Majalah Kedokteran Bandung
Majalah Kedokteran Bandung (MKB)/Bandung Medical Journal publishes peer-reviewed original articles and case reports in basic medical research, clinical research, and applied medical science. This journal is published quarterly (March, June, September, and December) by Faculty of Medicine Universitas Padjadjaran. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted with acceptance for publication.
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<![CDATA[Rare Case of Periampullary Duodenal Carcinoma ]]>
<![CDATA[Maghfirah, Desi]]>;
<![CDATA[Abubakar, Azzaki]]>;
<![CDATA[Yusuf, Fauzi]]>;
<![CDATA[Riswan, Muhammad]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.1988
<![CDATA[Periampullary carcinoma is a malignancy that appears around the vatteri ampulla. This malignancy can originate from the pancreas, duodenum, and distal choledochal duct. Duodenal cancer is a very rare case, only about 0.3% of the gastrointestinal malignancies. Reported cases are increasing with the increasing use of esophagogastroduodenoscopy. The most frequently found carcinomas of the duodenum include adenocarcinoma, carcinoid, lymphoma, and leiomyosarcoma. The symptoms of these carcinomas are often not specific so the diagnosis is often late, leading to a poor prognosis. Early diagnosis and proper therapy provide a good prognosis. The case reported here representeda 52-year-old woman presented with hematemesis melena, anemia, jaundice, epigastric mass, right hypochondrial pain, and weight loss. From the esophagogastroduodenoscopy, the mass was found to obstruct half of the duodenum lumen and bleeding, which was easily triggered, was observed in the second part of the duodenum. CT scan revealed a mass in the head of the pancreas with gall bladder hydrops and obstruction of the intra and extra-hepatic billier system. After a Whipple operation Laparotomy, the histology showed papillary adenocarcinoma duodenum. Patients then underwen chemotherapy with 5 fluorouracil regimen. Patient's clinical condition is currently improving and no complaint is conveyed by the patient.]]>
<![CDATA[Correlation between Serum Uric Acid Level and Severity of Coronary Artery Stenosis in Patients with Acute Coronary Syndrome ]]>
<![CDATA[Diding Heri Prasetyo]]>;
<![CDATA[Sally Aman Nasution]]>;
<![CDATA[Idrus Alwi]]>;
<![CDATA[Murdani Abdullah]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2221
<![CDATA[Acute coronary syndrome (ACS) is a life-threatening disease which remains one of the causes of high morbidity and mortality despite the current advances in treatment. The relationship between the serum uric acid (SUA) level and ischemic heart disease continues to be controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between the two factors has not yet fully understood. Prior epidemiological evidence of the causal relationship between the too is still argumentative. Various studies have been done using the same methods; yet, the outcomes were different. This study aimeds to conduct a meta-analysis to synthesize the results of recent studies in order to obtain accurate quantitative data. This systematic study followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline and studies published in the period of January 2010 to May 2020 were screened using the Cochrane Library, Ebsco, Medline/PubMed, ProQuest and Science Direct as the sources. Meta-analysis was conducted to synthesize the association between the SUA level and severity of coronary artery stenosis using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2 and the meta-analysis was performed using Comprehensive Meta Analysis Version 3 (CMA3) software. Five studies (n = 601 subjects) identified a correlation between serum uric acid level and Gensini score (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis, whereas publication bias was not found. Thus, the severity of coronary artery stenosis in patients with ACS is positively correlated with serum uric acid level.]]>
<![CDATA[Retrospective Analysis on Intraoperative Neuromonitoring (IOM) of Potential Nerve Injury in Scoliosis Correction Surgery ]]>
<![CDATA[Omat Rachmat]]>;
<![CDATA[Dohar AL Tobing]]>;
<![CDATA[Ilma Fiddiyanti]]>;
<![CDATA[Rr. Nur Fauziyah]]>;
<![CDATA[Jenifer Kiem Aviani]]>;
<![CDATA[Rr. Anisa Siwianti Handayani]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2123
