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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 21 Documents
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Search results for , issue "Vol. 29 No. 2 (2020): June" : 21 Documents clear
A case series of eight scoliosis patients undergone pedicle screw placement with freehand technique: study for safety and accuracy
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.191978

Abstract

BACKGROUND Pedicle screws and rods are routinely inserted in the vertebrae thoracic to lumbar in scoliosis reconstruction surgery to gain deformity correction and fusion. Intraoperative imaging is often needed to ensure accuracy, but surgical time will be longer and there will be more radiation exposure. Meanwhile, freehand technique is accepted as safe. This study was aimed to evaluate the accuracy of screw insertion in the freehand technique used in adolescent scoliosis surgery. METHODS This case series evaluated a total of 127 pedicle screws inserted using the freehand technique in 8 out of 28 adolescent scoliosis patients from 2011 to 2016 whom agreed for computed tomography (CT) scan follow-up from 2011 to 2016 in Dr. Seotomo Hospital, Surabaya. The accuracy and safety of the freehand technique were evaluated postoperatively in each patient using a CT scan. A successful screw was considered accurate if it was within the vertebral body and inside the safety zone (within the limit of 2–4 mm to the medial or lateral side of the vertebral body. RESULTS Of the 127 screws inserted, 106 (83.5%) were accurately placed, and 110 (86.6%) were within the safe zone. According to the level of the spine, in the upper and middle thoracic spine, the inserted screws were accurate in 69.4% and 74.9% within the safety zone, whereas in the lower thoracic and lumbar spine, 94.0% and 95.0% within the safety zone. CONCLUSIONS The freehand technique in scoliosis reconstructive surgery performed by experienced surgeons is accurate and safe.
Neutrophil-to-lymphocyte ratio for predictor of in-hospital mortality in ST-segment elevation myocardial infarction: a meta-analysis
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202795

Abstract

BACKGROUND ST-segment elevation myocardial infarction (STEMI) is the most life-threatening condition of acute coronary syndrome that carries a poor prognosis of in-hospital mortality. Multiple scoring systems have been developed to predict in-hospital mortality and other cardiovascular events. Neutrophil-to-lymphocyte ratio (NLR) is hardly used as a predictor of in-hospital mortality. This study was aimed to determine the predictive value of NLR concerning in-hospital mortality in STEMI patients. METHODS Literature search and pooled analysis related to studies on MEDLINE/PubMed, EBSCO, Science Direct, Cochrane, and ProQuest were retrieved. Inclusion criteria were met if they were cohort studies, the subjects were STEMI patient, contained pretreatment NLR cut-off, and considered in-hospital mortality, which is defined as cardiac or all-cause mortality. Quality assessment was conducted using Newcastle-Ottawa scale. Review Manager version 5.3 (The Nordic Cochrane Centre, Copenhagen) was used for meta-analysis. RESULTS We found 12 studies with a total of 7,251 STEMI subjects with median NLR cut-off value of 5.6. Elevated NLR on admission carries a high risk of in-hospital mortality (odds ratio [OR] = 3.00, 95% confidence interval [CI] = 2.46–3.67). A slightly higher risk of all-cause mortality (OR = 2.74, 95% CI = 1.99–3.77) was observed compared with cardiac-related mortality (OR = 3.20, 95% CI = 2.47–4.14). No significant heterogeneity was observed between these studies (p = 0.46, I2 = 0%). CONCLUSIONS Elevated NLR predicts a higher in-hospital mortality rate of STEMI patients.
Optimization of the apolipoprotein B mRNA editing enzyme catalytic polypeptidelike-3G (APOBEC3G) gene to enhance its expression in Escherichia coli
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202853

Abstract

BACKGROUND Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like-3G (APOBEC3G) can abolish HIV infection by inducing lethal mutations in the HIV genome. The HIV protein virion infectivity factor (Vif) can interact with APOBEC3G protein and cause its degradation. Development of a method that can screen substances inhibiting the APOBEC3G-Vif interaction is necessary for identification of substances that potentially used in anti-HIV drug development. In order to increase expression of recombinant APOBEC3G protein that will be used in APOBEC3G-Vif interaction assay, we developed an optimized APOBEC3G gene for expression in Escherichia coli. METHODS The gene coding APOBEC3G was codon-optimized in accordance with prokaryotic codon using DNA 2.0 software to avoid bias codons that could inhibit its expression. The APOBEC3G gene was synthesized and sub-cloned into pQE80L plasmid vector. pQE80L containing APOBEC3G was screened by polymerase chain reaction, enzyme restriction, and sequencing to verify its DNA sequence. The recombinant APOBEC3G was expressed in E. coli under isopropyl-β-D-thiogalactoside (IPTG) induction and purified by using nickel-nitrilotriacetic acid (Ni-NTA) resin. RESULTS The synthetic gene coding APOBEC3G was successfully cloned into the pQE80L vector and could be expressed abundantly in E. coli BL21 in the presence of IPTG. CONCLUSIONS Recombinant APOBEC3G is robustly expressed in E. coli BL21, and the APOBEC3G protein could be purified by using Ni-NTA. The molecular weight of the recombinant APOBEC3G produced is smaller than the expected value. However, the protein is predicted to be able to interact with Vif because this interaction is determined by a specific domain located on the N-terminal of APOBEC3G.
Milk protein consumption improves muscle performance and total antioxidant status in young soccer athletes: a randomized controlled trial
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202872

