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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

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The relationship between soldierâs body readiness level and the anxiousness tendency of students in the flyer academy of the Indonesian Air Force Army Adisutjipto Airbase Yogyakarta Sumarni DW, Wahyudi Cecep Sugeng Kristanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 03 (2013)
Publisher : Universitas Gadjah Mada

Training the Indonesian Air Force flyers takes a lot of time and fund. The cramped trainingschedule, demand of discipline and achievement, and intense stress from the fear of dying fromplane accidents give the flyer students an even bigger stress that could potentially lead toanxiousness. In the selection of flyer candidates in the field, the most important aspect to benoticed is the body readiness of the candidates, whereas the mental health is frequently leftunchecked. There was a case in a training session where a flyer student experienced a badmental and academic achievement that, after being traced, resulted from poor mental healthtest, although the military body readiness test was good. It left the country with a loss fromhaving to discharge the student. The aim of this study was to identify the relationship betweenthe military body readiness level and the anxiousness tendency of a flyer apprentice. This was anobservational study with cross-sectional design. The research subjects was the flyer students ofthe Indonesian National Air Force Army in Adisutjipto Airbase Yogyakarta. The sample was takenfrom all of the subjects which fulfilled the inclusion and exclusion criteria. The measurement ofthe anxiousness used the TMAS (Taylor Manifest Anxiety Scale), whereas the military bodyreadiness value was taken directly in the field test. Moreover, psychological stress was alsomeasured using Instrument of Psychosocial Stressor Assessment (IPSP). The results were analyzedusing Chi-Square test and multiple regression analysis. It was found that there was no significantlyrelationship between the military body readiness value and the anxiousness tendency of theflyer student in the flyer academy of the Indonesian National Air Force Army in AdisutjiptoAirbase Yogyakarta (p>0,05). The psychological stress factor has a role in creating the anxiousnesstendency of the flyer students.

Synergistic interaction between quercetin and doxorubicin on MCF-7 human breast cancer cell line Indwiani Astuti, Abdul Khairul Rizki Purba Mustofa
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 03 (2013)
Publisher : Universitas Gadjah Mada

The effectiveness of doxorubicin has decreased due to resistance of cancer cells. One of thenatural ingredients that are proven to reduce the resistance to anticancer is quercetin. Quercetininteracts with doxorubicin via a competition of P-glycoprotein (P-gp) transporter activity. Theaim of this study is to evaluate the interaction of quercetin and doxorubicin as cytotoxicityeffect on MCF-7 cells. Cytotoxicity test was conducted by the MTT method. Mechanism ofinteraction between doxorubicin and quercetin was evaluated with isobologram analysis.Doxorubicin and quercetin inhibited the growth of MCF-7 cells significantly. Doxorubicin andquercetin respectively had IC50 of 21ïM and 103 ïM. The interaction of doxorubicin and quercetinwere characterized by the amount of doxorubicin IC50 equivalent and quercetin IC50 equivalentless than 1 and the point-intercept of each IC50 notation equivalent plotted on the graph belowthe additive line. Analysis of isobolograms indicated that the interaction doxorubisn and quercetinin each of the ratios had synergy. Quercetin can be considered to be in a combination wit

Symptoms of depression and quality of life in functional dyspepsia patients Agus Siswanto, Muhammad Eko Cahyanto Neneng Ratnasari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 02 (2014)
Publisher : Universitas Gadjah Mada

Dyspepsia is a common disorder characterized by heartburn, nausea, vomiting, bloating, feelingof fullness or early satiety, and belching. Functional dyspepsia (FD) or non-ulcer dyspepsia is asyndrome without any physical or endoscopic abnormalities underlying these symptoms. Theimpacts of FD on psychological disturbances and quality of life in patients have been postulated.However, it has not much been a concern. This study was conducted to evaluate the relationshipbetween symptoms of depression and quality of life in patients with FD. This was an observationalstudy with cross-sectional design involving 30 patients. The symptoms of depression weremeasured by beck depression inventory (BDI) and the quality of life of patients were measuredby SF-36. The results showed that FD were more suffered consecutively by female patients(66.7%), age over 45 years (53.4%), housewives (56.6%), educated graduates (56.6%) andmarried (90.0%). Moreover, patients who experienced symptoms of clinical depression withlow, moderate and severe levels were 16.3%, 33.3% dan 10.0%, respectively. A significantcorrelation between depressive symptoms and the overall of patients quality of life was observed(r = 0.481; p<0.05). Furthermore analysis showed that among eight domains of health in SF-36analyzed, a negative significant correlation was observed between the depressive symptoms andthe three domains of health i.e. general physical function, limitation of motion caused byphysical problems, and vitality. In conclusion, there is a negative correlation between depressivesymptoms and quality of life in patients with FD.

