Sanus Medical Journal <p style="text-align: justify;"><strong>SMJ (Sanus Medical Journal) </strong>is a peer-reviewed medical and health journal published by the Faculty of Medicine, Muhammadiyah Prof. DR. HAMKA University, Jakarta. <strong>SMJ </strong>publishes articles in the fields of Medicine, Health, Medical and Health Education, and Islamic Medicine. The scope of <strong>SMJ</strong> goes beyond the boundaries of discussions in the fields of clinical medicine and health in general, by providing new insights into etiologies, determinants, distribution, management and prevention of diseases in individuals and communities.</p> en-US (Fauzano Rahmatul Mukhlisin, S.Hum) (Imaduddin, Amd) Mon, 28 Feb 2022 00:00:00 +0000 OJS 60 Karakteristik Mutasi EGFR pada Pasien Kanker Paru Jenis Adenokarsinoma yang Diterapi dengan Tyrosien Kinase Inhibitor (TKI) di Rumah Sakit Paru Dr. H.A Rotinsulu Bandung <p><em>This descriptive study describes the proportion of Epidermal&nbsp;</em><em>Growth Factor Receptor (EGFR) mutations in lung cancer&nbsp;</em><em>Adenocarcinoma patients at Rumah Sakit Paru (RS Paru) Dr. H.&nbsp;</em><em>A Rotinsulu Bandung in the range of 2018 to 2020.&nbsp;</em></p> <p><em>EGFR mutations were examined using RGQ thera screen&nbsp;</em><em>technology Real"‘Time Polymerase Chain Reaction from FFPE&nbsp;</em><em>or cytology smear.</em></p> <p><em>There are 44 data point mutations after examining the EGFR&nbsp;</em><em>mutation. 59% cases were 40"‘60 years old group dan 52 % were&nbsp;</em><em>female.</em></p> <p><em>It was found that in this group 86% patient with single mutation&nbsp;</em><em>and 16% had doube mutations. EGFR mutations occurred in&nbsp;</em><em>Exon 21 L858R in 13 cases (30 %), Exon 21 L861Q in 1 case&nbsp;</em><em>(2%), Exon 19del in 24 cases (55%), double mutation Exon 19&nbsp;</em><em>and Exon 20 T790M type in 2 cases (4%), double mutation Exon&nbsp;</em><em>19del and Exon 21 in 4 cases (9%).</em></p> Desi Puspita, Vitri Dwi Astuti, Rina, Edi Sampurno Copyright (c) 2022 Sanus Medical Journal Mon, 28 Feb 2022 00:00:00 +0000 A Rare Case of Metaplastic Breast Carcinoma with Squamous Differentiation in Young Female: A Case Report <p><strong>Background.</strong> Metaplastic breast carcinoma is a very rare breast cancer, only about 0.2"‘1% of all invasive breast carcinomas. The prognosis of these cancer is poor and aggressive, reported to have lower response rates to conventional adjuvant chemotherapy and a worse clinical outcome after chemotherapy than other forms triple"‘negative breast carcinomas. Histopathologically, metaplastic breast carcinoma has distinct patterns with different outcomes. Among the types of metaplastic carcinoma, squamous cell, high grade spindle cell and high grade adenosquamous carcinoma are associated with the worst prognosis. We report one case of metaplastic breast carcinoma with squamous differentiation in young patient.</p> <p><strong>Methods.</strong> We examined the breast tumor tissue of a female patient, evaluated the macroscopic and microscopic features and asked the patient about the clinical course of the disease. Inform consent was obtained from the patient for publication of this case report and accompanying images.</p> <p><strong>Results.</strong> We reported a young female patient with final diagnosis of pathology Mixed Infiltrating Duct Carcinoma of No Special Type Grade 3 and Metaplastic Breast Carcinoma with Squamous Differentiation (30%) that has invaded fat tissue with Ductal Carcinoma Insitu of High Nuclear Grade 3 with basis of the operation is still positive for the tumor mass. Patients lost follow"‘up and did not continue therapy.</p> <p><strong>Conclusion.</strong> Morphology of metaplastic breast carcinoma are important factors influencing patient outcome. Early diagnosis and wide local excision of the squamous"‘type metaplastic breast carcinoma mass can make a better prognosis.</p> Rohana Agustina Copyright (c) 2022 Sanus Medical Journal Mon, 28 Feb 2022 00:00:00 +0000 Laporan Kasus Karsinoma Sel Skuamosa yang Berkembang dari Papiloma Tipe Inverted Sinonasal pada Pekerja Pabrik Cermin <p><strong>Background.</strong> Sinonasal inverted (PI) papilloma is a benign tumor of the mucosal epithelium of the nasal cavity and paranasal sinuses with an endophytic growth pattern. PI is more common in men in the fifth and sixth decades of life. These tumors have local aggressive behavior, high recurrence rates, and can undergo malignant transformation. Squamous cell carcinoma (SCC) is the most common malignancy developed from sinonasal PI. SSC developed from PI (KSS/PI) is related to exposure in the work environment.</p> <p><strong>Methods.</strong> We report a sinonasal SCC/PI case by describing the clinical manifestations, radiological features, and histopathological features of a young male patient who was a non"‘smoker mirror"‘making factory worker.</p> <p><strong>Results.