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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
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 12 Documents
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Search results for , issue "Vol 54, No 3 (2022)" : 12 Documents clear
Characteristics of patients with Hepatitis B and C at Dr. Moewardi General Hospital in Surakarta, Indonesia Benedictus Aditya Satya Laksana Adji; Triyanta Yuli Pramana; Tri Nugraha Susilawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202207

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain a significant health burden in the world, which is mainly attributed to patients who develop chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). The epidemiology of hepatitis B and C in Surakarta, Central Java Province, Indonesia has never been reported. This study aimed to investigate the demographic, clinical, and laboratory characteristics of patients with hepatitis B and C who were admitted to Dr. Moewardi General Hospital, Surakarta in 2019. The medical records of patients with hepatitis B (n=94) and hepatitis C (n=75) were examined, and the data were analyzed using the chi-square and Mann-Whitney tests. The patients with hepatitis C were generally older, more likely to develop jaundice and ascites, and had higher levels of serum urea, creatinine, AST, and total bilirubin compared to those with hepatitis B. In conclusion, patients with HCV infection had worse clinical presentation and laboratory profiles than those with HBV infection. However, further research is needed on a wider scale to confirm this result.
Prediction score for post-stroke cognitive impairment (PSCI) after acute ischemic stroke Johan Budiman; Jarir At Thobari; Rizaldy Taslim Pinzon
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202204

Abstract

It was estimated that patients with ischemic stroke and post-stroke cognitive impairment (PSCI) have been increasing. In addition, this PSCI is often late diagnosed when it has already developed into post-stroke dementia. Only a few studies have developed a scoring system of predictor factors cognitive impairment (CI) for post-acute ischemic stroke in Indonesia. This study aimed to develop a scoring system of predictor factors of CI for post-stroke ischemic patients. The patients included were >18 years old diagnosed with acute ischemic stroke who underwent mini-mental state examination (MMSE) and clock drawing test (CDT) examination on day-30 at Bethesda Hospital Yogyakarta. It was retrospective cohort study design and samples were obtained from the stroke registry and medical records. Patients who had a history of CI and incomplete medical records were excluded. The results of MSSE and CDT at day-30 were the outcomes of this study. To evaluate the relationship between the independent variable and the dependent variable, chi-squared tests were perforemd followed by multivariate logistic regression analysis with Hosmer-Lemeshow tests with backward likelihood-ratio (LR) method and by assessing the final area under the curve (AUC) model. The final model was transformed into a scoring system to determine the value of probability prediction of PSCI, the optimal cut-off point, the sensitivity value and specificity value of the cognitive impairment scoring system at day-30 after acute ischemic stroke. A total of 140 subjects were included in the study with an average age of 62.8 years, 86 (61.4%) males and 54 (38.6%) females. Ninety-one subjects (65%) experienced post-stroke CI. The multivariate analysis showed age >70 years, education level ≤6 years, modified ranking score (mRS) >3 at diagnosis, Barthel index score ≤4 at diagnosis, the number of multiple lesions and the location of lesion in the cortex were independent predictor factors affecting CI 30 days after acute ischemic stroke. The developed predictor score obtained AUC discrimination value of 82.6% (95%CI:0.757-0.896) and calibration value of p>0.366. The scoring system had a value range of 0-7, and with a cut-off ≥1, it had a sensitivity value of 86.8% and a specificity value of 59.2%. It can be concluded that the predictor score has a good performance in predicting the occurrence of PSCI at day-30 after acute ischemic stroke.
Potential skin problems of diabetes mellitus patients: a review Iryani Andamari; H. Bing Thio; Hardyanto Soebono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202211

