Cermin Dunia Kedokteran

The Relationship between Extroverted and Introverted Personality Types and Academic Procrastination in Medical Student

2025-11-14T15:40:58+07:00

Background: Academic procrastination refers to the act of postponing the completion of crucial and scheduled tasks. This research seeks the relationship between personality types (introvert and extrovert) and academic procrastination. Methods: A quantitative descriptive approach with a cross-sectional design. The participants include students from the Faculty of Medicine (FK) at Muhammadiyah University (UM) in Palembang, from the 2020 and 2021 cohorts; 127 individuals fulfilled the inclusion and exclusion criteria. The sampling technique was a total sampling. The tools used in this study were the Eysenck personality questionnaire (EPQ) and the active procrastination scale (APS). Results: A sum of 83 respondents (65.4%) displayed an extrovert personality, while 44 respondents (34.6%) showed an introvert personality; 114 respondents (89.8%) demonstrated low levels of academic procrastination behavior, whereas 13 respondents (10.2%) reported high levels of academic procrastination. A bivariate analysis showed that the relationship between personality type and academic procrastination had a p-value of 0.765 (p > 0.05). Conclusion: No significant correlation between personality type and academic procrastination among medical students from the 2020 and 2021 cohorts at FK UM Palembang. Additional research is required to investigate other factors that may lead to academic procrastination in medical students.

The Relationship between Interleukin 6 (IL-6) Levels and Disease Activity (SLEDAI-2K) and Manifestations of Renal and Non-Renal Damage in Patients with Systemic Lupus Erythematosus

2025-11-14T15:39:00+07:00

Introduction: Systemic lupus erythematosus (SLE) is a chronic, heterogeneous, and complex autoimmune disease. Several studies have linked IL-6 levels and SLE. This study sought to investigate the relationship between IL-6 levels and degree of disease activity and manifestations of renal-non-renal damage in SLE. Methods: A retrospective cross-sectional study of 67 SLE patients based on the SLICC 2012/ACR EULAR 2019 criteria for at least 6 months at the Rheumatology Polyclinic of AM General Hospital, Medan from June to August 2023 who met the inclusion and exclusion criteria. Assessment of renal-non-renal damage used the SLICC Damage
Index-SDI score and the degree of disease activity was measured with SLEDAI-2K. Results: The highest median IL-6 level of 87.32 pg/mL was found in the remission group, while the lowest median IL-6 level of 46.05 pg/mL was found in patients with mild disease. No significant relationship between IL-6 levels and the degree of SLE disease activity (p = 0.158). The median interleukin-6 value in the group of subjects with renal damage was 71.95 pg/mL, while in the group of subjects with non-renal damage it was 53.05 pg/mL. No correlation was found between IL-6 levels and disease activity (p = 0.158), but there was a significant correlation between IL-6 levels
and renal damage (p = 0.045). Conclusion: No relationship between IL-6 levels and the degree of disease activity (p = 0.158), but a significant relationship between IL-6 levels and renal damage (p = 0.045).

The Effect of Smoking on Matrix Metalloproteinase-9 (MMP-9) Expression and Its Relationship with Chronic Obstructive Pulmonary Disease

2025-11-21T14:02:31+07:00

Introduction: Cigarette smoke can induce the expression of matrix metalloproteinase-9 (MMP-9) and is associated with COPD. This review aims to assess the impact of cigarette smoke on MMP-9 expression and its association with COPD. Methods: This study is a scoping review using articles analyzing the impact of cigarette smoke on MMP-9 levels in COPD patients from the PubMed and Google Scholar databases. A total of 11 articles that met the inclusion criteria were used in this review, of which 6 studies used serum or plasma, 1 study used bronchoalveolar lavage (BAL), and 4 studies used sputum samples to measure MMP-9 levels. Results: Overall, MMP-9 levels were found to be significantly greater in COPD patients who smoked compared to non-smoking COPD patients and healthy individuals. MMP-9 levels increased with increasing severity of COPD. MMP-9 levels correlated with the smoking index. Conclusion: More cigarette consumption will further increase MMP-9 levels. Smoking increases MMP-9 expression and is associated with COPD.

