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INDONESIA
Medical Journal of Indonesia
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 7 Documents
 1 
Search results for , issue "Online First" : 7 Documents clear
Comparing suturing techniques and materials in hypospadias repair: a prospective cohort study Nainggolan, Ebram; Raharja, Putu Angga Risky; Situmorang, Gerhard Reinaldi; Rodjani, Arry; Wahyudi, Irfan
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257921

Abstract

BACKGROUND Various techniques are available for hypospadias surgery, but the most effective suturing techniques and suture materials remain debated. This study aimed to evaluate the outcomes of hypospadias repair using various suturing techniques and materials. METHODS This prospective cohort study was conducted from August 2023 to August 2024 and included all patients who underwent hypospadias surgery at Cipto Mangunkusumo Hospital. We compared the outcomes of 2 suturing techniques (interrupted versus continuous) and 2 suture materials (6-0 polydioxanone [PDS] versus poliglecaprone 25) used for neourethra suturing. Follow-up assessments were conducted at 1, 2, and 4 weeks postoperatively, and subsequently every 3 to 6 months, focusing on complications. RESULTS 162 participants were included, with a mean age of 6.27 (3.99) years and a mean follow-up period of 20.39 (14.25) weeks. Complications occurred in 31 patients (19.1%), with a significant association between hypospadias type and complication occurrence (p = 0.039). Complication rates were 9.4% in distal, 12.5% in midshaft, and 26.8% in proximal cases. No significant differences were found between suturing techniques (interrupted: 19% versus continuous: 12%, p = 0.429) or suture materials (6-0 PDS: 22% versus 6-0 poliglecaprone 25: 9%, p = 0.998). Subgroup analyses by hypospadias type also showed no significant differences by suture type or technique (all p>0.05), although a trend toward significance was noted in proximal cases (p = 0.062). CONCLUSIONS The choice of suturing techniques and suture materials does not affect complication rates in hypospadias repair, allowing surgeons to decide based on personal expertise and preference.
Formulation of mice diet with low cholecalciferol content Sumariyono; Handayani, Dian; Setiati, Siti; Amalialjinan, Nadia; Abellia, Gaby; Anindyanti, Risma Debby; Dienillah, Syifa Sarah; Ernawati; Tanadi, Caroline
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257859

Abstract

BACKGROUND Vitamin D deficiency has been linked to autoimmune diseases, cancer, and cardiovascular diseases. Although 1 study attempted to elucidate the ingredients required to make this diet, the process remained unclear. Hence, this study aimed to customize a low cholecalciferol diet with good tolerability in mice. METHODS We customized a diet containing a normal cholecalciferol content (1 IU/g diet) and another with a low cholecalciferol content (0.05 IU/g diet). Samples from both diets were sent to an independent laboratory to ensure that the levels of cholecalciferol, phosphorus, and calcium present in the custom diets matched our calculations. 5 mice were fed the customized normal cholecalciferol diet for 1 week to assess tolerability. Tolerability was assessed by measuring the amount of food consumed, weight gained, and the presence of any adverse events. RESULTS Cholecalciferol, phosphorous, and calcium levels in both diets satisfactorily matched our calculations. The diet was well tolerated without any adverse events or mortalities. The mice consumed an adequate amount of food (mean: 5.34 [0.08] g diet/day, 95% confidence interval [CI]: 5.12–5.56; 19.38 kcal, fat: 0.43 g, protein: 0.14 g, carbohydrates: 3.16 g, and cholecalciferol: 0.007 mg) and gained a slight amount of weight by the end of the experiment (mean: 1.86 [0.46] g, 95% CI: 0.58–3.14). CONCLUSIONS This study successfully created 2 custom diets with quantified cholecalciferol contents. This animal model may prove valuable for studies involving vitamin D.
Efficacy of fetal hemoglobin inducers in adult transfusion-dependent beta-thalassemia patients: a systematic review and meta-analysis Naufal, Muhammad Afif; Fauzi, Ahmad; Rengganis, Iris
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257796

