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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 17 Documents
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Search results for , issue "Vol. 29 No. 3 (2020): September" : 17 Documents clear
Percutaneous atrial septal defect closure in infant weighing
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.192665

Abstract

Percutaneous closure has become a preferred treatment for secundum atrial septal defect (ASD). However, this approach remains challenging in treating small infant weighing <10 kg because of procedure-related complications. The closure of ASD in other congenital anomalies, such as a bilateral superior vena cava (SVC), should be cautiously conducted. A 15-month-old boy with a body weight of 8 kg was diagnosed with secundum ASD (9–11 mm in diameter), residual pulmonary stenosis, and bilateral SVC. Transcatheter closure of ASD was successfully performed by using a 12 mm CeraFlex occluder device (Lifetech Scientific Corporation). Post-procedural examination showed good results without any impingement to the adjacent structure. Therefore,the transcatheter closure of ASD in infant weighing <10 kg and having bilateral SVC is technically feasible and safe.
Surgical site infection after digestive surgery in a single tertiary hospital in Indonesia: six years of data
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.192698

Abstract

BACKGROUND Surgical site infection (SSI) is responsible for increasing cost, morbidity, and mortality related to surgical operations, and has continued to be a significant problem even in hospitals with advanced facilities. This study aimed to describe the SSI among patients after digestive surgery. METHODS From 2012 to 2017, all abdominal surgeries with SSI in Cipto Mangunkusumo Hospital, except obstetrics and gynecology cases, were included in the study. Demographic characteristics, nutritional status, preoperative and intraoperative conditions, wound contamination/SSI type, and mortality data were reported. RESULTS From 4,893 abdominal surgeries during the period, 135 subjects (2.8%) developed SSI with 42.2% of cases were the clean-contaminated type. Most of the cases were males (66.7%), aged between 25–65 years old (80.0%), subjective goal assessment B (46.7%), had normal weight (57.8%), had longer duration of surgery (70.4%), and had preoperative stay between 2–15 days (65.2%). Most of the SSI patients survived (77.8%). CONCLUSIONS Even though the SSI in Cipto Mangunkusumo Hospital was low, it still needs improvement in preoperative care, intraoperative care, and SSI awareness. Therefore, further studies are required to understand how to reduce the incidence, risk, and SSI-related mortality.
Nine-segment laminectomy is safe for the resection of a schwannoma extending from C-2 to T-3: a rare case report
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.192844

Abstract

Cervical spine schwannoma, which is long and entirely intracanal, is rare to be found. Its rarity and atypical feature leads to difficulty in diagnosing and managing cases because of the scarcity of available literature. The surgical removal of this type of schwannomas via multisegment laminectomy is a great challenge because of various risks of postoperative complications. This report describes cervical spine schwannoma that was initially was not suspected as schwannoma and was subject to surgical removal via nine-segment laminectomy. In one year after surgery, motor function returned to normal strength, no new neurological deficits occurred, and no kyphotic deformity, which is a common complication of multisegment laminectomy.
IL-1, IL-6, TNF-α, and MIF in relative adrenal insufficiency in septic shock: a piglet model
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202943

Abstract

BACKGROUND Inflammatory mediators released during septic shock are involved in the mechanism of adrenal insufficiency. This study investigated the role of interleukin (IL)-6, IL-1, tumor necrosis factor (TNF)-α, and macrophage migration inhibitory factor (MIF) in septic shock with relative adrenal insufficiency (RAI). METHODS We conducted a 6-month experimental study in 20 piglets. Following endotoxin administration, their hemodynamics were monitored and blood samples were drawn to test the levels of cytokines IL-1, IL-6, TNF-α, and MIF every 15 min until septic shock onset as well as during a corticotropin stimulation test. Septic shock was managed by administering fluid resuscitation, inotropic drugs, and hydrocortisone. At the end of the study, the piglet models were classified as either RAI or non-RAI. Immunohistochemistry staining was performed on the hypothalamus of the RAI group. RESULTS The level of IL-6 at 45 min was higher in the RAI group than the non-RAI group (p = 0.008), and that of IL-1 was similar in the two groups during septic shock. The RAI group had higher TNF-α levels at 15 min (p = 0.002) and at 30 min (p = 0.007) than the non-RAI group, and the MIF level during septic shock was higher in the RAI group (p = 0.003) than the non-RAI group. CONCLUSIONS Cytokine-induced inflammatory process of adrenal gland reflected in TNF-α level in 15 min and 30 min, IL-6 in 45 min, and MIF in septic shock condition but not in IL-1.
A randomized controlled clinical trial of carbohydrate mix-fortified nutrition in type 2 diabetes mellitus patients
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203398

