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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Core Subject : Science,
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
Articles 2,170 Documents
Hormonal Contraceptive Use as Risk Factor for Breast Cancer in Young Javanese Women Luna Fitria Kusuma; Kristanto Yuli Yarso
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.617 KB) | DOI: 10.19106/JMedScieSup0048042016017

Abstract

Previous study from 351 Indonesian women shown that they had breast cancers at younger age compared with western. In this study we investigate role of hormonal contraceptive as risk factor for Indonesian Javanese young breast cancer cases. However, the presence different life style between ethnic alter their risk as causal factors across populations. Diagnostic and prognostic study findings, including breast cancer prediction rules, must therefore be validated in Asian women. We undertook case-control study to determine population-based distributions of breast cancer among young Javanese people, one of the largest populations in Indonesia (Southeast Asia). A total of 500 women diagnosed with breast cancer participated in this study, divided in to two group young (less 40 years old) and mature breast cancer. Data for hormonal contraceptive, clinico-pathological characteristics and other risk factors were collected. We found that young Javanese women who use hormonal contraceptive for more than 10 years had a 4,67 fold increased risk of being diagnosed with breast cancer in young age (p<0,01). We didn’t found any differences between this two groups in menarche and parity. Interestingly for Javanese women who breast feeding more than 18 months increase 1,74 fold increased risk of being diagnosed with breast cancer in young age (p<0,01). 
Risk factors in childrenwith platelet refractoriness Jonliberti Purba; Sri Mulatsih; Neti Nurani; Teguh Triyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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.
The administration of long-term high-fat diet in ovariectomized wistar rat (Study on Daily Food Intake, Lee Index, Abdominal Fat Mass and Leptin Serum Levels) Dita Fitriani; Andreanyta Meliala; Denny Agustiningsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 2 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (416.805 KB) | DOI: 10.19106/JMedSci004802201601

Abstract

ABSTRACT Leptin and estrogen have an important role in energy homeostasis through anorexic effects on the central nervous system. These hormones can decrease food intake, increases energy expenditure and thermogenesis. Long-term high-fat diet can lead to impaired leptin function. Moreover, estrogen, deficiency is a risk factor of obesity in menopause. The aim of this study is to investigate the effect of long-term high-fat diet on leptin serum levels in ovariectomized rats. Twenty-eight female Wistar rats (Rattus norvegicus) aged 6-8 weeks with body weight 120-150 g were used in this study. Rats were divided into 4 groups i.e. OVXSC groups: rat were ovariectomized and given a standard diet; OVXH groups: rat were ovariectomized and given a high-fat diet; SHAMSC groups: rat were not ovariectomized and given a standard diet; SHAMHF groups : rat were not ovariectomized and given a high-fat diet. Pre-post test with control group design for measurement of serum leptin levels, food intake, and Lee index. While post-test only control group design for measurement of abdominal fat mass. Pearson test was used to analyze the correlation between leptin serum levels, food intake, Lee index and abdominal fat mass. Paired t-test was used to analyze the differences between values before and after being treated. The daily food intake dropped in rat fed a high-fat diet although it was not statistically significant (p>0.05). Ovariectomy significantly increase Lee index (p<0.05). Obesity occurs in ovariectomized group, both of high-fat diet and standard diet. Abdominal fat mass was significantly higher in high-fat compared to standard diet group (p<0.05). Increase in levels of serum leptin highest in OVX-HF group (16.45 ± 8.75 ng/mL), and the lowest in the SHAM-SC (2.98 ± 1.61 ng/mL). In conclusion, serum leptin levels positively correlated with Lee index and abdominal fat mass, but negatively correlated with daily food intake.
Oncoplasty: How to start and experience from Yogyakarta Herjuna Hardiyanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.045 KB) | DOI: 10.19106/JMedScieSup0048042016013

