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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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Radial extracorporeal shockwave therapy on calcaneal spurs: a randomized controlled trial
Medical Journal of Indonesia Vol. 28 No. 4 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i4.3039

Abstract

BACKGROUND The effectiveness of extracorporeal shockwave therapy (ESWT) in handling pain and calcaneal spurs is still controversial, whereas research on the effectiveness of ESWT in the reactive ossification process of calcaneal spurs, involving osteoprotegerin (OPG) and the receptor activator of nuclear factor-kappa B (RANK), does not exist. This study was aimed to assess the effect of ESWT on pain, the length of the spur, plasma OPG and RANK level on the calcaneal spur. METHODS This study was a randomized controlled trial in patients with calcaneal spurs. ESWT was administered at the pain point by applying 2,000 shocks, at an intensity of 2 bars, given six times with a 7‖10-day interval. The visual analog scale (VAS) data, plasma OPG and RANK level were analyzed using Mann–€“Whitney U test, whereas spur size was analyzed using chi-square test. RESULTS One month after therapy at rest (p < 0.001) and when walking after getting up (p = 0.020), the VAS was lower than that in the control group. The plasma OPG level was lower than control group shortly after therapy (p < 0.001). The plasma RANK level was higher than control group shortly after therapy (p < 0.001). ESWT did not affect the reduction of spur measurement (p = 0.382). CONCLUSIONS ESWT reduced pain, decreased plasma OPG level, and increased plasma RANK level. Although ESWT did not have any effect on spur reduction, it affected plasma OPG and RANK level that play a role in the activity of osteoblasts and osteoclasts.
Risk factor mapping and case map of environmentally based disease in Yogyakarta
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.v28i2.3093

Abstract

BACKGROUND A geographic information system (GIS) is required to guide interventions into prevent ARI and reduce the incidence of cases. The purpose of this study is to find out whether there is spatial autocorrelation in the spread of ARI; to obtain spatial information about the ARI risk factors, the ARI case map, and the factors related to the occurrence of ARI. METHODS This study is a quantitative research study with case-control study design.The sampling technique was purposive sampling. Spatial analysis techniques used were buffers and spatial clustering. The measurement of spatial autocorrelation was calculated by Moran’s Index method. RESULTS The risk factors for ARI based on the history of ARI disease were cough and cold in the last one year, and cough and cold lasting more than two weeks (OR = 15.691; 95% CI = 6.558-37.546 and OR = 6.645; 95% CI = 3.013-14.652). The risk factors for ARI based on the house physical environment were the room density, existence of glass windows on the house roof, electricity as a light source, presence of family members who smoke, and proximity to pollution exposure and waste disposal. Moran's Index value shows positive spatial autocorrelation. CONCLUSIONS GIS produces ARI distribution patterns. Based on the results of the cluster, the incidence of ARI cases in this region are interrelated or one case with another case is closely related, due to its close position.
Double-J stents forgotten for four years: a case report
Medical Journal of Indonesia Vol. 28 No. 3 (2019): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i3.3132

Abstract

Placement of double-J ureteral stents after endourologic procedures and some open urological surgeries are practical and safe. However, when neglected in situ, undesired problems may occur, leading to serious medical and legal issues. Complications from ureteral stents with protracted indwelling durations include urosepsis, renal failure, encrustation, and spontaneous fractures which may be retained or voided in the urine (stenturia). We report a 40-year-old woman of forgotten double-J ureteral stents, inserted 4 years prior to this study during a gynecologic operation. The patient had pulled out the double-J stents from her urethra herself and presented with impending sepsis. Then, she underwent ureterorenoscopic lithotripsy, but it failed to remove the remaining encrusted double-J stent. As a result, percutaneous nephrolithotomy was performed successfully and she had symptom-free thereafter.
Cytotoxic effect of natural cuttlefish bone xenograft: an in vitro and in vivo study
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.203141

Abstract

BACKGROUND Commercialized synthetic bone grafts are commonly used to replace the bone defect. Cuttlefish bone is naturally available and widely studied, but the specific cytotoxicity test has not been conducted. This study aimed to evaluate the cytotoxicity of the xenograft compared to commercial grafts. METHODS We performed an in vitro test evaluating the viability of human mesenchymal stem cells (hMSCs) when cultured for 48 hours with the tested materials (cuttlefish bone graft and fabricated PerOssal®). The trypsinized mitochondrial activity of the viable hMSC was assayed based on colorimetry of the formazan color change. The tested material was considered nontoxic if >70% of the hMSCs were viable. The in vivo cytotoxic effect was evaluated by implanting the graft material in the femoral muscle of New Zealand (NZ) white rabbits. Nine rabbits were used in each test (cuttlefish bone, PerOssal®, and NaCl 0.9%). The systemic acute pyrogenic effect was evaluated based on 72 hours body weight changes and rectal temperature changes every 30 min in the first 3 hours and 72 hours post-implantation. RESULTSThe mean percentage of hMSC viability when cultured with cuttlefish bone graft and PerOssal® was comparable (93.47% and 105.37%, respectively, p = 0.240). The in vivo cytotoxicity on NZ rabbit was similar between all tested materials, as shown by the minor changes in body weight (<10% body weight, p = 0.391) and rectal temperature (<0.5°C, p = 0.127). CONCLUSIONS Cuttlefish bone xenograft and fabricated PerOssal® have a similar non-cytotoxic effects on hMSCs and non-pyrogenic systemic effects on rabbits.
Improving a long-acting reversible contraception usage by understanding client perspectives
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.203149

