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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 22, No 3 (2013): August" : 13 Documents clear

Effect of enhanced external counterpulsation therapy on myeloperoxidase in lowering cardiovascular events of patients with chronic heart failure Rampengan, Starry H.; Setianto, Budhi; Posangi, Jimmy; Immanuel, Suzanna; Prihartono, Judo; Siagian, Minarma; Kalim, Harmani; Inneke, Sirowanto; Abdullah, Murdani; Waspadji, Sarwono
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Chronic heart failure (CHF) is a slowly progressive disease with high morbidity and mortality; therefore, the management using pharmacological treatments frequently fails to improve outcome. Enhanced external counterpulsation (EECP), a non-invasive treatment, may serve as alternative treatment for heart failure. This study was aimed to evaluate the influence of EECP on myeloperoxidase (MPO) as inflammatory marker as well as cardiac events outcome.Methods: This was an open randomized controlled clinical trial on 66 CHF patients visiting several cardiovascular clinics in Manado between January-December 2012. The subjects were randomly divided into two groups, i.e. the group who receive EECP therapy and those who did not receive EECP therapy with 33 patients in each group. Myeloperoxidase (MPO) as inflammatory marker was examined at baseline and after 6 months of observation. Cardiovascular events were observed as well after 6 months of observation. Unpaired t-test was use to analyze the difference of MPO between the two groups, and chi-square followed by calculation of relative risk were used for estimation of cardiovascular event outcomes.Results: MPO measurement at baseline and after 6 months in EECP group were 643.16 ± 239.40 pM and 422.31 ± 156.26 pM, respectively (p < 0.001). Whereas in non EECP group, the MPO values were 584.69 ± 281.40 pM and 517.64 ± 189.68 pM, repectively (p = 0.792). MPO reduction was observed in all patients of EECP group and in 13 patients (48%) of non-EECP group (p < 0.001). Cardiovascular events were observed in 7 (21.21%) and 15 (45.45%) of patients in EECP and non-EECP groups, respectively (p = 0.037).Conclusion: EECP therapy significantly decreased the level of MPO as inflammatory marker and this decrease was correlated with the reduction of cardiovascular events in CHF patients. (Med J Indones. 2013;22:152-60. doi: 10.13181/mji.v22i3.584)Keywords: CHF, cardiovascular events, EECP, myeloperoxidase

Urinary catheterization in gynecological surgery: When should it be removed? Fattah, Adly N.A.; Santoso, Budi I.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: The aim of this study was to determine the most appropriate time for urinary catheter removal following a gynecological surgery.Methods: Critical appraisal of clinical trial articles were conducted. It was aimed to answer our clinical question whether 24-hour postoperative urinary catheter removal is superior compared to other durations in avoiding postoperative urinary retention (PUR) and urinary tract infection (UTI). The search was conducted on the Cochrane Library® and PubMed® using keywords “postoperative urinary retention”, “postoperative catheterization” and “urinary retention AND catheterization”. Reference lists of relevant articles were searched for other possibly relevant trials.Results: Seven articles were available as full text, then appraisals of six prospective RCTs involving 846 women underwent hysterectomy and vaginal prolapse surgery were performed finding at the re-catheterization and UTI rate. Subjects in earlier-removal groups were 3 to 4 times more likely to have re-catheterization (OR = 3.10-4.0) compared to later-removal groups, while they who have it removed on 5th day were 14 times more likely to develop UTI compared with immediate group (OR = 14.786, 95% CI 3.187- 68.595).Conclusion: The 24-hour catheterization policy in hysterectomy and vaginal prolapse surgery remains most appropriate although associated with an increased risk of re-catheterization. The removal of catheter before 24 hour (6 or 12 hour) could be considered to be used as one of interventions in further RCT(s) to find out the best duration which would result in lowest incidence in both of UTI and PUR. (Med J Indones. 2013;22:183-8. doi: 10.13181/mji.v22i3.589)Keywords: Catheter, hysterectomy, prolapse, urinary tract infection

