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INDONESIA
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
Comparison between plasma lactate and lactate clearance with the impact of acute phase complication in burn injury patient Hamilton Lowis; Sachraswaty R. Laidding; Fonny Josh; Yudhy Arius; Fritz Nasuhuly; Joko Hendarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (196.027 KB) | DOI: 10.19106/JMedSci005301202103

Abstract

Severe burn can cause rapid loss of intravascular volume with resultant adecrease in peripheral blood flow which reduces tissue oxygen transport and inturn, increases plasma lactate. Plasma lactate and lactate clearance are usefulparameters to compare complicated and uncomplicated burn patients in theacute phase. The study aimed to evaluate the initial and 24-h plasma lactatelevels as well as lactate clearance as useful parameters to assess acute phasecomplications of burn patients. This was a cross-sectional study involving35 burn patients who admitted at Abdul Wahab Sjahranie District Hospital,Samarinda during the period of September 2018 to September 2019. Thestudy was immediately begun after admission of the patients. Plasma lactatelevels were measured at admission and24-h after the first measurement. Theacute phase complication was assessed 72 h after burns from the laboratoryparameter. Fisher’s exact test and t test using SPSS software version 24wereapplied for statistical analysis. The 24-h plasma lactate level (p= 0.001) andplasma lactate clearance (p = 0.002) were significantly correlated with theoccurrence of acute phase complications of burns. However, the initial plasmalactate level was not significantly correlated (p = 0.609). In conclusion, there isa significantly correlation between 24-h plasma lactate level and plasma lactateclearance are with the occurrence of acute phase complications of burns.
The predictor factor of final visual acuity (VA) of acute retrobulbar neuritis patients receiving optic neuritis treatment trial (ONTT) regiment Tatang Talka Gani; Melvina Nidya Sandra; Indra Tri Mahayana; Datu Respatika; Hartono Hartono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.167 KB) | DOI: 10.19106/JMedSci005302202104

Abstract

The study aimed to investigate the efficacy of intravenous optic neuritis treatment trial (ONTT) regiment on the treatment ofpatients with acute retrobulbar neuritis.This was a cross sectional studyusing medical records data of patients diagnosed with unilateral or bilateral retrobulbar neuritis by normal funduscopic findings and typical optic neuritis perimetry results within 14 days of onset fromtheNeuro-ophthalmology Clinic, Department of Ophthalmology, Dr. Sardjito General Hospital, Yogyakarta from January to December 2015. Medical records data of patients who received 1000 mg methylprednisolone IV per day for 3 days followed by 11 days 1 mg/kg body weight oral prednisolone were reviewed. Visual acuity (VA) at onset, final VA at time of follow up, delta VA improvement and time of follow up were included in the analyses.Twenty data of patients aged 33.95±8.07 years with VA at onset of 1.96±0.81 (~ 1 mCF) were analyzed in this study. Significantly improvement in final VAafter treatment to be 1.39±1.12 (~5mCF) was reported (p=0.001). The VA at onsetwas a predictive factor for final VA (p <0.001). Every 1.17 increase of final VA for every one-point decreased VA at onset (p<0.001). Time follow up showed to be trend (p=0.059),however, age and sex were not a predictive factorof final VA (p>0.05). In conclusion, there is VA improvement after the treatment of ONTT regiment. The VA at onset is a predictive factorof final VA on patients with acute retrobulbar neuritis.ABSTRAKPenelitian ini bertujuan mengkaji efektivitas regimen optic neuritis treatment trial (ONTT) intravena pada pengobatan pasien dengan neuritis retrobulbar faseakut. Penelitian potong lintang ini menggunakan rekam medis pasien yang didiagnosis neuritis retrobulbar unilateral atau bilateral dengan temuan funduskopi normal dan hasil perimetri neuritis optik yang khas dalam waktu 14 haris etelah onset dari Klinik Neuro-optamalmologi, Departemen Oftalmologi, Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta dari Januari-Desember 2015. Data rekam medis pasien yang menerima1000 mg metilprednisolon IV per haris elama 3 hari diikuti oleh prednisolon oral selama 11 hari dengan dosis 1 mg/kg berat badan dianalisis. Ketajaman visual (VA) saat onset, VA akhir saat tindaklanjut, peningkatan VA, dan waktu tindak lanjut dianalisis. Sebanyak 20 data pasien berumur 33,95 ±8,07 tahun dengan VA saat onset 1,96 ±0,81 (~ 1 mCF) dianalisis dalam penelitian ini. Perbaikan VA akhir menjadi 1,39±1,12 (~5mCF) dilaporkan (p=0,001). Ketajaman visual saat onset merupakan factor predictor VA akhir (p<0,001). Setiap peningkatan VA akhir sebesar 1,17 menurunkan satu poin VA saat onset (p<0.001). Waktu tindak lanjut cenderung menjadi factor prediktor (p=0,059), namun demikian usia, jenis kelamin bukan factor predictor VA akhir (p>0,05). Dapat disimpulkan, terdapat peningkatan VA pasien setelah pengobatan regimen ONTT. Ketajaman visual saat onset merupakan factor prediktor VA akhir pada pasien dengan neuritis retrobulbar akut.
Correlation between vascular endothelial growth factor (VEGF) expression with histopathological findings in osteosarcoma Fikar Arsyad Hakim; Yuni Artha Prabowo Putro; Yudha Mathan Sakti; Rahadyan Magetsari; Irianiwati Widodo; Ery Kus Dwianingsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (13.335 KB) | DOI: 10.19106/JMedSci005302202101