Bibliometric Analysis of Telemedicine Service Utilisation in Obstetrics and Gynaecology

2025-12-11T16:48:06+07:00

Introduction: Telemedicine in health services has various advantages, such as cost flexibility and time efficiency. This research aims to map research related to the application of telemedicine in obstetrics and gynecology. Methods: This study is a quantitative, descriptiveanalytical research using bibliometric analysis of articles published in the Scopus database from 2014 to 2024. Results: We obtained 36 articles on the application of telemedicine in obstetrics and gynecology, with a fluctuating number each year. The country with the most affiliated researchers was the United States, with 19 publications. Most articles were research articles (80.6%) and published in medical journals (67.3%). Conclusion: Based on the study’s results, 4 countries have conducted collaborative research, and 3 keyword mapping clusters relate to the application of telemedicine in obstetrics and gynecology. Cross-sector and cross-border collaboration is necessary, especially in ethical and legal aspects that enable the implementation of cross-border or cross-continental telemedicine. Further research and literature review are needed to assess further the procedures, benefits, and barriers to implementing telemedicine services in obstetrics and gynecology.

Instant Tempeh Porridge and Commercial Diabetic Preparation for Patients with Type 2 Diabetes Mellitus, Caput Pancreas Cancer, and Hypoalbuminemia: Case Study.

2025-07-27T10:37:28+07:00

Introduction: Patients with diabetes mellitus and caput pancreas cancer generally experience decreased food intake due to gastrointestinal complaints, such as abdominal pain, nausea, vomiting, and feeling full. This condition can be managed by providing small portions of nutrientdense and easily digested food to prevent decline in nutritional status and patient condition. Case: A 58-year-old male with right upper abdominal pain, fever, and white stools was treated for caput pancreas cancer and hypoalbuminemia. History of type 2 diabetes mellitus for 2
years and biliary stent placement. Food intake at home is < 25% of the requirement. The patient is underweight with body mass index (BMI) 16 kg/m2, hypoalbuminemia (2.6 g/dL), and hyperglycemia (random glucose 220 mg/dL). This nutritional intervention aims to gradually optimize
food intake (target > 80% requirement) in 5 days, with easily digestible and low glycemic index food in the form of modification of instant tempeh porridge and commercial diabetic preparation in small portion. Discussion: The nutritional intervention is acceptable to the patient.
Conclusion: Modified instant tempeh porridge and commercial diabetic preparation can increase patient intake with good acceptance and improve gastrointestinal tolerance.

Type II Acute Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease (COPD) Acute Exacerbation Treated with High Flow Nasal Cannula (HFNC): Case Report

2025-01-10T17:20:15+07:00

Introduction: Acute respiratory failure is a condition seen in respiratory system failure to supply gas exchange, oxygenation, and elimination of carbon dioxide (CO2) processes that occurs in minutes or hours. Case: A 57-year-old male came to the emergency room with complaints of shortness of breath since 5 days ago, worsened during light activities. The patient also complained of worsening cough since 5 days ago, accompanied by thick yellowish-white phlegm. History of smoking 12 sticks/day since the age of 20 years and quit 5 years ago. Diagnosis was acute respiratory failure type II and the cause was chronic obstructive pulmonary disease (COPD) acute exacerbation. The management is high flow nasal cannula (HFNC) with FiO2 80%, because HFNC has an additional heating and humidification system that makes it more comfortable. Discussion: Alveolar hypoventilation and increased minute ventilation in COPD patients may carry a type II acute respiratory failure risk. Conclusion: Type II acute respiratory failure commonly occurs in patients with chronic respiratory diseases such as COPD. High flow nasal cannula (HFNC) oxygen therapy may be the best option.

