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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 relationship between body mass index (BMI) with the distance of the skin-epidural space in 3rd and 4th lumbar epidural anesthesia in nonobstetric surgery of Indonesian patients Sri Rahardjo, Agung Sutrisno Yusmein Uyun
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Universitas Gadjah Mada

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Abstract

Skin to epidural space distance varies in an insertion of epidural needle which can greatly affectthe identification of the epidural space and epidural anesthesia complications. Therefore, acareful prediction of skin to epidural space distance is needed in doing insertions. The purposeof this study was to evaluate the relationship between body mass index (BMI) and the distanceof skin to the epidural space in the 3rd – 4th lumbar epidural anesthesia in nonobstetric surgery ofIndonesian patients. This was a prospective observational study with cross sectional designinvolving patients of both sexes between the age 18-65 years with ASA physical status I-II whounderwent non obstetric surgery with 3rd-4th lumbar epidural anesthesia in Dr. Sardjito GeneralHospital, Yogyakarta and in Satellite Hospital. Weight, height and BMI were considered as theindependent variables, whereas skin to epidural space distance was considered as dependentvariable. Data were collected and analyzed using multiple regression analysis continued usingPearson’s correlation test to evaluate the relationship between BMI and skin to epidural spacedistance. One hundred patients selected from October to December 2011 were evaluated in thisstudy. The mean of weight, height and BMI were 57.35±11.59 kg, 155.98±5.88 cm and23.52±4.26 kg/m2, respectively. The mean of skin to epidural space distance of non obstetricsurgery of Indonesian patients was 40.89±9.95 mm. Multiple regression analysis showed thatBMI had a strongest relationship (r= 0.81; p<0.03) with skin to epidural space distance comparedto weight (r= 0.11; p=0.78) and height (r= 0.04; p<0.83). Further analysis using Pearsoncorrelation test showed that a significantly good correlation of BMI (r=0.92; p=0.001) andbody weight (r=0.87; p=0.001) with the skin to epidural space distance were observed. Inconclusion, BMI and body weight have a significant correlation with the skin to epidural spacedistance in non obstetric surgery patient. 
Validity of BI-RADS System Mammography to detect breast cancer at Dr Sardjito Hospital Yogyakarta Teguh Aryandono, Indrasto Histopaedianto Lina Choridah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Breast cancer is the second most common cancer among women worldwide and the sixth common cause of mortality in Indonesia. The diagnosis of breast cancer may be established by physical and imaging examinations, but definitive diagnosis should be verified by histopathologic examination. Mammography is an easy non-invasive imaging method to detect breast cancer with good accuracy. The lack of uniformity in mammography reporting has led to confusion as to the interpretation and management recommendation. The American College of Radiology Breast Imaging Reporting and Data System (BIRADS) has provided a standardized reporting system for mammography. The validity of this system at Dr Sardjito Hospital Yogyakarta has not been evaluated.Objective: To know the sensitivity, specificity, positive and negative predictive values, and accuracy of the BI-RADS System Mammography in diagnosing breast cancer.Methods: This study was a diagnostic test with cross sectional design on breast cancer diagnosis based on BI-RADS system mammography. All medical record files of patients with breast lump who underwent mammography and histopatologic examination, at Dr Sardjito Hospital Yogyakarta between December 2003-March 2008, were included in the analysis.Results: BI-RADS System Mammography at Dr Sardjito Hospital Yogyakarta had sensitivity of 87.5%, specificity of 93.7%, positive predictive value of 96.5%, negative predictive value 78.95%, positive likelihood ratio 14, negative likelihood ratio 0.13, prevalence 66.6%, and accuracy 89.6%.Conclusion: Mammography examination using BI-RADS System in Sardjito Hospital Yogyakarta was favourable in detecting breastcancer.Key words: breast cancer - BI-RADS mammography - histopathology - diagnostic value
