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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. 2 (2025): June" : 12 Documents clear
Perianesthetic management in a teenager with focal cortical dysplasia who underwent an epilepsy surgery Yeap, Boon Tat; Koo, Thai Hau; Ang, Song Yee; Hassan, Mohamad Hasyizan
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.257555

Abstract

Medically resistant epilepsy (MRE) is defined as the failure of adequate trials of 2 tolerated and appropriately used antiepileptic drugs to achieve sustained seizure freedom, where epilepsy surgery (ES) is indicated in patients with MRE due to complex epileptic syndromes, such as Lennox-Gastaut and Sturge-Weber syndromes, and focal cortical dysplasia (FCD), to disconnect the epileptogenic foci from other cerebral structures. ES demands excruciating perianesthetic considerations due to its complexity and various pharmacological interactions. Our patient is a 15-year-old male with MRE secondary to FCD. He successfully underwent ES in our neurosurgical center. We describe our perianesthetic challenges in addition to a brief overview of MRE and FCD.
Clinical profiles and treatment evaluation of tuberculous uveitis in tertiary eye hospital in Jakarta Mahayani, Ni Made Widya; Susiyanti, Made; Sjamsoe, Soedarman; Utami, Anna Nur
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257609

Abstract

BACKGROUND Tuberculous uveitis (TU) is the second most common cause of intraocular inflammation in Indonesia. This study aimed to determine the clinical characteristics of patients with TU and the therapies used at Jakarta Eye Center (JEC) Eye Hospitals and Clinics. METHODS This retrospective descriptive study included 265 eyes of 189 patients diagnosed with TU at the JEC Eye Hospital and Clinics between January 2018 and June 2022. This study used secondary data collected by reviewing patient medical records, including clinical profiles and therapeutic characteristics recorded during treatment. Data were analyzed using SPSS software version 24 for Windows. RESULTS Most patients (68.3%) complained of blurry vision, and 99 (52.4%) underwent an interferon-gamma release assay. HIV infection was present in 8.5% of the patients, and 4.8% had diabetes mellitus. Among them, 27 (14.3%) had posterior uveitis, 34 (18.0%) had anterior uveitis, and 127 (67.2%) had panuveitis. The most common feature of inflammation was vitreous opacity. Visual acuity (VA) improved to 0.4 (1.11) after treatment. The most common complication was cataract formation (71 patients). In the group that received combination therapy with systemic steroids and anti-tuberculosis treatment (ATT), 58.7% had a better VA. CONCLUSIONS TU has several clinical manifestations. Treatment with systemic steroids, ATT, or a combination of both can improve VA.
Conservative surgery for stage IC2 mucinous borderline ovarian tumor: a five-year follow-up case report Utami, Tofan Widya; Nasution, Hiro Hidaya Danial; Oktalia, Arisda; Kusuma, Fitriyadi; Purwoto, Gatot
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.257637

Abstract

Mucinous borderline ovarian tumors (MBOTs) represent a significant portion of all borderline ovarian tumors, including variants such as microinvasion and intraepithelial carcinoma, which have a higher recurrence risk. Conservative surgery is recommended for patients with MBOTs seeking fertility preservation, despite remaining a debated option to reduce recurrency. This case highlighted successful MBOT management using conservative surgery with unilateral salpingo-oophorectomy, providing insights into optimal recurrence control. A 30-year-old woman presented with abdominal enlargement, with imaging revealed a large right ovarian mass suspected to be malignant. A left salpingo-oophorectomy was performed, with final histopathology confirming MBOTs with microinvasion and intraepithelial carcinoma. No malignancy was found in the peritoneal fluid, and no adjuvant therapy was given due to fertility preservation reasons. No recurrence after 5 years of follow-up. This report highlights the potential of conservative surgery as a fertility-preserving option for young patients with stage IC2 MBOTs.
Validation and adaptation of the Indonesian version of thyroid cancer quality of life questionnaire Pramono, Laurentius Aswin; Shatri, Hamzah; Subekti, Imam; Prihartono, Nurhayati Adnan; Hatma, Ratna Djuwita; Kurniawidjaja, Meily; Prasetyo, Sabarinah; Kurniawan, Felicia
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257639

