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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

164 165 166 167 168

Prefrontal cortex cell proliferation of adult rats after chronic stress treated with ethanolic extract of Centella asiatica (L) Urban. Yuniasih Mulyani Jubeliene Taihuttu; Ginus Partadiredja; Dwi Cahyani Ratna Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 1 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The decrease of proliferation level of cells in several regions of adult brain is found afterstress exposure. One of such area is prefrontal cortex. Herbal medicine as antistresshas been used widely. Centella asiatica (L) Urban extract was reported to have potentcompounds to increase brain function. The objective of this study is to investigate theeffects of ethanolic extract C. asiatica on cell proliferation of the adult prefrontal cortexin rats (PFC) after chronic stress. Adult male Sprague-Dawley rats, weighing 260-390g were randomly assigned into six experimental groups, with five rats per group, i.e.Group 1 as nomal control without chronic stress, Group 2 as stress control, Group 3 aspositive control given fluoxetine, Group 4-6 as treatment groups given 150; 300 and 600of ethanolic extrac C. asiatica, respectively. Extract were administered orally to the ratsfollowing a period of restraint duration of 6 hours/day for 21 days. Bromodeoxyuridine(BrdU) immunohistochemistry was used to label the proliferated cells. Physical fractionatormethod was used to estimate the total number of proliferated cells. One-way analysis ofvariance (ANOVA) followed by Tukey post hoc test was used to evaluate the differencebetween groups. BrdU-labeled cells on medial prefrontal cortex were as follows:1715.3±1345.1 (Group 1), 2659.2±2250.6 (Group 2), 4077.4±2415.3 (Group 3),1784.1±908.3 (Group 4), 3056.6±4263.3 (Group 5), and 2153.4±2259.4 (Group 6).No significance difference between groups was observed (p>0.05). In conclusion, theadministration of ethanolic extract of C. asiatica does not influence cell proliferation onprefrontal cortex of rats after chronic stress.

The effects of ethanolic extract of Phaleria macrocarpa (Scheff.) Boerl leaf on macrophage phagocytic activity in diabetic rat model Ira Cinta Lestari; Muhammad Ghufron; Sri Herwiyanti; Yustina Andwi Ari Sumiwi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 2 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Diabetic patients suffer inflammation and immune deficiency as a consequence of the decrease in macrophage phagocytic activity, thus making them vulnerable to infection. The ability of Ethanolic Extract of Phaleria macrocarpa Leaf (EEPML) to increase macrophage phagocytic activity has also a potential in the diabetic case. EEPML also has anti-inflammatory effect. In this study the EEPML potential to increase peritoneal macrophage phagocytic activity and change M1 and M2 macrophage percentage in diabetic rat model is investigated. This was a quasi experimental study with post test only control group design. Fourty five male Sprague Dawley rats within the age of 8 weeks were classified into normal control group, diabetic control group with solvent, diabetic with 7mg/200g, 14mg/200g, and 28mg/200g of EEPML peroral administration, once a day. The diabetic rat model was made with streptozotocin and nicotinamide injection. The rats were terminated in 3rd, 14th and 25th day of extract administration. Peritoneal fluid was isolated then cultured for macrophage phagocytic activity assay with latex beads. M1 and M2 macrophage percentage was analyzed using flow cytometry with anti CD40 and CD206 antibody. Result of statistical analysis show that active macrophage and phagocytic index mean of EEPML rat groups on day 3, 14 and 25 was significantly higher than the control group. The mean of M1 macrophage percentage of EEPML rat groups was significantly higher than control on day 3 and 14, and lower on day 25, while mean of M2 macrophage percentage didn’t show any significant difference within groups. Conclusion of this study is administration of EEPML increases peritoneal macrophage phagocytic activity on day 3, 14 and 25. This is also increases M1 macrophage percentage on day 14, decrease M1 macrophage percentage on day 25, and doesn’t change peritoneal M2 macrophage percentage in diabetic rat model.

