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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
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The role of clinical reminder system to drug prescribing on patients of the National Health Insurance with ischemic stroke Faramita Hiola; Iwan Dwiprahasto; Rizaldy Pinzon
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202204

Abstract

Since 2014 Indonesia has entered the era of universal health coverage (UHC) and public health financing system managed by the Social Security Organizing Agency Law/SSOAL (Badan Penyelenggara Jaminan Sosial/BPJS) . In this system, a national formulary was used as the basis for prescribing drugs by clinicians. One effort for quality and cost control in UHC was to develop a clinical reminder system (CRS) to help prescriber set treatment options in accordance with the national formulary.  The aim of this study was to measure the role of CRS to the compatibility of drug prescribing in patients with ischemic stroke in Bethesda Hospital Yogyakarta, Indonesia. This study was carried out using quasi-experimental with pre-test and post-test design. The subjects of this study were outpatient ischemic stroke and the National Health Insurance (NHI) participant, age >18 years and had complete medication data. Prescribing data were compared between stroke patients treated at the hospital before and after implementation of CRS. The study was performed in 200 National Health Insurance (NHI) scheme outpatients with ischemic stroke. The groups consisted of 100 patients without CRS and 100 patients with CRS. The basic characteristics of both groups were similar. The results showed that after implementation of CRS, a significant improvement in the compliance of the neurologist prescribing medicine used to be available only in national formulary (RR: 1.02; 95% CI=1.00-1.04; p=0.015). Among others the most significant improvement was the prescription of antidyslipidemic using HMG-CoA medicine available in formulary. In conclusion, CRS can improve the compliance of prescribing with national formulary in stroke ischemic patients.
Association between the level of high-sensitivity troponin I (Hs-Trop I) and major adverse cardiovascular events in patients with acute myocardial infarction of segment elevation (STEMI) with primary percutaneous coronary intervention (PCI) Daniel Daniel; Firandi Saputra; Hendry Purnasidha Bagaswoto; Budi Yuli Setianto
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/JMedSci005401202203

Abstract

ST-segment elevation myocardial infarction (STEMI) is a condition which increases the risk of developing major adverse cardiovascular events (MACEs). For patients with STEMI, an efficient method of risk stratification is necessary in order to evaluate the clinical outcome. Troponin has been commonly used in the diagnosis of both STEMI and NSTEMI. The use of high sensitivity assays of troponin has been extensively studied in order to measure the size of myocardial damage caused by STEMI. This study aimed to investigate the association between the level of high sensitivity troponin I (Hs-Trop I) and the incidence of MACEs in patients with primary percutaneous coronary intervention (PCI) in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. It was a cross-sectional observational analytic study involving a total of 195 patients. Data were obtained from both the SCIENCE (Sardjito Cardiovascular Intensive Care) registry and the medical record of Dr. Sardjito General Hospital. Pearson’s Chi square test to evaluate the association between variables was applied. To determine the effect of confounding variables, a multivariate analysis was used. A significant difference in the baseline characteristics between the supramedian and inframedian Hs-Trop I groups (cutoff value of 2063.8 ng/mL) in age, onset, total ischemic time, wire crossing time and the smoking history of both groups was observed. Bivariate analysis showed a significant associations between Hs-Trop I and MACEs (p = 0.033), acute heart failure (p = 0.009) as well as mortality (p = 0.024). Meanwhile, no significant association between Hs-Trop I and cardiogenic shock (p = 0.977) and malignant arrythmia (p = 0.551) was reported. Furthermore, multivariate analysis showed Hs-Trop I, age and wire crossing time were significantly associated with the incidence of MACEs (p = 0.045). In conclusion, there is a significant association between the Hs-Trop I levels and the MACEs events in STEMI patients with primary PCI in Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Relationship between high-risk human papilloma virus (HPV) and subclinical condyloma acuminata (CA) in the cervix of high-risk women Benjamin Ricardo Rubirosa Lumban Tobing; Richard Hutapea; Kristina Nadeak
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202206

