Journal Of The Indonesian Medical Association <p>Journal Of The Indonesian Medical Association (JInMA) atau Majalah Kedokteran Indonesia (MKI) merupakan jurnal ilmiah kedokteran yang berada dibawah naungan Pengurus Besar Ikatan Dokter Indonesia (PB IDI) dan jurnal terakreditasi Kemenristek DIKTI.&nbsp;</p> <p>MKI JInMA memuat beberapa tipe artikel yaitu artikel penelitian, laporan kasus,<em> evidence-based case reports</em> (EBCR), tinjauan pustaka, dan editorial.</p> <p>MKI JInMA saat ini terbit dengan frekuensi per dua bulan.&nbsp;</p> <p>&nbsp;</p> en-US (Evi Suprapti, S.E) (Evi Suprapti, S.E) Thu, 23 Sep 2021 15:42:00 +0700 OJS 60 The Role of Cerebral Oxygen Saturation Measured by Near-Infrared Spectroscopy (NIRS) in Evaluating Pediatric Shock Resuscitation Outcome <p>Shock in children remains public health importance and causes significant morbidity and mortality worldwide. Hypoperfusion in shock results in decreased oxygen delivery to the tissues, causing a shift from more efficient aerobic pathways to anaerobic metabolism, which results in lactate as the end product. Unlike blood lactate measurement, near-infrared spectroscopy (NIRS) monitoring system is safe and easy to use in measuring tissue oxygenation non-invasively. However, NIRS monitoring has yet to be validated against a standard measure of regional oxygenation. The primary objective of this article is to review the role of cerebral oxygen saturation (rSO<sub>2</sub>) measured by NIRS in evaluating the outcome of pediatric shock resuscitation.</p> Irene Yuniar, Arifah Nur Shadrina Copyright (c) 2021 Journal Of The Indonesian Medical Association Tue, 21 Sep 2021 11:36:59 +0700 Characteristics of Deep Vein Thrombosis Patients: Systematic Review <p><em><strong>Pendahuluan</strong>: Trombosis vena dalam (TVD) merupakan salah satu penyebab kematian terbesar di dunia. TVD memiliki faktor risiko yang bermacam-macam sehingga presentasi pasien TVD dapat berbeda pada tiap kelompok usia, jenis kelamin, dan ras. Penelitian ini bertujuan untuk memperoleh informasi mengenai karakteristik pasien thrombosis vena dalam.</em><br><em><strong>Metode</strong>: Penelitian ini menggunakan studi pendekatan kualitatif yang merupakan studi pustaka yang menggunakan buku-buku dan literatur-literatur lainnya sebagai objek utama. Penelitian ini menggunakan mesin pencarian, seperti Pubmed, Google Scholar, dan Clinical Key untuk mendapatkan jurnal-jurnal yang berkaitan dengan karakteristik pasien trombosis vena dalam.</em><br><em><strong>Hasil</strong>: Dari 17 literatur, ditemukan bahwa karakteristik pasien TVD berbeda pada tiap kelompok usia, jenis kelamin, dan ras. Semakin tua usia pasien, derajat keparahan TVD meningkat karena adanya kondisi lain yang biasanya muncul di usia lanjut. Laki-laki lebih rentan mengalami TVD dari perempuan tanpa faktor risiko reproduktif, seperti kehamilan dan menopause. Orang Afrika memiliki presentasi TVD lebih parah dibandingkan dengan ras lain. Risiko paling rendah ditemukan pada orang Asia, meskipun tidak ada perbedaan mortalitas yang signifikan antar ras.</em><br><em><strong>Kesimpulan</strong>: Karakteristik pasien TVD (angka kejadian, faktor risiko, lokasi, dan tingkat keparahan) bervariasi pada tiap kelompok usia, jenis kelamin, dan ras.