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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
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
 205   206   207   208   209 
Predictive factors for recurrence in patients with Graves’ Disease following treatment with methimazole Mohammad Robikhul Ikhsan; Raden Bowo Pramono; Hemi Sinorita; Vina Yanti Susanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (190.332 KB) | DOI: 10.19106/JMedSci005303202102

Abstract

Graves’ disease (GD) contributes for 60–80% of all hyperthyroidism. Methimazoleis the first line drug and most commonly used as antithyroid drug (ATD). However,the relapse rate following ATD therapy is 40–50%. The aimed of this studywas to evaluate long-term ATD treatments and to identify prognostic factorsthat contribute to GD recurrence. A total of 46 GD patients who referred to theEndocrinology Clinic, Dr. Sardjito General Hospital, Yogyakarta between January2016 and December 2018 with thyrotropin receptor antibody (TRAb) tested andtreated with methimazole were included in this study. Size of goiter was measuredbased on WHO grading system and eye syndrome based on NOSPEC score system.Patients were classified into recurrence and remission groups based on TRAbevaluation at 12 month following treatment. Result of thyroid hormone level (FT4)and subject characteristic as predictive factors observed at 3-, 6- and 12-month post-treatment were compared and analyzed.Among 46 patient involved in this study, 23patients demonstrated remission of hyperthyroidism based on TRAb evaluation at12-month. The size of thyroid at onset of disease in 30 (65%) patients was grade 2 orabove (p<0.05). Free FT4 levels at the end of observation (12 month) was 1.9±0.6 ng/dL in recurrent and 1.4±0.5 ng/dL in remission group (p<0.05). TRAb levels at earlyof study was higher in the recurrent group (p<0.05). Logistic regression analysisdemonstrated that thyroid size, FT4 level, and TRAb at diagnosis were associatedwith recurrencies. In conclusion, GD patients with large thyroids size, high TRAblevels, and high FT4 level at the onset of disease tended to fail to respond to ATD andwere associated with recurrence incidence.
Effects of valsartan compared with telmisartan in reducing insulin resistance on type 2 diabetes mellitus (T2DM) patients with hypertension Hemi Sinorita; Luthfan Budi Purnomo; R.Bowo Pramono
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 (199.179 KB) | DOI: 10.19106/JMedSci005302202102

Abstract

Insulin resistance is a major risk factor for patients with type 2 diabetesmellitus (T2DM). Telmisartan and valsartan are angiotensin II type I receptorblockers (ARBs) that are often used in patients with metabolic syndrome andT2DM. This study aimed to compare the effect of valsartan and telmisartan inreducing insulin resistance on T2DM with hypertension. Patients of T2DM wereopen-label screened at the Endocrinology Policlinic, Department of InternalMedicine, Dr. Sardjito General Hospital, Yogyakarta, and then randomized intotwo groups. The first group received valsartan 80 mg per day up to 160 mg perday, the second group received telmisartan 40 mg per day up to 80 mg per dayin addition with life-style modifying and diabetes therapy. Homeostasis modelassessment of insulin resistance (HOMA-IR), triglyceride and HDL cholesterollevels of patients were measured before and after receiving telmisartan andvalsartan for 12 weeks. A total of forty-nine outpatients were involved in thisstudy comprised of 25 female patients (51%) and 24 male patients (49%) with27 patients (55.1%) received telmisartan and 22 patients (44.9%) receivedvalsartan as the hypertension therapy. No significantl difference were observedbetween telmisartan group compared with valsartan group in HOMA-IR (14.01± 16.39 vs. 5.31 ± 3.51; p=0.053), triglyceride levels (165.71 ± 94.70 vs 144.41 ±48.33 mg/dL; p=0.620), HDL-C level (48.57 ± 9.78 vs 49.24 vs 49.24 ± 12.56 mg/dL;p=0.999). In conclusion, telmisartan demonstrated no difference compared tovalsartan in reducing insulin resistance on T2DM patients with hypertension.
Resistin associated with higher cardiovascular events in intermediate grace score of acute coronary syndrome Rizki Amalia Gumilang; Nahar Taufiq; Budi Yuli Setianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.875 KB) | DOI: 10.19106/JMedSci005303202105

