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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 11 Documents
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Search results for , issue "Vol. 34 No. 3 (2025): September" : 11 Documents clear
Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Adipose-derived mesenchymal stem cells enhance regeneration in a chronic peripheral sciatic nerve injury Sprague-Dawley rat model Widodo, Wahyu; Dilogo, Ismail Hadisoebroto; Kamal, Achmad Fauzi; Antarianto, Radiana Dhewayani; Wuyung, Puspita Eka; Siregar, Nurjati Chairani; Octaviana, Fitri; Kekalih, Aria; Suroto, Heri; Aprilya, Dina; Canintika, Anissa Feby
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257780

Abstract

BACKGROUND Obtaining optimal functional outcomes in patients with chronic peripheral nerve injuries (PNIs) remains challenging due to the limited regeneration of the neuromuscular junction (NMJ). Adipose-derived mesenchymal stem cells (AD-MSCs) can differentiate into Schwann-like cells, secrete neurotrophic factors, and recruit native Schwann cells. This study aimed to analyze the effects of AD-MSCs on functional outcomes in a chronic PNI model. METHODS An in vivo study was performed using 20 male Sprague-Dawley rats with chronic PNI of the right sciatic nerve. Rats were divided into two groups: the AD-MSC group (n = 10), receiving human AD-MSC injections in the NMJ; and the control group (n = 10), receiving normal saline injections. Walking track analysis and electrophysiological assessments were performed 8 weeks after the nerve repair. Postmortem gastrocnemius muscle weights and immunohistochemical examinations were also performed. RESULTS The AD-MSCs showed significantly larger fiber diameters than the control group (45.54 [13.1] versus 35.46 [6.64]; p = 0.011). While clinical, electrophysiological, and gastrocnemius muscle weight data suggested a trend toward improved outcomes in the AD-MSCs group, the differences were not statistically significant. CONCLUSIONS AD-MSC implantation may enhance nerve regeneration, as demonstrated by a better outcome profile in the AD-MSCs group.
Emicizumab prophylaxis in severe hemophilia A with inhibitor: impact on quality of life and musculoskeletal outcomes Wiharta, Fitri Primacakti; Saraswati, Made Citra; Abigail, Dina Clarisa Rumora; Chozie, Novie Amelia
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.257819

Abstract

Emicizumab has been acknowledged for its effectiveness in preventing bleeding in patients with hemophilia A developing inhibitors. This report examined the impact of emicizumab prophylaxis on health-related quality of life (HRQoL) and musculoskeletal outcomes in a 10-year-old male with severe hemophilia A and a high titer of factor VIII (FVIII) inhibitor, presenting with hemophilic arthropathy on the right knee and left elbow. He had been unable to walk and was previously treated on-demand with a plasma-derived FVIII concentrate. He received emicizumab prophylaxis for 16 months. HRQoL was evaluated using a hemophilia-specific questionnaire, while musculoskeletal outcomes were assessed using hemophilia early arthropathy detection with ultrasound (HEAD-US) and the hemophilia joint health score (HJHS). During treatment, no breakthrough bleeding occurred, and the patient regained the ability to walk. Emicizumab prophylaxis significantly improved in HRQoL, especially in physical health and sports and and school domains, aligning with bleeding rates, HEAD-US, and HJHS assessments.
Factors contributing to the prevalence of potential drug-drug interactions among hospitalized elderly patients in a tertiary hospital in Eastern Java, Indonesia Faisal, Shah; Khotib, Junaidi; Wibisono, Cahyo; Hamidah, Khusnul Fitri; Utomo, Febriansyah Nur; Zairina, Elida
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257888

