Sriwijaya Journal of Medicine

Comparison of The Efficacy of Single Antibiotic Ear Tampon Versus Combination Antibiotic–Steroid Ear Tampon in Patients with Acute Diffuse Otitis Externa

2026-01-25T02:16:07+00:00

Acute diffuse otitis externa is an acute inflammatory condition of the external auditory canal commonly associated with otalgia and ear canal oedema. Standard management includes aural toilet, pain control, and topical antimicrobial therapy, which may be administered using ear tampons with or without corticosteroids. This study aimed to compare the effectiveness of single-antibiotic ear tampons versus antibiotic–steroid combination ear tampons in reducing pain and ear canal oedema in patients with acute diffuse otitis externa. This double-blind randomized controlled clinical trial analyzed 40 patients with acute diffuse otitis externa who completed follow-up and were assigned to receive either single-antibiotic ear tampons or antibiotic–steroid combination ear tampons. Pain intensity was assessed using the Visual Analog Scale, and ear canal oedema was evaluated using the Brighton scale at baseline and on days 1, 3, and 5 after tampon insertion. Longitudinal analysis was performed using repeated-measures models. Both treatment groups demonstrated significant improvement in pain and oedema over time. However, longitudinal analysis showed that the antibiotic–steroid combination group experienced a significantly faster reduction in pain than the single-antibiotic group, whereas the trajectory of oedema improvement did not differ significantly between groups. Multivariable longitudinal analysis confirmed that treatment type and baseline pain severity were associated with pain outcome, while baseline oedema severity was strongly associated with oedema outcome. Both treatment regimens were effective over time, but antibiotic–steroid ear tampons provided faster pain relief, while oedema improvement remained comparable between groups.

Factors Associated with the Types of Chronic Suppurative Otitis Media

2026-02-16T10:29:11+00:00

Chronic Suppurative Otitis Media (CSOM) is a common condition of the middle ear that may lead to serious complications if not properly managed. Several environmental and host-related factors are believed to influence the clinical presentation of CSOM. However, evidence examining their association with specific CSOM subtypes remains limited. This research was conducted to examine factors associated with different types of CSOM. A cross-sectional analytical approach was applied at Dr. Mohammad Hoesin General Hospital, Palembang, during July–September 2025, with a total of 68 CSOM patients participating in the study. Data on age, sex, cigarette smoke exposure, history of upper respiratory tract infections (URTIs), and allergic rhinitis were collected using structured interviews. The CSOM type was determined through otoscopic examination. The chi-square test was applied for bivariate analysis, and multivariable logistic regression analysis was performed to obtain adjusted odds ratios (aOR). Cigarette smoke exposure (aOR = 8.28; 95% CI: 1.85–37.01) and allergic rhinitis (aOR = 5.73; 95% CI: 1.31–24.99) were significantly associated with the atticoantral type of CSOM, whereas recurrent URTIs showed a positive association that was not statistically significant after controlling for other variables. (aOR = 2.64; 95% CI: 0.59–11.80). The results of this study imply that cigarette smoke exposure and allergic rhinitis are significantly associated with the atticoantral type of CSOM, while recurrent URTIs may act as a contributing factor.

Correlation Between Serum BDNF Levels and Specific Cognitive Domains of MoCA-Ina in Elderly with Mild Cognitive Impairment: An Exploratory Study

2026-04-02T06:41:43+00:00

Brain-Derived Neurotrophic Factor (BDNF) decline is closely linked to Mild Cognitive Impairment (MCI) in the elderly. However, sociodemographic variables frequently confound this neurobiological relationship. This study evaluates the correlation between baseline serum BDNF levels and specific MoCA-Ina cognitive domains in MCI patients, adjusting for age and educational background. This exploratory cross-sectional study included 30 MCI subjects (≥60 years) at Dr. Mohammad Hoesin General Hospital. Serum BDNF was quantified via ELISA. Cognitive performance was measured across seven MoCA-Ina domains. Data were analyzed using Spearman’s rank and non-parametric partial correlations. The initial unadjusted analysis showed no significant correlation between BDNF and total MoCA-Ina scores (r = 0.282, p = 0.131). However, statistically controlling for age and education revealed a significant moderate positive correlation (r = 0.428, 95% CI 0.07–0.69, p = 0.023). Domain-specific analysis demonstrated a significant positive correlation exclusively in the Abstraction domain (r = 0.392, 95% CI 0.02–0.67, p = 0.039). Adjusting for age and cognitive reserve unmasks a significant positive correlation between baseline serum BDNF, global cognition, and abstraction performance in MCI. Peripheral BDNF represents a potential biomarker for prefrontal cognitive dynamics when sociodemographic confounders are properly integrated.

