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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 9 Documents
 1 
Search results for , issue "Vol. 16 No. 1 (2007): January-March" : 9 Documents clear
Patterns of bacterial resistance against Ceftriaxone from 2002 to 2005 in the Clinical Microbiology Laboratory of the Faculty of Medicine, University of Indonesia
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.248

Abstract

The spread of drug resistant microbes is a global public health challenge which impairs the efficacy of antimicrobial agents and causes substantial increase in morbidity and mortality rates, including healthcare-associated costs. Monitoring of antimicrobial drug resistance from documented microbial epidemiology & resistance rate is useful in preventing the emergence of resistance. This study reports on the pattern of bacterial resistance against ceftriaxone in the past 4 years. The data were obtained from specimens examined in the Clinical Microbiology Laboratory, Department of Microbiology Faculty of Medicine, University of Indonesia from 2002 to 2005. Microbial species were determined from culture and identification tests. Disc diffusion method was used for sensitivity testing of ceftriaxone to 14 Gram-negative and 7 Gram-positive bacteria. Although resistance rates were increased from 2002 to 2005, resistance rates of ceftriaxone were found to be less than 50%. Low resistance rates (< 3%) were observed for Salmonella typhi, Salmonella paratyphi A, Shigella flexneri, Serratia marcescens, and Streptococcus pneumoniae. These results could be useful in developing guidelines on the use of ceftriaxone in Indonesia. (Med J Indones 2007; 16:3-6) Keywords: Microbial drug resistance, disc diffusion method, Gram-positive, Gram-negative
Effectiveness of intravenous clarithromycin followed by oral clarithromycin in acute exacerbation of asthma with respiratory tract infection
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.249

Abstract

In addition to its antimicrobial activity, macrolides have an immunomodulatory effect that may be beneficial to patients with asthma. This quasi-experimental study aimed to determine the effect of intravenous clarithromycin followed by oral administration in 37 patients with acute exacerbations asthma caused by respiratory tract infection during January - December 2005. Patients with mild to moderate exacerbations of asthma with respiratory tract infection meeting the inclusion and exclusion criteria were given intravenous clarithromycin 2 x 500 mg/day for not more than 5 days and followed by oral clarithromycin 2 x 500 mg/day for 7 days. Outcome variables were improvement of clinical symptoms according to the asthma exacerbation score and peak expiratory flow rate (PEFR). After 10 days, treatment resulted significant improvement in total asthma exacerbation score and morning PEFR in 35 patients enrolled this project. Based on clinical improvement and laboratory findings, the number of days required for intravenous clarithromycin was less then 3 days for 21 subjects, 3-5 days in 14 subjects. The most common causative pathogens were S. β-haemolyticus and Streptococcus sp. It was concluded that clarithromycin improved clinical symptoms and PEFR in exacerbation of asthma caused by respiratory tract infection. (Med J Indones 2007; 16:7-13) Keywords: Claritromycin, asthma exacerbation, respiratory tract infection
Heart rate turbulence in patients after primary percutaneous coronary intervention and fibrinolytic treatment for acute myocardial infarction
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.250

Abstract

Heart rate turbulence (HRT) as novel predictor of sudden cardiac death were superior to all other presently available indicators. HRT significantly was improves after successful reperfusion reflecting rapid restoration of baroreceptor response. We investigated turbulence onset (TO) and turbulence slope (TS) values among patients with acute ST-elevation myocardial infarction (STEMI) underwent revascularization by means of primary PCI or fibrinolytic. We hypothesized that the values of TO and TS were different in two kinds of revascularization treatment. The subjects underwent 24 hours ECG recording after revascularization therapy. TO was quantified by the relative change of the first two sinus RR intervals following a ventricular premature beat (VPB) and the last two sinus RR intervals before the VPB. TS was quantified by the maximum positive slope of a regression line assessed over any sequence of five subsequent sinus rhythm RR intervals within the first two sinus rhythm intervals after a VPB. Thirteen patients (mean of age 56± 9 years old) who underwent revascularization treatment of acute STEMI were eligible as subject of this study.Ten patients underwent fibrinolytic therapy and three patients underwent primary PCI. TO value was significantly different between PCI group and fibrinolytic group (-3.3± 1.7 % vs -0.2± 0.9 % ; P=0.03). The Primary PCI group has better outcome on turbulence slope value (TS) than fibrinolytic group but not significance (7.7± 4.4 msec/RR interval vs 3.4± 2.6 msec/RR interval; P = 0.056). In conclusion, TO was better in acute STEMI patient undergone PCI compare to that undergone fibrinolytic therapy. (Med J Indones 2007; 16:19-24) Keywords: heart rate turbulence, revascularization, myocardial infarction
The role of transthoracal echocardiography in closing secundum atrial septal defects with Amplatzer Septal Occluder
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.251