Abstract

Previous studies revealed that inflammatory biomarkers have a role in the clinical outcomes of acute coronary syndromes (ACS) and also in prediction of cardiovascular events using GRACE score. Resistin, a recently identified inflammatory biomarker, also has a role in clinical outcomes of ACS but its role related to GRACE score risk stratification is unknown. Three risk stratifications of ACS based on GRACE scores were used i.e. low, intermediate, and high.  Some studies reported that inflammatory biomarkers have a role in cardiovascular events of patients with low risk GRACE scores, but their role in the patients with intermediate risk still needs to be elucidated. This study aimed to investigate the role of resistin in cardiovascular events of ACS patients with intermediate risk GRACE score. This was an observational study using a cross-sectional design involving sixty-three patients with ACS who fulfilled the inclusion and exclusion criteria. Blood samples were drawn 24 h after onset. Resistin level was analyzed and classified according to its median values. The cardiovascular event was defined as mortality, ischemic events, acute heart failure or arrhythmia during hospitalization. The result showed that cardiovascular events were significantly higher in patients with resistin levels higher than median i.e. 23.8% compared to those with resistin levels similar or lower than median i.e. 11.1% (OR 3.348, 95%CI: 1.125-10.007 p=0.027). It can be concluded high resistin level is associated with an increase of cardiovascular events of ACS with intermediate risk GRACE score.
Complication of trans-rectal prostate biopsy based on Clavien index: 5 years of experience Adhitya Fajar Prasetya; Johan Renaldo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.032 KB) | DOI: 10.19106/JMedSci005303202107

Abstract

Trans-rectal prostate biopsy has become the gold standard for early diagnosis of prostate cancer in developing countries. Despite its low risk, there are some post-procedural complications. The complications are classified by using a modified Clavien-Dindo system. The study aimed to recognize complications of trans-rectal prostate biopsy procedure by using Clavien-Dindo classification index. All patients undergoing trans-rectal prostate biopsy procedure in the Department of Urology, Dr. Soetomo General Hospital between January 2015-December 2019, were retrospectively analyzed in terms of post-procedural complaints, underlying comorbidities and ongoing additional examinations. The complaints were compiled into Clavien-Dindo classification. Univariate analysis of various predictors of post-procedural complications was also conducted. It was found 98 complication events from 400 patients (24.5%). Most complications were 1st degree (dysuria, hematuria, urinary retention, fever, rectal pain and bleeding, erectile dysfunction, and constipation).  In univariate analysis, positive results of urinary culture correlated to the emergence of post-procedural complications. In conclusion, the incidence of post-trans-rectal prostate biopsy complication in Dr. Soetomo General Hospital reached 24.5%. From all of the risk factors, positive urinary culture is related to the post-biopsy complication. Most complications are in the 1st grade of Clavien index, suggesting that the procedure is relatively safe and has a low risk
Comparison of diagnostic accuracy between clinical examination and magnetic resonance imaging (MRI) in diagnosing anterior cruciate ligament (ACL) rupture on Indonesian population Luthfi Hidayat; Aditya Fuad Robby Triangga; Muhamad Afrizal Farkhan; Bernadeta Fuad Paramita Rahayu; Rahadyan Magetsari
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 (872.563 KB) | DOI: 10.19106/JMedSci005302202107

Abstract

Anterior cruciate ligament (ACL) injury is the most common knee ligament injured. Anterior drawer and Lachman tests are the most common physical examinations for helping diagnose ACL injuries, while magnetic resonance imaging (MRI) is the first choice of supporting examination for evaluating any internal abnormality of the knee. However, studies concerning the accuracy of those examinations in the Indonesian population are limited. This study aimed to compare the accuracy between the anterior drawer test, Lachman test, and MRI in diagnosing ACL injury in Javanese patients. This retrospective study used medical records data of patients who underwent knee arthroscopy in the Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital, Yogyakarta in 2018. The MRI and the clinical examination results were compared to the arthroscopy results as the gold standard. The study showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the anterior drawer test were 86.67% (95%CI: 69.28-96.24%), 80% (CI: 44.39-97.48%), 92.86% (CI: 78.88-97.84), 66.67% (CI: 43.28-83.98%), and 85% (CI: 70.16-94.29%), respectively. Lachman test had 96.67% (CI: 82.78-99.92%) sensitivity, 90% (CI: 55.50-99.75%) specificity, 96.67% (CI: 81.86-99.47%) PPV, 90% (CI: 56.44-98.43%) NPV, and 95% (CI: 83.08-99.39%) accuracy. The diagnostic parameters of MRI were 83.33% (CI: 65.28-94.36%) for sensitivity, 60% (CI: 26.24-87.84%) for specificity, 86.21% (CI: 74.21-93.14%) for PPV, 54.55% (CI: 31.77-75.57%) for NPV, and 77.50% (CI: 61.55-89.16%) for accuracy. In conclusion, the Lachman test has better accuracy than the anterior drawer test. Both the anterior drawer and Lachman tests had higher accuracy compared to the MRI.
Pro-inflammatory cytokine (IL-6) and total count lymphocyte profiles in COVID-19 patients with different severity levels Shinta Dewi Permata Sari; Wening Tri Mawanti; Dewi Martalena; Erlin Listiyaningsih; Rizkyana Avissa; Rini Latifah; Wawang S Sukarya
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (381.351 KB) | DOI: 10.19106/JMedSci005303202101

