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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 1,648 Documents
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A survey on the management of overactive bladder by Indonesian urologists
Medical Journal of Indonesia Vol. 24 No. 2 (2015): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i2.1172

Abstract

Background: Overactive bladder (OAB) is a clinical syndrome consisting of symptom complex of urgency, with or without incontinence which has significant effects on quality of life and has to be managed properly. The aim of this study was to review the management of OAB by Indonesian urologists.Methods: A self-constructed questionnaires containing diagnostic and treatment options of OAB patients were distributed to Indonesian urologists. This was a cross-sectional study and descriptive analysis method was used to analyze the data.Results: 129 Indonesian urologists participated in this study. Most of them faced more than 20 OAB cases per year with the most common type was OAB without incontinence or dry OAB (57.4%). Most urologists (34.1%) ordered at least three diagnostic tools to determine OAB. They were bladder diary, urinalysis and scoring system. The most used scoring system (48.9%) was the overactive bladder symptoms score (OABSS). Thirty-five point seven percents (35.7%) of urologists used antimuscarinic and behavioral therapy as initial therapy. Solifenacin 5 mg/day was the most common antimuscarinic prescribed as the first line therapy (48%). Most common items commonly evaluated for follow-up: symptoms (96.9%), bladder diary (72.9%); and drug’s side effect (58.1%). When initial therapy had failed, most of the urologists (54.3%) chose to increase the dose of antimuscarinic. None of them chose bladder botulinum toxin injection as their additional therapy.Conclusion: OAB is a frequent disorder which remains a challenge for urologists. The management of patients with OAB by Indonesian urologists has been suitable with the previous studies and guidelines.
A year of transformation comes to its end
Medical Journal of Indonesia Vol. 23 No. 4 (2014): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v23i4.1175

Abstract

[No abstract available]
Steroid response as prognostic factor and its correlation with molecular assessment of childhood acute lymphoblastic leukemia
Medical Journal of Indonesia Vol. 24 No. 4 (2015): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i4.1177

Abstract

Background: Survival rate of children with acute lymphoblastic leukemia (ALL) in Indonesia remains low. Risk stratification accuracy is important to improve survival. In developed countries, risk stratification is determined based on gene fusion that is known related to steroid resistency. Steroid response at day-8 correlates with prognosis. The assessment can be applied in centers that cannot perform molecular assessment. This study aims to evaluate whether steroid response correlated to molecular assessment. Methods: A cross-sectional study was performed at Child Health Department, Cipto Mangunkusumo Hospital (January 2013-March 2014), a total of 73 patients were enrolled. Steroid was given for 7 days. Peripheral blast count at day 8 was evaluated, good response if blast count <1000 /µL and poor if ≥1000 /µL. Fusion gene detection was also performed. The data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: Fusion gene was detected in 45 patients. In 1–€“10 years age group, 26/32 (81%) subjects had good response, while 75% in <1 year age group and 7/9 (78%) in ≥10 years age group had poor response. 5/7 (71%) subjetcs had leukocyte count >100,000 /µL and 7/8 (88%) with T-cell showed poor response. Age, leukocyte count, and T-cell were statistically correlated with steroid response (p<0.05). E2A-PBX1 fusion gene was the most common 19/45 (42%), followed by TEL-AML1 17/45 (38%), BCR-ABL 5/45 (17%), and MLL-AF4 1/45 (3%). Four of five subjects (80%) with BCR-ABL and one subject with MLL-AF4 had poor steroid response. On the other hand, 12/19 (63%) with E2A-PBX1 and 13/17 (77%) with TEL-AML1 had good response. There was no correlation between steroid response and molecular assessment. Conclusion: Steroid response correlates with age, leukocyte count, and T-cell but not with molecular assessment.
Can a pneumothorax break your heart?
Medical Journal of Indonesia Vol. 24 No. 1 (2015): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i1.1179

Abstract

Takotsubo cardiomyopathy or apical ballooning is a condition characterized by transitory left ventricular dysfunction, affecting commonly postmenopausal females after foregoing acute emotional or physical stress. We report a case of a 63 year old female presenting with severe dyspnea and right-sided secondary spontaneous pneumothorax, initially treated with tube thoracostomy. Despite the fact that pneumothorax resolved, shortness of breath persisted and due to ST-segment elevation and increased Troponin I levels, she was admitted to cardiac catheterization. A significant coronary stenosis was ruled out and the diagnosis of a Takotsubo cardiomyopathy was established. Electrocardiographic findings were normalized within three days and attributable to prolonged air leakage. A thoracoscopic apex resection followed by a partial parietal pleurectomy was performed. Although Takotsubo cardiomyopathy is a rare syndrome, it should always be considered as a potential cardiac complication of a pneumothorax.
Changes in peripapillary retinal nerve fiber layer thickness in chronic glaucoma and non-glaucoma patients after phacoemulsification cataract surgery
Medical Journal of Indonesia Vol. 24 No. 4 (2015): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i4.1181

