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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. 35 No. 1 (2026): March" : 12 Documents clear
SOX2 expression in the primary tumor of castration-naive metastatic prostate adenocarcinoma in association with metastasis extent Saraswati, Meilania; Kekalih, Aria; Lisnawati; Rahadiani, Nur; Asmarinah; Hernowo, Bethy Suryawathy; Hamid, Agus Rizal Ardy Hariandy; Mochtar, Chaidir Arif
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247588

Abstract

BACKGROUND Poor prognosis in patients with metastatic prostate adenocarcinoma (mPCa) may be due to the expression of stem cell-related genes. This study aimed to demonstrate the association between the expression of cancer stem cell markers and metastasis in patients with castration-naive mPCa. METHODS This cross-sectional, analytical study investigated a formalin-fixed paraffin-embedded prostate specimens from patients diagnosed in Cipto Mangunkusumo Hospital. Patients aged ≥50 years old were grouped based on the extent of metastases (high-volume disease [HVD] and low-volume disease [LVD]). In each case, immunohistochemical staining for CD133, CD44, SOX2, and androgen receptor was performed and analyzed using H-score. All data were recorded and analyzed using SPSS software version 20.0. RESULTS A total of 61 patients were recruited from 2020 to 2023 and divided into the HVD (n = 38) and LVD (n = 23) groups, with a mean age of 67.9 years. 45 of the patients had International Society of Urological Pathology (ISUP) grade 5 disease, while 16 of them had grade <5. A significant difference of ISUP grade and PSA serum level was observed in the HVD versus LVD group (p = 0.017 and <0.001, respectively). Additionally, a significant association was found between SOX2 expression and metastatic extent. CONCLUSIONS The LVD group showed higher SOX2 expression in the primary tumor compared to the HVD group. Different SOX2 expressions in various sites and stages may be due to the cancer cells’ systemic network.
Optimal time point for evaluation in a chronic peripheral nerve injury rat model: a preclinical study 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. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257778

Abstract

BACKGROUND Peripheral nerve injury (PNI) can cause severe functional disabilities and progresses dynamically over time. Since evaluations held at different time points will yield different results, finding an optimal model for PNI comparison is needed. This study aimed to create an animal model of chronic denervation that simulates the progress of nerve injury. METHODS 6 male Sprague-Dawley rats underwent complete sciatic nerve transection in their right hind limbs, with severed nerve ends secured to a nearby muscle to prevent nerve regrowth. The rats were sacrificed at 2, 3, and 4 weeks. The assessment included walking analysis (pre- and post-injury), wet muscle weight measurement, and histological examination. RESULTS Progressive gastrocnemius muscle degeneration was observed at 3 different time points. Minimal degenerative changes were noted at 2 weeks, while extensive fibrosis (83.25 [12.19]% collagen area) appeared in the 4th week. The 3rd-week samples showed lymphocyte infiltrations, muscular atrophy, and progressive fibrosis, making it the best model for chronic PNI. CONCLUSIONS A 3-week chronic denervation model is proposed as a long-term PNI for further regenerative research.
Patient-reported outcomes and quality of life after pelvic organ prolapse surgery in Indonesia Hakim, Surahman; Hadinata, Valencia; Wiguna, Igor Ian; Tanoto, Kevin; Amelia, Safira; Kadarusman, Adib Kamil Putra
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258009

Abstract

BACKGROUND Pelvic organ prolapse (POP) is a common condition in older women that significantly impacts quality of life (QoL). Traditional surgical success measures primarily focus on anatomical outcomes, but patient-reported outcomes provide offer a more comprehensive assessment of symptom relief and overall well-being. This study aimed to evaluate patient-reported outcomes and QoL with the Pelvic Floor Disability Index (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) following POP surgery. METHODS This cross-sectional study analyzed secondary data from medical records and patient interviews at Cipto Mangunkusumo Hospital, Jakarta. Patients diagnosed with POP who underwent surgery were followed up at 1, 3, 6, and 12 months postoperatively. PFDI-20 and PFIQ-7 scores were used to assess symptom impact and QoL. RESULTS Among 34 patients, the most common surgical method was total vaginal hysterectomy (79%), followed by colpocleisis (59%), and sacrospinous hysteropexy (6%). Postoperative PFDI-20 scores showed 76% of patients experienced minimal to no impact, while PFIQ-7 scores indicated 91% reported minimal to no impact on their QoL. 2 patients reported moderate impact, particularly in the urinary domain. No patients experienced severe or very severe impairment at any follow-up interval. CONCLUSIONS Incorporating patient-reported outcomes with anatomical assessments provides a more accurate evaluation of surgical success in POP based on PFDI-20 and PFIQ-7 scores. Because POP is a multidimensional condition, assessing surgical outcomes requires a multimodal approach that considers symptom relief and QoL.
Xen® Gel Stent versus PreserFlo™ MicroShunt as a subconjunctival shunt devices in glaucoma: a systematic review Huda, Muhammad Khoirul; Suryono, Astrianda Nadya
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258110

