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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
 209   210   211   212   213 
A report of two cases of type 2 diabetes mellitus (T2DM): happy and longevity Hemi Sinorita; Sri Sutarni; Abdul Gofir
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/JMedSci005404202211

Abstract

Chronic hyperglycemia in patients with type 2 diabetes mellitus (T2DM) is associated with the development of complications and the increase of risk of mortality. Patients with T2DM have a shorter life expectancy than non-diabetic population. It is attributed to cardiovascular disease, stroke, renal disease, and infection. Depression secondary to T2DM worsens the quality of life. On the contrary, positive emotions correlated strongly with long life expectancy. A number of mechanisms might explain this correlation. We reported two geriatric patients over 80 y.o. with T2DM comorbidity for more than 20 years. Discussion point of these cases is the subject’s longer life span compared to the average diabetic patient’s life expectancy and great quality of life despite the disease burden of chronic hyperglycemia in T2DM and cardiovascular risk.
Prediction score for post-stroke cognitive impairment (PSCI) after acute ischemic stroke Johan Budiman; Jarir At Thobari; Rizaldy Taslim Pinzon
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/JMedSci005403202204

Abstract

It was estimated that patients with ischemic stroke and post-stroke cognitive impairment (PSCI) have been increasing. In addition, this PSCI is often late diagnosed when it has already developed into post-stroke dementia. Only a few studies have developed a scoring system of predictor factors cognitive impairment (CI) for post-acute ischemic stroke in Indonesia. This study aimed to develop a scoring system of predictor factors of CI for post-stroke ischemic patients. The patients included were >18 years old diagnosed with acute ischemic stroke who underwent mini-mental state examination (MMSE) and clock drawing test (CDT) examination on day-30 at Bethesda Hospital Yogyakarta. It was retrospective cohort study design and samples were obtained from the stroke registry and medical records. Patients who had a history of CI and incomplete medical records were excluded. The results of MSSE and CDT at day-30 were the outcomes of this study. To evaluate the relationship between the independent variable and the dependent variable, chi-squared tests were perforemd followed by multivariate logistic regression analysis with Hosmer-Lemeshow tests with backward likelihood-ratio (LR) method and by assessing the final area under the curve (AUC) model. The final model was transformed into a scoring system to determine the value of probability prediction of PSCI, the optimal cut-off point, the sensitivity value and specificity value of the cognitive impairment scoring system at day-30 after acute ischemic stroke. A total of 140 subjects were included in the study with an average age of 62.8 years, 86 (61.4%) males and 54 (38.6%) females. Ninety-one subjects (65%) experienced post-stroke CI. The multivariate analysis showed age >70 years, education level ≤6 years, modified ranking score (mRS) >3 at diagnosis, Barthel index score ≤4 at diagnosis, the number of multiple lesions and the location of lesion in the cortex were independent predictor factors affecting CI 30 days after acute ischemic stroke. The developed predictor score obtained AUC discrimination value of 82.6% (95%CI:0.757-0.896) and calibration value of p>0.366. The scoring system had a value range of 0-7, and with a cut-off ≥1, it had a sensitivity value of 86.8% and a specificity value of 59.2%. It can be concluded that the predictor score has a good performance in predicting the occurrence of PSCI at day-30 after acute ischemic stroke.
Potential skin problems of diabetes mellitus patients: a review Iryani Andamari; H. Bing Thio; Hardyanto Soebono
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/JMedSci005403202211

