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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. 32 No. 2 (2023): June" : 12 Documents clear
Behavioral change readiness among obese adolescents in Jakarta, Indonesia
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236543

Abstract

BACKGROUND Prochaska’s transtheoretical model of behavioral change process, consisting of stages and processes of change, should be monitored to evaluate obesity management, particularly in adolescents. Two of four processes of change are supporting relationships, which promote behavioral change, and weight management actions, which are activities that push individuals to a particular direction in patients’ weight loss progress. This study aimed to determine the participants’ current stages of change, nutritional status, and their relationship with the processes of change. METHODS This cross-sectional study used secondary data collected in 2018 from 115 obese adolescents aged 15–21 years in Jakarta, Indonesia, using an Indonesian-translated and validated questionnaire adapted from Andrés et al’s study. The questionnaire evaluated participants’ processes of change, focusing on scores of supporting relationships (5 items) and weight management actions (10 items). RESULTS Of the participants, 71.3% were classified as obese grade I, and 28.7% were obese grade II. Most participants were in the contemplation (31.3%) and action (31.3%) stages. The mean supporting relationships and weight management actions scores were different between participants with obese I and obese II (66.67 versus 80, p = 0.004; 64.17 versus 70, p = 0.008, respectively). Meanwhile, no differences were identified in supporting relationships and weight management actions scores in all stages of change. CONCLUSIONS Adolescents with obesity and higher BMI (based on the obesity grading of the WHO Asia Pacific) tended to have significantly higher scores for supporting relationships and weight management actions, indicating that external reinforcement and immediate weight loss actions played pivotal roles in readiness for behavioral change.
Accuracy of machine learning models using ultrasound images in prostate cancer diagnosis: a systematic review
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236765

Abstract

BACKGROUND In prostate cancer (PCa) diagnosis, many developed machine learning (ML) models using ultrasound images show good accuracy. This study aimed to analyze the accuracy of neural network ML models in PCa diagnosis using ultrasound images. METHODS The protocol was registered with PROSPERO registration number CRD42021277309. Three reviewers independently conducted a literature search in 5 online databases (PubMed, EBSCO, Proquest, ScienceDirect, and Scopus). We included all cohort, case-control, and cross-sectional studies in English, that used neural networks ML models for PCa diagnosis in humans. Conference/review articles and studies with combination examination with magnetic resonance imaging or had no diagnostic parameters were excluded. RESULTS Of 391 titles and abstracts screened, 9 articles relevant to the study were included. Risk of bias analysis was conducted using the QUADAS-2 tool. Of the 9 articles, 5 used artificial neural networks, 1 used deep learning, 1 used recurrent neural networks, and 2 used convolutional neural networks. The included articles showed a varied area under the curve (AUC) of 0.76–0.98. Factors affecting the accuracy of artificial intelligence (AI) were the AI model, mode and type of transrectal sonography, Gleason grading, and prostate-specific antigen level. CONCLUSIONS The accuracy of neural network ML models in PCa diagnosis using ultrasound images was relatively high, with an AUC value above 0.7. Thus, this modality is promising for PCa diagnosis that can provide instant information for further workup and help doctors decide whether to perform a prostate biopsy.
Quadrigeminal plate arachnoid cyst presenting with eye movement related migraine: a rare case report
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.236858

Abstract

Type II arachnoid cyst of the quadrigeminal cistern is the rarest type of arachnoid cyst (10% prevalence) in adults and is generally asymptomatic. We reported an unusual case of chronic right-sided migraine provoked by right eye adduction, right eye adduction soreness, and dry eye symptoms in a 47-year-old woman with quadrigeminal arachnoid cyst confirmed by radiological findings with the compression of the tectal plate, vermis, and superomedial cerebellum’s part. She was treated conservatively without improvement for 1 year before surgical intervention was conducted. Microsurgery for cyst excision and fenestration was done, followed by immediate relief from all her complaints after 3 months of follow-up. These findings should help clinicians consider surgical intervention for patients with chronic symptoms related to nerve function that have no improvement with the initial treatment.
Diversity of Spa gene between methicillin-resistant and methicillin-sensitive Staphylococcus aureus bacteria in a tertiary referral hospital, Indonesia
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236862