</strong> Clinical manifestations of pain, epistaxis, and proptosis in patients suggest malignancy. Computed Tomography (CT) results showed lesions of the nasal cavity and paranasal sinuses with bone destruction and expansion of the mass to the intracranial point of the aggressive behavior of the tumor. Microscopic histopathological examination revealed endophytic squamous epithelial growth characteristic of an inverted papilloma accompanied by cell atypia, invasive components, connective tissue desmoplasia, and keratin pearls, suggesting a well"‘differentiated keratinized squamous cell carcinoma that developed from the sinonasal inverted papilloma. Exposure to dust in the work environment is related to malignancy in this patient.</p> <p><strong>Conclusion.</strong> Support of clinical and radiological data, adequate sampling, and identification of malignancy morphology routinely on histopathological examination is critical to avoid misdiagnosis of sinonasal SCC/PI. A complete history directed at extracting risk factors can add value in establishing a diagnosis.</p> Fety Riani, Ita Marlita Sari Copyright (c) 2022 Sanus Medical Journal Mon, 28 Feb 2022 00:00:00 +0000 Narrow distance inter-pregnancies increase the incidence of Post-Partum hemorrhage <p><strong>Background and Aims.</strong> Maternal Mortality Rate (MMR) is the parameters of women's health status in community. The single most common cause of maternal mortality is obstetric haemorrhage, generally occurring postpartum. Most postpartum haemorrhage cases are caused by uterus atony, myometrium tonus loss, placenta retention, and clotting disorders. Short pregnancy intervals can cause threefolds of anaemia than normal pregnancy intervals. Pregnant women who suffer from anaemia has the possibility experiencing a postpartum bleeding caused by atonia uteri. This research aims to acknowledge the effect of narrow distance interpregnancy on a postpartum haemorrhage.</p> <p><strong>Methods.</strong> This study uses an observational analytic study with a cross"‘sectional design. The data used is secondary data of pregnant women based on medical record to calculate the distance of interpregnancy with the incidence of postpartum bleeding during childbirth at Budhi Asih General Hospital of East Jakarta. The inclusion criteria are women who underwent childbirth during 2017"‘2018, multiparity, and postpartum women between 20"‘35 years old. The exclusion criteria are women with a history of postpartum haemorrhages caused by placental retention, tear of the reproductive tract or blood coagulation), gemelli parturition, macrosomia, assisted&nbsp;childbirth, grande multiparity, induction childbirth, and&nbsp;dystocia.</p> <p><strong>Results.</strong> The number of samples used in this study amounted to 111 people. Postpartum haemorrhage are significantly associated with short interpregnancy intervals (p=0,000).</p> <p><strong>Conclusion.</strong> Narrower pregnancy interval will leads to postpartum haemorrhage. To prevent this, it is important to consider contraception utilization, to improve iron consumption for pregnant women, and to provide decent antenatal care.</p> Nadhira Farah Puspitasaria, Irmiya Rachmiyani Copyright (c) 2022 Sanus Medical Journal Mon, 28 Feb 2022 00:00:00 +0000 Pengaruh Nyeri Kronik dalam Penurunan Fungsi kognitif <p>Nyeri merupakan gejala yang sering dikeluhkan&nbsp;masyarakat, Di Indonesia sendiri nyeri kronik adalah alasan&nbsp;paling umum pasien untuk berkunjung ke klinik rawat jalan.&nbsp;Nyeri kronik merujuk pada nyeri yang berkelanjutan lebih dari&nbsp;tiga bulan. Penyebab nyeri kronik tersering adalah nyeri&nbsp;punggung bawah kronik, diikuti oleh nyeri leher kronik,&nbsp;migrain, osteoartritis, gangguan muskuloskeletal lainnya, nyeri&nbsp;kepala akibat penggunaan obat yang berlebihan, dan&nbsp;polineuropati diabetikum</p> <p>Prevalensi nyeri kronik meningkat seiring dengan&nbsp;bertambahnya usia. Nyeri kronik merupakan masalah kesehatan di seluruh dunia, mempengaruhi 19% orang dewasa&nbsp;Eropa dan 20,4% di Amerika Serikat.&nbsp;</p> <p>Keluhan subjektif pasien nyeri kronik dari berbagai&nbsp;penelitian menunjukkan bahwa nyeri kronik dikaitkan dengan defisit kognitif. Pada pasien nyeri kronik terjadi interaksi antara&nbsp;nyeri dan fungsi kognitif secara lebih kompleks. Hal ini&nbsp;menyebabkan gangguan fungsi otak yang berkembang&nbsp;mengikuti progresi dari nyeri kronik. Pada nyeri kronik&nbsp;dijumpai aktifitas neuron yang berlebihan, disfungsi jaringan&nbsp;dan pengurangan volume grey matter. Kehilangan grey matter&nbsp;dijumpai dalam amigdala, korteks entorinal girus hipokampus,&nbsp;girus singulata anterior, thalamus dan insula.</p> <p>Hubungan antara nyeri kronik dan penurunan fungsi&nbsp;kognitif selayaknya diperhatikan lebih lanjut dikarenakan memiliki implikasi terhadap fungsi dan kualitas hidup individu. Berbagai penelitian menunjukkan hasil hubungan signifikan&nbsp;terbalik penurunan dari atensi, memori, proses informasi dan&nbsp;fungsi eksekutif pada pasien dengan nyeri kronik.</p> Fahreza Arraisyi, Yudhisman Imran Copyright (c) 2022 Sanus Medical Journal Mon, 28 Feb 2022 00:00:00 +0000