ntiplasmodial Activity of Fractions Isolated from Methanolic Extrac of Meniran Herb (Phyllanthus niruri L) traditionally Used to Treat Malaria Subagus Wahyuono, Mustofa Esti Nurwening Sholikhah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 01 (2007)
Publisher : Universitas Gadjah Mada

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Abstract

Latar belakang: Tanaman meniran (P.niruri L.) secara tradisional telah digunakan untuk mengobati malaria. Penelitian pendahuluan terhadap berbagai ekstrak tanaman meniran menunjukkan bahwa ekstrak metanol adalah aktif terhadap P.falciparum. Namun demikian, fraksi manakah dalam ekstrak metanol yang mempunyai aktivitas antiplasmodium belum pernah dikaji.Tujuan: untuk mengetahui aktivitas antiplasmodium fraksi aktif tanaman meniran.Bahan dan cara: Fraksinasi yang mengacu pada bioassay dilakukan dengan menggunakan pelarut yang sesuai untuk memisahkan fraksi aktif dari ekstrak metanol. Pada awalnya, ekstrak metanol dipisahkan dengan etil asetat sehingga diperoleh fraksi larut etil asetat dan tidak larut etil asetat. Fraksi tidak larut etil asetat selanjutnya dipisahkan dengan kolom kromatografi dengan fase diam Sephadex LH-20 dan fase gerak n-hexan : metanol : asam asetat (7,5 : 12,5 v/v : 10 tetes) sehingga diperoleh 4 fraksi untuk diuji aktivitasnya. Aktivitas antiplasmodium pada strain P. falciparum ditunjukkan dengan nilai IC50 yaitu kadar fraksi aktif yang mampu menghambat pertumbuhan parasit hingga 50%. Identifikasi kandungan senyawa dalam fraksi aktif dilakukan dengan metode kromatografi lapis tipis (KLT).Hasil:Hasil penelitian menunjukkan bahwa fraksi tidak larut etil asetat leih aktif (IC50, 2,2-2,4 mg/mL) dari pada fraksi larut etil asetat (IC50, 4,3-4,8mg/mL). Dan pemisahan fraksi tidak larut etil asetat diperoleh 9 fraksi yang dapat dikelompokkan menjadi 4 fraksi berdasarkan gambaran KLTnya. fraksi III (FIII) merupakan fraksi paling aktif dengan IC50, 3,4-4,1 mg/mL. Identifikasi kandungan aktif F III dengan KLT menunjukkan adanya senyawa polifenol. Penelitian lanjut akan dilakukan untuk mengisolasi dan memurnikan senyawa polifenol dan mengkaji aktivitas antiplasmodiumnya.Simpulan: Fraksi III dari ekstrak metanol meniran yang mengandung senyawa polifenol merupakan fraksi paling aktif secara in vitro terhadap P.falciparum.Key words: Phyllanthus niruri, malaria, antiplasmodial activity, in vitro, polyphenol
Evaluation of substrate metabolism in critically ill pediatric patients Antonius H Pudjiadi, Nurnaningsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 02 (2008)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Critically ill pediatric patients are characterized by a hypermetabolic state, a catabolic response, and a decreased capacity to utilize substrate. Metabolic state of critically ill pediatric patients can be detected by analyzing substrate utilization.Objective: To determine the metabolic state of critically ill pediatric patients using PRISM III Score, blood glucose level, and urinary nitrogen excretion.Methods: A cross sectional study was conducted in Pediatric Intensive Care Unit (PICU) of Cipto Mangunkusumo Hospital Jakarta between May and September 2006. All admitted PICU patients, except those with renal or hepatic failure, burns, diabetic ketoacidosis and died in the first 24 hours, were included. PRISM III Scores were measured in the first 24-hours of admission. Blood glucose level was observed at random within the first hour of hospitalization, while urinary nitrogen excretion was measured using urine collected in the second 24-hours of admission.Results: Fifteen cases were eligible for this study. Their age ranged between 1 to 96 months. The median (01 ;03) for PRISM III Scores, random blood glucose, and urinary nitrogen excretion were 6.0 (3.0;11.0), 123.0 (100.0;227.0), and 279.4 (124.3;408.4) mg/dL, respectively. There were no significant correlations between PRISM III Scores and random blood glucose (r=0.40;p=0.14), and between PRISM III Scores and urinary nitrogen excretion (r = -0.27;p = 0.33). There was significant correlation between random blood glucose and urinary nitrogen excretion (r=0.56;p=0.03).Conclusion: Critically ill pediatric patients had a catabolic state that had no association with PRISM III Scores. Random blood glucose level within the first hour of admission predicted the increasing protein catabolism.Key words: critically ill pediatric patients - blood glucose level - urinary nitrogen excretion - PRISM III Score.
