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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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Indonesia national health policy in the transition of disease burden and health insurance coverage
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.v26i1.1975

Abstract

[no abstract available]
A case series of eight scoliosis patients undergone pedicle screw placement with freehand technique: study for safety and accuracy
Medical Journal of Indonesia Vol. 29 No. 2 (2020): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.cr.191978

Abstract

BACKGROUND Pedicle screws and rods are routinely inserted in the vertebrae thoracic to lumbar in scoliosis reconstruction surgery to gain deformity correction and fusion. Intraoperative imaging is often needed to ensure accuracy, but surgical time will be longer and there will be more radiation exposure. Meanwhile, freehand technique is accepted as safe. This study was aimed to evaluate the accuracy of screw insertion in the freehand technique used in adolescent scoliosis surgery. METHODS This case series evaluated a total of 127 pedicle screws inserted using the freehand technique in 8 out of 28 adolescent scoliosis patients from 2011 to 2016 whom agreed for computed tomography (CT) scan follow-up from 2011 to 2016 in Dr. Seotomo Hospital, Surabaya. The accuracy and safety of the freehand technique were evaluated postoperatively in each patient using a CT scan. A successful screw was considered accurate if it was within the vertebral body and inside the safety zone (within the limit of 2–4 mm to the medial or lateral side of the vertebral body. RESULTS Of the 127 screws inserted, 106 (83.5%) were accurately placed, and 110 (86.6%) were within the safe zone. According to the level of the spine, in the upper and middle thoracic spine, the inserted screws were accurate in 69.4% and 74.9% within the safety zone, whereas in the lower thoracic and lumbar spine, 94.0% and 95.0% within the safety zone. CONCLUSIONS The freehand technique in scoliosis reconstructive surgery performed by experienced surgeons is accurate and safe.
Overexpression of p53 in extra large (more than 10 cm) hepatocellular carcinoma
Medical Journal of Indonesia Vol. 27 No. 2 (2018): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v27i2.1980

Abstract

Background: Extra large hepatocellular carcinoma (HCC) of >10 cm managed in our center shows a specific characteristic in tropical regions. This type of HCC exhibits distinct p53 expression. This study aimed to determine the association between p53 expression and tumor size and behavior. Method:Subjects with HCC who underwent surgical resection in our hospital during 2012–2015 were enrolled in this study. Subject’s characteristics, tumor size, histopathology findings, and tumor behavior were variables observed. An immunohistochemical study on p53 expression was conducted to determine its association with those variables. Results:This study involved 38 subjects with tumor size ranging from 3 cm to 25 cm in diameter and 20 subjects (52.8%) with tumor size ranging from 10 cm to 25 cm in diameter. Only 13 samples were evaluated for p53 expression. Five subjects with >10 cm (extra large) tumor showed highly/overexpressed p53 (intensity>50%), two subjects with strong p53 expression (intensity>5%–50%), and two subjects with weak expression. Three subjects with <10 cm (large) tumor showed strong expression of p53 (5%–9%) and a subject with 3 cm tumor showed weak p53 expression (<5%). Highly expressed p53 was found in patients with microvascular invasion, inflammatory response, mitosis, and necrosis. Conclusion: Overexpression of p53 was associated with extra large and poorly differentiated HCC.
Can glycated hemoglobin act as a reliable glycemic indicator in patients with diabetic chronic kidney disease? evidence from the Northeast of Thailand
Medical Journal of Indonesia Vol. 26 No. 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v26i2.1995

Abstract

Background: Chronic kidney diseases (CKD) is a common microvascular complication in patients with diabetes mellitus (DM) which requires adequate glycemic control. Glycated hemoglobin (HbA1c) is a conventional biomarker to estimate glycemic status, but its role in diabetic CKD patients is unclear. Therefore, this study aimed to determine whether patients with high HbA1c are associated to develop diabetic CKD. Methods: Data were obtained from a clinical registry of diabetic patients who were treated in a district hospital in the Northeast of Thailand. CKD was defined according to the estimated glomerular filtration rate (eGFR<60mL/min/1.73m2). Anthropometric and biochemical measurements of the patient were taken by review of medical records. Multiple logistic regression analysis was used to determine the likelihood of the association between HbA1c and CKD. Results: Among 4,050 participants, 1,027 (25.3%) developed diabetic CKD. Older age (adjusted odds ratio (AOR): 4.88, 95% confidence interval (CI): 3.71-6.42, p<0.05), female (AOR: 1.38, 95% CI: 1.05-1.73, p<0.05), and hypertension (AOR: 1.52, 95% CI: 1.21-1.91, p<0.05) were found as the risk factors of diabetic CKD. However, patients with high HbA1c (>6.5%) were negatively associated with diabetic CKD (AOR: 0.66, 95% CI: 0.51-0.86, p<0.05). Conclusion: This study found patients with higher HbA1c level were not associated with diabetic CKD. Therefore, using the conventional cut-off values of HbA1c in diabetic CKD patients may be problematic in the clinical settings. Enhanced detection of glycemic status in patients with diabetic CKD is warranted to improve the outcome.
Acanthamoeba keratitis: a challenge in diagnosis and the role of amniotic membrane transplant as an alternative therapy
Medical Journal of Indonesia Vol. 27 No. 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v27i4.2007