Abstract

Background: Phacoemulsification is a common cataract operation nowadays. During phacoemulsification, variation in intraocular pressure (IOP) may occur, which might change the retinal nerve fiber layer (RNFL) thickness. This study was aimed to evaluate the change in peripapillary RNFL thickness and mean deviation (MD) of visual field after phacoemulsification in chronic primary glaucoma and non-glaucoma patients. Methods: Cohort prospective study was done on 26 patients (13 chronic glaucoma eyes and 13 non-glaucoma eyes) who underwent phacoemulsification. The changes in peripapillary RNFL thickness and MD of visual field were measured as the primary outcome. Comparison between pre- and post-surgery was analyzed with paired t-test, while unpaired t-test was used for comparison between groups. Results: There were no significant changes in RNFL thickness on both groups. Average RNFL thickness in glaucoma group before and after phacoemulsification were 94.9±20.0 μm and 99.1±21.3 μm, respectively (p>0.05). Average RNFL thickness in non-glaucoma group were 100.2±11.1 μm and 101.7±6.8 μm, respectively (p>0.05). Glaucoma patients yielded decreasing mean deviation (MD) of visual field, but it was not statistically significant (p=0.071). In contrast, the MD of visual field after surgery was significantly increased in non-glaucoma group (p=0.005). Conclusion: Phacoemulsification tended to increase peripapillary RNFL thickness in glaucoma or non-glaucoma patients. The visual field tended to decrease in glaucoma patients, but was significantly increased in non-glaucoma patients.
Short-term outcome of ceramic-on-ceramic total hip replacement in young adult patients
Medical Journal of Indonesia Vol. 24 No. 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i3.1184

Abstract

Background: Ceramic-on-ceramic (CoC) total hip replacement (THR) was developed to minimize debris and osteolytic reaction. The major concern is its brittleness. The aim of this study was to evaluate the short-term outcome of CoC THR in young adult patients. Methods: 11 patients, 13 THR procedures, were followed up until six months after surgery in Cipto Mangunkusumo Hospital. Evaluation included Harris hip score (HHS), visual analog scale (VAS), patients' complaint, short form-36 (SF-36), and acetabular and femoral component angles. Data were analyzed using Wilcoxon signed rank test, paired t-test, and Spearman test. Results: The average age of the patients was 33.6 years old and 55% of them were female. Systemic lupus erythematosus was the main causative disease for THR. The VAS average decreased before surgery and after six months of surgery (5 to 1). Pre- and post-operative HHS and SF-36 increased significantly by (25 to 92) and (21 to 54) respectively. Squeaking sound was reported by two patients. No correlation was found between acetabular and femoral component and squeaking incidence. Conclusion: CoC THR showed excellent short term outcome for young adult patients. With proper indications, CoC THR ensures excellent clinical outcomes and promising survivorship.
Gene expression and enzyme activities of carbonic anhydrase and glutaminase in rat kidneys induced by chronic systemic hypoxia
Medical Journal of Indonesia Vol. 24 No. 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i3.1190

Abstract

Background: Hypoxia can cause acidosis. Kidney plays an essential role in maintaining acid-base balance, which involves the activities of carbonic anhydrase (CA) and glutaminase (GLS). This study is aimed to determine the expression and activities of the CA9 and GLS1 enzymes in relation to hypoxia inducible factor-1α (HIF-1α), a transcription factor protein which is a marker of hypoxia. Methods: This study was an in vivo experimental study with coupled paralel design. used 25 male Sprague-Dawley rats weighing 150-200 g. Rats were divided into 5 groups: the control group (normoxic condition) and 4 treatment groups. The latter were kept in a hypoxic chamber (10% O2: 90% N2) for 1, 3, 5 and 7 days. All rats were euthanized after treatment, kidneys excised, tissues homogenized and investigated for gene expression of CA9, GLS1 and HIF-1α. On protein level, total enzymatic activities of CA and GLS and protein of HIF-1α were also investigated. Data were analyzed statistically using ANOVA for significance, and as its alternative, used Mann-Whitney and Kruskal-Wallis test. Results: Results showed that HIF-1α mRNA increased during hypoxia, but not HIF-1α protein. It seemed that acidosis occurs in kidney tissue, indicated by increased CA9 and GLS1 mRNA expression and specific activity of total CA and GLS1. Expression of CA9 and GLS1 mRNA both showed strong positive correlation with HIF-1α mRNA, but not with HIF-1α protein. Conclusion: It is suggested that during chronic systemic hypoxia, gene expression of CA9 and GLS1 and their enzyme activities were increased as a response to acidosis and related with the expression of HIF-1α mRNA.
Palmaris longus absence in six largest Indonesian ethnicities and its relationship with gender, ethnicity, and hand dominance
Medical Journal of Indonesia Vol. 24 No. 1 (2015): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i1.1191

