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Medical Journal of Indonesia

MJI
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Published by Universitas Indonesia

ISSN : 08531773 EISSN : 22528083 DOI : 10.13181

Core Subject : Health,

Medicine & Pharmacology

This quarterly medical journal is an official scientific journal of the Faculty of Medicine Universitas Indonesia in collaboration with German-Indonesian Medical Association (DIGM) Indexed in: IMSEAR; CAB Abstracts; Global Health; HINARI; DOAJ; DRJI; Google Scholar; JournalTOCs; Ulrichsweb Global Serial Directory; WorldCat; New Jour; Electronic Journals Library; ISJD Accredited (2013-2018) by DIKTI Kemendikbud Republik Indonesia (No:58/DIKTI/Kep/2013)

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Articles 13 Documents

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Search results for , issue " Vol 19, No 4 (2010): November" : 13 Documents clear

The application of correction factors on serum retinol of Indonesia school children Htet, Min K.; Chiwile, Faraja P.; Dillon, Drupadi
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: Vitamin A deficiency among children is still a public health problem in Indonesia. Serum/plasma retinol concentration is the best indicator in assessing vitamin A status. However, there is growing concern that infection/ inflammation lowers serumÂ retinol concentration, thus creating potential misinterpretation of vitamin A status, which could affect policy makers in planning suitable nutrition programs targeted at community. The aim of this study was to highlight the importance of applying correction factors, to better interpret serum retinol as a nutritional statusbiomarker.Methods: A cross sectional study involving 54 apparently healthy school children was conducted in East Nusa Tenggara. Height, body weight, concentrations of serum retinol, CRP and AGP were assessed. Based on concentrations of serum CRP and AGP, four infl ammation groups were determined, namely reference,Â incubation, early convalescence and late convalescence groups. Correction factor was obtained by dividing serum retinolÂ concentration of reference group by that of the other three groups. Correction factors were then used to correct serum retinol concentration without anyÂ influence of infection/ inflammation.Results: The prevalence of stunting and underweight were 43% and 22% respectively, but there was no wasting among the school children. Applying correction factor lowered the prevalence of vitamin A defi ciency from 20.4% to 18.5%; thus changing vitamin A defi ciency from a severe public health problem to a moderate public health problem.Conclusion: Correcting serum retinol concentration for the infl uence of infection reduced the apparent severity of vitamin A deficiency. This could affect policy for planning nutrition programs designed for communities. (Med J Indones 2010;Â 19:258-63)Keywords: correction factor, infection, school children, serum retinol

Effectiveness of group counseling in smoking cessation program amongst adolescent smokers in Malaysia Ismail, Rohani; Syed Aljunid, Syed Mohamed A.; Latip, Khalib A.; Puteh, Sharifa E. W.
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To assess the effectiveness of groups counseling for smoking cessation among secondary school students.Methods: This study was conducted among secondary school students in two districts in Selangor Malaysia, during July 2005 until August 2006. Upon screening, 346 students were randomly assigned into intervention group (IG) (n=158) and non intervention group (NIG) (n=188). IG underwent structured group counseling regularly for four months, while no group counseling was given to the NIG but subjected to the regular smoking cessation activities organized by their respective schools. Â Â Â Â Knowledge and attitude towards smoking and quit rate wereÂ measured in both groups before intervention, and at 4, 8, and 12 months after intervention.Results: Revealed that students in IG had signifi cantly higher knowledge scores than those in NIG during follow-up visits (24.29+7.97 vs 23.58+8.44 on the fi rst visit), (29.10+8.52 vs 24.09+8.69 on the second visit) (26.59+8.26 vs 22.08+8.04 on the third visit) and (25.54+8.34 vs 21.26+9.60 on the fourth visit). Attitude scores were not signifi cantly different in both groups. Quit rate at four months after intervention was signifi cantly higher in IG as compared to the NIG (45%; 71/158 vs 32%; 60/188) (P=0.013).Conclusion: Group counseling is very effective in improving the respondentsâ knowledge and quite rate, but not their attitudes toward smoking. (Med J Indones 2010; 19:273-9)Keywords: attitude, group counseling, intervention, knowledge, smoking cessation

Tobacco control policy in Indonesia Pawitan, Jeanne A.
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