Abstract

BACKGROUND Muscle performance and antioxidant balance are closely related to an athlete achievement. Milk proteins (whey and casein) contain essential and non-essential amino acids, which benefit muscle performance through increased antioxidant levels. This study was aimed to evaluate the effects of milk protein on muscle performance and total antioxidant status (TAS) in soccer athletes. METHODS A randomized controlled trial was conducted on 20 males 16- to 18-year-old athletes at the Central Java Soccer Club in January 2018. For 28 days, the treatment group received 24 g/d of milk protein and the control group received 24 g/d of maltodextrin. Muscle performance was measured through a 20-m sprint, shuttle run, Illinois run, standing broad jump, sit-ups, push-ups, sit-and-reach test, and one-repetition maximum (1RM) leg extension. TAS was analyzed using the 2,2-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) method. RESULTS The treatment group had a decreased shuttle run time (-0.16 [0.11] versus 0.08 [0.14] sec), greater increase in sit-ups (6.80 [2.57] versus 1.10 [2.84] times/60 sec), greater increase in push-ups (2.40 [1.78] versus 0.30 [1.77] times/60 sec), and greater increase in 1RM leg extension (32.00 [13.78] versus 3.50 [13.75] kg). After adjustments for age, energy intake, carbohydrates, and pre-interventional performance, these parameters remained significantly improved after the intervention of milk protein. The TAS increase was greater in the treatment group than in the control group (0.36 [0.32] versus -0.12 [0.20] mmol/l) before and after adjustment for age, vitamin C, iron, selenium intake, and TAS pre-treatment. CONCLUSIONS Milk protein supplementation for 28 days increased muscle performance and TAS.
Vitamin D₃ levels in the maternal serum, cord blood, and placenta of preeclamptic pregnant women
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202951

Abstract

BACKGROUND Preeclampsia is affected by oxidative stress, a free-radical produced as a by-product of endothelial damage, and antioxidant imbalance, such as vitamin D₃. This study was aimed to compare the vitamin D₃ levels in the placenta, cord blood, and maternal serum between patients with and without preeclampsia. METHODS This cross-sectional study included 86 patients from Cipto Mangunkusumo Hospital and Tangerang District Hospital, in which 47 had preeclampsia (13 early-onset and 16 late-onset preeclampsia cases) and 39 had no preeclampsia. The placenta, cord blood, and maternal serum were taken after labor, then were analyzed according to preeclampsia and non-preeclampsia; furthermore, the preeclampsia group was analyzed in a subgroup of early- and late-onset preeclampsia. This is analyzed with either unpaired t-test, Mann–Whitney U test, or Kruskal–Wallis test. RESULTS The maternal serum, cord blood, and placental tissue vitamin D₃ levels (16.30 [6.20–49.00], 11.80 [3.50–38.60], and 49.00 [22.00–411.00] ng/ml, respectively) of the preeclampsia group were similar to those of the non-preeclampsia group (13.50 [4.80–29.20], 11.70 [1.00–28.80], and 43.40 [11.80–153.00] ng/ml, respectively) (p = 0.459, 0.964, and 0.354, respectively). However, the placental tissue vitamin D₃ levels in early-onset preeclampsia (79.00 [36.00–411.00] ng/ml) were higher than those in late-onset preeclampsia (40.00 [22.00–171.00] ng/ml) (p = 0.006). CONCLUSIONS The vitamin D₃ levels between patients with and without preeclampsia were similar. However, the placental tissue vitamin D₃ levels in early-onset preeclampsia were higher than those in late-onset preeclampsia, possibly because of the different pathophysiology between early- and late-onset preeclampsia.
Cytotoxic effect of natural cuttlefish bone xenograft: an in vitro and in vivo study
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203141

Abstract

BACKGROUND Commercialized synthetic bone grafts are commonly used to replace the bone defect. Cuttlefish bone is naturally available and widely studied, but the specific cytotoxicity test has not been conducted. This study aimed to evaluate the cytotoxicity of the xenograft compared to commercial grafts. METHODS We performed an in vitro test evaluating the viability of human mesenchymal stem cells (hMSCs) when cultured for 48 hours with the tested materials (cuttlefish bone graft and fabricated PerOssal®). The trypsinized mitochondrial activity of the viable hMSC was assayed based on colorimetry of the formazan color change. The tested material was considered nontoxic if >70% of the hMSCs were viable. The in vivo cytotoxic effect was evaluated by implanting the graft material in the femoral muscle of New Zealand (NZ) white rabbits. Nine rabbits were used in each test (cuttlefish bone, PerOssal®, and NaCl 0.9%). The systemic acute pyrogenic effect was evaluated based on 72 hours body weight changes and rectal temperature changes every 30 min in the first 3 hours and 72 hours post-implantation. RESULTSThe mean percentage of hMSC viability when cultured with cuttlefish bone graft and PerOssal® was comparable (93.47% and 105.37%, respectively, p = 0.240). The in vivo cytotoxicity on NZ rabbit was similar between all tested materials, as shown by the minor changes in body weight (<10% body weight, p = 0.391) and rectal temperature (<0.5°C, p = 0.127). CONCLUSIONS Cuttlefish bone xenograft and fabricated PerOssal® have a similar non-cytotoxic effects on hMSCs and non-pyrogenic systemic effects on rabbits.
Improving a long-acting reversible contraception usage by understanding client perspectives
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203149

