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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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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 10 Documents

Search results for , issue "Vol 52, No 2 (2020)" : 10 Documents clear

Sinonasal or nasopharyngeal undifferentiated Carcinoma?: diagnostic pitfall and the role of Epstein-Barrvirus (EBV) and human papillomavirus(HPV) examination Wahyu Tri Widayati; Ery Kus Dwianingsih; Bustanul Ardianto; Didik Setyo Heriyanto; Sagung Rai Indrasari; Camelia Herdini; . Irianiwati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Undifferentiated carcinoma of the head and neck is frequently observed in nasopharynx, however it may also occur in oropharynx, salivary gland and sinonasal. Overlapping lesions in those regionscreate difficulty in determining the origin of the tumor. Thus, it causes diagnostic pitfall not only for pathologists, but also for clinicians. A 40 yearold man, presented with nasal obstruction, epistaxis, diplopia, and headache for a yearand showed nasal cavitysinistra and nasopharynx masses on CT-scan. Lymph node enlargement was not detected. First biopsywas performed and histopathologically diagnosed as nasopharyngeal undifferentiated carcinoma(NPC), extended into nasal cavity. Chemo-radiation protocol for NPC was conducted, and showing uncomplete response. Second biopsy was done, and reviewed with the first biopsy result. Thetumourwas arranged insolid, syncytial and trabecular pattern, with vesicular nuclei, prominent nucleoli, and lack of lymphoplasmacytic infiltrat. Immunohistochemistry (IHC) analysis of p16, EBNA1 and LMP1 were negative. PCR analysis of HPV-18 was positive, while EBV detection showed negative result. General association of EBV with NPC suggests that the presence of latent EBV infection can serve as a positive marker for NPC. Therefore, in this case, the EBV negativity and strong HPV association led to diagnosis of SNUC. The distinction of sinonasal undifferentiated carcinoma (SNUC) or from NPC was important for appropriate management and therapy.

The prognostic value of lymph nodes mRNA CXCL12 expression in the breast cancer idha safitri; Irianiwati Widodo; Didik Setyo Heriyanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Prognosis of breast carcinoma is influenced by age, tumor size, histological grade and type, lymph node status, as well as metastasic status. Chemokine receptor CXCR-4 with its ligand, CXCL-12, may play an important role in metastasis of breast carcinoma. However, the role of CXCL-12 mRNA as a prognostic factor and a therapeutic target of human breast cancer remains controversial. This study aimed to investigate the level of CXCL-12 mRNA expression in lymph nodes of patients with invasive ductal breast carcinoma and the difference within the prognostic factors. Axillary lymph nodes obtained from 50 cases of invasive ductal breast carcinoma, were divided into two groups, with and without lymph node metastasis. Each group consisted of 25 cases. Total RNA was extracted from formalin-fixed paraffin-embedded. The CXCL-12 mRNA expression was examined using qRT-PCR method. The mean differences between the two groups were analyzed using Mann-Whitney test. The differences between CXCL-12 mRNA expression and each prognostic factor ware analyzed using Mann-Whitney comparison test. CXCL-12 mRNA expression was significantly higher in the lymph node of patients with metastasis of breast carcinoma compared to the non-metastasis cases (p<0.01). There were significant differences between CXCL-12 mRNA expression with poorly histological grade (p=0.003), bigger primary tumor size (p=0.005) and age of ≥45 y.o (p=0.012) in the metastatic group, but there were no significant differences between both age of <45 and ≥45 y.o.This study suggests that the higher CXCL-12 mRNA expression level are associated with bigger tumor size and poor differentiation in breast cancer patient with lymph nodes metastasis

Validation test of Indonesian pelvic floor distress inventory-20 (Indonesian PFDI-20) Pangastuti, Nuring; Iman, Santoso Budi; Denny, Agustiningsih; Emilia, Ova
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The pelvic floor distress inventory-20 (PFDI-20) questionnaire is one of the questionnaires used to help find out complaints of pelvic floor dysfunction. The questionnaire is also frequently used in studies related to pelvic floor dysfunction. The validation test results of the questionnaire have not been obtained from Indonesian population.This study aimed to obtain an Indonesian PFDI-20 questionnaire that is in accordance with the original questionnaire and valid as well as reliable use for the Indonesian population.The validation test series were conducted through several stages: forward translation, back-translation, expert panel, pre-testing, and cognitive interviewing, final version and documentation. Data of 77 female respondents of reproductive age in the Yogyakarta Special Region were collected from January to March 2018.The statistical test result of questionnaire validity from the corrected item-total correlation of each question item has value more than 0.30 (0.385-0.781) indicating that the Indonesian PFDI-20 questionnaire was valid. Test reliability of the questionnaire using Cronbach’s alpha with a high significant result of 0.911 (0.902-0.913)> r table was obtained. In conclusion, the Indonesian PFDI-20 questionnaire is valid and reliable, thereforeit can be used in Indonesian population.