Abstract

BACKGROUND The rising incidence of thyroid cancer in Indonesia has become a public health concern. This study was aimed to evaluate the validity of the thyroid cancer-quality of life-Indonesian version (ThyCa-QoL-ID). METHODS This cross-sectional study involved translating the original ThyCa-QoL questionnaire from English to Indonesian (T1), which was then back-translated into English (T2). The T2 questionnaire was compared with the original ThyCa-QoL questionnaire to refine T1, resulting in T3. The T3 questionnaire underwent cognitive and transcultural validation through individual assessment and focus group discussions with 10 doctors and 10 nurses at Cipto Mangunkusumo Hospital and St. Carolus Hospital, and 5 patients with thyroid cancer from St. Carolus Hospital. This process ensured cultural, language, and literacy adaptation processes for patients across different age groups. RESULTS The ThyCa-QoL questionnaire demonstrated validity, with all questions showing correlation calculation (r) above the r table. Test-retest reliability was measured by calculating the intraclass correlation coefficient for each question on the ThyCa-QoL questionnaire. The reliability test can be seen in the value of Cronbach’s alpha (0.915), exceeding the standard Cronbach’s alpha value standard (0.6). CONCLUSIONS The ThyCa-QoL-ID was confirmed as a valid and reliable tool for assessing the QoL of patients with thyroid cancer in Indonesia.
Laparoscopic Tenckhoff catheter insertion technique with Alken telescopic metal dilator in pediatric population Situmorang, Gerhard Reinaldi; Alfarissi, Fekhaza; Raharja, Putu Angga Risky; Rodjani, Arry; Wahyudi, Irfan
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257670

Abstract

BACKGROUND End-stage renal disease (ESRD) is a major public health concern worldwide, with peritoneal dialysis (PD) offering a key alternative to hemodialysis. Flow restriction due to catheter migration is a common complication, affecting 7–26% of patients with PD. This study aimed to reduce complications in pediatric patients by examining a novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator. METHODS In a prospective observational study conducted between September 2018 and October 2022, 33 pediatric patients with ESRD underwent laparoscopic Tenckhoff catheter insertion using a combination of laparoscopic and Seldinger techniques with Alken dilators. This approach involves rectus sheath tunneling using a nephrostomy puncture needle, wire insertion, and dilatation of up to 15 Fr using Alken telescopic metal dilators under laparoscopic guidance. Survival analysis was used to assess catheter survival and complication rates. RESULTS The mean (standard deviation [SD]) patient age was 11.92 (3.7) years, with a median follow-up of 21.3 months. Catheter survival was 84.8%, with 5 catheter withdrawals due to infections (4 cases) or obstruction (1 case). Early and late complications, including exit-site infection, peritonitis, and catheter obstruction, occurred annually at rates of 0.10, 0.03, and 0.02 episodes per patient, respectively. No pericatheter leakage occurred. CONCLUSIONS This novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator become a simple and minimally invasive method, and associated with high catheter survival and low complication rates. Therefore, further comparative studies are recommended.
Extracorporeal shockwave therapy in managing lower urinary tract dysfunction: a scoping review Handayani, Yoshimi; Yufika, Amanda; Lestari, Lazulfa Inda; Setiono, Steven
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.rev.257696

