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Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia

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Published by Pengurus Besar Ikatan Dokter Indonesia

ISSN : 20891067 EISSN : 26543796 DOI : http://dx.doi.org/10.47830

Core Subject : Health, Science, Education,

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

Journal Of The Indonesian Medical Association (JInMA) / Majalah Kedokteran Indonesia (MKI) adalah Jurnal yang berada di bawah naungan Pengurus Besar Ikatan Dokter Indonesia (PB IDI) dan sebagai Kanal InformasiIlmiah di Kalangan Dokter Umum dan Dokter Spesialis serta Profesi Terkait.

Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)

Articles 442 Documents

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Penilaian Dampak Pengelolaan Antimikroba terhadap Rasionalitas Antibiotik di Rumah Sakit Tersier Agustina, Nenden Nursyamsi; Fitrianto, Agus; Santosa, Qodri; Naufalin, Rafa; Maulena, Ufik; Anjarwati, Dwi Utami
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-821

Introduction: Irrational use of antibiotics can lead to antibiotics resistance, necessitating efforts for prevention. The implementation of an Antimicrobial Stewardship Program aims to mitigate inapproriate antimicrobial prescribing. This study aims to compare antibiotic rationality based on quantity, quality, and total cost of antimicrobial utilization following the Antimicrobial Stewardship Program in a tertiary hospital setting.Methods: This was a cross-sectional study. Data were obtained from the medical record of 120 patients hospitalized in the pediatrics ward and classified into two groups: post-program and control. The quantity of antibiotic utilization was measured using Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD). Antibiotic rationality was assessed using Gyssens modified category. Normality was evaluated using the Kolmogorov-Smirnov test and analyzed with an independent t-test.Results: There was 10% increase of prudent antibiotic use and a 30.61% reduction in total cost in the post-program study group. However, there was no significant difference in the quantity of antimicrobial utilization in both groups (p=0.06).Conclusion: The program improves the rationality of prudent antibiotic prescription and reduces the total cost of antimicrobial utilization.

Peran Alfamangostin dalam Minyak Jagung dalam Memperbaiki Profil Lipid pada Tikus yang Diinduksi Pakan Tinggi Lemak Tjahjani, Susy; Jasaputra, Diana Krisanti; Permadi, Andieni Faqhira; Hidayat, Ester; Sitepu, Valerie Caroline; Radithya, Putu Audiva
Majalah Kedokteran Indonesia Vol 74 No 1 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.1-2024-856

Introduction: Alphamangostin is a component of the mangosteen peel extract (Garcinia mangostana L) that has potential as a therapy for dyslipidemia. However, alphamangostin has low solubility, resulting in low bioavailability when administered orally. This study aims to investigate the potential of alphamangostin dissolved in corn oil on serum lipid profiles in vivo.Methods: The study was conducted on 24 Sprague Dawley strain Rattus norvegicus rats divided into 6 treatment groups (NC, HFD, CO, D1, D2, and Sim), with 4 rats each group randomly assigned. After a 1-week acclimatization period, each group received the following treatments: standard diet for 4 weeks (NC), high-fat diet + propylthiouracil (PTU) for 4 weeks (HFD), HFD + corn oil (CO), HFD + alphamangostin in corn oil at 7 mg/KgBW (D1), HFD + alphamangostin in corn oil at 35 mg/KgBW (D2), and HFD + simvastatin at 3.6 mg/KgBW (Sim). Treatments for CO, D1, D2, and Sim were administered for 2 weeks. Serum total cholesterol, HDL, LDL, and triglycerides were examined before and after treatment, and the differences were analyzed statistically.Results: The administration of alphamangostin at a dose of 7 mg/KgBW (D1) and corn oil (CO) significantly decreased LDL cholesterol levels (p less than 0.05), and alphamangostin at a dose of 35 mg/KgBW (D2) significantly decreased triglyceride levels (p less than 0.05). Meanwhile, there were decreases in total cholesterol levels and increases in HDL cholesterol levels in the alphamangostin and corn oil groups, but these changes were not statistically significant (p greater than 0.05).Conclusions: Alphamangostin can reduce LDL cholesterol and triglyceride levels in high-fat diet-induced rats.