Abstract

BACKGROUND Glaucoma is the leading cause of irreversible blindness and is primarily managed by reducing intraocular pressure (IOP). Minimally invasive glaucoma surgeries, particularly subconjunctival shunt devices such as Xen® Gel Stent and PreserFlo™ MicroShunt, have emerged as alternatives to traditional trabeculectomy. This study aimed to evaluate their effectiveness in lowering IOP, reducing medication use, and assessing reinterventions and safety. METHODS A systematic review was conducted in accordance with Cochrane and PRISMA guidelines. Comprehensive literature searches were conducted across PubMed, Cochrane, EBSCOhost, and Google Scholar databases from the earliest available date to September 2023. Studies comparing Xen® Gel Stent and PreserFlo™ MicroShunt in adult patients with glaucoma were included. Data were extracted on study design, sample size, IOP outcomes, antiglaucoma medication use, reinterventions, and safety outcomes. Quality assessment was performed using the Newcastle-Ottawa Scale. RESULTS Of 5 European studies (2020–2023; 329 patients, 6–18 months of follow-up), 3 studies reported lower postoperative IOP with PreserFlo™ MicroShunt (11.8 [3.7] versus 13.6 [3.5] mmHg, p = 0.02; 10.3 [2.1] versus 14.2 [2.1] mmHg, p = 0.0005; 10.3 [3.2] versus 13.1 [6.4] mmHg, p = 0.019). Only one study noted fewer antiglaucoma medications with PreserFlo™ MicroShunt (0.2 [0.6] versus 1.1 [2.4], p = 0.04). Reinterventions including needling and bleb revisions were higher with Xen® Gel Stent (35.4% versus 11.5%; 20% versus 5%). Complication profiles varied, with hypotony more common in Xen® Gel Stent (6.5% versus 0%), hyphema more common with PreserFlo™ MicroShunt (7.7% versus 3.2%), and stent curling and migration more common with Xen® Gel Stent (15% versus 0%; 2% versus 0%), respectively. CONCLUSIONS Both Xen® Gel Stent and PreserFlo™ MicroShunt effectively lowered IOP and reduced medication burden in patients with glaucoma. PreserFlo™ MicroShunt may provide superior IOP control and fewer postoperative interventions. Further prospective studies in diverse populations are warranted.
Inter- and intra-rater reliability of modified near-infrared camera to assess superficial lymphatic system in breast cancer-related lymphedema Brahma, Bayu; Yusuf, Prasandhya Astagiri; Priambodo, Purnomo Sidi; Harimurti, Kuntjoro; Haryono, Samuel Johny; Harlim; Suryadi; Paskahenru, Mahesa; Lesmana, Rika; Manangka, Rumuat Semuel Wullul; Taher, Akmal; Panigoro, Sonar Soni
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258234

Abstract

BACKGROUND Near-infrared (NIR) fluorescence imaging is one of the most useful diagnostic methods for breast cancer-related lymphedema (BCRL). It utilizes indocyanine green (ICG) lymphography, which requires a commercial camera that is not widely available. This study aimed to qualitatively assess the reliability of the modified NIR camera in diagnosing BCRL. METHODS This prospective cross-sectional study was conducted between December 2023 and December 2024 in breast cancer (BC) patients with BCRL. A commercial mirrorless digital camera was modified by incorporating an excitation light source and spectral filters to enable NIR imaging. To evaluate the camera reliability, intra- and inter-observer agreements were assessed using Kappa analysis. Three independent observers evaluated dermal backflow patterns of lymphatic flow: linear, splash, stardust, and diffuse patterns. RESULTS 60 BC patients with BCRL resulting in 280 images were included. The mean (standard deviation) age was 54.7 (10.1) years and body mass index were 27.1 (4.5) kg/m². Most patients had stage IIA BC (40%) and stage IV ICG lymphography (38%). Intra-observer analysis showed observers 1 and 2 of had a Kappa of 1.00 (95% confidence interval [CI]: 1.00–1.00), while observer 3 had Kappa of 0.99 (95% CI: 0.97–1.00). Inter-observer analysis between observers 1 and 2 showed Kappa 1.00 (95% CI: 1.00–1.00), while observers 1–3 and 2–3 had Kappa of 0.99 (95% CI: 0.97–1.00). Observer 3 misinterpreted 3 linear as splash patterns. CONCLUSIONS This study showed a high inter- and intra-observer agreements making it reliable for BCRL diagnosis.
Versatile, low-cost ophthalmic wet lab device to improve diagnostic and surgical eye training Mardianto, Umar; Victor, Andi Arus; Yusuf, Prasandhya Astagiri; Juniantito, Vetnizah; Kekalih, Aria; Rahayu, Tri; Bustamam, Alhadi; Edwar, Lukman
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.bc.257865