Abstract

Vascular endothelial growth factor (VEGF) expression is associated with malignancy progression, metastasis, and poor prognosis in many malignancies, including osteosarcoma. However, studies concerning correlations between VEGF expression and histopathological prognostic factors ofosteosarcoma are limited. This study aimed to evaluate the correlations between VEGF expression and histopathological findings in osteosarcoma’spatients.This was a cross-sectional study using formalin-fixed paraffin embedded (FFPE) samples of 32 osteosarcoma’s patients from Dr. Sardjito General Hospital, Yogyakarta. Histopathological findings of specimens were re-evaluated by two independent observers, recorded for the subtypes, invasiveness, grading, mitotic counts, and tumor infiltrating lymphocytes (TIL). Expression of VEGF was determined based on immunostaining and evaluated using immunoreactivity score (IRS).Chi-square and Spearman correlation test were used to analyze the association between variables. Range of VEGF expression score was 0 to 11, with mean 5.09. Significant negative correlation between the VEGF expression and TIL was observed (p=0.046). However, there was no significant correlations between the VEGF expression and osteosarcomas subtypes, invasion, grading or mitotic counts (p> 0.05). In conclusion, the VEGF expression is associated with TIL. Further study is needed to evaluate the roles of VEGF and lymphocytes in osteosarcoma development dan progression in order to better understand of the role of VEGF in immunotherapy of osteosarcoma.
Prognostic factor for prolonged ventilator usage and ICU occupancy time after mitral valve replacement surgery: a retrospective cohort study . Supomo; Herpringga Lara Sakti; Galih Asa Andrianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.358 KB) | DOI: 10.19106/JMedSci005301202104

Abstract

This study was conducted to identify the prognostic factors for prolongedventilator usage time and ICU occupancy time after mitral valve replacement(MVR) surgery. It was a retrospective cohort study involving 70 MVR surgerypatients at Dr. Sardjito General Hospital, Yogyakarta, Indonesia during theperiod of January 2013 to December 2018. Prognostic factors as independentvariables including age, gender, heart failure, ejection fraction, pulmonaryhypertension, chronic pulmonary disease, active endocarditis, renalinsufficiency, duration of aortic cross clamp (AOX) time and cardiopulmonarybypass (CPB) time were evaluated. Where as the dependent variables werethe prolongation of ventilator usage time (>24 h) and the intensive care unit(ICU) occupancy time (>96 h). Of the total 70 studied patients, 25 patients(35.7%) used ventilator >24 h, meanwhile 15 patients (21.4%) occupied the ICU>96 h. Patients who used ventilator >24 h had CPB time ≥126.5 min (OR=10;95%CI=2.581-41.252), renal insufficiency (OR= 14; 95%CI = 1.487-150.970), andactive endocarditis (OR=7; 95%CI = 1.257-45.213). Meanwhile, patients whooccupied the ICU >96 h had age ≥40 years old (OR=6.4; 95% CI = 1.26-15.3),CPB time ≥126.5 min (OR=5.7; 95% CI = 1.8-38.1), and heart failure with NYHAfunctional classification 3 (OR=9.8; (95% CI = 1.4-67.2). In conclusion, theprognostic factors for prolonged ventilator usage time after MVR surgery areCPB time ≥126.5 min, renal insufficiency and active endocarditis. Furthermore,the prognostic factors for prolonged ICU occupancy time are age ≥40 years old,heart failure with NYHA functional classification 3 and CPB time ≥126.5 min.
Insulin resistance and non-alcoholic fatty liver disease: a review of the pathophysiology and the potential targets for drug actions Taoreed Adegoke Azeez; Morenike Osundina
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 4 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (267.293 KB) | DOI: 10.19106/JMedSci005204202010

