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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 12 Documents
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Search results for , issue "Vol. 34 No. 1 (2025): March" : 12 Documents clear
Reproductive function after radioactive iodine treatment for differentiated thyroid carcinoma patients: a systematic review Elliyanti, Aisyah; Aziza, Zulva; Kurniawati, Yulia; Khambri, Daan; Amir, Arni; Katar, Yusticia
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257458

Abstract

BACKGROUND Thyroid cancer is one of the most prevalent cancers in the endocrine system, with a rapidly rising incidence over the past 3 decades. Treatment for patients with differentiated thyroid cancer (DTC) typically includes surgery, radioactive iodine (I-131) therapy, and levothyroxine (L-T4) suppressive therapy. This study aimed to explore the potential side effects of I-131 therapy on reproductive function in men and women with DTC. METHODS A literature search was performed using 4 databases (PubMed, ScienceDirect, BioMed Central, and Google Scholar), limited to English publications since 2013. Clinical trials and observational studies that evaluated I-131 in DTC, focused on reproductive-age patients, and included pre-therapy or during-therapy examinations, administered doses, and treatment frequencies of I-131 were selected. The Joanna Briggs Institute Critical Appraisal Checklist is used as a comprehensive evaluation tool, and the literature quality was categorized as high, moderate, and low. RESULTS The final 17 articles examined the effect of I-131, with 13 focusing on women's reproductive function and 4 on men's. Women who received I-131 therapy can lower anti-Mullerian hormone levels and disrupt menstrual cycles within the first year, and it does not affect subsequent pregnancies. For men, the therapy led to elevated levels of follicle-stimulating hormone and luteinizing hormone, along with changes in sperm quantity, morphology, and motility, which tend to normalize within a year post-therapy. CONCLUSIONS The reproductive side effects associated with I-131 therapy are generally transient, with most individuals experiencing a return to normal within 1 year following treatment.
Effects of lung recruitment maneuver using mechanical ventilator in preterm infant microcirculation: a clinical trial Iskandar, Adhi Teguh Perma; Djer, Mulyadi Muhammad; Supriyatno, Bambang; Kaban, Risma Kerina; Kautsar, Ahmad; Rahmadhany, Anisa; Sutjipto, Fiolita Indranita; Suhendro; Advani, Najib; Santoso, Dewi Irawati Soeria; Prihartono, Joedo; Yuniati, Tetty
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247472

Abstract

BACKGROUND Preterm infants often require continuous positive airway pressure due to immature respiratory tracts. Bronchopulmonary dysplasia (BPD) manifests as prolonged oxygen dependence until 28 days of age and is classified into mild, moderate, or severe forms. The lung recruitment maneuver (LRM) aims to reopen collapsed alveoli, enhancing oxygenation during mechanical ventilation using the assist control volume guarantee mode (MV-AC/VG). This study aimed to evaluate the impact of LRM on alveolar and endothelial injuries, neonatal microcirculation, and its relation to BPD reduction or mortality in preterm infants. METHODS This study was conducted from March 2021 to April 2022 at Cipto Mangunkusumo and Bunda Menteng Hospitals, Jakarta. The participants are <32 weeks infants with severe respiratory distress syndrome requiring MV-AC/VG, divided into LRM and control groups (n = 55 each). The alveolar injury was assessed using plasma surfactant protein-D (SP-D), endothelial injury by flow cytometry for endothelial microparticles (CD-31⁺/CD-42-), and neonatal microcirculation via transcutaneous-artery CO2 gap (TcPCO₂-PaCO₂) and transcutaneous O2 index (TcPO₂/PaO₂) measurements at 1 and 72 hours post-ventilation. RESULTS LRM did not negatively affect preterm infants (24–32 weeks) undergoing invasive mechanical ventilation. At 72 hours, no significant differences were observed in alveolar (SP-D) and endothelial injury (CD-31+/CD-42-), nor in BPD reduction or mortality by 36 weeks. CONCLUSIONS LRM is a beneficial intervention for enhancing respiratory support and microcirculation in preterm infants. Among survivors, LRM reduced the time to achieve the lowest FiO2 (60.0 versus 435.0 hours, p<0.0001), shortened respiratory support duration (25.0 versus 36.83 days, p = 0.044), and improved TcO2 index (1.00 versus 1.00, p = 0.009).
Safety and immunogenicity of the CoV2-Bio in a healthy population aged 18 years and older in Indonesia Maria, Suzy; Olfriani, Ciho; Koesnoe, Sukamto; Sekartini, Rini; Soedjatmiko; Medise, Bernie Endyarni; Yuniar, Irene; Indawati, Wahyuni; Wirahmadi, Angga; Sari, Rini Mulia; Adi, Nuri Purwito; Retnaningdyah, Windri
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247476

