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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 2,170 Documents
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Effects of ferro sulphate and carbon tetrachloride in liver of rat Ngadikun, Ngadikun Ngadikun
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Ferro sulphate (FeSO4) overload and carbon tetrachloride (CCl4) are chemical hepatocarcinogen. Ferro sulphatedisrupts the redox balance of the cell and generates chronic oxidative stress by which modulates signaling networksrelated to malignant transformation. Meanwhile CCl4 induces hepatic damage in lipid peroxidation and decreasesactivities of antioxidant enzymes and generation of free radicals. The aim of this study is to investigate the effect ofa pause of chemical hepatocarcinogen induced in Rattus norvegicus rats. Twomonths old adultmaleRattus norvegicusrats weighing around 110–191 g were used. The ratswere divided into three groups. In group I (n=3), no-treatmentcontrol; in group II (n=3), rats were fed 3.5%FeSO4 in the diet together with 0.1 ml/ kgBWCCl4 administered bygavage per os 5 days a week for 3 weeks. However, in group III (n=3), rats were administered by chemicalhepatocarcinogen like group I then continued with no-treatment for 2 weeks (a pause of 2 weeks was inserted).Body weight were determined per week. At the end of the experiment, rats were fasted overnight, and then 3.0 mlof blood was drawn from the rats from the vena orbitalis in EDTA-tube and then sacrificed. Liver and body weight ofrats were determined for each group. Plasma was prepared to biochemical estimation of different parameters liketotal protein (TP), non-functional plasma enzymes: aspartate aminotransferase (AST), alanine aminotransferase(ALT), and gamma glutamyl transferase (GT) by biochemical test kits in SYNCHRON CX® System(s). The livertissuewas used for histological and immunohistochemical assessment. All datawere analyzedwith one-way ANOVA,p<0.05 for the statistical comparison of groups in Matrix Laboratory (MATLAB) programs in MicrosoftWindowsXP.According to the research results of the body weight on treated group gained significantly less body weight thancontrol group (p= 0.00). Liver weight at the end of the experiment were significantly decreased in treated groupcompared to control (p=0.00); but Liver/ Body weight ratio were significantly increased in treated group comparedto control (p=0.00). The blood plasma were significant differences in the values of TP and GT (p = 0.00 and0.00), but the values of AST, ALT, and ratio of AST to ALT were not significant differences (p=0.62, 0.67, and0.26 respectively). Histopathological studies of the liver section of treated group showed the damage of the livercells. In the group of a pause of chemical hepatocarcinogen induced in rats were no major morphological changeswere observed compared to group that administered for 3 weeks, except for decreased steatosis level. An overalldecrease in vacuoles at the group of a pause suggested a changemetabolismand toxin depletion over time. Furthermore,p53 immunohistochemistry on 9 cases revealed no p53 mutations or protein overexpression. It was concluded thatp-53 mutation was not detected in Rattus norvegicus rats that induced hepatocarcinogenic agent FeSO4 3.5%andCCl4 0.1 ml/ kg BW for 3 weeks and hepatic injury still encountered in a pause of chemical hepatocarcinogeninduced showed that the recovery was not complete.Key words: pause of chemical hepatocarcinogen induced - Rattus norvegicus - liver tissue - total protein - nonfunctionalplasma enzymes
The role of clinical pathway on the outcomes of ischemic stroke patients at Bethesda Hospital Yogyakarta Rizaldy Pinzon, Francisca Diana Alexandra Iwan Dwiprahasto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Stroke becomes world health problem all over the world because it is the causal factor of high mortality and disability. Good and well-organized process of healthcare service will improve the outcome of the patients with stroke. Clinical pathway may be used as clear standard to help reduce unnecessary variations of medical treatment and measure. The study aimed at finding out the correlation between the use of clinical pathway and the outcome of the patients with ischemic stroke in Bethesda Hospital Yogyakarta. It was an observational and analytic study with cohort restorative study design. The author compared the outcomes of acute ischemic stroke between the group with clinical pathway and the group without the clinical pathway. Data was collected using consecutive sampling from the electronic registry and medical record data of the patients from January 1st, 2011 to December 31st, 2011. It was conducted to 124 patients with ischemic stroke assigned to two groups (the first groups of 62 