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INDONESIA
Medical Journal of Indonesia
Published by Universitas Indonesia
ISSN : 08531773     EISSN : 22528083     DOI : 10.13181
Core Subject : Health,
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
Chlorhexidine-alcohol versus povidone-iodine as preoperative skin preparation to prevent surgical site infection: a meta-analysis
Medical Journal of Indonesia Vol. 26 No. 1 (2017): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v26i1.1388

Abstract

Background: Surgical site infection remains substantial problems to surgeons and patients as it increases the morbidity, mortality, length of stay, hospital cost, rate of re-admission, and rate of re-surgery. This study aims to compare the use of chlorhexidine-alcohol versus povidone-iodine for preoperative skin preparation to prevent surgical site infection.Methods: The literature search was conducted through the PubMed database on November 2015. Included studies were RCTs with the year of publication up to 2015 which compared the use of chlorhexidine-alcohol versus povidone-iodine in its effectiveness reducing surgical site infection in adult patients. The quality of the study was assessed using Jadad Score. A meta-analysis was conducted in the included study to obtain a pooled estimate of the effect size. The evidence of heterogeneity and publication bias was also assessed.Results: Six RCTs with a total of 2,080 patients were included in the meta-analysis. It showed that the use of chlorhexidine-alcohol was associated significantly with fewer SSIs (pooled risk ratio=0.60 (95% CI=0.45-0.79)) and fewer positive skin culture results (pooled risk ratio, RR=0.38 (95% CI=0.28-0.51)) compared with povidone iodine.Conclusion: Preoperative skin antisepsis with chlorhexidine is more effective than povidone-iodine in preventing surgical site infection.
Increased vimentin mRNA expression in MCF-7 breast cancer cell line after repeated endoxifen-treatment
Medical Journal of Indonesia Vol. 25 No. 4 (2016): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i4.1397

Abstract

Background: Epithelial mesenchymal transition (EMT) plays a significant role in the development of cancer cell resistance to drugs. Vimentin, a type III intermediate filament protein, is a marker of EMT. Vimentin's over-expression in cancer correlates well with increased tumor growth, change in cell shape and poor prognosis. Endoxifen is an active metabolite of tamoxifen and has become a new potent agent in the treatment of breast cancer. This is a study that aimed to investigate the effect of endoxifen exposure with or without estradiol on cell viability, cell morphology and EMT progression through the analysis of vimentin mRNA expression after 4-week treatment. Methods: Endoxifen, 100 nM or 1,000 nM, with or without beta-estradiol were given repeatedly to MCF-7 cells. Cells treated with dimethyl sulfoxide (DMSO) 0.001% were used as control. After 2- and 4-week exposure, the cells were counted, analyzed for mRNA vimentin expression, and observed for morphological changes. Results: Compared to control, there were significant decreases in vimentin mRNA expressions in endoxifen and endoxifen+β-estradiol treated cells after 2-weeks, which then significantly increased after 4-week compared with the 2-week exposure. We found no change in morphology of MCF-7 cells. Conclusion: Repeated exposure of endoxifen might induce EMT progression through increased expression of vimentin in MCF-7 breast cancer cell line.
Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women in primary health centers in Surabaya
Medical Journal of Indonesia Vol. 26 No. 4 (2017): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v26i4.1398

Abstract

Background: Offering free HIV screening service for pregnant women in primary health center in Surabaya has become obligatory since 2014, but only 70% used the service. Prior studies on HIV screening mostly focused on Voluntary Counseling and Testing. Methods: This was a cross-sectional study. Interviews were conducted with 150 pregnant women attending antenatal care in 1 of 9 public health centers (PHCs) in Surabaya and offered HIV screening within the same PHC. The eligibility criterium was pregnant women attending antenatal care in PHCs. The exclusion criteria were having been counseled for HIV prior to the interviews and/or experiencing an obstetric emergency. Using PRECEDE Framework with the concept of a comprehensive framework, this study focuses on identifying determinants of HIV PITC service use in PHCs in Surabaya. Binary logistic regressions and multiple binary logistic regressions were used in analyses. Results: The service use was associated with self-confidence of getting blood drawn for the test (p<0.001, adjusted OR=12.368, 95% CI=3.237–47.250) and past use of midwife private service for current pregnancy (p=0.029, adjusted OR=3.902, 95% CI=1.150–13.246). Self-confidence of getting blood drawn for HIV test mediated the effect of past use of midwife'€™s private service on HIV screening use. Conclusion: Past use of midwife'€™s private service affected self-confidence of getting blood drawn for HIV test on HIV screening use, and self-confidence affected the use of HIV PITC. This study results suggest that more midwives'€™ private practices are needed to increase the use of HIV PITC screening in PHC.
Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing
Medical Journal of Indonesia Vol. 26 No. 1 (2017): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v26i1.1401