Abstract

COVID-19 is caused by the SARS-CoV-2 infection that attacked the human respiratory system. In severe conditions, it causes pneumonia, kidney failure, acute respiratory distress syndrome (ARDS), and even death. The SARS-CoV-2 infection triggers the immune cells to secrete an excess of pro-inflammatory cytokines lead to cytokine storm. It is believed to become one of the mechanisms that cause the ARDS condition. The level of pro-inflammatory cytokines will differ with each case severity. This study aimed to evaluate the profile of pro-inflammatory cytokines in COVID-19 patients with different severity. Therefore, it could be used as therapeutic approach for cytokine storm conditions. It was a cross sectional study using plasma samples of COVID-19 patients from Jakarta Islamic Hospital, Pondok Kopi and Dr. M. Goenawan Partowidigdo Hospital, Cisarua, Indonesia. The COVID-19 patients with severe (n=20) and mild to moderate (n=25) severity were involved in this study. As negative control plasma sample from healthy subjects (n=13) was used. Plasma IL-6 levels were measured using the ELISA technique and plasma lymphocyte levels were measured using a hematology analyzer. The results showed that no significant difference between severity and gender was observed (p=0.256). Meanwhile, there is a significant difference in IL-6 level between negative control, mild-moderate, and severe categories (p=0.015). The average IL-6 level in severe categories was higher than mild-moderate and negative control categories, with values 105.375, 59.75, and 64.577 pg/mL, respectively. This result becomes supporting evidence that there is a cytokine storm condition in severe COVID-19 patients. Furthermore, the lymphocyte level in the severe group is significantly lower than the mild to moderate group. This result may indicate lymphocytopenia in the severe group.
Risk factors of sensory hearing loss in nasopharyngeal carcinoma patients obtaining conventional radiotherapy Odhi Anggani; Sagung Rai Indrasari; Feri Trihandoko; Anisa Haqul Khoiria; Ashadi Prasetyo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (194.153 KB) | DOI: 10.19106/JMedSci005303202106

Abstract

Previous studies proven that cochlear hair cells’ death plays an important role in sensorineural hearing loss due to radiation exposure. Other studies compared the differences between the impact of conventional radiotherapy (CRT) and intensity modulated radiation therapy (IMRT) on hearing loss in patients with nasopharyngeal carcinoma. Although, few differences found in some clinical manifestation, however no statistical analysis had been carried out. The aim of study was to evaluate the risk of sensory hearing loss in nasopharyngeal carcinoma patients who received CRT compared to IMRT.  A case control study was performed on nasopharyngeal carcinoma patients who received radiotherapy at Dr. Sardjito General Hospital, Yogyakarta. The result of DPOAE between NPC patients who received CRT and IMRT was compared in this study. Statistical analysis was performed using chi square test and multivariate analysis. The result showed that patients who received CRT significantly altered the risk for sensory hearing loss in the contralateral ear as much as 11.2 times according to the multivariate analysis (CI 95%: 2.2 – 56.6; p=0.004). In conclusion, the risk of sensory hearing loss in patients with nasopharyngeal carcinoma who received CRT is a greater compared to IMRT.
Prostat cancer profile in Dr. Sardjito General Hospital Yogyakarta Yurisal Akhmad Dany; Ahmad Zulfan Hendri; Indrawarman Soerohardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (514.187 KB) | DOI: 10.19106/JMedSci005303202104