Potential of Rosella Extract (Hibiscus sabdariffa L.) to Herbal Medicine: Focus on Body Weight, Islets Langerhans Cells Count, and Relative organ weight in Diabetes Mellitus Rats

2026-04-14T14:25:56+00:00

The Rosella (Hibiscus sabdariffa L.), is useful as an antidiabetic, but research reports on relative body weight, Islets of Langerhans cells, and relative organ weight are still limited. To investigate the potential of Rosella extract to herbal medicine in rat models of diabetes mellitus as confirmed in body weight, Islets of Langerhans cells, and relative organ weight. Thirty adult male Rattus novergicus L. rats divided into 6 main groups, as a normal control group (KN), a negative control group (K-) induced by alloxan, a positive control (K+) induced by alloxan and glibenkamid, and 3 treatment groups given alloxan and Rosella extract at doses of 15% (P1), 30% (P2), and 60% (P3). All rats were weighed until the end of the treatmen for 14 days. On the last day, we collected the relative weighed of liver and kidneys organ, also the histopatological islet Langerhans cells count. Data were analyzed univariately to describe the effect Rosella extract on the study variables. The body weight are tended to increase but was still within in normal range for rat body weight. The Islet Langerhans cells count value was highest in the treatment group with a 30% dose of 2396.6. Meanwhile, the relative weight of the kidney and liver organs in all groups given Rosella extract tended to be the same as the normal group. The Rosella extract has the potential as a herbal medicine through confirmation of normal body weight, islet Langerhans cell count, kidney and liver relative weight in rats diabetes mellitus models.

Association Between Remnant Cholesterol, Non-HDL Cholesterol, and HbA1c in Statin-Treated Patients with Type 2 Diabetes Mellitus

2026-05-11T07:31:45+00:00

Type 2 diabetes mellitus (T2DM) is strongly associated with an increasing risk of cardiovascular complications and is often paired with atherogenic dyslipidemia. Remnant cholesterol (RC) and non-high-density lipoprotein (non-HDL) cholesterol are increasingly recognized as markers reflecting the entire burden of atherogenic lipoproteins. Nevertheless, how these parameters relate to each other and to glycemic control remains insufficiently explored. This was a cross-sectional research designed to assess the correlation between RC and non-HDL cholesterol, along with their association with glycemic status in patients with T2DM. A cross-sectional study was conducted using secondary clinical data obtained from medical records of patients attending the Integrated Diabetes Clinic of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, between November and December 2025. All participants were receiving statin therapy. Remnant cholesterol was calculated as total cholesterol minus LDL cholesterol minus HDL cholesterol, whereas non-HDL cholesterol was calculated as total cholesterol minus HDL cholesterol. Correlation analysis was performed using Spearman’s rank correlation coefficient because all variables showed non-normal distributions. A total of 100 participants were analyzed. The results showed a moderate positive correlation between remnant cholesterol and non-HDL cholesterol (r = 0.618; p < 0.001). Conversely, no statistically significant correlation was identified between HbA1c and non-HDL cholesterol (r = –0.180; p = 0.074). These findings indicate that remnant cholesterol was positively correlated with non-HDL cholesterol, whereas HbA1c was not. Because RC and non-HDL cholesterol share calculated lipid components and all participants were receiving statin therapy, these findings should be interpreted cautiously.

