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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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Phylogenetic analysis and predicted functional effect of protein mutations of E6 and E7 HPV16 strains isolated in Indonesia
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.v24i4.1197

Abstract

Background: E6 and E7 are oncoproteins of HPV16. Natural amino acid variation in HPV16 E6 can alter its carcinogenic potential. The aim of this study was to analyze phylogenetically E6 and E7 genes and proteins of HPV16 from Indonesia and predict the effects of single amino acid substitution on protein function. This analysis could be used to reduce time, effort, and research cost as initial screening in selection of protein or isolates to be tested in vitro or in vivo. Methods: In this study, E6 and E7 gene sequences were obtained from 12 samples of Indonesian isolates, which were compared with HPV16R (prototype) and 6 standard isolates in the category of European (E), Asian (As), Asian-American (AA), African-1 (Af-1), African-2 (Af-2), and North American (NA) branch from Genbank. Bioedit v.7.0.0 was used to analyze the composition and substitution of single amino acids. Phylogenetic analysis of E6 and E7 genes and proteins was performed using Clustal X (1.81) and NJPLOT softwares. Effects of single amino acid substitutions on protein function of E6 and E7 were analysed by SNAP. Results: Java variants and isolate ui66* belonged to European branch, while the others belonged to Asian and African branches. Twelve changes of amino acids were found in E6 and one in E7 proteins. SNAP analysis showed two non neutral mutations, i.e. R10I and C63G in E6 proteins. R10I mutations were found in Af-2 genotype (AF472509) and Indonesian isolates (Af2*), while C63G mutation was found only in Af2*. Conclusion: E6 proteins of HPV16 variants were more variable than E7. SNAP analysis showed that only E6 protein of African-2 branch had functional differences compared to HPV16R.
The effect of medial arch support over the plantar pressure and triceps surae muscle strength after prolonged standing
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.v24i3.1198

Abstract

Background: The activity with prolonged standing position is one of the causes of abnormalities in the lower leg and foot. The aim of this study is to discover the effect of medial arch support over the distribution of plantar pressure when standing and walking. Methods: This was an experimental study with pre- and post-design the strength of triceps surae muscle after prolonged standing, was also evaluated in an experimental study with pre- and post-design. Variables of plantar pressure measurement are the contact area and pressure peak were measured by using the Mat-scan tool. The measurement of the triceps surae muscle strength was done with a hand-held dynamometer, before and after using the medial arch support. Measurement was performed before and after working with prolonged standing position which took place about seven hours using the medial arch support inserted in the shoes. Data was analyzed using paired T-test. Results: There was a significant difference of peak pressure between standing (p = 0.041) and walking (p = 0.001). Whereas the contact area showed a significant decrease in the width of the contact area when standing (104.12 ± 12.42 vs 99.08 ± 10.21 p = 0.023). Whereas, the triceps surae muscle strength pre- and post-standing prolonged did not indicate a significant difference. Conclusion: There was decrease in peak pressure when standing and walking and decrease in contact area when standing on plantar after used of the medial arch support after prolonged standing.
Incidence and associated factors of posterior capsule opacification in pseudophakic patients at Cipto Mangunkusumo Hospital
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.v24i3.1199