Abstract

Ophthalmologists rely on wet lab training for both diagnostic procedures and surgical techniques. Existing wet lab devices are limited to surgical training and lack functionality for performing required perioperative diagnostic examinations. This study aimed to develop an affordable, easily manufactured eye holder to enhance ophthalmology training for wet lab simulations. A three-dimensional (3D)-printed animal eye holder was designed in 3D with a funnel-shaped structure resembling an orbital eye socket. The design was optimized for optimal wet lab activities. The animal eye holder device demonstrated potential use for ultrasound biometry, handheld keratometry, tonometry, and ophthalmological surgical training. These activities can be performed effectively after the animals’ eyes are stabilized inside the holder in flat and inclined positions. This innovative animal eye holder is the first designed to provide flexible diagnostic practice and surgical training, especially during wet lab activities.
A case of Lhermitte-Duclos disease: the classical “tiger stripes” in magnetic resonance imaging Sensusiati, Anggraini Dwi; Apriawan, Tedy; Fauziah, Dyah
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.258118

Abstract

Dysplastic gangliocytoma or Lhermitte-Duclos disease (LDD), is a rare benign cerebellar tumor often presenting with nonspecific symptoms such as intracranial hypertension, cerebellar dysfunction, or cranial nerve deficits, and associated with phacomatosis. The characteristic “tiger stripe” sign on magnetic resonance imaging (MRI) is highly suggestive of LDD, though nodular medulloblastoma remains an important differential diagnosis. We report a 51-year-old woman with arm and leg phacomatosis who presented with a right cerebellar hypodense lesion on computed tomography extending frontally. MRI demonstrated the hallmark “tiger stripe” appearance, and histopathology following surgery confirmed LDD. On follow-up, despite evidence of a recurrent mass on MRI, her cranial nerve paresis improved postoperatively. Imaging revealed hypointense striations on T1 and alternating linear hyperintensities on T2 sequences, obscuring the cerebellar folia, features that distinguish LDD from other cerebellar tumors. This case underscores the diagnostic value of MRI, emphasizing early recognition to prevent misdiagnosis and guide surgical planning.
Effect of umbilical cord-mesenchymal stem cells on skin tensile strength in pressure ulcers: a rat model study Aulia, Indri; Dilogo, Ismail Hadisoebroto; Prasetyono, Theddeus Octavianus Hari; Pawitan, Jeanne Adiwinata; Kekalih, Aria; Siregar, Nurjati Chairani; Whulanza, Yudan; Hasibuan, Lisa
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.268222

Abstract

BACKGROUND Stem cell therapy has emerged as a promising alternative for the management of chronic wounds, including pressure ulcers. Tensile strength, which reflects the biomechanical integrity of the skin, serves as an objective measure of wound healing. This study aimed to evaluate the effect of locally administered umbilical cord-mesenchymal stem cells (UC-MSCs) on the tensile strength of healing 3rd-degree pressure ulcers in a Sprague Dawley rat model. METHODS 21 adult male Sprague Dawley rats were divided into 3 groups: normal rats without ulcers, untreated pressure ulcer as control, and pressure ulcers treated with UC-MSCs. The treatment group received locally injected 4 × 10⁶ UC-MSCs at the ulcer site. On day-21, the tensile strength parameters (rupture point, elongation at break, and elastic modulus) of the dorsal skin were assessed using the Universal Testing System. RESULTS When expressed relative to normal skin tensile strength, the UC-MSC group exhibited higher tensile parameters that were higher than the controls by 2.08% for rupture point, 3.29% for elongation at break, and 8.42% for elastic modulus. Although these differences between the UC-MSCs and control groups across all tensile strength parameters were not statistically significant, a clear trend toward improved tensile strength parameters were observed in the UC-MSCs group. CONCLUSIONS Local UC-MSCs administration showed a consistent trend toward improved tensile strength in healing 3rd-degree pressure ulcers, albeit without statistically significant differences compared to controls. These findings support the further exploration of UC-MSCs as a potential treatment for promoting biomechanical restoration in healing pressure ulcers.
Economic burden and healthcare costs of congenital anomalies of the kidney and urinary tract: a systematic review Alvarino, Akbar Muzakki; Pahlevi, Reza; Situmorang, Gerhard Renaldi; Wahyudi, Irfan; Rodjani, Arry; Raharja, Putu Angga Risky
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258074

