Cermin Dunia Kedokteran

The Effect of Exclusive Breastfeeding, Low Birth Weight, and Maternal Height on the Incidence of Stunting in Children Under 2 Years of Age in Tapin District, Indonesia

Ade Riza — 2025-01-13

Background: Stunting affects intergenerational linear growth; short mothers are preceded by stunted childhood and will give birth to babies with low birth weight (LBW). Exclusive breastfeeding is known as one of the factors to prevent stunting. This study was conducted to see the effect of exclusive breastfeeding, history of low birth weight, and mother’s height on the incidence of stunting among below-two-year-old children in Tapin district. Method: Cross-sectional with a bivariate Chi-Square analysis test with odds ratio to assess the risk. Result: The results showed that the incidence of stunting was associated with the mother’s height (p=0.002, OR 8.325, 95% CI 2.117–32.741). Exclusive breastfeeding and low birth weight were not associated with the incidence of stunting (p=0.751, OR 1.303, 95%CI 0.454-3.738 for exclusive breastfeeding and p=0.201, OR 2.222, 95%CI 0.849–5.818 for LBW). Conclusion: Mother’s height affects the incidence of stunting in below-two-year-old children in Tapin district.

Anti-Epileptic Drug (OAE) Selection for Women with Epilepsy of Childbearing Age

Jenita Surianggo — 2025-01-13

Epilepsy is the most common chronic brain disorder and can affect people of all ages. Globally, an estimated 60 million people are diagnosed with epilepsy, half of whom are women, and about a third of women with epilepsy are of childbearing age. The main therapy for epilepsy is anti-epileptic drugs to control epileptic seizures. In Indonesia, first-line anti-epileptic drugs are carbamazepine, valproic acid, phenobarbital, and phenytoin, while second-line anti-epileptic drugs are lamotrigine, levetiracetam, clobazam, and topiramate. There are many concerns when women with epilepsy start planning a pregnancy, especially regarding the effect of epilepsy drugs on pregnancy and their effects on the fetus, such as teratogenic effects, neonatal outcomes, and neurodevelopmental impacts. The choice of anti-epileptic drugs (AEDs) in women of childbearing age must be considered carefully.

Hepatorenal Syndrome in Patients with Cirrhosis

Lenny Sulystio — 2025-01-13

Hepatorenal syndrome (HRS) is a serious renal complication that frequently develops in patients with decompensated cirrhosis, causes systemic circulatory disturbance. HRS involves complex pathogenesis mechanisms and treatment. Various therapies have been developed to tackle HRS, such as the use of vasoconstrictor agents, intravenous albumin, transjugular intrahepatic portosystemic shunting (TIPS), and liver transplantation.

Management of Hypoglicemia in Diabetic Patients.

Ricky Pramudya — 2025-01-13

Hypoglycemia is a complication of diabetes mellitus (DM) that may be deleterious. The most frequent cause of hypoglycemia in diabetes patients is inappropriate doses of insulin and/or anti-diabetic drugs. Hypoglycemia occurs more often in type 1 DM patients than in type 2 DM patients. Prompt recognition and treatment is critical because hypoglycemia increased morbidity and mortality.

MRI as Diagnostic Modality of Myocarditis in Patients with Unexplained Chest Pain

Prasetyo Andriono — 2025-01-13

Myocarditis is the inflammation of the cardiac muscle. Diagnosis can be challenging as the symptoms are not typical. Cardiac magnetic resonance imaging (MRI) can be used to diagnose myocarditis, allows more reliable quantitative measurements, and a clear discrimination from other mimicking conditions. We include 3 patients with myocarditis.

65 Year Old Woman with Schizoaffective Disorder Very Late Onset dan Withdrawal Benzodiazepine

Muhammad Rian Fathurrahman — 2025-01-13

Schizoaffective disorder is characterized by a combination of symptoms of schizophrenia and of affective disorders. This paper reports a 65-year-old female with sychotic symptoms and agitation. The patient was diagnosed as bipolar type schizoaffective with benzodiazepine withdrawal based on the presence of symptoms of schizophrenia and mood involvement and a history of abrupt discontinuation of benzodiazepines. Patient carried out daily activities independently even though her social relations are disrupted. Schizoaffective onset over 60 years is very rare. Unspecific symptoms and comorbidities may delay diagnosis.

Post-Tuberculosis Obstruction Syndrome (SOPT)

Made Alit Darmawan — 2025-01-13

Pulmonary tuberculosis can cause post-tuberculosis obstruction syndrome as its complication. This case shows symptoms of obstruction in the form of shortness of breath for a month accompanied by cough and weight loss. Patient had a history of pulmonary TB and completely treated pulmonary tuberculosis; the radiology revealed a pathognomonic sign for post-tuberculosis obstruction syndrome such as fibrous infiltrate at the upper lobes of right and left lungs and retracted hilus.

Fetal Outcome in Pregnancy Infected Syphilis Treated with Penicillin G: A Systematic Review

Joshua Nathaniel — 2025-01-13

Background: Syphilis infection during pregnancy can cause congenital syphilis. Syphilis in pregnant women is treated with penicillin to prevent fetal infection and congenital syphilis. A systematic literature review is conducted to determine the efficacy of penicillin G by reviewing outcome parameters. Methods: A systematic literature review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Results: Through searches on PubMed, Science Direct, and Cochrane using keywords ‘Antibiotics’, ‘Pregnancy’, ‘Syphilis’, and ‘Treatment’, 230 articles were found. Twenty-five articles were duplicates, 135 articles did not meet the inclusion criteria, 75 articles were literature reviews, and 58 articles were not related to pregnant women, resulting in 6 journals that met the inclusion criteria. Conclusion: Penicillin G benzathine is the most common antibiotic used to treat syphilis in pregnancy. A total of 1,190 cases (26.26%) of congenital syphilis were found among 4,531 pregnant women infected with syphilis and receiving penicillin G benzathine therapy. The incidence of congenital syphilis was 2.4% in pregnant women who received therapy since the first trimester. The incidence of congenital syphilis increased 12 times if therapy was given in the second trimester and 33 times if given in the third trimester.

