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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 11 Documents
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Search results for , issue "Vol. 19 No. 3 (2010): August" : 11 Documents clear
A second generation of RT-PCR assay for detection of human immunodeficiency virus type 1 (HIV-1) infection
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.397

Abstract

Aim A spesific and rapid diagnosis such as RT-PCR assay is the most needed to minimize transmission of HIV-1 infection. Therefore, in this study we developed the RT-PCR assay that was spesific against the gag gene of HIV-1. Methods The developed RT-PCR assay was evaluated against 46 specimens that were obtained from voluntary counseling and testing for HIV (VCT) in Rumah Sakit Umum Pemerintah (RSUP) Sanglah, Bali. To get the sensitivity and specificity of RT-PCR assay, the results of assays were compared with the results of commercially serologic teststhat were commonly used in Indonesia. Results The RT-PCR assay could detect 21 of 26 serologic test-positive specimens and showed 19 negative results of 20 serologic test-negative specimens. There was one specimen that was positive in RT-PCR but negative in serologic assay, which might depict a true yield at particular condition when the serologic assay was unable to detect. Five serologic positive-test specimens were negative by RT-PCR that was possibly caused by low detection level of the assay. Conclusion The RT-PCR assay is potential to be used for the detection of HIV-1 infection with a sensitivity and specificity of 80.8% and 95.0% respectively. (Med J Indones 2010;19:154-7)
Demographic characteristics, risk factors and immunocytochemistry of p16INK4a, Ki-67, MCM5, and survivin as predictors for the progress of cervical precancer lesion
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.398

Abstract

Aim To identify the predictive factors and biomarkers in the progression of cervical precancer lesion or Cervical Intraepithelial Neoplasia (CIN). Methods The study was conducted from August 2007 to September 2008. Design of the study was case-control with stratifications of test dose response. The cases were patients with CIN. Control patients were non CIN patients. Bivariate analysis followed by multivariate analysis was conducted. Results There were 130 patients, consisting of 124 CIN patients divided into CIN 1, CIN 2 and CIN 3, with the following numbers of patients: 30, 41, and 33, respectively and 26 patients without CIN (non CIN). Bivariate analysis showed that age < 41 years, education ≥13 years, sexual partner ≥2, first sexual relationship at age < 22 years, smoking, the presence of sexuallly transmitted infections, positive HPV DNA, high p16INK4a, Ki-67, MCM5 and Survivin expression constituted independent variables for the occurrence of CIN with P value of < 0.05. However, on multivariate analysis, independent variables that emerged were age, education ≥13 years, sexual partner ≥2 persons, positive HPV DNA, and over expression of p16INK4a, Ki-67 and Survivin that showed a P value of < 0.005. Conclusion Younger ages, education age ≥13 years, sexual partner ≥2 persons, positive HPV DNA, high p16INK4a, Ki-67 and Survivin expression constituted the risk factors for the occurrence of the progress of CIN, and was used in the equation to predict the progress of cervical precancer lesion. (Med J Indones 2010;19:147-53)
Angiopoietin like protein 3 (Angptl3), fatty acid binding protein 4 (FABP4) and homeostasis model assessment of insulin resistance (HOMA-IR) among Indonesian obese non diabetic males
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.399

Abstract

Aim To reveal the correlation between Angptl3, FABP4 and HOMA-IR among Indonesian obese non diabetic males. Methods This is a cross sectional study with 133 obese non diabetic males volunteers (characterized by waist circumference > 90 cm; fasting blood glucose < 126 mg/dL; and no diabetic specific symptoms) age between 30-60 years which was done in Jakarta, Indonesia. We measured biochemical markers such as Angptl3, FABP4, FFA, fasting insulin and fasting glucose. We also measured weight, height, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Correlation between each marker was measured using Pearson and Spearman's analysis. Results Pearson and Spearman's correlation analysis showed significant positive correlation between Angptl3 and FABP4 (r = 0.319; P = 0.000), Angptl3 and FFA (r = 0.171; r = 0.049), FABP4 and HOMA-IR (r = 0.202; P = 0.019), FFA and FABP4 (r = 0.506; P = 0.000), WC and HOMA-IR (r = 0.323; P = 0.000), WC and FABP4 (r = 0.387; P = 0.000), Body Mass Index (BMI) and HOMA-IR (r = 0.270; P = 0.002), BMI and FABP4 (r = 0.362; P = 0.000). Conclusion This study showed positive significant correlations between Angptl3-FABP4, Angptl3-FFA, FFA-FABP4 and FABP4-HOMA-IR. We suggest that Angptl3 can activate lipolysis in adipose tissue (through its correlation with FABP4), and Angptl3 concentration is related to insulin resistance risk among Indonesian obese non diabetic males. (Med J Indones 2010;19:185-90)
Atrial fibrillation ablation guided with electroanatomical mapping system: A one year follow up
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.400

