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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
Treatment of functioning pituitary macroadenoma with endoscopic transsphenoidal surgery: a case report Agusni Agusni; Willy Adhimarta; Andi Asadul Islam; Djoko Widodo; Nasrullah Nasrullah; Andi Ihwan; Prihantono Prihantono; Muhammad Faruk
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/JMedSci005304202109

Abstract

Pituitary macroadenomas are benign tumors in the pituitary gland measuring more than 1 cm in diameter. Pituitary adenomas account for 8 to 10% of all intracranial tumors and occur primarily in the anterior pituitary lobe and rarely in the posterior lobe. Most pituitary macroadenomas are non-functioning tumors, which show clinical symptoms due to tumor pressure and do not increase hormonal activity. In this case, a 40 y.o. woman was diagnosed with a pituitary macroadenoma after showing clinical symptoms of a functioning tumor, namely acromegaly, prognathism, and large, beefy hands and feet, for the past 4 years. Complaints were accompanied by amenorrhea, intermittent cephalgia, and hemianopsia in the right eye. Blood laboratory tests revealed increased levels of prolactin and growth hormone, while the results of computed tomography (CT) scans and magnetic resonance imaging (MRI) of the head indicate the presence of a pituitary macroadenoma. Endoscopic transsphenoidal surgery, a minimally invasive procedure, was performed with minimal complications.
Effect of nitrate administration on plasma nitric oxide levels in patients with peripheral arterial disease at Dr. Sardjito General Hospital, Yogyakarta Arditya Damarkusuma; Muhamad Taufik Ismail; Hariadi Hariawan; Sherly Primasari Agus
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/JMedSci005304202105

Abstract

Peripheral arterial disease (PAD) is a disease involving reduction of blood flow to the inferior extremity associated with atherosclerotic lesions. In 2010, more than 200 million people with PAD were reported globally, including 54.8 million in Southeast Asia. The high prevalence of PAD causes its management become challenging for clinicians. Nitric oxide (NO) has a role in endothelial function that is associated with the appearance of symptoms in PAD patients. Exogenous nitrate is usually used as a primary vasodilator in the treatment of angina pectoris and Prinzmetal angina. However, information concerning the role of nitrate administration to improve symptomatic PAD patients is limited. This study aimed to evaluate the effectiveness of exogenous nitrates in increasing plasma NO levels and improving PAD patients. A prospective pre-post clinical trial involving PAD patients who were registered in the vascular registry at Dr. Sardjito General Hospital, Yogyakarta  was conducted. Primary endpoint was the change in plasma NO levels after short term administration of nitroglycerin oral 2.5 mg once daily (4 h) and long term (7 d). Analysis of variance test with Bonferroni posttest was used for statistical hypothesis testing. Among 33 subjects who completed this study, no negative side effects, and only one hypotensive patient was reported at the first follow-up after 4 h of the nitroglycerin administration. Plasma NO levels increased in the post 4 h and in the post 7 d administration. However, no statistically significant was observed (p > 0.05). Administration of exogenous nitrates in patients with PAD increases the plasma NO levels, even though it is not statistically significant.
Endoscopic dacryocystorhinostomy as an option management of syndrome- related congenital dacryocystocele: a case report Yunia Irawati; Alexander Krishna Ernanda; Florentina Priscilia; Retno Sulistyo Wardani
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/JMedSci005304202110

