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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 12 Documents
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Search results for , issue "Vol. 13 No. 3 (2004): July-September" : 12 Documents clear
The influence of lipoprotein(a) on fibrinolytic activity
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.142

Abstract

Lipoprotein(a) is a plasma lipoprotein whose structure and composition are similar with low density lipoprotein (LDL) with an addition of apo(a) that is bound to apo B100. The structure of apo(a) is similar with plasminogen, a proenzym in fibrinolytic system. Due to this similarity, it is assumed that Lp(a) can inhibit plasminogen activity and decreases fibrinolytic activity. The purpose of this study is to prove that addition of Lp(a) to normal plasma can inhibit fibrinolytic activity. Four healthy people whose fibrinogen levels, plasminogen activities and euglobulin clot lysis time were within normal range were enrolled in this study. Fibrinolytic activity were assessed by euglobulin clot lysis time (ECLT). In the first experiment, the addition of Lp(a) was done before centrifugation to obtain euglobulin precipitates, while in the second experiment, Lp(a) was added to the euglobulin precipitates. As a control, ECLT was performed in the plasma with the addition of NaCl 0.9% in the same volume with Lp(a). The results of the study showed that in the first experiment, there was no clot formation. It is assumed that Lp(a) can bind fibrinogen and both of them floated in the supernatant, so there was no fibrinogen in the euglobulin precipitate that can be clotted by thrombin. In the second experiment, the clot did not dissolve until the fourth day. In conclusion, the addition of Lp(a) to normal plasma can inhibit the activity of fibrinolytic system. (Med J Indones 2004; 13: 135-9) Keywords: plasminogen, fibrinogen, apo(a), euglobulin clot lysis time (ECLT)
Pancreaticoduodenectomy for periampullary tumors at Dr. Cipto Mangunkusumo Hospital, Jakarta
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.143

Abstract

We reported our experience on 31 pancreaticoduodenectomy out of 141 periampullary tumors during 1994 until 2002; 16 of them were female, and age average 17-68 years. Jaundice was the most common presenting sign; 14 patients showed plasma albumin lower than 3.5 g/dl, and 10 patients had bilirubin level more than 10 mg/dl. We performed classical Whipple technique in 17, pyloric preserving pancreaticoduodenectomy in 11, and total pancreaticoduodenectomy in 3 patients. The mean of operative time was 436 minutes (290-570 minutes). The patients were grouped into 2 periods, between 1994-1999 and thereafter. With experience, the amount of blood loss has decreased from 2000 ml to 400 ml. Histopathologic results showed adenocarcinoma of the pancreas head in 11, adenocarcinoma of the ampulla of Vater in 11, carcinoma of duodenum in 4, head of pancreas benign cyst in 2, and benign tumor in 3 patients. The surgical mortality was 4 in the first 12 patients, in contrast to only 1 in the last 19 patients. The most serious complication was pancreatic leakage in 14 patients, in 4 of them it was responsible as the cause of death. The length of stay after operation varied between 12 and 47 days. Until the end of this report 7 patients are still alive, and 4 patients lost of contact. Recurrence was detected in 13 out of 22 survivors, occurring between 4 to 24 months after operation and 12 patients died 2-3 months later. Three patients died due to other causes. We conclude that pancreoticoduodenectomy is an effective technique, and the operative mortality is decreasing. Furthermore, morbidity especially from pancreatic leakages can be treated in our hospital. (Med J Indones 2004; 13: 166-70) Keywords: operative outcome, Whipple technique, pancreatic leakage
Ability of prostate specific antigen to predict bone scan result in prostate cancer patients
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.144