Chronic constipation as a risk factor of urinary tract infection in children Pungky Ardany Kusuma, Irna Fajri Syahny Mohammad Juffrie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Universitas Gadjah Mada

The prevalence of urinary tract infection (UTI) in children is still quite high. In Dr. SardjitoGeneral Hospital, Yogyakarta the incidence of UTI is reported about 3.5%. One of the riskfactors of the incidence of UTI is chronic constipation. However, it is often not a concern in themanagement of UTI pediatric patients. The aim of the study was to evaluate the influence ofchronic constipation in increasing the risk of UTI in children. This was an observational studywith case-control design. Children with symptoms of UTI who visited at the Installation of ChildHealth, Dr. Sardjito General Hospital, Yogyakarta underwent dipstick urinalysis test and urineculture examination. Patients who showed positive urine culture was included in the case group,meanwhile patients who showed negative urine culture was included in the control group. Allpatients were then asked the history of the chronic constipation. The association between theconstipation and the incident of UTI was evaluated using bivariate analysis continued bymultivariate analysis. One hundred and twenty eight eligible subjects consisting 64 subjects ineach group were involved in this study. Statistical analysis showed that children with chronicconstipation have a 3.77 times higher risk of UTI (OR=3.77; 95%CI=3.21-4.32) compare tothose without constipation. Furthermore, the chronic constipation remained to be independentrisk factor of UTI. The incidence of UTI increased 3.99 times higher in children with constipationcompare to those without constipation (aOR=3.99; 95% CI=1.028-15.48). In conclusion, chronicconstipation has been proven to be a risk factor of UTI in children

Sensitivity of serum C-reactive protein (CRP) levels compared to white blood cell count (WBC) as a predictor of surgical site infection in patients undergoing major surgery Supomo, Felix Hangandi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Universitas Gadjah Mada

Early diagnosis and treatment of infections is essential in the care of the surgical patients. Rapidand appropriate diagnosis for an infection can prevent irrational use of antibiotics in the surgicalcare. A blood culture is a standard method to detect and identify bacteria causing the infections.However, it is time-consuming to confirm the results. Therefore, an alternative method thatsensitive and specific to reduce the time necessary to confirm the laboratory report is urgentlyneeded. The aim of this study was to compare the sensitivity and specificity of C-reactiveprotein (CRP) with white blood cell (WBC) count as a predictor of surgical site infection (SSI) inpatients who underwent major surgery. This was a descriptive analytical study with a prospectiveobservational design involving patients who underwent major surgery in Department of Surgery,Dr. Sardjito General Hospital, Yogyakarta between Octobers until December 2011. On the thirdday post operative surgery, serum CRP level and WBC were measured. In addition, bacterialculture from the surgical wound of patients who suffered SSI, according to Centers for DiseaseControl (CDC) criteria, was performed. Among 49 patients who involved in this study, 16patients (32.7%) suffered from SSI consisting 12 cases of superficial SSIs and 4 cases of deepSSIs. Among 9 patients who had an abnormal WBC count, 6 patients experienced SSI, whileamong 9 patients who had CRP serum levels above 8 mg/dL, 7 patients suffered from SSI. Thesensitivity and specificity of serum CRP levels in predicting SSI was 43.75% and 93.93%,respectively. Whereas the sensitivity and specificity of WBC was 31.25% and 87.87%,respectively. In conclusion, CRP is more sensitive and specific than WBC in predicting SSI inpatients who underwent major surgery.

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

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 ÂºC or <36 ÂºC, 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.

Relationship of Geriatric Nutritional Risk Index (GNRI) with length of hospitalization and mortality rate in elderly patients Neneng Ratnasari, Retno Ambarukminingsih I Dewa Putu Pramantara
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Universitas Gadjah Mada

