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Folia Medica Indonesiana The Unit of Journal Consortium and Folia Medica Indonesiana Faculty of Medicine, Universitas Airlangga Jl. Prof. Dr. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, Jawa Timur 60132, Indonesia
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Folia Medica Indonesiana
Published by Universitas Airlangga
ISSN : 23558398     EISSN : 2599056X     DOI : https://doi.org/10.65346/2958-4515.2401
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Folia Medica Indonesiana, as indicated by its name, focuses on publishing good quality articles about research and education on health science and medicine in Indonesia. However, due to the fast growth of science and knowledge in these fields, we also welcome submitted articles from around the world, especially the ones that contain related matters from lower-middle income countries. Folia Medica Indonesiana is an open-access, peer-reviewed journal that is published online at least four times a year. The scope covers various aspects of basic medical sciences includes anatomy, physiology, pathology, microbiology, pharmacology, and molecular medicine) and clinical medicine (covers specialties like internal medicine, surgery, pediatrics, oncology, psychiatry, etc). We highlight the pathology and potential treatment of metabolic syndromes and infectious diseases. Folia Medica Indonesiana also encourages the publication of articles about health education. The scope includes, but is not limited to, articles that emphasize on preventive education on certain diseases in a community, also research report of various materials and/or methods to develop medical education. We recognize the importance of this type of articles to be published alongside the assigned topic in each of our yearly issues, to provide our readers with updated information in medical sciences’ research and education simultaneously.
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Search results for , issue "Vol. 60, No. 2" : 10 Documents clear
Obstacles to the Implementation of clinical practice guidelines at Mandau District General Hospital. Zelvia, Sindy; Nasution, Sri Wahyuni; Girsang, Ermi; Nasution, Sri Lestari Ramadhani
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. Given the suboptimal implementation of clinical practice guidelines at Mandau District General Hospital, it is important to conduct research on potential obstacles to this problem. 2. The findings of this study can encourage hospitals to develop and apply effective clinical practice guidelines while also addressing the obstacles to their implementation. Abstract Clinical practice guidelines are procedures followed by physicians to optimize healthcare services and achieve more effective outcomes. Conducted in October 2022, this study aimed to analyze the factors that hinder the implementation of clinical practice guidelines among physicians at Mandau District General Hospital, Bengkalis, Indonesia. This study used an analytical survey design and a cross-sectional approach. This study included all 85 individuals who were employed as general practitioners at the Mandau District General Hospital. The data were subjected to univariate, bivariate, and multivariate analyses. The independent t-test was used in the data analysis, with a value of p<0.05 considered significant. The results showed that there was an association between the implementation of clinical practice guidelines and several variables, including the levels of ability in recognizing and explaining clinical pictures of diseases (p=0.008), diagnosing diseases (p=0.004), carrying out initial management (p=0.000), and carrying out independent and directed management (p=0.001). Upon conducting the follow-up analysis on logistic regression, it was found that the variables that were associated with the implementation of clinical practice guidelines were the ability to carry out initial management (p=0.000, OR=65.512, 95% CI=22.048–98.835). In conclusion, physicians' insufficient ability to perform initial management hinders the implementation of clinical practice guidelines. This study suggests incorporating the findings as input in the evaluation and development of training for physicians on the implementation of clinical practice guidelines.
