Cermin Dunia Kedokteran

The Relationship between Treatment Phases and the Quality of Life of Pulmonary TB Patients at the Perumnas I Community Health Centre in Pontianak, Indonesia

Jihan Nabila, Agus Fitriangga, Eka Ardiani Putri — Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, also known as acid-fast bacteria. One measure to control TB cases is treatment. The success of treatment affects the quality of life of patients with TB. Medication can improve the quality of life among tuberculosis (TB) patients. This study aims to determine the relationship between the treatment phase and the quality of life among TB patients at Puskesmas Perumnas I, Pontianak. Methods: Cross-sectional observational analytic study and a total sampling method with 23 TB patients as subjects. The quality of life was assessed with WHOQOL-BREF. Univariate and bivariate data analysis was carried out using the Fisher correlation coefficient. Univariate analysis was used to examine the distribution of research subject characteristics, while bivariate analysis was used to determine the relationship
between treatment phase and quality of life. Results: There is a significant relationship between the treatment phase and the quality of life of tuberculosis patients at the Perumnas I Pontianak Health Center (Sig. (2-tailed) p = 0.005). Conclusion: There is a significant relationship between the treatment phase and the quality of life of tuberculosis patients at the Perumnas I Pontianak Health Center.

The Relationship between Stress and Burnout among Medical Students at Ahmad Dahlan University

Siti Ma'rifatus Shifa, Widea Rossi Desvita, Nurul Qomariyah — Tue, 10 Feb 2026 00:00:00 +0700

Background: Burnout can occur in individuals exposed to intense and prolonged repetitive stress. The various activities of medical students require a change in learning style from high school to college, which has the potential to cause stress. This study aims to determine the relationship between stress and burnout among students of the Faculty of Medicine, Universitas Ahmad Dahlan. Methods: The research was conducted quantitatively with a cross-sectional design. The sample was 60 students in the 3rd, 5th, and 7th semesters chosen with a with random stratified sampling technique. Results: Most of the students (80.0%) had moderate stress levels and most of the burnout levels were low (45.0%). Bivariate analysis obtained p value < 0.001 and r value = 0.641 (r > 0). In addition, an R-squared of 0.411 was obtained, which shows that the stress level makes a statistical contribution of 41.1% to the variation in burnout, and the remaining 58.9% could be influenced by other factors. Conclusion: There was a significant positive relationship between stress and burnout among students of the Faculty Medicine, Universitas Ahmad Dahlan.

Exploring the Efficacy of Olive Oil in Preventing Pressure Ulcers: A Systematic Review

Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Pressure ulcers frequently occur in bedridden patients as a result of immobility and friction, causing delays in recovery and leading to complications. Natural skin care, including olive oil, have shown promising results in preventing ulcers. This paper aims to assess
the efficacy of olive oil in reducing the risk factors associated with pressure ulcers and preventing their occurrence in bedridden patients. Methods: A systematic review using PRISMA guidelines, examining studies from 2012 to 2025. All studies measuring the effect of olive
oil in preventing pressure ulcers in bedridden patients and calculating the risk using the Braden Scale Score were included. The RoB 2 and ROBINS-I quality assessment tools assessed the risk of bias. Results: Ten studies with a low risk of bias, comprising 662 participants, were included. Nine studies showed a preventive effect of pressure ulcers, while one study showed that pressure ulcers were still developing despite olive oil application. Conclusion: Olive oil is beneficial in reducing pressure ulcer risk factors and preventing pressure ulcers in bedridden patients.

The Effects of Omega-3 Supplementation on Inflammatory Markers in Colorectal Cancer Patients: Evidence-Based Case Report

Vanessa Aryani Octavia M, Diyah Eka Andayani — Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have immunomodulatory and anti-inflammatory effects that may help reduce inflammatory markers such as interleukin-6 (IL-6) and
C-reactive protein (CRP) in colorectal cancer (CRC) patients. Methods: A literature search was conducted in PubMed, Cochrane Library, and Google Scholar from May to June 2025. Included studies were meta-analyses or randomized controlled trials (RCTs) evaluating omega-3 supplementation in adult CRC patients, with inflammatory markers as primary outcomes. Critical assessment tools and levels of evidence of the final articles are based on the Oxford Centre for Evidence-Based Medicine. Results: Three meta-analyses were reviewed. Omega-3 supplementation was given orally (660 mg–4.8 g/day) or parenterally (0.1–0.2 g/kg/day) for 5 to 84 days. IL-6 and tumor necrosis factor-α (TNF-α) levels were significantly reduced in most studies. CRP showed modest and inconsistent improvement, while
albumin slightly increased. High heterogeneity in dose, timing, and administration routes limited the strength of interpretation. Conclusion: Omega-3 supplementation appears to reduce systemic inflammation in CRC patients, particularly through IL-6 suppression. Although the effect on CRP is inconsistent and albumin improvement is mild, these findings suggest a potential benefit in inflammatory and nutritional status. Further standardized and high-quality RCTs are needed to confirm clinical utility and optimal dosing strategies.

