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Published by Universitas Gadjah Mada

ISSN : 01261312 EISSN : 23563931 DOI : http://dx.doi.org/10.19106/JMedSci005303202101

Core Subject : Science,

Immunology & microbiology Neuroscience

Journal of the Medical Sciences (JMedSci) or Berkala Ilmu Kedokteran (BIK) is an international, open-access, and double-blind peer-reviewed journal, published by Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia. JMedSci aiming to communicate high-quality articles in the areas of biomedical science from basic to clinical sciences.The journal welcomes papers from original articles, case reports, reviews, and book reviews. All papers published in JMedSci are freely available as downloadable pdf files. The journal began its publication on March 1973 and published quarterly (January, April, July, and October). JMedSci is abstracted and indexed in DOAJ, Crossref, Google Scholar, Sinta, Indonesia One Search. JMedSci is accredited by Directorate of General Higher Education, the Ministry of Research, Technology, and Higher Education, Indonesia

Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)

Articles 6 Documents

Search results for , issue "Vol 49, No 2 (2017)" : 6 Documents clear

Level of Adipokines and Insulin Resistance in Obese Javanese Population Pramudji Hastuti; . Tasmini; AH Sadewa; DM Chornelia; D Karita
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Introduction: Obesity is a condition involving low-level chronic inflammation as indicated by increased levels of C-reactive protein (CRP), TNF, interleukin and other inflammatory markers in the blood. Some endocrine mediators, such as paracrine and autocrine derived from adipose tissue play an important role in regulating the function of adipocytes, especially related to insulin sensitivity. Significant complications of obesity, including insulin resistance as a risk factor of Type 2 diabetes are associated with myocardial infarction, stroke, and peripheral vascular disease.Aim: The purpose of this study is to determine the level of C-reactive protein (CRP), TNF-alpha, interleukin, resistin and insulin resistance in the obese group compared to controls sampled from a Javanese population.Method: This study is a preliminary study of 120 people, consisting of 60 obese and 60 controls. Lipid profiles, levels of C-reactive protein (CRP), TNF-alpha, interleukin, resistin were examined with Elisa methods and insulin resistance was calculated by HOMA IR index.Results: This study found levels of glucose, insulin, CRP, and HOMA-IR were higher and significantly different in obese group than control (P <0.05). The TNF-alpha and resistin levels were not significantly different between obese and control groups (P>0.05)Conclusion: The study showed that there were increased levels of adipokines and insulin resistance in obese group compared with the control in the sample of Javanese population.Keywords: Obese, insulin resistance, CRP, TNF-Alpha, Interleukin, Resistin

Hospital-based Phase III Cardiac Rehabilitation Program Improves Low Density Lipoprotein, Triglyceride, and Fasting Blood Glucose Level in Coronary Artery Disease Patients : a 6-month Follow up Bambang Dwiputra; Fajar Panjaitan; Evan Hindoro; Nurul Fathoni; Anwar Santoso
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTBackground. Cardiac rehabilitation (CR) has been reported as effective for improving coronary risk factors and increasing exercise tolerance in patients with coronary artery disease (CAD) after cardiac events. It may be performed in 3 stages: acute (phase I), subacute (phase II), and chronic (phase III). In Indonesia, most cardiac rehabilitation programs have been phase I and some phase II, whereas phase III cardiac rehabilitation has not often been performed as it was not covered by national health insurance.Objectives. We assessed the beneficial effects of 6-month hospital-based phase III comprehensive cardiac rehabilitation on physical status and coronary risk factors among CAD patients.Methods. 74 patients were stratified as the intervention group (n=37) and the control group (n=37). In the intervention group, patients participated in hospital-based phase III CR for 6 months, whereas in the control group, they received standard care. CR program consists of warm-up (senam jantung sehat), aerobic exercise, cool-down stretching, and health education session three days a week. Blood glucose and lipid profile examination were performed at the beginning and sixth month to assess patient’s metabolic status.Results. Of 74 patients observed, most patients were male (85.1%) with mean age 54.7+3.4 years old. 57 patients had post-procedural history (77% post-PCI, 4% post-CABG), 8 patients (11%) were still active smokers, 31 patients (42%) had diabetes, and 60 patients (81%) had hypertension. Participation of hospital-based phase III CR program was significantly correlated with lower low-density lipoprotein (LDL) level (p=0.003, r=0,41), triglyceride level (p=0.001, r=0,38), and fasting blood glucose (p<0.001, r=0,46) during 6-month follow up.Conclusion. Patients with CAD who underwent hospital-based phase III CR program had significantly better fasting glucose control, LDL, and triglyceride level during 6-month follow up. These results may encourage other hospitals to perform the same program achieving better prognosis of CAD patients.Keywords: cardiac rehabilitation, high density lipoprotein, low density lipoprotein, triglyceride, blood glucose

