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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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Effects of ciprofloxacin concentrations on the resistance of uropathogen Escherichia coli: in vitro kinetics and dynamics simulation mode Maya Dian Rakhmawatie; . Mustofa; Eti Nurwening Sholikhah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Ciprofloxacin is recommended for complicated urinary tract infection (UTIs) caused by multidrug-resistant pathogens included Escherichia coli. However, its optimum dose for UTIs remains uncertain that may cause the bacterial resistance. This study was conducted to evaluate the effects of ciprofloxacin concentrations on the resistance of E. coli. The in vitro pharmacokinetic/pharmacodynamic (PK/PD) models of ciprofloxacin 750 mg oral dose twice a day for one daywas compared to that dose of 500 mg twice a day for three days.Pharmacokinetic parameters i.e.AUC0-24 and Cmax. and pharmacodynamic parameter i.e. MIC of ciprofloxacin against E. coli which previously had MIC of 0.5 µg/mL were determined. The PK/PD parameters combination of ciprofloxacin included AUC0-24/MIC, Cmax/MIC, and T>MIC ratio were used to evaluate its antimicrobial activities which was measured based on kill and re-growth rates of bacterial colony after the ciprofloxacin administration. The result showed that MIC value against E. coli increase to 8-16 and 32-64 µg/mL after ciprofloxacin 750 and 500 mg administration, respectively, indicating the emergence of resistance. Both doses of ciprofloxacin were able to reduce the number of bacterial colony in the first two hours administration. However, after two hours administration, those both doses could make re-growth of bacterial colony. The value of AUC0-24/MIC (120.42±1.27 vs.92.62±9.36), Cmax/MIC (4.75±0.21 vs. 3.26±0.30), and (T>MIC 89.58±7.22 vs. 76.39±9.39) after ciprofloxacin administration at dose of 750 mg were higher than those at dose of 500 mg. The increase of AUC0-24/MIC and Cmax/MIC values could reduce the number of bacteria colony, however could not for T>MIC value. In conclusion, the AUC0-24/MIC and Cmax/MIC parameters of ciprofloxacincan be used to evaluate its activity. In addition, ciprofloxacin twice per day at dose 500 mg for three days and 750 mg for one day are not different in the inhibition of E. coli resistance emergence.

Dysphagia as presenting symptom of myasthenia gravis: a case series of successful outcome in multidisciplinary approach Anton Haryono; Rery Budiarti; . Muyassaroh
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Dysphagia can be caused by mechanic or neurologic disorders. Neurologic dysphagia is commonly related to cerebrovascular disease, parkinson disease, amyotropic lateral sclerosis, tardive dyskinesia, and myasthenia gravis (MG). About 15-40% dysphagia occurred in MG generalized type. Only 6% MG with dysphagia were reported as a single symptom. The case reports aimed to demonstrate the role of otolaryngologist in multidisciplinary approach of the MG management. Two cases of MG were reported. First case was a 33 years old woman with moderate MG generalized type with ocular, dysphagia, and disarthria symptoms and second case was a 46 years old man with acute severe MG with crisis. Management therapy was applied according to onset and severity of MG. Acetylcholinesterase (AChE) and corticosteroid were administered for the first case, whereas therapeutic plasma exchange (TPE) for second case. In conclusion, disfagia in MG can be accompanied with other symptom, therefore its management should be based on the severity in order to give a positive result.

