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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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Giant fetus in fetu in a female child with fever: A case report Rochadi, Mei Neni Sitaresmi, Soeripto, Hanggoro Tri Rinonce Pieri Kumaladewi, Siti Iqbalwati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 01 (2009)
Publisher : Universitas Gadjah Mada

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Abstract

Fetus in fetu is a form of monozygotic diamniotic twin pregnancy where the parasitic twin installs and grows in the body of its partner. It is a rare condition, with a reported incidence of 1 in 500.000 live births. The majority of these cases occur in children younger than 18 months with the chief complaint of an intraabdominal mass, and have a 2:1 male predominance. The size and weight of the fetus vary, from 4 cm to 24.5 cm and from 1.2 g to 1.8 kg. Whether this entity represents a highly differentiated teratoma versus a parasitic twin remains controversial. The objective of this paper was to report a rare condition of giant fetus in fetu in female child with fever, especially to emphasize the importance of proper examination. Although fetus in fetu is very rare, it should remembered as a possibility in an intraabdominal. In some cases further detailed examinations should be done to confirm the diagnosis. A rare case of giant fetus in fetu in a 20th month female patient with fever was reported. Intrabdominal mass was found as the first sign related to fetus in fetu but was neglected by the parents. USG, plain abdominal photo and CT-scan had revealed the diagnosis preoperatively. Proper examination of the fetus in fetu was done including grossly by doing extensive dissection, and detailed histological tissue examination from several sites to make diagnosis completely. Key words: giant fetus in fetu - fetiform teratoma - congenital abnormality - retroperitoneal, fever
The Difference of High Sensitivity-C Reactive Protein in the Diabetic Patient with depression and Diabetic Patiens without Depression Hamzah Shatri, Deddy N.W.Achadiono, A. Siswanto, E. Mudjaddid
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 02 (2009)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Both depression and diabetes mellitus have been related to a higher risk of developing coronary heart disease. Inflammation may be important in the pathogenesis of atherothrombosis. There are many markers of inflammation, one of them is high sensitivity-C reactive protein. Objective: To determine the difference of high sensitivity-C reactive protein in the diabetic patients with depression and in the diabetic patients without depression. Methods: This study used cross-sectional design and examined 64 diabetic patients, aged 30-60 years old. The patients were divided into two groups, Le. with and without depression group.We measured depression using the DSM IV. The diagnosis of diabetes mellitus used PERKENI criteria 2006. We measured the serum concentration of CRP with a high sensitivity assay. Other measured factors included gender, marital status, occupation, blood glucose, HbA 1 c, body mass index, smoking and duration of diabetes. The association between hyperglycemia and hs-CRP were also studied. Results: There were 32 diabetic patients with depression and 32 diabetic patients without depression. Body mass index were corelated with depression in diabetic patients (p = 0.008) but the other factors such as gender, age, marital status, occupation, blood glucose, HbA 1 c, duration of diabetes were not corellated with depression in diabetic patients (p > 0.05). The mean of hs-CRP consentration was higher in diabetic patients with depression (5183.44:t3974.66 vs 2103,17:t1502.94 mg II, p=0.001) than in diabetic patients without depression. There was no association between blood glucose control (HbA 1 c) and hs-CRP concentration. Conclusion: High sensitivity-C reactive protein concentration was higher in diabetic patiens with depression compared with diabetic patients without depression.Key words: hs-CRP - with and without depression diabetes mellitus type II
The effect of operating room design and behavior of operating room staff on surgical site infection (881) incidence Iwan Dwiprahasto, Yulianto Widodo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Universitas Gadjah Mada