Abstract

BACKGROUND According to the WHO Target Product Profiles for COVID-19 Vaccines, vaccine development should be indicated for active immunization in all populations, in conjunction with other control measures to curtail the pandemic. Several RBD-based COVID-19 vaccines are being evaluated and have shown advantages. CoV2-Bio was developed based on the wild-type SARS-CoV-2 RBD amino acid sequence, representing residues of the spike protein of the Wuhan-Hu-1 isolate. This study aimed to evaluate the safety and immunogenicity of CoV2-Bio when compared to CoronaVac. METHODS This was an observer-blinded, randomized controlled prospective study of safety and immunogenicity of the CoV2-Bio in healthy adult population. A total of 54 healthy participants were randomized to receive either 3 doses of CoV2-Bio or 2 doses of CoronaVac, and 1 dose of placebo, administered 28 days apart. Participants were followed up for safety and immunogenicity. IgG antibody titers (ELISA) and neutralization assay against Wuhan and Delta strains were evaluated at baseline, Days 28, 56, and 84. We assessed seropositive rate, seroconversion, and GMT as parameters. RESULTS Both vaccines were well tolerated and induced good antibody response. The incidence rate and intensity of local and systemic adverse events did not differ between vaccine and control groups. The vaccine group showed a larger proportion of seroconversion (4-fold increase antibody) (87.5% versus 46.2%, p = 0.001) and higher GMT (305.9 AU/ml versus 102.4 AU/ml, p<0.001) when compared to control group. CONCLUSIONS 3 doses of the CoV2-Bio are safe and immunogenic in healthy adult population. 3 doses of the CoV2-Bio COVID-19 vaccine produce a better immunogenicity profile compared to CoronaVac.
Subcutaneous emphysema: an indirect sign of anastomotic leak in cecal volvulus Hoe, Vee Chuan; Kong, Shu Ning; Gilbert, Peh Voon Yeow; Razi, Muhammad Amirrul Nizam; Sibin, Rohamini; Hayati, Firdaus
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.247507

Abstract

Cecal volvulus (CV) is a rare cause of intestinal obstruction. A 22-year-old man with cerebral palsy presented with intestinal obstruction symptoms for 2 days. Abdominal computed tomography (CT) revealed a severely dilated cecum, confirmed as CV, during exploratory laparotomy. A right hemicolectomy with primary anastomosis was performed due to an unhealthy cecum. However, his postoperative recovery was stormy as he developed right flank subcutaneous emphysema, but the surgical drain was empty. Follow-up CT showed no extravasation of oral contrast from the lumen, but a relaparotomy noticed a small leak at the posterolateral aspect of the anastomosis, which was reinforced. He recovered well and was discharged 5 days after the relaparotomy. In conclusion, despite being uncommon, subcutaneous emphysema can become an indirect sign of an anastomotic leak even in a negative CT scan.
Comparing anastomosis techniques on ischemia time in multi-arterial kidney grafts: a systematic review and meta-analysis Hernawan Rahmat Muharia, Bayu; Situmorang, Gerhard Reinaldi; Rasyid, Nur; Rodjani, Arry; Birowo, Ponco
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257527

Abstract

BACKGROUND Kidney transplants with multiple renal arteries (MRAs) address donor shortages but carry higher vascular risks than single renal arteries. This study aimed to evaluate how different anastomosis techniques affect outcomes in kidney transplants with MRAs through meta-analysis and systematic review, concluding the continuous discussion about the best reconstructive strategy. METHODS A comprehensive search across 5 databases (PubMed, ScienceDirect, Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) was conducted until December 17, 2024, to find studies comparing anastomoses technique in MRA grafts. Meta-analysis was performed using Review Manager software version 5.4, generating pooled effect estimates for mean difference (MD) and risk ratio (RR), two-sided p-values, and 95% confidence intervals (CIs). RESULTS Two retrospective cohort studies were included in the meta-analysis. There was no significant difference between end-to-side and side-to-side anastomosis in warm ischemia time (MD = 15.64, 95% CI: −6.82−38.10, p = 0.17) or cold ischemia time (MD = −16.74, 95% CI: −105.61−72.14, p = 0.71). The complication rate showed no significant variation between side-to-side and end-to-side anastomosis (RR = 2.38, 95% CI: 0.41−13.70, p = 0.33). Meta-analysis on graft function and rejection was impossible due to differences in measurements and the small number of studies. CONCLUSIONS Different anastomosis techniques for MRA grafts did not result in longer ischemia times or higher complication rates. Graft function and rejection rates were comparable between side-to-side and end-to-side anastomosis, suggesting both were equally feasible for renal transplants with MRAs. Further studies are required to verify these findings.
Vitamin D in regulating immune response in patients with recurrent pregnancy loss: a case-control study Khudhair, Hasan Abd Ali
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257552

