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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 2,170 Documents

153 154 155 156 157

The effect of the implementation of evidence-based drug formulary on antibacterial use in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia Erna Kristin; Dwi Indria Anggraini; Jarir At Thobari; Alfi Yasmina
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The increase of drug expenditure in the hospital has facilitated the implementation of an evidence-based drug formulary. The aim of this study was to assess the change in antibacterial use after the implementation of an evidence-based drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan, Indonesia. This study used a pre-posttest design. Drug use data in the period before (2010-2011) and after (2012-2013) the formulary implementation were extracted from the hospital medical records. The drug use in the hospital before and after the implementation was compared using t-test and chi-square test, with the significance level of 0.05. Average number of drugs prescribed per prescription after the implementation was similar with that before the implementation (4.4 vs 4.6; p > 0.05). However, the proportion of generic drugs prescribed increased significantly after the formulary implementation (17.0% vs 52.7%; p < 0.05). Moreover, it was still significantly increased when the analysis was conducted only for antibacterial drugs (25.9% vs 72.0%; p < 0.05). Average drug cost per prescription was 34% lower after the intervention (p < 0.05), and the average cost for antibacterial drug was also decreased (26%). The use of antibacterial drugs was significantly decreased after the intervention (12.5% vs 6.9%; p < 0.05). The most often antibacterial drugs prescribed before the interventions were beta-lactams and macrolides; while quinolones were more increasingly used after the intervention. In conclusion, the implementation of evidence-based hospital drug formulary in a private hospital at Tanjung Enim, Sumatera Selatan significantly increase generic drug use and decreased antibacterial use and average drug cost per prescription. Key words : drug formulary – prescribing pattern – generic drug – antibacterial – private hospital

Zinc deficiency and school-age children’s memories . Setianingsih; Djaswadi Dasuki; Indria Laksmi Gamayanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Zinc deficiency is associated with cognitive and motor delay in children. Moreover, it is associatedwith deficits in activity and attention in nutritional deficiency children. This study was conductedto evaluate the correlation between zinc deficiency with memory of children. A cross sectionalstudy design was employed from June 1st to 30th, 2013 among school-age children in KlatenDistrict, Central Java who met inclusion and exclusion criteria. Sixty five eligible children wereassessed their health, socio-economic and nutritional status. Hemoglobin levels were measuredby the standart cyanoblue method. Plasma zinc levels were analyzed with flame atomic absorptionspectrophotometry (AAS). Short-term memory (STM) was measured using the instrument WechslerIntellegence Scale for Children (WISC0 subtest Digit Span Memory Test and long term memory(LTM) was assessed using the recall of narrative. Independent t-test was used to compare theSTM or LTM between groups of each independent factors. Linear regression analysis was usedto determine the independent factors associated with the STM or LTM. The STM scores of thechildren with zinc deficiency (6.1 ± 1.3) was significantly higher than those with normal zinclevel (10.7 ± 3.1) [p=0.0004; 95%CI= -6.98 – (-2.14)]. However, the LTM for both group ofthe children were not significantly different (p=0.658; 95%CI= -3.16 – 2.01). A significantcorrelations between zinc levels, hemoglobin level and socio-economic status with the STM scoreswere observed (p<0.05), whereas nutritional status was not (p>0.05). In contrast, no significantcorrelations between zinc levels, hemoglobin levels, socio-economic status, nutritional status andthe LTM scores was observed in the school age children (p>0.05). In conclusion, zinc deficiency isassociated with STM loss in the school age children, however it is not associated with LTM loss.Moreover, hemoglobin level and socio-economic status are found to be independent factors forSTM loss, however they are not independent factors for LTM loss.

AAssociation between migraine and ischaemic stroke in Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Indonesia Yahdiyani Razanah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Headache especially the migraine type has been correlated with various disease, such as stroke. There are some controversies in studies that reported association between migraine and ischaemic stroke. Thus, study that investigate the association between migrain – stroke andalso identify stroke risk factor are needed. Study showed there is no statistically significant relationship between migraine and ischaemic stroke in RSUD Prof. Dr. Margono Soekarjo Purwokerto (p=0,235). Analysis of confounding variables such as hypertension, smoking, diabetes, obesity, alcohol consumption, and oral contraceptive shows that hypertension is a predictor for stroke.

