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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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Comparison of neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV) and platelet lymphocyte ratio (PLR) in preeclampsia and normotensive pregnancies Dinar Yudistira Firdaus; Assangga Guyansyah; Umiyanti Thenu; Selvia D. Denggo
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/JMedSci005404202204

Abstract

The study aimed to compare the NLR (neutrophil lymphocyte ratio), MPV (meanplatelet volume), and PLR (platelet lymphocyte ratio) values in preeclampsiaand normotensive pregnancies. This was a retrospective case-control studyusing medical records of pregnancies between January 1, – December 31, 2019.A total 31 pregnancies with preeclampsia who met the inclusion and exclusioncriteria were involved in the study. As control, 31 normotensive pregnanciesrecruited by simple random sampling were used. The data were presented asmean ± standard deviation (SD) and analyzed by using SPSS program. Receiveroperating characteristic (ROC) curve were used to determine the optimal cutoff point for predicting preeclampsia. The NLR and MPV values of patients withpreeclampsia were significantly higher compare to normotensive pregnancy(p<0.001). Whereas, the PLR value of both groups was not significantlydifferent (p>0.245). The result of AUC analysis showed that the NLR and MPVhave AUC values of 0.758 (95%CI:0.637-0.878; p=0.000) and 0.903 (95%CI:0.816-0.989; p=0.000), respectively. Further analysis showed that the optimal cut-offpoint for NLR was 4.0 (sensitivity of 64.5% and a specificity of 71.0%) and forMPV was 7.55 (sensitivity of 87.1% and specificity of 80.0%). In conclusion, theNLR and MPV values are significantly higher in preeclampsia. However, theMPV value has a better predictive value than NLR for preeclampsia.
Exercise-based cardiac rehabilitation adaptation protocol during Covid-19 pandemic achieved similar results as compared to non-pandemic usual practice: a single center experience Anggoro Budi Hartopo; Irsad Andi Arso; Ade Meidian Ambari; Bambang Dwiputra; Basuni Radi
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/JMedSci005404202207

Abstract

During the Covid-19 pandemic, exercise-based cardiac rehabilitation (EBCR) faced challenges. Adaptation protocols were implemented to circumvent these challenges. The study aimed to investigate whether the adaptation protocols of EBCR during Covid-19 period influenced the result of cardiac rehabilitation. This was a retrospective cohort study. The subjects were patients who underwent an EBCR program in Dr. Sardjito General Hospital. Yogyakarta, Indonesia. The registry of cardiac rehabilitation was obtained and divided into two periods: non-Covid-19 period and Covid-19 period. During the non-Covid-19 period, 3 EBCR sessions per wk (10-12 total sessions) were performed. During the Covid-19 period, EBCR was reduced to 2 sessions per wk (10-12 total sessions). The functional capacities were evaluated as metabolic equivalents (METs) and exercise test time (min) by treadmill test. A total of 122 subjects completed the EBCR. There were no significant differences in METs and exercise minute achieved between two time periods. Among subjects with different sessions per wk, namely 2, 3, and 4-5 sessions per wk, there were no significant differences in METs (7.01±1.89; 7.23±1.74; and 7.33±2.13, p=0.813) and minutesachieved (6.72±1.94; 6.96±1.96; and 6.81±1.84, p=0.848) in the end sessions. In conclusion, the adaptation of EBCR protocols during the Covid-19 period by reducing the number of sessions per wk has similar results as compared to the usual regular EBCR practice.
A comparison study of GeneXpert and In-House N1N2 CDC Real-Time RT-PCR for detection of SARS-CoV-2 infection Andi Yasmon; Lola Febriana Dewi; Fithriyah Fithriyah; Ariyani Kiranasari; Andriansjah Rukmana; Yulia Rosa Saharman; Fera Ibrahim; Pratiwi Sudarmono
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/JMedSci005403202203