Abstract

Congenital dacryocystocele (CD) is a rare anomaly of the medial region of the orbit, caused by distal at the level of the valve of Hasner and proximal at the level of the valve of Rosenmuller obstruction of the lacrimal system. It may present as isolated abnormalities or maybe associated with syndromes. We described a neonate with a history of bilateral enlarged lacrimal sacs below medial canthal tendon with blue-grayish color and epiphora.  Computed tomography (CT) scan resulted in congenital dacryocystocele. She was given topical antibiotics and Crigler massage as conservative treatment. In the first week, the right eye got a complete resolution. Otherwise, the left eye’s lesion was worsening. The patient underwent endoscopic dacryocystorhinostomy (En-DCR) and silicone intubation on the left eye. Epiphora resolved with no recurrence at one month follow up. Conservative treatment and En-DCR have a success rate with no complication and widely used nowadays. In the case of CD associated with a syndrome, multidiscipline workups and treatment are essential.
Evaluation of oxidative stress levels using glutathione peroxidase (GPx) expression on hyperglycemia-induced rats testis Andreas Pramudito; Sakti Ronggowardhana Brodjonegoro; Ahmad Zulfan; Aria Danurdoro; Didik Setyo Heriyanto
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/JMedSci005304202103

Abstract

Diabetes mellitus (DM) is a global health problem with an estimated 422 million cases worldwide. Previous studies reported a correlation between hyperglycemia and oxidative stress‐related male infertility in DM. Glutathione peroxidase (GPx) can cause DNA damage due to oxidative reactions. Therefore, it could be used as potential indicator of antioxidant therapy. The study aimed to evaluate the expression level of GPx on the hyperglycemia-induced rats. This was an experimental case-control study using 27 Wistar rats divided into three groups i.e. hyperglycemia induction for four weeks group, eight weeks group, and a control group with no intervention. Following after induction, total RNA from the rats' testis was extracted, and GPx expression was analyzed using qPCR. Data were analyzed using SPSS, and a p <0.05 was considered significant. The study showed a significantly higher GPx mRNA expression level after hyperglycemia induction in both 4 and 8 weeks groups (16.93 ± 3.32 and 17.62 ± 3.42) compared to control group (9.94 ± 2.91) (p< 0.05). However, no significantly different between the 4 weeks group and 8 weeks group was observed (p >0.05). In conclusion, hyperglycemia increases GPx mRNA expression in rats. It may change the testicular environment's oxidative processes and impairs male reproductive function in the Sertoli cells with no exception.
Genetic variant of TGF-ß associated with decreased renal function in type II diabetes mellitus patient: single center pilot study in Indonesia Anggelia Puspasari; Elfiani Elfiani; Susan Tarawifa; Rina Nofri Enis; Asro Hayani
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/JMedSci005304202101

Abstract

The interaction between genetic factors, blood glucose and hypertension plays a role in the onset of diabetic kidney disease (DKD) in type II diabetes mellitus (T2DM). Genetic variation of TGF-ß1 is associated with renal complication in T2DM with varying results between ethnicities. The Jambi Malay ethnic, which is the majority ethnic in Jambi Province, is an area that reports an increased prevalence of T2DM with DKD as the most frequent microvascular complications. In addition, previous study reported controlling blood glucose not associated with DKD indicating genetic may have play a role in DKD in this population. Studies related to genetic variation and decreased kidney function in T2DM patients has never been performed in this ethnic group. This study aimed to investigate the role of TGF-ß genetic variation as risk factor for decreased renal function in T2DM patients from Jambi Malay ethnicity. We conducted a cross sectional study involving 70 patients with T2DM. The inclusion criteria for renal complication based on a decrease in the glomerular filtration rate (GFR) of less than 60 mL/min/1.73. The genotyping method used was amplification refractory mutation system polymerase chain reaction (ARMS-PCR) for TGF-β1 rs1800470 T/C. Bivariate and multivariate analysis was performed to analyze phenotype and genotype association. The result of bivariate analysis showed T2DM patients with genotype CT (p:0.006; OR:0.125; 95% CI:0.027-0.575) and CC (p:0.007; OR:0.104; 95% CI:0.020-0.546) or C allele carrier (p:0.003; OR:0.117; 95% CI:0.027-0.500) had lower risk for decreased renal function than TT genotype. Multivariate analysis that included blood pressure and age variables showed the same finding for CT (p:0.007; OR:0.086; 95% CI:0.014-0.508) and CC genotype (p:0.022; OR:0.115; 95% CI:0.018-0.731). It is concluded from this study that T2DM patients with genotype CT, CC and carrier allele C have a lower risk for suffering kidney complications than genotype TT.
Earlobe crease as a marker of coronary heart disease: a systematic review Jonathan Ricardo Hamonangan; Fitri Agustina Huspa; Rien Afrianti
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/JMedSci005304202108