Evaluation of artemisinin-based combination therapy (ACT) to uncomplicated falciparum malaria patients in Purworejo District, Central Java, Indonesia Michael Bhadi Bia; E. Elsa Herdiana Murhandarwati; Neil F Lobo; William A Hawley; . Supargiyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 1 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Artemisinin-based Combination Therapy (ACT) to treat uncomplicated Plasmodiumfalciparum malaria has been applied in Purworejo District, Central Java, Indonesia, since2004. However evaluation of the two ACT regimens used ie: Artesunate Amodiaquine(AAQ) and Dihydroartemisinin-Piperaquine (DHP) co-administered with Primaquine (PQ)has not been performed. This study aims to evaluate the efficacy and side effects ofAAQ+PQ and DHP+PQ treatment in uncomplicated falciparum malaria in Purworejo. Inthis descriptive and observational study, 46 Pf infected patients who fullfill the inclusionand exclusion criterias were recruited from December 2010 to August 2011. StandardACT treatment were given to the patients followed by WHO drug efficacy evaluation for28 days. The clinical symptoms and adverse events was also evaluated over the course ofthe treatment. From all recruited subjects, 37 patients received DHP+PQ and 9 patientsreceived AAQ+PQ. On the DHP+PQ treated patient, all subjects were free of asexualand sexual parasites by Day-3 while on AAQ+PQ treated patient, this parasite clearancewas achieved faster as early as on D-2 at the latest. On the otherhand, the disappearanceof fever was also last longer in DHP+PQ treated patient which in one patient last onD-14, while in AAQ+PQ treated patient, the symptom of fever dissappeared by D-2at the latest. No Early or Late Treatment Failures were found on either DHP+PQ orAAQ+PQ treatment as well as clinical and parasitological failures. However, the presenceof adverse events cause by both drugs should not be ignored to ensure drug compliance.

The correlation between occurrence of dental caries and oral health-related quality of life (OHRQoL) of elderly population in Yogyakarta Special Region Dewi Agustina; L Hanindriyo; E Widita; R Widyaningrum
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 2 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Dental caries is the most common oral disease affecting humans. Based on the Indonesia Basic Health Research (Riskesdas) 2013, prevalence of dental caries in 2013 increased up to 53.2% from 43.4% in 2007. One of the two most increasing prevalence occurred in population of more than 65 years. This disease might affect oral health-related quality of life (OHRQoL) since it causes pain, physical and psychological discomfort. The aim of the study was to evaluate the correlation between occurrence of dental caries and OHRQoL in elderly population in Yogyakarta Special Region. One hundred and eighteen people aged 60 – 80 years consisting 73 female and 45 male involved in the study. The occurrence of dental caries and OHRQoL were determined using decay-missing-filling teeth (DMFT) index, whereas geriatric oral health assessment index (GOHAI) instruments, respectively. The data then were classified into very low, low, moderate and high DMFT and low, moderate and high GOHAI. Spearman’s rank correlation test was conducted to determine correlation between occurrence of dental caries and OHRQoL. Mean scores ofDMFT index and GOHAI were 16.61 ± 7.16 and 47.97 ± 9.03, respectively. Very low, low, moderate, and high DMFT index were experienced by 4 (3.38%), 13 (11.02%), 25 (21.19%) and 76 (64.41%) of 118 elderly, respectively. Low, moderate and high GOHAI were experienced by 71 (60.17%), 25 (21.19%) and 22 (18.64%) of 118 elderly, respectively. Spearman’s rank correlation test showed that the correlation coefficient (r) was -0.263 (p=0.004). There is a negative moderate significant correlation between the occurrence of dental caries and OHRQoL of elderly population in Yogyakarta Special Region.

