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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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DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia
Medical Journal of Indonesia Vol. 28 No. 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i1.2931

Abstract

BACKGROUND Indonesia was a part of the most recent edition of DiabCare Asia held in 2008. DiabCare Asia 2012 is modeled after a similar project to provide the latest information to facilitate healthcare policymaking in this area. METHODS This was an observational, non-interventional, cross-sectional study of patients with type 2 diabetes mellitus from primary, secondary, and tertiary care centers in Indonesia. Patient data collected included demography, medical history complications, eye and foot examinations, diabetes management, and most recent laboratory investigations. Blood samples were collected from all patients for the analysis of glycated hemoglobin (HbA1c). RESULTS A total of 1,967 patients participated in the study, with a mean (SD) age of 58.4 (9.5) years and a median (range) duration of diabetes 6.0 (0.1−47.0) years. The percentage of patients with HbA1c <7.0% was 30.8% and the mean (SD) HbA1c level was 8.3 (2.2%). The proportion of patients using insulin was 34.7% with a mean (SD) total daily dose of 37.9 (24.1) IU. The most common diabetes-related complications were peripheral neuropathy (59.1%), erectile dysfunction (32.4%), and eye complications (29.1%). CONCLUSIONS Glycemic and metabolic control remain unsatisfactory in type 2 diabetes patients in Indonesia. Efforts are needed to optimize control and prevent complications in these patients.
Survey frequency of the depression and anxiety levels of infertile women in western Iran
Medical Journal of Indonesia Vol. 28 No. 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i1.2940

Abstract

BACKGROUND Infertility among couples is a painful emotional problem, which results in the feeling of grief in the form of psychological problems such as depression and anxiety. The present study was aimed to survey the frequency of depression and anxiety levels of infertile women in western Iran in 2017. METHODS This cross-sectional study used a simple random sampling method for selecting the sample. The study population consisted of all infertile women who went to Farhangian health center in Ilam. The Beck’s Depression Inventory, Beck’s Anxiety Inventory, and demographic characteristics questionnaire were used for collecting the data. The questionnaires were distributed among midwife experts and patients. The collected data were analyzed by the chi-square test and variance analysis using SPSS version 20. RESULTS Among 200 infertile women, 53.5%, 32%, 11%, and 3.5% suffered from severe, moderate, mild, and no anxiety, respectively. However, 96.5% suffered from various degrees of anxiety with 85.5% from clinical anxiety. In addition, 42%, 19.5%, 14.5%, and 24% suffered from severe, moderate, mild, and no depression, respectively. However, 76% suffered from various degrees of depression with 61.5% from clinical depression. There is a significant relationship between the education level of husbands, education level of women, and type of infertility (p<0.05). Women who had a lower than diploma education level and primary infertility suffered from higher anxiety levels. CONCLUSIONS There was a high level of anxiety and depression in infertile women; therefore, it is necessary to pay attention to these disorders in the process of treatment of infertile women.
IL-1, IL-6, TNF-α, and MIF in relative adrenal insufficiency in septic shock: a piglet model
Medical Journal of Indonesia Vol. 29 No. 3 (2020): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.202943

Abstract

BACKGROUND Inflammatory mediators released during septic shock are involved in the mechanism of adrenal insufficiency. This study investigated the role of interleukin (IL)-6, IL-1, tumor necrosis factor (TNF)-α, and macrophage migration inhibitory factor (MIF) in septic shock with relative adrenal insufficiency (RAI). METHODS We conducted a 6-month experimental study in 20 piglets. Following endotoxin administration, their hemodynamics were monitored and blood samples were drawn to test the levels of cytokines IL-1, IL-6, TNF-α, and MIF every 15 min until septic shock onset as well as during a corticotropin stimulation test. Septic shock was managed by administering fluid resuscitation, inotropic drugs, and hydrocortisone. At the end of the study, the piglet models were classified as either RAI or non-RAI. Immunohistochemistry staining was performed on the hypothalamus of the RAI group. RESULTS The level of IL-6 at 45 min was higher in the RAI group than the non-RAI group (p = 0.008), and that of IL-1 was similar in the two groups during septic shock. The RAI group had higher TNF-α levels at 15 min (p = 0.002) and at 30 min (p = 0.007) than the non-RAI group, and the MIF level during septic shock was higher in the RAI group (p = 0.003) than the non-RAI group. CONCLUSIONS Cytokine-induced inflammatory process of adrenal gland reflected in TNF-α level in 15 min and 30 min, IL-6 in 45 min, and MIF in septic shock condition but not in IL-1.
First trimester maternal upper arm circumference correlated to placental size and neonatal anthropometry
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.192950