Abstract

COVID-19 is a disease caused by SARS-CoV-2, a new virus from genus β-coronaviruses. This disease has been declared a pandemic by WHO on 11 March 2020 until now. The nucleic acid tests are the most frequently used assays because of their high sensitivity and specificity. One of the tests is the GeneXpert, a real-time reverse transcription polymerase chain reaction (rRT-PCR)-based assay platform. The use of the GeneXpert shows great public health interest because of the rapid (50 min), the minimum number of trained staff, and less infrastructure and equipment. However, there are limited data on the application of the GeneXpert for the detection of SARS-CoV-2. Therefore, we conducted a comparative study between the GeneXpert and in-house N1N2 CDC rRT-PCR assay. Of 86 samples, 17 were rRT-PCR positive while 13 were GeneXpert positive. Of rRT-PCR positive 17 samples, 7 were GeneXpert negative [58.82% (10/17] sensitivity]. We also found that 3 GeneXpert positive samples showed rRT-PCR negative (95.65% [66/69] specificity). It is concluded that negative results by the GeneXpert can not rule out the possibility of SARS-CoV-2 infection, particularly in close-contact individuals and the interpretation of the positive result should be analyzed carefully, particularly amplification with Ct>40.
Therapeutic options for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases producing Escherichia coli and Klebsiella sp. isolated from various clinical samples Vimal Kumar; Narinder Kaur; Shubham Chauhan; Rosy Bala; Jyoti Chauhan; Harit Kumar; Shivani Devi
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/JMedSci005403202205

Abstract

Escherichia coli and Klebsiella sp. are the predominant species isolated from clinical samples. Recent and proper understanding of the antibiotic susceptibility pattern of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases (AmpC) producing E. coli and Klebsiella sp. will prevent the distribution and future incidence of ESBL and AmpC. We designed this study to understand antibiotic susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. isolated from a tertiary care hospital in North India. A cross-sectional study was conducted from March 2021 to February 2022. Guring this period, various clinical samples were collected and further tested for ESBL producing E. coli and Klebsiella sp. by using the Double disc Synergy test, whereas AmpC was detected by the Boronic acid disk potentiation method. Their antibiotic susceptibility patterns were noted. Various clinical specimens were collected, in which 37.95% were shown growth of bacteria. Among them, 46.67% of E. coli and 25.21% of Klebsiella sp. were identified by standard laboratory protocol. ESBL producing isolates were 44.37% and 34.20% in E. coli and Klebsiella sp., respectively. Whereas AmpC production was detected in 18.27% of E. coli and 29.36% of Klebsiella sp. ESBL and AmpC producing E. coli and Klebsiella sp. isolated from pus, blood, and sputum samples showed the highest sensitivity towards colistin, tigecycline, and imipenem while in urine samples imipenem, meropenem showed the highest sensitivity. Susceptibility patterns of ESBL and AmpC producing E. coli and Klebsiella sp. from various clinical specimens enhance hospital infection management and help clinicians to prescribe the appropriate antibiotics. The carbapenem, nitrofurantoin, colistin and tigecycline were showed highest susceptible against ESBL and AmpC producing E. coli and Klebsiella sp.
Antibiotic effectiveness on biofilm-producing Escherichia coli isolated from catheterized patients Wani D Gunardi; Ade Dharmawan; Nicolas Layanto
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/JMedSci005403202202

Abstract

Biofilm is one of the factors that facilitate the occurrence of catheter-associated urinary tract infection (CAUTI). Escherichia coli is reported as one of the most dominant bacteria that have virulence factors including biofilm formation. Uropathogenic E. coli (UPEC) shows increasing resistance to several antibiotics. Examination of the antibiotic sensitivity on the biofilm-producing E. coli and its activity on biofilm formation are important for selecting high effectiveness antibiotics which is beneficial for the management of CAUTI patients. A total of 35 E. coli isolates were recultured in the medium of LB agar and blood agar. The isolates were evaluated the sensitivity based on their MIC value to several antibiotics. In addition, the antibiofilm activity of the antibiotics based on their MBIC value was also evaluated. The data obtained were analyzed both descriptively and analytically. Almost the E. coli isolates have good sensitivity to meropenem antibiotics, amoxicillin-clavulanic acid, and Fosfomycin. However, among the evaluated antibiotics, only fosfomycin that showed antibiofilm activity. The different in terms of the resistance phenotype between the urinary isolates and the catheter isolates was observed. However, there were no significantly differences in the MIC value (pMIC=0.522) and the MBIC value (pMBIC = 0.523). In conclusion, the alternatives of antibiotic therapy for the planktonic bacteria are amoxicillin-clavulanic acid and fosfomycin, while for the biofilm bacteria is fosfomycin. A biofilm screening examination on the catheter to improve the effectiveness of therapy management for CAUTI patients is recommended.
Pathological fracture in fibrous dysplasia: a case report Bambang Supriyadi
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/JMedSci005403202210