Abstract

BACKGROUND Patients with transfusion-dependent beta-thalassemia (TDBT) face risks of iron overload, which also burdens national expenditures in Indonesia. Elevated fetal hemoglobin (HbF) expression is associated with reduced blood transfusion dependency. This study aimed to assess the efficacy and safety profile of HbF inducers as adjuvant therapy for adult patients with TDBT and appraise its feasibility for Indonesian patients. METHODS This study analyzed 7 trials of HbF inducers, such as hydroxyurea, thalidomide, butyrate, and decitabine, in 382 adult participants (mean age >16), including 28 patients with non-TDBT. Outcomes assessed included hemoglobin (Hb) levels, transfusion needs, and adverse events (AEs). Studies were sourced from PubMed, Cochrane, Embase, and individual searches. The standardized mean difference (SMD) was used as the primary effect size. The protocol was registered in PROSPERO (CRD4202454646368). RESULTS High heterogeneity was observed, with HbF inducers associated with a significant decrease in transfusion needs (SMD = −0.88; 95% confidence interval [CI] = −1.37 to −0.26); I2 = 79%, P✗2<0.01). No significant change in Hb levels was found (SMD = 0.11; 95% CI = −0.69 to 0.91; I2 = 90%, P✗2<0.01). The most common AEs were transaminitis and cytopenias, which were tolerable and alleviated upon dose cessation. CONCLUSIONS HbF induction agents can be used as adjuvant therapy for TDBT, considering their cost-effectiveness, efficacy, and safety profiles.
Estrogen receptor expression in type 1 endometrial cancer and its association with lymphovascular space invasion Fidiawati, Wiwit Ade; Andrijono; Siregar, Nurjati Chairani; Prihartono, Joedo; Purwoto, Gatot; Hellyanti, Tantri
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257842

Abstract

BACKGROUND Endometrial cancer (EC) ranks sixth in female genital malignancy and originates in the endometrial lining. Estrogen receptor (ER) expression is important in EC prognosis and recurrence, influenced by the presence of lymphovascular space invasion (LVSI). This study aimed to determine the association between ER expression and LVSI in type 1 EC. METHODS A retrospective analysis was conducted on 135 patients with type 1 EC who underwent surgery at the Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between January 2012 and December 2022. Immunohistochemistry (IHC) with ER antibodies was performed on all samples in April 2023. ER expression was evaluated using the Allred scoring system, and its association between ER expression (percentage and intensity stain) and LSVI was statistically analyzed. RESULTS Of 135 samples, 44 (32.6%) were LVSI-positive. No significant association was found between IHC percentage stain and LVSI (p = 0.994). However, a significant association was found between IHC stain intensity and LVSI-positive in patients with type 1 EC (p = 0.022). ER intensity score 2 had a higher LVSI risk compared to score 1 and score 3 (from 51%, 26%, and 26%, respectively). CONCLUSIONS ER expression is associated with LVSI of type 1 EC. While IHC stain percentage showed no correlation with LVSI, stain intensity was significantly linked to LVSI-positive in patients with type 1 EC. Regular assessment of ER expression can provide significant prognostic information, support hormonal therapy, and identifying clinical characteristics of tumors.
Empagliflozin for liver and lipid profile in metabolic dysfunction-associated fatty liver disease: a meta-analysis Suhardi, Kevin Fernando; Sutadji, Jonathan Christianto; Putri, Agustina Rajendra; Tsamara, Ghina; Faratisha, Icha Farihah Deniyati; Viazelda, Aqsha Tiara; Soeslistijo, Soebagijo Adi
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257855

Abstract

BACKGROUND Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common chronic liver condition often associated with obesity and diabetes. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, is an antidiabetic medication that improves glycemic control, insulin resistance, and body weight. This study aimed to examine the efficacy of empagliflozin in adults with MAFLD. METHODS A comprehensive literature search was performed using the PubMed, ScienceDirect, Cochrane Library, Scopus, and Wiley Online Library databases. Randomized controlled trials assessing liver function, lipid profile, metabolic profile, and body composition were included. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects models, and study quality was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. RESULTS 6 RCTs with a total of 636 participants were analyzed. Empagliflozin significantly reduced alanine aminotransferase levels (WMD: –6.65 IU/l, 95% CI: –13.02 to –0.28; p = 0.04) and gamma-glutamyl transferase levels (WMD: −10.60 IU/l, 95% CI: −29.05 to −7.68; p<0.00001). A non-significant reduction in aspartate aminotransferase was observed (WMD: –4.69 IU/l, 95% CI: –9.89 to 0.51; p = 0.08). Empagliflozin significantly improved low-density lipoprotein cholesterol (p = 0.02) and total cholesterol (p = 0.05) levels but did not significantly affect triglycerides, high-density lipoprotein cholesterol, metabolic profiles, or body composition. CONCLUSIONS This meta-analysis highlights the beneficial effects of empagliflozin on liver function and indicates the need for further research on its metabolic effects and long-term outcomes in managing MAFLD.
Effects of Physalis angulata extracts on bleomycin-induced rat: analysis on lung inflammation and fibrosis Wibowo, Suryo Anggoro Kusumo; Rumende, Cleopas Martin; Isbagio, Harry; Setiyono, Agus; Setiabudy, Rianto; Rachmadi, Lisnawati; Kertia, Nyoman
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257875