The Effects of Intermittent Fasting on the Size and Number of Subcutaneus Adipocytes in Obese Mouse Models Larasati, Veny; Rasyid, Riana Sari Puspita; Fertilita, Soilia; Suciati, Tri; Farhan, Muhammad
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study helps bridge the gap between systemic effects and tissue-level changes, providing a deeper understanding of how histological analysis can be used to explore the effects of intermittent fasting on adipocytes and body weight regulation. 2. This study contributes to obesity management through lifestyle modification, specifically intermittent fasting, by focusing on histological changes in adipose tissue. Abstract The accumulation of adipose tissue can have deleterious effects and lead to obesity. Intermittent fasting (IF), an approach that involves time-restricted eating, has gained popularity as an obesity treatment option because it enhances insulin sensitivity and promotes beneficial changes in glucose metabolism. This study used a time-restricted meal intake (TRM) approach to assess the effects of IF on the histological features of obese mouse models' subcutaneous inguinal adipose tissue. The investigation employed an in vivo experimental posttest-only control group design. Twenty male mice were divided into four groups: a normal control group, an obese control group, a TRM group with a high-fat diet (TRM-HF), and a TRM group with a standard diet (TRM-S). The TRM treatment was administered for fourteen days, with a fasting window from 4 p.m. to 8 a.m. The pre- and post-treatment weight analyses were conducted using the paired t-test for normally distributed data and the Wilcoxon test for non-normally distributed data (p<0.05). One-way analysis of variance (ANOVA) was employed for unpaired data on the post-treatment weight. Per field of view, there were an average of 120,500 cells (49,700–136,200) in the normal control group, 68,380±9,194 cells in the obese control group, 70,860±11,029 cells in the TRM-HF group, and 79,360±5,112 cells in the TRM-S group. The average cell sizes (μm3) were 56,730.142±19,273.257 in the normal control group, 138,934.331±27,670.558 in the obese control group, 106,827.767±20,580.501 in the TRM-HF group, and 68,689.114±8,219.727 in the TRM-S group. The number of cells in each group did not differ significantly, but there were significant variations in cell size. The mice receiving TRM treatment did not exhibit substantial body weight changes, whereas the obese control group showed a significant body weight increase. In conclusion, TRM has an effect on cell size but does not affect the quantity of adipocytes in subcutaneous inguinal fat tissue.
Attenuation of Cadmium Toxicity by Methanol Extracts of Rauvolfia vomitoria and Aframomum melegueta leaves Adeniyi, Temidayo; Akinpelu, Moronkeji; Akinlami, Omokehinde; Kolawole, Molade James; Oloye, Jesufemi; Akogun, Imoleayo
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study provides insight into the detrimental effect of cadmium exposure on mammalian cells using a murine model. 2. The co-administration of Rauvolfia vomitoria and Aframomum melegueta leaf extracts is more effective in ameliorating cadmium-induced toxicity than a single administration of each plant extract. 3. The co-administration of Rauvolfia vomitoria and Aframomum melegueta plant extracts can upregulate the expression of IL-10 and reverse the derangements in the TNF-α, IL-6, SOD, and GPX levels. Abstract Cadmium has long been known to be an environmental pollutant that can harm human health, with toxicity majorly affecting the kidneys and liver. This study aimed to investigate the mitigating potential of methanol extracts of Rauvolfia vomitoria and Aframomum melegueta leaves in cadmium-induced liver toxicity. Twenty-five male adult Wistar rats, averagely weighing 200 g, were randomly allocated into five groups, each comprising five rats. Group 1 was unexposed to any substances and only received distilled water. Group 2 was given cadmium at a standard dose of 12 mg/kg bw. Groups 3, 4, and 5 received 12 mg/kg bw of cadmium, and each group was treated with 200 mg/kg bw of Rauvolfia vomitoria leaf extract, Aframomum melegueta leaf extract, and a combination of both extracts, respectively. After 28 days, the animals were euthanized to obtain their livers, which were then excised and processed for histopathological, mRNA expression, and biochemical analyses. A one-way analysis of variance (ANOVA) was used to analyze the data, and Duncan multiple tests were employed to compare the categorical variables (p<0.05). The results revealed elevated levels of interleukin 10 (IL-10) in the rats treated with Rauvolfia vomitoria and Aframomum melegueta extracts when compared to Group 2. On the other hand, the treatment groups exhibited a significant decrease in tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) levels, along with significantly elevated levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx). Group 5 showed a normal liver histoarchitecture similar to Group 1, reversing the histopathological abnormalities shown in Group 2. In conclusion, the co-administrative treatment using Rauvolfia vomitoria and Aframomum melegueta extracts reversed the cadmium-induced toxicity better than using each plant extract individually. This further suggests that Rauvolfia vomitoria and Aframomum melegueta leaf methanol extracts may ameliorate the effects of cadmium-induced toxicity, including reducing oxidative stress and fortifying the anti-oxidant system.