Abstract

Earlobe crease (ELC) is a wrinkle-line in the skin that surrounds the ear approximately one third of the length between the tragus and the posteroinferior edge of the earlobe. Since the first study in 1973, the relationship between ELC and coronary heart disease (CHD) remains unclear. In addition, the pathogenesis of ELC has not well described, yet. This review aimed to evaluate the relationship between CHD and the presence of ELC using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. Eligible studies obtained from PubMed and Google Scholar using relevant keywords were collected. The assessment of quality of the studies was carried out based on the National Heart Lung and Blood Institute. Among 21 studies collected, 19 studies reported a correlation between the ELC and CHD indicating that ELC as a potential marker of CHD. Seven studies reported a significant association of ELC with CHD after adjusting confounding variables such as age, sex and other risk factors for atherosclerosis in analysis. Seven studies reported that subjects with ELC had more significantly severe CHD based on coronary angiography. The sensitivity of the ELC was reported between 30-98% and the specificity between 43-91%. Two studies reported no relationship between ELC and CHD after adjustment of age in analysis. Earlobe crease is a dermatological sign which was reported to have potential as a marker of CHD. Further study with large sample in population from various ethnics is needed in order to obtain a robust conclusion regarding the clinical importance of ELC in predicting CHD.
Ultraviolet phototherapy for treatment of various dermatoses Irwan Saputra Batubara; Larisa Paramitha Wibawa; Erdina Pusponegoro; Windy Keumala Budianti; Githa Rahmayunita; Shannaz Nadia Yusharyahya
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/JMedSci005304202107

Abstract

Ultraviolet (UV) radiation has been applied to treat many chronic skin diseases. Based on the wavelength, UV radiation consists of three types, namely ultraviolet C (UVC), ultraviolet B (UVB), and ultraviolet A (UVA). The types of UV that are widely used in dermatology are narrowband ultraviolet B (NB-UVB), broadband ultraviolet B (BB-UVB), UVA1, and psoralen combined with UVA (PUVA). The interaction between UV and the skin determines the effectiveness of phototherapy. The biological effects of UV are used in the management of inflammatory skin diseases, malignancies, and various rare dermatoses. Apart from these benefits, UV increases the risk of photoaging and skin cancer. Therefore, further researches are necessary to enhance the effectiveness and safety of phototherapy. This literature review discusses the role of phototherapy in various dermatoses other than psoriasis and vitiligo.
Untranslated region-5' and viral protein 1-based genetic stability analysis of bulk polio in Indonesia 2010-2019 Andi Yasmon; Normasari Normasari; Fithriyah Fithriyah; Fadilah Fadilah
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/JMedSci005304202106

Abstract

Cases of vaccine-associated paralytic poliomyelitis (VAPP) continued increasingly from 2010-2019 in the world. Oral polio vaccine (OPV) is the live attenuated virus-based vaccine that could genetically revert to neurovirulent during the vaccine production process or when the virus replicates in the human body. The poliovirus neurovirulence is determined by the UTR-5' region and VP1 coding region. UTR-5' played a role in protein translation and VP1 was responsible for the immunogenicity of the virus. Some reported mutations in UTR-5' and VP1 could affect the neurovirulence of poliovirus. In this study, we analyzed the genetic stability of the UTR-5' and VP1 in the bulk of OPV types -1 and -3 produced in 2010 - 2019. The results of the analysis of UTR-5' sequences in Sabin strain types-1 and -3 and VP1 sequences on Sabin virus type 1 did not show any mutations. Meanwhile, the VP1 sequences in Sabin strain type 3 showed nucleotide mutation C2493U that caused the substitution amino acid Thr6Ile amino acid in all samples of the type 3 bulk polio test. Based on the results of in silico analysis, this mutation in VP1 did not contribute significantly to the neurovirulence of the virus.
Pulmonary arterial hypertension after atrial septal defect closure: a case report Lucia Kris Dinarti; Dyah Wulan Anggrahini; Muhammad Reyhan Hadwiono; Abdul Majid Halim Wiradhika; Vera Dewanto; Anggoro Budi Hartopo
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/JMedSci005304202111