Prognostic factors for mortality in patients with severe traumatic brain injury in Yogyakarta, Indonesia Desin Pambudi Sejahtera; Ismail Setyopranoto; Indarwati Setyaningsih; Sri Sutarni; Tri Ratnaningsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Determining an accurate prognosis in patients with severe traumatic brain injury (TBI) still becomes a difficult challenge for neurologists. Clinical and laboratory findings have been used as important parameters to establish clinical decisions or even predict future prognosis including death in these patients. We studied the clinical, laboratory and neuroimaging parameters in predicting mortality in patients with severe TBI. This study used the medical records of severe TBI cases in Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2015 until July 2016. We evaluated the clinical, laboratory, and neuroimaging examinations of seventy patients with severe TBI in association with mortality. The result showed among 70 patients involved, 35 were dead. Clinical findings of age <40 y.o. (OR=1.143; p=0.015), multiple injuries (OR=5.712; p=0.045), and systolic blood pressure >140 mmHg (OR=3.852; p=0.008) were associated with mortality. Laboratory and neuroimaging parameters of hyponatremia (OR=3.667; p=0.027), hyperkalemia (OR=1.771; p=0.030), and the presence of traumatic subarachnoid hemorrhage (SAH) (OR=6.526; p=0.003) in head CT-scan were significantly associated with mortality. In conclusion, our study showed that productive age <40 y.o. multiple injuries, hyponatremia, hyperkalemia and the presence of traumatic SAH increase the mortality risk in patients with severe TBI.

Vitamin D suppresses inflammatory responses in insulin resistance Rona Kartika; Heri Wibowo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Vitamin D has been known as a vitamin for bone health and mineral homeostasis. However, since the discovery of vitamin D receptor (VDR) in various types of cell, that statement has changed. Immune cells are known to express VDR and enzyme 1α-hydroxylase that could convert vitamin D into its active form, 1.25 dihydroxyvitamin D. In immune cells, vitamin D works as an immunomodulator which affects various levels of immune response. The net effects of vitamin D are increasing mucosal immunity, but dampening the adaptive immune system. Vitamin D deficiency is commonly found in people with diabetes mellitus (DM) and obesity. It is also associated with increased insulin resistance and poor glucose control. This review will explain how vitamin D as immunomodulator dampens insulin resistance. In immune cells from subjects with insulin resistance, administration of vitamin D could reduce the expression of pro-inflammatory cytokines through the NF-κB and MAPK pathways, thus the levels of pro-inflammatory cytokines such as TNFα, IL-1β, and IL-6 are decreased. The same thing happens in preadipocytes and mature adipocytes cells. In these cells, vitamin D suppresses the expression of pro-inflammatory mediators such as IL-6 and MCP-1. Although in the invitro studies, the administration of vitamin D showed a promising effect in modulating the immune system, the clinical effect of vitamin D supplementation in reducing insulin resistance in individuals with type 2 DM (T2DM) and prediabetes is still inconclusive

Factors affecting tumor response to transarterial chemoembolization (TACE) therapy in patient with hepatocellular carcinoma (HCC) Alia Amalia; Nikmatia Latief; Bachtiar Murtala; Andi Alfian Zainuddin; Nu’man AS Daud
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Hepatocellular carcinoma (HCC) is a major problem of global health.Transarterial chemoembolization (TACE) is the treatment of choice for unresectable HCC. The TACE is routinely conducted in major hospitals in Indonesia, however it rarely published.The use of modified response in evaluation criteria in solid tumors (mRECIST) was introduced as an accurate method of measuring tumor response in HCC. This study aimedto investigate the factorsaffecting tumor response to TACE therapy in HCC patients by using mRECIST. It was a retrospective cohort study conducted on 30 patients who successfully underwent the first TACE procedure in the Department of Radiology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia from January 2016 to August 2019. The multiphase abdominal computed tomography before and after as well as laboratory examination results before TACE were collected and analyzed. Chi-Square and Spearman-tests were used for the statistical analysis. A significant relationship between tumor location (p=0.016), number of tumor (p=0.001) and Child-Pugh score with tumor response to TACE therapy (p = 0.016) was observed. Solitary tumors tend to have a better therapeutic response, meanwhile, tumors located in the left lobe of patients with Child-Pugh B scores showed a decreased tumor response. Furthermore, no a significant relationship between age (p=0.920), sex (p=0.303), tumor size> 5 cm (p=0.082) and alpha-fetoprotein (AFP) levels (p=0.414) with tumor response was observed. In conclusion, TACE is preferably therapy for multinodular and unresectable HCC. Tumor response after TACE can be well assessed using mRECIST. The factorsaffecting tumor response to TACE therapy arenumber of tumor, location, and Child-Pugh score

A fatal acute appendicitis with sepsis and pneumonia was caused by melioidosis: a case report Abu Tholib Aman; Yuli Mawarti; Agus Barmawi; Faisal Heryono; Rizka Humardewayanti Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

We report anunderdiagnosed fatal case of melioidosis that involved dygestion system which complicated with pneumonia, and sepsis. The case was initially diagnosed as acute appendicitis, and subsequently the patient underwent an exploratory laparatomy and appendectomy. He was discharged afer 3 days of hospitalization. Thirty days afterward, he was admitted to another private hospital to experience another exploratory laparatomy with indication of pancreatitis, intra-abdominal organs adhesions, and postoperative enterocutaneous fistula (ECF), and hospitalized there for 25 days. He eventually suffered from sepsis, pneumonia, unclosed ECF, anemia, hypoalbuminemia, and electrolyte imbalance. He then referred to a tertiary teaching hospital and hospitalized there for a total 134 days until he passed away. His clinical condition was declining, despite a long course of broad spectrum antibiotics. Treatment delay, prolong hospitalization, and complications were the inevitable, although Burkholderia pseudomallei was finally identified 2 weeks prior to his death. This case highlight that melioidosis canassociate with acute appendicitis, and that the delay on its diagnosis and treatment may trigger complications and death.