Abstract

Acanthamoeba keratitis (AK) is a very rare, sight-threatening corneal disease caused by the infection of a free-living amoeba. The aim of this report was to demonstrate the challenges in the diagnosis of AK with an atypical presentation. Amniotic membrane transplantation (AMT) was done in this case to accelerate wound healing. A woman who frequently used contact lens came with redness and a whitish spot in her left eye 2 weeks before admission. There was a history of rinsing contact lens in tap water. The patient had already been on a topical steroid for 2 weeks. Visual acuity of the left eye was light perception with wrong projection. Examination of the left cornea showed a semi-circular central ulcer with a 5.8-mm area and 1/3 stromal depth. It is surrounded by a feathery-edge infiltrate with positive satellite lesions but without hypopyon. It was diagnosed as corneal ulcers due to mixed infection (bacteria and fungi). After 2 weeks of bacterial and fungal therapy, the size of the ulcer decreased, but the corneal infiltrate remained; therefore, an Acanthamoeba culture was done to determine the possibility of Acanthamoeba infection. Two weeks after the Acanthamoeba topical therapy, the visual acuity improved. AMT was performed to accelerate wound healing. Two months post-AMT, visual acuity improved to 1/60 with no conjunctival or ciliary vasodilation, and the ulcer was resolved. The patient was planned to undergo keratoplasty. The diagnosis of AK with an atypical presentation is challenging. AMT can be used as an alternative therapy to accelerate wound healing.
The effect of lead acetate administration to the uterine malondialdehyde level and endometrial thickness in albino rats (Rattus novergicus)
Medical Journal of Indonesia Vol. 27 No. 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v27i3.2031

Abstract

Background: Indonesian seawater has been found to contain a high level of lead acetate and tends to become toxic. The previous study suggested lead acetate exposure could be harmful to many organs including the brain, liver, heart, as well as the reproductive system. This study aimed to analyze the effect of lead acetate on both the uterine level of malondialdehyde (MDA) level and endometrial thickness in female Wistar rats (Rattus norvegicus).Methods: Twenty-four rats were divided into 4 groups: 1 control group, and 3 treatment groups that were given lead acetate at 30, 100, and 300 ppm p.o./day for 30 days, consecutively. Rats were sacrificed; the uterus was isolated and processed for both MDA level measurements (using TBARS and a spectrophotometer) and histopathology using hematoxylin-eosin (HE) staining. Results: There was no significant difference in mean MDA level between the control and lead acetate administration groups. There was a reduction in endometrial thickness from 352.6±81.88 μm in the control group to 323.5±90.67 μm; 313.6±40.30 μm; 303.4±62.75 μm in 30, 100, and 300 ppm, respectively. Consequently, spacious uterus was observed reflects the endometrial damage, including the decrease in the size of the epithelium, columnar, stroma, and lumen in the whole part of the uterus and these differences in uterine thickening was considered statistically significant (p=0.005). Conclusion: Lead acetate could reduce the thickness of the endometrium but had no effect on the level of MDA in the uterus.
Epidemiology of erectile dysfunction in men with diabetes mellitus: a study in a primary health care center in Indonesia
Medical Journal of Indonesia Vol. 29 No. 1 (2020): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.192070