Antimicrobial Prescribing Profile at the Dermatovenereology Outpatient Clinic of Universitas Sebelas Maret Hospital Surakarta from August to December 2024

2026-05-17T11:14:35+00:00

Antimicrobial agents, both topical and systemic, are commonly used in dermatology for the management of infectious skin diseases. Data regarding antimicrobial prescribing patterns in dermatovenereology outpatient settings in Indonesia remain limited. This study aimed to describe the antimicrobial prescribing profile at the Dermatovenereology Outpatient Clinic of Universitas Sebelas Maret Hospital, Surakarta. A retrospective descriptive study was conducted using electronic medical records and outpatient pharmacy data. Prescriptions containing antimicrobial agents issued at the Dermatovenereology Outpatient Clinic of Universitas Sebelas Maret Hospital between August and December 2024 were analyzed. Of 2,383 dermatovenereology outpatients, 510 (21.4%) received an antimicrobial agent. Topical antimicrobials were prescribed more frequently than systemic antimicrobials. The most commonly prescribed topical antimicrobials were 2% mupirocin cream (42.94%), 0.1% gentamicin cream (23.14%), and 2% fusidic acid cream (7.06%). Among systemic antimicrobials, azithromycin was the most frequently prescribed (13.3%), followed by cefixime (5.69%), metronidazole (2.75%), clindamycin (1.96%), doxycycline (1.76%), and cefadroxil (1.37%). Antimicrobial prescribing at the Dermatovenereology Outpatient Clinic of Universitas Sebelas Maret Hospital was dominated by topical antimicrobial agents, particularly 2% mupirocin cream and 0.1% gentamicin cream, while azithromycin was the most frequently prescribed systemic antimicrobial. These findings provide baseline data for monitoring antimicrobial use and may support antimicrobial stewardship initiatives in dermatology practice.

Correlation Between Prematurity and Abnormal Hearing-Screening Outcomes in a Tertiary Pediatric Population: A Retrospective Study

2026-07-23T23:27:06+00:00

Prematurity is a recognized risk factor for neonatal hearing impairment, but its independent contribution may be difficult to distinguish from coexisting neonatal morbidities and intensive-care exposures. This study aims to assess the association between prematurity and abnormal hearing-screening outcomes and to describe the distribution of abnormal outcomes according to selected perinatal risk factors. This retrospective observational study included 349 participants who underwent otoacoustic emissions and/or auditory brainstem response testing. Participants were classified according to gestational age at birth as preterm (<37 completed weeks) or term (≥37 completed weeks). An abnormal outcome was defined as a “refer” result in either ear on either test. Groups were compared using the chi-square test and odds ratio (OR). Of 349 participants, 240 (68.8%) were born preterm and 109 (31.2%) were born at term. Overall, 169 participants (48.4%) had an abnormal hearing-screening result. The proportion was 45.8% (110/240) among premature participants and 54.1% (59/109) among term participants, with no significant difference (χ²=1.746; p=0.186; OR=0.72, 95% CI 0.45–1.13). High proportions of abnormal screening outcomes were observed among participants with documented ototoxic drug exposure (13/13, 100%), asphyxia (27/36, 75.0%), and hyperbilirubinemia (13/19, 68.4%). Prematurity alone was not associated with abnormal early hearing-screening outcomes in this high-risk population. The high referral rate supports universal screening and targeted audiological follow-up, particularly for participants with ototoxic exposure, asphyxia, or hyperbilirubinemia.

Nutritional Status Profile in Children with Acyanotic Congenital Heart Disease: Analysis of Relationship with Diagnosis and Defect Size