Abstract

AbstractReconstruction surgery after tumor removal is increasingly essential because of changes in patient expectations and demand. With the advance of early screening and detection, our ability to detect early stage cancer is significantly improved. Reconstruction is mostly suitable in patients with early stage cancer. In addition, there is growing ability that that immediate reconstruction in particular selected patients can be performed in a single time operation combining oncological and aesthetic procedures with considerably excellent result.  With the implementation of full coverage insurance by BPJS, most oncological surgery including in breast cancer will be performed by general surgeon in regency hospital. Reconstruction in selected patients usually is performed as delayed procedure by plastic surgeon. With the advance in surgical oncology training, breast surgery should be performed by surgical oncologist with specific oncoplasty training that can offer immediate reconstruction with both extensive removal tumor and reconstruction. Therefore, training in oncoplasty is very important for surgical oncologist. In Yogyakarta, we performed reconstruction after surgery of breast tumor, thyroid cancer, radical neck dissection and facial basal cell carcinoma with relatively excellent results. Further training and innovation are required to improve this early stage oncoplasty practice in Yogyakarta.Keywords : 
Anti-hepatitis B surface (anti-HBs) seroprotection in children with acute lymphoblastic leukemia post hepatitis B vaccination in Indonesia . Yustinah; Nenny Sri Mulyani; Roni Naning
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.908 KB) | DOI: 10.19106/JMedScie004601201402

Abstract

Children with acute lymphoblastic leukemia (ALL) receiving chemotherapy are at high risk fordeveloping hepatitis B infection. Protective effect of hepatitis B vaccination in children withALL in Indonesia has not been investigated yet. The aim of study was to determine the proportiondifference of anti-HBs seroprotection between children with ALL and without malignancy posthepatitis B vaccination. We had conducted a case-control study from January to February 2012at Dr. Sardjito General Hospital, Yogyakarta. We ascertained 1-15 years old children with ALLreceiving chemotherapy and without malignancy who had hepatitis B vaccination. Sixty sevenchildren were included in this study. Anti-HBs seroprotection level was measured using anenzyme-linked immunosorbent assay (ELISA). The results were analyzed using Chi-square test.Twenty one children (65.6%) with ALL and 13 children (37.1%) without malignancy showedanti-HBs seroprotection. The difference was statistically significant with p-value of 0.020(prevalence ratio [PR]=0.3; 95% CI=0.11-0.84). Both groups showed no significantly differenceof anti-HBs seroprotection according to either female gender, risk classification, or phase ofchemotherapy with p-value of 0.38 (PR =4; 95% CI=1.05-15.2), 0.248 (PR =3.37; 95%CI=0.58-19.6) or 0.214, respectively. In conclusion, the proportion of anti-HBs seroprotectionin children with ALL is higher than those without malignancy.
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)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (292.47 KB) | DOI: 10.19106/JMedSci004902201702

Abstract

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
Sedative hypnotics use as the risk factor for fall incidents on geriatric patients Christi Mambo; Jarir At Thobari; Woro Rukmi Pratiwi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (145.202 KB) | DOI: 10.19106/JMedScie004604201404

Abstract

Fall incident is one of geriatric syndromes that cause an increasing public health burden worldwide.The risk factors for falls incidents on geriatric patients have been identified included medicationuse. Benzodiazepine is a sedative hypnotic that found to be associated with an increase fallincidents. The aim of the study was to evaluate the influence of sedative hypnotics on the riskof fall incidents on geriatric patients. This was an observational study using cohort designinvolving 188 eligible geriatric patients comprising 94 patients who take sedative hypnotics and94 patients who not. All pasients then underwent a test for functional mobility and fall riskusing timed “up & go” test (TUG). The subjects who take ≤ 20 seconds to complete the TUG wasconsidered to have low risk for fall incidents, whereas those who take >20 seconds was consideredto have high risk for fall incidents. The results showed that the use of sedative hypnotics, sex,and number of drugs taken were associated with fall incidents on geriatric patients. Geriatricpatients who use sedative hypnotics were 2.41 times higher at risk of fall incidents than thosewho not use sedative hypnotics (95%CI;1.12-5.17; p=0.023). Geriatric patients who takealprazolam were 2.78 times higher at risk of fall incidents compared to those who not take(95% CI: 1.49-5.19; p=0.028). Furthermore, female geriatric patients were 3.29 times higher atrisk of fall incidents compared to male geriatic patients (95%CI: 1.58-6.88; p=0.001) and theuse of ≥ 4 kinds of drugs were 2.76 times higher at risk of fall incidents compared to the use of<4 kinds of drugs (95%CI:1.21-6.29; p=0.015). In conclusion, sedative hypnotics is found tobe a risk factor for fall incidents on geriatric patients.
The role of virulence factors inCandida albicanspathogenicity Tri Wibawa
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 1 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (815.604 KB) | DOI: 10.19106/JMedSci004801201606

