Majalah Kedokteran Sriwijaya

RAPIDLY PROGRESSIVE MENINGEAL MELANOMATOSIS PRESENTING DURING PREGNANCY: A RARE AND AGGRESSIVE ENTITY

Yunni Diansari — 2026-01-30

Meningeal melanomatosis is an extremely rare and aggressive melanocytic neoplasm of the central nervous system characterized by diffuse leptomeningeal involvement. Its occurrence during pregnancy is exceptionally uncommon and presents significant diagnostic and therapeutic challenges. A 39-year-old woman at 15 weeks of gestation presented with progressive headache and left-sided weakness. Brain MRI revealed a right frontal extra-axial mass with surrounding edema and subfalcine herniation. Surgical resection was performed due to neurological deterioration. Histopathological and immunohistochemical analysis confirmed malignant melanoma (S100-positive, HMB-45-positive, high Ki-67 index). Postoperative MRI demonstrated residual extra-axial mass suspicious for meningeal melanomatosis. Focal radiotherapy (20 Gy) was administered. The patient subsequently experienced spontaneous preterm delivery. Four months later, bilateral breast metastases were identified. Progressive neurological decline occurred, and the patient died eight months after initial diagnosis.Meningeal melanomatosis during pregnancy represents a rare and highly aggressive condition with poor prognosis despite multimodal treatment.

Keywords: Meningeal melanomatosis; Pregnancy; melanoma

ANIMATED VIDEOS' IMPACT ON INCREASING ANEMIA KNOWLEDGE

Toto Harto — 2026-01-30

Anemia is a global health problem caused by iron deficiency in adolescent girls. Health education using educational media such as animated videos is an effective method for improving students' understanding of anemia. This study aims to determine the effect of female students' knowledge on the effectiveness of animated videos about anemia. A quasi-experimental design with a pre-test and post-test approach was used. The research sample consisted of 47 people selected through total sampling. Data were collected using questionnaires to measure knowledge levels before and after the animated video intervention. Data analysis was performed using a paired t-test to determine the difference in knowledge levels before and after the intervention. The results showed a significant increase in students' knowledge levels after the animated video intervention (p value = 0.000). This indicates that animated videos are an effective educational medium for improving students' understanding of anemia. These findings also show that audiovisual media can attract students' attention and improve their memory of the material presented. Therefore, it is recommended that health education institutions use animated videos as educational tools to increase students' awareness and knowledge about anemia, and apply them in broader health promotion efforts.

ANALYSIS OF TB POLYCLINIC SERVICE QUALITY FROM THE ASPECT OF TREATMENT COMPLIANCE AND PATIENT SATISFACTION AS A RESPONSE TO THE INCREASE IN TB CASES IN COMMUNITY HEALTH CENTER IN PALEMBANG

Muhammad Aziz — 2026-01-14

WHO suggests seven dimensions of health service quality, namely effective, safe, patient- oriented, timely, efficient, fair, and integrated. Health centers are obliged to maintain good quality of service as a reflection of the quality of services provided to provide patient satisfaction. Tuberculosis continues to be a serious health problem in the world, including Indonesia. The incidence of tuberculosis is often associated with treatment compliance and patient satisfaction with health services. Data from the Palembang City health profile in 2020 showed that 43.8% of people suspected of tuberculosis received health services according to standards. This study aims to analyze the quality of TB poly services from the aspects of treatment compliance and patient satisfaction as a response to the increase in TB cases at the Palembang City Health Center. This type of research is analytic research with a cross-sectional design. Data were collected primarily through questionnaires and secondary through data on the number of TB patients at the Palembang City Health Center. The results showed that there was no significant relationship between the seven dimensions of service quality and treatment compliance (p >0.05). On the other hand, there was a significant relationship between the seven dimensions of service quality and patient satisfaction (p <0.05). So, the suggestion that can be given is the need for more in-depth and comprehensive research on other factors that might affect the quality of health services.

THE EFFECT OF RESVERATROL ADDITION ON IMPROVEMENT OF GLOBAL LONGITUDINAL STRAIN IN TYPE 2 DIABETES MELLITUS PATIENTS AT DR. MOHAMMAD HOESIN HOSPITAL PALEMBANG