Cytotoxic activity of simvastatin in T47D breast cancer cell lines and its effect on cyclin D1 expression and apoptosis Bayu Putra; Mae Sri Hartati Wahyuningsih; Eti Nurwening Sholikhah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Background: Statins (HMG-CoA Inhibitors) is a drug used for decreasing plasma cholesterol levels and used in therapy to prevent coronary artery disease. Research in animals and epidemiological studies showed that statin therapy can decrease risk against cancer associated with cholesterol. Based on that result then research of cytotoxic activity against simvastatin knowing cultur T47D breast cancer cells and his influence in decreasing expression of cyclin D1 and induction of apoptosis has been done.Research objectives: The aims of this research is to prove activities of simvastatin against T47D breast cancer cell culture, especially to examine cytotoxic activity, cyclin D1 expression, and simvastatin effect in apoptotic induction.Research method: The type of this research is quasi experiment with using posttest with non-equivalent control group design. Cytotoxicity test performed on T47D breast cancer cell cultures using MTT assay to determine IC50 values after given simvastatine. Expression of cyclin D1 and apoptosis induction test detected using flow cytometry with antibody monoclonal anti-cyclin D1 and Annexin V-Pi, then analyzed by FACS-Calibur program.Results: Simvastatin has cytotoxic effect against T47D breast cancer cells with IC50 values 25.25 µg/mL. Simvastatin with concentrations of 6.31; 12.62; 25.25 and 50.5 µg/mL was able to decrease the cyclin D1 expression. Furthermore, simvastatin can induce apoptosis with EC50 values 26.96 µg/mL in T47D breast cancer cells.Conclusion: Simvastatin has cytotoxic activity of in T47D breast cancer cells and decreasing cyclin D1 expression and inducing apoptosis activity in T47D breast cancer cells.Keywords: simvastatin, cytotoxic, cyclin D1, apoptotic, T47D.

Sensitivity of Total Protein Creatinine Ratio in Urine for Diagnosis Diabetic Nephropathy . Fatrinawati; . Windarwati; Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTDiabetic nephropathy is one of diabetic complication characterized by proteinuria and impaired renal function. Confirmation of diagnosis based either on urine value of albumin excretion rate (AER) 30-300 mg/24 hours or albumin creatinine ratio (ACR) 30-300 mg/g or total protein creatinine ratio (TPCR) 150-500 mg/g. It is reported that TPCR measurement is more acceptable since it is convenient, fast and does not require special preparation. The aim of this study is to investigate the accuracy of TPCR for diagnosis of diabetic nephropathy among type 2 diabetic patients.This was a diagnostic test study which involves 86 type 2 diabetic patients where urine TPCR value equal or more than 150mg/g was independently and blindly compared with AER as a refference standard to diagnose diabetic nephopathy. The inclusion criteria were type 2 diabetic patients that suspected suffer from diabetic nephropathy (long of illness is more than 4 years) and agree to participate in this study. Those whom were suffer from at least on of the following diseases urinary tract infection, congestive heart failure, liver dysfunction, pregnancy, multiple myeloma, microangiopathy hemolytic anemia (MAHA) and incomplete data were excluded from the study. The results of the study were analyzed using 2x2 table in order to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio for positive test result/LR(+),likelihood ratio for negative test result/LR(-),and accuracy. The average of TPCR among diabetic nephropathy patient was 248.07 mg/g. It was significantly higher as compared to those non diabetic nephropathy patient (103.52 mg/g). It was found 75 true positive result, 9 true negative result, and 2 false positive result. The result showed that TPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 97.4%, 100%, 100%, and 81,8% respectively to diagnose diabetic nephropathy.Total Protein Creatinine Ratio (TPCR) with value equal or more than 150 mg/g in the morning sample urine can be used to diagnose diabetic nephropathy.Keywords: diabetic nephropathy, total protein creatinine ratio, sensitivity, albumin excretion rate, diagnostic test study