Abstract

BACKGROUND Drug-drug interactions (DDIs) are the primary cause of adverse drug events. However, studies on potential DDIs (pDDIs) in hospitalized older adult patients in Indonesia remain limited. Therefore, this study aimed to investigate the prevalence and potential risk factors of pDDIs in this population. METHODS A prospective observational study assessing the medical profiles of hospitalized elderly patients was conducted at Universitas Airlangga Hospital from September 2023 to February 2024. Patient characteristics were recorded, and Micromedex® Drug-Reax software was used to check the pDDIs. Ethical approval was obtained for this study (No. 078/KEP/2023). Data were analyzed using SPSS software (version 26). RESULTS Of the 409 patients, 41.9% of the prescriptions contained pDDIs. Furthermore, 73 prescriptions (17.1%) had at least one pDDI, with 1–6 interactions per prescription. Of the 369 identified pDDIs, 209 (56.6%) were major interactions. Logistic regression analysis revealed increased odds of pDDIs in patients with previous medication use (adjusted odds ratio [aOR] = 2.254; crude odds ratio (cOR] = 1.771), polypharmacy (aOR = 16.309; cOR = 11.709), circulatory diseases (aOR = 4.082; cOR = 4.788), and genitourinary diseases (aOR = 1.819; cOR = 1.855). Conversely, patients with digestive system diseases had a significantly lower risk (aOR = 0.573; cOR = 0.608). CONCLUSIONS This study found a high prevalence of pDDIs (41.1%) among older hospitalized patients in Indonesia. Modifiable factors, such as polypharmacy and previous medication use, can reduce the risk of pDDIs and avoid adverse events.
Serum levels of IL-17A and cathelicidin antimicrobial peptide LL37 in females with breast cancer Al-Harbi, Ahmed Abdullah Ahmed; Shetawi, Asmaa Zaki; Al Zobair, Alya Abd Alaziz Najim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257971

Abstract

BACKGROUND Breast cancer (BC) is a leading cause of morbidity and mortality in women. Interleukin (IL)-17 and the antimicrobial peptide LL37 have been implicated in BC pathogenesis. This study aimed to assess their levels in women with BC and evaluate their correlation with molecular subclasses, clinical, and laboratory parameters. METHODS This study included 69 BC females and 35 healthy controls. Patients were classified based on metastatic status and molecular indicators. Serum IL-17A and LL37 concentrations were estimated using ELISA and compared across patient subgroups. The area under the curve (AUC) was analyzed to determine cut-off values, sensitivity, and specificity for their diagnostic potential in BC. RESULTS IL-17A and LL37 levels were notably higher in patients with BC than in controls (p<0.0001). LL37 levels were also higher in the metastatic than in the non-metastatic group and controls. IL-17A levels were considerably higher in patients with metastatic than in controls (p<0.0001), but did not differ significantly between metastatic and non-metastatic patients (p = 0.5573). Regarding diagnostic performance, LL37 showed an AUC of 0.989 (p<0.001) at the best cut-off value of 16.79 ng/ml, LL37 exhibited 95% sensitivity and 94% specificity, indicating diagnostic potential. IL-17A showed an AUC of 0.87 (p<0.001), with a best cut-off value of 15.11 pg/ml, 78.81% sensitivity, and 100% specificity. Both LL37 and IL-17A levels were correlated with each other (r = 0.284, p = 0.018). CONCLUSIONS Patients with BC had increased serum levels of IL-17A and LL37. Their estimation is important for the follow-up of patients with metastatic.
Comparison of stingless bee honey and silver sulfadiazine on diabetic wound healing in rat models Fajari, Nanang Miftah; Pranoto, Agung; Perdanakusuma, David Sontani; Prenggono, Muhammad Darwin; Rudiansyah, Mohammad; Nur'amin, Hendra Wana; Syarifa, Yulia; Hasrianti, Nuvita; Saputri, Imelda Nita; Afrianto, Muhammad Irawan; Husna, Annisa Halida
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257974