Abstract

BACKGROUND First maternal nutrition, represented by anthropometrics, is an important factor for fetal growth. This study aimed to determine the correlation between maternal nutritional status of first trimester pregnant women with placental size and neonatal anthropometry. METHODS A retrospective cohort study (N = 134) was conducted in Jakarta and Riau during August–September 2017. Correlation between first trimester maternal nutritional status, placental size (placental weight and volume), and neonatal anthropometry (birth weight, birth length, head circumference, and abdominal circumference) were examined using Spearman correlation test. RESULTS High maternal body mass index and upper arm circumference (UAC) are weakly correlated with high birth weight (r = 0.281, p<0.001 and r = 0.271, p<0.001), birth length (r = 0.176, p = 0.022 and r= 0.238, p = 0.002), head circumference (r = 0.251, p = 0.001 and r = 0.297, p<0.001), abdominal circumference (r = 0.227, p = 0.003 and r = 0.226, p = 0.003), placental weight (r = 0.198, p = 0.01 and r = 0.228, p<0.001), and placental volume (r = 0.194, p = 0.01 and r = 0.203, p = 0.008). In addition, high maternal height is also weakly correlated with high birth weight (r = 0.157, p = 0.043) and birth length (r = 0.158, p = 0.041). CONCLUSIONS UAC can be reliably used to assess the nutritional status of pregnant women and to predict placental and newborn sizes.
Vitamin D₃ levels in the maternal serum, cord blood, and placenta of preeclamptic pregnant women
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.oa.202951

Abstract

BACKGROUND Preeclampsia is affected by oxidative stress, a free-radical produced as a by-product of endothelial damage, and antioxidant imbalance, such as vitamin D₃. This study was aimed to compare the vitamin D₃ levels in the placenta, cord blood, and maternal serum between patients with and without preeclampsia. METHODS This cross-sectional study included 86 patients from Cipto Mangunkusumo Hospital and Tangerang District Hospital, in which 47 had preeclampsia (13 early-onset and 16 late-onset preeclampsia cases) and 39 had no preeclampsia. The placenta, cord blood, and maternal serum were taken after labor, then were analyzed according to preeclampsia and non-preeclampsia; furthermore, the preeclampsia group was analyzed in a subgroup of early- and late-onset preeclampsia. This is analyzed with either unpaired t-test, Mann–Whitney U test, or Kruskal–Wallis test. RESULTS The maternal serum, cord blood, and placental tissue vitamin D₃ levels (16.30 [6.20–49.00], 11.80 [3.50–38.60], and 49.00 [22.00–411.00] ng/ml, respectively) of the preeclampsia group were similar to those of the non-preeclampsia group (13.50 [4.80–29.20], 11.70 [1.00–28.80], and 43.40 [11.80–153.00] ng/ml, respectively) (p = 0.459, 0.964, and 0.354, respectively). However, the placental tissue vitamin D₃ levels in early-onset preeclampsia (79.00 [36.00–411.00] ng/ml) were higher than those in late-onset preeclampsia (40.00 [22.00–171.00] ng/ml) (p = 0.006). CONCLUSIONS The vitamin D₃ levels between patients with and without preeclampsia were similar. However, the placental tissue vitamin D₃ levels in early-onset preeclampsia were higher than those in late-onset preeclampsia, possibly because of the different pathophysiology between early- and late-onset preeclampsia.
Risk factor for Mycobacterium leprae detection in household contacts with leprosy patients: a study in Papua, East 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.192962

Abstract

BACKGROUND In the era of leprosy eradication, Jayapura is still one of the biggest leprosy pockets in Papua, Indonesia. The trend for leprosy case detection rate has remained relatively stable over recent years. This study was aimed to detect Mycobacterium leprae in household contacts and to evaluate the associated factors with the detection. METHODS This cross-sectional study recruited household contacts of leprosy patients who were diagnosed consecutively from March to August 2015 in Hamadi Point of Care, Jayapura. The leprosy patients were diagnosed using polymerase chain reaction (PCR). For each leprosy patient, up to four household contacts that had no symptom were included. Every household contact received screening through DNA detection of M. leprae extracted from nasal swab specimens and examined using PCR. Factors for bacteria detection included intensity, time duration and number of contacts living together in the same house, and random blood glucose levels were evaluated. Bivariate analysis was used to associate them with M. leprae detection in household contacts. RESULTS From 107 household contacts of 35 patients who had leprosy, M. leprae was detected in 19.6%. Household contacts with leprosy patients for >1 year was a risk factor for detection (OR = 12.45; 95% CI = 1.595–97.20; p = 0.002). Blood glucose (p = 0.444), ethnic (p = 0.456), sleeping proximity to leprosy case (p = 0.468) and relatives (p = 0.518) give no effect to M. leprae detection in household contacts. CONCLUSIONS Among the various risk factors studied, duration of living together with the patient significantly increased the risk of M. leprae transmission.
Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital
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.v27i4.2999