Abstract

Extracorporeal shockwave therapy (ESWT) exerts a range of biological effects, including anti-inflammatory, immunomodulatory, angiogenic, proliferative, and differential responses, as well as promoting nerve regeneration, enhancing membrane permeability, inducing stem cell attraction, and triggering the release of exosomes. It facilitates both interstitial and extracellular responses that support tissue regeneration by transferring energy into tissues. It may also reduce pain through hyperstimulation analgesia and attenuate inflammatory responses, making it a promising non invasive approach for various lower urinary tract dysfunction (LUTD) conditions, such as underactive bladder, overactive bladder, chronic pelvic pain syndrome, stress urinary incontinence, and interstitial cystitis. This study aimed to explore the efficacy and mechanisms of ESWT in managing LUTD.
Tumor apparent diffusion coefficient value and ratio in magnetic resonance imaging on cervical cancer Siregar, Trifonia Pingkan; Wanandi, Septelia Inawati; Darmiati, Sawitri; Kusuma, Fitriyadi; Sekarutami, Sri Mutya; Lisnawati; Prihartono, Joedo; Ilyas, Muhammad; Amalia, Ginva; Elfahmi, Khalida Ikhlasiya Tajdar Gefariena
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257715

Abstract

BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) is a noninvasive, non-contrast sequence for cancer detection. Research involving DW-MRI in cervical cancer has revealed lower apparent diffusion coefficient (ADC) values. This study aimed to evaluate the difference in tumor ADC values and ADC ratios (tumor-to-urine and tumor-to-muscle) with respect to tumor staging (early versus late) and histopathology (squamous cell carcinoma versus adenocarcinoma). METHODS This retrospective study included 56 patients with cervical cancer, divided into early- and late-stage groups. DW-MRI was performed in all patients, and the tumor ADC value, ADC ratio between the tumor and urine (ADC ratiot−u), and ADC ratio between the tumor and gluteal muscle (ADC ratiot−m) were measured. Statistical methods were employed to assess the difference in the tumor ADC value, ADC ratiot−u, and ADC ratiot−m with respect to cervical cancer stages and histopathological findings. RESULTS The median tumor ADC value was lower in the early-stage group than in the late-stage cervical cancer (0.75 × 10−3 mm²/s versus 0.8 × 10−3 mm²/s, p = 0.022). However, no differences were observed in ADC ratiot−u and ADC ratiot−m concerning the tumor staging, nor in ADC value, ADC ratiot−u, and ADC ratiot−m concerning histopathological findings (p = 0.29, 0.67 and 0.35, respectively), with no significant differences in the ADC ratiot−u (p = 0.153) and ADC ratiot−m (p = 0.260). In receiver operating characteristic analysis, the tumor ADC value was 75.0% sensitive and 50.0% specific in predicting late-stage cervical cancer with a cut-off value of 0.750 × 10−3 mm2/s. CONCLUSIONS The median tumor ADC value in early-stage patients was significantly lower than in the late-stage patients, suggesting that tumor ADC value has valuable potential for characterizing cervical cancer staging.
Prevalence and factors associated with frailty among hospitalized geriatric patients at a tertiary hospital in Egypt Elsorady, Khalid Elsayed; Al Adrosy, Taha Ibrahim
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257760

Abstract

BACKGROUND Frailty is a geriatric syndrome linked to poor clinical outcomes. Certain diseases and biomarkers may serve as indicators of frailty. This study aimed to assess the prevalence and factors associated with frailty among hospitalized geriatric patients. METHODS This cross-sectional study was conducted on 206 older adults at a tertiary care geriatrics hospital in Egypt. A comprehensive geriatric evaluation was conducted to identify geriatric syndromes. Clinical history and laboratory tests were performed. The clinical frailty scale (CFS) and the mini-mental state examination (MMSE) assessed frailty and cognitive abilities, respectively. Pressure injury (PI) was identified through physical examination. Prehospitalization medications were checked and counted. Polypharmacy was defined as the daily use of ≥5 medications. The Charlson comorbidity index (CCI) was used to determine multimorbidity. Potential frailty biomarkers included red cell distribution width, serum C-reactive protein/albumin ratio, and neutrophillymphocyte ratio. Logistic regression and Spearman’s correlation analyses were performed. RESULTS Frailty was prevalent among 59.2% of the participants and associated with older age, female sex, higher CCI, lower MMSE scores, and lower serum total proteins. Significant geriatric syndromes included dementia, PI, incontinence, polypharmacy, and falls. A history of stroke was a significant comorbidity. Dementia was associated with the highest odds of frailty (odds ratio: 15.695, p<0.001). CFS was negatively correlated with MMSE scores (r = −0.314, p = 0.002) and positively correlated with CCI (r = 0.227, p = 0.003). CONCLUSIONS Frailty is a prevalent geriatric syndrome associated with dementia, falls, multimorbidity, incontinence, PI, malnutrition, and polypharmacy. Novel biomarkers may indicate frailty at mild stages.
Association between high serum levels of soluble vascular cell adhesion molecule-1 and obesity in women Musafer, Karar Nadhum Jawad; Mohammed, Amera Kamal; Al-Thuwaini, Tahreer Mohammed; Huyop, Fahrul; Bradosty, Sarwan Wasman
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257801