Abstract

Background: Posterior capsule opacification (PCO) is the most common postoperative consequence of cataract surgery which may cause visual acuity reduction, yet the incidence in Indonesia has not been reported. The objectives of this study were to evaluate three years cumulative incidence of PCO and factors associated with PCO formation at Cipto Mangunkusumo Hospital, Jakarta. Methods: This was a retrospective descriptive study on patients with uneventful senile cataract surgery during year 2010. All related data were retrieved from medical records in year 2013, which included patient demographics, type of surgery, intraocular lens (IOL) characteristics (material, optic edge design and diameter). Moreover, time to first PCO diagnosis (month), and best corrected visual acuity (BCVA) pre-operatively, at time PCO was diagnosed and two weeks after Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser were noted (decimal). Results: A total of 578 eyes (485 patients) were involved in this study. Three years cumulative incidence of the PCO was 8.82% (51 eyes). Phacoemulsification surgery was performed in 496 (85.8%) eyes. The median time to PCO diagnosis was 21 months (range 1 to 34 months), mean of BCVA was 0.50 ± 0.26. Age (<65 and >65 years old) was not associated to PCO. Higher incidence of PCO was found in patients using hydrophilic acrylic IOL (10.7%) than in hydrophobic acrylic (6.2%). After Nd:YAG laser was performed, BCVA was improved to 1.00. Conclusion: Three years cumulative incidence of PCO was 8.82% and there was no defined factor related to PCO formation, but higher percentage of PCO occured in patients using hydrophilic acrylic IOL than in hydrophobic acrylic.
Body mass index and waist-to-height ratio cut-offs as predictors of high blood pressure in adolescents
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.v24i1.1200

Abstract

Background: Obesity is associated with increased risk for high blood pressure (BP). Although a routine BP measurement is indicated for all children visiting pediatric practice, recognition of children particularly at risk may save times. The aim of this study was to assess the cut-off point for body mass index (BMI) and waist-to-height ratio (WHtR) to predict high BP in adolescents. Methods: We conducted a cross-sectional study on 928 children aged 11 to 16 years in Yogyakarta. BP were measured using standard technique described by The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. BMI was adjusted for age and sex using the WHO 2007 growth reference. WHtR was ratio of waist circumference related to height in centimeters. Receiver operating characteristic (ROC) curves were used to estimate the best cut-offs. Results: The best cut-off point for BMI-for-age Z-score (BMIZ) to predict high BP was 0.51 with sensitivity and specificity of 82% (95% CI = 78-86) and 76% (95% CI = 67-78) for systolic BP and sensitivity and specificity of 82% (95% CI = 78-86) and 72% (95% CI = 68-76) for diastolic BP. The best cut-off point for WHtR was 0.45, with sensitivity of 76% (95% CI = 67-78) and specificity of 74% (95% CI = 71-79) for systolic BP and sensitivity of 76% (95% CI = 72-80) and specificity of 70% (95% CI = 61-75) for diastolic BP.Conclusion: BMIZ of 0.51 and WHtR of 0.45 are the best cut-off point to predict high BP in adolescents.
The effects of colloids or crystalloids on acute respiratory distress syndrome in swine (Sus scrofa) models with severe sepsis: analysis on extravascular lung water, IL-8, and VCAM-1
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1204

Abstract

Background: Acute respiratory distress syndrome (ARDS) is a fatal complication of severe sepsis. Due to its higher molecular weight, the use of colloids in fluid resuscitation may be associated with fewer cases of ARDS compared to crystalloids. Extravascular lung water (EVLW) elevation and levels of interleukin-8 (IL-8) and vascular cell adhesion molecule-1 (VCAM-1) have been studied as indicators playing a role in the pathogenesis of ARDS. The aim of the study was to determine the effects of colloid or crystalloid on the incidence of ARDS, elevation of EVLW, and levels of IL-8 and VCAM-1, in swine models with severe sepsis.Methods: This was a randomized trial conducted at the Laboratory of Experimental Surgery, School of Veterinary Medicine, IPB, using 22 healthy swine models with a body weight of 8 to 12 kg. Subjects were randomly allocated to receive either colloid or crystalloid fluid resuscitation. After administration of endotoxin, clinical signs of ARDS, EVLW, IL-8, and VCAM-1 were monitored during sepsis, severe sepsis, and one- and three hours after fluid resuscitation. Analysis of data using the Wilcoxon test , Kolmogorov-Smirnov test, Mann-Whitney test, unpaired t test.Results: Mild ARDS was more prevalent in the colloid group, while moderate ARDS was more frequent in the crystalloid group. EVLW elevation was lower in the colloid compared to the crystalloid group. There was no significant difference in IL-8 and VCAM-1 levels between the two groups.Conclusion: The use of colloids in fluid resuscitation does not decrease the probability of ARDS events compared to crystalloids. Compared to crystalloids, colloids are associated with a lower increase in EVLWI, but not with IL-8 or VCAM-1 levels.
Annular pancreas: the failure of side-to-side gastrojejunostomy anastomosis and the success of repair with Roux-en-Y gastrojejunostomy
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.v24i2.1207