</em></p> Ebenezer Verian Hutagalung, Teddy Arnold Sihite, Dimmy Prasetya Copyright (c) 2021 Journal Of The Indonesian Medical Association Tue, 21 Sep 2021 14:08:26 +0700 Diagnostic Test of Neutrofil-Lymphocyte Ratio In Acute Appendicitis In Zainoel Abidin General Hospital Banda Aceh <p><em><strong>Introductions</strong>: Acute appendicitis is an inflammation that occurs in the Vermiformis appendix. Inflammatory response to acute appendicitis is characterized by the activation of cellular and molecular effectors, including recruitment and activation of neutrophils. The Neutrophil Lymphocytes Ratio (NLR) is a comparison of neutrophil counts with lymphocytes used as a simple benchmark. </em><br><em><strong>Methods</strong>: we analysed with observational diagnostic test analytical design of retrospective cross sectional studies. The study subjects were acute appendicitis patients at Zainoel Abidin General Hospital in 2018-2019. Subjects upon arrival performed a blood test, and then calculated NLR, the result of NLR count compared to post-appendectomy anatomical pathology examination. The data is analyzed with descriptive statistical analysis, ROC curve analysis and diagnostic tests.</em><br><em><strong>Results</strong>: There were 176 samples was came to emergency room with diagnosed appendicitis, the most age was 17-25 years (31.2%), 81 male (46%), 95 female (54%). From patological anatomy result were 129 acute appendicitis and 47 chronic appendicitis. From the AUC ROC 0.96 obtained cut off point NLR &gt; 3,209 in acute appendicitis. Diagnostic tests obtained sensitivity 83,72% specificity 82,98%, positive guess value 97,71% and negative guess value 65,00% with 83,52% accuracy.</em><br><em><strong>Conclusion</strong>: we concluded NLR may predict diagnosis of acute appendicitis with NLR &gt; 3,209, sensitivity scores of 83,72% specificity 82,98%.</em></p> Idham Adyasa Manggala Putra, Dian Adi Syahputra, Muhammad Yusuf, Muntadhar Muhammad Isa, Safrizal Rahman, Jufriady Ismy Copyright (c) 2021 Journal Of The Indonesian Medical Association Tue, 21 Sep 2021 10:34:03 +0700 Sosiodemographic Analysis on The Mental Health Response of Mothers with Children Doing Distance Learning During COVID-19 Pandemic <p><em><strong>Introduction</strong>: The implementation of distance learning due to the COVID-19 pandemic has impacted not only the students but also parents especially mothers. This study was aimed to provide an overview of mothers’ mental health status (stress and anxiety) in Jabodetabek and its association with mother’s education level and occupation status, number of children, and number of children doing distance learning during the COVID-19 pandemic.</em><br><em><strong>Method</strong>: This was a cross-sectional study using an online questionnaire targeted to married women who have &gt;1 children in elementary school-high school doing distance learning in Jabodetabek. The data was collected in the period of 2-20 December 2020. Instruments used to measure stress and anxiety levels were PSS-10 and GAD-7.</em><br><em><strong>Results</strong>: There were 311 respondents aged between 27-61 years old. The average respondents had moderate stress and mild anxiety. The risk of severe stress increased significantly in mothers with elementary-middle education level (crude RR 2,1; 95%CI 1,04-4,4) and increased risk of moderate-severe anxiety in mothers with &gt; 3 children (crude RR 1,9; 95%CI 1,1-3,1).</em><br><em><strong>Conclusion</strong>: More than 50% of mothers with children in elementary school-high school in Jabodetabek had moderate stress and 31% showed signs of mild anxiety. The mother’s sociodemographic factor associated with the risk of severe stress was education level. The factor associated with moderate-severe anxiety risk was the number of children living under one roof.