Domain 15 of the serine proteinase inhibitor LEKTI blocks HIV infection in vitro Palesch, David; Varga, Edina; Marx, Ute C.; Vitzithum, Klaus; Kreutzmann, Peter; Forssmann, Wolf-Georg; Münch, Jan; Mägert, Hans-Jürgen
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Lympho-epithelial Kazal-type-related inhibitor (LEKTI) is a 15-domain serine proteinase inhibitor, parts of which have first been isolated from human blood filtrate. It is encoded by the gene SPINK5. In the past, different groups reported antiviral activities of certain serine proteinase inhibitors, such as mucous proteinase inhibitor and alpha1-proteinase inhibitor. The purpose of this study was to test two representative domains of the proteinase inhibitor LEKTI for anti-HIV activities.Methods: LEKTI domains 6 and 15 were recombinantly produced in E.coli. To test their inhibitory activity against HIV infection, the reporter cell line P4-R5 MAGI carrying an HIV-inducible reporter gene was infected by a CCR5-tropic HIV strain in the presence of different inhibitor concentrations. After three days, infection rates were determined by quantifying ß-galactosidase activities using the Galacto-Light Plus™ ß-Galactosidase Reporter Gene Assay.Results: In contrast to LEKTI domain 6, LEKTI domain 15 suppressed HIV-induced reporter gene activities with an IC50 value of approximately 29 µM.Conclusion: LEKTI domain 15 represents an inhibitor of HIV infection. (Med J Indones. 2013;22:131-5. doi: 10.13181/mji.v22i3.580)Keywords: HIV, inhibition, LEKTI, P4-R5 MAGI

Cortisol dynamics and endothelin-1/nitric oxide ratio are associated with clinical vasospasme July, Julius; Yunus, Yesaya; Sungono, Veli; As’ad, Suryani; Suhadi, Budhianto; Islam, Andi A.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Cortisol dynamics in serum might be related to clinical vasospasm, also known as delayed ischemic neurological deficits (DIND). Two vasoactive substances that play a role in pathophysiology of DIND are endothelin-1 (ET1) and nitric oxide (NO), both are proved associated with cortisol. This study aimed to know how cortisol play a role on ET1/NO ratio and its relationship to DIND.Methods: This was a prospective cohort study for the first 14 days after aneurysmal subarachnoid hemorrhage (SAH). Patients with inclusion criteria will be enrolled for blood test before surgery, and post-operative day 2, 4, 7, and 10 (between 8:00-9:00 AM). The blood tests were performed for cortisol, ACTH, CBG, NO, and ET1. Free cortisol is calculated with Coolens equation. Logistic regression was used to see the interaction model and its scale. Bivariate analysis (corelation) was used to see the relationship between total cortisol, free cortisol, NO, ET1, and clinical vasospasm (DIND).Results: Forty-four patients are enrolled into this study (20 male; 24 females). Mean age is 52.02 years (52.02 ± 11.23). There were 29 patients (66%) within DIND group and 15 patients Non-DIND as the control group. The mean of cortisol level shown is significantly higher in DIND group (35.99 ± 14.24) µg/dL compared to Non-DIND group (19.57 ± 6.19) µg/dL, p < 0.001. The mean of free cortisol level was significantly higher in DIND group (2.06 ± 1.094) µg/dL compared to non-DIND group (0.838 ± 0.365 µg/dL; p < 0.001). The Scatter Plot graph show that correlation of cortisol with ET1/NO ratio started increasing on day 4 and became stronger on day 10.Conclusion: Cortisol is associated with DIND following aneurysmal SAH, probably through its role in keeping the balance between ET1 and NO level. (Med J Indones. 2013;22:161-6. doi: 10.13181/mji.v22i3.585) Keywords: Cortisol dynamics, delayed ischemic neurological deficits, endothelin-1, nitric oxide