Management of hereditary breast cancer: Surgeon's perspective Ava Kwong
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Mutations due to hereditary related genes such as BRCA1, BRCA2, TP53 and PTEN confer greater risk of developing breast cancer and for BRCA mutations, also ovarian cancer. The risk assessment based on genetic testing allows options of high risk surveillance, prevention and may now also guide use of specific therapies for treatment such as targeted therapies and use of platinum base chemotherapy. The choice of management, once an individual has been found to carry the BRCA mutation may also vary. Moreover the availability of genetic testing, method of testing such as the transition into the use of Next Generation Sequencing techniques has also increased options of clinicians to the choice of testing.Breast Surgeons are most likely to be the first person who encounters the first presentation of a breast cancer patient. It is important for breast surgeons to be actively involved in the referrals of patients for genetic testing and subsequently planning of the management of such high risk individuals in a multidisciplinary setting. Basic principles of genetic testing and choice of management will be discussed in reference to the surgeon’s perspectives. Keywords: mutations, BRCA1. BRCA2. TP53, PTEN, NGS, multidisciplinary setting

Serum calcium ions, ratio of calcium/ creatinine urine and bone mass density in perimenopausal and postmenopausal women Riswan Hadi Kusuma; . Windarwati; Harjo Mulyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 02 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Early diagnosis of osteoporosis is important to take early prevention and treatment. Dual energyX-ray absorbtiometry (DEXA) scan is gold standard diagnosis of osteoporosis. However, it ishigh technology and high cost. Biochemical marker using calcium could be developed for diagnosisof osteoporosis. The study was conducted to evaluate the correlation between serum calciumions level as well as urine calcium and urine creatinine (UCa/UCr) ratio and Bone Mineral Density(BMD) in perimenopausal and postmenopausal women. This was an observational study withcross-sectional design involving women aged 45-75 years who fulfilled the inclusion and exclusioncriteria. Bone Mineral Density was measured using DEXA method. Serum and urine calcium ionswere measured using ISE method, while serum and urine creatinine were determined using Jaffemethod. Ratio of UCa/UCr were then calculated. The correlation between serum calcium ions aswell as the ratio UCa/UCr and BMD of subjects were then analyzed. A total 63 subjects wereinvolved in this study consists of 21 normal subjects, 22 subjects with osteopenia and 20subjects with osteoporosis. Negative correlation between BMD and age (r=-0.591; p=0.001)and positive correlation between BMD and body mass index (BMI) (r=0.432; p=0.001) wereobserved. No correlation between serum calcium ions and BMD (r= -0.145; p=0.258), howevernegative correlation between UCa/UCr ratio and BMD (r=-0.310; p=0.013) were reported.Furthermore, no correlation was found between serum calcium ions and lumbar BMD (r=0.036;p=0.778), while negative correlation was found between UCa/UCr ratio and lumbar BMD (r= -0.414; p=0.001). In conclusion, there is no correlation between serum calcium ions levels andBMD, however there is a weak negative correlation between UCa/UCr ratio and BMD

BRCA1 and BRCA2: Lack of Certainty and Its Clinical Implications Samuel J Haryono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

AbstractIn this time of amounting cancer incidence and mortality, genetic testing may be greatly valuable in deciding on appropriate clinical management. It is unfortunate that the test is not a practical interrogative problem. When positive, the patients can settle down with what to do next, whereas when negative, their family members may breathe out in relief from unnecessary intensive surveillance and prophylaxis, and then there is VUS (Variants of Uncertain Significance). How should a health provider deliver the elaboration and implication of VUS to a patient who had expended a lump sum of and had expected a level of certainty? Variants of UncertainSignificance have nowadays become a challenging spoiler in the setting of clinical management of cancer. How would one inform someone else on anything uninformative? BRCA1 and BRCA2 are two genes with high penetrance in breast cancer. Since their functions as tumor suppressor genes and DNA repair regulators, their mutation effects are only visible when there is Loss of Heterozygosity. Mutation of BRCA1/2 gene can be demonstrated within the tissue specimen and blood sample DNA; that would mean it has occupied all tissues and is inheritable. In the case of BRCA1 and BRCA2 mutations, 10-20% of all genetic test results will read VUS, In one previous study of sixteen Indonesian patients, 13 (81,25%) patients had VUS. There were variants that had not been found in other population. Trans-academically speaking, the reclassification of VUS in BRCA1/2 gene is not merely a challenge to clarify its clinical impacts, but also an obligation to accomplish our community contribution to science.There can be a set of factors to suggest that a VUS may be a deleterious mutation:Co-segregation: when the variant comes with multiple and multigenerational incidence of cancer, it is possible.Epidemiology: when a case control study demonstrates prevalence discrepancy, it is possible.Co-occurrence with deleterious mutation: when the variant is shared within the same gene in other individuals, it is possible.Evolutionary data: when the sequence is carried across species, it is possible.Amino acid substitution: when the substitute is structurally similar, it is impossible.Loss of heterozygosity: when there is loss of a wild type allele in tumor specimen, it is possible.Functional analysis: should an in vitro assay demonstrate a loss of protein function, it is probable.The ultimate solution is not yet available. However, there is clinical significance for families with VUSs, only if that can confidently be classified as the presence or absence of the associated disease. That condition may be achieved by increasing the availability of genetic testing so that there can be a larger, open-access repertoire of VUSs.