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Abstract

Introduction: In surgery, medical error is often related to surgical site infection (551).Santa Maria Hospital, Pemalang, is a private hospital which gives priority to quality and applies the patient safety principle. During 2006, there were 7 cases of 551 in 785 surgical cases in Santa Maria Hospital, Pemalang, but this number was considered as the tip of an iceberg. The high microorganism rate, operating room design which was not agreeable with the standard by Kepmenkes No 1204/MENKES/SK/X/2004, and the behavior of operating room staff were the risk factors of 55!. ObJective:To find out the effect of the change in operating room design and behavior of operating room staff on 551 incidence in Santa Maria, Pemalang, and to find out the risk factors of 55!. Method: It was a quasi-experimental study with pre- and post-test without control group design. Population were all operating room staff, while subject of this study was operating room design. Dependent variable was 551incidence, while independent variables were behavior of operating staff and operating room design. Data were analyzed with independent t-test, chi-square test, and multivariate logistic regression. Re.ult: The change in operating room design and operating room staff behavior has significantly decreased the incidence of 551 (OR = 3.646; 95%CI = 1.24 < OR< 10.77). Conclu.lon: Intervention on operating room design and staff behavior has decreased the incidence of 55!. Risk factors of 551were operating room design, operating room staff behavior, and duration of surgery.
The Efficacy of the Combination of 2% Lidocaine and 0,5% Bupivacaine as Preemptive Analgesia for post-operative pain in vitrectomy with or without scleral buckle under genral anasthesia Angela Nurini Agni, Marlyna Afifudin, Hartono,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 02 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Post-operative pain is one of the main problems in the surgical services so that analgesia is very much needed, even intravenously given. The concept of preemptive analgesia in surgical intervention is the provision of analgesia before the occurence of nociceptive stimulus. One of the agents for providing preemptive analgesia is local injection is local injection with local anasthetic, single or in combination. Objective: This study was aimed to evaluate the efficacy of combination of lidocain and bupivacain as preemptive analgesia in vitrectomy with or without sclera buckle under general anesthesia. Methods: Twenty eight patients who were scheduled for vitrectomy were included in this study. The patients were randomly classified into two equal groups. The surgery was conducted under general anesthesia for both groups, but in Group 1, subtenon anesthesia with local anesthetic was given as preemptive analgesia after induction anesthesia and before the start of surgery. Pain intensity was the primary outcome of this study. The pain intensity was measured in 3 hours and 24 hours after surgical procedure. Results: The baseline characteristics between the two groups were similar. The pain intensity was lower in the treatment group, but the difference was not statistically significant (1.00:t 1.71 vs 1.50:t 2.16, p = 0.109). The proportion of pain-free patients were similar between the two groups in 3 hours after procedure (65% vs 65%, p = 1.00). The proportion of pain-free patients were higher in the treatment group in 24 hours after procedure (100% vs 73%, p = 0.222, Fishers Exact Test}. The subtenon injection procedure was safe. There was insignificant difference in the incidence of side effects between the 2 groups. Conclusion: This study did not show any additional benefit of subtenon injection for vitrectomy. The pain intensity was similar between two groups. There were no increases on side effects after the procedure. Key words: vitrectomy - local anesthetic - post-operative pain - preemptive analgesia
Autoimmune urticaria in Rumah Sakit Umum Pusat Dr. Moh. Hoesin Palembang Thaha, M. Athuf
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 03 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: About 30% patients with chronic idiopathic urticaria (CIU)have circulating histamine-releasing autoantibodies against the a-subunit of high affinity IgEreceptor (FceRla),or IgE.This subgroup of patients has a disorder commonly referred as autoimmune urticaria. Objectives: This study was conducted to reveal the autoimmune urticariacases in Indonesian patients Methods: The autologous serum skin test (ASST)and histamine release assay (HRA)were conducted on 79 patients with CIU (53 females and 26 males). Patients with predominant physical urticaria and urticarial vasculitis were excluded from the study. Results: Seventeen patients had both positive autologous serum skin test and histamine release assay confirmative of autoimmune urticaria. Conclusion:CombinedpositiveASSTand HRAwere seen in 21.5% of CIUpatients, indicatingautoimmune urticaria. Key words: chronic idiopathic urticaria - anti-FceRla histamine-releasing autoantibodies -autoimmune urticaria - autologous serum skin test, histamine release assay.
The risk factor of urinarytract infection in patient with leukemia Pungky Ardani Kusuma, Melati Dini Hari, Soetaryo,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Urinary tract infection (UTI) is one of most common infectious diseases in patients wuth leukemia. Some researchers showed that the prevalence of UTI was the third highest after pneumonia and gastrointestinal tract infection among children with leukemia. UTI may be affected by many factors, i.e. host, microorganism, and environment. E. coli, Klebsiella, dan Proteus are the most common bacterial etiology of UTI in leukemia. Objective: The aim of this research was to know the risk factor of UTI in children with leukemia. Method: This research used case-control design. Subjects of this study were children (0-15 years old) with leukemia who came to Department of Pediatrics, Dr. Sardjito Hospital since January st, 2000 until October 3", 2008. There were 38 patients in case group and 109 patients in the control group. Data collected from medical records were age, gender, nutritional status, type of leukemia, treatment phase of leukemia, and absolute neutrophil count. Risk factors analyzed were age, gender, nutritional status, and neutropenia. UTI was diagnosed by bacterial culture and bacterial count. Result: Univariate analysis showed that female gender was the risk factor of UTI (OR 2.35; CI 1.10- 5.00), meanwhile age less than 5 years old (OR 0.48; CI 0.22-1.06L poor-fair nutritional status (OR 1.20; CI 0.52-2.78), and neutropenia (OR 0.73; CI 0.35-1.55) were not risk factors of UTI. Multivariate analysis showed that female gender was the risk factor of UTI (OR 2.36; CI 1.08-5.14). Conclusion: Female gender was a risk factor of UTI in children with leukemia Keywords: leukemia - children - gender - urinary tract infection - risk factors