Electrolyte Imbalance–Induced Brugada Phenocopy: A Complex Intersection of Hyperkalemia, Hyponatremia,and Acidosis – Case Report

2025-01-13T09:15:30+07:00

Introduction: Brugada phenocopies (BrP), which are different from real congenital Brugada syndrome (BrS), are clinical entities with different etiology. BrP can manifest in a range of conditions, such as metabolic disturbances like hypokalemia, hyperkalemia, hypophosphatemia, hyponatremia, and acute toxicity. Case: Brugada phenocopy was observed in the ECG of a 68-year-old male, resolved following the correction of hyperkalemia, hyponatremia, and acidosis. The patient presented with septic shock and multiorgan dysfunction, which contributed to severe electrolyte imbalance and metabolic derangements. Despite initial stabilization and improvement in ECG findings after targeted correction, the patient ultimately developed progressive clinical deterioration. Discussion: Recognizing BrP helps identify reversible causes of the ECG changes, allowing for proper treatment and prevention of complications. This case highlights the importance of evaluating underlying metabolic and systemic conditions when encountering Brugada-like ECG patterns. Conclusion: Brugada phenocopy can occur in hyperkalemia and hyponatremia in an acidosis state. Clinicians should consider comprehensive clinical assessment, laboratory evaluation, and ECG monitoring to distinguish BrP from congenital BrS, especially in critically ill patients.

Carbamazepine-Induced Stevens-Johnson Syndrome in an Epilepsy Patient: Case Report

2025-01-15T19:40:08+07:00

Introduction: As a first-line antiepileptic drug for partial and tonic-clonic seizures, carbamazepine requires long-term use. This drug carries a risk of Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) reaction. Case: A 23-year-old woman with a history of seizures had reddish rashes on the face, neck, chest, back, and left and right upper extremities covering 10% of the body surface area (BSA) after taking carbamazepine 200 mg twice a day for her seizures. Discussion: The patient was given methylprednisolone 16 mg tablets twice
a day, IV diphenhydramine twice a day, and other symptomatic drugs. After 9 days, the patient was discharged with phenytoin 100 mg tablets twice a day as a substitute for carbamazepine. Early treatment with high-dose systemic steroids provides benefits of rapid recovery,
especially in SJS patients where skin damage is not too extensive and can be restored by the anti-inflammatory effects of steroids. The main treatment of SJS/TEN is early recognition and immediate discontinuation of the drug. Conclusion: Carbamazepine is often a risk factor for
SJS, thus an alternative treatment is needed.

A 27-Year-Old Woman with Genitourinary Tuberculosis: Diagnosis Problem in Rural Indonesia - Case Report

2025-03-24T10:35:25+07:00

Introduction: Genitourinary tuberculosis (TB) is one of the most common forms of extrapulmonary TB, yet it is often misdiagnosed due to its nonspecific symptoms and very often mimic recurrent urinary tract infections. Case: A 27-year-old woman was referred to the hospital with complaints of frequent and painful urination for the past six months, along with intermittent fever and occasional cough.She had received multiple courses of antibiotics, but her symptoms did not resolve. Laboratory investigations, including urine microscopy, LAM antigen, and Xpert MTB/RIF, revealed Mycobacterium tuberculosis in the urine sample. A chest x-ray and sputum acid fast bacilli (AFB) examination indicated pulmonary tuberculosis. The patient was treated with standard anti-tuberculosis drugs for 6 months, resulting in clinical improvement. Discussion: Diagnosing genitourinary TB is challenging due to its nonspecific presentation and the limited sensitivity of routine urine microscopy. While Xpert MTB/RIF offers higher accuracy, its availability is restricted in many settings. LAM testing shows usefulness in HIV-associated TB, but its role in non-HIV genitourinary TB is still uncertain. Improved, accessible diagnostic strategies are needed for earlier detection. Conclusion: Genitourinary TB remains challenging to diagnose, particularly in rural areas with limited access to advanced diagnostics. A careful medical history, repeat urinalysis, and simple tests such as urine smear microscopy, LAM, and MTB/RIF can aid early detection. Early diagnosis is essential to prevent complications such as end-stage kidney failure.