Efektivitas Terapi Penghambat Pompa Proton pada Anak dengan Otitis Media Kronik: Sebuah Laporan Kasus Berbasis Bukti Hanrahan, Joanna Erin; Calista, Nabilla; Ardiantara, Sabda; Restuti, Ratna Dwi; Irawati, Nina; Rachmawati, Elvie Zulka Kautzia
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-870

Introduction: In Indonesia, 82% of children with otitis media have experienced chronic otitis media (COM). COM has a high recurrency rate and is multifactorial, one of which is caused by acid reflux. Proton pump inhibitor (PPI) therapy has been used to treat acid reflux and gives excellent result. Purpose: Reporting one case of a child with COM and laryngopharyngeal reflux (LPR) who received PPI therapy. An evidence-based literature review was done to evaluate the effectiveness of PPI therapy in patient with COM and LPR.Methods: Literature searching was done through 3 databases. Critical appraisal based on the Oxford Center for Evidence Based Medicine Checklists 2011.Results: After we sorted out duplications and screened articles according to our inclusion and exclusion criteria, we retrieved one article. This article is valid and applicable, yet PPI therapy did not give significant clinical improvement because of some reasons.Conclusion: From the literature review, PPI therapy on patient with COM did not give significant clinical improvement such as to stop middle ear discharge, yet in our case, PPI therapy could produce a clinical improvement and in line with previous experimental studies. Therefore, PPI therapy could still be considered given in children with COM.

Peran Skor Brixia sebagai Prediktor Kejadian Coronavirus Disease-19 (COVID-19)-associated Hemostatic Abnormalities (CAHA) Berdasarkan Kadar D-dimer Fiona, Fiona; Margiani, Ni Nyoman; Sitanggang, Firman Parulian; Eka Putra, I Wayan Gede Artawan; Anandasari, Pande Putu Yuli; Ayusta, I Made Dwijaputra
Majalah Kedokteran Indonesia Vol 73 No 3 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.3-2023-954

Introduction: Coronavirus Disease-19 (COVID-19) is a systemic disease that causes complications in respiratory system and coagulopathy, which is called COVID-19-associated hemostatic abnormalities (CAHA). The Brixia chest X-ray scoring system may benefit in detecting CAHA. This study aims to investigate the role of the Brixia score as a predictor of CAHA based on D-dimer levels. Methods: This was a cross-sectional study that used medical records from Radiology Installation, Sanglah General Hospital, Bali, during August 2020 until August 2021. Subjects were confirmed and hospitalized COVID-19 patients with mild to critical degree and aged 18-59 years old. Any other pulmonary diseases than COVID-19 in X-ray was excluded. Brixia score was determined independently and blindly determined by two radiologists. The incidence of CAHA was defined as an elevation of D-dimer in pulmonary COVID-19. We conducted interobserver Bland-Altman, followed by correlation test, receiver operating characteristic (ROC) analysis, and multiple logistic regression test to control for confounding factors. Result: This study included 70 subjects selected through random sampling. We found a positive correlation between the Brixia score and D-dimer levels (r=0.329, p less than 0.05). The ROC analysis indicated that a Brixia score cut-off ≥10 is the best predictor of CAHA, with a positive predictive value of 95.8% and a negative predictive value of 40.9%. Subjects with a Brixia score ≥10 were found to have a higher risk of developing CAHA (aOR 14.78, p less than 0.05) after controlling for age, gender, nutritional status, and comorbidities. Conclusion: There was a statistically significant association between Brixia score and CAHA in COVID-19 patients based on D-dimer levels. The Brixia score could be used as a predictor of CAHA with the cut-off value ≥10.

Laporan Awal: Survei Berbasis Situs Daring Mengenai Kekambuhan Psoriaris Pascavaksinasi Coronavirus Disease (COVID)-19 di Sumatera Utara, Indonesia Chandra, Rudi; Oentari, Widyaningsih; Djohan, Djohan; Natali, Oliviti
Majalah Kedokteran Indonesia Vol 73 No 3 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.3-2023-972

Introduction: Psoriasis is a chronic inflammatory skin disorder that is often associated with autoimmune conditions. Vaccination has been considered one of the external factors that can trigger psoriasis flare. Recently, there have been reports linking the COVID-19 vaccine to the occurrence of psoriasis flare. The objective of this study was to examine the impact of COVID-19 vaccination on the incidence of psoriasis flares in Indonesia. Methods: This web-based cross-sectional study utilized Google forms and was conducted from September 2020 to February 2021 in North Sumatera, Indonesia. The study included psoriasis patients aged less than 18 years who had received COVID-19 vaccines. Data were collected and analyzed descriptively. Result: Out of 130 respondents, most were women (60.8%) aged 26-35 years (33.1%) with a disease duration of 1-10 years (48.5%). The most common type of psoriasis before vaccination was plaque and scalp (20.4%). Approximately 80% had no history of COVID-19 infection prior to vaccination, and 71.5% received the Sinovac vaccine. Among them, 49 respondents (37.7%) experienced flares after vaccination, mainly following the first dose (57.1%) and predominantly with Sinovac (77.6%). Flares were more common in women (67.3%) aged 26-35 years (28.6%) with disease duration of 1-10 years (59.2%). Most flares occurred greater than 2 weeks after vaccination (51%), and the post-vaccination type of psoriasis was frequently plaque and scalp (24.5%). Conclusion: The incidence of psoriasis flares after COVID-19 vaccinations was 37.7%. The administration of COVID-19 vaccinations may play role as a potential trigger for flares in psoriasis patients.