Association between serum soluble ST2 level and right ventricle systolic function on pulmonary hypertension due to atrial septal defect Firandi Saputra; Anggoro Budi Hartopo; Hariadi Hariawan; Dyah Wulan Anggrahini; Lucia Kris Dinarti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Pulmonary hypertension (PH) due to atrial septal defect (ASD) may cause a decline in right ventricle (RV) function. Soluble ST2 isa prognostic biomarker for left ventricle dysfunction. However, its role in RV function has not been investigated. This study aimed to investigate the association between serumsoluble ST2 with RV systolic function in patients withASD–associatedPH. This was a cross sectional study. Subjects were patients participated in the COHARD-PH registry performed in Dr. Sardjito General Hospital, Yogyakarta Indonesia. The patients with ASD and PH confirmed by right heart catheterization (RHC) were enrolled in this study. The soluble ST2 level was measured in the serum collected from pulmonary artery during RHC. Right ventricle systolic function was determined by transthoracic echocardiography using peak systolic velocity of tricuspid annulus (S’) parameter. This study was performed in 32 adults with uncorrected ASD. They predominantly females [n=29 (90.6%)] with median age of 31(22.5-44.0) years old. Mean ASD diameter was 2.69±0.53 cm. Median mean pulmonary artery pressure (mPAP) 45.0 (36.25-70.0) mmHg. Median soluble ST2 level was 23.28 ng/mL. There were no significant correlations between soluble ST2 level with S’value (r=0.071; p=0.35), with mPAP (r=0.043; p=0.815), with pulmonary vasculer resistance (PVR) (r=0.025; p=0.893) and with right ventricle (RV) diameter (r=0.200; p=0.273). Soluble ST2 level was found higher in subject with RV dysfunctionbut not statistically significant. In conclusion, serum soluble ST2 level did not associate withRV systolic function, measured by S’, in adult ASD-associated PH.

Correlation between CD44 expression on histopathological grading, metastasis, survival overall (SO) and disease free survival (DFS) on women breast cancer Ahmad Syaifudin; Septiman Septiman; Indra Indra; Prihantono Prihantono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Breast cancer is one of the health problems in the world. In Indonesia, it washighest prevalence of cancerin 2018. CD44, a non-kinase transmembrane glycoprotein, plays an important role in cancer development and progression.It isresponsible for mediating of the adhesion between adjacent cells andalsobetween cells and the extracellular matrix. The aim of study was to investigatethe relationship between the CD44 expressionand histopathological grading, metastasis, overall survival (OS) as well as disease free survival (DFS)in breast cancer patients.Thiswas a retrospective cross sectional studyusing data on medical records of breast cancer cases at Dr. Wahidin Sudirohusodo General Hospital, Makasarfrom 2016 to 2018. Examination of CD44 expression were performed from paraffin block samples.Data of the CD44 expression and medical records obtained were then presented in tables and statistically analyzed using chi-squared and Kaplan–Meier survival analysis.No significantly relationship between the CD44 expression and histopathological grading was reported (p>0.05). However, significantly relationship between the CD44 expression and metastasis war reported (p<0.01). Patients with metastasis havinghigh CD44 expression was significantly higher (90%) than those patients without metastasis (60%) (p<0.01). No significantly relationship between the CD44 expression and OS or DFS was reported (p>0.05). In conclusion, there isrelationship between CD44 expression and metastasis in the breast cancer patients. However, there is norelationship between CD44 expression and histopathological grading, OS as well as DFS.

A simple epidemic model of COVID-19 and its application to Ukrainian, Indonesian, and the global data Serhii O. Soloviov; Mohamad S. Hakim; Iryna V. Dzyublyk; Serhii H. Ubohov; Ozar P. Mintser; Viktor V. Trokhymchuk
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 3 (2020): Special Issue: COVID-19
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

At the beginning of 2020, one of the most significant health problems for humanity is the pandemic of coronavirus disease 2019 (COVID-19). Here, we identify features and develop simple epidemic model of COVID-19 on the basis of available epidemiological data and existing trends worldwide. Modeling of COVID-19 epidemic process was based on a classic model. A key parameter of the model, i.e. transmission parameter of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was determined numerically with the use of available epidemiological daily reports of COVID-19 from 17 April to 23 May 2020. Numerical determination of transmission parameter of SARS-CoV-2 according to the absolute number of COVID-19 cases in Ukraine, Indonesia and worldwide data showed its global tendency to decrease over time. Approximation of the obtained numerical values of the transmission parameter of SARS-CoV-2 was carried out using the exponential function. The results of prognostic modeling showed that by the end of summer 2020, above 30 thousand COVID-19 cases are expected in Ukraine, 100 thousand COVID-19 cases in Indonesia, and 12 million COVID-19 cases worldwide. Thus, predicting the possible consequences of the implementation of various health care control programs COVID-19 involves a comprehensive study of the epidemic process of the disease as a whole and for certain periods of time with the subsequent construction of an adequate prediction model.