Testosterone Replacement Therapy in Late-Onset Hypogonadism

2024-10-15T10:57:18+07:00

Testosterone is a sex hormone that plays a critical role in various physiological functions in men, including regulating libido, muscle mass, fat composition, and bone health. Late-onset hypogonadism, which commonly occurs in older men, reflects age-related declines in testosterone levels and can be associated with chronic disease and adiposity. Diagnosis requires a comprehensive evaluation, including clinical symptoms and repeated morning serum testosterone levels. Testosterone replacement therapy (TRT) is a common treatment approach for symptomatic
hypogonadism, with dosage options including oral, intramuscular, transdermal, subdermal, and nasal. However, TRT has contraindications, particularly in men with active prostate cancer, high hematocrit, or certain cardiovascular diseases. Appropriate monitoring of therapy is necessary to evaluate the effectiveness of therapy, optimize dosage, and detect side effects such as polycythemia or elevated PSA. The primary goal of TRT in men with testosterone deficiency is to restore testosterone levels to the physiological range to improve sexual function, muscle strength, and quality of life in men with hypogonadism.

Anabolic Androgenic Steroid Withdrawal Syndrome: A Review for Healthcare Practitioners

2024-10-30T20:14:06+07:00

The non-medical use of anabolic androgenic steroid (AAS) has significantly increased among athletes, bodybuilders, and individuals who focus on physical performance as well as body aesthetics. Although AAS has certain therapeutic benefits, use outside of medical supervision can lead to AAS withdrawal syndrome. This condition is characterized by physical and psychological symptoms, such as fatigue, decreased libido, anxiety, depression, and sleep disturbances. Its primary mechanism is the suppression of the hypothalamic–pituitary–gonadal (HPG) axis, which reduces endogenous testosterone production after discontinuation of AAS. Disruption of this axis not only decreases endogenous testosterone production but also alters gonadotropin hormone dynamics and androgen receptor responsiveness. Several risk factors, such as high doses, prolonged duration of use, specific usage patterns (cycling, stacking, pyramiding), and a history of psychological disorders, may exacerbate withdrawal symptoms. Management of AAS withdrawal syndrome includes short-term hormonal therapy, agents that stimulate endogenous testosterone production, psychological interventions, and physical rehabilitation. A multidisciplinary approach and close medical monitoring are required to restore endocrine function, prevent complications, and improve the patient’s psychological well-being. This paper provides a comprehensive overview to assist healthcare practitioners in recognizing, diagnosing, and appropriately managing AAS withdrawal syndrome.

Regular Physical Activity as Anti-Ageing and Prevention of Sarcopenia in Women

2025-06-04T21:24:08+07:00

Aging is a natural process of declining body functions, including a decrease in muscle mass and strength known as sarcopenia. Sarcopenia has a higher prevalence in menopausal women due to the decline in estrogen levels. This condition affects quality of life, fall risk, and independence. This literature review explores the role of regular physical activity as an anti-aging intervention and prevention of sarcopenia in women. A literature search was conducted in the Google Scholar, PubMed, ScienceDirect, and DOAJ databases for relevant articles (original
research or reviews) published between 2024 and 2025. Data analysis used a narrative synthesis approach on 30 selected articles. Results showed that consistently performed physical activity, especially resistance training (moderate–high intensity), multimodal training, and
training with blood flow restriction, is highly effective in improving muscle mass, strength, and physical function. Combination of physical activity with adequate protein intake (≥ 1.0 g/kgBB/day) showed significant synergistic effects, especially in women with sarcopenic obesity.
Technology-based interventions potentially improve program adherence. It is concluded that regular physical activity, particularly resistance training supported by optimal nutrition, is an effective non-pharmacological strategy to slow the aging process and prevent sarcopenia.