Abstract

BACKGROUND Liquid meal replacement nutrition (LMRN) contains low glycemic index food (isomaltulose, resistant dextrin, and inulin), which can decrease large blood glucose level fluctuations and reduce food intake. This study aimed to determine the stability of daily blood glucose and the level of appetite sensations after intake of LMRN in type 2 diabetes mellitus (DM) patients. METHODS This randomized, controlled, crossover, and open-labeled study included 30 subjects with type 2 DM. Subjects attended two visit sessions to consume either LMRN or controlled-nutrition solid food (CNSF) for 4 consecutive days. Each subject had 2 days of 24-hour periods of blood glucose measurement using a continuous glucose monitoring system and had a 1-week washout period. Glycemic response (GR) and incremental area under the curve (iAUC) were calculated. The satiety level was measured using a visual analog scale. RESULTS After 48 hours, LMRN reduced GR compared with CNSF with glucose measurements of 13.72 (30.42) and 17.47 (36.38) mg/dl, respectively. The reduction on iAUC after consuming LMRN (36,891 [30,255.8] mg.min/dl) compared with CNSF (40,641 [38,798.9] mg.min/dl) was also noted. Subjects having LMRN felt less hungry and more satiated than those consuming CNSF. The administration of LMRN does not have any serious side effects. CONCLUSIONS LMRN provides a greater reduction of GR and longer term of satiety compared with CNSF without causing any serious side effects.
Infectivity and viability of dengue virus infected hepatocytes cocultured with peripheral blood mononuclear cells from a healthy subject
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203433

Abstract

BACKGROUND Dengue virus (DENV) can infect and replicate in monocytes, resulting in antibody-dependent enhancement. The liver is the main target of DENV, and the infection mechanisms of DENV include direct cytopathic effects (CPEs) of the virus, mitochondrial dysfunction, and effect of cellular and humoral immune factors in the liver. This study was aimed to explore the infectivity of DENV and viability of human hepatocytes using Huh 7it-1 cells cocultured with peripheral blood mononuclear cells (PBMCs). METHODS Huh 7it-1 cells were infected with dengue virus serotype-2 (DENV-2) New Guinea C strain at multiplicity of infection of 0.5 and 1 FFU/cell, and cocultured in vitro with and without adherent PBMCs. The infectivity of DENV was assessed by immunoperoxidase staining. The viability of Huh 7it-1 cells was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT, a tetrazole) assay and trypan blue staining. Data were statistically analyzed by Shapiro–Wilk and analysis of variance for normality significances. RESULTS The result showed that addition of PBMCs to DENV-2 infected Huh 7it-1 cells decreased the infectivity of DENV (15–37%). DENV-2 infection decreased the viability of Huh 7it-1 cells (15.5–20.8%). Despite the decrease in infectivity of DENV, the addition of PBMCs increased the Huh 7it-1 cells viability (4.5–10.2%). CONCLUSIONS Addition of PBMCs to Huh 7it-1 cells that are infected with DENV-2 decreased the infectivity of DENV and increased Huh 7it-1 cells viability.
β-endorphin response to aerobic and anaerobic exercises in Wistar male rats
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203569

Abstract

BACKGROUND Physical exercise is strongly associated with the release of β-endorphin. It is assumed that the type and intensity of physical exercise contributes to the release of β-endorphin. This study aimed to compare levels of β-endorphin in brain tissue in response to aerobic and anaerobic physical exercise. METHODS This study was an experimental laboratory study using 35 male Wistar rats divided into one control group and two physical exercise treatment groups: aerobic and anaerobic. Physical exercise was conducted on an animal treadmill running at aspeed of 20 m/min for 30 min of aerobic exercise and 35 m/min with 1-min intervals every 5 min for 20 min for anaerobic exercises. Each aerobic and anaerobic exercise group was furtherly classified into three subgroups (1×/week, 3×/week, and 7×/week). β-endorphin levels were determined using enzyme-linked immunosorbent assay. The data were analyzed using independent t-test and one-way analysis of variance. RESULTS The highest mean of β-endorphin level was found in the weekly exercise (54.45 [1.41] pg/ml) of aerobic exercise group and daily exercise (70.50 [11.67] pg/ml) of anaerobic exercise group. Mean of β-endorphin level in control group was 33.34 (3.54) pg/ml. A significant increased of β-endorphin mean level (p<0.001) was found in all aerobic and anaerobic exercise groups except the aerobic exercise 7×/week group(37.37 [6.30] pg/ml) compared to control. CONCLUSIONS Both aerobic and anaerobic physical exercise conducted for 6 weeks could increase the level of β-endorphin in brain tissue.
A randomized, controlled, cross-over study of the safety and efficacy of superabsorbent diaper for babies with mild-to-moderate diaper rash
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203630