Incidental bladder wall alteration as a surgical complication risk factor in Indonesian benign prostate hyperplasia patient Daniel Mahendra Krisna; Akhada Maulana; Erwin Kresnoadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 4 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Bladder obstruction due to benign prostatic hyperplasia (BPH) causes bladder walls alteration such as trabecular and diverticula. Although it is asymptomatic, however it affects the surgery complication. The aim of this study was to evaluate the correlation between bladder wall alteration and post-surgery complications in BPH patients. It was a descriptive observational study with cross-sectional design involving BPH patients who underwent histopathological examination and surgical intervention in the Bhayangkara Hospital Mataram from January 2010-December 2014. Data of the patients including age, place of birth, intraoperative finding, comorbid condition, and post-surgery complication were obtained from the medical record. The relationship between variables was analyzed using Pearson correlation test and linear regression test.A total 114 subjects were involved in this study with the most common age was in the range 60-69 years (43.0%). Seventy-fivesubjects (74.3%) had trans urethra resection of prostate (TURP). Trabecula (28.7%), diverticula (4.0%), and bladder stone (10.9%) were found when the surgical intervention performed. The most common post-surgical complication was chip or clot retention (56.4%). Significantly relationship betweenintraoperative finding with post-surgical complication was observed (r= 0.265; R2 = 0.07; p<0.05). In conclusion, there is correlation between bladder wall alteration and post-surgicalcomplication in BPH patients. Early bladder wall alteration screening is suggested in BPH patients before surgical intervention performed.

Low level of plasma VEGF-A and C allele of -2578*C/A polymorphism in the VEGF-A gene are risk factors of diabetic foot ulcer in Javanese ethnic Rahayu, Ika; Sinorita, Hemi; Timotius, Kris Herawan; Sadewa, Ahmad Hamim
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Diabetes mellitus (DM) is caused by abnormal insulin secretion, impairedinsulin action, or both. Approximately 12-25% of type 2 diabetes mellitus(T2DM) patients will develop diabetic foot ulcers (DFU). Vascular endothelialgrowth factor (VEGF) is a group of platelet-derived growth factors (PDGF)which have a potential role in angiogenesis. Low levels of VEGF-A can causeinsufficient angiogenesis leading to wound healing inhibition. The 2578*C/Apolymorphism of VEGF-A gene has been reported as a candidate markerfor the DFU development. However, the variant role in the development ofDFU in Javanese ethnic needs to be clarified. This study was conducted tocompare VEGF-A levels and the -2578*C/A polymorphism of the VEGF geneamong diabetic patients with and without DFU in Javanese ethnic. In thiscase-control study, the T2DM individuals with DFU as case group (n=19) andwithout DFU as control group (n=41) were recruited. The VEGF-A levelsweredetermined by ELISA. The ARMS-PCR technique was applied to investigate thepresence of -2578*C/A polymorphism of the VEGF gene. Data were analyzedwith independent t, Mann-Whitney, Chi-square, and Kruskal-Wallis tests withsignificance level of p<0.05. The median of plasma VEGF-A level was significantlydifferent between case and control groups (p=0.001). The genotype frequencyof -2578*C/A polymorphism of VEGF gene was no difference between case andcontrol groups. However, individuals with C allele have a higher risk factor todevelop DFU than A allele (CC+CA vs AA;p=0.042; OR=2.5). The plasma VEGF-Alevels were lower in T2DM subjects with DFU than those without DFU. Inconclusion,individuals with C allele of -2578*C/A polymorphism of VEGF geneare more susceptible to have DFU than individuals with A allele in Javaneseethnic with T2DM.