[No Abstract Available]

Proportion of influenza cases in severe acute respiratory illness in Indonesia during 2008-2009 Ramadhany, Ririn; Setiawaty, Vivi; Wibowo, Holy A.; Lokida, Dewi
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To access the proportion of Influenza which caused SARI casesMethods: From April 2008 until March 2009, 549 samples of nasal and throat swabs were collected from SARI patients from eight hospitals in eight provinces in Indonesia. The samples were analyzed for Influenza by real-time RT-PCR method using several specific primers for influenza A (A/H1N1, A/H3N2 and A/H5N1) and Influenza B. The sequence of these primers was provided by CDC, Atlanta.Results: We found 516 (94%) of the specimens testing results were not infl uenza A or B viruses. There was 21 (4%) cases caused by influenza A and 12 (2%) caused by influenza B. From the influenza A cases, one case of SARI was caused by A/H1N1, two cases were A/H5N1, 17 cases were A/H3N2 and one case was unsubtypeable Influenza A.Conclusion: The majority of SARI cases were not caused by influenza viruses. From this surveillance the most common influenzaÂ A related to SARI is A/H3N2. Facts of the avian influenza virus A/H5N1 cases have been found in Indonesia and the spread of novel virus influenza A/H1N1 in 2009 raised our concern about the importance of SARI surveillance. (Med J Indones 2010; 19:264-7)Keywords: influenza, severe acute respiratory illness

Impact of HIV/AIDS in the family on childrenâs quality of life Muhaimin, Toha
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: An AIDS epidemic has a negative social and economic impact to the families. The aim of the study is to explore the impact of HIV/AIDS in the family to the quality of life of the children, including other factors that might interfere.Methods: The study utilized the data of a survey conducted by the Health Research Center of the University of Indonesia (2007), in seven provinces consisting of 379 households (HH) with HIV and 370 HH without HIV. Childâs quality of life was measured at ages 5 to 11 years (pre-adolescent) using a composite of three variables (education, social environment, and physical activity), and was scored as âpoorâ and âgoodâ. Multiple logistic regression was performed to examine the impact of HIV/AIDS, household and child factor towards the childâs quality of life.Results: The presence of an HIV/AIDS patient in the HHÂ increases the risk of poor quality of life 1.59 times comparedto the risk in HH without HIV/AIDS. If the child is a female, the risk of poor quality of life increases 1.50 times compared to male children. A child who is poorly taken care of faces a 1.55 times higher risk of poor quality of life compared to children who are well taken care of. In younger children (5-7 yrs) the risk of poor quality of life increases 1.60 times compared to olderÂ children (8-11 yrs).Conclusion: The study showed that when a member of the family is infected with HIV, it will negatively affect the quality of life of a pre-teen child in that family. This negative effect is higher when the child is a female, does not receive proper care, and of younger age. (Med J Indones 2010; 19:280-6)Keywords: child care, childrenâs quality of life, impact ofÂ HIV/ AIDS

Analysis of fatty acids in Ghee and olive oil and their probable causal effect in lipoid pneumonia Mirghani, Zein; Zein, Tayseer; Annoble, Samuel; Winter, John; Mostafa, Randa
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To analyze and identify the fatty acids found in homemade ghee and in olive oil and compare those to fatty acids found in bronchoalevolar lavage of children with lipoid pneumonia.Methods: The fatty acids found in homemade fat âGheeâ and olive oil were analyzed by gas chromatography. Methyl ester derivatives suitable for GC analysis were prepared directly from olive oil or from Ghee using anhydrous methanolic-HCl. Bronchoscopy and bronchoalevolar lavage was performed in eight children aged between 2 and 4 years, all with history of using homemade ghee and/or olive oil in the recumbent position.Results: The analysis of fatty acids in Ghee and olive oil show similar gas chromatographic pattern as those of bronchoalevolar lavage.Conclusion: The three fatty acids responsible for the deleterious effects of lipoid pneumonia were identified. Lipoid pneumonia should be one of the differentials diagnosis in childrenÂ presenting with respiratory distress. (Med J Indones 2010; 19:252-7)Keywords: Bronchoalevolar lavage, gas chromatography, Ghee, methyl esters, lipoid pneumonia