Abstract

Aim AF is the most common arrhythmia in clinical practice and associated with an increased long-term risk of stroke, heart failure, and all-cause mortality. Catheter ablation of AF is relatively new modality to convert AF to sinus rhythm. This study was aimed to elaborate efficacy of catheter ablation in mixed type of AF. Methods Thirty patients (age of 52 ± 8 yo) comprised of 19 paroxysmal and 11 chronic AF underwent radiofrequency catheter ablation guided by electroanatomical CARTO™ mapping system. We used step wise ablation approach with circumferential pulmonary vein isolation (PVI) as a cornerstone. Additional ablation comprised of roof line, mitral isthmus line, complex fractionated atrial electrogram (CFAE), septal line and coronary sinus ablation was done respectively if indicated. All patients were followed up to 1 year for AF recurrence. Results Circumferential PVI was successfully performed in all patients but one. Average follow up period was 11.5 months. More than 80% of all patients remain in sinus rhythm at the end of follow period which 62% of them were free from any anti-arrhythmic drug. No major complication in all patients series. Conclusion Radiofrequency ablation guided with electroanatomical mapping is effective and safe in mixed type of AF. (Med J Indones 2009;19:172-8)
Percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic cardiomyopathy: Indonesian initial experience
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.401

Abstract

Aim Percutaneous transluminal septal myocardial ablation (PTSMA), a non-surgical intervention to treat hypertrophic cardiomyopathy (HCM), has been a standard treatment in developed countries. However, this procedure not yet systematically performed in Indonesia. This case series aim to study feasibility, safety and efficacy of PTSMA in National Cardiovascular Center Harapan Kita, Jakarta. Methods Three HCM patients (2 male) with dynamic left ventricle outflow tract (LVOT) pressure gradient of higher than 30 mmHg underwent PTSMA. Left ventricle apex pressure was measured using multipurpose catheter and aortic pressure was measured by means of left coronary guiding catheter simultaneously. Target vessel is confirmed by myocardial echocardiography contrast. Two ml absolute alcohol delivered to the target vessel by means over the wire balloon. Immediate pressure gradient changed 10 minute after alcohol administration was recorded. Continuous ECG monitoring is attemted along the procedure. Results All subject demonstrated more than 50% LVOT pressure gradient reduction. One subject experienced transient total AV block and right bundle branch block which completely recovered 6 hours after procedure. In one patient, target vessel must be changed as it gives perfusion to extensive area of right ventricle. Conclusion PTSMA guided with myocardial echocardiography contrast is feasible, safe and effective to reduce LVOT pressure gradient in HCM patient. (Med J Indones 2009;19:164-71)
Pulmonary dysfunction in obese early adolescents
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.402

Abstract

Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree. Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT) to assess FEV1/FVC, FEV1, FVC, V50, and V25. Results 110 subjects fulfilled study criteria, 83 (75.5%) were male and 27 (24.5%) were female with median BMI 26.7 (22.6-54.7) kg/m2; 92 subjects (83.6%) were superobese. History of asthma and allergic rhinitis were found in 32 (29.1%) and 46 (41.8%) subjects, respectively. 64 (58.2%) subjects had abnormal PFT results consisting of restrictive type in 28 (25.5%) subjects, obstructive in 3 (2.7%), and combined type in 33 (30%). Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction. Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%), followed by restrictive (25.5%), and obstructive type (2.7%). There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84)
The association of plasminogen activator inhibitor-1 level with ischemic stroke (preliminary study)
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.403

