Cermin Dunia Kedokteran

The Anti-hypercholesterolemic Effects of Cnidosculus aconitifolius Leaf Ethanol Extracts on The Formation of Coronary Artery Atherosclerotic Lesions in Atherogenic Diet-Fed Male Wistar Rat (Rattus norvegicus)

Ni Ketut Rake Putri Saraswati — 2025-05-07

Introduction: Foods high in cholesterol increase the production of free radicals and inflammation, and may also trigger the formation of atherosclerotic lesions. Cnidosculus aconitifolius or tree spinach leaves were known to have antioxidant and anti-inflammatory activities. This study was to determine the effect of Cnidosculus aconitifolius on blood cholesterol level and coronary artery atherosclerotic lesions formation using a rat model. Methods: A randomized post-test-only control group of 30 male Wistar rats (Rattus norvegicus), aged 2-3 months, randomly divided into 3 groups: standard control was given regular food; negative control was given an atherogenic diet; and the treatment group was given an atherogenic diet + Cnidosculus aconitifolius leaf ethanol extracts. The treatment lasted 44 days. Data was analyzed with OneWay ANOVA and Kruskal-Wallis test. Results: The total cholesterol and LDL levels were significantly lower in the treatment group compared to the control group (p<0.001). A decrease of atherosclerotic lesion scores in the treatment group compared to the control (p=0.010) was also observed. Conclusion: Cnidosculus aconitifolius leaf ethanol extracts have an anti-hypercholesterolemic effect, hence the potential to prevent the formation of atherosclerotic lesions in the coronary arteries of hypercholesterolemic Wistar rats.

Total Phenolic Concentration and Antioxidant Activity of Methanol Extract of Curry Leaf (Murraya koenigii L.)

Ardhita Felicia Tanuhariono — 2025-05-06

Introduction: Curry leaves (Murraya koenigii L.) are plants that naturally grow in the Indian subcontinent, except at the peak of the Himalayan mountains, which in their development have spread widely to various corners of the world. Traditionally, curry leaves have been used by people as medicine. However, it is now known that this plant contains carbazole alkaloid compounds and polyphenols that have antioxidant activity. This is very useful for controlling free radical levels in the human body so that they remain within reasonable limits. This is very useful for controlling the levels of free radicals in the human body to stay within reasonable limits. Free radicals are produced by normal cell metabolism which has recently been associated with the pathophysiology of various diseases. Methods: This in vitro research was to determine phenolic content and antioxidant potential in methanol extract of curry leaves. Total phenolic content testing used the Folin-Ciocalteu method and expressed by Gallic Acid Equivalent (GAE). Total antioxidant capacity testing used the DPPH method and Trolox as a comparison solution. Results: The total antioxidant capacity is expressed in the form of IC50. The total phenolic content of curry leaf methanol extract was 4007.78 μg/mL or equivalent to 133.59 mg GAE/g DW and the total antioxidant capacity of curry leaf methanol extract was 37.418 μg/mL. Conclusion: The total phenolic content of curry leaf methanol extract is high (>5 mg GAE/g). Correspondingly, the total antioxidant capacity of curry leaf methanol extract is also classified as very strong (<150 µg/mL).

The Relationship of Fast Food Consumption Behavior towards Severity of Acne Vulgaris in Male Students

Mariani Santosa — 2025-05-07

Introduction: Acne vulgaris has the highest prevalent skin disease in the world, with food is one of the most common triggers in adolescents. Availability of fast food has influenced young adults eating pattern. This study aims to determine the relationship between frequency of fast food consumption and severity of acne vulgaris in male students. Methods: This cross-sectional study was conducted on 129 male students. Frequency of fast food consumption and severity of acne vulgaris was measured using a modified FFQ questionnaire and GAGS score. Data were processed with STATA and analyzed using Chi-square. Results: The result showed that 65.89% male students often consumed fast food and the majority of respondents experienced mild acne vulgaris (55.81%). There was a significant relationship between frequency of fast food consumption and severity of acne vulgaris (p=0.020). Conclusion: The results of this study suggest a significant relationship between frequency of fast food consumption and severity of acne vulgaris among male students.