Serological Profiles of Systemic Lupus Erythematosus in Humanized Mice and Pristane-Induced Lupus Models Chilmi, Syahrul; Airlangga, Dimas Ikhsan; Susianti, Hani; Handono, Kusworini
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study compared the serological markers of pristane-induced mice to humanized mouse models of lupus achieved by transplanting stem cells from lupus patients, which is a novel method in Indonesia. 2. This study will allow for more accurate research into the pathophysiology of the disease and the development of new lupus treatment strategies. Abstract More studies related to systemic lupus erythematosus (SLE) therapy are urgently needed because of the current insufficiency in treatment effectiveness. However, due to ethical limitations, researchers use experimental animals as a substitute for conducting studies on humans. Models commonly used to study lupus include the pristane-induced mouse model and the recently developed humanized mouse model. The second model involves implanting human immune cells into immunodeficient mice. This study compared the serologic profiles of lupus antibodies, the antinuclear antibodies (ANA) and anti-double stranded DNA (anti-dsDNA), in both mouse models. The aim was to determine which one is more promising for use as a lupus animal model. Thirty BALB/c mice (Mus musculus) were used as subjects and divided into three groups: K1, K2, and K3. K1 served as the control group, consisting of healthy mice that received a placebo. The K2 mice were intraperitoneally injected with 0.5 cc of pristane. The K3 mice were transplanted with stem cell cultures from SLE patients, resulting in humanized mice with immune deficiencies. The mice were observed for 16 weeks, during which the ANA and anti-dsDNA levels in their serum were obtained for analysis using the Kruskal-Wallis test (p<0.05). The comparison revealed differences in the average ANA and anti-dsDNA levels among the three groups. K3 had the highest ANA and anti-dsDNA levels, followed by K1 and K2. The Kruskal-Wallis test indicated that the differences were not significant in the mean levels of ANA (p=0.156) and anti-dsDNA (p=0.061). In conclusion, the humanized mouse model has higher ANA and anti-dsDNA antibody levels compared to the pristane-induced mouse model, albeit without a significant difference. This suggests a positive picture of the humanized mouse model of lupus, making it an invaluable tool for studying the disease and testing potential therapeutic interventions.
Hemocoagulation Conditions Associated with Venom-Induced Consumption Coagulopathy due to Snakebite in Humans Prasetiyanti, Rinta; Hernaningsih, Yetti
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This review comprehensively highlighted aspects of hematologic abnormalities in snakebites, a topic that remains understudied globally. 2. This review contributes insights into the field of snakebite research and improves the management of snakebites by examining the diverse effects of different types of snakebites on hemocoagulation status. Abstract Snakebite remains an underreported health hazard worldwide. The most common effects of snakebite envenomation globally are hematological disorders, with venom-induced consumption coagulopathy (VICC) being the most prevalent and significant condition. This review aimed to explore the hematological aspects of snakebite, with a focus on snakebite-induced consumption coagulopathy. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a search across several databases, namely PubMed, ScienceDirect, and Google Scholar. The inclusion criteria for this review were studies on snakebite envenomation in humans with a discussion of relevant cases. Additionally, the included studies were conducted between 2010 and 2023 and published in the English language. Studies on animal models were excluded. We used the keywords “venom-induced consumption coagulopathy AND snake" in the search. The critical appraisal was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and the Mixed Methods Appraisal Tool (MMAT). The findings were presented as a qualitative synthesis of 14 articles covering 316 patients and various snakebite types. The studies on snakebite came from various countries, but mostly from Sri Lanka. The snake types exhibited variation, with certain species existing only in specific areas. The subjects fell into different age groups, from children to the elderly. The majority of the subjects were male. The subjects' youngest age was 6 years old, while the oldest was 70 years old. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were the most discussed variables. Some of the studies demonstrated an increase in PT and APTT, although other studies reported contrasting findings. In conclusion, certain types of snakebite have a different impact on the hemocoagulation status.