Mammographic Density and Estrogen Receptor α Gene Polymorphism in Javanese Women Lina Choridah; Teguh Aryandono; Arif Faisal; Ahmad Hamim Sadewa; Dewajani Purnomosari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Estrogen plays important roles in breast cancer as it binds its receptor in breast tissue. The most studied variants in estrogen receptor α encoded by ESR1 gene are the ESR1 PvuII and XbaI polymorphisms, which were associated with lower sensitivity to estrogen. We determined the proportion of ESR1 XbaI and PvuII polymorphisms in Javanese woman in Yogyakarta, Indonesia and analyzed the correlation between genetic variations with mammogram density. ESR1 XbaI and PvuII polymorphisms of 50 cases and 58 controls were identified using PCR-RFLP. Breast density was assessed based on digitizer mammograms. Quantitative analysis was performed using an interactive program based on cumulus of two thresholds. Mean of density and frequencies of SNPs were compared between cases and controls to identify the association between SNPs and cancer susceptibility. Mammographic density was significantly higher in cases (52%) than controls (0.41%) (p < 0.05). Women with one or two copies of the PvuII T allele and XbaI A allele had higher mammographic density compared with women with C and G alleles, respectively. The proportion between PP and TT genotype was not statistically significant (p > 0.05), while the proportion between AA and GG was significantly different (p < 0.05). Haplotype 2 (CG/PX) was associated with lower sensitivity to estrogen and reflects a decrease of mammographic density. These findings were consistent with other studies that showed that ESR1 polymorphisms may affect breast cancer risk through differences in breast density.

Pulmonary artery vegetation in a pediatric patient with ventricular septal defect: a case report Haryo Aribowo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTIntroduction: Infective endocarditis (IE) is one of the congenital heart disease complications which is frequently seen in ventricular septal defects (VSD). The Duke criteria are the diagnostic criteria for IE. One of the major criteria is evidence of vegetation. In VSD complicated with IE, vegetation is frequently found on the opening of the defect, on the right ventricular side of the opening, on the tricuspid valve, and less frequently it is found on the pulmonary valve. Vegetation found in the lumen of pulmonary artery is rarely reported.Case report: A 6 years old boy was consulted with congenital heart disease. His chief complaint was shortness of breath. He came with unspecific signs and symptoms with a history of frequent hospitalization due to pneumonia and paleness. Chest X-ray showed enlargement of heart chambers. Transthoracic echocardiography (TTE) revealed moderate size VSD and multiple vegetation on right ventricle outflow tract, pulmonary artery valve, and inside the lumen of main pulmonary artery and right pulmonary artery. The blood culture showed a positive result for S. viridans. He was treated with parenteral antibiotic and operated on later. We successfully performed evacuation of the vegetation and VSD closure.Conclusion: We reported a rare case of pulmonary artery vegetation in a boy with moderate VSD that we treated with combination of parenteral antibiotic followed by successful surgical vegetation evacuation and VSD closure.ABSTRAKPembukaan: Endokarditis infektif merupakan salah satu komplikasi penyakit jantung bawaan yang sering menyertai defek septum ventrikel (VSD). Kriteria Duke merupakan kriteria diagnosis untuk endokarditis infektif. Salah satu kriteria mayor nya adalah bukti adanya vegetasi. Pada VSD dengan komplikasi endokarditis infektif, vegetasi sering ditemukan pada pembukaan dari defek, pada ventrikel kanan, pada katup trikuspid, dan yang paling jarang pada katup pulmonalis. Vegetasi pada arteri pulmonalis jarang dilaporkan.Laporan kasus: Anak laki-laki berusia 6 tahun dikonsultasikan dengan penyakit jantung bawaan. Keluhan utamanya adalah sesak nafas. Pasien datang dengan tanda dan gejala yang tidak khas dengan riwayat rawat inap berulang karena pneumonia dan pucat. X-ray dada menunjukkan pembesaran ruangan-ruangan jantung. Transthoracic echocardiography menunjukkan VSD berukuran sedang dan vegetasi multiple pada right ventricle outflow track, katup pulmonalis, dan didalam lumen arteri pulmonalis komunis dan arteri pulmonalis kanan. Kultur darah positif untuk S. viridans. Pasien menerima antibiotik parenteral dan menjalani pembedahan setelahnya. Kami berhasil melakukan evakuasi vegetasi dan penutupan VSD.Kesimpulan: Kami melaporkan kasus vegetasi arteri pulmonal pada anak laki-laki dengan VSD sedang yang kami terapi dengan kombinasi antibiotik parenteral diikuti dengan pembedahan evakuasi vegetasi dan penutupan VSD.Keywords: pulmonary artery; vegetation; ventricular septal defect; infective endocarditis; surgery

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Nurhadiyahya

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