Abstract

Background: In Indonesia, chronic kidney disease (CKD) is primarily managed by hemodialysis (HD) because limited resources rule out the possibility of renal transplantation. HD patients are commonly accompanied by caregivers. However, most studies have neglected the health of caregivers, who play an important role in the survival of HD patients. This study aimed to determine the proportion of caregivers who suffer from anxiety and depression and the factors involved.Methods: This was a cross-sectional study involving 100 caregivers in the HD unit of Cipto Mangunkusumo Hospital, Jakarta. This study used the hospital anxiety depression scale (HADS) to determine the extent of anxiety and depression among caregivers. All caregivers were asked to fill out the questionnaire without assistance.Results: A total of 28% and 18% of caregivers were found to be anxious and depressed respectively. The caregiver's relationship with the patient, whether the caregiver was being paid or unpaid, the total duration of care, and income were not associated with levels of anxiety and depression. However, the proportion of each 24-hour period spent on care was significantly associated with anxiety (p=0.037) and depression (p=0.015). The time spent on care every 24 hours was also a significant predictor of anxiety (p=<0.001) and depression (p=0.021).Conclusion: One-third of caregivers were found to be anxious and/or depressed. The time spent on care every 24 hours was a strong predictor of both anxiety and depression.
The use of high-resolution melting techniques for mutation screening of diseases caused by trinucleotide repeats expansion, with emphasis on the AR gene
Medical Journal of Indonesia Vol. 28 No. 2 (2019): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i2.3008

Abstract

BACKGROUND Trinucleotide repeat expansion (TRE) diseases are genetic diseases caused by an increase in the number of CAG, CGG, and CTG codons. CAG repeat expansion in exon 1 of the androgen receptor (AR) gene is known to be associated with disorders of sex development (DSD) and spinal and bulbar muscular atrophy (SBMA). Because the traditional Southern blot for CAG repeat expansion is laborious and time-consuming, this study was aimed to use high-resolution melting (HRM) analysis to screen the CAG repeat length of the AR gene in Indonesian patients with DSD. METHODS In total, 30 male patients with DSD (46, XY), one male patient with SBMA, and 30 healthy males (control) were included in the study. The CAG repeat length was determined using HRM analysis, and Sanger sequencing was used to confirm the CAG repeat length. RESULTS For the DSD cases and controls, the melting temperature (Tm) was within the normal range of 89-91.05°C; however, Tm was 92.65°C for the SBMA case. Sanger sequencing confirmed that DSD cases had 13-27 CAG repeats, and the SBMA case had 54 CAG repeats. CONCLUSIONS HRM analysis using polymerase chain reaction is a sensitive, effective, and rapid technique for screening CAG repeat expansion in exon 1 of the AR gene. This is the first technique for AR gene screening that may be applicable to other TRE diseases.
Obesity and central obesity
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.v27i2.3014

Abstract

[no abstract available]
A cost-effectiveness and safety analysis of dual antiplatelet therapy comparing aspirin–clopidogrel to aspirin–ticagrelor in patients with acute coronary syndrome
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.v27i4.3024

Abstract

Background: Dual antiplatelet therapy (DAPT) using either an aspirin–clopidogrel (A–C) combination or aspirin–ticagrelor (A–T) combination has become the standard therapy for acute coronary syndrome (ACS). Ticagrelor shows better pharmacokinetic profiles but is more expensive. This study aimed to compare cost-effectiveness and safety profiles of A–C versus A–T in patients with ACS. Methods: This was a retrospective cohort study of ACS patient at the Cipto Mangunkusumo Hospital between 2014 and 2016. ACS patients treated for the first time with A–T or A–C were included. Occurrence of major adverse cardiovascular events (MACE) within 3, 6, 9, and 12 months were used as effectiveness outcomes, while safety outcomes were measured based on the incidence of adverse drug reactions (major and minor bleeding, dyspnea, and hyperuricemia). Cost-effectiveness analysis was presented as incremental cost-effectiveness ratio (ICER). Results: Data records obtained from 123 ACS patients treated with A–C and 57 ACS patients treated with A–T were evaluated. Within the first three months, the MACE rate was 15.8% in the A–T group and 31.7% in the A–C group (RR: 0.498, 95% CI: 0.259–0.957, p=0.039). There was no statistically significant difference observed in the number of MACE between groups after 6, 9, and 12 months. The A–T group had a higher incidence of major bleeding (melena) than the A–C group (5.3% vs 1.62%, p=0.681), especially in geriatric patients. Minor bleeding was observed in three patients of the A–C group, but in none of the patients in the A–T group. The cost of ICER was IDR 279,438, indicating the additional cost needed for avoiding MACE within 3 months, if A–T was used. Conclusion: The aspirin–ticagrelor combination is a clinically superior and cost-effective option for MACE prevention among ACS patients, especially during the first three months of DAPT, with a slight but not significantly higher major bleeding risk when compared to the aspirin–clopidogrel combination.

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