Abstract

BACKGROUND Despite the limited use of long-acting reversible contraception (LARC) in Indonesia, they have proven to be cost-effective in family planning programs. This study was aimed to identify the elements of ideas and views that people hold and their association with the use of LARC (intrauterine devices and implants) as a means of improving its utilization in Nusa Tenggara Barat (NTB) Province, Indonesia. METHODS Data were derived from the Improving Contraceptive Mix Methods survey of 6,384 respondents in Bima District, Central Lombok, and North Lombok, NTB Province, in 2015. Confirmatory factor analysis was used to identify suitable elements of 19 variables and generate three ideation elements on attitude, knowledge, and interpersonal communication. Subsequently, the association of three ideation elements with LARC use in NTB was examined. RESULTS Multivariate analysis revealed that LARC use was higher among women with a positive attitude toward LARC and high frequency of interpersonal communication. Women with positive attitudes had 7 times greater odds of using LARC than women with negative attitudes (adjusted odds ratio [aOR] = 7.18; 95% confidence interval [CI] = 6.09–8.55). Women with a high frequency of interpersonal communication were 2.4 times more likely to use LARC than women with low communication frequency (aOR = 2.40; 95% CI = 1.94–2.99). CONCLUSIONS To increase the use of LARC in NTB, family planning programs should not only focus on improving women’s knowledge but also prioritizing the promotion of positive attitudes toward LARC and facilitating interpersonal communication.
Percutaneous atrial septal defect closure using transesophageal echocardiography without fluoroscopy in a pregnant woman: a case report
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.193161

Abstract

Transcatheter closure is the treatment of choice for atrial septal defect (ASD); it has good efficacy and minimal complications. However, this approach in a pregnant woman is limited due to the risk of radiation exposure. A novel fluoroscopy-free technique has been introduced to reduce x-ray exposure. This case reported the experience of an ASD transcatheter closure in a pregnant woman without fluoroscopy guidance. To the best of our knowledge, this is the first successful fluoroscopy-free technique for transcatheter closure in Indonesia. The case is a 26-year-old primigravida at 26 weeks gestational age with secundum ASD and pulmonary hypertension. Transcatheter closure was successfully performed with a Cera ASD occluder (Lifetech Scientific Corporation, China) no. 28 mm guided by transesophageal echocardiography. During the procedure, transient supraventricular tachycardia was developed. There were no other major or minor periprocedural complications. ASD transcatheter closure in a pregnant woman without fluoroscopy is feasible, safe, and effective.
Erratum: Chronic physical exercise increases a neurogenesis marker within hippocampus
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.v27i3.3172

Abstract

[This corrects the article DOI: 10.13181/mji.v27i2.1685]
It's all about a leadership
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.v27i3.3175

Abstract

[no abstract available]
The future of radiotherapy and immunotherapy concomitantly in cancer management
Medical Journal of Indonesia Vol. 28 No. 4 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i4.3211

Abstract

Immunotherapy is a developing field in cancer treatment. Immunotherapy using immune checkpoint inhibitors has been successful in treating patients with metastatic disease, as well as patients who are refractory to standard treatments. Although immunotherapy has yielded considerably positive outcomes, its clinical benefits are limited to a small subset of patients. A combination of radiotherapy and immunotherapy has been shown to provide greater clinical benefits to more patients. Radiation, particularly hypofractionated radiation with stereotactic radiosurgery or stereotactic body radiotherapy, works by priming T cells, upregulating proinflammatory chemokines, and increasing the immunogenicity of tumor cells. Tumor cells develop immunosuppressive mechanisms that protect them from attack by the immune system. Immunotherapy works by disrupting the ability of tumor cells to setup these defenses. When combined with radiotherapy, it can synergistically enhance tumor cell death via cytotoxic T cells, thus causing systemic tumor regression and generating better clinical response.
The functional status, rehospitalization, and hospital cost reduction in geriatric patients after the implementation of the universal health coverage program in the national referral hospital Indonesia
Medical Journal of Indonesia Vol. 28 No. 4 (2019): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v28i4.3214

Abstract

BACKGROUND Universal health coverage program (UHCP) might implicate negatively toward geriatric care with its impact on higher cost. The evaluation had to be made, especially in functional status, rehospitalization, and cost-effectiveness. METHODS Retrospective cohort study with historical control was done. Seventy two geriatric inpatients in the pre-UHCP group and 86 in the UHCP group were recruited from Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Subjects with geriatric syndromes admitted from July to December 2013 (pre-UHCP era) and January to June 2014 (UHCP era). Functional status changes, rehospitalization, and process indicators were observed. Cost reduction was calculated using the incremental cost-effectiveness ratio (ICER), whereby costs, functional status changes, and rehospitalization of both groups were used to identify the differences. RESULTS Proportions of functional status increase were 35.3% and 34.8% in the pre- UHCP and UHCP groups, respectively (p = 1.00) and the decrease were 5.9% and 4.5% in the pre-UHCP and UHCP group, respectively (p = 1.00). Rehospitalization rates were 21.7% and 18.1% (p = 0.603) in the pre-UHCP and UHCP groups, respectively. Mean hospital expenses were between 17.1 million IDR (1,221 USD; 1 USD = 14,000 IDR) for the pre-UHCP group and 20.8 million IDR (1,486 USD) for the UHCP group. ICER showed that hospitalization cost was 3.7 million IDR (264 USD) higher to increase 1 activity of daily living score in the UHCP era. As for rehospitalization, the cost was 600,000 IDR (43 USD) less, with 3.6% smaller in readmission. CONCLUSIONS There was no changes in patients’ functional status after the UHCP implementation. There was a reduction in rehospitalization with lower cost in the UHCP era.

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