Abstract

Candida albicans is a classical example of causative agent for opportunistic fungalinfection. Normally, it colonizes skin, gastrointestinal tract, genital, and mucosalmembranes, but in certain condition it may responsible for diseases. This phenomenonwas mainly associated with immunological status of the host. However, there werefindings that showed the possibility of putative virulence factors work on the transitionof commensally to pathogenic role of the yeast. In this review, some virulence factorswere discussed. Indeed, there were factors that may be considered as putative virulencefactors of C. albicans.
Implementation of Medical Genetics in Medical Education Curriculum Teguh Aryandono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.235 KB) | DOI: 10.19106/JMedScieSup004804201634

Abstract

Primary care physicians should be aware that genomics has arrived at the doorstep of their practice. Genetic knowledge, skills, and attitudes are important to primary care physicians providing support and management to patients and families with (higher risks of) genetic conditions. At least one in ten patients seen in primary care has a disorder with a genetic component, including hereditary cancer.Primary care physicians must be able to advise patients on genetic and genomic manifestations of the associated diseases and disorders, to outline a primary pedigree to deliver the necessary information: the disease which the patients are at risk of, and to decide whether to refer the patients to genetic services.There is more and more evidence to the importance of clinical emphasis in the genetics classes, probably proceeding to a third-year refresher program in the longitudinal curriculum. An enhanced educational experience to improve genetics and genomics knowledge should be better structured in the imminent future.Keywords: primary care physicians, hereditary cancer, genetic curriculum, genetic services
The influence of iron supplementation in pregnant women to the occurrence of low birth weight (LBW) babies in Palu, Central Sulawesi Sri Restu; Djaswadi Dasuki; R. Detty Siti Nurdiati Z
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (464.054 KB) | DOI: 10.19106/JMedScie004601201406

Abstract

Low birth weight (LBW) babies remains a major problem world wide as it causes a high rate ofneonatal morbidity and mortality. One effort to reduce the prevalence of LBW babies is byproviding iron supplementation to the pregnant women. The aim of this study was to examinethe relationship between iron supplementation program and prevalence of LBW babies in Palu,Central Sulawesi. This was an observational study with case control design. Subjects were allLBW babies from mothers that had accepted iron supplementation during pregnancy. Samplesize in this study was 87 for case and 87 for control. Bivariate analysis showed that ironsupplementation that not comply the program had a significant correlation with prevalence ofLBW babies (p=0.01). Other significant factors include abnormal hemoglobin level (p=0.01),body mass index (BMI) (p=0.02), educational level (p=0.02), multiparity (p=0.03), andgestational age (prematurity) (p=0.03). Multivariate analysis revealed that the strongest riskfactor for the occurrence of LBW babies was iron supplementation that not comply the program(OR= 3.82; 95% CI: 1.77- 8.22). Other risk factors were hemoglobin level (OR= 3.45; 95% CI:1.59-7.49), BMI (OR= 2.27; 95% CI: 1.05-4.91), gestational age (OR= 3.11; 95% CI: 1.45-6.67), multiparity (OR= 2.98, 95% CI: 1.36-6.51), and educational level (OR= 2.38, 95% CI:1.12-5.03). Based on the analysis, the strongest risk factors that affected the prevalence of LBWwas iron supplementation, abnormal hemoglobin level, gestational age, multiparity and educationlevel. In conclusion, iron supplementation during pregnancy that not comply with the programwas the strongest risk factor of LBW babies. The prevalence of LBW babies can be reduced bycontrolling of iron supplementation, hemoglobin level, BMI, gestational age, parity and education.

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