Differences in Aerobic Capacity and Running Speed Across Various Somatotype Structures and Body Fat Compositions among Professional Football Athletes in Indonesia Ghozali, Dhoni Akbar; Ridhallah, Muhammad Syauqi; Shabrina, Syania; Nurhani, Ahmad Isnaini Shidqi; Hastami, Yunia; Rahayu, Dwi; Aryoseto, Lukman; Handayani, Selfi; Munawaroh, Siti; Wiyono, Nanang; Riyanto, Agus Sugeng; Budiono, Enrico Ananda; Rahma, Annisa Aghnia; Ilyas, Muhana Fawwazy
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study emphasizes the significance of understanding professional football players' various somatotype structures and body fat compositions as an important contribution to the area of sports science. This study lays the groundwork for future research to better understand the intricate interactions between somatotype structures, body composition, and athletic performance. 2. Since a one-size-fits-all approach may not be successful, this study advocates for tailored evaluations of training regimens to cater to athletes' unique requirements and skills, which may lead to higher overall performance. Abstract This study investigated the effects of somatotype structures and body fat composition on professional football athletes' aerobic capacities and running speed. This study used an analytical observational design with a cross-sectional approach. The subjects comprised 27 professional football athletes from Bhayangkara Football Club, located in Bekasi, Indonesia. This study measured several variables, i.e., players' age, playing position, somatotype structures assessed using the Somatotype Rating Form and Heath-Carter Somatochart, body fat composition measured using Brozek and Siri formulas, aerobic capacities determined by the maximum rate of oxygen (VO2 max) through the Yo-Yo Intermittent Recovery Test Level 2, and running speed over a 30 m distance. The data were presented as mean ± standard deviation (SD), frequency (n), and percentage. The Shapiro-Wilk was used to determine the normality of the data distribution. The statistical analyses were conducted using one-way analysis of variance (ANOVA) followed by the post-hoc least significant difference (LSD) test, the Kruskal-Wallis test followed by the post-hoc Mann-Whitney test, as well as the independent t-test, the Mann-Whitney test, and Pearson's or Spearman's correlation tests. A value of p<0.05 was considered statistically significant. The athletes exhibited a predominant somatotype structure of mesomorph-endomorph (88.9%). Notable associations were found between mesomorphy rating and running speed (r=-0.548; p=0.003), body fat composition and aerobic capacity (r=-0.448; p=0.019), as well as age and aerobic capacity (r=-0.515; p=0.006). Notably, differences in aerobic capacity were observed among various age groups (p=0.031). There were also differences in body fat composition (p=0.003) and running speed (p=0.036) between two distinct somatotype structures. These findings underscore the importance of considering individualized training and conditioning programs that account for athletes' unique body compositions and ages.