Abstract

Diabetes mellitus (DM) is one of the common metabolic disorders, and a major part of chronic diseases, the prevalence of which tends to increase due to multifactor. Blood vessels, kidneys, lungs, and skin are among the organs that are affected. The first problem that arises, or commonly exists among one-third of diabetics, are problems with their skin, although skin lesions may develop along with the progress of the disease, or can occur during the later phase of DM. The prevalence and symptoms of skin problems in type 1 DM (T1DM) and type 2 DM (T2DM) are often unclear, and at the beginning of the course of the diseases they often go undiagnosed. Several theories regarding the pathophysiology of DM can be used as a logical reference for the early identification and diagnosis of skin problems, aimed at preventing the worsened condition. The use of skin autofluorescence (SAF) and AGEs reader in several cases of skin problems, can also be an important marker as an adjunct to predict the possibility and progressiveness of DM. Skin problems linked to patients with DM can be categorized as strongly related to diabetes, non-specific and related to DM, skin infection in DM, and skin problems due to diabetic medication. With the current COVID-19 pandemic, there are additional demands for more critical investigation of skin problems in patients with DM. The skin problems that occur in DM may need to be examined from the early stage and it is necessary to inhibit the progression of skin problems, as well as to consider the need for multidisciplinary DM therapy.
Correlation of neutrophil ratio to lymphocyte levels before therapy with the incidence of metastasis, lymph node involvements, in urothelial type muscle invasive bladder cancer in Indonesia Rudi Rafian; Ahmad Zulfan Hendri; Indrawarman Soerohardjo; Raden Danarto
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/JMedSci005403202208

Abstract

Bladder cancer is cancer originated from the bladder mucosa or urothelium. Bladder cancer is the 9th most common malignancy worldwide and the most common malignancy of the urinary tract. Studies show that cancer triggers an inflammatory response, which causes changes in circulating inflammatory cells. Examination of neutrophils and lymphocytes is an inexpensive examination, reproducible, and easily obtained. Neutrophil to lymphocyte ratio (NLR) values have been used in several studies to evaluate the inflammatory response that occurs in tumors. In urology, the importance of NLR has been recognized in predicting progression and aggressiveness in urothelial bladder tumors, kidney cancer (RCC/renal cell carcinoma), and upper tract urothelial carcinoma (UTUC). This study was a cross-sectional study obtained retrospectively by evaluating the medical records of patients diagnosed with muscle-invasive bladder cancer (MIBC) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2017 to December 2019. The NLR data were categorized into NLR < 2.5 and > 2.5. As much as 150 patients with bladder cancer were included in this study, with a mean age of 56.43 ± 13.60 years. In the comparison of NLR values and the incidence of metastasis, there were 15 people (20%) with NLR values < 2.5 who had metastasis while 32 people (42.7%) from the group with NLR > 2.5 had metastasis (p = 0.003). In the comparison of NLR values and nodule involvement, there were 25 (33.3%) patients with NLR < 2.5 and 39 (52%) patients with NLR > 2.5 (p = 0.021). This study showed that patients with metastatic bladder tumors and lymph node involvement had a significantly higher NLR value. It can be concluded the NLR value can be used to predict the metastatic level and lymph node involvement in patients with bladder tumors. Even though it is not a specific marker of inflammation, the NLR examination is simple, affordable, easy to obtain, and widely available.
Cytologic diagnostic approach of pleuropulmonary blastoma: a case report Auliya Suluk Brilliant Sumpono; Alva Sinung Anindita; Junaedy Yunus; Didik Setyo Heriyanto
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/JMedSci005403202209

Abstract

Pleuropulmonary blastoma (PPB) is a very rare pediatric lung tumor that arises in the pulmonary parenchyma, mediastinum, and pleura. The tumor has rapid disease progression and therefore the prognosis is remarkably poor. We reported a 4-year-old girl who complained of high fever and shortness of breath for the past 8 weeks. The patient was referred from the previous hospital with a pulmonary mass. CT scan of the chest with contrast showed a solid cystic mass with necrotic areas in the 1st, 2nd, and 3rd segments of the left lung with sized 4.8 x 8.1 x 6.6 cm3. As the tumor mass was inoperable, an ultrasound-guided fine-needle aspiration biopsy (FNAB) was conducted to diagnose the pulmonary lesion. We concluded that the lung tumor was a PPB based on FNAB cytology and immunocytochemistry staining. The histopathology feature of PPB appeared similar to fetal lung tissue. Cytologic features obtained from fine-needle aspiration cytology smears and cell blocks followed by immunocytochemistry assay could provide a proper and accurate diagnosis in an inoperable surgical pathology case.
Effect of Robusta coffee extract gel on fibroblast and collagen during proliferative phase of IIB degree-burn on Long Evans rats Ulfa Elfiah; Muhammad Fahmi Naufal; Mochammad Amrun Hidayat
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/JMedSci005403202201