<![CDATA[Iatrogenic spinal injury resulting in paraplegia or paraparesis after surgical correction of scoliosis deformity is a rare complication but is very detrimental to the patient. Intraoperative Neuromonitoring (IOM) has become the gold standard to monitor surgical procedures which has potential risks to damage the spinal cord. This study aimed to retrospectively analyze the role of IOM in predicting the severity and extent of neurological injury during and after spinal correction surgery in adult idiopathic scoliosis cases related to surgical variables. This was a retrospective cohort study conducted at Dr. Cipto Mangunkusumo National Central Hospital, Fatmawati Central Hospital, and dr. Drajat Prawiranegara General Hospital during the period of 20 March 2018 to 20 August 2019. The primary outcomes were intraoperative monitoring status and post-operative neurological deficits status. Confounder data on scoliosis correction degree, intraoperative hemorrhage, and type of anesthesia used during surgery were retrieved. Chi-Square statistic was used in the analysis. Out of the ninety three patients eligible for this study, twenty two patients was detected as positive in IOM assessment. Four of the patients were found to be positive for post-operative neuromuscular defect. Thereby it can be concluded that IOM procedure can effectively prevent neurological deficits post-surgery with 81.8% specificity and 95.7% sensitivity among thosepositively detected by IOM. Some of the factors that could potentially influence false positive IOM results such as anesthetic used; dosage and administration procedures; magnitude of the scoliosis correction angle; and amount of bleeding during surgery have to be carefully analyzed.]]>
<![CDATA[Comparison of Diagnostic Accuracy of Tuberculosis Spondylitis between Genexpert and Histopathological Examination ]]>
<![CDATA[David Rudianto Salim]]>;
<![CDATA[Ahmad Ramdan]]>;
<![CDATA[Gibran Tristan Alpharian]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2234
<![CDATA[Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Spinal TB is associated with poor functional outcomes. Histopathological examination requires a long waiting times to obtain the results thus impractical for screening and may delay diagnosis. GeneXpert offers rapid tests for prompt screening and diagnosis. This study aimed to assess the diagnostic accuracy of GeneXpert in patients with spinal TB when compared to the histopathology test as the gold standard. This study was performed on patients in the Spine Clinic of the Department of Orthopedic and Traumatology, Dr. Hasan Sadikin General Hospital Bandung who were diagnosed with spinal TB during the period of May 2019–May 2020. Blood samples were collected from the patients and tested using GeneXpert and histopathological assessment. Results demonstrated 34 patients with a positive result and 6 patients with negative results on both diagnostic methods. Twenty nine out of 40 patients (72.5%) had rifampin-sensitive TB. Diagnostic accuracy of GeneXpert, when compared to histopathological examination, is represented by the sensitivity of 88.2%, specificity of 33.3%, positive predictive value of 88.2%, and negative predictive value of 33.3%. High sensitivity results forpatients with spinal TB on GeneXpert suggests that the test is appropriate to be used as a screening method and as a high-yield rapid diagnostic test for patients suspected for spinal TB.]]>
<![CDATA[Paternity Test Through Kinship Analysis as Forensic Identification Technique ]]>
<![CDATA[Ahmad Yudianto]]>;
<![CDATA[Fery Setiawan]]>;
<![CDATA[Reni Sumino]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2154
<![CDATA[Paternity tests is often faced with the unavailability of information from the father, mother, or child as a comparison in forensic DNA examination process. Therefore, comparisons with information from close family lines are needed, for example from the victim's siblings or the perpetrator if there are no comparisons from parents or siblings. This study was conducted by the Human Genetic Study Group of Airlangga University in its campus from January to April 2020. The aim of the study was to analyze the use of kinship analysis in paternity test through STR CODIS examination on siblings. This was an observational laboratory study with a temporary design. DNA sample extraction level and purity results were measured with the mean DNA sample level of 675±5.35ng/µL, while the purity values ranged from 1.05 to 1.86. The paternity test principle is based on comparison process between the parents’ alleles with the child’s alleles. However, if the parents’ alleles are not available, the siblings’ alleles can be used as a comparison for identification purpose, which is known as kinship analysis. Statistically, full siblings have a 2 alleles accuracy probability of [0.25] 25%, which was the same as not having the same allele or 0 allele, while 1 allele accuracy reached 50%. All CODIS STR loci had the highest percentage of 2 allele sharing. Therefore, it is recommended to use sibling or kinship analysis if both parents are absent.]]>