Abstract

Annular pancreas is a rare congenital anomaly characterized by a partial or complete encirclement of ectopic pancreas tissue around the duodenum. We report a case of annular pancreas in a 15 day-old infant admitted to the hospital with complaints of profuse and recurrent vomiting and loss of body weight. Non-contrast abdominal X-ray showed a dilated stomach with bubbles formation around the upper abdomen. An obstruction was noted and open laparotomy was performed. Upon laparotomy, pancreatic ring encircled the proximal duodenum causing an obstruction. Side-to-side gastrojejunostomy was performed and passage through the bypass was satisfactory. Four days after the operation, vomiting and bulging abdomen ensued. Contrast abdominal X-ray demonstrated filling defects at the level of obstruction and the anastomosis made. Anastomotic stricture was suspected and thus was corrected using Roux-en-Ygastrojejunostomy procedure. Postoperative course in this patient was satisfactory and patient was discharged after 24 days of hospitalization.
The role of copeptin as a novel cardiovascular biomarker
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.v24i1.1208

Abstract

Copeptin is a provasopressin-derived peptide, the precursor for arginine vasopressin (AVP), which is an antidiuretic hormone from the hypothalamus. Copeptin is secreted together with AVP equally as a response of AVP stimulation. While AVP’s main function is water and blood volume regulation and maintaining electrolyte homeostasis, copeptin’s function is still not fully understood. AVP, copeptin, and other vasopressinergic neuropeptides’ levels are elevated in acute stress caused by pathological conditions. Clinical use of AVP levels has many weaknesses. Copeptin can act as a replacement because of its molecular stability, easier testing methods, and faster results. For example, combination of copeptin and cardiac troponins can eliminate myocardial infarction (MI) diagnosis faster, while combined with brain-type natriuretic peptide (BNP) or its precursor can predict heart failure (HF) outcome. In cardiovascular shock, copeptin levels are elevated. As such, copeptin is a potential biomarker for MI diagnosis and predictor for HF mortality and morbidity.
The effect of multi-micronutrient and protein supplementation on iron and micronutrients status in pregnant women
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.v24i3.1209

Abstract

Background: Potential benefits of multiple micronutrient supplements has become an increasing interest seeing as the high rate of pregnant women with suboptimal nutritional status, but low compliance often reduces effectiveness of large-scale iron and folic acid supplementation program. The aim of this study was to investigate the efficacy of multi-micronutrient and protein supplementation on iron and micronutrients status in pregnant women. Methods: An exploratory study was conducted to 100 pregnant women ≤ 12 weeks, who underwent antenatal care in Budi Kemuliaan Hospital, Jakarta. The subjects received formulated powder milk containing multi-micronutrient and protein supplement monthly until delivery. Anthropometric measurement, maternal and cord blood exam, ultrasound and dietary recall were done. The data was analyzed by correlation test. Correlation between variables was tested using Pearson or Spearman correlation test. Results: The mean maternal hemoglobin level significantly decreased during study (p < 0.001), being the lowest in second trimester. The levels on the first, second, and third trimester respectively was 12.16 ± 1.03 g/d; 12 anemic subjects and 17 had low ferritin level, 10.85 ± 0.95 g/dL; 58 anemic subjects and 69 had low ferritin level, and 11.02 ± 0.35 g/dL; 50 anemic subjects and 51 had low level of ferritin). Ferritin and serum iron levels were decreased at trimester one and two (p < 0.001), also the zinc and vitamin D level declined. Anemia did not correlate with pregnancy outcomes such as preterm delivery, preeclampsia, or low birth weight. Conclusion: The levels of maternal hemoglobin, ferritin, iron, zinc, and vitamin D during pregnancy could not be maintained or increased by multi-micronutrient and protein supplementation.
Expression and specific activities of carbamoyl phosphate synthetase 1 in chronic hypoxic rats
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1213