The role of Various Factors in the Therapeutic Response of Calcipotriol in Mild to Moderate Plaque Type Psoriasis Patients Hardyanto Soebono, Siti Aminah Tri Susila Estri Sunardi Radiono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 02 (2007)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Psoriasis is a chronic skin inflammation and proliferation disease. Natural history of psoriasis depends on the genetic, age, sex, history of treatment and psychosocial stressor. Calcipotriol is suitable for long-term therapy with good efficacy and safety and clinical response variability but its activity is influenced by ultraviolet.Objective: To know the factors that may influence treatment response of calcipotriol ointment on mild to moderate plaque type psoriasis.Method: Longitudinal study of two times daily calcipotriol ointment 0.005% treatment in the psoriasis patients. Factors that may influence the natural course (age, sex, history of psoriasis in family, history of therapy, MED, working location and psychological stressor) were identified. Evaluation of therapy was performed in the 8th weeks and based on the PASI and PDI. Correlation between treatment responses with various factors were analyzed by using student t-test, Pearson and Spearman correlations and multiple linear regression.Result: At the end of study, PASI was shown to decrease 38.45%, while PDI was 28.70% (p
Prevalence and risk factors of hand dermatoses among pandan handicrafters Fajar Waskito, Erni Setiyawati Devi Artami S, Sri AwaliaFebriana,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 03 (2008)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Pandan handicraft is one of the industrial sectors which has a significant role in employing people in Kulonprogo, Yogyakarta. Development in this industry makes higher material exposure to the hands during the production procedures, that makes it essential to study the risk of suffering from hand dermatoses among the handicrafters.Objective: To determine the prevalence and risk factors of hand dermatoses among pandan handicrafters. Methods: Cross-sectional study was conducted on 80 subjects who was taken randomly from Pandan handicrafter population in Tanjungharjo village, Kulonprogo, Yogyakarta. Prevalence data were analyzed descriptively. Risk factors were analyzed using estimation of prevalence ratio (pr), 95% Confident Interval (el), and chi-square test.Results: Out of 74 subjects fulfilled the criteria, 58 (78.4%) were suffered from hand dermatoses. Callus was the most common disease occurred in 49 (66.2%) subjects, followed by irritant contact dermatitis (lCD) in 18 (24.3%) subjects. History of atopy was proven as risk factor for ICD (p = 0.025, pr = 2.872; 95%el = 0.913-9.032). Types and duration of work were not proven as risk factors, as well as no gloves protection during work.Conclusion: Callus was the most common hand dermatosis occurred among pandan handicrafters, followed by ICD. History of atopy was identified as a risk factor for ICD.Key words : pandan - handicrafter - hand dermatosis - occupational-atopy
Expression of CD5, CD1 0, Bcl-2 and Bcl-6 in diffuse large B cell lymphoma based on International Prognostic Index Guntersah, Indrawati Tody
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 03 (2007)
Publisher : Universitas Gadjah Mada

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Background: Diffuse large B cell lymphoma is the most common type of non-Hodgkin lymphoma. This tumor has heterogeneous clinical feature, morphology, genetic and molecular alterations. Diffuse large B cell lymphoma with a germinal centre ( GC ) pattern of gene expression including CD10 and Bcl-6 has a more favorable outcome. CD5 and Bcl-2 expression has been shown to have an adverse effect on the outcome in diffuse large B cell lymphomaObjective: To investigate the difference of CD5, CDlO, Bcl-2 and Bcl-6 expression based on International Prognostic Index IIPI) in diffuse large B cell lymphomaMethods: Fourty five cases of B cell diffuse large B