<![CDATA[Analisis Faktor-Faktor Yang Berhubungan Dengan Fungsi Paru Pada Pekerja Pabrik Pupuk X Di Palembang ]]>
<![CDATA[Raden Ayu Tanzila]]>;
<![CDATA[Ernes Putra Gunawan]]>;
<![CDATA[Aisyah Khairani]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2219
<![CDATA[Fertilizer industry workers are at risk of developing lung function disorders, especially from exposure to ammonia and urea dust. This study aimed to determine the vital lung capacity of workers at Fertilizer Factory X, Indonesia, and the influencing factors. This was a cross-sectional analytic observational study on 78 workers who work as an ammonia unit operators in the factory area who met the inclusion and exclusion criteria. Sampling was done consecutively from December 2019 to January 2020. Data were collected using a questionnaire while the pulmonary function measurement was performed using spirometry. Research variables included age, length of work, smoking habits, nutritional status, use of Personal Protective Equipment (PPE), and assessment of vital lung capacity. Data were analyzed using the Chi-Square test and the results showed that the vital lung capacity of most respondents was classified as normal (55.1%). There were significant relationships between vital capacity and risk factors for age (p=0.001), length of work (p=0.009), use of PPE (p=0.012), and smoking habits (p=0.020). It is concluded that there is a relationship between vital capacity and age, length of work, use of PPE, and smoking habits in workers of Fertilizer Factory X, Indonesia.]]>
<![CDATA[White Turmeric Rhizome Protection Effect of against Lung Tissue Damage in Copper Sulfate-Induced Wistar Rats ]]>
<![CDATA[Linda Chiuman]]>;
<![CDATA[Fahrul Azmi Tanjung]]>;
<![CDATA[Djamin Djamin]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2211
<![CDATA[One of common heavy metals that pollute rivers in Indonesia is copper, which can damage various organs, including the lungs. As a potential natural herbal medicine, white turmeric rhizome has antioxidant properties that potentially protect the body from copper pollution. This study aimed to explore the potential of the white turmeric rhizome (Curcuma zedoaria) to provide a protective effect on the lungs against copper contamination. This study was an experimental study performed in June 2020 on 25 copper-induced Wistar rats which were divided into five groups: negative group that received 1 ml of copper sulfate suspension at the 12th to 14th day; positive group that received 10 mg/200 g BW of ethanol extract from white turmeric without copper sulfate suspension; and three experimental groups that received 10 mg/200 gBW, 20 mg/200 gBW, and 40 mg/200 gBW of ethanol extract from white turmeric every day, respectively, followed by copper sulfate suspension at the 12th–14th day. After 14 days, the rats were sacrificed by chloroform inhalation and the lung was excised and processed for histopathology preparation. The edema, hemorrhage, leukocyte infiltration, and alveolar septal thickness were evaluated from the lung tissue perparation. The score of tissue damage was express as median (Range) and analyzed using the Kruskal-Wallis test. The result of this study shows that there was a significant difference in lung tissue score among all groups of treatment (p-Value=0.001). The experimental group with highest dosage extract presented a good protection effect as well as the positive group. Hence, white turmeric has a good protective property for the lung against damages caused by copper contamination.]]>
<![CDATA[Mutation and Phylogenetic Analysis of Spike Glycoprotein of Indonesian Isolates of Severe-Acute-Respiratory-Syndrome-Coronavirus-2 (SARS-CoV-2) ]]>
<![CDATA[Shabarni Gaffar]]>;
<![CDATA[Syifa Al Fauziah Rahmani]]>;
<![CDATA[Ari Hardianto]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2230