Abstract

Background: Urea biosynthesis is a very important process in the liver which needs ATP, CO2 and functional mitochondria or aerobic condition. Liver can adapt to hypoxic condition, generally and locally. This study aimed to analyze the effect of chronic hypoxia on liver urea biosynthesis as indicated by the level and specific activity of mRNA of carbamoyl phosphate synthetase 1 (CPS1), a key enzyme in urea biosynthesis in hypoxic rats. Methods: 20 male Sprague-Dawley rats were placed in hypoxic chamber supplied by a mixture of 10% O2 and 90% N2. Five rats were sacrificed at 1, 3, 5, and 7 days after exposure. Liver homogenates were analyzed for HIF-1 (hypoxia inducible factor-1) by ELISA, CPS1 mRNA by real time RT-PCR and CPS1 enzymatic specific activities by Pierson method. Data were analyzed by ANOVA test and Pearson correlation. Results: The HIF-1 in liver increased significantly, as well as CPS1 mRNA and CPS1 enzymatic activities (p<0.05). There was a strong correlation (r=0.618; p<0.01) between the level of CPS1 mRNA and CPS1 enzymatic activities, moderate correlation between HIF-1 and CPS1 mRNA (r=0.419; p<0.05) but no correlation between HIF-1 and CPS1 enzymatic activities. The study indicated that urea biosynthesis in liver was affected by hypoxia and partially under HIF-1 regulation. The study also found increase of urea and NH3 biosynthesis related to proteolysis as indicated by the decrease of total body weight and liver weight. Conclusion: There was an increase in the expression and specific activities of CPS1 in urea biosynthesis as a result of increasing proteolysis in chronic hypoxic condition.
Basal follicle stimulating hormone and leptin on the day of hCG administration predict successful fertilization in in vitro fertilization
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1215

Abstract

Background: Successful pregnancy in in vitro fertilization (IVF) program depends on multiple factors. This study aimed to determine whether age, body mass index (BMI), basal follicle stimulating hormone (FSH), estradiol, and leptin on the day of trigger ovulation with human chorionic gonadotropin (hCG) might be used as predictor for successful oocyte fertilization in in vitro fertilization (IVF) program. Methods: This is a cross sectional study conducted in Yasmin Fertility Clinic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Forty participating patients underwent IVF program, excluding smokers, patients with diabetic, morbid obesity, and severe oligospermia or azoospermia. Age, BMI, basal FSH, estradiol, leptin on the day of hCG administration, oocyte count on oocyte retrieval, the number of mature oocyte, and fertility rate were analyzed using bivariate and multivariate analysis to determine which eligible factors play role in predicting the successful of fertilization. Results: Significant correlation was found between basal FSH level and serum leptin/oocyte ratio on the day of hCG administration with successful fertilization. We found probability formula as follows: 1/(1+exp –€“(6.2 - 0.4(leptin serum/oocyte ratio) - 0.8(basal FSH)), with 77.8% sensitivity, 77.8% specificity, and AUC levels of 85.6% indicating strong predictability. Probability of successful fertilization related to basal FSH level of 5.90 mIU/mL and leptin serum/oocyte ratio of 3.98. Conclusion: The formula consisting of basal FSH and leptin serum/oocyte ratio on the day of trigger ovulation was capable in predicting the probability of successful fertilization in IVF procedure.

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