Pharmacogenomics and Pharmacogenetics: Some Cases in Oncology Rika Yuliwulandari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTPharmacogenomics and pharmacogenetics plays an important role in understanding how genetic variants influence drug efficacy and toxicity. In the case of cancer, both efficacy and toxicity of therapeutic agents determine the improvement of survival and quality of life in cancer patients. Effective treatment of Cancer, one of the most deadly diseases in the world, is importance for extending patient survival. Genetic variation influences the response of an individual to drug treatments that impact the efficacy and toxicity of the drugs. Understanding individual genetic variation is potential to make therapy safer and more effective by determining more appropriate drug selection and drug dosage for each individual patient. In the context of cancer, tumors may have specific disease-defining mutations, but a patient’s germline genetic variation will also affect drug response. Advance research technologies approach such as GWAS and next-generation sequencing technologies, statistical genetics analysis methods and clinical trial design have shown promise for discovery of genetic variants associated with drug response in cancer. Understanding the molecular characteristics of both the tumor and the patient, and establishing their relation with drug outcomes will be critical for the identification of predictive biomarkers and to provide the basis for individualized treatments. Since cancer is also frequent in Indonesia, pharmacogenomics study in oncology and its implementation in the clinical practice is important. Broad collaboration at national and international level could foster the application of personalized medicine in oncology.

The effect of combination of hemofilter, pre- and intraoperative methylprednisolone administration on systemic inflammatory response syndrome (SIRS) post open heart surgery . Supomo; Teguh Aryandono; Marsetyawan Soesatyo; Paulus Sudiharto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Systemic inflammatory response syndrome (SIRS) occurs in almost all patients whom undergo open heart surgery causes the increase its morbidity and mortality. The effect of pre- and intraoperative methylprednisolone administration combined with hemofilter application in cardiopulmonary bypass machine in the reduction of SIRS incidence remains controversial. This study aimed to evaluate the effect pre- and intraoperative methylprednisolone administration combined with hemofilter on SIRS incidence after open heart surgery. This was an experimental study using prospective randomized open-blinded evaluation (PROBE) design. Ninety-five patients from Dr. Sardjito General Hospital, Yogyakarta, and Dr. Cipto Mangunkusumo General Hospital, Jakarta, who had open heart surgery within the period of December 2011 to May 2012 were enrolled in this study. The patients were randomly allocated into two groups i.e. Group A (48 patients) received pre-; intra-; and postoperative methylprednisolone (15; 5 and 5 mg/kg BW, respectively) and hemofilter and Group B (47 patients) just received intra- and postoperative methylprednisolone (15 and 5 mg/kg BW). The SIRS incidence was evaluated in 3; 24; 48 and 72 hours post surgery. This study showed that the SIRS incidence in Group B at 3 (OR= 0.12; 95%CI=0.03-0.39; p< 0.001) and 24 (OR= 0.38; 95%CI=0.14-0.996; p< 0.031) hours postoperative were significantly higher than that in Group A. In conclusion, pre- and intraoperative methylprednisolone administration combined hemofilter significantly decrease the SIRS incidence post open heart surgery.

The efficacy of ondansetron in comparison with pethidine for prevention of shivering in pregnant patients undergoing a cesarean sectionwith spinal anesthesia Ferianto Bambang Suryono; . Pandit S; Bambang Suryono S
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 03 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Postanesthetic shivering (POS) is a common complication following spinal anesthesia. Severaldrugs have been used to prevent POS, including ondansetron and pethidine. This study wasconducted to compare the efficacy of ondansetron 8 mg with pethidine 0.4 mg/kg BW forprevention of shivering in pregnant patients undergoing a cesarean section with spinal anesthesia.This is a double blind controlled trial involving 96 pregnant patients between the age 18-40years with ASA physical status I-II, gestational age of 37-42 weeks, body weight of 40-70kg orBody Mass Index (BMI) <30, body height >145 cm who underwent a cesarean section withspinal anesthesia in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital. Exclusioncriteria included patients or families who refused to participate in the study, having a history ofallergy to bupivacaine, ondansetron, and pethidin, patients with a fetus known to have congenitalabnormalities earlier, body temperature early > 38 ºC or <36 ºC, pregnancy with complications(PEB, eclampsia, HELLP syndrome), and pregnant patients with heart disease (severe hypertension,heart trouble, abnormal heart valves). The patients were randomized into two groups i.e. 48patients of group ondansentron receiving intravenous ondansetron 8 mg and 48 patients ofgroup pethidine receiving intravenous pethidine 0.4 mg/kg BW. The patients were observed foroccurence and severity of POS, postoperative nausea and vomiting. The results showed thattwo patients (4.2%) on the ondansetron group and six patients (12.5%) on the pethidine groupexperienced of POS. Moreover, the efficacy of ondansetron in the prevention of POS (95.8%)was higher than pethidine (87.5%). However, there were not significantly different (p>0.05).The incidence of nausea on the ondansetron group (4.2%) was lower than the pethidine group(16.7%) (p<0.05). However, no significant difference in the incidences of vomiting was observedbetween the ondansetron (0%) dan the pethidine (4.2%) groups (p>0.05). In conclusion, theefficacy of ondansetron 8 mg is comparable to pethidine 0.4 mg/kgBW for prevention of shiveringin pregnant patients after spinal anesthesia.