<![CDATA[Coronavirus disease-2019 (COVID-19) is an infectious acute respiratory disease caused by SARS-CoV-2. The protein that plays a role in the entry of SARS-CoV-2 into human cells is the surface protein, or the Spike, which is thought to be the effective vaccine target to prevent SARS-CoV-2 infection. Until December 2020, Indonesia has reported 106 SARS-CoV-2 genome sequences identified from COVID-19 positive patients. The purpose of this study was to analyze the phylogenetic relationship of the Spike protein of the Indonesian isolates of SARS-CoV-2 Indonesian, as well as the virus mutations and their effects on changes in the amino acid. The 106 Indonesian SARS-CoV-2 genomes were downloaded from GISAID and the Spike nucleotide and amino acid sequences were analyzed by multiple sequence alignment (MSA) and mutation analysis using the ClustalW method. Phylogenetic trees were created using the Neighbor-Joining method in MEGA-X software. The results showed that 30 of the 106 Indonesian isolate SARS-CoV-2 Spike were 100% identical to the Wuhan-Hu-1, while the remaining 76 had experienced mutations at 1-4 sites. There were 43-point mutations in the Spike gene, 27 of which led to amino acid changes and four had not been reported in other countries. The global mutation D614G was found in 60 Indonesian isolates , of which West Java was the province with the most reports. The phylogenetic of Spike showed that the Indonesian samples have been divided into several branches that are far from Wuhan-Hu-1. This study indicates the possibility of differences in the protein structure of Indonesian isolate SARS-CoV-2 Spike that need to be further studied to manufacture a vaccine against the Indonesian strain of SARS-CoV-2.]]>
<![CDATA[IP-10 as a Non Sputum Biomarker in TB Treatment Monitoring ]]>
<![CDATA[Efriyani, Yuhpita Indah]]>;
<![CDATA[Parwati, Ida]]>;
<![CDATA[Tristina, Nina]]>;
<![CDATA[Tjandrawati, Anna]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2161
<![CDATA[There are currently still limitations in the diagnosis of tuberculosis (TB). Sputum collection as specimen for diagnosis is not only difficult but also has low sensitivity.In blood, IP-10/CXCL-10 chemokine plays a role in inducing the movements of chemotactic inflammatory cells towards the sites of inflammation. A high level of IP-10 is found in active pulmonary TB patients and significantly decline after the patients have completed the TB treatments. The aim of this study was to analyze the decline of the IP-10 level before and after 2 months of TB treatment. This study was conducted from March toJuni 2020. This was a comparative observational cohort study on active pulmonary TB patients who were >18 years old at the DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung. Thirty patients who met the inclusion criteria were followed up until 2 months of TB treatment. Serum of  these patients were collected and examined for the IP-10 level before and after 2 months of TB treatment. It was demonstrated that the median IP-10 level in new active pulmonary TB patients was 384.1 pg/mL (136.70–779.80) and dropped to 251.85 pg/mL (91.10–698.30) (p<0l001) two months of TB treatment. Thus, the IP-10 level in the active pulmonary TB patients is significantly declined (p<0.001) after 2 months of TB treatment and that serum IP-10 level could be considered as a non-sputum-based marker to monitor TB treatment.]]>
<![CDATA[Effects of Ethanol Extract from Sunkist (Citrus sinensis L. Osbeck) Peels on Rat’s Estrus Cycle ]]>
<![CDATA[Mutia, Maya Sari]]>;
<![CDATA[Suhartina, Suhartina]]>
<![CDATA[ Majalah Kedokteran Bandung Vol 53, No 1 (2021) ]]>
Publisher : <![CDATA[Faculty of Medicine, Universitas Padjadjaran ]]>
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DOI: 10.15395/mkb.v53n1.2167
<![CDATA[Kuhnle et al. has reported that Sunkist peels contain 36 µg/100 g wet weight of phytoesterogen. This study was designed to explore Sunkist peels' potential to recover the infertility due to ovulation failure. This study was performed in June 2020 at the Pharmacology Laboratory, Universitas Prima Indonesia, on 25 rats. These rats were divided into five groups: Control, Standard, and Sunkist Peels Extract-I, II, and III that received 1 ml of 0.5% Sodium Carboxymethyl cellulose suspension, ethinyl estradiol 50 g/kgBW, 300 mg/kgBW, 450 mg/k BW, and 600 mg/kgBW of ethanol extract from Sunkist peel, respectively. Every 8-12 hours, the rat’s vagina were swabbed and smear into on object glass to be stained by 10% Giemsa and viewed at 40x and 100x magnifications. The leucocytes, especially neutrophils, epithelial cells, cornified and epithelial cells as well as the density of cells in vaginal swab were evaluated to determine the estrus cycle of the rats. The length of estrus phases was express as median (IQR) and analyzed using the Kruskall-Wallis test. The result of this study showed that the standard and highest dosage extract showed a significant extending of estrus and metestrus phases compared to the control group and significantly shortened diestrus phases. Hence, the highest dosage of Sunkist extract can prevent infertility by increasing the period of estrus cycle (ovulation) at the same level as the standard group.]]>