Association between monocyte-high density lipoprotein ratio (MHR) and severity level of lower extremity artery disease (LEAD) . Faizin; Bambang Irawan; Hariadi Hariawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 4 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The incidence of lower extremity artery disease (LEAD) has increased worldwide in the last decade. Its severity has been associated with increased morbidity and mortality. Atherosclerosis is believed as the main cause of LEAD. Monocytes and low-density lipoprotein (LDL) are the hallmarks of atherosclerosis. High-density lipoprotein (HDL) plays a role in suppressing the activation of monocytes. The monocyte to HDL ratio (MHR) has been reported as a marker of coronary artery disease complexity. However, this marker has not been investigated to assessthe LEAD severity. The study aimed to investigate the association between MHR and LEAD severity. This was an analytic observational study using a cross-sectional design. Patients were selected from the Vascular Disease Registry in Dr.Sardjito General Hospital, Yogyakarta from January 2016 – January 2019. The blood sample was drawn at one day prior, on the day, or one day after duplex ultrasound performed. The duplex ultrasound was then interpreted based on the duplex ultrasound score. Patients were classified into two groups according to the score i.e. severe (score ≥ 8) and nonsevere (score< 8). Where as, the MHR was classified into two groups according to the cut-off point i.e. high (≥ 14.51) and low (< 14.51). The Chi-square test was used for statistical analysis and pvalue <0.05 was considered as statistically significant. A total of 50 patients were involved in this study. There were 21 (42%) patients in the severe group and 29 (58%) in the nonsevere group. The proportion of the high MHR group and the low MHR group with severe levels of LEAD were 12 (57.1%) and 9 (42.9%), respectively. However, it was not statistically significant [p = 0.145; CI95% PR 1.57 (0.81 – 3.03)]. In conclusion, there is no association between MHR and LEAD severity.

Dynamic myelin regulation as a novel form of neural plasticity . Yuliana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Dynamic changes in myelin could optimize information transmission in neuralcircuits and enhance conduction velocity. This review aimed to provide anunderstanding of how dynamic myelin plasticity is important in neuronalactivity and how astrocytes have an important role that is not equal in theperipheral nervous system. Myelin is dynamically regulated by neuronalactivity. It takes part continuously in nervous system plasticity duringdevelopment. Newly differentiating oligodendrocytes can create a new myelinsheath. Mature myelin sheaths can grow again in adults. Oligodendrocytesinteract with astrocytes in the central nervous system through gap junctions.Astrocytes have an important role as synaptic network integrators; therefore,decreasing astrocyte numbers will cause a loss of presynaptic plasticity. Theconcept considers plasticity as a mechanism that depends on myelination.Higher brain functions and myelination interplay in the hippocampus andprefrontal cortex. The mechanism and function of these changes remainpoorly understood. Genetic, neural activity, environment, and axonal activitymight play important roles. Dynamic myelin regulation reveals a new form ofneural plasticity. Myelination is similar to synapse formation and plasticity. Itenables plasticity in the central nervous system and helps improve the learningprocess.

Congenital cystic adenomatoid malformation: a case report Haryo Aribowo; Divva Aurelia Azhalisita Amelinda; Ghifari Farandhi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Congenital cystic adenomatoid malformation (CCAM) is a rare condition defined by multiple cysts produced in the lung that occur during the fetal period, with respiratory distress as presenting symptoms. Untreated CCAM may lead to repeated lung infection and pneumothorax. Many surgical techniques have been used to treat CCAM. However, those techniques showed various results. Moreover, less studies were performed to evaluate the effect of those surgical techniques in treating CCAM patients. We reported a management of a rare pediatric case of CCAM referred to the Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital. The patient was a 29-day-old male baby who presented with pneumothorax on the right lung due to CCAM. The plan of treatment for the patient was lobectomy until pneumonectomy on the affected lung. During the thoracotomy procedure, we found that all lobes in the right lung were covered with fibrous tissue. Based on this finding, a decortication procedure to remove the fibrous tissue continued by a bullectomy procedure with the insertion of a chest tube were performed. The patient continuously showed improvement in breathing and wound healing, thus making the patient discharged from the hospital on the nineteenth postoperative day. The cause of CCAM is thought to be congenital abnormalities of the bronchiole epithelium that produce multiple cysts. Due to its rarity and lack of research on CCAM, many CCAM patients are misdiagnosed/underdiagnosed. Common surgical methods used in this patient are lobectomy with continuation until pneumonectomy or bilobectomy, if necessary, to prevent recurrence. Parenchymal saving methods can be considered because they have the same outcome as lobectomy. As performed in this patient, thoracotomy decortication continued with bullectomy is adequately capable of alleviating respiratory distress symptoms and is thus described as successful.

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