Abstract

BACKGROUND Diabetic foot ulcers (DFUs) are a major health concern in Indonesia. Adjuvant therapies may improve healing by avoiding secondary infections, promoting angiogenesis, and supporting oxygen circulation. This aimed to evaluate the effect of stingless bee honey (SBH) from Heterotrigona itama on diabetic wound size in rats (Rattus norvegicus), compared to silver sulfadiazine (SSD). METHODS An experimental study was conducted on 13 diabetic wounds in streptozotocin-induced diabetic rats treated with three types of therapies: SSD (n = 5), pure SBH (n = 5), and SBH with 20% water content (n = 3). The study initially involved 21 rats, but eight died during the diabetes modeling and wound observation phases, presumably due to hyperglycemia. Baseline characteristics did not differ significantly across the groups. RESULTS SBH with 20% water content and pure SBH reduced wound size by 95.1% and 92.1%, outperforming SSD (77.4%), with all therapies showing statistically significant improvement (p<0.05). However, the differences between groups were not statistically significant (p = 0.162). CONCLUSIONS Topically applied SBH is a potential natural therapeutic agent for diabetic wounds, in addition to standard treatment such as SSD.
Effects of edaravone on hypoxia-induced lethality in male Swiss albino mice Shaki, Fatemeh; Mokhtaran, Mina; Raei, Maedeh; Razavi, Alireza; Shamshirian, Amir; Eslami, Shahram; Shamshirian, Danial; Ebrahimzadeh, Mohammad Ali
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257997

Abstract

BACKGROUND Edaravone has recently been used to treat acute cerebral infarction. This study aimed to evaluate the protective effects of edaravone against hypoxia-induced lethality and oxidative stress in mice using 3 experimental models of hypoxia: asphyxia, circulatory, and hemic hypoxia. METHODS 60 Swiss albino mice from the animal facility of Mazandaran University of Medical Sciences, Iran, were randomly housed in groups of 10 during January–March 2020 and received edaravone for 4 consecutive days. After inducing hypoxia, oxidative stress, lipid peroxidation (LPO), and glutathione (GSH) content were assessed. RESULTS The findings showed significant protective effects of edaravone in all hypoxia models, with the strongest effects in asphyxia and circulatory hypoxia, showing a dose-dependent response. It prolonged survival time at 2.5 mg/kg by 26.08 (0.79) min (p = 0.031) In addition, edaravone significantly inhibited hypoxia-induced oxidative stress (LPO and GSH oxidation) in all 3 hypoxia models. CONCLUSIONS Edaravone exhibits an excellent protective effect against different models of hypoxia by decreasing oxidative stress in brain tissue. In addition, the results showed dose-dependent effects of edaravone in the asphyxia and circulatory hypoxia models. Antioxidant activity might be a proposed mechanism for the anti-hypoxic activity of this drug.
Quality of life in Indonesian conjunctival tumor patients Indrakila, Senyum; Soewoto, Widyanti; Purnomo, Joko; Malindha, Erma; Asmara, Yusuf Vindra
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258027

Abstract

BACKGROUND As quality of life (QoL) research continues to expand, there remains a study gap of less common malignancies such as conjunctival tumors. This study aimed to investigate the differences in QoL between Indonesian patients with benign and malignant conjunctival tumors. METHODS This cross-sectional study was conducted from May–September 2024 and included 273 patients diagnosed with conjunctival tumors. The participants provided informed consent and completed the RAND SF-36 questionnaire to assess their QoL. A consecutive sampling method was employed to adequately represent benign and malignant tumor types. Data were analyzed using IBM SPSS version 26 to identify QoL differences among the patients. RESULTS This study found that squamous cell carcinoma was the most frequently observed conjunctival tumor, accounting for 28.9% of the cases. Patients with benign tumors had significantly higher QoL scores (69.61) than those with malignant tumors (43.05). Key factors influencing QoL included tumor type (p<0.001), age (p<0.001), sex (p = 0.039), occupation (p = 0.027), residence (p = 0.044), income (p = 0.010), and comorbidities (p = 0.045). CONCLUSIONS The results show significant disparities in QoL between patients with benign and malignant conjunctival tumors, emphasizing the impact of sociodemographic and tumor type on patient well-being. Focused healthcare plans are needed to help improve the QoL of patients with conjunctival tumors. Prioritizing early detection and providing complete support to enhance patient outcomes in Indonesia are crucial.
Intracorporeal urinary diversion robot-assisted radical cystectomy versus open radical cystectomy: a systematic review Nainggolan, Hoshea Jefferson; Rahman, Fakhri; Putera, Eka Setiawan Ananta
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258285