Abstract

Background: Palmaris longus (PL) tendon is often used as graft in tendon or ligament reconstruction. PL absence is a normal variation in human body. Its prevalence was different in various population. Serbian population had an absence rate of 42.4%, but in the Korean population it was only 4.0%. This study aimed to determine the prevalence of PL absence in various ethnic of Indonesian population and its relationship with gender and side of hand dominance. Methods: We conducted a cross-sectional study in 1230 people from six ethnicities in Indonesia. The absence of PL was determined by Schaeffer test and confirmed with Mishra and Thompson test. Data collection was performed by a single examiner in various cities in Indonesia. The relationship between PL absence with ethnicity, gender, and hand dominance were determined by Chi-square test. Results: Prevalence of PL absence in overall Indonesian population was 10.4% (bilateral 37.5% and unilateral 62.5%). The highest were in Batak and Madura ethnicities (15.5%), followed by Sunda (11.8%), Java (10.0%), Betawi (6.0%), and the lowest was Minang ethnicity (4.1%) (p = 0.008). Prevalence of PL absence in female and male were 10.7% 10.2%, respectively, p > 0.05). Conclusion: Compared to range of prevalence in other countries in the world, prevalence of PL absence in Indonesian population was moderate (10.4%). There was significant difference found between ethnicity, but not in gender. Surgeon should consider this data when planning for reconstruction procedures using PL graft in Indonesian population.
Validity and reliability of the Indonesian version of tinnitus handycap inventory
Medical Journal of Indonesia Vol. 24 No. 1 (2015): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i1.1193

Abstract

Background: To translate and assess the validity and reliability of the Indonesian version of Tinnitus Handycap Inventory (THI) as an psychometric instrument for evaluating the quality of life in tinnitus patients. This instrument will support the clinicians to determine the appropriate tinnitus management for them. Methods: A cross-sectional psychometric validation study was performed to assess the internal consistency, reliability and validity of the Indonesian version of THI in 50 subjective tinnitus patients at ENT outpatient clinic of Cipto Mangunkusumo Hospital between May-August 2010. 25 question items of original THI were translated, back-translated and validated using the transcultural validation by WHO. Results: The validity test demonstrated a significant correlation in the emotional and the catastrophic scale whilst there was no significant correlation in the functional scale for item F2 and particularly for item F15. Nevertheless, the validity test on the functional scale showed a good result. This study also showed high internal consistency and reliability for the total scale (Cronbach-α = 0.91) Conclusion: The evaluation result indicated that the reliability of adapted Indonesian version of the THI in our study is relatively high and could be applied in clinical examination or further otolaryngology study by both specialists and general physicians.
Serum vascular endothelial growth factor as a predictor of clinical outcomes in anterior circulation ischemic stroke
Medical Journal of Indonesia Vol. 24 No. 2 (2015): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v24i2.1196

Abstract

Background: Inflammatory response in the acute phase of ischemic stroke will trigger the process of neuroplasticity and determine the clinical outcomes. Angiogenesis and neurogenesis are induced by expression of vascular endothelial growth factor (VEGF) in the acute phase of stroke. The purpose of this study was to determine the association between VEGF serum level in acute phase of stroke with the clinical outcomes. Methods: This longitudinal cohort study was conducted on 64 patients suffering from first-attack of anterior circulation blockage as evidenced by cephalic diffusion-weighted magnetic resonance imaging (DWI). VEGF serum level was measured at 72 hours and 7 days after stroke and the clinical outcomes were assessed on day 30 post-stroke using the National Institutes of Health Stroke Scale (NIHSS). Results: VEGF level at hour-72 and on day-7 were 5.84 ± 0.736 ng/mL and 5.797 ± 0.96 ng/mL, respectively (p > 0.05). High VEGF levels at hour-72 can be used to predict poor clinical outcome 30 days after stroke (OR = 6.5; 95% CI = 1.15-36.61; p = 0.034). Subjects who have increasing levels of VEGF on day-7 compared to hour-72 tend to have better clinical outcomes on day-30. (NIHSS score = 1.33 ± 1.22 vs 3 ± 3.78; p = 0.232). Conclusion: VEGF levels in the acute phase of ischemic stroke reflect the degree of brain damage, the dynamic of the increase in VEGF levels after a stroke was associated with better clinical outcomes.

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