Optimal time of administration of fentanyl in reducing hemodynamic response in endotracheal intubation Guntur Muhammad Taqwin; Gusti Ngurah Artika; Sri Rahardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 02 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Laryngoscopy and endotracheal intubations are frequently conducted in general anesthesia.However, it can stimulate symphatic and sympatoadrenal activities. Several non andpharmacological interventions have been used to reduce the symphatic stimulation. Fentanyl isone of the opioid drugs that frequently used to decrease the cardiovascular responses after theintubations. In order to obtain an optimal effect, fentanyl should be administered in appropriatetime. This study was conducted to compare the time of fentanyl administration at 2, 5 and 7minutes before endotracheal intubation to reduce hemodynamic responses. This was anobervational study with a prospective cohort design on patients who were going to undergoelective sugical using general anesthesia followed laryngoscopy intubation in Dr Sardjito GeneralHospital and met the inclusion and exclusion criteria. The patients were then divided into 3groups i.e patients who received fentanyl 1.5 μg/kg body weight (BW) intravenously (IV) 2minutes (Group A), 5 minutes (Group B) and 7 minutes (Group C) before laryngoscopy intubations.The hemodynmic responses including sistolic and diastolic blood pressure (SBP and DBP), meanarterial pressure (MAP), heart rate (HR) and rate pressure product (RPP) were monitored andrecorded every 1 minute during 7 minutes period. The result showed that fentanyl administration5 minutes before laryngeal intubation was more effective in the decrease hemodynamic responsethat those 2 and 7 minutes. Significantly different in SBP in 2, 3, 4 and 7 minutes observationswas observed (p<0.05). Furthermore, significantly different in MAP in 2, 3 and 4 minutesobservation and in RPP in 1, 2, 3, 4 and 7 minute observation were also observed (p<0.05). Nosignificantly different was observed in HR during observation (p>0.05). In conclusion, theadministration of fentanyl 1.5 μg/kg BW IV at 5 minutes before intubation is more effectiveagainst hemodynamic responses in endotracheal intubation.

Coronary Artery Calcium Score Improved Cardiovascular Disease Risk Prediction in Asymptomatic Patients I Md Ady Wirawan; Rodney Wu; Malcolm Abernethy; Sarah Aldington; Peter Larsen
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

This study examined whether coronary artery calcium score (CACS) has a betteraccuracy than the cardiovascular risk prediction chart (CRPC), and evaluate thereclassification improvement of CACS if it isused as a screening tool compared withthe CRPC. CACS has a better accuracy than the CRPC and reclassified a considerableproportion (39%) of a symptomatic patient into correct cardiovascular risk categories.CACS should be assessed in asymptomatic people with5-year CVD risk score of5-10% and 10-15%.

Village based information display of health facility data and public awareness of Dengue Hemorrhagic Fever: a lesson from Mlati Primary Health Care Center of Yogyakarta Province Setyaningrum, Veronika Evita; Purwandari, Ari; Sudiyo, Sudiyo; Hasanbasri, Mubasysyir
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Public health agencies concern about the disease contraction processes at the population level. Early detection and prompt treatment can be made to prevent transmission in the earliest stage. Understanding that their areas are endemic to DHF and the fact that cases continue to occur from year to year, community and public health stakeholders have a reduced motivation to take actions to have precaution to dengue. The village community will not be aware of the problems until patients from their areas visit health facility. The goal of this paper is to illustrate health center initiative to raise DHF precaution through village based spatial data display of dengue for the villagers attention in raising agenda in the management of dengue hemorrhagic fever at the level where they live. The paper points out the success story of the team of health facility manager, active public health program managers, an information technology literate administrators, and participation of local and private health workers asking DHF suspects to have their blood test in the health center. Supporting staff with health informatics training background has been able to work together with laboratory workers. The laboratory workers input the computer application that translate patient thrombocyte count data into village based geographic-spatial display. These data provide quick evidence about what is happening in the population. Puskesmas manager has the MPH training with population health perspective and the moral of public health problem solving. By having this data, she could make the health promotion actions at the population level. This paper shows the ability of health center manager to link health facility data and the population level evidence for public health action. The data can be used to trigger community be aware of DHF and to raise agenda in the prevention of local diseases. This is an easy and feasible things to do. Primary care and public health are under the common responsibility of the puskesmas managers. It is clear that data of health facility serve as the warning system of disease contracting process at the population level and the promotion of simple evidence to push community to get involved in prevention activities.