Abstract

Condyloma acuminata (CA) is a sexually transmitted infection (STI) caused by both high- and low risk human papilloma virus (HPV) infection. Subclinical CA looks like a white spot after an acetic acid test. High-risk women are women who have a high risk of STIs, including CA. The aim of this study was to evaluate the relationship between high-risk HPV and subclinical CA in the cervix of high-risk women. This was a cross-sectional analytic study involving 30 high-risk women. The age, the age at first sexual intercourse, the frequency of sexual intercourse, the number of sexual partners and the use of condoms were recorded. Subclinical CA was diagnosed by the 5% acetowhite test. HPV infection was detected by PCR. Kruskal Wallis test was conducted to evaluate the relationship between variables and the results were considered to be significant if p<0.05. The HPV infection was detected in 15 high-risk women with subclinical CA and most subjects showed the high-risk type. No significantly relationship between age and using of condom with high-risk HPV or with subclinical CA (p> 0.05). No significantly relationship between age at first sexual intercourse and frequency of sexual intercourse with high-risk HPV was also observed (p> 0.05), however, a significantly relationship with subclinical CA was observed (p < 0.05).  In conclusion, there is a relationship between high-risk HPV and subclinical CA in the cervix of high-risk women.
Potential secondary metabolite analysis of soil Streptomyces sp. GMR22 and antibacterial assay on Porphyromonas gingivalis ATCC 33277 Hera Nirwati; Ema Damayanti; Eti Nurwening Sholikhah; . Mustofa; Jaka Widada
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202202

Abstract

Infectious diseases caused by oral pathogenic bacteria are currently a serious problem due to the increasing incidence of antimicrobial resistance. Streptomyces sp. GMR22, a soil actinobacterium which has large-genome size. In previous studies, it was known to have antifungal, and antibiofilm activity on Candida albicans. However, its antibacterial activity on oral pathogenic bacterium, Porphyromonas gingivalis is not clear. This study aimed to identify potential active compound based on genome mining analysis and to evaluate the antibacterial activity of GMR22 extract on P. gingivalis ATCC 33277. Potential active compounds and biosynthesis gene clusters were analysis using antiSMASH version 5. Antibacterial activity assay was carried out by the microdilution method on P. gingivalis ATCC 33277. Based on genome mining analysis polyketide synthase (PKS), the Streptomyces sp. GMR22 is the abundant BGCs (35%) and has large-predicted compounds which have antibiotic-antibacterial activity (22.9%). On antibacterial assay, chloroform extract of GMR22 at 7.8 – 62.5 µg/mL has high antibacterial activity on P. gingivalis compared to other extracts. Soil Streptomyces sp. GMR22 bacterium has biotechnological potential to produce active compounds for antibacterial.
Analysis of systemic risk factors of occipital stroke-related vision loss Indra Tri Mahayana; Nyssa Alexandra Tedjonegoro; Tatang Talka Gani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202203

Abstract

Occipital stroke is associated with visual field defects and other visual perceptual deficits that might lead to detrimental effects on health-related quality of life. This study aimed to evaluate the possible association between systemic risk factors and the features of occipital stroke. It was a retrospective observational study involving patients diagnosed with occipital stroke in Dr. Yap Eye Hospital, Yogyakarta, Indonesia, between 2013 and 2014. A total of 72 patients with occipital stroke proven with CT/MRI who underwent detailed evaluation of ocular and systemic risk factors were included in this study. The patients were divided into two groups with or without risk factors. The risk factors were hypertension, diabetes mellitus, and cardiac diseases. The effect of risk factors on sex, age groups (≤40, >40 and ≤60, >60 y.o.), stroke lesions (left occipital, right occipital, bilateral), and visual field defects (homonymous hemianopia, homonymous quadrantanopia, and others) were analyzed. Out of 72 patients, there were 56 males (77.8 %), and 16 females (22.2 %), with a mean age of 58.46 ± 11.83 y.o. The study found there was a significant difference in age with risk factors compared with those without risk factors (p = 0.025), as well as visual acuity with age groups (p = 0.005) and stroke lesions (p = 0.024). Analysis of risk factors showed that hypertension was significantly correlated with stroke lesions, whereas cardiac disease was significantly associated with age groups (p<0.05). Predictive analysis was performed using a linear regression model, and it showed that risk factors could predict the occurrence of stroke lesions. In conclusion, patients’ systemic risk factors are significantly associated with the older onset of occipital stroke and lower visual acuity, although not significantly associated with stroke location and visual field defect characteristics.
Increased blood-brain barrier permeability correlate with microglial activation at hippocampal CA1 region in acute and chronic bilateral common carotid artery ligation in rats Dian Prasetyo Wibisono; Nur Arfian; Handoyo Pramusinto; Fauziyatul Munawaroh; Yeshua Putra Krisnugraha; Daniel Agriva Tamba; Dwi Cahyani Ratna Sari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202201