</em></p> Miranda Rachellina, Asri Chasanah Adisasmita Copyright (c) 2021 Journal Of The Indonesian Medical Association Mon, 20 Sep 2021 00:00:00 +0700 Close Reduction Percutaneous Pinning (CRPP) versus Open Reduction Internal Fixation (ORIF) for Pediatric Supracondylar Humerus Fractures Gartland Type II and III: A Systematic Review and Meta-analysis <p><em><strong>Introduction</strong>: Displaced supracondylar fracture in children is a challenging injury that may result in impaired functional and cosmetic outcome if not well-treated. Utilization of Closed Reduction and Percutaneus Pinning (CRPP) increased for this pathology, some authors believe ORIF results better anatomical reduction and lower rate of loss of reduction. Study aims to compare CRPP and ORIF for pediatric supracondylar humerus fracture. </em><br><em><strong>Method</strong>: Systematic review was conducted based on PRISMA guideline. Inclusion criteria were age &lt;18 years old, comparing CRPP and ORIF for Supracondylar Humerus Fractures Gartland Type II, II.</em><br><em>Studies of one surgical technique, Gartland type I, case reports were excluded. For meta-analysis, 6 studies were included and fixed effect model used to pool the result. In each study, mean difference (MD) with 95% confidence interval (CI) was calculated for dichotomous outcomes using Review Manager. </em><br><em><strong>Result</strong>: Total of 252 patients aged 0-15 years old were included. CRPP more often performed than ORIF. Satisfactory outcomes measured by Flynn’s criteria were achieved in 87.74% in CRPP and 86.73% in ORIF patient group, indicating significant difference (Heterogeneity, I2 = 23%; WMD, 1.26; 0.58 to 2.73; P =0.56). </em><br><em><strong>Conclusion</strong>: Current systematic review and meta-analysis suggest that for displaced supracondylar humerus fractures, ORIF offers a comparable functional and cosmetic outcome compared to CRPP.</em></p> Putu Astawa, Made Agus Maharjana, Surya Adisthanaya, Made Winatra Satya Putra, Agus Suarjaya Putra, Sherly Desnita Savio Copyright (c) 2021 Journal Of The Indonesian Medical Association Tue, 21 Sep 2021 00:00:00 +0700 Sheehan Syndrome with Recurring Hyponatremia, Myositis and Secondary Amenorrhea <p><em><strong>Introduction</strong>: Sheehan syndrome may arise after giving birth, which is caused by reduced pituitary perfusion due to low blood pressure during or after parturition. It has varied and unspecific symptoms. Early diagnosis and treatment is important to prevent death. </em><br><em><strong>Case report:</strong> We reported a case of 39 years old female with recurring hyponatremia, myositis and secondary amenorrhea, which were consistent with sheehan syndrome.<br></em><em><strong>Discussion</strong>: Patient had history of severe postpartum bleeding. She presented with hyponatremia, hypokalemia, and hypokalemia. This electrolyte imbalance might be caused by anterior pituitary hormones deficit, possible posterior pituitary hormones deficit, disturbance of adrenocortical and estrogen hormone. Increased creatinine kinase showed myositis, and possibly caused by herbal medication or other condition.<br></em><em><strong>Conclusion</strong>: In this case, the patient was getting well after given adequate electrolyte and hormone replacement, without steroid administration.</em></p> Luse Loe, Nanny Natalia Mulyani Soetedjo, Hikmat Permana Copyright (c) 2021 Journal Of The Indonesian Medical Association Mon, 20 Sep 2021 00:00:00 +0700 Functional Constipation in Children <p>constipation has a negative impact, both for the child and their family, because it can reduce the quality of life, as well as impact on health care costs. The diagnosis of functional constipation is based on Rome IV criteria. The prevalence of functional constipation is related to geography, dietary habits and types, and exposure to stressful life events for children. Although most constipation in children is functional, an organic disorder must be excluded by looking for any alarm signs.</p> Muzal Kadim Copyright (c) 2021 Journal Of The Indonesian Medical Association Tue, 21 Sep 2021 11:59:25 +0700