Abstract

BACKGROUND Super-absorbent diaper is a disposable diaper with new technology which has a soft-airy structure, breathable sheet, and rich absorbent core. This study aimed to compare the safety and efficacy of super-absorbent diaper with standard absorbent diaper. METHODS A single-blinded, randomized, controlled, cross-over study was performed in 3–24 months babies. A safety study was performed in 113 babies without diaper rash (group A: super-absorbent to standard and B: standard to super-absorbent) and efficacy study in 59 babies with mild-to-moderate diaper rash (group C: super-absorbent to standard and D: standard to super-absorbent). Each group used super-absorbent or standard diaper for 2 weeks. Skin assessment scores (SAS) were recorded at baseline, week-2, and week-4. Non-parametric tests were used to analyze the data. RESULTS In the safety study, there was no significant increase of SAS in group A at week-2 and -4, but in group B there was a significant increase of SAS (1.9 to 4.1, p = 0.001) at week-2 with a significant reduction at week-4 (4.1 to 2.2, p<0.001). In the efficacy study, there was a reduction of SAS at week-2 in group C (p = 0.07) and D (p = 0.05). However, SAS increased in group C (6.4 to 8.3, p = 0.2) and decreased in group D (8.6 to 6.1, p = 0.13) at week-4. Super-absorbent diaper showed a significant reduction of SAS in the pubic areas (1.43 to 0.73, p<0.011). CONCLUSIONS The new super-absorbent diaper is safe to use and may have efficacy in the improvement of skin conditions and diaper rash, especially in the pubic areas.
Comparison of complications between transcatheter and surgical ventricle septal defect closure: a single-center cohort study
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203837

Abstract

BACKGROUND Some ventricular septal defects (VSDs) require an interventional procedure for closure. Transcatheter and surgical closures of VSD have similar effectiveness, but transcatheter VSD closure is considered associated with less complication than surgical closure. This study aimed to compare mid-term or long-term complications of transcatheter and surgical VSD closures. METHODS This was a retrospective cohort study compared the complication rates of transcatheter and surgical VSD closures performed in Cipto Mangunkusumo Hospital from January 1, 2010, to April 30, 2017, with 34 subjects in each group. The inclusion criteria were as follows: single lesion outlet perimembranous or doubly committed subarterial VSD, age 2–18 years, body weight >8 kg, and no arrhythmia. Electrocardiography and echocardiography were done to collect primary data. Other data were collected from medical records. Mid-term complications occurred 1–24 months after interventional closure. Long-term complications occurred 24 months after interventional closure. Complications were arrhythmia, valve regurgitation, and residual shunt. Data were analyzed by chi-square test. RESULTS The rate of worsening valve regurgitation was higher in the transcatheter group than in the surgical group (16 versus 11, p = 0.322). The number of patients with residual shunts were similar between the transcatheter group and surgical group (5 versus 5; p = 1.000). Both complications were found in mid- and long-term. Arrhythmia as a long-term complication occurred in five and seven patients in the transcatheter and surgical groups, respectively (p = 0.752). CONCLUSIONS Transcatheter and surgical VSD closures have similar mid or long-term complications.
Sentinel lymph node biopsy for breast cancer using methylene blue: a new anatomical landmark involving intercostobrachial and medial pectoral nodes
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.204008

Abstract

BACKGROUND Sentinel lymph node biopsy (SLNB) using blue dye is becoming popular in Indonesia given that knowledge on new anatomical landmarks involving intercostobrachial and medial pectoral nodes have replaced the need for radioisotope tracers. This study aimed to evaluate the utility of the proposed landmark involving intercostobrachial and medial pectoral nodes to determine axillary lymph node status during SLNB. METHODS A prospective study was conducted involving 55 patients with early-stage breast cancer who had clinically negative lymph nodes (T1–T2, cN0) between 2018 and 2019 at Cipto Mangunkusumo Hospital. During SLNB, methylene blue 1% was injected at the subareolar area to identify intercostobrachial and medial pectoral nodes followed by axillary lymph node dissection (ALND). Histopathological results of sentinel nodes (SNs) were then compared to those of other axillary nodes. RESULTS SNs were identified in 54 patients (98%), 33 (61%) of whom had both intercostobrachial and medial pectoral SNs. Among patients with SNs, there were 1 patient without intercostobrachial SNs, 10 patients without medial pectoral SNs, and 1 patient with medial pectoral SNs but no intercostobrachial SNs. Accordingly, SNs had a negative predictive value (NPV) of 96.77% for axillary metastasis (95% confidence interval = 81.54–99.51), with a false negative rate of 4.7%. No serious adverse events was observed. CONCLUSIONS The high identification rate and NPV, as well as the low false negative rate of the new anatomical landmark involving intercostobrachial and medial pectoral nodes during SLNB, suggest its reliability in determining axillary lymph node status.

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