Abstract

Fibrous dysplasia (FD) is described as a growth disorder characterized by the progressive replacement of normal bone elements by fibrous-osseus tissue. Bones affected by FD is presented with bone weakening and prone to pathological fracture. We reported a case of FD in an 8-years-old boy, who came to the hospital with pain in the upper right thigh after falling with bumps in his head and foot. An X-ray revealed a deformity as a diasteal scalloping with radiolucency lesions on one-third proximal of the right upper femur, greater trochanter, and lesser trochanter, with complete transverse discontinuity in the distal deformity. No similar lesion was found in the other bones. Bone structure and trabeculation in the deformity area has decreased and the cortex was thinning. On magnetic resonance imaging (MRI), bone size was enlarged, hypointense on T1WI and inhomogeneous hyperintense on T2WI. Fibrous dysplasia with a pathological fracture is a rare case. The appearance on the X-ray was diasteal scalloping with a ground-glass radiolucency represented with Shepherd's crook deformity. This lesion was accompanied by a pathological fracture (fragility fracture) on distal lesion. Fibrous dysplasia which characterized by bone developmental anomaly gave an inhomogeneous hypointense on T1W1 and hyperintense on T2WI.
Practical tips to adopt active lifestyle for university students during pandemic life: a narrative review Zaenal Muttaqien Sofro; Widya Wasityastuti; Rakhmat Ari Wibowo; Rahmaningsih Mara Sabirin; Siswanto Siswanto; Jajar Setiawan; Denny Agustiningsih
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/JMedSci005404202210

Abstract

The Covid-19 pandemic worsened the physical inactivity pandemic and also increased sedentary behavior across the population, including university students. While physical inactivity and sedentary behavior are detrimental to health and academic performance, there is an urgent need to help university students to adopt an active lifestyle during post-pandemic life. This narrative review discussed current physical activity (PA) and sedentary behavior recommendations, practical tips for adopting an active lifestyle by applying PA doses using the frequency, intensity, time, and type (FITT) principle, and behavioral strategies to adopt and maintain an active lifestyle. Finally, several considerations related to the PA-related musculoskeletal injury and cardiovascular events risks were also discussed with examples from interventions during the pandemic in university settings.
Family-centered rehabilitation in high risk infant; A case report Lulus Hardiyanti; Rizky Kusuma Wardhani; Aditya Rifqi Fauzi; . Gunadi
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/JMedSci005404202209

Abstract

Preterm infants are categorized as a high-risk group in neonatology. Theyare physiologically less mature and have limited compensatory responsesto the extrauterine environment compared with term infants. Preterminfants need long-term evaluation, monitoring, and follow-up to optimizeneonatal care and development through an extensive rehabilitationperiod. However, the COVID-19 pandemic restricted patient care andfollow-up in the outpatient hospital setting. This case report discusses ahigh-risk infant treated with family-centered rehabilitation (FCR). Thepatient's rehabilitation issues included delays in gross motor, fine motor,and language development and preventing complications that may arisein a high-risk premature infant. Considering recent occurrences, ourapproach to rehabilitation programs for high-risk infants needs to bereevaluated and revised, focusing on home programs through familycentered treatment. These techniques may aid in delivering rehabilitationtreatments to children with developmental delays during COVID-19.
Maternal determinants of average weekly fetal weight gain in Yogyakarta, Indonesia Eugenius Phyowai Ganap; Pakartian Ayu Sugmana; Riantina Rizky Amalia; Laksmi Ika Hidayati; Aditya Doni Pradana Doni Pradana
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/JMedSci005404202208