Abstract

Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers. Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group) or sham stimulation (the control group) were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1) were measured every week and compared between the two groups and analyzed by Mann-Whitney test. Results: The initial median ulcer size were 4.75 (0.10–9.94) cm2 and 2.33 (0.90–9.88) cm2 in laser-puncture and sham groups, respectively (p=0.027). The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09) vs -0.36 (-0.81 to -1.47) cm2, (p=0.000); at week 3–1 was -1.70 (-3.15 to -0.01) vs -0.36 (-0.80 to -0.28) cm2, (p=0.000); and at week 4–1 was -1.22 (-2.72 to 0.00) vs -0.38 (-0.74 to -0.57) cm2, (p=0.012). Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.
A novel echocardiography formula for calculating predicted pulmonary vascular resistance in patients with mitral stenosis
Medical Journal of Indonesia Vol. 25 No. 2 (2016): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i2.1405

Abstract

Background: Pulmonary vascular resistance (PVR) plays an important role in the natural history, prognosis, and outcome after valve intervention in patients with mitral stenosis (MS). The existing formula to estimate PVR by means of echocardiography is not readily applicable in the MS patient subset because it does not specifically calculate the risk of PVR in MS. The aim of this study was to find a new echocardiography formula to estimate PVR in MS. Methods: This diagnostic study was conducted in 2 stages. In the first stage, 58 consecutive subjects with MS were studied to find some model formulas for estimating PVR by multiple regression. Eight echo parameters were analyzed to seek their correlation with the invasive PVR value as a gold standard. The formula that had the best correlation and was easiest to use would be selected. In the second stage, those model formulas were validated by applying them to a further 34 consecutive MS subjects. Results: Four formulas which gave a discriminator coefficient of r2 0.62–0.68 were derived. The best model formula was proposed for further application. The new selected formula PVR=-7.465+3.566 TRvmax –(0.23 TVs’)+6.799 (RV-MPI) showed good correlation (r=0.71, p<0.001) to the invasive PVR value, with good reliability. TRvmax is maximal velocity of tricuspid regurgitation, TVs’ is systolic velocity of tricuspid annulus, and RV-MPI is right ventricle index myocardial performance. ROC curve showed that the cut off point 7.2 has good sensitivity and specificity (90% and 88%, respectively) to predict PVR 7 WU. Conclusion: This study has shown that a novel echocardiography formula can estimate PVR with good correlation and reliability in subjects with mitral stenosis.
Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women
Medical Journal of Indonesia Vol. 25 No. 3 (2016): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i3.1407

Abstract

Background: Mode of delivery and some certain risk factors have a relationship to postpartum stress urinary incontinence (SUI). For that reason, the objective of this study was to assess the prevalence of postpartum stress urinary incontinence (SUI), the relationship between postpartum SUI and mode of delivery; and the association between SUI and other demographic and obstetric factors.Methods: In this prospective observational cohort study, all primiparous women who were under postpartum care in obstetric and gynecologic ward were recruited. Four hundreds primiparous women with no history of urinary incontinence (UI) who fulfilled the criteria and would like to participate in this study were followed up for three months after delivery. The analysis was done using Stata 12. Bivariate analysis using Chi-square test and multivariate analysis using logistic regression test were done to obtain associated risk factors to postpartum SUI.Results: The prevalence of postpartum SUI was 8.8%. The mode of delivery was significantly associated with postpartum SUI, there were more women who got vaginal delivery that had stress urinary incontinence (14.1%) compared to women caesarean section (7.1%) with OR=2.1 (95% CI=1.05-4.31), this risk increased when vaginal delivery was assisted with vacuum instrument (OR=9.1, 95% CI=3.9-21.6). There was no statistical difference of stress urinary incontinence incidences in patients with emergency or elective caesarean section with OR=0.84 (95% CI=0.28-2.57). Based on multivariate analysis BMI ≥30 kg/m2 at labor, vacuum assisted delivery, birth weight more than 3,360 g, and second stage labor more than 60 minutes appeared to be associated with an increased rate of postpartum SUI.Conclusion: Stress urinary incontinence increased in the early postpartum period of a primiparous woman. Although vaginal delivery increased the risk of postpartum SUI, elective nor emergency caesarean delivery without vaginal delivery id not appear to increase the risk of stress urinary incontinence.
Current situation of Helicobacter pylori infection in Indonesia
Medical Journal of Indonesia Vol. 25 No. 4 (2016): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i4.1408

