Ahmad Dahlan Medical Journal

A Consultation-Liaison Psychiatry Approach to Anxiety in a Patient with Multidrug-Resistant Tuberculosis: Case Report

2026-04-01T08:43:13+00:00

The interplay of social stigma, the grueling duration of treatment, and residual drug toxicities frequently triggers psychiatric comorbidities in multidrug-resistant TB (MDR-TB), which can severely compromise treatment adherence. We reported a 24-year-old female MDR-TB patient presented with escalating insomnia and severe anxiety. Her psychological distress followed the onset of physical complications three months prior, including peripheral paresthesia (tingling) and impaired mobility. These physical symptoms exacerbated her breathlessness and sleep disturbances. Following a referral to the psychiatry department, a Consultation-Liaison Psychiatry (CLP) framework was initiated. Through integrated psychiatric intervention and pharmacological dose adjustment for her MDR-TB regimen, the patient’s anxiety significantly diminished, and her physical side effects became manageable. The following evaluation of MDR-TB, both clinically and radiologically, showed improvement. The patient declared cured after a six-month duration of MDR-TB treatment. CLP provides a vital bridge in specialized care, addressing the depression, anxiety, and psychosis that often act as barriers to successful MDR-TB recovery.

BOWEL OBSTRUCTION DUE TO SIGMOID COLON ENTRAPMENT TO INTRAUTERINE AFTER CURETTAGE PROCEDURE

2025-10-07T03:51:44+00:00

Uterine perforation represents an uncommon yet potentially severe complication of uterine curettage, as it may involve intra-abdominal organs and result in life-threatening outcomes. Timely identification and appropriate management are essential to prevent serious morbidity. We report a 37-year-old woman who presented with abdominal distension, inability to pass gas, and absence of defecation three days after undergoing uterine curettage for retained placenta. Abdominal X-ray suggested large bowel obstruction. Exploratory laparotomy revealed sigmoid colon entrapment within a uterine perforation. The bowel was viable and successfully reduced, followed by uterine repair. The patient had an uneventful recovery and was discharged in good condition. Uterine perforation can manifest with delayed and nonspecific clinical signs, making diagnosis challenging. While the small intestine is more frequently affected, the occurrence of sigmoid colon entrapment within a uterine defect is exceptionally uncommon. Diagnostic imaging, particularly computed tomography (CT), can assist in identifying the condition; nevertheless, surgical exploration remains the gold standard for establishing the diagnosis and providing definitive management. This case highlights the need to consider uterine perforation accompanied by bowel incarceration in patients who develop bowel obstruction symptoms following curettage. Prompt diagnosis and early surgical management are essential to minimize complications and ensure optimal patient outcomes.

In Vitro Evaluation of Antibacterial Potential BioMint D-Spray Derived from Anredera cordifolia and Mentha spicata Extracts on Diabetic Wound Pathogens

2026-04-01T08:48:26+00:00

Diabetes mellitus is a metabolic disorder associated with a high risk of complications, particularly Diabetic Foot Ulcers (DFU). Indonesia recorded approximately 20.4 million diabetes cases in 2024, increasing the demand for effective and affordable wound care. Anredera cordifolia and Mentha spicata contain bioactive compounds including flavonoids, saponins, carvone, and phenolic acids with proven antibacterial and anti-inflammatory properties, making them promising natural candidates for diabetic wound management. This study employed a true experimental design using a combined extract of Anredera cordifolia and Mentha spicata leaves at a 1:1 ratio prepared via maceration. Phytochemical screening and pH testing were performed to characterize the extract. Antibacterial activity was assessed using the well diffusion method at concentrations of 60%, 70%, 80%, 90%, and 100%, followed by incubation for 12 and 24 hours and observed. Inhibition zone diameters were analyzed using the Shapiro-Wilk normality test followed by One-Way ANOVA at α = 0.05. Phytochemical analysis confirmed the presence of flavonoids, alkaloids, and tannins, with all concentrations exhibiting an acidic pH of 4.0. Antibacterial activity against Staphylococcus aureus was observed across all concentrations, with 60% established as the minimum inhibitory concentration (MIC). Inhibition zone diameters ranged from 14.20 mm to 15.40 mm across observation periods. The combined extract demonstrated intermediate antibacterial activity against Staphylococcus aureus based on CLSI standards, with inhibition zones of 14.20 to 15.40 mm compared to novobiocin (22 mm). No statistically significant difference was observed between concentrations. Further in vivo studies are recommended to evaluate pharmacological effects and optimal concentration in biological systems.

Hypertension Control and Cardiovascular Risk Profiles in Patients with Established Coronary Artery Disease: A Single-Centre Study

2026-03-01T22:16:11+00:00

Coronary artery disease (CAD) remains a leading cause of global morbidity and mortality, driven by interconnected risk factors such as hypertension, diabetes mellitus, smoking, obesity, and dyslipidemia. Effective management of these factors is essential in secondary prevention. This study aimed to compare the level of hypertension control with other cardiometabolic risk factors among CAD patients. Using a cross-sectional design, 40 CAD patients with multiple risk factors at Mitra Medika Amplas Hospital were assessed for hypertension control, smoking status, blood glucose regulation, achievement of ideal body weight, and dyslipidemia management based on clinical measurements and questionnaire data. Data were analyzed using descriptive statistics. Associations between risk factors and their level of control were assessed using the Chi-square test, with Fisher’s exact test applied when expected cell counts were small. Hypertension emerged as the most well-controlled risk factor, whereas blood glucose, body weight, and especially dyslipidemia showed poor levels of control. The study also found that an increasing number of coexisting risk factors correlated with progressively lower control of each individual factor. These findings underscore the need for more comprehensive, structured, and multidisciplinary risk-factor management to improve the effectiveness of secondary prevention in CAD patients.

COMPARISON OF PAIN PERCEPTION IN CATARACT SURGERY WITH PHACO- HORIZONTAL-CHOP TECHNIQUE VERSUS VERTICAL-CHOP TECHNIQUE IN GRADE 3 CATARACT

2026-04-04T01:57:32+00:00

Most cataract surgery is done by phacoemulsification method. Phacoemulsification cataract surgery with horizontal chop and vertical chop techniques is quite effective until now. In cataract surgery, generally used topical anesthetic pantocaine 0.5% (tetracaine 0.5%) to control pain in patients. This research aims to compare pain perception using a numeric rating scale in grade 3 cataracts operated by the phaco-horizontal-chop versus vertical-chop technique. This study is a comparative analytical study with a total of 87 subjects, consisting of 45 subjects undergoing surgery with the horizontal-chop technique, and 43 subjects with the vertical-chop technique. All patients were given the same topical anesthetic, pantocaine 0,5%. After the operation done, each subject will be asked about their pain perception using a numerical rating scale parameter. Then, the data were analyzed using univariate and bivariate analysis using chi-square. Among the 87 patients, mean pain scale in this study was 3.51, with a median value of 3.00. The minimum value of the pain scale was 1 while the maximum value was 6. The results showed that there was no significant relationship to pain experienced by patients undergoing phacoemulsification cataract surgery with the horizontal-chop technique compared with the vertical-chop (p = 1,000).