Abstract

BACKGROUND Recurrent pregnancy loss (RPL) is linked to lower vitamin D levels and altered immune responses, though unclear mechanisms. This study aimed to identify the effect of vitamin D on the balance between interleukin (IL)-10/IL-17A in women with RPL. METHODS This case-control study was conducted at the Bint Al-Huda Teaching Hospital, Thi-Qar Governorate, Iraq, from August 2022 to March 2023. Three study groups were included: RPL (47 women), non-aborted pregnant (40 women), and control (38 women). The sera concentrations of IL-17A, vitamin D, and IL-10 had been quantitatively detected using ELISA. SPSS was used for statistical analysis. RESULTS Women with RPL had significantly lower vitamin D levels (19.6 ng/ml) and higher IL-17A levels (35.66 ng/l) than the non-aborted pregnant (23.46 ng/ml, 24.04 ng/l) and control groups (25.69 ng/ml, 19.87 ng/l). IL-10 levels were substantially depleted in the RPL group (3.96 pg/ml), leading to a statistically lower IL-10/IL-17A ratio (0.19) than in the non-aborted pregnant (0.58) and control (1.60) groups. Regression analysis revealed a valuable positive association between vitamin D and IL-17A in all groups and between vitamin D and IL-10/IL-17A ratio in RPL and control groups. Vitamin D was also significantly associated with IL-10 in the non-aborted pregnant group. However, no statistical relationship was reported between vitamin D and IL-10 levels in the RPL and control groups. CONCLUSIONS Increased IL-17A and decreased IL-10 contributed to unexplained RPL. The IL-10/IL-17A ratio predicted endometrial function, and vitamin D affects these cytokines, potentially reducing inflammation.
Predictors of syphilis infection among HIV pre-exposure prophylaxis users Nguyen, Thanh Tran Ai; Vu-Tri, Thanh; Nguyen, Vu Hoang Anh; Nguyen-Thi, My-Tien; Luu-Thi, Huyen-Trang; Ly, Thanh-Thao; Phan, Yen Thi Hoai
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257601

Abstract

BACKGROUND Pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention worldwide. However, research has shown a contradictory trend in which PrEP helps reduce HIV incidence, but increases sexually transmitted infections (STIs), especially in high-risk groups like men who have sex with men and female sex workers. This study aimed to examine the association between sex, age, occupational status, hepatitis B virus (HBV) infection, and hepatitis C virus (HCV) infection with syphilis infection among PrEP users. METHODS The cross-sectional survey was conducted over 1 year, with 864 participants in Thu Duc City Hospital, Vietnam. The chi-square test was utilized for descriptive analysis. Binary logistic regression models estimated the association between sex, age, occupational status, HBV infection, and HCV infection with syphilis infection. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. RESULTS Of 864 participants, 147 (18.2%) men and 68 (23.7%) employed individuals were tested positive for syphilis. The findings indicated that men (OR = 13.805; 95% CI = 1.886−101.024), employed individuals (OR = 1.838; 95% CI = 1.191−2.834), and HBV infection (OR = 2.076; 95% CI = 1.108−3.891) were significantly associated with an increased risk of syphilis infection. CONCLUSIONS Men, employed individuals, and individuals infected with HBV face a higher risk of syphilis infection among PrEP users.
Expression of DUSP1, LINC02202, and LINC01554 as a biomarker panel in the diagnosis and prognosis of breast cancer Khoshnazar, Seyedeh Mahdieh; Kazemi, Mandana; Jahanbani, Parnian; Abed, Mohammad Reza Moghare; Afshoon, Shamim
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257624