Abstract

IIB Degree-burn takes longer to heal because only a small epithelium component remains. It requires a topical agent that can accelerate the wound healing process. One of the wound healing signs is the increased collagen formation as an extracellular matrix produced by fibroblast in the proliferative phase. This study aimed to prove the effect of Robusta coffee extract gel as a topical agent on increasing the number of fibroblasts and collagen density in IIB degree-burn treatment on Long Evans rats. This study used 24 Long Evans rats which were divided into three groups, namely positive control (silver sulfadiazine), negative control (gel base), and treatment group (2.5% of Robusta coffee extract gel). The results showed a higher number of fibroblast (p<0.05) and a denser collagen density (p<0.05) of the Robusta coffee extract gel compared to the control group on day 8 and day 14. These results indicated that the number of fibroblasts and collagen increases that can scavenge free radicals and stimulate the release of cytokines that play a role in increasing fibroblast proliferation. Robusta coffee affects expanding the number of fibroblasts and collagen density to be an alternative topical agent of second-degree burns treatment.
Decreasing of hand colonization and sterility of refill antiseptic in Dr. Yap Eye Hospital, Yogyakarta Briliana Nur Rohima; Syarah Rysty; Ulupi Rina Hapsari; Palupi Dwi Astuti
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/JMedSci005404202201

Abstract

Dr. Yap Eye Hospital, Yogyakarta uses aseptic gel containing 70% ethyl alcohol to refill antiseptic containers during times of antiseptic scarcity. The study aimed to evaluate the effectiveness and sterility of the refill antiseptics in reducing the number of colonization on the hands of nurses. It was a quasi-experimental using pre- and post-control groups design involving 56 nurses who used antiseptics in a bottle sterilized by plasma device (plasma bottle) compare to those washed using detergent (detergent bottle) before being refilled. Sterility tests were performed every two wk for up to two mo. Colonization pre and post hand hygiene practices were determined as an efficacy test and compared using the Mann-Whitney test in STATA 14. Antiseptic in plasma bottles remains sterile until the week8th since refilled, longer than detergent bottles (6th weeks). The pre-handrub colorizations were 0.04-16.92 CFU/cm2 and decreased significantly post-handrub to 0.00-3.08 CFU/cm2 (p<0.0001). Significant decrease pre- vs post-handrub colonization was observed in usage of detergent bottle (0.04-31.04 vs 0.00-10.48 CFU/cm2, p=0.0007). There was no significant difference in ∆ colonization for two bottles (0.40-15.76 vs 0.04-30.92 CFU/cm2, p=0.8790). In conclusion, antiseptic in the plasma bottle remains sterile longer than in the detergent bottle since refilled. Both of them are equally effective in reducing colonization after handrub activity.
The influence of tympanic membrane perforation site on the hearing level of conductive hearing loss in chronic suppurative otitis media Adhika Banu Wicaksono; Edhie Samodra; Melysa Fitriana; Feri Trihandoko; Anisa Haqul Khoiria; Dyah Ayu Kartika Dewanti
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/JMedSci005403202206