Lupus Nephritis: Recent Classification and Management

Irianto — 2025-05-07

Lupus nephritis (LN) is one of the most common complications in systemic lupus erythematosus. If not detected quickly, LN will often cause reduced kidney function in five years necessitating kidney replacement. Diagnosis and classification of LN are made with a kidney biopsy. The drug of choice is based on the histopathology classification and needs to be tailored case by case. If complete remission is not achieved or if it relapses, the causes need to be investigated. More nephron cells can be saved in earlier therapy to prevent end stage kidney disease complications.

Leukocoria as a Warning Sign of Coats Disease and Other Retinal Disorders

Carennia Paramita — 2025-05-07

Coats’ disease is an idiopathic condition characterized by non-hereditary exudative retinopathy caused by abnormal retinal vascular development. Patients often present with signs such as leukocoria, significant vision loss, and strabismus. Some characteristic features include telangiectasia, aneurysms, and exudative retinal detachment. Ultrasonography and computed tomography scan can detect masses and calcifications, which are useful in ruling out differential diagnosis of retinoblastoma. Coats’ disease has 5 stages, but it is not uncommon for patients to seek treatment in advanced stages or when it has progressed to a malignancy in children, such as retinoblastoma, therefore the patient will be referred for enucleation.

19-year-old man with unilateral gynecomastia

Noviane Angrella — 2025-05-07

Introduction: Gynecomastia is a condition of breast enlargement in men due to breast gland proliferation that is generally bilateral. Unilateral gynecomastia is rarely found in young adults. Case: A 19-year-old male presenting with right breast enlargement noticed within the past month. There was no pain, no breast discharge, and no hard lump when palpated. On physical examination, the right breast was larger than the left breast, without skin changes (peau d’orange, ulceration), nipple retraction, or any discharge. Glandular enlargement with a diameter of +5 cm, painless, tender, immobile, firm borders, no galactorrhea, no palpable lumps. Laboratory examination was within normal limits. The diagnosis was unilateral right gynecomastia. A simple mastectomy was performed on the right breast. Histopathologic findings supported the diagnosis of gynecomastia. Conclusion: Anamnesis and physical examination can establish the diagnosis of gynecomastia. Further laboratory and imaging evaluations are required to substantiate clinical suspicion or in unclear cases and to search for underlying causes.

Limb Salvage with Darrach Procedure and Single Bone Technique on Giant Cell Tumor of the Ulna (Campanacci Type 3)

Rhyan Darma Saputra — 2025-05-07

Introduction: Giant cell tumor of bone (GCTB) is a rare, benign but locally aggressive tumor that uncommonly afects distal ulna. Case: This case is a 30-year-old female with worsening pain, swelling, and limited wrist motion. Imaging studies revealed cortical destruction and soft tissue infltration characteristic of an aggressive GCTB. Campanacci type 3 GCTB of the distal ulna was diagnosed and managed through limb salvage surgery using a combination of Darrach procedure and single bone technique.This combined approach aims to achieve tumor clearance while preserving limb function. Post-operative management included soft tissue closure using an abdominal fap. Conclusion: The case highlights the challenges in managing aggressive GCTBs of the distal ulna and demonstrates a viable limb salvage strategy. Long-term follow-up is recommended to evaluate functional outcomes and to monitor for recurrence, because tumor’s aggressive nature.

Acute Appendicitis in Pregnancy

Yudha Prasetyo Utomo — 2025-05-07

Introduction: Acute appendicitis is the most common cause of non-obstetric surgical disease in pregnant women. However, clinical fndings may not be typical during pregnancy. The diagnosis of acute appendicitis in pregnancy is not straightforward as clinical signs may be mistaken for pregnancy-related symptoms. Case: An 18-year-old female G2P1A0, 10 weeks pregnant with lower middle abdominal continuous pain for 5 hours with nausea and vomiting twice and incomplete micturition. Vaginal bleeding and amniotic fuid discharge were ruled out. Physical examination revealed decreased bowel sounds, tenderness in the hypogastric, right iliac, and McBurney points, positive Dunphy, Psoas, and Obturator signs. With an Alvarado score of 7 and ultrasound results, acute appendicitis was diagnosed. An appendectomy was performed. Histopathological fndings suggest acute suppurative appendicitis. Conclusion: Appendicitis in pregnancy requires rapid and accurate diagnosis because the clinical symptoms are often considered to be symptoms of pregnancy.

