Diponegoro Medical Journal (jurnal Kedokteran Diponegoro)

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EISSN: 25408844
Total articles ≅ 164

Latest articles in this journal

Yuri Savitri, Wina Yunida M Siregar, Viola Septina, M Fathul Arif, Arini Nashirah, Narisha Amelia Putri
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11; https://doi.org/10.14710/dmj.v11i6.35882

Right Heart Failure (RHF) as a rapidly progressive syndrome with systemic congestion in the setting of impaired RV filling and/or decreased RV outflow output. A 28-year-old male patient, a photographer, lived in North Aceh was admitted to the ED of Cut Meutia Hospital. He was admitted with worsening dyspnea since 2 days before, initiated after a periode of fever. He also complained of fatigue, palpitations in ordinary activities and chest pain occasionally. He had history of presyncope and syncope. He denied any history of hypertension, type 2 diabetes, allergies, and active smoking. He had no congenital or family history of heart disease. Physical examination revealed full of conciousness with slightly abnormal vital sign. He had malar rash, dilated jugular vein. The apex of the heart shifts to the axilla anterior line, S1>S2 with systolic murmur (+). ECG showed complete RBBB with RAD and chest x-ray showed cardiomegaly. The transthoracic echocardiogram revealed severe TR (Tricuspid Regurgitation), dilatation of RARV (Right Atrium Right Ventricle), with severe PH (Pulmonary Hypertension). The patient was diagnosed with RHF (Right Heart Failure) caused by primary PH. The patient was placed on intravenous furosemide, spironolacton, digoxin, and sildenafil. Treatment and lifestyle modification were expected to improve the quality of life.
Yuri Savitri, Helma Humairah, Jauza Raudhatul Jannah Mendrofa, Nurul Afni, Della Vega Nisha Ayuna
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11; https://doi.org/10.14710/dmj.v11i6.35993

Rheumatic heart disease (RHD) is damage of the heart valves due to acute rheumatic fever (ARF) which results from the body’s autoimmune response to Streptococcus pyogenes (group A Streptococcus bacteria) infection which is a throat infection. Acute rheumatic fever is one of the most important causes of cardiovascular morbidity and mortality in the developing countries. A 25-years-old male patient, domiciled in Alue Dalam, Darul Aman, East Aceh, admitted to emergency department of Cut Mutia hospital, the patient was brought to the hospital by his family at 05.0o pm on January 27th, 2022. Patient referred from Graha Bunda hospital. Patient was admitted to the hospital with complaints shortness of breath. Shortness of breath is felt during activity and worsens at night. Shortness of breath since yesterday. The patient also complained of pounding. The pounding has been felt for five days before arriving at the hospital. The patient also has chest pain, and tired easily. Past medical history such hypertension and diabetes mellitus are denied. Physical examination before treatment was obtained: the patient looked restless, weakness, and akker. Echocardiography examination showed the MR Severe, MS moderate, AR moderate, TR moderate, PH mild, AML calsification, all chamber dilatation, and thrombus LV. The patient was given initial treatment in Cut Mutia General Hospital.
Deaniar Hafilah, Asep Bayu Dani Nandiyanto
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11; https://doi.org/10.14710/dmj.v11i6.35896

Background: Nanocrystalline cellulose has potential for biomedical applications due to its abundant material availability, biodegradability, biocompatibility, and low weight. Research on nanocrystalline cellulose as medical implants has rarely been studied in the past 10 years, although this material has tremendous potential such as bone implants and cardiovascular implants. Objective: This study aims to analyze the development of research on nanocrystalline cellulose as medical implants using a bibliometric approach with computational analysis using VOSviewer. Methods: The article data was obtained using the Publish or Perish software by retrieving the database from Google Scholar. The keyword “nanocrystalline cellulose, medical implants, biomedical" is used with the publication time span from 2012 to 2020. Data processing uses Microsoft Excel. Computational mapping using VOSviewer. Results: Research on the application of nanocrystalline cellulose has been carried out several times, this can be proven from computational mapping analysis using VOSviewer which shows the term "nanocrystalline cellulose" is in the same cluster as the term "medical implant". However, research on the application of nanocrystalline cellulose as medical implants is still rarely carried out, this is evidenced by the small frequency indicated by the two terms. Conclusion: Based on the results of mapping the collected article data, research on the application of nanocrystalline cellulose as medical implants is an interesting topic. However, this topic is still rarely studied. Therefore, this review can be a starting point for selecting the topic of research on the application of nanocrystalline cellulose materials as medical implants as a consideration for determining the research theme to be taken.
Riska Kurnelia Ananda, Asep Bayu Dani Nandiyanto
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11; https://doi.org/10.14710/dmj.v11i6.35942