Development of motor learning implementation for ischemic stroke: finding expert consensus Umi Budi Rahayu; Samekto Wibowo; Ismail Setyopranoto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 4 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The main purpose of this study was to investigate motor learning implementation forischemic stroke from experts on the field of motor learning in stroke patients includingthe neurologist, medical rehabilitation specialists and physiotherapists. To collect thedata and answer the research questions, statements were made on the basis of thestudy of literature and the grains exploration of the statements in the questionnaire usingthe Delphi Method. Formulation development model was based iteration or judgmentof experts. Validation assessment statement grain tested by the Content Validity Ratio(CVR) and Content Validity Index (CVI) was used to analyze the data. The finding clearup that CVR value of each item statement was 1 and the value of CVI also 1. There were6 indicators in a 26-point declaration on the implementation of the development model ofmotor learning intervention for ischemic stroke. Six indicators included basic theories thatsupport the importance of intervention motor learning, motor learning stages, principlesof motor learning, dosage, timing of and kinds of motor learning interventions that can beprovided as well as application development intervention model motor learning, allowinggiven for ischemic stroke. In conclusion, based on the content validity of the results ofthe consensus expert judgments are six indicators of the importance of motor learningapplication for ischemic stroke.

The effect of combination of triamcinolone acetonide and methotrexate on keloidfibroblast activity in dermis equivalent Endra Yustin E. S; Fajar Waskito; Yohanes Widodo Wirohadidjojo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 02 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (99.776 KB)

Background: Triamcinolone acetonid (TA) intralesion has been a standard treatment for keloids for manyyears, due to its effect in inhibiting collagen synthesis and fibroblast proliferation. However, until now theclinical result is unsatisfactory. Keloid flattening is slow and sometimes adverse reactions may occur.Methotrexate (MTX) is a chemotherapeutic agent having an antiproliferating effect which act as an antifolicacid. Because of this effect, MTX is potential to be used in combination with TA for the treatment inkeloid. Fibroblast populated collagen lattice (FPCL) was a dermal equivalent usually used for fibroblastactivity measurement.Objective: To understand the inhibition of fibroblast keloid activities of MTX in vitro on FPCL contraction,compared to TA and MTX plus TA.Methods: This research used simple parallel multigroups experimental study design, and conducted on thirdpassage keloid fibroblast culture, which was isolated from one patient. Fibroblast was cultivated in collagentype 1 from rat tail (FPCL). Keloid fibroblasts was classified into 16 groups, and treated with 5, 10, 20mM TA, 1.75, 3.5, 7 mM MTX, combination of TA and MTX, and a control negative. FPCL contractionindicating activities of fibroblast was measured using Scion Image software. Mean of FPCL contractionwas analyzed using one way analysis of variance (ANOVA).Results: All treatments could inhibit FPCL contraction until day 2 (p<0.05). The highest inhibition of FPCLwas found in combination of TA 20 mM + MTX 7 mM (p<0.05). The treatment that could inhibit FPCLcontraction until day 3 was only group MTX 3.5 mM + TA 20 mM. This result indicated that a combinationof TA and MTX was stronger in inhibiting keloid fibroblast activities compared with TA and MTX alone.Key words: keloid fibroblast - growth factors - triamcinolone acetonid - methotrexate - FPCL contraction

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