Abstract

BACKGROUND Spa typing is an effective and fast technique to identify the prevalence and spread of Staphylococcus aureus strains based on their spa gene profiles. The distribution of spa types will contribute to control the spread of S. aureus. Little is known regarding the spa types of S. aureus in Indonesia. This study aimed to investigate the diversity of spa gene among S. aureus carriage isolates in North Sumatra Province, Indonesia. METHODS 79 S. aureus isolates consisting of 39 methicillin-resistant S. aureus (MRSA) and 40 methicillin-susceptible S. aureus (MSSA) carriage isolates were identified by VITEK2 Compact (Biomerieux, Indonesia) to detect mecA gene. All samples underwent spa typing and sequencing. RESULTS Spa gene was detected among 31/39 (79%) of the MRSA isolates and 24/40 (60%) of the MSSA isolates. Most spa typing genes were identified between 350 and 400 base pair (bp). t258 and t852 were the most prevalence spa types among MRSA and MSSA isolates, respectively. CONCLUSIONS Many MRSA and MSSA isolates encoded spa gene. The most genes detected were t258 and t852, identified in Germany and Portugal, respectively; while t18977 was initially identified in Malaysia. This indicated a global spread of MRSA according to spa typing.
Prognostic value of neutrophil-to-lymphocyte ratio and fibrinogen levels in ovarian cancer
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236880

Abstract

BACKGROUND High neutrophil-to-lymphocyte ratio (NLR) and fibrinogen levels have been associated with mortality in several malignancies. However, the studies on the association between NLR or fibrinogen levels and ovarian cancer prognosis are inconsistent. This study aimed to investigate the prognostic roles of NLR and fibrinogen in ovarian cancer. METHODS A systematic search of electronic databases was performed to analyze studies on the association of pre-treatment NLR and fibrinogen levels with overall survival (OS) and progression-free survival (PFS) among patients with ovarian cancer. The hazard ratio (HR) and corresponding 95% confidence intervals [CIs] were analyzed. All statistical analyses were done using RevMan version 5.4 (Cochrane, United Kingdom). RESULTS A total of 7,312 patients from 27 studies were included. The median cut-off for high NLR was 3.6 for OS among 17 studies and 3.23 for PFS among 11 studies reporting an NLR HR. The median cut-off for fibrinogen levels was 4.0 in 9 studies reporting fibrinogen levels HR. High NLR was associated with lower OS (HR 1.35, 95% CI 1.18 to 1.55, p<0.0001, I2 = 76%) and PFS (HR 1.35, 95% CI 1.14 to 1.60, p = 0.0005, I2 = 71%). High fibrinogen levels were associated with lower OS (HR 1.44, 95% CI 1.14 to 1.82, p = 0.002, I2 = 81%) and PFS (HR 1.34, 95% CI 1.17 to 1.55, p<0.0001, I2 = 15%). This association occurred in all ovarian cancer types. CONCLUSIONS High pre-treatment NLR and plasma fibrinogen levels were related to poor OS and PFS in ovarian cancer.
Risk of seizure recurrence in children with new-onset afebrile seizure
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236927

Abstract

BACKGROUND A seizure is a brief change in the normal neuronal electrical activity of the brain that causes changes in consciousness, perception, behavior, or movement. This study aimed to evaluate clinical findings, initial electroencephalography (EEG), and brain imaging findings as predictors of seizure recurrence after the first nonfebrile seizure. METHODS This prospective follow-up study was conducted at Azadi Teaching Hospital, Kirkuk from July 2019 to January 2022 and enrolled 150 patients, ranging from 1 month to 15 years of age, who presented with their first afebrile seizure. The seizure types were classified based on the International League Against Epilepsy in 2017. A brain imaging with EEG was performed within 72 hours after admission. RESULTS The median age of the patients was 5 years. A higher risk of seizure recurrence occurred in patients with focal seizure (relative risk [RR] = 6.604) (95% confidence interval [CI] 3.975–10.971), seizure occurrence at sleep (RR = 3.815) (95% CI 2.410–6.039), an abnormal neurological presentation such as Todd’s paralysis (RR = 1.739) (95% CI 1.252–2.415), a positive family history of seizures (RR = 2.333) (95% CI 1.598–3.408), abnormal EEG (RR = 0.171) (95% CI 0.092–0.318), and abnormal brain image findings (RR = 0.681) (95% CI 0.492–0.941) within 72 hours. Seizure recurrence was not correlated with sex. CONCLUSIONS Early and late childhood new-onset afebrile seizures with a positive family history, focal epilepsy, seizure during sleep, prolonged attack duration with frequent attacks within 24 hours, and abnormal initial EEG and brain image had a high risk of seizure recurrence.
Metaverse in Medical Education
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.com.236932