Abstract

Most patients with congenital heart disease (CHD) who underwent successful shunts defect repair can be remained asymptomatic for years. It leads to a high number of losses to follow-up after patients discharge. After closure, pulmonary hypertension (PH) prevalence seems to be high and associated with increased morbidity and mortality. We reported a 55 y.o. female diagnosed with pulmonary arterial hypertension (PAH) and atrial fibrillation (AF) 31 years after atrial septal defect (ASD) closure by surgery, who never had routine follow-up evaluation because she remained asymptomatic for years. Physical examination revealed heart enlargement with irregular rhythm and pan systolic murmur in the fourth left sternal border. Electrocardiogram showed AF normal ventricular response, right axis deviation and suggestive for right ventricular hypertrophy. Laboratory testing found the NT pro-BNP level was 2,476 pg/mL. The chest X-ray showed enlargement of the heart and was representative of PH. From echocardiography study, transthoracic and transoesophageal echocardiography, we found no sign of residual shunt. There were right atrial and right ventricular dilatation, severe tricuspid regurgitation (TR) and a high probability of PH with TR velocity of 4.46 m/s. Right heart catheterization concluded mean pulmonary arterial pressure 46 mmHg, flow ratio 1.1, and pulmonary artery resistance index 15.5 Woods unit.m-2. We highlight this case because of the high incidence of PH long after defect closure. The high number of lost to follow-up patients can lead to morbidity and mortality.
Malignant bilateral ovarian steroid cell tumor without androgenic manifestation: an unusual finding Emilia Theresia; Bob Irsan; Ery Kus Dwianingsih; Moh Nailul Fahmi; Heru Pradjatmo; . Irianiwati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 1 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005401202208

Abstract

Steroid cell tumor is a rarest ovarian neoplasm, classified as a pure stromal tumor and mostly is unilateral. Even though this tumor can exhibit malignant behavior but the morphology of cells showed benign characteristics which can become a diagnosis pitfall especially in the frozen section. Moreover patient without any hormonal imbalance or virilizing signs could make the diagnosis process more difficult. Here we reported a case bilateral steroid cell tumor of the ovary in a 42 y.o. unmarried woman without any virilization or hirsutism symptoms. Abdominal ultrasonography and computed tomography (CT) scan revealed a right ovarian solid tumor accompanied by ascites and right pleural effusion. There was significantly increased of Ca 125 level (1138 U/mL) and normal level of testosterone (0.10 ng/mL). Frozen section was done from the right ovarium mass and ascites fluid, the result was benign. From the total abdominal hysterectomy and bilateral salpingo-oophorectomy tissues,  histological picture showed diffuse and nests tumor separated by thin fibrous connective tissue with small round centered nuclei, mild atypia, and abundant pale cytoplasm. Large area of necrosis was found especially in the right ovarian tumor, tumor implant to the right fallopian tube and in the uterine serous layer. Periodic acid-Schiff (PAS) stain was negative in more than half tumor cells population. Immunostaining for Melan-A and Calretinin were focally positive, with Ki-67 labeling index ± 5%, and negative for cytokeratin 7 (CK7), cytokeratin 20 (CK20) and smooth muscle actin (SMA). Based on the tumor size, necrosis area, tumor implantation, and immunohistochemistry profiles, we conclude that were malignant steroid cell tumor. Currently, the patient is undergoing postoperative recovery and planned for platinum-based chemotherapy. A careful correlation between clinical and radiological findings, as well as histopathological results, is always essential, as is amply demonstrated by this particular case.

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