Abstract

BACKGROUND Congenital anomalies of the kidney and urinary tract (CAKUT) cause significant morbidity and economic burden worldwide, highlighting the needs to understand its associated costs. This study aimed to assess the economic burden of CAKUT management. METHODS A systematic review was conducted across 5 databases, including PubMed, ScienceDirect, ProQuest, Nature, and Google Scholar, for studies published up to September 11, 2024, focusing on both direct (e.g., hospitalizations, surgeries, and treatments) and indirect (e.g., lost work time and complications management) healthcare costs related to CAKUT and published in English. Non-economic studies, reviews, editorials, abstracts, animal/in vitro studies, and duplicates were excluded. Methodological quality was assessed using the Risk Of Bias In Non-randomized Studies - of Interventions tool. Narrative synthesis and descriptive statistics were applied. Cost-effectiveness analysis followed Joanna Briggs Institute guidelines. RESULTS 8 studies met the inclusion criteria, revealing wide variations in CAKUT-related healthcare costs across countries and interventions. These studies focused on reviewing both direct and indirect costs, along with interventions that reduce overall healthcare expenditure. Key findings include: (1) In the USA, bilateral renal agenesis costs averaged USD 26,032; (2) In Australia, early whole exome sequencing reduced diagnostic costs by 20% in genetic kidney disease cases; (3) Robotic surgery demonstrated long-term cost-effectiveness despite higher inpatient costs; (4) Other cost-saving strategies include the early renal ultrasound algorithm and genomic testing for CAKUT. CONCLUSIONS CAKUT imposes a significant and variable economic burden globally. Identifying cost-effective interventions is crucial for optimizing care and reducing the financial impact. Further research on cost management strategies is needed to improve outcomes and efficiency.
Modified BI-RADS model for stratifying borderline breast lesions based on BI-RADS: a cross-sectional study Kuntjoro, Lydia Purna; Riwanto, Ignatius; Sukmaningtyas, Hermina; Prajoko, Yan Wisnu; Suhartono; Choridah, Lina; Mahati, Endang; Tjandra, Kevin Christian; Pravitha, Clarissa Aulia
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258117

Abstract

BACKGROUND Breast imaging reporting and data system (BI-RADS) is a globally recognized method for categorizing breast lesions. However, it is dependent on subjective interpretation, which can result in variability between radiologists. Currently, no scoring system exists to assist in categorizing borderline findings as either benign or malignant. This study aimed to introduce a scoring system that classifies borderline breast lesion findings without altering the standard BI-RADS interpretation and minimizes inter-reader variability. METHODS This single-center retrospective cross-sectional study included 215 women who underwent breast ultrasound (US) and histopathology between January 2021 and December 2022, excluding those with non-neoplastic breast lesions. The index test was US BI-RADS features, and the reference standard was histopathology. Prevalence ratios (PRs) and probability scores were used to assess the risk contribution of individual US features. The diagnostic performance of the BI-RADS interpretation strategy and predictive scoring model was compared with that of the standard BI-RADS classification using SPSS software version 26. RESULTS Margin, orientation, and age had the highest PRs of malignancy, with odds ratios and 95% confidence intervals of 39.86 (13.19–120.47), 17.47 (2.42–125.72), and 9.74 (3.51–27.04), respectively. These three characteristics increased the probability of malignancy by 99.53%. A comparison of diagnostic tests between the modified BI-RADS interpretation strategy and the standard BI-RADS classification revealed improvements in specificity (94.0% versus 84.7%), positive predictive value (85.0% versus 70.5%), accuracy (89.3% versus 84.7%), and area under the curve (0.931 versus 0.873). CONCLUSIONS According to the interpretation strategy, margin, orientation, and age, this US scoring model appear to be promising tools for classifying borderline malignant masses.

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