Gonadothropin-releasing hormone agonist as a treatment of choice for central precocious puberty Batubara, Jose R.L.
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Precocious puberty is defi ned as pubertal development which occurs too early. The age limit in this term is based on the onset of puberty in normal population. Some points have to be taken into account, such as ethnicity, gender, nutritional conditions, and secular trends. In girls, precocious puberty is defi ned by breast development occured before 8 years old. In boys, precocious puberty is defi ned as gonadarche or pubarche before 9 years of age. The clinical course of precocious puberty varies widely, ranging from alternating, slowly progressive, and rapidly progressiveÂ Â Â form. The rapidly progressive forms of idiopathic central precocious puberty need to be treated because it may result in early epiphyseal closure and short fi nal height, and also pyschosocial problems in the affected children and the family. The aims of treatment are to arrest physical maturation, prevent early menarche, and also improve adult height combined with normal body proportions. Gonadotropin releasing hormone analogue is the treatment of choice for central precocious puberty. Gonadotropin releasing horomone analogue has suppressive effect on the pituitarygonadal axis, therefore it suppresses LH secretion. This leads to the return of estradiol and testosterone to prepubertal levels. Treatment using gonadotropin releasing horomone analogue is shown to reduce breast size, pubic hair, ovarian and uterine size in girls, and decrease testicular size in boys. Gonadotropin releasing hormone analogue is effective in halting progression of secondary sexual characteristics development, presenting menstrual cycle, slowing bone-age advancement, and also improving fi nal height. (Med J Indones 2010; 19:287-92)Keywords: gonadache, GRH analogue, pubarche , precocious puberty

Colorectal cancer among young native Indonesians: A clinicopathological and molecular assessment on microsatellite instability Sudoyo, Aru W.; Hernowo, Bethy; Krisnuhoni, Ening; Reksodiputro, Ary H.; Hardjodisastro, Daldiyono
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities â Jakarta, Makassar, and Bandung - were reviewed. The ânativeâ ethnic groups were selected from those originating from Java, Makassar (South Celebes),Â Minangkabau (West Sumatra). Ethnicity of 121 colorectalÂ carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well asÂ immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability and. (Med J Indones 2010; 19:245-51)Keywords: colorectal cancer, microsatellite instability, MLH1, MSH2, native Indonesian, SMAD4

Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person Kaniawati, Marita; Yusuf, Irawan; Bakri, Syakib; Santoso, Anwar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1 (PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice.Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 control healthy subjects. HDL type was classifi ed into antiatherogenic andÂ proatherogenic based on the levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method, PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined by homogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levels of ApoA-I, PON-1, Neopterin andHDL-cholesterol as independent variables. Proatherogenic/ antiatherogenic HDL type was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios.Results: Patientâs age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/ dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterin successively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed that OR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 â 217.382), 1.647 (95% CI : 0.412 â 6.586), 4.317 (95% CI : 1.098 â 16.977). Using scoring system, we concluded that total score > 18 was proatherogenic HDL type, and total score < 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenic HDL type in ACS population.Conclusions: Dysfunctional HDL or proatherogenic/anti atherogenicÂ HDL type can be predicted by using ApoA-Iâ PON-1âNeopterinâHDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenic HDL type, and those with score of > 18 were having proatherogenic HDL type. (Med J Indones 2010; 19:228-34)Keywords: ApoliproteinA-I (ApoA-I), HDL-cholesterol, neopterin, paraoxonase-1 (PON-1), proatherogenic/antiatherogenic HDL

The DiabCare Asia 2008 study â Outcomes on control and complications of type 2 diabetic patients in Indonesia Soewondo, Pradana; Soegondo, Sidartawan; Suastika, Ketut; Pranoto, Agung; Soeatmadji, Djoko W.; Tjokroprawiro, Askandar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 Â± 2.0%). 47.2% had FPG>130 mg/dL (161.6Â±14.6 mg/dL). Dyslipidemia was reported in 60%Â (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most commonÂ complication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (Â± insulin), 37.7% were on insulin (Â±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territoryConclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in Indonesia. (Med J Indones 2010; 19:235-44)Keywords: DiabCare, DiabCare Indonesia, Diabetes complications, Dyslipidaemia, Glycaemic control, Hypertension.

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