cell lymphoma from embedding parafin tissue were constituted the basis of the study. Immunohistochemical examination using CD20, CD5, CD10, Bcl-2 and Bcl-6 monoclonal antibody was done. The difference of CD5, CD10, Bcl-2 and Bcl-6 expression between high and low IPI of diffuse large B cell lymphoma were analized by chi square testResult: There Vlias significant difference between the number of cases with positivity of CD5 and CD10 expression in high and low IPI of diffuse large B cell lymphoma. The result supported that immunophenotyping related B cell differentiation can help to predict clinical behavior and prognosis in diffuse large B cell lymphoma.Conclusion: Conclusion: There was significant difference between the number of cases with positivity of CD5 and CD10 expression in high and low IPI of diffuse large B cell lymphoma. The result supported that immunophenotyping related B cell differentiation can help to predict clinical behavior and prognosis in diffuse large B cell lymphoma.Key words : diffuse large B cell lymphoma, CD5, CD 10, IPI
The correlation between the intensity of benzene exposure and complete blood count in the oil and natural gas company workers in East Kalimantan Ngatidjan, Idha Arfianti Wiraagni Iwan Dwiprahasto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Universitas Gadjah Mada

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Abstract

Benzene is one of the dangerous chemical substances which can cause some health disturbances.Meta-analysis shows that people who are exposed to benzene have a leukemia risk of 1.4 timesmore than the ones who are not. The employees who are exposed to benzene for a long timehave a probability to receive the toxic effect from benzene. This study was conducted to evaluatethe relationship between the intensity of benzene exposure and blood count of employees in theoil and natural gas company in East Kalimantan. This research was conducted to 897 employeeswith case control design. The control group consisted of 521 subjects, whereas the case groupconsisted of 376 subjects. The subjects were 39.91±10.90 years old, with the working termbetween 1 to 36 years. Data were obtained from routine medical check-up and health riskassessment in 2007 – 2010. The independent variable namely benzene exposure and the dependentvariable namely result of blood count, were analyzed by using chi-square bivariat analysis.Intensity of benzene exposure was measured as OVM (Organic Vapour Monitor) for externaldosage and SPMA (S-phenylmercapturic acid) for internal dosage. The intensity of benzene in2007 was 1.07± 5.5 ppm (OVM) and average of SPMA was 11.54±5.28 ìg/g creatinine. Theintensity of benzene in 2009 was 4.15±13.6 ppm (OVM) and SPMA was 55.90±43.6 ìg/gcreatinine. The employees who were exposed to benzene had a risk of having a decrease ofeither hemoglobin, erythrocyte, thrombocyte, or leukocyte 1.71 times (95% CI, 1.18–2.48)compared with the control, although this reduction was still in the normal range (p= 0.004). Inconclusion, there was no relationship between the intensity of benzene exposure with the lowblood count of the employees.Keywords: benzene exposure - complete blood counts - oil and gas earth - mining - toxic effect
Human papillomavirus (HPV) as the causal factor of tympanal cholesteatoma in malignant-type chronic suppurative otitis media Rianto, Bambang Udji Djoko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 04 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Tympanal cholesteatoma is an uncoordinated, uncontrolled hyperproliferative epidermic epithelial cells keratinized with aggressive, erosive and destructive development to the mucous membrane and the bone of external auditory canal and tympanic cavity. This process is invasive and may migrate to the surrounding tissue. Ethiopathogenesis of tympanic cholesteatoma is unknown. Histological examination shows that there are hyperproliferative development, papillomatous, koilocyte clusters and destruction of the bone. These abnormalities are characteristics