Background: A Study to determine the development of research can be done by bibliometric analysis technique. There are many studies that have been carried out on bibliometric analysis. However, research on bibliometric analysis of published data in the field of protein nanoparticles that has been carried out specifically to determine research development has not been carried out. Objective: This study aims to examine the development of protein nanoparticle research through a bibliometric approach. Methods: The article data was obtained from the Google Scholar database using the publish or perish reference manager software. The keyword "Protein Nanoparticles" is used with a publication time span from 2012 to 2022. Data processing uses Microsoft Excel. Computational mapping using VOSviewer. Results: The article data obtained and considered relevant were 390 articles. The results of the analysis of the development of protein nanoparticle publications in the last 10 years show quite frequent fluctuations. Research fluctuations occurred in 2012 to 2020. There was a decline in 2020-2022 from 35 in 2020 to 19 in 2022. In 2012 and 2014 research on protein nanoparticles became popular, with 47 studies each. Conclusion: Based on the results of mapping the collected article data, it can be seen that the keyword protein nanoparticles is still rarely used in research. It can be concluded that the field of protein nanoparticles is still very likely to be researched and associated with other terms, this will have a higher impact on the novelty of the research.
Yuri Savitri, Jauza Raudhatul Jannah Mendrofa
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11; https://doi.org/10.14710/dmj.v11i6.35990

Rheumatic heart disease (rheumatic heart disease) is an acquired heart disease which is a heart valve disorder that persists due to previous acute rheumatic fever, mainly affecting the mitral valve (75%), the aorta (25%), rarely affecting the tricuspid valve, and never affecting the valves lungs. A 52-year-old male patient, domiciled in Mutiara (Alue Awe) Lhokseumawe City, Indonesia. Come for outpatient treatment at Polyclinic of Cut Meutia Hospital. Patients are who routinely go to the polyclinic every month to take medicine. The patient complains of left chest pain, shortness of breath, heart palpitations, cough, tired easily during activities, especially during strenuous activities. History of Diabetes Mellitus is denied, history of hypertension (+). The patient admitted that he was diagnosed with rheumatic heart disease at the age of 19 years. The patient has been undergoing treatment for 33 years by routinely complete checks related to his heart every year and regularly taking medication at the polyclinic every month. The patient admitted at junior high school age he often experienced attacks of fever that went up and down accompanied by pain in the throat. Physical examination found: Compos Mentis (E4V5M6), BP:140/40 mmHg, HR : 92x/i, RR: 23x/i, T; 37.1°C, SpO2 : 95%. Chest examination showed vesicular breath sounds, Rhonki (-), Wheezing (-), Diastolic murmur (+).Echocardiography showed an EF of 70%. AR Severe, MR Moderate. AML Prolapse, Calcification (+), LV Dilatation, LVH Eccentric
Thomas Handoyo, Nur Farhanah, Gianina Dinda Pamungkas
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11, pp 247-252; https://doi.org/10.14710/dmj.v11i5.35628

Background : Treatment of COVID-19 using IL-6 inhibitors, including Sarilumab or Tocilizumab, significantly decreased mortality risk. Though, Remdesivir therapy gave benefits, morbidity and mortality remained high. Baricitinib, a JAK inhibitor, can inhibit IL-6 activation pathway and has a potential effect of inhibiting disease progression to become severe. Objective : This study aimed to evaluate the use of Baricitinib for COVID-19 patients. Methods : This study was conducted by searching for observational and randomized controlled trial studies through online databases, “PubMed” and “Google Scholar”. Studies included must evaluate Baricitinib effectivity as therapy for hospitalized COVID-19 patients. This study included 11 studies (9 observational and 2 randomized controlled trial). Patients included had moderate-to-severe symptoms of COVID-19. Results : Standard dose of Baricitinib was administered at 4 mg daily dose. Length of therapy was varied between 5-14 days, or up to patients’ discharge. Baricitinib therapy among included studies was administered with intravenous Remdesivir, Steroid, Tocilizumab, or other complement therapies. Mortality rate within 7-day of hospitalization with Baricitinib was 4.4%. Requirement of invasive mechanic ventilation rate after Baricitinib administration was approximately 4%. Laboratory parameters were significantly getting better after Baricitinib administration: IL-6; CRP; ferritin; and D-dimer. Serious adverse events in a randomized controlled trial, occurred more often in placebo treated compared to Baricitinib treated group. Conclusion : Baricitinib as therapy for COVID-19 patients can decrease progression, morbidity, and mortality of the disease. Further studies are needed to evaluate the benefit of Baricitinib as main therapy for COVID-19.
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11, pp 242-246; https://doi.org/10.14710/dmj.v11i5.35631

Background: High or uncontrolled blood sugar levels are still widely found, one of which is due to the patient's lack of knowledge about the disease, diet and treatment of DM sufferers. Overcoming these problems by providing health education. Diabetes self management education (DSME) is a process to support knowledge, skills and abilities in diabetes self-care. Objective: This study examines the influence of diabetes self management education with ava on the knowledge of diabetes mellitus type 2. Methods: The design of this study used a quasy experiment with a pre-test and post-test nonequivalent control group approach. The population in this study were all elderly people with Diabetes Mellitus as many as 170 people, the sample was 60 respondents who were taken using the simple random sampling technique. The instrument used was a questionnaire given before and after the intervention. Data were analyzed using the Wilcoxon Signed Ranks Test with α = 0.05. Results: The research results obtained that the respondent's knowledge after (post test) giving intervention DSME with AVA obtained a Mean Rank value of 3.00 while the level of knowledge before it was carried out (pre test) obtained a Mean Rank value of 2.50 obtained a Sig value of 0.0001 which means if p
Muhammad Ilham, Endang Mahati, Muflihatul Muniroh, Yora Nindita
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11, pp 257-262; https://doi.org/10.14710/dmj.v11i5.35304