patients with clinical pathway and the second groups of 62 patients without clinical pathway). The basic characteristics of the two groups were the same. The results of the analysis showed that there was a significant decrease in the incidence of complication and a significant increase in the use of antiplatelete drugs, antidiabetic drugs and statin as secondary preventive measure of the recurrent stroke. There was not any significant difference in the duration of the hospitalized healthcare, the financing and the mortality between the two observation groups. The study indicated that the use of the clinical pathway in the stroke treatment improved the outcome of the patients with stroke. It was necessary to conduct further study to evaluate the effectiveness of the clinical pathway in improving the outcome of the patients with bigger number of the subjects and the longer period of time. Keywords: clinical pathway - stroke - outcomes  
Agreement between pediatrician and trained paramedic in the assessment of gestational age among newborns using New Ballard Scored Tunjung Wibowo, Henky Sulistyo Djauhar Ismail
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 02 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Accurate gestational age assessment is important in newborn examination to determine further management. Oneof methods to estimate newborn gestation is New Ballard Score (NBS). With limited number of pediatrician especiallyin remote areas, it is expected trained paramedic will be able to perform NBS examination properly. The aim of thisstudy was to assess whether there is agreement between pediatricians and trained paramedics in determiningnewborn gestational age using NBS. This was a cross sectional study. Ballard scoring was performed by pediatriciansand trained paramedics in Dentatama Mother and Child Hospital, Sragen Distric, Central Java, Indonesia fromFebruary-May 2008. Statistical analysis was performed using intraclass correlation. This study was performed in175 newborns those consisted of 55.4% males and 44.6% females. From those newborns, 30.3% were deliveredby caesarian section, and 10.3% were premature baby. Majority of Ballard score examination (69.7%) was performedin 2nd day. According to intraclass correlation, there was a very strong correlation agreement between pediatriciansand trained paramedics (r=0.925 and p<0.05). The result of Ballard score examination that close to gold standardthose which were performed at 48-96 hours of age (r=0.993 and p<0.05). In conclusion, there was a goodagreement between pediatricians and trained paramedics in assessing newborn gestational age using NBS.Key words: Ballard score - trained paramedic - newborn – pedriatician - hospital
Histocompatibility evaluation of combination of gypsum with carbonated hydroxyapatite as bone substitutes in subcutaneous tissue Ika Dewi Ana, Dyah Listyarifah Rina Susilowati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 02 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Combination of gypsum with carbonated hydroxyapatite (CHA) has shown to improve bone healing process. Softtissue biocompatibility test is required prior to clinical application of bone substitutes since the materials contactwith the soft tissues upon application and can cause severe inflammatory response. The aim of this study was toevaluate histocompatibility of gypsum compared to combination of gypsum-CHA in subcutaneous tissue. Disks ofgypsum and gypsum-CHA were implanted on paravertebral subcutaneous tissue of 25 male Wistar rats. Histologicalsection were stained with Hematoxylin Eosin then evaluated and scored with a histological grading scale for softtissueimplants. A two-way ANOVA was used to analyze the histomorphometrical results with 95% confidenceinterval (p<0.05). The results showed that acute inflammatory cells were found in both groups at 6 hour and on day5 and 7 after implantation at similar level. Chronic inflammatory cells and capsule were observed on day 7, 14, and21. Moreover, there was no significant difference (p>0.05) of histomorphometrics score between both implants ineach implantation periods. It could be concluded that histocompatibility level of gypsum and combination of gypsum-CHA to soft tissue was the same until day 21 iof mplantation.Key words: gypsum - carbonated hydroxyapatite – biocompatibility – histocompatibility - subcutaneous implant
Association between environmental allergen sensitization with severity of atopic dermatitis in children and young adult at Dr. Sardjito General Hospital, Yogyakarta Brahmanti, Herwinda