Abstract

Inflammatory processes might play a key role in the pathogenesis of post-stroke epilepsy. The activation of microglia and release of vascular cell adhesion molecule-1 (VCAM1) might induce blood-brain barrier (BBB) disintegration. However, the influence of such pathomechanisms in the generation of post-stroke epilepsy is still not clear. We investigated whether cerebral ischemia exerts effects on inflammation in the hippocampus by measuring the hippocampal injury score, expression of a microglial marker, and expression of VCAM1 in rats. A total of 24 Sprague Dawley rats were randomized into four groups with 6 rats in eachgroup i.e. sham operation (SO) as control, carotid ligation 1 (GCL1) as an acute model, carotid ligation 3 (GCL3) as a subacute model, and carotid ligation 7 (GCL7) as a chronic model. Immunostaining for microglia marker (CD68) was measured in rat brain tissue sections. The VCAM1 expression was evaluated by reverse transcription-polymerase chain reaction (RT-PCR). Cerebral ischemia increased the amount of microglial immunostaining and expression of VCAM1. The hippocampal injury score and microglial immunopositivity were significantly correlated with the duration of brain ischemia. We conclude that cerebral ischemia is correlated with neuroinflammatory reaction and disturbance of BBB permeability, and the correlation of those molecular impairments with the generation of post-stroke epilepsy remains to be elucidated.
Obesity and the role of genetic polymorphism: A review of genes as the risk of obesity Pramudji Hastuti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202209

Abstract

Obesity can be caused by environmental factors, which are higher energy input or lower energy expenditure. Environmental factors supported by genetic factors cause a person to have a different risk for developing obesity from to another. Genetics factors cause obesity through several pathways, which are impaired regulation in the hypothalamus and the regulation of energy expenditure. Obesity may be caused by one gene as monogenic-associated obesity, however, commonly caused by several genes together with environmental factors as the main multi-factorial risk of obesity. Obesity causes inflammation which leads to metabolic diseases. Many efforts are performed to prevent or treat obesity through the intervention to environmental and or genetic factors. Many attempts to reduce the prevalence of obesity were performed by influencing the environmental risk factors or the genetic risk factors. In this review, we identified the main genes which influence obesity. The genetic risks of obesity may be different from one to another country or between ethnic groups. Therefore, a better treatment approach should consider the differences role of genes in obesity rather than only changes in lifestyle. Nutrigenetic approach by considering the difference role of gens in responding to nutrients or drugs is recommended in individualized treatment plans.
Hearing loss in pediatric patients with congenital rubella syndrome Muyassaroh Muyassaroh; Nisa Alifia Rahmi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 2 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005402202205