Esophagogastrostomy with Linear Stapler Murny Rauf Procedure for Type III Achalasia – Case Report

Angela Djunaedi, Alders Alen Kusa Nitbani, Widhitomo Marino — Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Feeding difficulty is one of the main complaints of patients with achalasia. Achalasia is still considered a rare disorder with unknown etiology. The main goal of the treatment is to increase the patient’s quality of life and treat dysphagia to improve food intake.
A successful esophagogastrostomy Murny Rauf procedure for achalasia treatment in a limited-resource hospital is presented. Case: A 47-year-old woman was diagnosed with type III achalasia (Eckardt’s score: 12) and severe malnutrition. The esophagogastrostomy with the Murny Rauf procedure was conducted to increase food intake. The patient gained weight due to improved feeding several weeks after the surgery. Discussion: Diagnosis of achalasia is made by clinical symptoms and confirmed by a diagnostic procedure. In this case, nonsurgical medications were not considered due to the uncertainty of the benefit and difficulties of routine visits due to the far distance of the patient’s residence to the hospital which may incur additional transportation costs. Conclusion: The esophagogastrostomy Murny Rauf procedure provides advantages in treating achalasia. This procedure gave a new insight into developing an efficient procedure for achalasia in rural areas.

Recurrent Malaria: Case Report

Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Residents in malaria-endemic areas may experience more than 1 episode of malaria even in 1 season. Case: A 29-year-old male with fluctuating fever for 3 days accompanied by chills. The patient had just returned from Papua about 3 weeks before. The patient has worked in Papua for 1 year and has had 5 episodes of malaria: 3 falciparum malaria and 2 vivax malaria. Two months before this current complaint, the patient was taking DHP and primaquine. The patient did not take any malaria prevention drugs before leaving for Papua. At
initial examination, the temperature was 38.6oC with leukocytosis (13,580/μL). Peripheral blood malaria examination found Plasmodium vivax parasites, stages: trophozoite and gametocyte. Patients were given DHP therapy (dihydroartemisinin 40 mg + piperaquine phosphate 320 mg) 4 times a day for 3 days and primaquine 15 mg once a day. Discussion: On the second day of treatment or the fourth day since symptom onset, the clinical condition began to improve. On the fourth day of treatment or the sixth day since symptom onset, the patient had no complaints, and vital signs and physical examination were within normal limits. The patient was discharged after continuing primaquine 15 mg for the next 11 days. Conclusion: DHP therapy (dihydroartemisinin 40 mg + piperaquine phosphate 320 mg) 4 times a day for 3 days and primaquine once at 15 mg results in a radical curative effect.

Onychomadesis as a Rare Complication of Hand, Foot,and Mouth Disease: Case Report

Riana Suwarni, Anjar Nuryanto — Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Onychomadesis is a rare nail disorder characterized by the separation of the nail plate from the nail matrix, which may result in nail shedding. It has been reported as a late complication of hand, foot, and mouth disease (HFMD), a common viral infection in children
that is usually self-limited but may present with various complications. Case: A 4-year-old boy had developed whitish transverse lines on his fingernails and toenails, followed by separation of the nail from the nail matrix. Two months prior to the nail changes, the patient experienced
fever accompanied by papulovesicular rashes around the mouth, hands, and feet, as well as aphthous lesions in the oral cavity consistent with HFMD infection. At the time of the nail involvement, there was no pain, inflammation, or signs of secondary infection. Discussion: Based on the clinical history and physical findings, a diagnosis of onychomadesis as a late complication of HFMD was established. Onychomadesis is known to occur weeks to months after HFMD and is generally self-limited without the need for specific therapy. Conclusion: Onychomadesis
may occur as a late complication of HFMD in children. The condition is benign, does not require special treatment, and is expected to resolve completely within 6 weeks.

Bilateral Spontaneous Pneumothorax as Manifestation of COVID-19: Case Report

Tue, 10 Feb 2026 00:00:00 +0700

Introduction: Spontaneous pneumothorax occurs when part of the lung collapses and air accumulates in the pleural space. The cause of spontaneous pneumothorax is unclear, but this condition may increase the risk of death, particularly if it progresses to tension pneumothorax.
COVID-19 is primarily a respiratory disease and may present with various pulmonary manifestations, including rare and severe complications. Case: A 48-year-old woman presented with dyspnea, fever, cough, nausea, and fatigue. Initial rapid antibody testing for SARS-CoV-2 was
negative. Chest radiograph demonstrated an avascular area in the right lateral hemithorax with medial lung collapse, consistent with right spontaneous pneumothorax. Oxygen therapy and chest tube insertion were performed. Follow up chest x-ray showed resolution of the right
pneumothorax, however, a new pneumothorax developed on the left side. Nasopharyngeal and oropharyngeal swab testing for SARS-CoV-2 was reported positive a few days later, after the patient had died. Discussion: The occurrence of bilateral spontaneous pneumothorax
in this patient suggests lung involvement related to COVID-19 infection. Recognition of atypical pulmonary manifestations is essential, particularly when initial screening tests are negative. Conclusion: COVID-19 can manifest as spontaneous pneumothorax, including bilateral involvement. Early recognition is important to reduce morbidity and mortality.