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 01 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The important role of aeroallergens and food allergens as the most common environmental allergens in exacerbationof atopic dermatitis (AD) iswell known. Sensitization is an essential processwhich correlateswith clinicalmanifestationof AD. The study of AD in Indonesia, especially in Yogyakarta, has not been reported, yet. The aim of study is toevaluate the association between sensitization of environmental allergens with clinical severity of AD in children andyoung adult at Dr. Sardjito General Hospital, Yogyakarta. An analytic observational cross sectional study wasperformed on 33 children and young adult with AD. The severity of disease was determined by SCORing AtopicDermatitis (SCORAD). Assessment of sensitization was performed using specific IgE serum, atopy patch test, andprick test. Data were analyzed using chi-square or Fisher exact test and prevalence ratio (PR) with significancevalue of p<0.05 and 95%confidence interval (CI). The results showed that specific IgE positivity was associatedwith severity of AD. Percentage of specific IgE positivity to house dust mite was significantly higher in subject withmoderate/severe AD compared to those of mild AD (p=0.049; PR 1.13; 95% CI 1.01-1.59). The result was alsosimilar for cat dander (p=0.041; PR 1.1; 95%CI 1.09-4.98), cow’s milk (p=0.038; PR 1.21; 95% CI 1.02-2.2),and egg white (p=0.027; PR 1.23; 95% CI 1.15-2.97). Whereas specific IgE positivity to fish allergen was notstatistically different in subject with moderate/severe AD compared to those with mild AD (p=0.061; PR 0.8; 95%CI 0.76-2.8). According to atopy patch test and prick test result, no association was found between allergensensitization and severity of AD. If allmethodswere combined to increase the sensitivity of sensitizationmeasurement,then the association was found for all allergens. It could be concluded that environmental allergens sensitization isassociated with severity of AD in children and young adult at Dr. Sardjito General Hospital, Yogyakarta.Key words: atopic dermatitis-disease severity-sensitization-aeroallergen-food allergen
The protective effect of sunscreens against ultraviolet B-induced immunosuppression. A study on Langerhans cell depletion Yohanes Widodo Wirohadidjojo, Flora Ramona SP Fajar Waskito
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 42, No 01 (2010)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Ultraviolet B (UVB) radiation can act as immunosuppressant by inducing an epidermal Langerhans cells (LC) depletionwhich could be inhibited by topical sunscreen. Several kinds of sunscreens with various SPF (Sunscreen ProtectionFactor) are now available. The minimal SPF which able to inhibit the immunosuppressive effect of UVB amongpeople with skin photo-type IV has not been established yet. The aim of this study is to determine the minimal SPFcapable to inhibit UVB-induced immunosuppression among people with skin photo-type IV. A simple experimental(post test only experimental) study was conducted among 5 people’s circumsized foreskins with Fitzpatrick’s skinphoto-type IV. Each of them was divided into equal 5 pieces of 0.5 cm2. Each of three pieces of skin was treated bysunscreen SPF 15, SPF 30, and SPF 50, a single piece of skin was treated with placebo, and all of them then weretreated by a single 100 mJ/cm2 of UVB 30 minutes later. A rest single piece of skin was used as control. After 24hours of incubation in incubator of 37O C and 5% CO2, all of them then was fixed by buffer formalin, blocked byparaffin, cut in 2mm of thickness, and then stained with anti CD 1a antibody with AEC as chromogen and Mayer’shematoxylin as counterstaining. The number of LC was counted by Image J Analysis programmed and the mean ofLCwere analyzed by Kruskal-Wallis test dan Mann-Whitney test. There were very significantly different of themean number of LC between UVB placebo group and control group (p < 0.01). Compared to the control group,mean number of LC among SPF 30 and SPF 50 treated groups were not significantly different (p>0.05). Sunscreenwith SPF 15 had LC number lower than control group significantly (p<0.05). The lowest SPF for preventing UVBinduced LC depletion among people with skin photo-type IV was 30.Key words : UVB - immunosupression – sunscreens – SPF -CD1aexpression
Risk factors in childrenwith platelet refractoriness Neti Nurani, Teguh Triyono, Jonliberti Purba Sri Mulatsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.51 KB) | DOI: 10.19106/JMedScie004501201305

Abstract