Abstract

Aim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke. Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago. Results High PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 - 12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 - 58 years old) than in the older subjects (60 - 84 years old) (20% vs. 9.8 %) (p=0.004). Conclusion The result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association. (Med J Indones 2009;19:158-63)
Combine proper exercise and regular taking antihypertensive medicine was better to lower diastolic blood pressure among diastolic prehypertensive and hypertensive subjects
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.404

Abstract

Aim To prove that proper exercise and taking antihypertensive medicine may reduce diastolic blood pressure (DBP) by ≥ 5 mmHg. Method A quasi-experimentation study was done on employees of a government bureau in Jakarta, for 8 weeks from March to August 2008. All prehypertensive and hypertensive subjects were detected through a survey prior to the quasi-experimentation study. A talk was given at the beginning of the quasi-experimentation study, and weekly counseling sessions on exercise, taking medications, and other related topics continued for 8 weeks. Cox regression was used for calculating relative risk. Results A total 1,016 employees out of 1,300 were involved in this blood pressure survey. Of these, 318 subjects had a DBP of 80 mmHg or more. Out of 120 subjects who voluntarily participated, 104 subjects completed the quasi-experimentation study. Compared to those who did not exercise properly and did not take antihypertensive medicines, subjects who did exercise properly and took medicines regularly had a lower diastolic blood pressure DBP ≥5 mmHg by more than 12-fold [adjusted relative risk (RRa) = 12.32; 95% confidence interval (CI) = 0,65-234,54; P = 0.095. However subjects who exercised properly or took antyhypertensive medicines irregularly were found to lower their DBP ≥5 mmHg by almost 11 fold [adjusted relative risk (RRa) = 10.94; 95% confidence interval (CI) = 2.04-58.74]; P = 0.005. Subjects with DBP = 90-99mmHg had a decrease of DBP ≥5 mmHg 4.8 fold (RRa = 4.75; 95% CI = 1.19-18.65) compared to those with DBP = 80-89mmHg. Compared to the normal subjects, the obese, resting pulse rate bradycardia, and high average pulse pressure subjects had less probability of lowering DBP ≥ 5mmHg, by 87%, 90%, and 65%, respectively. Conclusion Combine proper exercise and taking antihypertensive medicine was reduce DBP by ≥5 mmHg among DBP (pre-) hypertensive subjects. The obese, bradycardia, or high pulse pressure subjects failed to lowering their DBP ≥5 mmHg by proper exercise and taking antihypertensive medicine. (Med J Indones 2009;19:191-8)
Diagnostic test of predicted height model in Indonesian elderly: a study in an urban area
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.405

Abstract

Aim In an anthropometric assessment, elderly are frequently unable to measure their height due to mobility and skeletal deformities. An alternative is to use a surrogate value of stature from arm span, knee height, and sitting height. The equations developed for predicting height in Indonesian elderly using these three predictors. The equations put in the nutritional assessment card (NSA) of older people. Before the card which is the first new technology in Indonesia will be applied in the community, it should be tested. The study aimed was to conduct diagnostic test of predicted height model in the card compared to actual height. Methods Model validation towards 400 healthy elderly conducted in Jakarta City with cross-sectional design. The study was the second validation test of the model besides Depok City representing semi urban area which was undertaken as the first study. Result Male elderly had higher mean age, height, weight, arm span, knee height, and sitting height as compared to female elderly. The highest correlation between knee height and standing height was similar in women (r = 0.80; P < 0.001) and men (r = 0.78; P < 0.001), and followed by arm span and sitting height. Knee height had the lowest difference with standing height in men (3.13 cm) and women (2.79 cm). Knee height had the biggest sensitivity (92.2%), and the highest specificity on sitting height (91.2%). Conclusion Stature prediction equation based on knee-height, arm span, and sitting height are applicable for nutritional status assessment in Indonesian elderly. (Med J Indones 2010;19:199-204)
Incretin-based therapies for type 2 diabetes mellitus in Asian patients: Analysis of clinical trials
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.406

Abstract

Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin) for the treatment of type 2 diabetes mellitus in Asian population. Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used. Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian). It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid) compared to the effects observed in studies with Caucasian population, with comparable safety profile. Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12)

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