Abstract

The objective of this study is to assess the relation between serum prostate specific antigen (PSA), clinical tumor stage, tumor grade, and bone scan result in an attempt to seek the ability of serum PSA to predict bone metastases in newly diagnosed prostate cancer patients. A retrospective analysis was conducted on clinical files of prostate cancer patients which were diagnosed in our institutions between January 1995 and December 2003. Patients on which initial serum PSA were obtained after urethral manipulation or after receiving therapy were excluded. The results of bone scans were related to levels of serum PSA, clinical tumor stage, and tumor grade. Of 103 patients who were included in this investigation, 61 patients (59.2%) had a positive bone scan and 42 patients (40.8%) had a negative bone scan with mean PSA value 471.13 ± 853.34 ng/ml and 61.00 ± 124.47 ng/ml respectively (p < 0.05). The risk of having a positive bone scan increased with advancing serum PSA levels, clinical tumor stage, and tumor grade (p < 0.05). Using receiver operating characteristic curves, PSA had the best correlation with bone scan results (the area under curve was 0.812). Bone scan results were predicted best by the combination of serum PSA, clinical tumor stage, and tumor grade. Bone scans were positive in 5 of 19 patients with PSA level < 10 ng/ml. None of 8 patients with PSA levels < 10 ng/ml, clinical tumor stage T1 or 2 and tumor grade 1 or 2 had a positive bone scan. In conclusion, we suggest that routine bone scan examination may not be necessary in patients with newly diagnosed, untreated prostate cancer, who have serum PSA level < 10 ng/ml with clinical tumor stage T1 or 2 and tumor grade 1 or 2. (Med J Indones 2004; 13: 151-5)Keywords: prostate cancer, bone metastases, tumor grade, tumor stage
Diabetic nephropathy among type 2 diabetes mellitus patients in Dr. Cipto Mangunkusumo Hospital
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.145

Abstract

Diabetic nephropathy has been known as one of the most serious long-term complications of diabetes mellitus (DM), which could lead to end-stage kidney failure. However, data showing the presence of diabetic nephropathy among ambulatory type 2 diabetic patients is currently not available. This cross-sectional study was conducted to find the prevalence of diabetic nephropathy among non-hospitalized type 2 diabetic patients, who came for the first time to the Metabolic and Endocrinology Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta. From December 2001 to June 2002, 100 new type 2 diabetic patients were included in the study. Forty-two of them were men and the mean age was 54 ± 9.6 years. Overt nephropathy (macroalbuminuria) was found in 11% of patients, while incipient nephropathy (microalbuminuria) was 26%, and the rest were normal (normoalbuminuria). Duration of illness of more than 5 years was significantly correlated with the degree of albuminuria. However, there is no significant correlation between the degree of albuminuria and other risk factors, i.e. patient’s age, dyslipidemia, hypertension, obesity, HbA1c level. All patients with overt nephropathy had creatinine clearance test below 75 ml/ min. (mean 45.3 mL/min), significantly lower than patients with micro- or normoalbuminuria (p=0.01). Retinopathy was found in 10 out of 11 (90%) patients with overt nephropathy. Multivariate analysis showed that the duration of illness and retinopathy was significantly correlated with the presence of diabetic nephropathy (p< 0.05). We concluded that the prevalence of diabetic nephropathy (i.e. overt nephropathy with retinopathy) among non-hospitalized type 2 diabetic patients was 10%. The duration of illness was an important risk factor for the development of this complication. (Med J Indones 2004; 13: 161-5) Keywords: diabetic nephropathy, chronic kidney disease, diabetic retinopathy, albuminuria, ambulatory type 2 diabetic patients
Effects of tomato juices (Lycopersicum esculentum Mill) consumption on plasma lycopene levels of male light smokers
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.146

Abstract

The study was an experimental study with pre- and post-test design, to evaluate the effects of tomato juices (Lycopersicum esculentum Mill) consumption on plasma lycopene level. Blood sample of 27 subjects with average age of 34.70 ± 5.74 years old, moderate education level (85.2%), experienced direct contact with working environmental pollutant (40.74%) and smoked kretek cigarettes (77.78%) were given treatment with 350 gram/day of tomato juices (Lycopersicum esculentum Mill) which had been properly prepared for 4 consecutive days. The lycopene plasma level was examined before and after treatment. The findings showed that after treatment, the lycopene plasma level significantly increased. This showed that consumption of properly prepared of tomato juices will increase the lycopene plasma level. (Med J Indones 2004; 13: 146-50) Keywords: light smoker, tomato juices, lycopene plasma
Role of β−lactamase in the susceptibility of clinical isolates to β−lactam antibiotics
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.147