Platelet transfusions are often performed in pediatric patients. Nevertheless, platelet transfusion has its own risk and it alsoincrease the cost of care. Therefore,its effectiveness needs to be evaluated. This study aimed to assess the clinical risk factors namely sepsis, splenomegaly, DIC, severe bleeding and the history of platelet transfusion in the incidence of refractory platelets. This was a case-control study conducted during the period of August 2010 to September 2011.From a total of 1403 cases of transfusion, there were 86 incidences of refractory and 86 of nonrefractory. From the bivariate analysis, it was obtained that sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegaly [OR 2.82 (1.32-6.04.12), p = 0006] heavy bleeding [OR 8:41 (4.19-16.871), p = 0.000 ], DIC [OR 22.96 (6.73-78.35), p = 0.000] and the history of platelet transfusions [OR 5:33 (2.78-10.23), p = 0.000] increase the risk of refractory platelets. On multivariate analysis, sepsis (OR 2.96 [95% CI: 1:19 to 7:32], p = 0019), splenomegaly (OR 3.94 [95% CI: 2:21 to 16:00], p = 0.000), severe bleeding (OR 3:53 [95% CI : 1.40-8.89], p = 0.008), DIC (5:54 OR [95% CI: 1.29-22.75], p = 0021) and platelet transfusion the history (OR 2.84 [95% CI: 2.74-9.77], p = 0.001) were the independent risk factors for the occurrence of children refractory. In conclusion, sepsis, splenomegaly, severe bleeding, DIC, andthe history of platelet transfusion are the risk factors in pediatric patients refractory platelets. ABSTRAKTransfusitrombositseringdilakukanpadapasienanak.Transfusitrombositsendirimemilikirisikoterhadappasiendanmenambahbiayaperawatan, sehinggaperludievaluasiefektifitasnya.Menilaifaktorrisikoklinisyakni sepsis, splenomegali, DIC, pendarahanberatdanriwayattransfusitrombositterhadapkejadianrefraktertrombosit.Penelitianinimerupakanpenelitiankasuskontroluntukmenilaifaktorrisikoterjadinyarefraktertrombositseperti sepsis, DIC, splenomegali, pendarahanberat, riwayattransfusitrombosit.SelamaperiodeAgustus 2010 sampai September 2011 terdapat 1403 kasustransfusi, darikeseluruhankasustersebutdiambil 86 kejadianrefrakterdan 86 non refrakter. bivariatdidapatkan sepsis [OR 5.91 (2.90-12.05)], p = 0.000], splenomegali [OR 2.82 (1.32- 6.04.12), p = 0.006] pendarahanberat [OR 8.41(4.19-16.871), p = 0.000], DIC [OR 22.96 (6.73- 78.35), p = 0.000] riwayattransfusitrombosit [OR 5.33(2.78-10.23), p = 0.000] meningkatkanrisikorefraktertrombosit. Padaanalisismultivariat sepsis (OR 2.96 [95%IK; 1.19-7.32], p = 0.019), splenomegali (OR 3.94 [IK 95%;2.21-16.00], p = 0.000), pendarahanberat (OR 3.53 [95% IK; 1.40-8.89], p = 0.008), DIC (OR 5.54 [95% IK; 1.29-22.75], p =0.021) danriwayattransfusitrombosit(OR 2.84 [95% IK; 2.74-9.77], p =0.001) merupakanfaktorrisikoindependenterjadinyarefrakterpadaanak. Sepsis, splenomegali, pendarahanberat, DIC danriwayattransfusitrombositmerupakanfaktorrisikoterjadinyarefraktertrombositpadapasienanak. Keywords:refractory platelets - CCI - number of platelets – children(istilah CCI belum pernah muncul dalam abstrak dan tiba2 ada dalam keywords, mohon ditanyakan ke penulis)
Risk factors related to malaria incidence at Santu’un village, Tabalong District, South Kalimantan Province Tri Baskoro Tunggul Satoto, Junus Widjaja Supargiyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 02 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Santu’un Village is one of malaria endemic areas in Muara Uya Sub district, Tabalong District, South KalimantanProvince, Indonesia. Annual Parasite Incidences (APIs) from 2007 to 2009 were 11.4, 82.9, and 25.8‰ respectively.The majority of Muara Uya population are rubber tappers, gold miners and loggers in the forest. Moreover, most ofthe Muara Uya population do not use mosquito nets when sleeping at night. These occupations and communityhabits may contribute in high malaria incidence in Muara Uya. However, study concerning risk factor of malaria hasnot been performed yet. The study was conducted in order to evaluate risk factors that might correlate with malariaincidence in Santu’un village, Muara Uya subdistrict. Two hundred and ninety one subjects were enrolled in thisstudy. Those consisted of 70 people whom microscopically malaria positive and 221 people whom malaria negative.Household visits were conducted to each subject to perform interviews. Data collection of malaria risk factors wasobtained using questionaire. The results indicated that three main occupations, loggers, gold miners and rubbertapper, were significantly represent risk factors of malaria incidence. The community habits that also significantlycorrelated with malaria incidence were the not using of mosquito repellents and not using bed nets. Two clusteringcases were also observed during the year of 2010. The coordinate of the first cluster was 1.863500 S and 115.606700E with diameter of 0.65 km and the coordinate of the second cluster was 1.838667 S and 115.607200 E withdiameter of 0.67 km. In conclusion, in Santu’un village, the risk factor that correlated with the malaria incidencewere loggers, gold miners, rubber tappers. In addition the not using of mosquito repellents and not using bed netswere also risk factors of malaria incidence.Key words: malaria -risk factors-annual parasite incidence-Muara Uya-South Kalimantan