HbA1c and Pulsatility Index in Middle Cerebral Artery of Patients with Acute Thrombotic Stroke Bintan, Rio Tasti Surpa Rahmat; Setyowati, Sita; Adrianto, Yudhi
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. The findings of this study indicate that clinicians should remain vigilant, as effective glycemic control, reflected by optimal HbA1c levels, does not necessarily correlate with favorable distal cerebrovascular resistance, as measured by pulsatility index (PI). 2. This study recommends that patients with acute thrombotic stroke undergo a comprehensive examination to ensure an accurate diagnosis and appropriate treatment. Abstract Stroke is the second leading cause of death and disability in the world. Diabetes mellitus is a risk factor for stroke with an increase in blood viscosity associated with hyperglycemia, and HbA1c is a well-established biomarker primarily used for the long-term monitoring of glycemic control in patients with diabetes mellitus. The Pulsatility index (PI) parameter of Trans Cranial Doppler (TCD) can measure blood vessel resistance. This study was to prove the correlation between HbA1c and PI in Middle Cerebral Artery (MCA) of acute thrombotic stroke patients. A cross-sectional study was conducted to thrombotic stroke patients treated at the neurological ward of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from March 2019 to April 2020 who met the inclusion and exclusion criteria. Data were obtained from medical records. Statistical analysis was performed using Spearman test for numerical data and Chi-square for categorical data with a significant value of p <0.05. There were 32 subjects who met the inclusion and exclusion criteria. A total of 24 subjects (75%) were males and 8 (25%) females with a mean age of 56.41±13.22 years. PI MCA results were abnormal in 14 subjects (43.75%) with an average of 1.8±0.97 and PI MCA was normal in 18 subjects (56.25%) with an average of 0.87±0.15. The average HbA1c was 6.55±1.9%. There was no statistically significant association observed between HbA1c and PI in MCA examination (r=0.07; p=0.73). In conclusion, the findings of this study indicate the lack of correlation between pulsatility index and HbA1c in patients with acute ischemic stroke. This underscores the importance of comprehensive cerebrovascular evaluation regardless of HbA1c status.
Estrous cycle and uterine weight of ovariectomized menopause female rat models after treatment with Leucaena leucocephala (Lam.) de Wit leaf extract Wiratmini, Ngurah Intan; Sukmaningsih, Anak Agung Sagung Alit; Setyawati, Iriani
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study found that Leucaena leucocephala leaf ethanol extract has the ability to stimulate the growth of vaginal epithelial cells in ovariectomised rats. 2. Leucaena leucocephala leaf extract can be developed as a safe and cost-effective natural alternative for hormone replacement therapy in premenopausal women and livestock. Highlights: 1. This study found that Leucaena leucocephala leaf ethanol extract has the ability to stimulate the growth of vaginal epithelial cells in ovariectomised rats. 2. Leucaena leucocephala leaf extract can be developed as a safe and cost-effective natural alternative for hormone replacement therapy in premenopausal women and livestock. Abstract Hormone replacement therapy has adverse effects that may cause additional health problems, such as hot flashes, cancer, ischemic stroke, and death. Phytoestrogen is an alternative ingredient used for hormone replacement therapy with less risk. The Leucaena leucocephala (Lam.) de Wit plant is widely used as a medicinal ingredient and animal feed. This study aimed to determine the effect of Leucaena leucocephala leaf extract on the uterine weight and estrous cycle of ovariectomized rats. This research used a completely randomized control design, which included two treatment groups (P1 and P2) and two control groups (negative (K-) and positive (K+)) with six replications in each group (n=24). The negative control (K-) was given 2 mL of corn oil, while K+ received 0.1 mg/kg bw of 17β-estradiol. P1 and P2 were administered 250 and 300 mg/kg bw of Leucaena leucocephala leaf extract, respectively. The extract was administered daily by gavage for 30 days. Estrous cycle data were obtained on day 31 by previously collecting vaginal swabs twice a day for 15 days. After the rats were sacrificed under anesthesia using chloroform, they underwent surgery to remove the uterine organs for weight measurement. The data were analyzed for normality and homogeneity using the Shapiro-Wilk and Levene tests. The data distribution were not normal, so the Kruskal Wallis test was used to test the hypothesis. If there was a difference between controls and treatments, the analysis continued with the Mann-Whitney test (p<0.05). The controls and treatments exhibited a significant difference in the length of each phase and overall estrous cycle. The post hoc Duncan test revealed that the highest uterine weight was found in 17β-estradiol treated rat. It was significantly different with both extracts treated rats. Both extract effect on uterine weight were not significantly difference. In conclusion, administering Leucaena leucocephala leaf extract results in an increased uterine weight and a normal estrous cycle in ovariectomized rats.