Abstract

Diabetes mellitus (DM) is one of the common metabolic disorders, and a major part of chronic diseases, the prevalence of which tends to increase due to multifactor. Blood vessels, kidneys, lungs, and skin are among the organs that are affected. The first problem that arises, or commonly exists among one-third of diabetics, are problems with their skin, although skin lesions may develop along with the progress of the disease, or can occur during the later phase of DM. The prevalence and symptoms of skin problems in type 1 DM (T1DM) and type 2 DM (T2DM) are often unclear, and at the beginning of the course of the diseases they often go undiagnosed. Several theories regarding the pathophysiology of DM can be used as a logical reference for the early identification and diagnosis of skin problems, aimed at preventing the worsened condition. The use of skin autofluorescence (SAF) and AGEs reader in several cases of skin problems, can also be an important marker as an adjunct to predict the possibility and progressiveness of DM. Skin problems linked to patients with DM can be categorized as strongly related to diabetes, non-specific and related to DM, skin infection in DM, and skin problems due to diabetic medication. With the current COVID-19 pandemic, there are additional demands for more critical investigation of skin problems in patients with DM. The skin problems that occur in DM may need to be examined from the early stage and it is necessary to inhibit the progression of skin problems, as well as to consider the need for multidisciplinary DM therapy.
Correlation of neutrophil ratio to lymphocyte levels before therapy with the incidence of metastasis, lymph node involvements, in urothelial type muscle invasive bladder cancer in Indonesia Rudi Rafian; Ahmad Zulfan Hendri; Indrawarman Soerohardjo; Raden Danarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202208

Abstract

Bladder cancer is cancer originated from the bladder mucosa or urothelium. Bladder cancer is the 9th most common malignancy worldwide and the most common malignancy of the urinary tract. Studies show that cancer triggers an inflammatory response, which causes changes in circulating inflammatory cells. Examination of neutrophils and lymphocytes is an inexpensive examination, reproducible, and easily obtained. Neutrophil to lymphocyte ratio (NLR) values have been used in several studies to evaluate the inflammatory response that occurs in tumors. In urology, the importance of NLR has been recognized in predicting progression and aggressiveness in urothelial bladder tumors, kidney cancer (RCC/renal cell carcinoma), and upper tract urothelial carcinoma (UTUC). This study was a cross-sectional study obtained retrospectively by evaluating the medical records of patients diagnosed with muscle-invasive bladder cancer (MIBC) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2017 to December 2019. The NLR data were categorized into NLR < 2.5 and > 2.5. As much as 150 patients with bladder cancer were included in this study, with a mean age of 56.43 ± 13.60 years. In the comparison of NLR values and the incidence of metastasis, there were 15 people (20%) with NLR values < 2.5 who had metastasis while 32 people (42.7%) from the group with NLR > 2.5 had metastasis (p = 0.003). In the comparison of NLR values and nodule involvement, there were 25 (33.3%) patients with NLR < 2.5 and 39 (52%) patients with NLR > 2.5 (p = 0.021). This study showed that patients with metastatic bladder tumors and lymph node involvement had a significantly higher NLR value. It can be concluded the NLR value can be used to predict the metastatic level and lymph node involvement in patients with bladder tumors. Even though it is not a specific marker of inflammation, the NLR examination is simple, affordable, easy to obtain, and widely available.
Cytologic diagnostic approach of pleuropulmonary blastoma: a case report Auliya Suluk Brilliant Sumpono; Alva Sinung Anindita; Junaedy Yunus; Didik Setyo Heriyanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202209

Abstract

Pleuropulmonary blastoma (PPB) is a very rare pediatric lung tumor that arises in the pulmonary parenchyma, mediastinum, and pleura. The tumor has rapid disease progression and therefore the prognosis is remarkably poor. We reported a 4-year-old girl who complained of high fever and shortness of breath for the past 8 weeks. The patient was referred from the previous hospital with a pulmonary mass. CT scan of the chest with contrast showed a solid cystic mass with necrotic areas in the 1st, 2nd, and 3rd segments of the left lung with sized 4.8 x 8.1 x 6.6 cm3. As the tumor mass was inoperable, an ultrasound-guided fine-needle aspiration biopsy (FNAB) was conducted to diagnose the pulmonary lesion. We concluded that the lung tumor was a PPB based on FNAB cytology and immunocytochemistry staining. The histopathology feature of PPB appeared similar to fetal lung tissue. Cytologic features obtained from fine-needle aspiration cytology smears and cell blocks followed by immunocytochemistry assay could provide a proper and accurate diagnosis in an inoperable surgical pathology case.
Effect of Robusta coffee extract gel on fibroblast and collagen during proliferative phase of IIB degree-burn on Long Evans rats Ulfa Elfiah; Muhammad Fahmi Naufal; Mochammad Amrun Hidayat
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202201