A comparison study on the blood transfusion reaction between the elective and the emergency operation’s patients Ishandono Dachlan, Hidayati Samsiarah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 02 (2011)
Publisher : Universitas Gadjah Mada

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Abstract

Blood transfusion is principally a process of transferring blood or blood components from one individual (the donor) toanother individual (the recipient). Blood transfusion can be either a life saving condition or a life threatening situation dueto the complications happened. Therefore, blood transfusion should be conducted with clear and accurate indication inorder to obtain a condition in which the advantages outweighs the disadvantages. The aim of this study was to evaluatethe differences of the blood transfusion reactions between the patients underwent the emergency surgery with theelective surgery. This was a cross sectional study using data from the medical records from January to December 2009and from the observation on blood transfusion patients from January to May 2010. Data were analyzed using independentt-test, Chi-square test or the logistic regression, with 95% confidence interval (p<0.05). Two hundred and sixty eightdata from medical records and directly observation on blood transfusion patients were obtained during the study. Thewere significant differences of patient reactions after blood transfusion on both types of operation and blood componentstransferred (p<0.05).The transfusion reactions were more frequent in emergency surgery (54.9%) compared withelective surgery (30.5%). Based on types of blood component transfered, the transfusion reaction was more frequentafter Whole Blood/WB transfusion (84.9%) compared with Packed Red Cell/PRC transfusion (25.1%) and Fresh FrozenPlasma/FFP transfusion (25%). The types of operation and blood products had been proven to be the risk factors in bloodtransfusion. Moreover the blood products contributed more in the transfusion reactions compared with the types ofoperation (p<0.05). Amount of transfused blood based on haemoglobin correction formula on both the emergency orelective operations was not significantly different (p>0.05). In conclusion, blood transfusion reactions happened morefrequently in emergency surgery than elective surgery. The WB also generated transfusion reaction more frequently thanthe PRC. The amount of blood required based on hemoglobin correction formula for most patients was similar to the bloodtransfused.Key words: blood transfusion-type of operation-transfusion reaction - whole blood-haemoboglobin correction formula
Iterleukin-4 and interferon-in allergic contact dermatitis with atopic background in leather tannery factory worker H Kariosentono, S Widhiati AS Siswati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 43, No 01 (2011)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Immune response in allergic contact dermatitis (ACD) patient is dominated by T helper-1 (Th-1) response characterizedwith increase in interferon gamma (IFN-). However, in atopic individual, the immune response is dominated by Thelper-2 (Th-2) response which characterized with the presence of interleukin-4 (IL-4). Based on that condition, it ishypothesized that atopic individual was hardly to develope ACD. In leather factory, many workers are prone todevelope ACD. The aim of this study is to differentiate the cytokine profiles of IL-4 and IFN-of ACD patients withor without atopic background. Using a cross-sectional design, this study involved 30 subject assigned into twogroups, one group consisted of 15 subjects with ACD who had atopic background (ACD atopic), the other groupconsisted of 15 subjectswith ACD who had no atopic background (ACD non atopic). Both groups were examined bypatch test and confirmed to have ACD when the result was minimally+1 in 48 and/or 96 hours examination. Atopicskin diathesis score 8 was used to determine the possibility of having atopic background. Serum IL-4 and IFN-concentrationwere determined using ELISA. Data were analyzed using SPSS with Mann-Whitney non- parametrictest. The results showed that the mean value of IL-4 in both groups were 0.18±0.14 pg/mL and 0.25±0.29 pg/mL (p=0.917) whereas the mean value of IFN- in both groups were 13.03 ±23.90 pg/mL and 2.76±5.67 pg/mL, (p=0.096). In conclusion, the cytokine profiles of IL-4 and IFN-were not significantly different between ACDatopic and ACD non atopic individuals. This finding suggested that atopic and non-atopic individuals had a similarimmunologic response during development of ACD.Key words: immunologic response-cytokine-occupational contact dematitis-T helper-patch testing

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