Sociodemographic Profiles of Pregnant Woman with Urinary Tract Infection: A Systematic Review of Current Research

Fitriyadi Kusuma — 2025-01-13

Introduction: Untreated UTIs during pregnancy can lead to complications for both the mother and the fetus, highlighting the importance of appropriate management. Understanding the sociodemographic profiles of pregnant women with UTIs can aid in tailored interventions and care. Methods: This systematic review followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024507145). Cohort cross-sectional studies focusing on the sociodemographic profiles of pregnant women with UTI were systematically searched and selected from databases such as ScienceDirect, Cochrane, Scopus, and PubMed. Eligibility criteria included relevance to sociodemographic profiles, clear extraction and statistical analysis methods, and publication in English. Data extraction and study selection were conducted independently by six researchers, with any discrepancies resolved through discussion. Results: Three studies met the inclusion criteria and were included in the systematic review. The studies conducted in the United States, Cameroon, and Bangladesh, which included 46,398 pregnant women, revealed diverse sociodemographic factors associated with UTI risk among pregnant women. Factors such as low educational attainment, low household income, and racial/ethnic disparities were identified as significant contributors to UTI prevalence in the United States. In Cameroon, although a high UTI prevalence was observed, no significant risk factors were identified. In Bangladesh, maternal undernutrition, primiparity, and low paternal education were significant risk factors for UTIs among pregnant women. Antibiotic sensitivity was varied, indicating the complexity of UTI management. Conclusion: The systematic review emphasizes the importance of considering sociodemographic factors in understanding and addressing UTI risk among pregnant women. Socioeconomic status, cultural disparities, and health-related factors play significant roles in UTI prevalence and management. An intervention to target specific sociodemographic characteristics may be necessary to effectively prevent and manage UTIs in pregnant women across different geographical and socioeconomic contexts.

The Role of Vitamin D Supplementation in The Prevention of Asthma Exacerbation - Evidence-Based Case Report

Devina Sagitania — 2025-01-13

Background: Asthma is a chronic inflammatory condition affecting the airways, marked by tissue changes and heightened bronchial sensitivity. Vitamin D, as an immunomodulator, may affect the inflammatory responses of the airways. Recent studies suggest that vitamin D supplementation has resulted in fewer exacerbations of asthma and improved lung function in both individuals with asthma and smokers. Other studies revealed a reduction of asthma exacerbations in corticosteroid-treated patients. This study sought to investigate whether vitamin D supplementation can decrease the frequency of asthma exacerbations. Methods: Literature research was done on three databases: PubMed, Cochrane Library, and ScienceDirect, related to the clinical question. Articles were chosen according to specific inclusion and exclusion criteria. All articles were critically appraised using the Oxford Center for Evidence-Based Medicine worksheet. Results: Three meta-analysis articles were critically appraised. The result is vitamin D supplementation can lower the incidence of asthma exacerbation, despite varying doses of vitamin D. Conclusion: Vitamin D supplementation was associated with a decrease in asthma exacerbations, despite varying doses of vitamin D. Vitamin D supplementation to corticosteroids can be considered potentially cost-effective and safe to prevent asthma exacerbations. Future studies should analyze the effect of vitamin D supplementation in long-term asthma therapy using the same dose.

Heat-not-burn tobacco (HnBT): The Issue of Cigarette Product Substitutes and Their Health Impacts

Agustiawan Agustiawan — 2025-01-13

The health risks caused by cigarette smoking have led companies to develop and advertise alternative nicotine products, such as e-cigarettes and “heat-not-burn” (HnB) without burning tobacco. United States Federal Drug Administration (US FDA) approved the product I Quit Ordinary Smoking (IQOS) for commercial purposes in the United States. HnB tobacco products heats tobacco (up to 350°C) to produce nicotine aerosol that is inhaled without burning it at a much higher temperature (800°C). Reports show that 37% HnB users experienced at least one symptom, the most was sore throat (25.1%) followed by eye discomfort (22.3%). The notion that HnB tobacco product is an alternative to reduce the impact of conventional cigarettes is not entirely true. HnB tobacco can still have negative health impacts.

N-butylphthalide: Neuroprotector for Ischemic Stroke

Lyon Clement — 2025-01-13

Stroke, especially ischemic stroke, is still one of the most prioritized health problems in Indonesia with an enormous burden and cost. The main strategy to treat ischemic stroke, which is reperfusion therapy by thrombolytic therapy or thrombectomy, has various challenges in its practices, especially regarding the recommended time window due to facility and infrastructure limitations. N-butylphthalide (NBP) is a neuroprotector with the potential ability to improve cerebral microcirculation, protect the blood-brain barrier, protect neurons from apoptosis, induce neurogenesis, and maintain neuron survivability in the condition of ischemic stroke based on preclinical studies. Clinically, NBP showed benefits mainly in improving post-stroke disability. NBP is a promising neuroprotector for better clinical outcomes.