Abstract

Transesophageal echocardiography (TEE) under general anesthesia has become a routine procedure as guidance in implanting Amplatzer septal occluder (ASO) for closing secundum atrial septal defects (ASDs) together with fluoroscopy in cardiac catheterization laboratory. To simplify the procedure and reduce the cost, recently we used transthoracal echocardiography (TTE) in guiding the ASO implantation. Aim of this study is to evaluate accuracy and performance of ASO procedure guided by TTE compared to ASO procedure guided by TEE. This is a comparative study. Ninety-one patients with ASDs referred for transcatheter closure with ASO in National Cardiovascular Center Harapan Kita Hospital Jakarta were reviewed. In the 22 patients, TTE were used as guidance instead of TEE. Patients selection were performed in the outpatient clinic by TEE. The stretched diameter was measured by TEE or TTE and fluoroscopy. Patients were divided into two groups, TEE group consisted of procedures guided by TEE, and TTE group guided by TTE. From 91 patients, 83 can be evaluated. It consisted of 61 patients in TEE group and 22 in TTE group. Measurement of defects sizes with TTE and TEE have a high correlation with fluoroscopic measurements (r=0.837 and r=0.853, respectively). There were no significant differences between the accuracy of TTE and TEE sizes measurement (p=0.085) compared to fluoroscopy. Fluoroscopy time in ASO procedures guided by TEE was significantly longer than those guided by TTE (33.2 ± 21.3 min vs. 22.8 ± 19.3 min, P=0.014). There was also no significant differences in the failure of devices implantation between TEE and TTE guidance. All patients were in good condition at follow-up. ASO procedures guided by TTE have similar accuracy to those guided by TEE, with shorter fluoroscopy time. TTE guidance also has no difference in failure rate compared to TEE guidance. (Med J Indones 2007; 16:14-8) Keywords: amplatzer septal occluder, secundum atrial septal defect, transthoral echocardiography
Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.252

Abstract

A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques) and six months (for ECCE only). Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14), quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72) and for PEA is USD 528 (± USD 125). VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001). However, there was no significant difference between them (p = 0.225). This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31) Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14
Lessons learned from health and fitness prescription: a Malaysian experience
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.253

Abstract

Proportion of chronic diseases sufferers are increased by age. The usual control measures are therapeutic prescription and clinical counseling. However, its low compliance rate has interfered this effort. Therefore, community intervention can be a suitable prescriptive option to provide a long lasting effect. For that, a package of community intervention has been established in one sub-urban area in Malaysia to observe its acceptability, thus it can be acted as a social instrumentation to bring both biological and social benefits to this group of community. This study used quasi-experimental design on a cohort of elderly citizen aged 45 and above. Respondents are exposed to a mixed and planned prescribed fitness activity using participatory approach. Process involved in program implementation is closely observed both quantitatively and qualitatively. Community participation occurred in a positive and fast mode, with 78% being the elderly people aged above 45 years old. Initial observation revealed that about 47.6% suffering hypertension, while 38.4% hypercholesterolemia, 16.8% obese and 7.1% diabetes mellitus. Physically active members were moderate - about 31.0%. In term of process, participatory approach seems to be very effective to mobilize community towards health and fitness. A planned community fitness program is a form of social instrumentation to bring biological and social benefits to chronic diseases sufferers. It has also useful to promote favorable lifestyle and quality of life of this group of people. (Med J Indones 2007; 16:39-46) Keywords: community intervention, community participation, fitness program, disease burden
Malaria in Jayapura District, Papua Province, Indonesia and resistance to sulfadoxine-pyrimethamine
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.254