Abstract

Combination of β−lactam antibiotic with β−lactamase inhibitor has been proven to overcome resistance caused by β−lactamase production. An evaluation to the MIC of some β−lactam antibiotics to β−lactamase producing isolates will be reported. A. anitratus, E. coli, K. pneumoniae, Proteus sp, Pseudomonas sp, S. aureus, S. epidermidis, S. pneumoniae, S. viridans, and β−hemolytic Streptococcus, were challenged to Ampicillin/Sulbactam (AMS), Amoxicillin/Clavulanic acid (AMC), Cefoperazone (CFP), Cefoperazone/Sulbactam (CSL), Ceftriaxone (CRO), dan Cefotaxime (CTX) using ETest techniques. β−lactamase production was identified using Cefinase disk. Sixtyfour percent of isolates were capable of producing β−lactamase. All E. coli and K. pneumoniae tested were β−lactamase producer, none of Proteus sp, Pseudomonas sp, and S. epidermidis tested produced β−lactamase. In β−lactamase producing group, Sulbactam was able to reduce resistance to CFP from 25% to 5%. About 20% of β−lactamase producing isolates which were resistant to CFP, were susceptible to CSL. Susceptibility of S.viridans to AMS, AMC, CFP, and CSL was higher than 80%, but less than 50% to CRO and CTX. S. pneumoniae was less susceptible to tested antibiotics, 50 to 60% susceptibility was shown to AMC, CFP, and CSL. S.aureus was 60 to 70% susceptible, while β−haemolytic Streptococcus showed good response to the tested antibiotics. Only 30% or less of K. pneumoniae and E. coli was susceptible to AMS and AMC. A. anitratus showed good susceptibility only to AMS (78%) and CSL (89%). Sixtyfour percent of isolate studied produced β−lactamase. β−lactamase inhibitor could reduce resistance of β−lactamase producing organism to β−lactam antibiotic from 25 to 5 percent. (Med J Indones 2004; 13: 140-5)Keywords: Antibiotic Susceptibility, MIC, β−lactam antibiotic, β−lactamase inhibitor
The use of brain CT Scan in craniocerebral trauma with Glasgow coma scale scores of 13 – 15 in Dr. Cipto Mangunkusumo Hospital 1999-2001
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.148

Abstract

There is still a controversy among the neurologists whether brain CT scan must be performed on the mild head trauma patients. This study was executed to find out the correlation between the brain CT scan image findings and its clinical impairment among the mild head trauma patients with Glasgow coma scale (GCS) score of 13 to 15. The study was a retrospective study by analyzing the uniform medical records of the head trauma patients hospitalized at the Neurology ward of Dr. Cipto Mangunkusumo Hospital within the period of 1999 to 2001. During that period 1,663 patients were hospitalized due to head trauma, and 1,166 of them (70.1 %) were suffered from mild head trauma patients with GCS score of 13-15. Among those with brain CT scan examinations (N: 271), the neurological abnormalities were found on 144 (53.1%) of patients, consisted of cerebral edema (11,4%), intracerebral hemorrhage (5.5%), epidural hemorrhage (16.2%), subdural hemorrhage (18.1%), subarachnoid hemorrhage (5.5%), and combination (13.8%). The further analysis showed that cranial nerves disturbance, amnesia, loss of conciousness for more than 10 minutes, and vomiting are significantly correlated to the brain CT scan abnormality. Combination of the above four clinical signs and symptoms have sensitivity of 90 % in predicting brain insults. This findings may be used as a simple set of clinical criteria for identifying mild head trauma patients who need undergo CT scan examination. (Med J Indones 2004; 13: 156-60) Keywords: mild head injury, brain CT scan
Assessment of antibiotics use after introducing a hospital formulary by ATC/DDD methodology
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.149