Abstract

Chronic suppurative otitis media (CSOM) is an infection of the middle ear cavity both partially and totally. It is characterized by ear discharge through a tympanic membrane perforation for over a period of 2 to 6 weeks. Hearing loss is the most common complication of CSOM. One of the degrees of hearing loss in tympanic membrane perforation is depending on the site of perforation, but this premise is still debatable because of pros and contras by some researchers. This study aimed to assess the degree of hearing loss in relation to the site of tympanic membrane perforation. A cross-sectional prospective study design was performed involving 43 patients of safe type CSOM who came to the Department of Otolaryngology Head and Neck Surgery from the period January 2016 to November 2018. All subjects were divided into 4 groups based on the site of perforation. There was a perforation in the posteroinferior, the posterosuperior, the anteroinferior, and the anterosuperior. A statistical analysis using Anova along with multivariate analysis was conducted. Our result showed that the most common site of tympanic membrane perforation was at the anteroinferior (30 samples, 59.8%). The highest hearing threshold was seen at posteroinferior with a mean hearing level of 37.7±2.0 dB, anteroinferior with a mean hearing level of 31.7±0.7 dB, anterosuperior with a mean hearing level 30.7±1.4 dB, and posterosuperior mean hearing level 28.9±1.5 dB. The difference was found significant with p=0.004. Posteroinferior tympanic membrane perforation had a higher number of hearing loss compared to the other sites. In conclusion, the tympanic membrane perforation site has an important role in the hearing level of conductive hearing loss in CSOM.
Evaluation of clinical pathway implementation and clinical practice guidelines in the management of deep neck abscess (DNA) at Dr. Sardjito, General Hospital Yogyakarta, Indonesia Dian Paramita Wulandari; Hesti Dyah Palupi; Feri Trihandoko
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/JMedSci005404202206

Abstract

Deep neck abscess (DNA) is an infectious condition categorized as anemergency case with high mortality and morbidity. The incidence decreasesover time due to extensive use of antibiotics, operative intervention, andimproved awareness of dental hygiene. Management of DNA must be carriedout appropriately and efficiently to prevent complications that may occur,such as jugular vein thrombosis, pericarditis, and pneumonia. Patients withDNA are often categorized as high-cost patients, because of the long durationof hospitalization, the need for special examinations, and complicatedmanagement. Clinical practice guidelines (CPG) and clinical pathways (CP)are a standard created for management, quality, and cost control. The studyaimed to evaluate the implementation of the CPG and CP in DNA patients atDr. Sardjito General Hospital, Yogyakarta. The study used medical recordsdata of DNA patients from January 2018 to December 2020 who met theinclusion and exclusion criteria. A total of 55 subjects were obtained, withcompliance to complete CPG filling of 98.3% and CP filling of 96.2%. There was100% completion in CPG filling categorized as good compliance, whilst thenumber of good compliances for CP was 92.7%. In conclusion, the diagnosisand management of DNA patients at Dr. Sardjito General Hospital has goodcompliance with CPG and CP available.
Effect of Citrullus lanatus seed oil on xerosis in leprosy patients Puteri Wulandari; Syahril Rahmat Lubis; Deryne Anggia Paramita
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/JMedSci005404202203

Abstract

Xerosis in leprosy patients may result from defects in sweat gland function.Red watermelon (Citrullus lanatus) seed oil a lot of contains linoleic acid,which can hydrate the skin and reduce trans-epidermal water loss (TEWL).This study aimed to evaluate the effect of C. lanatus seed oil administrationin leprosy patients with xerosis. It was a clinical study with one group pretestposttest control group design involving 30 leprosy patients with xerosis at theDepartment of Dermatology and Venereology, Dr. Pirngadi Medan Hospital, thePolyclinic of Dermatology and Venerology, Universitas Sumatera Utara Hospitaland the Department of Dermatology and Venerology, H. Adam Malik GeneralHospital, Medan, Indonesia. Patients were asked to topically administration of2 mL C. lanatus seed oil to the right and left legs for two times daily for 4 weeks.Specified symptom sum score (SRRC) and skin capacitance (SCap) were thenmeasured before the intervention at the first visit (week 0), week 2, and week 4.A significantly different on SRRC and SCap of the leprosy patients was observedon the 2nd and 4th week after C. lanatus oil administration compared to week 0(p<0.001). No side effects of erythema, blistering, and burning were observed.However, a mild degree itching was observed in 2 (6.7%) patients. Majority ofleprosy patients feel good satisfaction (83.4%), followed by a moderate (13.3%)and a low satisfaction (3.3%). In conclusion, topically administration of redwatermelon (C. lanatus) seed oil can reduce the xerosis degree in leprosypatients as indicated by the decrease of SRRC and the increase of SCap. Theseed oil is well tolerated and gives a good satisfaction on the patients.

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