Derajat Gangguan Dengar dan Letak Perforasi Membran Timpani pada Pasien OMSK : Sebuah Seri Kasus Aditomo, Rano; Swasti Wijayanti, Renny; Selvi Yanuarista, Gabrina
Majalah Kedokteran Indonesia Vol 74 No 4 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.4-2024-974

Introduction: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear characterized by a perforation of the tympanic membrane with mucoid or mucopurulent secretions that persists or intermittently for 8 weeks. Tympanic membrane perforation causes a decrease in the surface area of the tympanic membrane for sound transmission and causes sound waves to be directly transmitted to the middle ear. CSOM may cause hearing loss from mild to deafness. Case reports: This research is a case series was conducted at the ENT Department in Sultan Agung Islamic Hospital Semarang during September 2022-January 2023. A total of 7 patients were admitted to the ENT Department in Sultan Agung Isalmic Hospital with diagnosis of CSOM. 6 patients (86%) had hearing loss and 1 patient (14%) had only tinnitus without any hearing loss. As many as 67% had CHL and 19% had MHL and SNHL. The most common perforations were found in the AI quadrant (43%) followed by the AS and PI quadrants (28.5% each). Patients with perforation experienced the heaviest degree of hearing loss in the AS quadrant (82.5db) and the mildest in the AI quadrant (32.5db). Conclusion: Patients with perforations in the PI quadrant have a worse degree of hearing loss than those with perforations in the AI quadrant, especially in cases of Conductive Hearing Loss. Patients with a larger perforation area have a worse degree of hearing loss than those with smaller area of perforation.

Hubungan Pengetahuan dan Tingkat Kecemasan Orang Tua terhadap Vaksinasi Covid-19 pada Anak Jusuf, Siti Khodijah Nur'Aini; Nurdin, Azizah; Sakinah, Andi Irhamnia; Sa’diyah, Halimah
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-987

Introduction: The COVID-19 vaccine is crucial as a preventive measure against infection with the SARS-CoV-2 virus. The Indonesian Pediatric Association (IDAI) has approved the vaccination for children under 12 years, allowing them to receive up to the second dose. However, a lack of knowledge about the vaccine has led to hesitancy among parents, fueled by misinformation and concerns about potential side effects on their children. This study aims to explore the correlation between parental knowledge and their anxiety levels concerning the COVID-19 vaccination for their children.Methods: We conducted a cross-sectional survey with 207 parents of students from SDIT Nurul Fikri in Makassar City. The research instrument was a structured questionnaire. Data were analyzed through univariate analysis, followed by bivariate comparisons using the Chi-square test and multivariate regression.Results: Among the respondents, a majority (58%) exhibited limited knowledge of COVID-19, with 50.2% reporting varying degrees of anxiety about the vaccination for their children. Of the children, 46.3% had received the complete vaccination series. Statistical analysis revealed a significant correlation between parental knowledge and anxiety levels regarding their child’s COVID-19 vaccination (α less than 0.05; p=0.007).Conclusion: There is a significant correlation between knowledge and anxiety concerning children's COVID-19 vaccination, with knowledge being the most significant predictor of anxiety levels.

Ide Bunuh Diri sebagai Faktor Risiko Bunuh Diri di Asia: Telaah Sistematis dan Meta-analisis dari Studi Kasus-Kontrol Cathleen, Fabiola; Ivano Kalaij, Ayers Gilberth; Soelaeman, Muhamad Faza; Raharja, Sarah Latifa
Majalah Kedokteran Indonesia Vol 73 No 3 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.3-2023-990

Introduction: Suicide has become the third leading cause of death among individuals in their productive years, underscoring the pressing requirement for effective preventive measures and risk assessment strategies. Earlier studies have indicated that suicidal ideation may play a role as a risk factor of completing suicide. To bolster this understanding, we conducted a systematic review and meta-analysis focusing on the relationship between suicidal ideation and completed suicide within Asian populations. Methods: This review adopted a systematic approach, adhering to the four-phased PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram and checklist. Case-control studies were selected, focusing on samples of individuals aged 15-44 years who had received psychiatric care. Exclusion criteria included language barriers, incomplete or inaccessible texts, publications older than 2000, and participants with co-existing medical conditions that could interfere with the results. To assess the quality and potential bias of the included studies, the Oxford’s Critical Appraisal Skills Programme (CASP) Case-Control Checklist and critical appraisal worksheet were utilized. Result: The search process yielded a total of 641 records, from which six studies were finally included in the meta-analysis. We found a statistically significant association between suicidal ideation and suicide (aOR 4.20; 95%CI 3.00-5.88, p less than 0.00001) with low heterogenity among the studies. The most common bias identified was related to the acceptability of case recruitment. Conclusion: Suicidal ideation can act as a predictor of suicide risk in Asian populations. Incorporating the assessment of suicidal ideation in suicide prevention initiatives is critical for promptly identifying and intervening with individuals at risk.