Abstract

BACKGROUND Radical cystectomy is the standard treatment for advanced bladder cancer, with open surgery associated with significant perioperative morbidity. This study aimed to compare efficacy, safety, and cost-effectiveness of robotic-assisted versus open radical cystectomy (ORC) with intracorporeal urinary diversion (ICUD). METHODS A systematic review was conducted across databases (PubMed, Cochrane Library, ClinicalTrials.gov, and Google Scholar) following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, with the following keywords: “robotic-assisted cystectomy”, “open cystectomy”, “intracorporeal urinary diversion”, “bladder cancer”, “perioperative results”, “complications”, and “oncological efficacy”. Only studies published in the last 10 years were included, with literature searching completed in December 2024. RESULTS 8 studies comparing robot-assisted radical cystectomy (RARC) with ICUD to ORC were included. RARC with ICUD showed reduced blood loss, fewer transfusions, shorter hospital stays, and faster recovery with earlier bowel function, but longer operative times. Recurrence and survival, were similar between both approaches. CONCLUSIONS RARC with ICUD is a promising alternative to open cystectomy, providing perioperative benefits and faster recovery while maintaining equivalent oncologic outcomes. However, higher initial costs and technical complexity must be considered. Further research should assess quality of life, functional recovery, and overall healthcare impact.
Artificial intelligence for enhanced diagnostic precision of prostate cancer Hamid, Agus Rizal Ardy Hariandy; Harahap, Agnes Stephanie; Miranda, Monik Ediana; Gibran, Kahlil; Shabrina, Nabila Husna
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258312

Abstract

BACKGROUND Accurate diagnosis and grading of prostate cancer are essential for treatment planning. The role of artificial intelligence in prostate cancer intervention and diagnosis (RAPID) is a study aimed at developing artificial intelligence (AI) models to enhance diagnostic precision in prostate cancer by distinguishing malignant from non-cancerous histopathological findings. METHODS Histopathological images were collected between 2023 and 2024 at the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia. The dataset included benign prostatic hyperplasia and prostate cancer cases. All slides were digitized and manually annotated by pathologists. Patch-based classification was performed using convolutional neural network and transformer-based models to differentiate malignant from non-malignant tissues. RESULTS A total of 529 whole-slide images were processed, yielding 26,418 image patches for model training and testing. Deep learning models achieved strong performance in classification. Architectures including EfficientNetV2B0, Xception, ConvNeXt-Tiny, and Vision Transformer (ViT) achieved near-perfect classification outcomes. EfficientNetV2B0 reached an AUC of 1.00 (95% CI: 1.00–1.00), sensitivity 0.99 (95% CI: 0.99–1.00), and specificity 1.00 (95% CI: 1.00–1.00). Xception and ConvNeXt-Tiny both achieved AUC 1.00 (95% CI: 1.00–1.00) with sensitivity and specificity of 1.00 (95% CI: 1.00–1.00). ViT performed strongly with AUC 0.999 (95% CI: 0.99–1.00), sensitivity 0.99 (95% CI: 0.99–0.99), and specificity 0.99 (95% CI: 0.99–0.99). CONCLUSIONS RAPID demonstrated high potential as an AI-based diagnostic tool for prostate cancer, showing excellent accuracy in histopathological classification using the Indonesian dataset. These findings highlight the feasibility of deploying deep learning models to support diagnostic decision-making in clinical practice.

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