Abstract

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Mutation of PAX3 and MITF genes in a family with type 1 Waardenburg syndrome: a case series
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.236954

Abstract

Waardenburg syndrome (WS) is a rare genetical disorder, characterized with pigmentary abnormalities of the eyes, skin, hair, dystopia canthorum, and sensorineural deafness. In Majene, West Sulawesi, 12 members of a 4-generation family presented manifestations of WS. We examined the presence of mutations in 5 family members with type 1 WS and the other 5 normal phenotype family members to identify mutations of PAX3 and MITF genes. Ophthalmic examination and peripheral blood test were done. Conventional polymerase chain reaction and direct Sanger sequencing were then performed to detect the mutation. 26 mutations of PAX3 gene were only identified in patients with major and minor criteria, including 7 missense mutations (substitutions) and 2 insertions in exons 1, 2, and 6, as well as 17 intronic changes in intron 8. No mutations were detected in MITF gene.
Food-induced brain activity in adult obesity: a quantitative electroencephalographic study
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236974

Abstract

BACKGROUND Obesity may be associated with declined food consumption control through neurological and behavioral processes, as well as heightened responsiveness of the brain’s reward systems. Performing neuroimaging and neurophysiological methods such as electroencephalography (EEG) can examine the connection between brain function and behavior. This study aimed to identify brain regulation of feeding behavior to food cues, which could be a potential neuromodulatory intervention target in adult obesity. METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Jakarta, involving 40 adults with obesity. EEG analysis was performed to measure electrophysiological brain activity during eyes-open condition and during exposure to high-calorie food cues. Student’s t-tests were performed to identify any significant differences between the groups (p<0.05). RESULTS Beta waves in the frontal (channel F7) and gamma waves in the central (channels C3 and C4) and parietal (channels P3 and P4) regions were significantly increased during food cues compared to resting state/eyes-open condition without stimulation. Theta waves in the frontal (channels F7 and F8), central (channel C3), and parietal (channels P3 and P4) regions and alpha waves in the central (channels C3 and C4) and parietal (channels P3 and P4) regions were significantly decreased during food cues compared with resting state. CONCLUSIONS In adults with obesity, increased beta activity in the frontal and gamma in the central and parietal regions suggested increased food-cue awareness and heightened attentional focus toward food stimuli. Additionally, decreased alpha and theta activities in frontal regions could underline deficits in executive functions and higher motivation.
Coagulation factors as potential predictors of COVID-19 patient outcomes
Medical Journal of Indonesia Vol. 32 No. 2 (2023): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236992

Abstract

BACKGROUND Causes of death and length of hospitalization in patients with COVID-19 have been associated with coagulopathy. The coagulopathy mechanism involves the process of coagulation and endothelial damage triggered by an inflammatory response of the SARS-CoV-2 infection due to excessive release of proinflammatory cytokines. This study aimed to determine the association of coagulation factors as potential predictors of COVID-19 patient outcomes. METHODS This retrospective study was performed on 595 patients at Wahidin Sudirohusodo Hospital, Makassar, from June 2020 to June 2021. Participants were recruited using total sampling and assessed for COVID-19 severity using the World Health Organization classification and coagulation factors (D-dimer, fibrinogen, thrombocyte, and prothrombin time [PT]). Patient outcome assessments were survival and length of hospitalization. RESULTS We found a significant sex-based disparity, with a higher COVID-19 incidence in males. Severe cases were more common among those aged >50 years, with prolonged hospitalization (>10 days) linked to higher severity (odds ratio [OR] = 2.22, 95% confidence interval [CI] = 1.31–3.77, p<0.001). Elevated fibrinogen and D-dimer levels, as well as prolonged PT, predicted severe cases. However, D-dimer had the highest influence compared to other coagulation factors (OR = 14.50, 95% CI = 5.85–35.95, p<0.001), while prolonged PT influenced mortality rates (OR = 4.02, 95% CI = 1.35–12.00, p = 0.01). CONCLUSIONS Coagulation factors, such as elevated D-dimer and fibrinogen levels and prolonged PT, predicted the severity of COVID-19 patients leading to death.

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