Abstract

BACKGROUND Breast cancer is a major global health challenge, with diverse and complex gene expression profiles. Long noncoding RNAs (lncRNAs) have emerged as key regulators of various cancers, including breast cancer. This study aimed to investigate the expression and prognostic value of dual specificity phosphatase 1 (DUSP1), LINC02202, and LINC01554 in breast cancer tissues and explore their association with clinical parameters. METHODS DUSP1, LINC02202, and LINC01554 expression in healthy and breast tumor tissues were compared using in vitro and in silico conditions. In silico conditions examined their association with patient survival and disease prognosis through Kaplan−Meier and receiver operating characteristic curves. In vitro conditions examined the association between their expression and clinical parameters, such as tumor size, disease stage, and disease prognosis. RESULTS Our study found that DUSP1, LINC02202, and LINC01554 were significantly downregulated in breast tumor tissues compared to healthy tissues, as shown by both in vitro and in silico analyses. Their expression levels are also significantly associated with the prognosis of breast cancer. Notably, only LINC02202 expression was significantly correlated with reduced patient survival and tumor size. CONCLUSIONS This study provides novel insights into the expression and function of DUSP1 mRNA, LINC02202, and LINC01554 lncRNAs in breast cancer and identifies potential biomarkers and therapeutic targets for this disease.
Hematologic profile of hemoglobin constant spring and its co-inheritance with hemoglobin C: a case report Adzahar, Sumaiyah; Rahman, Sharifah Sakinah Syed Abdul; Nordin, Mohammad Hudzaifah; Rameli, Nabilah
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.257664

Abstract

Hemoglobin constant spring (Hb CS) is an alpha-globin variant characterized by an elongated alpha chain due to a mutation that leads to unstable hemoglobin (Hb) levels. Hemoglobin C (Hb C) is a beta-globin variant associated with mild hemolytic anemia. The co-inheritance of Hb CS and Hb C is uncommon and presents distinct hematologic features. We report the case of a 7-year-old Malaysian male who developed acute polyarthritis due to streptococcal infection. Routine blood tests revealed microcytic hypochromic anemia, suggestive of a thalassemia trait. Hb analysis via high-performance liquid chromatography and capillary electrophoresis detected low hemoglobin A levels with an additional peak in the Hb C zone. DNA analysis confirmed compound heterozygosity for Hb CS and Hb C. Family screening revealed that the mother is an Hb C carrier, and the father is an Hb CS carrier. This case report examined the hematological profile of a patient with this genetic combination.
Urinary calcium and matrix Gla protein levels in the kidney stones: a case-control study Ali, Zulfikar; Selanno, Fradelino Esau; Gunawan, I Putu Gde Fredy; Sulchan, Mohammad; Birowo, Ponco; Winarni, Tri Indah
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257748

Abstract

BACKGROUND Kidney stones are a global issue with varying prevalence. The most common metabolic risk factor is hypercalciuria, a condition where excess calcium in the urine promotes stone formation. Matrix Gla protein (MGP) inhibits stone formation by preventing crystal growth. This study aimed to analyze the correlation between urinary calcium and MGP levels in kidney stone formation. METHODS A case-control study at Kardinah Hospital, Indonesia, included 64 patients with kidney stone and 64 healthy controls. Exclusion criteria included renal failure, stroke, kidney tumor, heart failure, and hemodialysis. Urinary calcium and MGP were measured using the 5’-nitro-5’-methyl-BAPTA method and enzyme-linked immunosorbent assay. Cut-off values were determined via receiver operating characteristic analysis. RESULTS Among 128 participants (mean age: 51.6), the optimal cut-off for urinary MGP was 1,405 ng/l (p = 0.00024) with 62.5% sensitivity and 72% specificity. Urinary calcium cut-off was 72.5 mg/24 hours with 81.3% sensitivity and 62.5% specificity. Higher urinary calcium and MGP levels were linked to kidney stones (OR: 7.22; 95% CI: 3.23–16.18 and OR: 4.26; 95% CI: 2.03–8.96, respectively). A significant association was found between urinary calcium and MGP (OR: 5.11; 95% CI: 2.31–11.29, p = 0.00006) that hypercalciuria and increased MGP levels are predictors of kidney stone formation. CONCLUSIONS Urinary calcium and MGP levels are associated with kidney stones. Elevated urinary calcium (>1,405 ng/l) increases MGP levels more than 5-fold. Depending on their levels, urinary calcium and MGP act as both promoters and inhibitors of stone formation.

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