A comprehensive management of hypertension among patients with metabolic syndrome: an evidence-based update Nursalim, Alvin; Siregar, Parlindungan
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Individuals with hypertension and metabolic syndrome are at increased risk of developing future morbidities. Therefore, an evidence-based comprehensive approach is required. It is recommended to start with lifestyle modification as the first step, then followed by antihypertensive drugs. Weight loss through decreased caloric intake and increased excercise have been proven to yield a better control over diabetes, blood pressure, and lipid profile. Inhibitor of renin-angiotensin is the recommended first-line drugs for this population, while β blocker and diuretic should remain as the second line drugs due to increased risk of developing new onset diabetes with these drugs. A more rigorous blood pressure control is reasonable with a target of < 130/80. A comprehensive management which include good control over blood pressure, weight, blood glucose, and lipid profile, may reduce future morbidities among hypertensive individuals with metabolic syndrome. (Med J Indones. 2013;22:189-94. doi: 10.13181/mji.v22i3.590) Keywords: Cardiovascular, diabetes, hypertension, metabolic syndrome

Acalypha indica root extract increases post-hypoxic rat hippocampal tissue culture cell viability via phospholipase A2 inhibition Yolanda, Sophie; Andraini, Trinovita; Kusuma, Indra
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Phospholipase A2 (PLA2) is involved in inflammation and cell death following stroke, and inhibition of its activity may promote neuroregeneration. This study aimed to observe the influence of Acalypha indica Linn root extract towards relative cell viability and PLA2 enzyme level in post-hypoxic hippocampal tissue culture.Methods: Experimental in vitro study using 24 primary neuronal cell cultures obtained from Sprague Dawley rat exposed to hypoxia with 5% O2 / 5% CO2 / N2 balanced gas for 24 hours. Post-hypoxia, Acalypha indica Linn root extract was added at doses of 10, 15, and 20 mg/mL to three treatment groups. No treatment was given to the control group. Each group consists of six samples. After 72 hours of incubation, relative cell viability was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) examination, and phospholipase A2 enzyme level was determined using ELISA.Results: PLA2 enzyme level of rat hippocampal tissue culture treated with Acalypha indica Linn root extract at 10, 15, and 20 mg/mL were significantly lower than that of control (5.55 ng/mL, 6.85 ng/mL, and 7.42 ng/mL vs 7.96 ng/mL, p < 0.05).Conclusion: Acalypha indica Linn root extract increases the relative cell viability and decreases the PLA2 enzyme level of post-hypoxic mouse hippocampal tissue with the optimal dose of the extract at 10 mg/mL. (Med J Indones. 2013;22:136-40 doi: 10.13181/mji.v22i3.581)Keywords: Acalypha indica Linn, cell viability, hypoxia, neurogenesis, phospholipase A2

Efficacy of Garcinia mangostana L. (mangosteen rind extract) to reduce acne severity Sutono, Toni
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: In vitro studies showed that extract of mangosteen rind (EMR) (Garcinia mangostana L.) containing xanthones has antibacterial effect against Propionibacterium acnes and also anti-inflammatory effect. The aim of this study is to determine the efficacy of EMR in reducing acne vulgaris (AV).Methods: A randomized, double-blind, placebo controlled clinical trial was done on 94 subjects (18-30 years) with mild and moderate AV. The treatment group was given 400 mg EMR 3 times daily orally, for 3 weeks and control group was given placebo capsules. As a standard therapy, all subjects were given a topical cream of 0.025% retinoic acid applied on acne lesions during night time. Efficacy was assessed by counting the acne lesion number as well as proportion of subjects with more than 20% decrease in lesion. The decrease of plasma malondialdehyde (MDA) levels were also measured.Results: After 3 weeks of treatment, acne lesion counts was significantly reduced in both groups [from 934 to 584 lesion (37%) in treatment group, p < 0.001 and from 832 to 608 lesion (27%) in control group, p < 0.001]. Comparison between the two groups revealed a non significant difference (p > 0.55). The proportion of subjects whose acne lesion reduced ≥ 20% was 73% (33 of 45 subjects) in treatment group vs 66% (27 of 41 subjects) in control (p > 0.2). The level MDA was reduced from 1.16 to 1.02 nmol/mL in treatment group and from 1.32 become 1.02 nmol/mL in control (p > 0.48).Conclusion: Extract of mangosteen rind given orally for 3 weeks clinically reduced acne severity better than placebo, although statistically was not significant. Antioxidant effect of EMR seem to be unspecific in reducing acne severity. (Med J Indones. 2013;22:167-72. doi: 10.13181/mji.v22i3.586) Keywords: Acne vulgaris, malondialdehyde, mangosteen rind extract, retinoid acid