Abstract

Malaria poses a major public health problem in Papua. The rapid spread of drug-resistant parasites and deterioration of the malaria control program following the monetary crisis and civil strife in the late 90'es have worsened the malaria situation in many areas of Papua. To re-assess the current magnitude of malaria problem, a malariometric survey was conducted in three sub-districts of Jayapura District, as well as antimalarial drug sensitivity test using sulfadoxine-pyrimethamine (SP) at the outpatient clinics of Abepura General Hospital (RSU), Hamadi Primary Health Center and Panti Asuhan Katolik Clinics, Sentani, Jayapura District, Papua Province. Screening of 543 subjects in three sub-districts revealed 185 malaria positive subjects, either with P. falciparum, P. vivax or mixed of the two species. All of the malaria cases were asymptomatic. In the SP drug sensitivity test, of the 56 subjects involved, 32 were classified as early treatment failure and two subjects were classified as late treatment failure. The remaining 22 subjects were classified as adequate clinical and parasitological response (ACPR). These results indicated that the surveyed area has a high malaria prevalence and treatment failure to SP and therefore alert to the need of deploying new antimalarial regiment that suit the remote setting. (Med J Indones 2007; 16:32-8) Keywords: malaria, sulfadoxine-pyrimethamine (SP) resistance, Jayapura District, Indonesia
Breast Cancer Management: Present Scenario
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.255

Abstract

The treatment management of breast cancer is perhaps the most controversial of all and has evolved a sea change over the years. Contrast enhanced MRI imaging is emerging as the most efficient imaging diagnostic tool. Newer approaches for the biopsy of inoperable breast cancer are aimed at obtaining diagnostically adequate tissue samples while minimizing invasiveness and the risk of complications. The regional vigour that Halsted followed rigorously, albeit, achieved significant locoregional control, could not lead to improved long-term survival. With the passage of time, people have understood the systemic nature of the disease and the paramount need to incorporate systemic treatment even in relatively earlier stages and curtain surgical ablative techniques. The role of primary systemic therapy in the management of breast cancer is fast emerging as a vital option. In HER 2/neu gene overexpressed patients, addition of trastuzumab to the systemic treatment is a distinct improvement in overall survival. (Med J Indones 2007; 16:55-60) Keywords: breast cancer, tumour, chemotherapy, radiotherapy, systemic therapy
Gout: Diagnosis and management
Medical Journal of Indonesia Vol. 16 No. 1 (2007): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i1.256

Abstract

Goutis a heterogeneous group of diseases resulting from monosodium urate (MSU) crystal deposition in tissues or from supersaturation of uric acid in extracellular fluids. Clinical manifestations include 1) Recurrent attacks of articular and periarticular inflammation, also called gouty arthritis; 2) Accumulation of articular, osseous, soft tissue, and cartilaginous crystalline deposits, called tophi; 3) Uric acid calculi in the urinary tract; and 4) Interstitial nephropathy with renal function impairment, called gouty nephropathy. Gout predominantly is a disease of adult men, with a peak incidence in the fifth decade. In women usually found after menopause.The metabolic disorder underlying gout is hyperuricaemia. The duration and magnitude of hyperuricemia directly correlate with the likelihood of developing gouty arthritis and uric acid urolithiasis, and with age at onset of initial clinical gouty manifestations. The urate crystals induce phagocytes and synovial cells to generate and release such mediators as cyclooxygenase and lipoxygenase metabolites of arachidonic acid, phospholipase A2-activating protein, lysosomal proteases, tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, and IL-8. Definitive diagnosis of gout needs the demonstration of MSU crystals in synovial fluid or tophus. Gout is frequently associated with comorbidity such as obesity, hypertension, renal disease and dyslipidaemia. Therapeutic goals include terminating acute attacks; providing rapid, safe relief of pain and inflammation; averting future attacks; and preventing such complications as formation of tophi, kidney stones, and destructive arthropathy. Colchicine, nonsteroidal anti-inflammatory drugs and corticosteroid are drugs used for treating acute gouty arthritis. Colchicine is also used for prophylaxis. Urate lowering drugs also play a role in prophylactic management of gout. With early intervention, careful monitoring, and patient education, the prognosis is excellent. (Med J Indones 2007; 16:47-54) Keywords: Hyperuricemia, tophus, arthritis, inflammatory mediators, dietary and lifestyle, urate lowering drugs

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