Abstract

The epidemiology of Helicobacter pylori (H. pylori) has been changing over the past decades. Indonesia was reported have a low prevalence of H. pylori infection compared to other countries in Asia. Some studies in Indonesia have evaluated that poor sanitation, age, religion, ethnicity are the risk factors for H. pylori infection. Compared to other diagnostic tests, the urine test will be reliable for the detection of H. pylori in Indonesia because it is non-invasive and low cost with high accuracy. Although we have already performed studies on the prevalence of H. pylori infection in several ethnics, we still have some questions that remain unclear regarding H. pylori infection in Indonesia. Therefore, we have a need to build a H. pylori center that provide facilities for culturing, evaluating antibiotic resistance, and obtaining the genotype information that may explain the differences in H. pylori infection among ethnic groups in Indonesia.
Diastolic function in patients with preeclampsia during pre- and post-partum period using tissue doppler imaging
Medical Journal of Indonesia Vol. 25 No. 2 (2016): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i2.1410

Abstract

Background: Prior studies have compared the E/e’ elevation in preeclampsia patients to normal patients, however there are no data whether this elevation persists after birth. The aim of this study is to analyze diastolic function in preeclampsia patients during pre- and post-partum period using E/e’ parameter measurement. Methods: This is a prospective cohort study of pregnant women with preeclampsia who were hospitalized and planned for pregnancy termination. Basic clinical characteristics were obtained from all samples. Echocardiography was done prepartum, 48-72 hours after termination, and 40-60 days postpartum. Post hoc analysis using least significant difference method was used to compare the results between measurements. Results: 30 subjects were enrolled in the study. Analysis on E/e’ characteristics showed statistical difference between prepartum E/e’ and 40 days postpartum E/e’ (11.87±3.184 vs 9.43±2.529, p=0.001, CI=1.123-3.751), as well as between 48 hours post-partum and 40 days post-partum period (12.12±2.754 vs 9.43±2.529, p<0.001, CI=1.615-3.771). There were no statistical differences between pre-partum E/e’ and 48 hours post-partum E/e’ (11.87±3.184 vs 12.12±2.754, p=0.633, CI=-1.345-0.832). Conclusion: This study showed diastolic dysfunction in preeclampsia patients persists up until a few days after birth, but resolves in time (40 days after birth) as measured by tissue doppler imaging.
Evaluation of cardiac function tests in Sudanese adult patients with sickle cell trait
Medical Journal of Indonesia Vol. 25 No. 3 (2016): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i3.1412

Abstract

Background: Cardiac dysfunctions have been recognized as a common complication of sickle cell anaemia (SCA), and together with pulmonary disorder accounts for many deaths in these patients. However, sickle cell traits appear clinically normal, although they have genetic abnormality. The aim of this study was to assess the effect of sickle cell trait on cardiac prognostic markers by measuring high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), cardiac creatine kinase (CK-MB), ultra-sensitive C reactive protein (us-CRP), total homocysteine (Hyc), and N-terminal pro-brain natriuretic peptide (NT-pro BNP) tests in adult Sudanese patients with sickle cell trait. Methods: A cross-sectional study was performed in 200 healthy volunteers as a control group and 200 diagnosed patients with sickle cell trait. It was carried out in Khartoum Specialized Hospital, Al-Bayan Hospital, Obayed Clinical Center and Dr. Nadir Specialized Hospital, Sudan between January 2015 and January 2016. All participants were between 20-32 years old. LDL-C, HDL-C, CK-MB, NT-proBNP and hs-CRP concentrations were measured by Hitachi 912 full-automated Chemistry Analyzer (Roche Diagnostics, Germany) as manufacturer procedure, while homocysteine level was measured by ELISA technique using special kit. Results: When compared to control group, the levels of LDL-C, hs-CRP and NT-proBNP revealed significant increase in patients’ sera (p<0.001), while Hyc and CK-MB levels were increased insignificantly in patients with SCT (p=0.069, p=0.054 respectively). On the other hand, comparison to control group, HDL-C showed insignificant reduction in patients (p=0.099). Conclusion: The results suggest that sickle cell trait increased the risk of patient-related complication secondary to cardiac dysfunction.
The dream comes true–start for the new beginning
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.v25i1.1413

Abstract

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