Abstract

BACKGROUND Diabetes mellitus (DM) is one of the factors causing erectile dysfunction (ED) and may affect a person's quality of life. This study was aimed to describe the epidemiology of ED in men with DM in a primary health care. METHODS The study used a cross-sectional study design conducted from January to March 2017 at the Tlogosari Kulon Health Center, Semarang. There were 122 diabetic men who were all included in the study. The data were collected using interviewerassisted questionnaires. The status of ED was measured by the erectile dysfunction intensity scale adapted to the International Index of Erectile Function. RESULTS The results showed that the prevalence of diabetic men with ED was 84.4%. Most men with ED had age of ≥46 years (91.0%), experienced work stress (88.5%), had low physical activity (93.1%), had obesity (88.0%) of which 86.3% had central obesity, smoking (84.6%), had DM >5 years (91.2%), and took antihypertensive drugs (90.0%). The fasting blood glucose level of respondents ≥126 mg/dl was 86.0%, and 91.7% had sexual desire disorder. The duration of DM and aging are contributing factors of ED in males with DM, with a p-value of 0.016 and 0.013, respectively. CONCLUSIONS The prevalence of ED in primary health care is still high, and the determining factors were the duration of DM and aging. Public health centers are advised to undertake health promotion on the prevention of factors that can lead to sexual dysfunction in males with DM.
Factors that influence the survival of unstable pelvic fracture in the acute phase
Medical Journal of Indonesia Vol. 27 No. 1 (2018): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v27i1.2078

Abstract

Background: The fatality rate of unstable pelvic fracture is still high (20–€“50%) due to acute phase hemorrhage or late multiple organ failure. The assurance for 100% survival in acute phase had been reported if the emergency room team have the right technique, right timing, and right protocol. The aim of this study was to evaluate and to date factors that influence the non-survival unstable pelvic fracture within 2x24 hours.Methods: This retrospective study was conducted in emergency unit of Dr. Soetomo General Hospital Surabaya during 2012–€“2016 for unstable pelvic fracture with unstable hemodynamic, without concomitant head or thoracic injury and admitted within 4 hours after the incident. All patients were handled according to the protocol for resuscitation and C-clamp insertion immediately. X-ray was taken after the insertion to check the C-clamp position and to confirm the diagnosis. The 2x24-hour data were taken whether the patient survive or not survive, including mean arterial pressure (MAP) pre-and post, heart rate (HR) pre-and post, and initial hemoglobin and platelet count. Data were analyzed with independent t-test and multiple regression analysis.Results: Twenty two patients were recorded as the inclusive criteria, separated into 17 survivors and 5 non-survivors. They were comprised of 14 males and 8 female patients, with an average of 31.9±15.3 years old. The MAP post, HR pre-and post, and platelet count were significantly different. The factor that influenced the survival within 2x24 hours was the MAP post C-clamp (>70 mmHg) (p<0.05).Conclusion: The acute phase 2x24-hour outcome after C-clamp insertion and resuscitation was significantly influenced by MAP post C-clamp and resuscitation.
International collaboration for implementation of equal access to family-based primary healthcare in Indonesia
Medical Journal of Indonesia Vol. 26 No. 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v26i2.2103

Abstract

[No abstract available]
A randomized controlled trial of high parenteral protein feeding in septic children: the role of tumor necrosis factor-alpha-308 polymorphism
Medical Journal of Indonesia Vol. 29 No. 1 (2020): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.192104

Abstract

BACKGROUND Septic children cause high protein degradation and inadequate nutritional intake would worsen the outcomes. In addition, there are conflicting results of association between tumor necrosis factor-α (TNFA)-308 polymorphism and poorer outcomes. This study was aimed to investigate the impact of high protein feeding in septic children and to examine the role of the TNFA-308 polymorphism in outcome of sepsis. METHODS In this randomized controlled trial, septic children were randomly assigned to receive either high protein feeding (amino acid of 4 g/kg of body weight [kgBW]/day) or standard nutrient (amino acid of 2 g/kgBW/day) for three days in the pediatric intensive care unit of four hospitals in Indonesia. The patient’s enrollment was done between April 2016 and May 2017. The primary outcome was the pediatric logistic organ dysfunction (PELOD) score. TNFA-308 polymorphism was investigated using restriction fragment length polymorphism method in both groups. PELOD score was analyzed as mean differences and gene polymorphism was analyzed with mortality in a subgroup. RESULTS There were 40 children in each group. PELOD score on day-1 (22.4 versus 20.5, p = 0.429), day-2 (20.5 versus 19.8, p = 0.815), and day-3 (18.8 versus 19.8, p = 0.772) were not lower in high protein feeding compared to standard feeding. TNFA-308 polymorphism had no role in mortality of both groups (high protein, p = 0.426; standard, p = 0.456). CONCLUSIONS From this study, researchers concluded that a high protein intervention did not significantly decrease the PELOD score, length of stay, and duration of ventilator use in both groups.

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