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> PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI) en-US Journal Of The Indonesian Medical Association 2089-1067 Optimizing Diabetes Mellitus Care As a Key to Prevent Severe COVID-19 <p><em>Coronavirus disease 2019 (COVID-19) is one of the leading health problems globally, including in Indonesia. The first case of COVID-19 in Indonesia was discovered on March 2nd 2020. From then until August 7th 2022, 6.244.978 cases of COVID-19 and 157.095 COVID-19-related death have been recorded. A high virus transmission rate, various clinical manifestations, morbidity and mortality caused by COVID-19 alerts clinician to notice some factors which can make a person vulnerable to COVID-19 and which factors contribute to severe COVID-19. Indonesia’s COVID-19 case fatality rate (CFR) is higher than the global CFR. COVID-19 mortality in Indonesia mainly occurs in patients with comorbidity, of which the most common is diabetes mellitus.</em></p> Luse Loe Ferius Soewito Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 105 108 10.47830/jinma-vol.72.3-2022-840 The Relationship of Risk Factors and Comorbidity with Chest Radiography Features of COVID-19 Confirmed Patients <p><em><strong>Introduction</strong>: COVID-19 is a worldwide health problem with a high mortality rate, especially in patients with risk factors. One type of examination to inspect the severity of COVID-19 patients is a chest radiograph. There is a lack of studies on chest radiography features in Indonesia. This study aims to observe the relationship between age, gender, and comorbid conditions with chest radiography features in COVID-19 confirmed.</em><br><em><strong>Method</strong>: This study was conducted at dr. Soebandi General Hospital uses a cross-sectional design with medical records as the instrument. Chest radiography examination was performed using BSTI classification. Meanwhile, data were analyzed using Chi-Square and contingency coefficient C.</em><br><em><strong>Result</strong>: The study included 173 patients: 52% were 40-59 years old, 36,4% were 20-39 years old, and 11,6% were ≥ 60 years old; 56,1% were female and 53,9% were male; 50,9% have comorbidities, with hypertension, diabetes, and COPD were the most type of comorbidities. About 48,6% sample had a normal chest radiograph, 27,7% had a mild severity, 17,3% had a moderate severity, and 6,4% had a severe severity. There was a correlation between age and comorbidity with chest radiography features. Otherwise, no correlation was found between sex and chest radiography features.</em><br><em><strong>Conclusion</strong>: Age and comorbidity were found as significant risk factors for the severity of chest radiograph in COVID-19 with a moderate correlation. However, no correlation was found between sex and chest radiography features.</em></p> Heni Fatmawati Zhafirah Rana Labibah Jauhar Firdaus Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 109 115 10.47830/jinma-vol.72.3-2022-629 Characteristic Of Acute Cerebrovascular Disease In COVID-19 Patients In Mardi Rahayu Hospital Kudus <p><em><strong>Introduction</strong>: Several studies have reported that in patients with Coronavirus Disease 2019 (COVID-19), in addition to manifesting abnormalities in the respiratory tract, it can also cause several neurological manifestations, including acute cerebrovascular disease. Acute cerebrovascular disease in COVID-19 is associated with worse manifestation and outcome; therefore, this study wanted to describe the characteristic of acute cerebrovascular disease in COVID-19 patients. The study aims to describe the characteristic of acute cerebrovascular disease in COVID-19 patients.</em><br><em><strong>Method</strong>: This study was a retrospective observational single-centre study by reviewing the electronic or physical medical records of confirmed COVID-19 patients admitted to Mardi Rahayu Hospital, Kudus from 1 March 2020 to 31 March 2021. The extracted data would be analyzed using the χ2 dan Kolmogorov-Smirnov test for categorical variables and the Mann-Whitney test for numerical variables.</em><br><em><strong>Result</strong>: From 1053 cases of confirmed COVID-19 that were studied, there were 50(4.7%) cases of acute cerebrovascular disease. Acute cerebrovascular disease patients had older age (57.5 (34-78) years vs 52 (1-88) years, p0.02), were more likely to have hypertension (39(78%) vs 357(35.5%), p&lt;0.01), diabetes 31 (62%) vs 383 (38.2%), p=0.01), and prior cerebrovascular disease (11(22%) vs 8(0.8%), p=0.028), had more severe clinical manifestation (32(64%) vs 379(37.8%), p&lt;0.01), and had worse outcome (22(44%) vs 218(21.7%), p=0.01). </em><br><em><strong>Conclusion</strong>: We found that cerebrovascular disease in COVID-19 patients had worse outcomes and clinical manifestation; therefore, management of these cases is better done more cautiously.</em></p> Ivan Agusta Dwi Kristiawan Milka Ardena Lianto Lie Fenny Lanawati Yudiarto Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 116 123 10.47830/jinma-vol.72.3-2022-734 The Relationship Of Hypercoagulation And Mortality In Hospitalized Confirmed Patients Corona Virus Disease-19 (Covid-19) <p><em><strong>Introduction</strong>: The clinical manifestations of COVID-19 vary from asymptomatic to symptomatic. COVID-19 patients with severe symptoms often have coagulation disorders similar to systemic coagulopathy. This is associated with a significant increase in mortality. The purpose of this study was to determine the relationship between hypercoagulation and death in hospitalized patients with confirmed COVID-19.