Screening of Tuberculosis Infection through Acid-Fast Bacilli Tests among Waste Workers in Gresik, Indonesia Utomo, Budi; Fatmaningrum, Widati; , Sulistiawati; Fauziyah, Shifa; Khuen, Chan Chow; Fadhilah, Nur; Sucipto, Teguh Hari
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. This study was the first in Gresik, Indonesia, to conduct mass screening of tuberculosis among waste workers, comprising various demographic profiles. 2. Although the tuberculosis screening of the waste workers showed negative results, mass examination using an acid-fast bacilli smear remains crucial to detect latent infections and prevent transmissions. Abstract Tuberculosis is a major source of illness and mortality worldwide. Therefore, tuberculosis screening is important to increase the number of active case-finding in a community. Bacteriological examinations can be used to initiate community-based active case-finding. Waste workers face a high risk of contracting Mycobacterium tuberculosis due to their constant exposure to waste. This study aimed to conduct bacteriological examinations to identify tuberculosis infections among waste workers in Gresik, Indonesia, who were considered a high-risk group. An analytical observational study was carried out throughout September 2023 in the Ngipik subdistrict, Gresik, East Java, Indonesia. The primary study was conducted using a cross-sectional design using interviews, measurements, and sputum examinations for all samples. The screening involved a total of 72 waste workers who had daily contact with various types of sewage and waste, including medical waste. The data were analyzed descriptively because of the constant variable. Following the analysis, the data were presented using a table and a figure. According to the acid-fast bacilli examinations, all of the samples yielded negative results. Nevertheless, this study concludes that it is imperative to carry out mass tuberculosis screening in various settings, specifically among those with a high risk. Mass screening can uncover the potential of latent tuberculosis and, thus, reduce its transmission.
Effects of Minocycline as a Neuroprotective Agent for Stroke on Mmp-9 Levels, Functional Outcome, and Mortality Nisa, Ayu Imamatun; Damayanti, Arlia Ayu; Nagasastra, Jeffri; Machin, Abdulloh; Qorib, Mohammad Fathul; , Retnaningsih; Hamidi, Baarid Luqman
Folia Medica Indonesiana Vol. 60, No. 2
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Highlights: 1. As minocycline plays an important role in stroke microglia activation and iron chelation, it is important to further analyze its effects on stroke treatment. 2. This meta-analysis revealed a significant effect of minocycline therapy, as evidenced by improved functional outcomes and inhibited matrix metalloproteinase-9 (MMP-9) activity. Abstract Stroke is the most common and devastating cerebrovascular disease. Many neuroprotective medications, such as scale and minocycline, have been developed to help the nervous system recover or regenerate after a stroke. However, it remains unclear whether minocycline provides a beneficial effect on stroke. We conducted this systematic review and meta-analysis to synthesize the effects of minocycline in stroke treatment. The systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with registration number CRD42023485168. The quality of the eligible studies was assessed using the Jadad scale. This systematic review included three ischemic stroke trials, seven intracerebral hemorrhage trials, and one study on acute stroke. There was a significant association between minocycline intervention and stroke severity according to the National Institute of Health Stroke Scale (NIHSS), with a pooled mean difference (MD) of -1.92, a 95% confidence interval (CI) of -3.39 to -0.45, and a value of p=0.01. In the subgroup of ischemic stroke, the modified Rankin Scale (mRS) was significantly lower in the minocycline treatment group compared to the control group (MD=-0.89, 95% CI=-1.54 to -0.25, p=0.007). Additionally, matrix metalloproteinase-9 (MMP-9) levels for the intracerebral hemorrhage subgroup were significantly lower in the minocycline treatment group compared to the control group (MD=-19.93, 95% CI=-36.9 to -2.96, p=0.02). The analysis revealed that minocycline intervention was not significantly associated with hematoma volume, mortality, or stroke recurrence. Our findings indicate that minocycline supplementation is a potential intervention strategy for treating ischemic stroke and intracerebral hemorrhage.

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