Abstract

BACKGROUND Obesity and metabolic disorders are associated with persistent low-level inflammation connected to soluble vascular cell adhesion molecule-1 (sVCAM-1). Recent research highlights its connection to endothelial dysfunction in female obesity. This study aimed to investigate the relationship between sVCAM-1 levels and obesity-related risk factors in women from Kirkuk City, Iraq. METHODS A case-control study was conducted on 90 women aged 20–50, including 43 participants with obesity and 47 healthy controls. Blood samples were collected, processed, and analyzed to measure various biochemical markers, including sVCAM-1. Logistic regression analysis was utilized to examine the association between sVCAM-1 levels and obesity-related parameters. Correlation analysis was performed to assess associations with body mass index (BMI). Statistical analysis was conducted using SPSS software version 23.0. RESULTS Correlation analysis revealed that BMI was significantly correlated with alanine aminotransferase (r = 0.37, p = 0.011), uric acid (r = 0.30, p = 0.04), insulin (r = 0.37, p = 0.01), homeostatic model assessment of insulin resistance (r = 0.47, p = 0.002), and sVCAM-1 (r = 0.53, p = 0.001). These results suggest that elevated sVCAM-1 levels may serve as predictive biomarkers for increased insulin resistance in obese individuals. These findings indicate that sVCAM-1 is strongly linked to female obesity and insulin resistance. CONCLUSIONS This study confirms the potential use of sVCAM-1 as a prognostic biomarker for obesity-related metabolic disturbances and its role in identifying individuals with a higher risk of developing insulin resistance.
Comparison between free and pedicled anterolateral thigh flaps and surgical outcomes in soft tissue reconstruction Hamid, Agus Roy Rusly Hariantana
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258140

Abstract

BACKGROUND The anterolateral thigh (ALT) flap, harvested either as a free flap with microsurgical anastomosis or as a pedicled flap with an intact blood supply, is widely used to repair soft tissue defects. This study aimed to evaluate the ALT flap, both free and pedicled variants, as a reliable option for reconstruction, focusing on flap viability and complications. METHODS This cross-sectional study included 30 patients who underwent free or pedicled ALT flap reconstruction at IGNG Ngoerah Hospital, Bali, between 2020 and 2024. Inclusion criteria were complete medical records and confirmed vascular flow on preoperative Doppler ultrasound. Statistical analysis was performed using Fisher’s exact test for bivariate analysis. The primary outcomes evaluated were the incidence of complications and their association with the type of flap. RESULTS ALT flaps were used as free flaps in 60% of cases and as pedicled flaps in 40%. Most patients were adult males, with flap placements mainly in the abdomen (36.7%). Wound dehiscence and necrosis occurred in 13.3% of cases. Wound dehiscence and complications requiring follow-up occurred more frequently in patients undergoing free flap procedures (38.9% versus 8.3%, p<0.001; 22.2% versus 0%, p = 0.001). In contrast, the incidence of necrosis was comparable between the two flaps (16.75% versus 8.3%, p = 0.632). CONCLUSIONS The free ALT flap showed a higher risk of partial flap necrosis and required more intensive monitoring. Pedicled ALT flap demonstrated a lower complication rate and more straightforward postoperative care, suggesting a more favorable option.

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