Ahmad Khaeril Irfan — 2026-01-29

Type 2 diabetes mellitus (T2DM) increases the risk of myocardial fibrosis, which contributes to cardiovascular complications. The prevalence of myocardial fibrosis in diabetic patients ranges from 15–62% based on a meta-analysis. Global Longitudinal Strain (GLS) assessment with Speckle Tracking Echocardiography (STE) can detect myocardial fibrosis non-invasively, with GLS < -21% to rule out fibrosis and GLS > -15% to diagnose fibrosis. Resveratrol, a natural polyphenol, is known to have cardioprotective effects; however, clinical evidence in T2DM patients is still limited to animal studies. This study aims to evaluate the effectiveness of resveratrol administration on improving cardiac fibrosis as measured by GLS in T2DM patients.This study was a double-blind randomized controlled trial in T2DM patients with GLS <21% at Dr. Mohammad Hoesin Hospital Palembang (June–November 2025). A total of 32 subjects were divided into two groups (16 each) using block permuted randomization: an intervention group and a control group for 12 weeks. Outcomes measured included changes in GLS, EF, and IVSD. Data analysis was performed using SPSS 29.Of the 40 subjects, 12 dropped out. In the analyzed subjects (14 per group), resveratrol administration for 12 weeks reduced GLS more than placebo (mean difference -1.92% vs -0.74%; p=0.006) and increased EF (mean difference +3.35% vs -4.2%; p=0.003), while IVSD did not change significantly. Resveratrol was shown to be an independent predictor of GLS and EF improvement in multivariate analysis. Mild side effects (bloating) were reported in 14.8% of resveratrol subjects.Resveratrol significantly improves GLS and EF in T2DM patients but does not affect IVSD. Resveratrol has potential as a long-term adjunctive therapy.

Determinants Of Recovery Among Pulmonary Tuberculosis Patients In Talang Putri Sub disctrict

dientyah anggina — 2026-04-30

Pulmonary tuberculosis (TB) remains a major global health problem with treatment success still below the WHO target. Recovery among TB patient is influenced by various determinants, including socioeconomic, individual and external factors. The study aimed to identify determinants associated with the recovery among pulmonary TB patients in Talang Putri Sub district. A quantitative study with a cross-sectional design was conducted from November 2025 to February 2026. The study involved 80 pulmonary patients in the continuation phase selected using convenience sampling. Data were collected through questionnaires and medical record. Data were analyzed using Fisher Exact Test. The majority of patients were cured (97.5%). Significant factors associated with recovery were employment (p=0.014; PR=9.75) age (p=0.043; PR=5.2), treatment history (p=0.011; PR=26.00). income (p=0.519), PMO role (p=1.00), and healthcare worker role (p=0.112) were not significantly associated with the recovery. Recovery among pulmonary TB patients is significantly influenced by employment, age, treatment history, and family support. Family support being the most dominant factor. Strengthening family-based intervention is essential to improve TB treatment outcomes

Ecological Dominance, Biting Behavior, and Molecular Detection of Brugia malayi in Culex quinquefasciatus from Filariasis Endemic Wetlands of South Sumatra, Indonesia

Rini Pratiwi — 2026-04-14

Lymphatic filariasis (LF) remains endemic in Indonesian wetland ecosystems despite long-term mass drug administration (MDA). Environmental modification may alter mosquito community structure and promote the emergence of alternative vector species. A longitudinal entomological survey was conducted in two endemic villages in Banyuasin Regency, South Sumatra. Adult mosquitoes were collected using indoor and outdoor human landing collections and resting collections. Ecological indices, including abundance, dominance, man-hour density (MHD), and man-biting rate (MBR), were calculated. Molecular detection of Brugia malayi was performed using PCR targeting the yACA gene, followed by sequencing confirmation. A total of 1,342 female Culex mosquitoes representing eight species were collected. Culex quinquefasciatus was overwhelmingly dominant (92.4%), particularly in Muara Sugih Village, and exhibited marked endophagic and endophilic behavior. Biting density and MBR were substantially higher in Muara Sugih than in Sedang Village. PCR and sequencing confirmed the presence of B. malayi DNA in Cx. quinquefasciatus. The ecological dominance, indoor feeding behavior, and molecular evidence of B. malayi infection in Cx. quinquefasciatus suggest its potential role as a supplementary vector in modified wetland ecosystems. Integration of ecological surveillance and molecular xenomonitoring is essential to detect residual transmission and support LF elimination in post-MDA settings.

PEDIATRIC MASSIVE TRANSFUSION SAFETY STRATEGY

Dini Meta Rica — 2026-01-30

Pediatric massive transfusion is a time-critical intervention in which uncontrolled hemorrhage may rapidly causing developmental hemostatic differences, dilutional coagulopathy, hypothermia, acidosis, and electrolyte disturbance, leading to substantial morbidity and mortality. In contrast to adult practice, pediatric transfusion management remains less standardized, and bedside decisions are still frequently influenced by extrapolated evidence, local protocols, and clinician judgment. This review aimed to summarize a practical, safety-oriented approach to pediatric massive transfusion, with emphasis on perioperative assessment, monitoring, activation criteria, transfusion protocols, and prevention of transfusion-related complications.We performed a narrative review of literature published between 2018 and 2026. Priority was given clinical practice guidelines, expert consensus documents, systematic reviews, and clinically relevant observational studies addressing pediatric major hemorrhage, trauma, cardiac surgery, extracorporeal support, viscoelastic testing, tranexamic acid, whole blood, and patient blood management. Evidence was selected for clinical relevance to perioperative anesthesia practice and synthesized theme.Safe pediatric massive transfusion requires early recognition of major bleeding, timely protocol activation, balanced and goal-directed blood product delivery, close hemodynamic and hemostatic reassessment, and active prevention of predictable metabolic and transfusion-related complications. Overall, the current literature supports a restrictive, physiology-guided approach while underscoring the need for stronger prospective pediatric evidence