The influence of stigma and depression on quality of life of leprosy patients Agnes S. Siswati, Jenny MC Siagian, Carla R Marchira
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 01 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Stigma attached to leprosy-affected individuals is one of the strongest stigma of diseases. Depression is often occurred to many lepers. Stigma and depression are two factors which affect the quality of life of the lepers. Objective: To determine whether stigma and depression affect the quality of life of leprosy patients in Dermatovenereology outpatient clinic at RSUP Dr Sardjito Hospital. Methods: It was a quantitative and cross-sectional research. The quantitative analysis was conducted with chi-square and multiple regression methods. Result: There was no significant correlation between stigma and quality of life of leprosy patients. The factors which significantly correlated with quality of life were gender, income, and depression score (p < 0.051. Depression score significantly affected the quality of life (B 1.876; P < 0.05; CI 1.166-36.5661. Conclusion: Depression affected the quality of life more than deformity and demographic factors among leprosy patients in Dermatovenereology outpatient clinic at RSUP Dr Sardjito Yogyakarta. Key words: stigma - depression - lepro
The Role of Hearing Aids use on Reading Ability in Deaf Students Djoko Rianto, Bambang Udji
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 02 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Introduction: Reading is a very complex process, which includes the cognitive process, initialized by visual analysis and letter transformation into vocabulary form, word identification by letter sound mapping, correlating words and interpretation. Deafness causes difficulties in acquiring language information via hearing process thus inhibiting a successful conversation process. Hearing aids can amplify sound information to the auditory organs. Objective: To know the effect of hearing aids on deaf students. Methods: A historical cohort design was done. The reading ability of 35 deaf students with hearing aids who received early education were compared to those without hearing aids. The variables measured included age, age of school enrollment, length of studies, degree of deafness, sex, parental educational level. Results: Regression analysis showed that hearing aids plays a role to significantly increase reading ability statistically (p: 0.006; OR: 10.197; 95% CI: 1.939-53.628) compared to students without hearing aids, besides the length of studies variable (p: 0.002; OR: 38.250: 95% CI: 3.739-391.361). Conclusion: This study concluded that the use of hearing aids significantly play a role to increase reading ability in deaf students who receive early education. Key words: hearing aids - deaf student - reading ability.
Optimal temperature for normal human skin fibroblast proliferation and glucose uptake, an in vitro study Sunardi Radiono, Yohanes Widodo, DeviArtami Susetiati, LailyNoorQomariah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 03 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Devi Artami Susetiati, Laily Noor Qomariah, Sunardi Radiono,Yohanes Widodo Wirohadidjojo -Optimal temperature for normal human skin fibroblast proliferation and glucose uptake; In vitro study Background: Wrinkles is caused by a decrease in collagen synthesis and an increase in collagen degradation. Collagen synthesis depends on fibroblast proliferation. Collagen synthesis needsglucose, so that collagen synthesis may be expressed by the increase in glucose uptake. Skin rejuvenation with heating may increase the collagen synthesis. The effect of short-term heating and optimal temperature on fibroblast proliferation and glucose uptake has not yet been defined. Objective: This study was aimed to determine the optimal temperature of short-term heating for normal human skin fibroblasts proliferation and glucose uptake. Methods: A simple experimental study was conducted on 3rd passage subculture of normal human skin fibroblasts culture, isolated from 2 patients. Normal human skin fibroblasts with complete DMEM were classified into 5 groups, and then heated for a minute with thermocycler-machine at 36°C, 46°C, 56°C, 66°C, and 72 °C. Those cells were incubated for 7 days in complete DMEM and subsequently fibroblasts proliferation was measured by MTT -assay. Glucose uptake was measured by glucometer Medisafe- Terumo. The differences in glucose uptake and fibroblasts proliferation were analyzed with one-way Anova. Result: Optimal temperature for fibroblasts proliferation was 46°C, and 66°C for collagen synthesis. Conclusion: Skin rejuvenation based on heating could be performed at two different temperatures, each cycle consisted of 66°C on first heating, and seven days later, at 46°C on second heating.
Electrocardiographic pattern changed in hospitalized leptospirosis and its association with disease severity Bambang Irawan, Anggoro Budi Hartopo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Electrocardiographic (ECG)changes have been observed in leptospirosis. The prevalence of ECG alterations may reach 80%. Despite of this finding,few studies have been conducted to assess ECGpatterns in only hospitalized leptospirosis patients in Indonesia. Objective: To reveal the prevalence and type of ECGalterations in hospitalizedleptospirosisand its association with disease severity. Methods: This was a cross-sectional study using medical record data. Patients hospitalized in Dr. Sardjito Hospital (January 2003 - December 2007) with leptospirosis (lCDXA27.9) were enrolled. Electrocardiogramstaken in 24 hours of admission were evaluated. Disease severity was determined based on clinical and laboratory findings. Association between disease severity with ECGrecordings were performed using Kruskal-Wallisand Chi square test. P value < 0.05 was significant. Results: Sixtysamples were analyzed.The prevalence of alterationof ECGrecordingswas 66.7%. Sinustachycardia was the most frequent (36.7 %). The most common arrhythmia was atrial fibrillation(10 %). Other abnormalities were alterationof ventricularrepolarization(8.3%1.extrasystoles (6.6%) and disorderof conduction (4.9%). Although not significant, those with atrial fibrillationtended to have the worst clinicaland laboratory findings. Conclusions: The prevalenceof alterationof ECGrecordingsin hospitalizedleptospirosiswas 66.7 %. Atrialfibrillation was the most frequent arrhythmia, and patients with this arrhythmia were likelyto have the most severe disease.

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