One Step Nucleic Acid Amplification (OSNA) Study in Indonesia Samuel J Haryono; Lenny Sari; Sony Sugiharto; I Gusti Bagus Datasena; Raymond Mulyarahardja; . Rudianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTSentinel lymph node (SLN) is defined as the first of a few selected lymphatic nodes, into which lymphatic fluid from a primary tumor drains. Streamlined processing of sentinel lymph nodes (SLN) for detection of lymph node metastasis involves the able command over methodical blocks of SLN identification, surgical removal of SLN and SLN analysis. One Step Nucleic Acid Amplification (OSNA) method, which relies on CK19 mRNA expression to detect intraoperatively lymph node metastases in breast cancer cases, emerged as a plausible alternative to the current gold standard that uses histopathological node analysis. Sixty selected axillary sentinel lymph nodes from thirty breast cancer patients. Sentinel lymph nodes were directly bi-halved after collection using customized lymph node cutting device (Sysmex), or scalpel. The first halves were subjected to histopathological examination and were stored in specimen containers containing fresh formaldehyde prior to processing. The adjacent halves were weighed to comply with the required mass by OSNA detection in the range of 50 – 600 mg and wrapped in clean foils for storage in -80°C prior to OSNA analysis. 60 SLNs were same diagnosis using both methods. 25 SLNs were negative and 25 SLNs were positive using both methods. 3 SLNs were positive on OSNA but negative on histology. Other 7 SLNs were negative on OSNA but positive on histology, and these 1 nodes contained only micrometastasis lesion. These results suggest that OSNA is a useful for detecting SLNs metastasis, but a copy number of CK19 might be an indepedent factor from prediction and prognosis of breast cancer.

Negative Correlation between cross-linked fibrin degradation products (d-dimer) and glasgow coma scale (GCS) scores in patients with head injury Andriani Tri Susilowati; Usi Sukorini; . Setyawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 02 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Traumatic Brain Injury (TBI) is damage in the brain caused by a traumatically injuring external force. To observe its severity, the Glasgow Coma Scale (GCS) and Computed Tomography (CT) scan are used. In addition, D-dimer as an end product of fibrinolytic activity is proposed as the predictor of TBI outcome. The increase of D-dimer value is correlated with severity. CT-scan is too expensive and requires patients’ mobility that can cause worse incidents. The aim of this study was to correlate between D-dimer and GCS in patients with traumatic brain injury. The cross sectional observational analytic design was carried out in the study. The TBI patients with 24 hours onset admitted to Emergency Room Dr. Sardjito Hospital Yogyakarta will be included with inclusion and exclusion criteria consecutively. Glasgow coma scale was measured and plasma D-Dimer was examined using Nycocard with immunofiltration method. Correlation between plasma D-Dimer and Glasgow Coma Scale was tested using Pearson Correlation when the population distribution was normal and Spearman when it was not normally distributed. There was a strong negative correlation between D-dimer and Glasgow Coma Scale (r=-0.622; p<0.001) and Prothrombin Time with D-dimer value (r=0527; p<0.001). Moreover, it was found that haemoglobin had a correlation with D-dimer (r=-0.517; p=0.001). Haemoglobin and PT had a correlation with Glasgow Coma Scale (r=0.419 vs -0.591; p<0.001) and neutrophil had poor correlation with Glasgow Coma Scale (r=-0.336; p=0.034). In conclusion, there was a strong negative correlation between degradation product of cross-linked fibrin (D-dimer) and Glasgow Coma Scale in patients with traumatic brain injury. Keywords: D-Dimer - Glasgow Coma Scale - Traumatic Brain Injury - CT scan - correlation

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