Surabaya Medical Journal

Association between blue light exposure from digital devices and dry eye syndrome in young adults: a systematic review

Maria Evane Navy Cahaya Putri — 2025-05-30

Background: The rise in digital device usage has amplified exposure to blue light, raising concerns regarding its impact on ocular health, particularly in relation to dry eye syndrome (DES). This systematic review aims to assess the association between blue light exposure and DES severity among young adults, with a focus on studies demonstrating significant findings and minimal risk of bias. Objective: This review examines the impact of blue light exposure on DES in young adults, focusing on symptom severity and the potential benefits of blue light filters. Material and Method: A comprehensive search was conducted in PubMed, Scopus, and Google Scholar, covering the period from 2015 to 2025. Out of 20 identified studies, eight met the inclusion criteria. Data extraction focused on blue light exposure, DES assessment, and effect sizes. Risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS). Conclusion: Blue light exposure is significantly associated with increased DES symptoms in young adults. Implementing screen time management strategies and blue light filters may mitigate ocular surface damage. Further longitudinal studies are necessary to validate preventive strategies and assess long-term outcomes.

Exploring Dental Students' Perspectives: The Impact of Hybrid Learning in a Post-Pandemic World

Maryam Hameed Alwan — 2025-05-30

Background: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experience with electronic teaching during the COVID-19 isolation period. Additionally, the majority of students (62.6%) reported enjoying E-learning during the pandemic. Conclusions: Online education has been a crucial lifeline for many students' academic experiences and is becoming increasingly important in the new landscape of higher education. It requires greater attention and appropriate investment from institutions, instructors, and students alike. Additionally, educational systems worldwide should adopt online learning programs to effectively address unexpected circumstances.

Demographic Trends in Clear Cell Renal Cell Carcinoma: Insights from Tertiary Hospital in Surabaya

Aditya Sita Sari — 2025-05-30

Background: Clear cell renal cell carcinoma (ccRCC) is the most common renal malignancy, with distinct clinicopathological features. Despite established global patterns, regional characteristics in Indonesia remain understudied. This study describes ccRCC profiles at a tertiary Indonesian hospital, focusing on demographic trends, tumor characteristics, and staging patterns to enhance local diagnostic and management approaches. Objective: This study aims to describe the characteristics of ccRCC in Dr. Soetomo General Academic Hospital from 2014-2022. Material and Method: This is a retrospective descriptive study using secondary data including age, sex, tumor size, and pathological grade. Result: There were 50 patients of ccRCC throughout 9 years, most of them were male (70%), and 30% were female. Age group span between 31-80, with 51-60 age group being the most dominant (18%). Tumor sizes were grouped by <7 cm (40%) and >7 cm (60%), with 14 cm being the biggest size. The most common histopathology stage was T2 (42%), followed by T3 (32%), T1 (14%), and T4 (12%). Conclusion: The most common patients of ccRCC in Dr. Soetomo General Academic Hospital Surabaya were male patients, aged 51-60, with mostly > 7cm tumor size and in stage T2.

Caesarean delivery using general anesthesia in pregnant woman with placenta accreta accompanied with massive hemorrhage

Kiki Rizqiyatul Lailiyah — 2025-05-30

Background: Placenta accreta spectrum (PAS) is a disorder of placental implantation that causes peripartum bleeding and is the main cause of maternal death. PAS has a high risk of intraoperative bleeding therefore blood preparation and transfusion are essential. Objective: To describe the medical management of obstetric emergency of caesarean surgery with hypovolemic shock underwent general anaesthesia in patient with placenta accreta. Case: A woman, 36 years old, diagnosed with G4P3A0, gestational age 27-28 weeks with placenta accreta with blood pressure of 63/43, heart rate of 135, respiratory rate (RR) of 30, SpO₂ 97% O₂ non rebreathing oxygen mask (NRBM) 10 lpm, experiencing vaginal bleeding since 6 days, was planned for caesarean delivery with emergency surgery due to hypovolemic shock as the result of massive hemorrhage, anemia, leukopenia, and hyponatremia. PAS diagnosis was determined after ultrasound imaging. Operation duration was 3.5 hours, with blood loss of 3,500 ml. After the surgery, she was transferred to the Intensive Care Unit (ICU). General anesthesia was chosen to maintain hemodynamic stability. The medical decision for this case was caesarean hysterectomy with the placenta left in situ after delivery of the foetus. Conclusion: Successful management of placenta accreta with massive bleeding is the result of appropriate perioperative management, good preparation and teamwork.

Common Salt for Umbilical Granuloma: A Successful Case Report

Rendi Aji Prihaningtyas — 2025-05-30

Background: During the neonatal period, umbilical granuloma is a common problem. However, limited is recognized about its etiology and the most effective treatment method remains unknown. Case presentation: A 40-day-old girl visited the pediatric outpatient department with a non-watery umbilical mass after the umbilical cord was separated. A clear, flesh-like mass measuring 1x0.8x0.5 cm protruded from the umbilicus. There was no yellowish discharge and the surrounding skin was normal. Common salt was applied to the umbilical mass three times a day. On the second day of saline treatment, the granuloma became blackish, and on the third day, the granuloma detached. After a week, the umbilicus became clear. Conclusion: For an umbilical granuloma, the common salt treatment appears to be a practical, affordable, and effective treatment option, especially in limited healthcare facilities.