Aplikasi Antimicrobial Susceptibility Test (AST) dalam Mendeteksi Carbapenem-Resistant Enterobacteriaceae (CRE): Sebuah Tinjauan Sistematis Yasmin, Thania; Mashuri, Yusuf Ari; Maryani, Maryani; Susilawati, Tri Nugraha
Majalah Kedokteran Indonesia Vol 73 No 3 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.3-2023-991

Introduction: Indonesia has the highest prevalence of carbapenem-resistant Enterobacteriaceae (CRE) in Asia. This shows the importance of early detection and treatment of CRE cases. This systematic review presents recent studies on the global pravelence of CRE, the use of antimicrobial susceptibility test (AST) for detecting CRE, and detection methods of carbapenemase-producing CRE (CP-CRE). Method: A systematic review was conducted on English scientific articles published in PubMed, Science Direct, and Scopus from January 2018 to February 2022. Inclusion criteria were studies that performed CRE examination on human samples and the keywords were ‘antimicrobial susceptibility test’ OR ‘microbial sensitivity test’ OR ‘antimicrobial susceptibility breakpoint determination’ AND ‘carbapenem-resistant Enterobactericeae’ OR ‘carbapenemase-producing Enterobacteriaceae’. The study selection was carried out according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Result: The literature search and study selection method resulted in a total of 11 articles for data extraction and analysis. The prevalence of CRE was 9.6% in the study that aimed for CRE screening. CRE is detected mostly by Vitek-2® in urine and blood samples showing imipenem and meropenem-resistant bacteria. Conclusion: The prevalence of CRE was high in the CRE case screening study. The most common CRE detection method is Vitek-2® that could be replaced with disk diffusion method in limited resources settings. CRE detection can be followed by the detection of carbapenemase-producing CRE (CP-CRE) by using genotypic, phenotypic, and fluorogenic assays.

Gangguan Perkembangan Seksual 46,XY: Sebuah Laporan Kasus dan Tinjauan Pustaka Welni, Trisia; Fakhrurrazi, Fakhrurrazi
Majalah Kedokteran Indonesia Vol 73 No 5 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.5-2023-993

Introduction: Disorder of sex development (DSD) is a condition characterized by atypical anatomy of the reproductive organs, making it difficult to clearly identify the genitalia. DSD cases encompass various types and causes. Among them, 46,XY DSD is a very rarely found disorder. This paper provides a case illustration and a literature review on 46,XY DSD.Case Report: A 7-year-old male child was brought by his parents due to the presence of ambiguous genitalia, which had been noted since birth. The child’s growth, development, and nutritional status were normal. Genital examination revealed a scrotum resembling labia majora, hypospadias, a penis size of approximately 2 cm, and symmetrically palpable scrotum and testes. Karyotyping analysis showed a 46,XY chromosomal pattern.Discussion: 46,XY DSD occured from defect in androgen synthesis and target cell resistance to androgens. Clinically, individuals with 46,XY DSD may present with ambiguous genitalia, cryptorchidism, hypospadias, and micropenis, although manifestations will vary depending on the type and degree of androgen hormone disorder. Diagnostic evaluations should include chromosomal analysis, assessment of sex steroid hormone levels, and imaging studies, such as pelvic ultrasound within 24 hours of birth, genitogram, and even MRI for evaluating Mullerian structures. The management of DSD is carried out by a multidisciplinary team, encompassing medical therapy, surgery, sex steroid replacement therapy, gender assignment, and psychosocial support.Conclusion: 46,XY DSD is a rare occurrence. Comprehensive diagnostic assessments are necessary for each DSD case to determine the type, cause, and comprehensive management in accordance with the etiology.

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Contact Name
Ferius Soewito

Contact Email
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Phone
+6221-31937910

Journal Mail Official
jinma_mki@idionline.org

Editorial Address
Jl. Dr. G. S. S. Y Ratulangie No. 29, Menteng, Jakarta Pusat 10350

Location
Kota adm. jakarta pusat,

Dki jakarta

INDONESIA