2026-07-23T23:26:48+00:00

Congenital heart disease (CHD) occurs in approximately 9 per 1,000 live births and can impair growth due to chronic hemodynamic burden, feeding difficulties, and increased energy demands. This study aimed to describe the nutritional status of children with acyanotic CHD and assess its relationship with diagnosis and defect size. A cross-sectional analytical study was conducted involving 34 children with patent ductus arteriosus (PDA) or ventricular septal defect (VSD) scheduled for transcatheter closure. Nutritional status was determined using anthropometric measurements, while defect size was assessed by 2D echocardiography. Associations were analyzed using Spearman correlation and Kruskal-Wallis tests. Of the 34 subjects, 58.8% (n=20) had good nutritional status, 29.4% (n=10) were undernourished, and 11.8% (n=4) had severe malnutrition. Malnutrition was slightly more common in VSD (50.0%) than PDA (37.5%). Defect size ranged from 2.0–7.0 mm, with a median of 5.0 mm, and most defects were classified as small to moderate. Median defect sizes were 5.0 mm in both the good nutritional status and undernutrition groups and 4.5 mm in the severe malnutrition group, with no significant difference (p=0.549). Nutritional status was also not significantly correlated with absolute defect size (ρ=0.128; p=0.473). Although most children had good nutritional status, malnutrition remained prevalent (41.2%). These findings suggest that malnutrition in CHD is multifactorial and cannot be explained solely by the anatomical diameter of the defect.

Drug Utilization Pattern Study of Magnesium Sulphate In Pregnant Patients with Preeclampsia at Mohammad Hoesin Hospital, Palembang

2026-07-12T01:35:42+00:00

Preeclampsia is a hypertensive disorder of pregnancy characterized by systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg on two measurements taken at least 4 hours apart after 20 weeks of gestation, accompanied by new-onset proteinuria. Preeclampsia with severe features may progress to eclampsia. Magnesium sulphate is recommended for seizure prophylaxis because of its effectiveness and relatively low risk of serious neonatal adverse effects. This study aimed to evaluate the appropriateness of magnesium sulphate prescribing in pregnant women with preeclampsia at Mohammad Hoesin Hospital Palembang based on predefined prescribing indicators. This descriptive drug utilization study was conducted from August to September 2024 using total sampling of medical records that met the inclusion criteria, resulting in 45 samples. Data were analyzed using SPSS version 27.0 for MacOS and presented as frequency distributions. The prevalence of preeclampsia was 77.46%. All patients had preeclampsia with severe features (100%); most were housewives (68.9%), multiparous (55.5%), multigravida (80%), and had a gestational age ≥34 weeks (71.1%). Magnesium sulphate use was appropriate regarding indication (100%), dosage regimen (100%), duration of administration (100%), and absence of contraindications (100%). Eighteen patients (40%) received concomitant nifedipine, while 27 patients (60%) had no identified potential drug interactions. Overall, magnesium sulphate uses in pregnant women with preeclampsia at Mohammad Hoesin Hospital Palembang met the evaluated rational drug use criteria.

Laparoscopic Management of a Translocated Intrauterine Device in a Postmenopausal Woman: A Case Report

2025-10-23T02:01:01+00:00

Intrauterine device perforation is rare, yet remains one of the most serious complications of long-term IUD (Intrauterine Device) use. Although extrauterine migration has been reported in multiple pelvic and abdominal structures, chronic migration in postmenopausal women with very long retention periods is uncommon. We present a distinctive case involving a 60-year-old female patient who has retained a copper-T intrauterine device for a duration of 19 years without any subsequent medical follow-up and has been in a postmenopausal state for the past 17 years. She presented with a one-month history of abdominal pain. Ultrasonography and abdominal radiography demonstrated the absence of the device within the uterine cavity. Diagnostic laparoscopy elucidated the presence of the intrauterine device penetrating the posterior uterine wall and exhibiting a strong adherence to the right fallopian tube, extending towards the fimbriae, accompanied by substantial adhesions associated with copper. The device was successfully removed via laparoscopic adhesiolysis. This case highlights an unusual presentation of extrauterine IUD migration in which the strings remained visible at the external cervical os despite perforation and adnexal adhesion. Postmenopausal uterine atrophy, myometrial thinning, and the chronic inflammatory response induced by copper likely contributed to progressive erosion and adhesion formation. Current WHO and ACOG recommendations advise the removal of all migrated IUDs regardless of symptoms to prevent complications. The present case demonstrates that ongoing surveillance after IUD insertion and removal of the device following menopause is essential to prevent delayed perforation, chronic migration, and complex surgical retrieval.