Abstract

Congenital rubella syndrome (CRS) is caused by rubella infection in pregnant women. It was estimated 100.000 children with CRS, with 46% found in developing countries. The CRS consists of symptoms like sensorineural hearing loss (SNHL), congenital heart disease, cataract or congenital glaucoma, and other symptoms. Sensorineural hearing loss is the commonest symptoms compared with others. This study aimed to determine the hearing loss in CRS in Dr. Kariadi Central Hospital, Semarang, Central Java. This was a descriptive study using data from medical records from CRS pediatric patients who had BERA examination from January 2019 until December 2020. The CRS was characterized with one or more symptoms: SNHL, congenital cataract, congenital heart disease, and laboratory IgG and/or IgM Rubella (+). The SNHL was described from refer OAE result, tympanometry A, and BERA with hearing threshold ≥40 dB. Follow-up evaluation was performed with Google form questionnaire. There were 55 CRS cases with 70.9% had bilateral SNHL, mostly with very severe hearing loss. Normal hearing was found in 16 children (28.1%). From 30 children who were followed up, there were 20 children who had bilateral SNHL with 30% were moderate-severe degree and 70% profound. With further multidisciplinary management in children with CRS and parental support, 65% children used hearing aid and 40% had auditory-verbal therapy (AVT). Evaluation of the AVT showed progress in 30% children. In conclusion, SNHL is found in 70.9% children with CRS. Further management using hearing aid and AVT shows progress on few children.
Effect of hormonal contraceptives on the ocular surface and the tear film Muhammad Syauqie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 4 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005404202205

Abstract

Dry eye syndrome (DES) is a common multifactorial disease of the tears andocular surface associated with sex hormones. Hormonal contraception is arisk factor for DES, but its relationship with DES exacerbations in womenof childbearing age is still unclear. This study aimed to evaluate changesof the tear film and ocular surface of young women using the hormonalcontraceptive agent. It was a case-control study involving 56 healthywomen aged 20 to 45 y.o. Subjects was divided into two groups i.e. thehormonal contraceptives group and the control group without hormonalcontraceptive. Subjects were interviewed with the ocular surface diseaseindex (OSDI) questionnaire. Tear secretion and tear stability were measuredusing Schirmer’s I test and fluorescein tear break-up time test (TBUT).Ocular surface impression cytology with cellulose acetate filter paper wastaken from inferonasal bulbar conjunctiva and was stained with periodicacid- Schiff (PAS) and counterstained with hematoxylin and eosin (HE). Nosignificantly decrease in tear secretion and tear stability in the hormonalcontraceptives group compared with the control groups was observed (p >0.05). However, a statistically significant decrease in goblet cell density andconjunctival epithelium metaplasia was observed, where 25% of the hormonalcontraceptives group had an abnormal impression cytology result comparedwith the control group (p<0.05). The hormonal contraceptives group also hada higher OSDI score than the control group, although it was not statisticallysignificant (p> 0.05). The hormonal contraceptives group had a signifificanteffect on the ocular surface in which it induced squamous metaplasia andinflflammation of conjunctival cells and the reduced number of goblet cellsp<0.05). The slightly decreased tear film volume and stability accompaniedby an increase in OSDI score found in the hormonal contraceptives groupsupport the possibility of hormonal contraceptive use as one of the riskfactors in the occurrence of dry eye syndrome.
Characteristics of patients with Hepatitis B and C at Dr. Moewardi General Hospital in Surakarta, Indonesia Benedictus Aditya Satya Laksana Adji; Triyanta Yuli Pramana; Tri Nugraha Susilawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 54, No 3 (2022)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005403202207

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain a significant health burden in the world, which is mainly attributed to patients who develop chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). The epidemiology of hepatitis B and C in Surakarta, Central Java Province, Indonesia has never been reported. This study aimed to investigate the demographic, clinical, and laboratory characteristics of patients with hepatitis B and C who were admitted to Dr. Moewardi General Hospital, Surakarta in 2019. The medical records of patients with hepatitis B (n=94) and hepatitis C (n=75) were examined, and the data were analyzed using the chi-square and Mann-Whitney tests. The patients with hepatitis C were generally older, more likely to develop jaundice and ascites, and had higher levels of serum urea, creatinine, AST, and total bilirubin compared to those with hepatitis B. In conclusion, patients with HCV infection had worse clinical presentation and laboratory profiles than those with HBV infection. However, further research is needed on a wider scale to confirm this result.

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