Abstract

Insulin resistance refers to the reduced physiological effects of insulin on various tissues. Insulin resistance has been implicated in the pathophysiology of non-alcoholic fatty liver disease (NAFLD), which is a spectrum of diseases ranging from hepatic steatosis on one end to steatohepatitis, liver cirrhosis and hepatocellular carcinoma on the other end. In most parts of the developed world, it is now the most commoncause of chronic liver disease and the most commonindication for liver transplantation. A similar findingis emerging in the developing world due to the rising prevalence of obesity and widespread adoption of Western lifestyles. Despite these epidemiological data, there are no universally approved medications for the treatment of NAFLD. The pathophysiological mechanisms of NAFLD essentially include adipose tissue insulin resistance, hepatic insulin resistance, inflammation and fibrosis. At the subcellular level, mitochondrial dysfunction, oxidative changes and endoplasmic reticulum dysfunction have been documented. Several drugs have been tested in vitro and in animal studies to target these pathophysiological mechanisms. Some are presently going through clinical trials, while others have already gone through clinical trials with variable results. Other potential target sites of drug development for the treatment of NAFLD are based on the complex pathophysiology of the disease. Insulin resistance plays an important role in the development of NAFLD. There are potential targets in the pathophysiology of NAFLD that can be explored in the development of medications for the disease.
The rotavirus causing acute gastroenteritis in children of under 5-year of age in Indonesia 1972-2018: a review Abu Tholib Aman
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (38.498 KB) | DOI: 10.19106/JMedSci005301202105

Abstract

The reason of this review is the absence of thorough information of rotavirusinfection that had been the major cause of severe diarrhea in children of under5-years of age in Indonesia, despite numerous publications elaborating rotavirusinfection in some geographic areas of Indonesia. A review was conductedtowards 52 published articles covering rotavirus research in Indonesia duringperiod of 1972-2018.A thirty three selected articles were match with reviewcriteria which comprises rotavirus positive rate, clinical features, and severityof rotavirus infection, as well as genotypes of the rotavirus. Rotavirus has beenknown as the major cause of severe diarrhea among children under 5 years ofage world wide including in Indonesia. The rotavirus positive rates were rangefrom 31.1 to 90.9%, which variably to different subject’s population, studycriteria and methods, and time. Rotavirus can cause severe diarrhea withmajority of infected children suffered from dehydration, vomiting, and fever.The first genotyping conducted in Indonesia in the early 1980s revealed thepredominant genotypes were G3 and G4, followed by G2, and small proportionof G1 and mixed genotypes. However the following decades G1 and G2 were onthe raise with G3 predominantly re-appeared on 2015. G9 was first identified in2004, and occasionally detected until 2015. The P genotyping revealed P[4], P[6],and P[8] were the common genotypes detected. Mixed and untyped genotypeswere also detected in various proportion. Rotavirus diarrhea is a vaccinationpreventable disease, after natural infection, the immune system will produceprotective antibodies that will protect from infection of both homotypic andheterotypic, however homotypic infection will protect stronger. Therefore thisreview recommends continuous rotavirus genotypes surveillance in Indonesia.
Epidermophyton floccosum as apossible aethiological agent of tinea capitis: a case report Rudi Chandra; Nova Z Lubis
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1398.153 KB) | DOI: 10.19106/JMedSci005302202110

Abstract

Tinea capitis is a superficial fungal infection of scalp that affects particularly school-aged children. It is usually caused by dermatophytes, although Epidermophyton floccosum can cause the tinea capitis. Tinea capitis caused by the E. floccosum is quite interesting because it can confirm the sporadic occurrence of hair parasitism by this dermatophyte. In this article, it was reported tinea capitis caused by E. floccosum. A 15-year-old girl, presented with itchy scaly alopecia on scalp since 1 week ago. The patient denied any contact with cat or dog, and there was not any family history. On physical examinations, lymphadenopathies were found at both lateral neck and alopecia with scales and crusts, lenticular to nummular sizes, at scalp. Hair-pull test was positive. The trichoscopy examination found comma hairs, broken hairs, and black dots. The fungal culture examination discovered the growth of E. floccosum. The patient was diagnosed with tinea capitis and treated with 500 mg of griseofulvin orally, 10 mg of cetirizine orally, and 2% of ketoconazole shampoo. Epidermophyton floccosum is an anthropophilic dermatophyte that frequently causes tinea cruris, tinea pedis, tinea corporis and onychomycosis, but not tinea capitis. Several reports have showed the capability of E. floccosum in perforating hairs and causing tinea capitis. In conclusion, E. floccosum is a possible aethiological agent of tinea capitis through its ability to perforate hairs.
Effectivity of alkaline water on the clinical improvement in laryngopharyngeal reflux Muhammad Rizka Yahya; Rery Budiarti; Dwi Antono; . Farokah; . Muyassaroh
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.823 KB) | DOI: 10.19106/JMedSci005301202101