Abstract

The objective of this study is to compare the use of antibiotics at the Metropolitan Medical Center Hospital in Jakarta, Indonesia (MMCH), before and after the implementation of a hospital formulary. All antibiotic data under J01 Anatomical Therapeutic Chemical (ATC) classification were collected from pharmacy inpatient and outpatient records. Quantitative antibiotic use was expressed in Defined Daily Doses/100 bed-days (DDDs/hbd) for inpatients and DDDs/1000 patients/day (DDDs/tpd) for outpatients. The general quality of drug use was assessed in number of drugs that account for 90% of the use (DU90%) and the adherence to hospital formulary by substance and brand name within the DU90% segment. Quantitative and qualitative antibiotic use were compared before and after implementation of the formulary (1999 to 2000). The Wilcoxon rank sign test was used to compare overall antibiotic use. Inpatient antibiotic usage decreased significantly by 23.1%, 124.96 DDDs/hbd in 1999 to 96.13 DDDs/hbd during 2000 (p= 0.03) and outpatient antibiotic usage decreased insignificantly by 4.9%, 3.49 DDDs/tpd during 1999 to 3.32 DDDs/tpd during 2000 (p=0.58).The most commonly antibiotic use was ciprofloxacin in inpatient setting during the study and in out-patient setting was amoxicillin in 1999 and ciprofloxacin in 2000. The adherence to the formulary by substance and by brand name in inpatient department was 100% and 90.5% and in outpatient department was 100% and 94.3% during the study. DU 90% by substance name and by brand name was considerably not improved in both settings. The conclusion is that the effectiveness of one year formulary implementation at MMCH was only revealed in inpatient setting. (Med J Indones 2004; 13: 173-9) Keywords: antibiotic use, hospital formulary
The prevalence of orthostatic hypotension and its risk factors among 40 years and above adult population in Indonesia
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.150

Abstract

Factors associated with orthostatic hypotension such as age, drug induced hypotension, hypertension and diabetes mellitus have still been debatable. Most of previous studies were conducted in subjects 65 years or older, only a few were done in subjects from younger to older adults. The purpose of this study is to find the prevalence and predictor factors of orthostatic hypotension among adult population aged 40 years and above in Indonesia. This study is a part of Indonesian Hypertension Epidemiologic Survey. A random sample of 4436 subjects aged 40–94 years was obtained from various municipalities in every big island in Indonesia. Orthostatic testing, assesment of history of medical conditions (diabetes mellitus, stroke, and hypertension), blood pressure measurement and use of anti-hypertensive medications were performed. A stepwise logistic regression was used to determine the significant predictor of orthostatic hypotension. A total of 561 persons (12.6%) experienced orthostatic hypotension. Central α2-agonist and other centrally acting drug is the only anti hypertension medicine which influences orthostatic hypotension. Multivariate analysis showed that high systolic and diastolic blood pressures were predictor factors of orthostatic hypotension. The use of anti-hypertensive medicine was a protective factor for orthostatic hypotension. This study confirms the conclusion that age is not a predictor factor for orthostatic hypotension. In fact, the existence of comorbidities in the subjects such as hypertension (high systolic and diastolic blood pressure) is a predictor factor, while the use of anti-hypertensive medication is a protective factor. (Med J Indones 2004; 13: 180-9) Keywords: adult, orthostatic hypotension, prevalence, risk factor
Genetic variation among dengue virus that possibly correlate with pathogenesis
Medical Journal of Indonesia Vol. 13 No. 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i3.151

Abstract

Dengue disease are reemerging disease and major health concern in tropical and subtropical regions because of the increasing number of patients, expanding endemic areas and increased occurrence of severe clinical manifestation (DHF/DSS) in the last two decades. Despite extensive studies, it is not fully elucidated mechanism by which dengue infection progress to DHF/DSS. Information obtained so far indicates that both host-related factor and virus virulence are involved. Recent studies have shown several structural differences of dengue virus genome between those associated with DF only and those with the potential to cause DHF. That genome differences might be correlated with pathogenesis. (Med J Indones 2004; 13: 190-4) Keywords: dengue virus, virulence factor, pathogenesis

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