</em><br><em><strong>Method</strong>: This research is an analytic observational, quantitative approach with a cross sectional research design. The method of collecting secondary data comes from medical record data on inpatients who have confirmed COVID-19 at the Islamic Hospital in Jakarta Sukapura, by total sampling.</em><br><em><strong>Result</strong>: There are 625 research subjects. Most of the subjects were women (52.3%) at the age of 50-59 years (26.6%). The status of living patients was (98.9 %). The value of D dimer tends to increase, the value of PT is normal, and the value of APTT is normal. The Case Fatality Rate (CFR) in the subject was 0.0112% (CFR &lt; 4.35% = low CFR). </em><br><em><strong>Conclusion</strong>: There is a low CFR in hospitalized patients with confirmed COVID-19 at RSIJ Sukapura. The results of the examination on the parameters of coagulant agents based on patient status in hospitalized patients who were confirmed to be COVID-19 at RSIJ Sukapura, on the D-dimer and APTT parameters there was no significant relationship, while on the PT parameter there was a significant relationship.</em></p> Muhammad Fachri Faidah Farihatul Fajriyah Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 124 131 10.47830/jinma-vol.72.3-2022-793 Career In Forensic Medicine: Today And Future’s Perspectives <p><em><strong>Introduction</strong>: The lack of experts in forensic medicine will become a serious problem globally in the future. In Indonesia, the unique position of forensic medicine at the intersection between medicine and law itself means that the role of forensic doctors can still expand widely. The future development of forensic medicine in Indonesia is determined mainly by forensic doctors and prospective forensic doctors themselves. Therefore, this study aims to determine the motivation of doctors in choosing the specialty of forensic medicine and their views on work as forensic doctors. </em><br><em><strong>Methods</strong>: This is a cross-sectional descriptive observational research using mixed methods, with forensic doctors and residents as respondents. </em><br><em><strong>Result</strong>: The results show that 17.8% chose forensic medicine because of their interests and 11.1% because they considered forensic medicine to be a challenging specialty. The absence of scholarships, the lack of institutional and family support, the lack of number and variety of cases in various educational centers, and the limited supporting facilities and financing of forensic medical services are the main obstacles for forensic doctors. </em><br><em><strong>Conclusion</strong>: Regeneration is needed to meet the need of forensic doctors in various regions in Indonesia by spreading information about the importance of forensic medicine. Good coordination between forensic experts, the Indonesian Forensic Doctors Association (PDFI), other professional organizations, and relevant stakeholders is needed to overcome various obstacles and ensure the growth of forensic medicine in Indonesia.</em></p> Noverika Windasari Citra Manela Sani Tanzilah Putri Dianita Ika Meilia Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 132 138 10.47830/jinma-vol.72.3-2022-680 Respiratory Rehabilitation Management in Adult Neglected Spinal Muscular Atrophy Type II Patient: A Case Report <p><em><strong>Introduction</strong>: Physical Medicine and Rehabilitation Specialists (Physiatrists) usually take care of patients with Spinal Muscular Atrophy Type II in an early childhood. The progression of respiratory dysfunction should be considered as the most disabling condition in patient with Spinal Muscular Atrophy Type II and need further respiratory rehabilitation approaches.</em><br><em>This case describes an adult Spinal Muscular Atrophy Type II that is considered a late or neglected case as a lost case in the management of respiratory rehabilitation but his remain functional reserve must be optimized to reach a manageable respiratory outcome in daily living.</em></p> Laras Hapsari Siti Chandra Widjanantie Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 139 143 10.47830/jinma-vol.72.3-2022-306 Role Of Mammography In Breast Cancer Screening: A Literature Review <p><em>Breast cancer is the most common cancer among women in Indonesia. The cure rate can be increased by early detection and appropriate therapy. The early detection modality recommended by WHO is screening mammography. The aim of this study was to determine the role and advantages &amp; disadvantages of mammography compared to other modalities through narrative literature review with 30 literature that met the inclusion and exclusion criteria. The advantages of screening mammography are reducing mortality, increasing early treatment, and improving the quality of diagnostics as a follow-up to the results of screening. The disadvantages of this modality are overdiagnosis, false alarm, interval cancer, and radiation risk. Screening mammography can be combined with other modalities to increase accuracy such as MRI in high-risk women and ultrasound in women with denser breasts. The recommendation to initiate routine screening mammography at one year is 40 years. Barriers that often occur in lower middle-income countries are lack of knowledge &amp; awareness, unavailable infrastructure &amp; resources, accessibility, inadequate costs and the persistence of fear and shame. Therefore, the benefits of screening outweigh the risks and can be combined with other modalities to increase accuracy.</em></p> Hari Soekersi Yohana Azhar Kiran Shadentyra Akbari Copyright (c) 2022 Journal Of The Indonesian Medical Association 2022-08-30 2022-08-30 72 3 144 150 10.47830/jinma-vol.72.3-2022-627