Abstract

Prostate  cancer  is  the  fourth  most  common  type  of  non-skin  malignancy  in  male malignancies. In Indonesia, the definitive data are unreported, however, Globocan  reported  prostate  cancer  in  5th  place  in  2018.    Early  diagnosis  and  treatment  of  this  cancer  are  associated  with  reduced  mortality  rates.  This  study aimed to investigate the profile of prostate cancer in Dr. Sardjito General Hospital,  Yogyakarta,  Indonesia.  A  retrospective  study  involving  a  total  of  90  prostate cancer patients who underwent follow-up care at Dr. Sardjito General Hospital, Yogyakarta in the period of 2015 to 2020 was conducted. Data of the patients from their medical records consisted of age, gender, prostate volume, PSA  level,  testosterone  level,  hydronephrosis,  TURP  history,  histopathology  results,  Gleason  scores,  ISUP  grade,  and  staging  TNM  were  collected.  The  average of patients age was 67 ±10.4 y.o. where 22 (24.4%) patients aged < 60 y.o., 34 (37.8%) patients aged 61-70 y.o. and 34 (37.8%) patients aged >70 y.o. Almost of all patients (87 patients or 97.8%) were diagnosed as adenocarcinoma. Most of patients (73 patients or 81.4%) had prostate volume (TAUS) > 30 cm3 with the median at diagnosis was 51 cm3 (38.3 – 104.4). Furthermore, the median of PSA for diagnosis was 234.4 (94.4 – 1720.3) ng/mL and the median of testosterone level  at  diagnosis  was  317  (10  -  384)  ng/dL.  In  conclusion,  most  patients  with  prostate  cancer  are  identified  as  adenocarcinoma  with  metastatic  stage.  In  general, the prostate cancer patients age more than 61 years old with prostate volume  (TAUS)  >  30  cm3.  In  addition,  prostate  volume  and  testosterone  level  can be routinely used as initial screening and periodic assessment to evaluate prognosis and disease progression.
Effect of kelor (Moringa oleifera Lam) ethanolic leaves extract on uterus of pregnant mice and its teratogenicity Desy Armalina; Neni Susilaningsih; Indah Saraswati; Eva Annisa
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005304202102

Abstract

Moringa oleifera Lam (Moringaceae) is a source of additional dietary. It contains 9 essential amino acids, calcium, iron, potassium, magnesium, zinc and vitamins A, C, E and B which have a major role in the immune system. Previous study reported that M. oleifera Lam can increase the hemoglobin of breastfeeding mothers. In contrast, M. oleifera Lam is well known as abortifacient plant, therefore it is not recommended to use during pregnancy. The aim of this study was to evaluate the effect of M. oleifera Lam ethanolic leaves extract M. oleifera Lam on uterus of pregnant mice and its teratogenic effect. Twenty pregnant female Balb/c mice were used in this experimental study. Mice were randomized divided into four groups with five mice in each group. Group C as control, mice were not given anything. Group T1-T3 were given M. oleifera Lam ethanolic leaves extract during pregnancy age 7-18 days with doses of 10, 20 and 30 mg/kg BW, respectively.  Phytochemical analysis was performed quantitatively and qualitatively. On day 19, a caesarean section was performed to take the uterus, count the number of living foetus, dead foetus, disability, and other morphological abnormalities. No significant difference between all groups was observed. The abortifacient effect was not also observed in the uterus. Qualitative phytochemical analysis results showed that alkaloids, flavonoids, phenols, steroids, and tannins are identified in this extract. Quantitative steroids analysis results showed that the extract contained steroids of 1057.6 ppm. In conclusion, the M. oleifera Lam ethanolic leaves extract at dose of 30 mg/kg BW does not show any effect on the uterus of pregnant mice. Further study concerning the effects on other organs and hormones is recommended.
Correlation of histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) to the platelet count in patient with dengue viral infection Riyadi Adrizain; Maharani Simanjuntak; Andri Rezano
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005304202104

Abstract

Thrombocytopenia is often associated with clinically worse outcomes in dengue viral infection (DVI) patients. Histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) have been reported to induce thrombocytopenia. These drugs are administered to DVI patients due to misinterpretation of abdominal pain. The study aimed to evaluate the correlation between H2RA and PPI administration with thrombocytopenia event on hospitalized DVI patients. An analytical retrospective cross-sectional study was conducted using medical records of the patient admitted by final diagnosed DVI in seven major hospital in Bandung from January 1st to December 31st, 2015. Patients were separated into two groups i.e. with and without H2RA and PPI. Pearson point biserial analysis was then applied to evaluate the correlation of each drug administration to platelet count of DVI.  A total of 4005 patients with final diagnosed DVI involved in this study. About 11.0% and 25.1% of the patients received H2RA and PPI, respectively. Mostly the DVI patients receiving H2RA (55%) and PPI (50.8%) showed the platelet count <50.000/mm3. A very weak positive correlation between the administration of H2RA (p <0.001; r=0.103) and PPI (p <0.001; r=0.138) with the low platelet count of the patients was observed. In conclusion, the administration of H2RA and PPI is correlated to the low platelet count in DVI patients. Although the correlation is weak, H2RA and PPI should be administered with caution due to its thrombocytopenia side effect.

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