Utilization of banana (Musa paradisiaca L.) peel as pectin source as antidiarrheal on castor oil-induced diarrheal Wistar rats model Martin Adhitya Subagio; Cecilia Noviyanti Salim; Qorina Putri Srisantoso; Yora Nindita; Astika Widy Utomo; Nani Maharani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Banana (Musa paradisiaca L.) peel, locally name pisang raja, contains a high concentration of pectin which is used as antidiarrheal to absorb irritants and increase stool consistency. However, it’s use to increase the stool consistency has not been studied, yet. The study aimed to investigate the effect banana peel extract (BPE) administration on stool consistency of diarrheal rat model. It was an experimental study with a post-test only control group design. Thirty male Wistar rats were induced diarrhea with castor oil and then randomized into five groups. Group I as positive control group was given attapulgite at dose of 124 mg/kg BW. Group II as negative control was given 0.5 mL of 1% tween 80. Group III, IV and V as treatment group were give BPE at different doses of 100, 200 and 400 mg/kg BW, respectively.T he stool consistency was measured every hour for 4 h by weighing fresh and dry stool weight and then the water content was calculated. Data analysis was conducted using one-way ANOVA and LSD post hoc test. Significantly different in stool consistency between Group III, IV, and V compared to Group II (p<0.05) and between groups Group III and IV compare to Group I (p<0.05) were observed. However, there was no significantly different between group V compared to Group I (p=0.149).In conclusion, BPE can increase the stool consistency of castor oil-induced diarrhea rats. The BPE at the dose of 400 mg/kg BW has similar effect to attapulgite.

The association between malaria incidences and air temperature at Kulon Progo District, Yogyakarta Special Province . Nilasari; Lutfan Lazuardi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Malaria is still a public health problem in Indonesia including in Kulon Progo District, Yogyakarta Special Province. Kulon Progo District remains become malaria endemic area, with significant number of malaria cases for more than the last ten years. Previous studies proved that malaria transmission is associated with climatic conditions. However, these conditions have never been investigated in Kulon Progo District. The aim of this ecological study was to investigate the association between the distribution of malaria cases and climatic condition in the Kulon Progo District using spatial-temporal approach. A total of 1439 malaria cases were collected during the period of 2005-2015. Time-trend, bivariate analysis, and spatial analysis were performed. The results showed that air temperature lag 0 (p = 0.0000; r = 0.5225), air temperature lag 1 (p = 0.0009; r = 0.2850), air temperature lag 2 (p = 0.0329; r = 0.1858) related to the incidence of malaria. Spatial analysis and time-trend analysis also showed direct relationship pattern between malaria and air temperature. In conclusion, there is a relationship between malaria cases and air temperature in Kulon Progo District. Spatial analysis approach is important for early alert system, to decrease morbidity and mortality due to malaria.

Diagnosis value of prostate specific antigen density (PSAD) and prostate specific antigen (PSA) in bone metastases of prostate cancer among Indonesian population Ahmad Zulfan Hendri; Andy Zulfiqqar; Indrawarman soeharjo; Raden Danarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Cancer prostate (PCa) is currently reported as the most diagnosed cancer in males. Bone metastases in PCa indicate poor prognosis and the major cause of pain and death. Early diagnosis of metastases is important in PCa management. Prostate specific antigen (PSA) velocity was used to predict overall survival and metastasis-free survival. However, this test should be conducted 2 times, for at least 4 weeks apart. Therefore, a cross-sectional test with higher positive probability value is needed. This study aimed to compare PSA density (PSAD) and PSA level to evaluate patients at risk of bone metastases in Yogyakarta, Indonesia. Aretrospective study with a total subject of 106 patients with (n = 31) and without (n = 75) bone metastases were analyzed. The initial PSA measurement, as well as bone scan and prostate volume, were evaluated in all patients. Bone survey found to be positive in 31/106 (29.2%) patients. The total of 50(47.2%), 10(9.4%) and 46(43.4%) patients had PSA level <50, 50-100 and >100ng/mL, respectively. Furthermore, receiver operating characteristic (ROC) area under the curve of PSAD (0.75) was higher that that ofPSA (0.65).PSAD more than 0.15 indicated sensitivity of 93% and specificity of 38%, while PSA more than 20 ng/mL shown sensitivity 82% and specificity 21%. In conclusion, PSAD level more than 0.15 shows high sensitivity and specificity in causing potential skeletal metastases. Using this PSAD cut-off value, unnecessary investigation canbe avoided.

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