Abstract

BACKGROUND Despite the limited use of long-acting reversible contraception (LARC) in Indonesia, they have proven to be cost-effective in family planning programs. This study was aimed to identify the elements of ideas and views that people hold and their association with the use of LARC (intrauterine devices and implants) as a means of improving its utilization in Nusa Tenggara Barat (NTB) Province, Indonesia. METHODS Data were derived from the Improving Contraceptive Mix Methods survey of 6,384 respondents in Bima District, Central Lombok, and North Lombok, NTB Province, in 2015. Confirmatory factor analysis was used to identify suitable elements of 19 variables and generate three ideation elements on attitude, knowledge, and interpersonal communication. Subsequently, the association of three ideation elements with LARC use in NTB was examined. RESULTS Multivariate analysis revealed that LARC use was higher among women with a positive attitude toward LARC and high frequency of interpersonal communication. Women with positive attitudes had 7 times greater odds of using LARC than women with negative attitudes (adjusted odds ratio [aOR] = 7.18; 95% confidence interval [CI] = 6.09–8.55). Women with a high frequency of interpersonal communication were 2.4 times more likely to use LARC than women with low communication frequency (aOR = 2.40; 95% CI = 1.94–2.99). CONCLUSIONS To increase the use of LARC in NTB, family planning programs should not only focus on improving women’s knowledge but also prioritizing the promotion of positive attitudes toward LARC and facilitating interpersonal communication.
Percutaneous atrial septal defect closure using transesophageal echocardiography without fluoroscopy in a pregnant woman: a case report
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.193161

Abstract

Transcatheter closure is the treatment of choice for atrial septal defect (ASD); it has good efficacy and minimal complications. However, this approach in a pregnant woman is limited due to the risk of radiation exposure. A novel fluoroscopy-free technique has been introduced to reduce x-ray exposure. This case reported the experience of an ASD transcatheter closure in a pregnant woman without fluoroscopy guidance. To the best of our knowledge, this is the first successful fluoroscopy-free technique for transcatheter closure in Indonesia. The case is a 26-year-old primigravida at 26 weeks gestational age with secundum ASD and pulmonary hypertension. Transcatheter closure was successfully performed with a Cera ASD occluder (Lifetech Scientific Corporation, China) no. 28 mm guided by transesophageal echocardiography. During the procedure, transient supraventricular tachycardia was developed. There were no other major or minor periprocedural complications. ASD transcatheter closure in a pregnant woman without fluoroscopy is feasible, safe, and effective.
Causes of mortality in a neonatal intensive care unit in Iran: one year data
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203449

Abstract

BACKGROUND Neonatal mortality rate is a major health index. Approximately, 65% of all deaths in the first year of life occur during this 4-week period. The present study was conducted to investigate the mortality rates and causes of death in a neonatal intensive care unit (NICU) in Ahvaz, Iran in a year. METHODS This cross-sectional study was conducted in the NICU of Sina Hospital in Ahvaz. Medical records were studied, and data from 1,040 newborns admitted to the NICU within one year (March 2016 to March 2017) were collected following a checklist. Of these newborns, 123 died, and their relevant data were collected. Data were analyzed using SPSS, version 20 (SPSS Inc., USA). RESULTS The mortality rate was 11.82% (123 cases) out of 1,040 newborns admitted to NICU. Most of the newborns (48.8%) died on days 1–7. The causes of death were respiratory distress syndrome (RDS) (34.1%), asphyxia (25.2%), anomalies (10.6%), sepsis (7.3%), intracerebral hemorrhage (8.1%), pulmonary hemorrhage (7.3%), and other causes (6.4%), such as hydrops, severe pneumothorax, severe renal failure, and others. CONCLUSIONS The mortality rate in the NICU of this center was similar to that in other Iranian provinces. The most common causes of NICU mortality included prematurity and its complications, such as asphyxia and RDS. Thus, a strategic plan for reducing preterm delivery and asphyxia are necessary.
Cybersex addiction: an overview of the development and treatment of a newly emerging disorder
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.rev.203464

Abstract

Cybersex addiction is a non-substance related addiction that involves online sexual activity on the internet. Nowadays, various kinds of things related to sex or pornography are easily accessible through internet media. In Indonesia, sexuality is usually assumed taboo but most young people have been exposed to pornography. It can lead to an addiction with many negative effects on users, such as relationships, money, and psychiatric problems like major depression and anxiety disorders. A few instruments may be used to detect cybersex behavior. This review was aimed to provide a comprehensive discussion about cybersex addiction in Indonesian society and the importance of its screening for this condition to enable its early detection and subsequent management.

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