Blood lactate level in Wistar rats after four and twelve week intermittent aerobic training Sari, Dewi N.; Endardjo, Sutjahjo; Santoso, Dewi I.S.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Aerobic training can be done not only continuously, but also intermittently. Intermittent aerobic training aimed to get blood lactate level lower than continuous aerobic training. Blood lactate concentration in one of the various factors that determine training performance. However, until recently, little studies about intermittent aerobic training and blood lactate levels have been done. Therefore, this study aimed to measure blood lactate levels in Wistar rats after 4 and 12 weeks of intermittent aerobic training.Methods: 16 Wistar rats were divided into two groups, control and aerobic group. Every group was divided into two subgroups, 4-week and 12-week subgroup. Aerobic group performed training using T-6000 treadmill with a speed of 20 m/minute for 20 minutes, with resting period for 90 seconds every 5 minute. Measurements of lactate level was done with L-lactate (PAP) Randox kit (LC2389).Results: Blood lactate level in the 4-week aerobic group was 2.11 mmol/L, while that of the 4-week control group was 1.82 mmol/L (p > 0.05). Meanwhile, lactate level in 12-week aerobic group was 1.71 mmol/L (p < 0.05), and significantly lower than in 12-week control group, which was 3.03 mmol/L.Conclusion: This study showed that lactate level after 12-week intermittent aerobic training was the lowest compared to 4-week intermittent aerobic and 12-week control group. (Med J Indones. 2013;22:141-5. doi: 10.13181/mji.v22i3.582)Keywords: Blood lactate, intermittent aerobic training, Wistar rat

Distal radius morphometry of Indonesian population Hadi, Syaiful A.; Wijiono, Wijiono
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Distal radius morphometry (radial inclination, palmar tilt, radial height, and ulnar variance) is an important parameter in the evaluation and treatment of distal radius fractures in which anatomical alignment must be corrected. Currently, treatment of distal radius fractures in Indonesia is still based on morphometry of western population or from the contralateral side. The aim of this study is to determine distal radius morphometry of Indonesian population and to compare between right and left side, male and female gender.Methods: Distal radius morphometry was measured from 400 plain X-ray of right and left wrist AP and lateral projection. Samples were taken consecutively in Moh. Ridwan Meuraksa Army Hospital, Jakarta, from June to September 2010. Radial inclination, palmar tilt, radial height, and ulnar variance was measured. Data were recorded using tables and grouped between male and female, right and left side, statistical analysis was performed using Mann-Whitney test.Results: From 400 plain X-ray evaluated, there were 300 males and 100 females with the mean age of 25.5 years old (18-48). The mean of radial inclination was 23.99 ± 3.75°, palmar tilt 13.76 ± 4.36°, radial height 11.31 ± 1.66 mm, and ulnar variance -0.45 ± 2.03 mm. There were statistically significant differences between right and left side of radial inclination, palmar tilt, radial height, and ulnar variance. There was also statistically significant difference between male and female.Conclusion: Distal radius morphometry in Indonesian population may provide valuable data for the treatment of distal radius fractures. The use of contralateral side as reference should be reconsidered. (Med J Indones. 2013;22:173-7. doi: 10.13181/mji.v22i3.597) Keywords: morphometry, palmar tilt, radial height, radial inclination, ulnar variance

Medicinal plants: source of new lead compounds in therapeutics Louisa, Melva
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

[no abstract available]

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