Comparison of Side Effects of ARNI vs ACEi/ARB in Heart Failure Therapy

Anjar Nuryanto — 2025-05-07

Introduction: Pharmacological treatment of heart failure continues to develop. Newer drugs such as ARNI (angiotensin receptor neprilysin inhibitor) have become standard for heart failure treatment. This systematic review aims to compare the side efects of ARNI with those of previous standard heart failure therapy. Methods: This research uses PRISMA rules to analyze articles from PubMed and Cochrane. Results: A total of 2,741 articles, excluding duplicates, were selected for title and abstract screening. Twelve articles met the requirements for thorough screening. Of the 12 articles, 4 articles were selected for systematic review analysis. There were 6,553 samples, 2,580 in the ARNI group and 2,390 in the ACEI/ARB group. ARNI was better in reducing the risk of decreased eGFR (RR: 0.51; 0.34-0.78) and the incidence of hyperkalemia (RR: 0.87; 0.76-0.99) but the risk of symptomatic hypotension was greater in the ARNI group (RR: 1.47; 1.23-1.70). Conclusion: The risk of hypotension as well as a reduced risk of cardiovascular death and rehospitalization was higher in the ARNI group, while the risk of decreased eGFR and hyperkalemia was higher in the ACEi/ARB group.

The Association between Cycling and Male Infertility: A Systematic Review of Current Research

Kemal Akbar Suryoadji — 2025-05-07

Introduction: Cycling is a popular sport and also has various health benefits. However, cycling carries health risks, including fertility problems. This research aims to explore the association between cycling and infertility in men. Methods: This systematic review was conducted according to a PROSPERO protocol (ID: CRD42024509255) and PRISMA guidelines using the PubMed, Cochrane, and ScienceDirect databases. Keywords “(Bicycle) AND (Infertility)” are used. The risk of bias was assessed based on the Cochrane risk of bias tool for cohort studies. Results: The final two cohort studies were included with a total of 487 cyclists. Regular cycling of more than 1.5 hours/week was associated with 34% (95% CI 4-55%) lower sperm concentration compared to control. Regular cycling of more than 5 hours/week was associated with lower sperm concentration (OR 1.92, 95% CI 1.03-3.56) and lower total sperm motility (OR 2.05, 95% CI 1.19-3.56) compared to the control group. Conclusion: There is a relationship between cycling and male infertility; a decrease in sperm concentration in men who cycle at least 1.5 hours/week and lower sperm motility in men who cycle for at least 5 hours/week. The direct efect of cycling on the incidence of infertility as a consequence needs to be explored further.

The Association between Electrophysiology Profile and Risk of Cardiovascular Events: A Systematic Review

Muhammad Haris Firdaus — 2025-05-07

Introduction: Cardiovascular diseases (CVDs) are the leading cause of death, accounting for 31% of global mortalities. This systematic review explores the role of electrophysiological profles in cardiovascular prevention, focusing on their integration into risk management protocols. Methods: A comprehensive review was conducted using the PubMed database, adhering to PRISMA guidelines. Of the 1,050 identifed studies, 10 met the inclusion criteria and were assessed for quality using the STROBE method. Results: Key electrophysiological markers were identifed as signifcant predictors of cardiovascular events. Abnormalities in Holter monitoring, such as a turbulence slope (TS) ≤25 ms/RRI, are strongly correlated with sudden cardiac death (HR 4.7). Prolonged QT intervals in ECG were linked to increased mortality from cardiac arrest (HR 2.4) and heart failure (HR 1.74). ST-segment depression during exercise stress testing was a strong predictor of coronary heart disease death (HR 2.47), especially during the recovery phase (HR 4.01). Discussion: Electrophysiological markers like Holter monitoring, ECG fndings and exercise stress testing are valuable for identifying high-risk individuals. Their integration into routine screening could improve early detection and prevention strategies, further research is needed to standardize protocols.

Maternal Iodine Levels and Their Impact on Breast Milk Iodine Concentration

Ingrid Siahaan — 2025-05-07

Adequate iodine intake during pregnancy and lactation is vital for thyroid hormone synthesis which iscrucial for fetal and neonatal development, especially with exclusive breastfeeding. This review explores the link between maternal iodine levels and breast milk iodine concentration (BMIC), focusing on factors infuencing maternal iodine and its impact on BMIC. This review synthesizes current findings on the determinants of maternal iodine status, including dietary intake, supplementation, and iodine metabolism, and their impact on BMIC underscores the necessity for healthcare providers to monitor and guide iodine intake in pregnant and lactating women. The fndings advocate for targeted public health interventions and the implementation of robust guidelines to ensure adequate iodine nutrition.