Myocardial Infarction in Patients with HIV Infection: A Case Report

Adriani Sakina, Fitri Rahmah — Tue, 10 Feb 2026 00:00:00 +0700

Introduction: The association of myocardial infarction and HIV infection is influenced by many risk factors, either the specific risk factors of cardiovascular and metabolic disease, or HIV-related risk factors related to the immunologic process and the effects of antiretrovirals (ARV). Case: A 43-year-old man on ARV therapy presented with chest pain as heaviness under the left breastbone and referred to the shoulder to the back for 24 hours. The ECG showed ST-segment elevation in leads II, III, and aVF. The patient underwent intensive cardiac care and received
aspirin therapy with a loading dose of 160 mg, followed by a maintenance dose of 80 mg daily, clopidogrel therapy with a loading dose of 300 mg, followed by a maintenance dose of 75 mg daily, and intravenous anticoagulant enoxaparin injection therapy, 75 mg twice daily. The
patient also finally stopped smoking. Discussion: Myocardial infarction in people with HIV is a multifactorial condition influenced by various risk factors, chronic inflammation associated with HIV, endothelial dysfunction, and the effects of certain ARV therapies. The combination of tenofovir-based ARVs and efavirenz has not been shown to increase the risk of myocardial infarction and even has a protective effect on lipid profiles. Conclusion: In general, management of myocardial infarction in HIV-infected patients did not differ from that of general population;
one important issue being the drug interaction of ARV with antiplatelet agents and statins. The prognosis of HIV-infected patients who had myocardial infarction did not differ from that of those without. However, acute myocardial infarction recurrence in the HIV-infected population is higher than general population.

Optimising Circadian Rhythms Through Physical Activity as an Anti-Ageing Strategy

Nitya Indira I Gusti Ayu, Inten Dwi Primayanti I Dewa Ayu — Tue, 10 Feb 2026 00:00:00 +0700

Aging is a complex, multifactorial biological process characterized by progressive decline in physiological function and increased vulnerability to chronic diseases. This process is closely associated with circadian rhythm dysfunction, an endogenous 24-hour biological regulatory system that plays a crucial role in maintaining homeostasis through the regulation of metabolism, immune function, and the sleep-wake cycle. Circadian dysregulation not only accompanies aging but may also accelerate degenerative processes and increase the risk of various chronic diseases. Physical activity is recognized as a potent non-photic zeitgeber capable of modulating and strengthening both
central and peripheral circadian rhythms. The mechanisms involved include regulation of clock gene expression, modulation of core body temperature, alterations in hormonal, and effects on metabolic pathways and cellular energy sensors. This literature review discusses the
interaction between circadian rhythms, physical activity, and the aging process, and examines how optimization of circadian rhythm through appropriately planned physical activity may contribute as a progressive anti-aging strategy. Such an approach has the potential to support
improved healthspan and preservation of physiological function with advancing age.

Delayed Spleen Bleeding

Juven Luvianto, I Wayan Periadijaya — Tue, 10 Feb 2026 00:00:00 +0700

Delayed spleen hemorrhage (DSH) is defined as rupture or hemorrhage of the spleen occurring 48 hours or more after blunt trauma. Although relatively uncommon, DSH is associated with a higher mortality rate compared to acute splenic injury. The interval between the initial trauma
and the onset of DSH may range from several days to weeks or even months, and it may also occur following minor trauma. The spleen is a highly vascular organ, making splenic injury a potentially life-threatening condition due to the risk of intra-abdominal hemorrhage. DSH can develop in patients who were previously hemodynamically stable and had no radiological evidence of splenic injury on initial imaging. Diagnosis is often challenging because clinical manifestations may be nonspecific and long time interval since the trauma. Imaging studies, particularly computed tomography, play a crucial role in confirming the diagnosis and assessing the severity of splenic injury. Management of DSH depends on the patient’s hemodynamic status and the grade of the splenic injury, and may include non-operative management, embolization, or surgical intervention. Early recognition is essential to improving clinical awareness, accelerating diagnosis, and reducing morbidity and mortality risks.

Clinical Implications of Gut-Lung Axis in Systemic Chemotherapy for Lung Cancer

Tue, 10 Feb 2026 00:00:00 +0700

Lung cancer incidence continues to increase globally, with an estimated mortality rate of 18% worldwide. Current management strategies focus on early screening, early treatment, and palliative care. However, more fundamental approaches are needed to improve treatment outcomes. The gut-lung axis has emerged as an important factor in lung cancer pathophysiology, as it plays a role in pulmonary immune defense and is influenced by changes in gut and lung microbiota. Alterations in microbial composition have been observed in lung cancer patients and may contribute to disease progression. Systemic chemotherapy, while targeting cancer cells, also exerts systemic effects that may disrupt gut and lung microbiota, leading to dysbiosis. These changes may influence treatment response, immune modulation, and clinical outcomes in lung cancer patients. This narrative review explores the role of the gut-lung axis in lung cancer and examines the impact of systemic chemotherapy on gut and lung microbiota. Understanding the interaction between chemotherapy and the gut-lung axis may provide insight into potential adjuvant strategies to improve treatment effectiveness and patient quality of life.