive management in patients with metabolic risk factors.

Incidental I-131 Uptake in Ovarian Carcinoma in a Patient with Differentiated Thyroid Carcinoma: A Case Report

2025-04-26T18:51:16+07:00

Introduction: Radioactive iodine (I-131) therapy is an essential component in the management of differentiated thyroid carcinoma (DTC) following total thyroidectomy. Post-therapy whole-body scintigraphy (PT-WBS) with I-131 aims to detect residual thyroid tissue, recurrence, or metastatic spread. Radioiodine uptake outside the thyroid region may suggest metastases or false-positive findings, thus requiring careful interpretation. Case: A 47-year-old woman with differentiated thyroid carcinoma (DTC) underwent I-131 therapy. The PT-WBS and single photon emission computed tomography/computed tomography (SPECT/CT) revealed no I-131 uptake in the thyroid bed, but instead showed unexpected I-131 uptake in bilateral ovarian masses. Subsequent histopathological and immunohistochemical evaluation after total hysterectomy with bilateral salpingo-oophorectomy confirmed that the masses were ovarian carcinoma. Discussion: Radioiodine uptake in ovarian carcinoma is extremely rare and may be attributed to the expression of the sodium-iodide symporter (NIS) in the ovarian surface epithelium (OSE). Other contributing factors may include increased tumor vascularity, local inflammation, and enhanced capillary permeability that facilitate iodine retention. Conclusion: This case highlights the importance of considering non-thyroidal malignancies in the interpretation of PT-WBS findings, particularly when atypical uptake is observed.

Lateral Inguinal Hernia in a 13-Year-Old Child: A Case Report

2025-05-29T11:00:29+07:00

Background: Indirect inguinal hernia, particularly in children, is typically due to the failure of the processus vaginalis closure and is located lateral to the inferior epigastric vessels. Hernias are generally found in children aged 0-5 years, in premature infants, and in elderly individuals aged 75-80 years. In this case, however, the patient is 13 years old, an age that is considered uncommon for the manifestation of a congenital hernia. Case: A 13-year-old boy presented with a one-month history of an intermittent left scrotal bulge. Physical examination in the standing position revealed an elongated lump extending from the left inguinal region down to the left scrotum, which became more prominent during the Valsalva maneuver. The lump was spontaneously reduced when the patient was lying down. The lump had a soft consistency, welldefined margins, a smooth surface, and was reducible on pressure. Two similar-sized testes were palpable in the scrotum. The diagnosis was left indirect inguinal hernia; the patient underwent herniotomy without complications. Postoperative recovery was uneventful with no residual complaints. Discussion: Indirect inguinal hernias in children are generally caused by the persistence of the processus vaginalis and are characterized by a lump that appears when intra-abdominal pressure increases. Diagnosis is clinical, and the definitive treatment is surgery (herniotomy) due to the higher risk of incarceration. Conclusion: This case highlights the importance of early detection and appropriate management in the pediatric population to prevent complications such as incarceration or strangulation.

The Relationship between Obesity, Dietary Habits, and Pain During Bowel Movements in Children with Functional Constipation: A Literature Review

2026-04-20T14:17:28+07:00

Background: Functional constipation is defined as delayed or difficult bowel movements lasting ≥2 weeks that cause the patient distress. This study aims to examine the relationship between obesity, dietary patterns, and defecation pain with the incidence of functional constipation in children. Methods: A literature review was conducted using predefined keywords from data sources Google Scholar, PubMed, and ScienceDirect. Inclusion criteria included open-access articles published between 2014 and 2024. A total of 9 articles that met the criteria were further analyzed. Results: Functional constipation is associated with several risk factors, including obesity, unhealthy dietary patterns, and defecation pain. Some studies showed a positive correlation between obesity and functional constipation, although the results varied and were not always statistically significant. Low-fiber, high-fat diets have been reported to impair intestinal motility. Pain during defecation may reinforce the behavior of stool withholding, which ultimately worsens constipation symptoms. Conclusion: This review highlights the importance of factors such as obesity, dietary habits, and defecation pain in preventing and managing functional constipation in children.

Rosacea: Symptoms, Diagnosis, and Management

2024-10-18T21:16:22+07:00

Rosacea is a chronic inflammatory skin condition primarily affecting the central face, characterized by redness, visible blood vessels, and acne-like lesions. The exact cause of rosacea is not fully understood, but it is believed to involve genetic, immune, and environmental factors. The diagnostic criteria for rosacea on the face, particularly the cheeks, nose, and perioral area, include the primary symptom of persistent central facial erythema, often accompanied by flushing in a characteristic pattern that may periodically worsen. Common triggers include sun exposure, stress, and certain foods. The condition is classified into subtypes based on phenotypic presentation, with central erythema as a key symptom. Management requires a multidisciplinary approach, including lifestyle modifications, topical and systemic therapies, and,at times, laser treatments, to improve patient quality of life. The prognosis for rosacea is influenced by two main factors: the severity of the condition and the presence of comorbidities, both of which can affect the patient’s quality of life. Further research is needed to explore the underlying mechanisms and develop more effective treatments.

Diagnosis and Management of Retinoblastoma

2024-12-06T09:18:03+07:00

Retinoblastoma is a malignant tumor that originates from the inner nuclear layer of the retina. High morbidity and mortality are caused by late diagnosis. There are two genetic types of retinoblastoma. The first type is hereditary, also known as germline, while the second type is non-hereditary, also known as sporadic or somatic. Tumor classification and staging are important to know because they are key factors in determining prognosis and influence long-term visual function following systemic chemotherapy and focal therapy. International collaboration has developed the International Classification of Retinoblastoma (intraocular tumors). Management aims to save lives and prevent tumor spread, followed by eye preservation and optimization of visual function. Treatment options for retinoblastoma are based on the international classification of intraocular retinoblastoma, the presence or absence of extraocular clinical factors, germline test results, the family’s psychosocial situation, and healthcare facility resources. Early detection of tumors, prevention of metastasis, and appropriate management can maintain globe preservation and optimize vision. If detected early and treated appropriately, the survival rate can be nearly 100%.