Background: Antioxidant is a substance that can catch and neutralize free radicals so that the process of oxidative stress can be stopped and cell damage can be avoided. Kaffir lime peel contains antioxidant compounds that have the potential to be the neuroprotective agent and can protect neurons from free radical-induced damage.Objective: To evaluate the effect of kaffir lime peel extract (Citrus hystrix) on the plasma malondialdehyde (MDA) level of mice induced by Scopolamine (SCM).Method: This research was a true experimental study with a post-test-only controlled group design. Thirty mice were randomly divided into 5 groups consisting of a healthy control (K+), Negative Control (K-), extract 5 mg/20gBW group (P1), 10 mg/20gBW group (P2), 20 mg/20gBW group (P3). SCM was injected intraperitoneally on days 1-7 and kaffir lime peel extract was given orally on days 2-7, the MDA levels testing of mice using TBARS method on day 8. Data analysis used One-Way ANOVA test and continued with Post Hoc LSD test.Results: The mean MDA levels of K+, K-, P1, P2, P3 were 4,212; 4,644; 3,481; 4,555; 4,733 nmol/mL, respectively. MDA levels of P1 were lower than K-, even though there were no statistically significant differences.Conclusion: There was no effect of administration kaffir lime peel extract (Citrus hystrix) on MDA levels in mice with scopolamine-induced dementia.Keywords: Citrus hystrix, malondialdehyde, dementia, mice
Meisi Islami Bulan, Eva Annisaa, Intan Rahmania Eka Dini
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11, pp 237-241; https://doi.org/10.14710/dmj.v11i5.35368

Backgrounds: Hypertension and Diabetes Mellitus are interrelated diseases and have a strong predisposition to the occurrence of cardiovascular disease and atherosclerosis. BPJS Kesehatan states that the cost of hypertension services has increased every year, indicating the need to control costs through pharmacoeconomic studies. One method that can be used is cost-effectiveness analysis. Find out the effective drugs in terms of cost and therapy. Aim: To determine the cost-effectiveness of Captopril and Amlodipine for hypertensive patients with co-morbidities of diabetes mellitus at the Magelang District Health Center. Methods: This study was conducted retrospectively with medical record data for 2019-2020. The sample in this study was 35 with 15 groups of 10 mg/day amlodipine and 20 groups of 25 mg/day captopril. The outcome assessed was the number of patients who achieved the therapeutic target for 1 month using the drug. Results: The percentage of therapeutic effectiveness of amlodipine 10 mg/day was 86,7% while captopril 25 mg was 60%. The average direct medical cost of the amlodipine 10 mg/day is Rp10.429,30 greater than captopril 25 mg/day, which is Rp7.298,80. The ACER value of amlodipine 10 mg/day was Rp. 12.023,00 and captopril 25 mg/day was Rp. 12.164,00. Calculation of ICER value of the average direct medical cost of the 10 mg/day amlodipine group is Rp10.423,93 greater than captopril 25 mg/day, which is Rp7.298,80. Conclusion : Amlodipine is more cost-effective than captopril with an ACER value of RP. 12.023,00.
Meiriani Sari, Nany Hairunisa
Diponegoro Medical Journal (jurnal Kedokteran Diponegoro), Volume 11, pp 268-274; https://doi.org/10.14710/dmj.v11i5.35895

Monkeypox disease (monkey smallpox) is a disease that has never been found in Indonesia since it was first discovered in humans in the Congo in 1970. So if there is one positive confirmed event, then the disease is an Extraordinary Event (KLB). This disease has become a global concern because since May 13, 2022, WHO has received reports of Monkeypox cases from non-endemic countries. It has expanded to 4 WHO regions: Europe, America, Eastern Mediterranean, and Western Pacific. Until now, further investigations and studies are still being carried out to understand more about the epidemiology, sources of infection, and transmission patterns in non-endemic countries that have reported new cases, such as Indonesia. Until now, no specific treatment has been proven to treat Monkeypox infection. Currently, the therapy used is symptomatic support. The antiviral tecovirimat, or TPOXX, developed by the European Medicines Agency (EMA) as a Monkeypox therapy in 2022 based on research, has not been marketed freely. In addition, antivirals such as cidofovir and brincidofovir have been shown to be effective against orthopox virus in vitro and in animal studies. However, the effectiveness of this drug against monkeypox in humans is not yet known. However, this disease can be prevented by vaccination. In Indonesia, the Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine is recommended to prevent Monkeypox disease. The existence of the outbreak report is important to discuss, explore, and understand more about the disease and its management and prevention.
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