of papillomavirus.Objective: To know the whether HPV-18 is the risk factor in the occurrence of tympanic cholesteatoma ini malignant-type chronic suupurative otitis media.Methods: A case-control study was conducted on 31 tympanal cholesteatoma specimens from malignanttype chronic suppurative otitis media as the case group, and 31 mucosal tympanic cavity specimens from benign-type chronic suppurative otitis media as the control group. For detecting Polymerase chain reaction (PCR) examination was used to detect DNA HPV-18, that performed in Parasitology laboratorium Faculty of Medicine, Gadjah Mada University.Results: Polymerase chain reaction (PCR) examination showed that there were 21 (67.7%) DNA HPV-18 positive specimens in the case group, while in the control group there were 5 (16.1 %) DNA HPV-18 positive specimens. This difference was statistically significant (p = 0.0001; Odds ratio: 1 0.92; 95 % confidence interval = 2.83-45.29). Immunohistochemistry examination was used to identify host immune response to HPV, by observing the interleukin-1 IIl-1) and interferon g IIFN g) expressions. Both Il-1 and IFN g cytokines were highly expressed in tympanic cholesteatoma samples, compared to both in the control group. The difference was statistically significant (p < 0.05, Odds ratio 14.29; 95% confidence interval: 3.64-60.5 and p< 0.05, Odds ratio:10.2; 95% confidence interval: 2.74-40.35, respectively). Conclusion: It can be concluded that HPV-18 DNA was iidentified, and was one of the multiple risk factors in the occurence of tympanic cholesteatoma in malignant-type chronic suppurative otitis media..Key words: tympanal cholesteatoma - human papillomavirus - malignant-type chronic suppurative otitis media
Effect of temperature and storage duration of Aedes aegypti mosquito specimens artificially infected with dengue-3 virus on the results of immunohistochemical examination Tri Baskoro Tunggul Satoto, Susilawati Sitti Rohmah Umniyati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 44, No 01 (2012)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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To confirm the presence of any dengue viral in a mosquito, mosquito’s head can be squashed ona slide and stained with immunohistochemical staining. The remaining samples then can bestored in the cryo freezer at -80ºC to avoid specimen damage. However, for laboratories withlimited facilities, with only a refrigerator with a temperature range of -20ºC to 4ºC is available,examination to evaluate whether the dengue antigen can still be detected in specimens storedat these temperature is necessary. It was a quasi-experimental study. Three to five-day-old adultfemale Aedes aegypti mosquitoes were injected intrathoracically with dengue-3 (DENV-3) strainH-87 virus and then maintained for about 7 days. The dengue viral antigen on mosquitoes wasidentified using immunohistochemical method after stored at a temperature of 4oC, -20oC, -80oCfor 2, 4 and 8 weeks. Mosquito specimens that were not stored were used as a positive control.Kappa value was counted to analyze level of agreements between two observers. Two-wayAnova was used to analyze mean positive rates. Kappa value showed poor agreement (0.00-0.16) between two observers when the specimens were stored at 4oC for 2-8 weeks, and showedgood agreement (Kappa value of 0.77), when stored at -20oC for 4 weeks. The kappa valueshowed very good agreement (0.90-0.92) when the specimens were stored at -20oC for 2 weeks,and at -80oC for 2-8 weeks. Mean positive rates of the specimens stored at 4oC were significantlylower (p<0.005) than stored at -20oC and -80oC, but there were no significant differencesbetween specimens stored at -20oC and -80oC (p>0.05). In conclusion, availability of thedengue viral antigen on mosquito specimens was influenced by temperature and storage durationof the specimens.Keywords: dengue virus - head squash - immunohistochemistry - kappa agreement - temperature

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