Abstract

BACKGROUND Scleroderma is an immune-mediated connective tissue disease, with interstitial lung disease as one of its manifestations. Physalis angulata (P. angulata) or ciplukan has shown potential in treating fibrosis, but its role in preventing lung inflammation and fibrosis remains unknown. This study aimed to evaluate the effect of P. angulata extract in a bleomycin (BLM)-induced scleroderma rat. METHODS Sprague-Dawley rats were divided into 6 groups. For lung inflammation prevention, 3 groups received: (1) BLM only, (2) BLM+50 mg/kgBW P. angulata, and (3) BLM+100 mg/kgBW P. angulata. After 14 days, rats were sacrificed and bronchoalveolar lavage (BAL) leukocyte count, interleukin-6 (IL-6) levels, and lung injury score were assessed. For fibrosis prevention, another 3 groups received the same interventions and were sacrificed after 51 days. Fibrosis score, fibrosis area, hydroxyproline, transforming growth factor-beta (TGF-β), and matrix metalloproteinase-13 (MMP-13) levels were analyzed. BLM was administered subcutaneously, while P. angulata was given orally for 14 days. IL-6, TGF-β, and MMP-13 were measured by ELISA and hydroxyproline by colorimetric method. Mean differences and p-values were calculated using appropriate statistical tests. RESULTS P. angulata extract did not prevent lung inflammation, as there were no differences in BAL leukocyte count (p = 0.126), IL-6 levels (p = 0.173), or lung injury scores (p = 0.397) between the BLM-only group and those receiving P. angulata. The extract also did not prevent lung fibrosis, with no differences in fibrosis scores (p = 0.173), fibrosis area (p = 0.359), hydroxyproline (p = 0.295), TGF-β (p = 0.374), or MMP-13 (p = 0.088) levels among groups. CONCLUSIONS P. angulata extract did not prevent the development of lung inflammation or fibrosis.
Effect of matrix metalloproteinase-9 inhibitors in hepatitis B virus replication Kalista, Kemal Fariz; Harimurti, Kuntjoro; Immanuel, Suzanna; Iskandriati, Diah; Lesmana, Cosmas Rinaldi Adithya; Ibrahim, Fera; Gani, Rino Alvani
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257895

Abstract

BACKGROUND Hepatitis B virus (HBV) remains difficult to eradicate due to the persistence of covalently closed circular DNA (cccDNA). Matrix metalloproteinase-9 (MMP-9) enhances HBV replication, but the effects of its inhibition remain unexplored. This study aimed to investigate the effects of MMP-9 inhibitors on HBV replication markers. METHODS Primary hepatocyte cultures were obtained from the livers of 6 Tupaia javanica. Cultures were infected with HBV from human sera and divided into control and intervention groups. The intervention group received MMP-9 inhibitors at 1, 3, and 7 nM. The control group received phosphate-buffered saline. Levels of hepatitis B surface antigen (HBsAg), HBV DNA, cccDNA, MMP-9, interferon alpha and beta receptor subunit 1 (IFNAR1), and interferon beta (IFN-β) were measured in both groups before and 72 hours post-intervention. RESULTS MMP-9 inhibitor administration at 1, 3, and 7 nM consistently reduced HBsAg, HBV DNA, cccDNA, and MMP-9 levels, though not statistically significant. Median HBV DNA levels at 1, 3, and 7 nM were 7.05, 5.29, and 5.98 ×103 copies/ml, respectively. Mean cccDNA levels at 1, 3, and 7 nM were 14.15, 11.04, and 13.94 ×103 copies/ml, respectively. The 3 nM dose increased IFNAR1 levels, while the 7 nM dose increased IFN-β, but neither change was significant. Among the tested doses, 3 nM showed the most favorable effects despite the lack of significance. CONCLUSIONS MMP-9 inhibitor suppressed HBsAg, HBV DNA, cccDNA, and MMP-9 while increasing IFNAR1 and IFN-β in vitro.

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