Abstract

IIB Degree-burn takes longer to heal because only a small epithelium component remains. It requires a topical agent that can accelerate the wound healing process. One of the wound healing signs is the increased collagen formation as an extracellular matrix produced by fibroblast in the proliferative phase. This study aimed to prove the effect of Robusta coffee extract gel as a topical agent on increasing the number of fibroblasts and collagen density in IIB degree-burn treatment on Long Evans rats. This study used 24 Long Evans rats which were divided into three groups, namely positive control (silver sulfadiazine), negative control (gel base), and treatment group (2.5% of Robusta coffee extract gel). The results showed a higher number of fibroblast (p<0.05) and a denser collagen density (p<0.05) of the Robusta coffee extract gel compared to the control group on day 8 and day 14. These results indicated that the number of fibroblasts and collagen increases that can scavenge free radicals and stimulate the release of cytokines that play a role in increasing fibroblast proliferation. Robusta coffee affects expanding the number of fibroblasts and collagen density to be an alternative topical agent of second-degree burns treatment.
The influence of tympanic membrane perforation site on the hearing level of conductive hearing loss in chronic suppurative otitis media Adhika Banu Wicaksono; Edhie Samodra; Melysa Fitriana; Feri Trihandoko; Anisa Haqul Khoiria; Dyah Ayu Kartika Dewanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202206

Abstract

Chronic suppurative otitis media (CSOM) is an infection of the middle ear cavity both partially and totally. It is characterized by ear discharge through a tympanic membrane perforation for over a period of 2 to 6 weeks. Hearing loss is the most common complication of CSOM. One of the degrees of hearing loss in tympanic membrane perforation is depending on the site of perforation, but this premise is still debatable because of pros and contras by some researchers. This study aimed to assess the degree of hearing loss in relation to the site of tympanic membrane perforation. A cross-sectional prospective study design was performed involving 43 patients of safe type CSOM who came to the Department of Otolaryngology Head and Neck Surgery from the period January 2016 to November 2018. All subjects were divided into 4 groups based on the site of perforation. There was a perforation in the posteroinferior, the posterosuperior, the anteroinferior, and the anterosuperior. A statistical analysis using Anova along with multivariate analysis was conducted. Our result showed that the most common site of tympanic membrane perforation was at the anteroinferior (30 samples, 59.8%). The highest hearing threshold was seen at posteroinferior with a mean hearing level of 37.7±2.0 dB, anteroinferior with a mean hearing level of 31.7±0.7 dB, anterosuperior with a mean hearing level 30.7±1.4 dB, and posterosuperior mean hearing level 28.9±1.5 dB. The difference was found significant with p=0.004. Posteroinferior tympanic membrane perforation had a higher number of hearing loss compared to the other sites. In conclusion, the tympanic membrane perforation site has an important role in the hearing level of conductive hearing loss in CSOM.
A comparison study of GeneXpert and In-House N1N2 CDC Real-Time RT-PCR for detection of SARS-CoV-2 infection Andi Yasmon; Lola Febriana Dewi; Fithriyah Fithriyah; Ariyani Kiranasari; Andriansjah Rukmana; Yulia Rosa Saharman; Fera Ibrahim; Pratiwi Sudarmono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202203