An Infant with biliary atresia: a case report

Syania Mega Octariyandra — 2025-05-30

Background: In children, biliary atresia (BA) is the most frequent cause of liver transplantation. Cholestasis, an early sign of biliary atresia, is rarely identified by primary care physicians as it is often mistaken for physiological jaundice. Early detection of biliary atresia is necessary to optimize outcomes and prevent end-stage liver disease. Case Presentation: A 2-month-old baby girl presented to the hospital with complaints of persistent jaundice since birth, accompanied by pale-colored stools. Physical examination revealed sclera icteric, hepatomegaly, splenomegaly, and umbilical hernia were found. Laboratory results showed a direct bilirubin level of 5.98 mg/dL, total bilirubin 7.22 mg/dL, albumin 3.31 g/dL, ALP 223 U/L, GGT 360.4 U/L, AST 307 U/L, ALT 313 U/L, APTT 34.2 seconds, and PT 12.4 seconds, Toxoplasma IgG 3.3 (reactive), CMV IgG 90.4 (reactive), and CMV IgM 3.09 (reactive). Thyroid function tests showed FT4 level of 360.4 ng/dL and TSH 307 µIU/mL suggesting congenital hypothyroidism. A 2-phase abdominal ultrasound examination showed impaired gallbladder contractility. Liver biopsy showed extrahepatic cholestasis and fibrosis of the portal tract (F1 stage). Contrast-enhanced MRCP was performed and showed biliary atresia with hepatosplenomegaly. The patient was diagnosed with biliary atresia, CMV infection, and congenital hypothyroidism. The patient was referred to pediatric surgery for Kasai portoenterostomy (KPE) surgery. Conclusion: The diagnosis of biliary atresia requires a combination of several laboratory modalities as well as radiologic and histopathologic studies. Early detection of cholestasis is necessary; if the infant is found to be jaundice at 2 weeks of age, serum bilirubin levels must be evaluated to avoid delays in BA management

Surviving fetus from a preterm abdominal pregnancy

Rahmania — 2025-05-30

Background: Abdominal pregnancy is a rare and severe form of ectopic pregnancy in which the embryo implants in the peritoneal cavity, rather than in the fallopian tubes, ovaries, or uterine ligaments. Based on the implantation site, abdominal pregnancy is classified into primary and secondary types. The clinical symptoms of abdominal pregnancy, as described in various references, are typically nonspecific. Combined with imaging is critical in establishing an early and accurate diagnosis. Objective: This is a case report of surviving fetus from a preterm abdominal pregnancy. Case: Herein we report on a case of a 30-year-old woman with a history of obstetrics G2P1A0 and a gestational age of 24-26 weeks with an abdominal pregnancy and managed successfully with an outcome of a live neonate weighing 800 grams and measuring 30 cm in length. Surgery was the treatment of choice for the patient. Two laparotomies were performed on the patient. The first operation was to deliver the fetus and the second operation was total hysterectomy and bilateral salpingectomy. Conclusion: Cases of fetuses surviving abdominal pregnancy are extremely rare, compounded by the fact that the fetus is often preterm and not viable for delivery. Regular antenatal check-ups combined with imaging are crucial for making an early and accurate diagnosis, allowing for timely management adjustments and preventing further deterioration of both maternal and fetal conditions.

Preoperative management of septic shock due to cellulitis cruris

Christopher Edwin Marijono — 2025-05-30

Background: Septic shock is an emergency condition due to a systemic inflammatory response to infection, which can lead to multiple organ failure. Soft tissue infections such as cellulitis are one of the causes of sepsis, especially if not treated properly. Management of septic shock includes hemodynamic stabilization, antibiotic therapy, and control of the source of infection through debridement. The main challenge in this procedure is the risk of hemodynamic instability during anesthesia. Case Illustration: A 51-year-old man came with complaints of weakness and decreased consciousness, preceded by swelling and pain in the left leg. Examination showed septic shock with hypotension (69/45 mmHg), leukocytosis (34,000/µL), and AKI (creatinine 2.58 mg/dL). Fluid resuscitation and initial stabilization were performed before debridement. Anesthesia used total intravenous anesthesia (TIVA) with ketamine and sufentanil, and close monitoring with vasopressors. Conclusion: Management of septic shock due to cellulitis requires a multidisciplinary approach. Early stabilization, debridement, and appropriate anesthetic techniques play an important role in improving the patient's prognosis.

Treatment of an eyelid infantile hemangioma with potential ptosis development

Dila Nur Fitriani — 2025-05-30

Background: Infantile hemangiomas are prevalent benign vascular tumors in children, frequently found on the head and neck, and pose a notable risk of visual impairment when situated on the eyelids. Case presentation: This report presents the case of a 9-year-old girl with a right upper eyelid hemangioma that has been present since the age of 3. Initially, she received intralesional triamcinolone acetonide injections, which resulted in limited improvement, prompting the decision for surgical excision. The procedure was conducted via an anterior approach, successfully excising the tumor. Following the surgery, the patient experienced no complications, and her condition significantly improved. This case underscores the critical need for prompt intervention in eyelid hemangiomas to avert visual complications. Conclusion: Management strategies for infantile periocular hemangiomas are influenced by factors such as the stage and location of the lesion, as well as the risk of functional impairment, with surgical excision proving to be an effective treatment option during the involution phase.