Abstract

Laryngopharyngeal reflux (LPR) is the reflux of gastric acid through theupper oesophageal sphincter causing mucosal damage of the larynx, thegastrointestinal tract, and the upper airway. Alkaline water has the ability towithstand acidic conditions in the body, the formation of carbonic anhydrase,and reepithelization. This study aimed to investigate the effect of alkaline wateron the clinical improvement in LPR patients. A randomized control trial withpre-test and post-test control group design on LPR patients aged 18 to 60 y.o.was conducted at the ENT-HS outpatient clinic of Dr Kariadi Central Hospital,Semarang, Central Java, Indonesia. Thirty subjects were recruited and dividedinto two group with 15 subjects in each group. In the control group, the subjectswere given standard therapy and mineral water. In the treatment group, thesubjects were given standard therapy and alkaline water. The diagnosis ofLPR was made if the reflux scoring index (RSI) was ≥13, and the reflux findingscore (RFS) was >7. ,After two weeks of intervention, the clinical improvementswere evaluated by reassessing the RSI score. The data were analyzed usingthe Shapiro-Wilk test and independent t-test. The results showed that the mostcommon main complaint was throat clearing [11 subjects (37%)]. Based on theRSI score, there were clinical improvements in both the control (p <0.001) andthe treatment groups (p <0.001). However, there was no significant differencein the RSI score before and after the intervention in the control (p = 0.058)and the treatment groups (p = 0.322). In conclusion,tbe d there is an effect ofalkaline water on the clinical improvement of LPR patients. However, there isno significant difference in the clinical improvement between the control andthe treatment groups.
The management of childhood drowning in a tertiary hospital in Indonesia: a case report Dyah Kanya Wati; I Gde Doddy Kurnia Indrawan; Nyoman Gina Henny Kristianti; Felicia Anita Wijaya; Desak Made Widiastiti Arga; Arya Krisna Manggala
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (645.637 KB) | DOI: 10.19106/JMedSci005302202111

Abstract

The World Health Organization (WHO) stated that drowning becomes the third leading cause of death from unintentional injury. Furthermore it was reported more than 372,000 cases of death annually among children due to drowning accident. Inappropriate of resuscitation attempt, delay in early management, inappropriate monitoring and evaluation lead to drowning complications riks even death. However, studies concerning the management of childhood drowning in Indonesia is limited. Here, we reported a case of childhood drowning in Sanglah General Hospital in Denpasar, Bali. An 8 years old girl arrived at the hospital with deterioration of consciousness after found drowning in the swimming pool. The management of the case was performed according to the recent literature guidelines. The first attempt was performed by resuscitation, followed by pharmacological interventions using corticosteroids, non-invasive ventilation and series of laboratory examination. With regular follow up, patient showed good recovery and prognosis.
Excellent response of rituximab and bendamustine in elderly patient with relapsed diffuse large B-cell lymphoma: a case report Wiwiek Probowati; Merari Panti Astuti; Bambang Purwanto Utomo; Mardiah Suci Hardiyanti; Ibnu Purwanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.85 KB) | DOI: 10.19106/JMedSci005301202110

Abstract

Rituximab in combination with cyclophosphamide, doxorubicin, vincristine,and prednisone (R-CHOP) is currently the most widely used first-line therapyfor aggressive B-cell lymphomas. However, many patients, including thosewith organ dysfunction, may not tolerate the toxicities associated with thisregimen. Recent data from the phase III study group indolent lymphomas(StiL) non-Hodgkin lymphoma (NHL)-1 trial suggested that bendamustine plusrituximab were superior in effectiveness and tolerability compared to R-CHOPin the treatment of indolent and mantle cell lymphomas. Preliminary studyhas indicated the effective use of bendamustine alone or in combination inthe treatment of aggressive B-cell lymphomas as well. A 70-year-old malewith heavily treated relapsed diffuse large B-cell lymphoma (DLBCL) showedcomplete remission (CR) after receiving 8 cycles of rituximab in combinationwith bendamustine as 3rd line treatment. Bendamustine has demonstratedconsiderable efficacy and well-tolerated therapy in relapsed DLBCL patients.Our case report demonstrated that treating patients with bendamustinebasedregimen, even in the setting of organ impairment and elderly is safeand effective. Given the increasing evidence of its effectiveness, furtherinvestigation of bendamustine’s safety and tolerability aspects in specialgroups is recommended such as those with renal impairment.

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