Abstract

COVID-19 is a disease caused by SARS-CoV-2, a new virus from genus β-coronaviruses. This disease has been declared a pandemic by WHO on 11 March 2020 until now. The nucleic acid tests are the most frequently used assays because of their high sensitivity and specificity. One of the tests is the GeneXpert, a real-time reverse transcription polymerase chain reaction (rRT-PCR)-based assay platform. The use of the GeneXpert shows great public health interest because of the rapid (50 min), the minimum number of trained staff, and less infrastructure and equipment. However, there are limited data on the application of the GeneXpert for the detection of SARS-CoV-2. Therefore, we conducted a comparative study between the GeneXpert and in-house N1N2 CDC rRT-PCR assay. Of 86 samples, 17 were rRT-PCR positive while 13 were GeneXpert positive. Of rRT-PCR positive 17 samples, 7 were GeneXpert negative [58.82% (10/17] sensitivity]. We also found that 3 GeneXpert positive samples showed rRT-PCR negative (95.65% [66/69] specificity). It is concluded that negative results by the GeneXpert can not rule out the possibility of SARS-CoV-2 infection, particularly in close-contact individuals and the interpretation of the positive result should be analyzed carefully, particularly amplification with Ct>40.
Therapeutic options for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases producing Escherichia coli and Klebsiella sp. isolated from various clinical samples Vimal Kumar; Narinder Kaur; Shubham Chauhan; Rosy Bala; Jyoti Chauhan; Harit Kumar; Shivani Devi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202205

Abstract

Escherichia coli and Klebsiella sp. are the predominant species isolated from clinical samples. Recent and proper understanding of the antibiotic susceptibility pattern of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases (AmpC) producing E. coli and Klebsiella sp. will prevent the distribution and future incidence of ESBL and AmpC. We designed this study to understand antibiotic susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. isolated from a tertiary care hospital in North India. A cross-sectional study was conducted from March 2021 to February 2022. Guring this period, various clinical samples were collected and further tested for ESBL producing E. coli and Klebsiella sp. by using the Double disc Synergy test, whereas AmpC was detected by the Boronic acid disk potentiation method. Their antibiotic susceptibility patterns were noted. Various clinical specimens were collected, in which 37.95% were shown growth of bacteria. Among them, 46.67% of E. coli and 25.21% of Klebsiella sp. were identified by standard laboratory protocol. ESBL producing isolates were 44.37% and 34.20% in E. coli and Klebsiella sp., respectively. Whereas AmpC production was detected in 18.27% of E. coli and 29.36% of Klebsiella sp. ESBL and AmpC producing E. coli and Klebsiella sp. isolated from pus, blood, and sputum samples showed the highest sensitivity towards colistin, tigecycline, and imipenem while in urine samples imipenem, meropenem showed the highest sensitivity. Susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. from various clinical specimens enhance hospital infection management and help clinicians to prescribe the appropriate antibiotics. The carbapenem, nitrofurantoin, colistin and tigecycline were showed highest susceptible against ESBL and AmpC producing E. coli and Klebsiella sp.
Antibiotic effectiveness on biofilm-producing Escherichia coli isolated from catheterized patients Wani D Gunardi; Ade Dharmawan; Nicolas Layanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202202

Abstract

Biofilm is one of the factors that facilitate the occurrence of catheter-associated urinary tract infection (CAUTI). Escherichia coli is reported as one of the most dominant bacteria that have virulence factors including biofilm formation. Uropathogenic E. coli (UPEC) shows increasing resistance to several antibiotics. Examination of the antibiotic sensitivity on the biofilm-producing E. coli and its activity on biofilm formation are important for selecting high effectiveness antibiotics which is beneficial for the management of CAUTI patients. A total of 35 E. coli isolates were recultured in the medium of LB agar and blood agar. The isolates were evaluated the sensitivity based on their MIC value to several antibiotics. In addition, the antibiofilm activity of the antibiotics based on their MBIC value was also evaluated. The data obtained were analyzed both descriptively and analytically. Almost the E. coli isolates have good sensitivity to meropenem antibiotics, amoxicillin-clavulanic acid, and Fosfomycin. However, among the evaluated antibiotics, only fosfomycin that showed antibiofilm activity. The different in terms of the resistance phenotype between the urinary isolates and the catheter isolates was observed. However, there were no significantly differences in the MIC value (pMIC=0.522) and the MBIC value (pMBIC = 0.523). In conclusion, the alternatives of antibiotic therapy for the planktonic bacteria are amoxicillin-clavulanic acid and fosfomycin, while for the biofilm bacteria is fosfomycin. A biofilm screening examination on the catheter to improve the effectiveness of therapy management for CAUTI patients is recommended.

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