The proportion of elderly population is growing faster than any other age group. Malnutrition isa widespread problem in elderly and has been recognized as the most common cause of mortalityand morbidity. Mini Nutritional Assessment (MNA) is recommended to detect malnutrition riskamong geriatrics. However, it is just appropriate for geriatric who stay at home. For hospitalizationpatients, Nutritional Risk Index (NRI) that using albumin and weight is recommended. However,the weight data is often not possible obtained in geriatrics. Therefore, Geriatric Nutritional RiskIndex (GNRI) using ideal body weight is recommended. The aim of this study was to evaluaterelationship of GNRI with length of hospitalization and mortality rate in geriatric patients. Thiswas an observational study with a prospective cohort design conducted in Dr. Sardjito GeneralHospital, Yogyakarta from January to February 2012. Patients who met the inclusion and exclusioncriteria were recruited. Laboratoty and clinical examinations as well as GNRI scoring were thenperformed. Patients were grouped into two groups i.e. patients with GNRI score < 82 and eâ82. The patients were then monitored during hospitalization until they were discharged due todie or recovered. The length of stay and patients died were then recorded. The results showedthat the length of stay of patients with GNRI score < 82 (14.32 Â± 8.20 days) was significantlylonger than those with GNRI score ï³82 (9.31 Â± 6.15 days) (p = 0.006). Moreover, the mortalityrate of patients with GNRI score < 82 (42.1%) was significantly higher than those with GNRIscore ï³82 (2.8%) (p = 0.000). Kaplan-Meier survival analysis showed survival rate of patientswith GNRI score <82 rapidly decreased when compared with those with GNRI score ï³82. Inconclusion, there is negative correlation between GNRI with length of hospitalization and mortalityrate in elderly.

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

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

Hygiene, sanitation and the soil transmitted helminths (STH) infection among elementary school students in West Lombok Sri Sumarni, Rahmawati Soeyoko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 02 (2014)
Publisher : Universitas Gadjah Mada

The prevalenses of soil transmitted helminths (STH) infection in Lombok are relatively high. It isclosley associated with poor environmetal hygiene, non healthy sanitation status, poverty andimproper health services. The highest prevalences is normally observed in elementary school children.The aim of this study was to evalaute the relationship between hygiene, sanitation and STH infectionamong elementary school children in West Lombok. An observational study with cross-sectionaldesign was performed involving 197 elementary school children in Terong Tawah Village, LabuapiSub District, West Lombok District and 197 children in Ampenan, Mataram City as control. Thestool specimen of the children were collected and processed using Kato-Katz technique. Hygieneand sanitation of each subject that consisted nail hygiene, hand washing, using footwear, latrine,clean water availability, house floor, soil around the house were taken by questionnaire and directobservation. The result showed that the prevalences of STH among elementary school children inTerong Tawah (81.7%) was higher than that in Ampenan (12.7%).Trichuris trichiura was thepredominant helminth both in Terong Tawah (36.0%) and Ampenan (7.0%) followed by A.lumbricoides (20.4% in Terong Tawah and 4.5% in Ampenan). The mix infections between T.trichiura and A. lumbricoides among the children in Terong Tawah (24.4%) and Ampenan (1.0%)were also found. A significant relationship between hygiene and sanitaion i.e. nail cleaniness, washinghands, contaminated soil around the house and STH infection among elementary school children inTerong Tawah and Ampenan (p<0.05). In conclusion, there is a significant relationship betweenpersonal hygiene, environmental sanitation and STH infections among elementary school children.

Efficacy of pethidine 0.1 and 0.2 mg/kg body weight as an adjuvant of intrathecal bupivacaine 0.5% 10 mg in preventing shivering Djayanti Sari, Nur Hesti Kusumasari IG Ngurah Rai Artika
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Universitas Gadjah Mada

Shivering related with spinal anesthesia commonly occurs in patients. It is not only uncomfortablefor the patients, but also related to some complication. The efficacy of pethidine in the preventionof shivering is well known. The aim of this study was to compare the efficacy of intrathecalpethidine 0.1 mg/kg body weight (BW) and 0.2 mg/kg BW as shivering-prevention drug afterspinal anesthesia. This was a randomized, double-blind controlled trial study involving 196subjects between the age 18-40 years with ASA physical status I-II, gestional age 37-42 weeks,BW of 40-70 kg or Body Mass Index (BMI) <30 kg/m2, body height >145 cm who underwent acaesarean delivery section with spinal anesthesia based of World Health Organization (WHO)procedure in cesarean delivery in Dr. Sardjito General Hospital, Yogyakarta and affiliated hospital.Subjects were divided into two groups with 98 subjects of each group. Group A was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.1 mg/kg BW, and Group B was given anhyperbaric 0.5% bupivacaine 10 mg and pethidine 0.2 mg/kg BW in the same volume (2.5 mL).The seubjects were observed for the incidence and severity of shivering and side effects ofpehtidine. The results showed that the incidence of shivering in Group A (35.70%) was significantlygreater than in Group B (22.44%) (p<0.05). However, the onzet an duration of shivering werenot significantly different in both groups (p>0.05). Moreover, the incidence of nausea andvomiting in Group A (8.33%) was significantly lower than Group B (22.45%). In conclusion,pethidine 0.2 mg/kg BW is more effective to preven shivering than pethidine 0.1 mg/kg BWalthough the incidence of its side effects is more higher.

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