Abstract

Average fetal weight gain (AWG) is one of the important parameters usuallyused as an indicator to identify the fetal risk of poor outcomes of intrauterinegrowth restriction (IUGR) or macrosomia. This study aimed to investigate theassociation between AWG and maternal factors such as body weight (BW), bodymass index (BMI), middle-upper arm circumference (MUAC), and economicstatus in Yogyakarta, Indonesia. This community-based cross-sectional studywas conducted in one district in the Yogyakarta Special Province, Indonesia.The study included 50 mother-infant pairs who delivered at term (37-42 weeksof pregnancy). The mother’s BW, height, BMI, and MUAC were recorded usinga case-report form. Questionnaires were also completed to establish therespondents’ economic status. Maternal factors associated with fetal birthweight were determined using univariate and multivariate analyses. Themothers registered in our study mostly had good nutritional status (74.0% hadan optimal MUAC > 23cm). The mean AWG and birth weights were 172.6 ±24.5g/wk and 3.08 ± 0.34kg, respectively. Univariable analysis models wereused to assess the associations between each variable and AWG (with a cut-offvalue of 153.8 g/wk). Our study found no associations between higher MUACand higher AWG (OR=1.03; 95% CI: 0.83-1.27; p=0.77) and energy intakes perday with AWG (OR=1.0; 95% CI: 1.00-1.001; p=0.21). Socioeconomic factors suchas the mother’s educational background also showed no association with AWG(OR=0.38; 95% CI: 0.92-1.57; p=0.18). In conclusion, this finding shows that thereis no association between variables such as MUAC, mother’s age, energy intake,and educational background with the average fetal weight gain achieved.
Vitamin D levels of obesity and non-obesity health workers: a cross-sectional study in Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta Siti Nur Rohmah; Dwita Dyah Adyarini; Prenali Dwisthi Sattwika; Anastasia Evi Handayaningsih; Hemi Sinorita; Vina Yanti Susanti
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/JMedSci005404202202

Abstract

Obesity is one of the causes of chronic diseases, such as diabetes, hypertension, stroke, cancer, dyslipidemia, and heart disease. It is considered a financial burden on national health insurance since it drains the largest health fund. The study aimed to determine the difference in vitamin D levels in obese and non-obese health workers and analyze the factors that influence it. This was a cross-sectional study of the obese and non-obese health workers at Dr. Sardjito General Hospital, Yogyakarta. A total of 50 subjects, including 25 obese and 25 non-obese subjects were involved. Serum vitamin D levels was determined by ELISA. There was no significant difference between the obese and non-obese groups on vitamin D status (p<0.365). Vitamin D deficiency was found in 10% of subjects, whereas insufficient vitamin D levels were found in 46 and 44% of subjects, respectively. Vitamin D deficiency was more common in the obese (12%) than non-obese (8%) group. Contrarily, vitamin D insufficiency was more common in the non-obese (56%) than obese (36%) group. The serum vitamin D levels in the obese [30.08 (14.67-101.71) ng/mL] was not significantly different compare to those non-obese [28.54 (14.38-54.41) ng/mL] (p = 0.691). The multivariate analysis significantly showed that outdoor activities <30 min had a 7.061 times greater risk of having vitamin D deficiency/insufficiency compared to outdoor activities >30 min (OR 7.061; 95% CI: 1.064-46.872; p=0.043). In conclusion, there is no significant difference in vitamin D levels between the obese and non-obese groups. Vitamin D deficiency/insufficiency is more common in non-obese subjects than in obese subjects. Outdoor activity <30 min is a risk factor for vitamin D insufficiency/deficiency despite living in a tropical country with abundant sunlight throughout the year. 

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