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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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Streptococcus suis meningitis related to processing and consuming raw pork during Balinese tradition, Mebat
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.cr.193249

Abstract

Streptococcus suis is a zoonotic pathogen that can infect humans, especially meningitis. S. suis meningitis has been commonly diagnosed in Bali, which is associated with the consumption of raw pork. We reported case of S. suis meningitis that could have occurred due to the ingestion of undercooked pork during a traditional ceremony, which also involved two more patients with similar symptoms. A 62-year-old male was brought to the emergency unit because of decreased consciousness (Glasgow coma scale 14/15) in the last 8 hours before admission. He also had a headache, high fever, and stiff neck. Examination of cerebrospinal fluid revealed the presence of S. suis infection and was confirmed by polymerase chain reaction. The patient was administered ceftriaxone and showed a clinical improvement on the third day without any hearing problem.
Association between HLA-Cw6 allele expression and characteristics of Javanese ethnic psoriasis patients in 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.v28i4.3283

Abstract

BACKGROUND Psoriasis is an autoimmune disease with involvement of genetic and environmental factors. The HLA-Cw6 allele is the strongest genetic factor that correlates with earlier onset and more severe clinical manifestation of psoriasis. In Javanese ethnic, HLA-Cw6 allelic expression has not been identified, although increasing psoriasis patients were found in hospital dermatology departments. The study was aimed to determine the allelic expression of HLA-Cw6 based on the onset and severity of psoriasis in Javanese ethnic. METHODS A cross-sectional study was conducted from March to September 2018. Sixty psoriasis patients in the Margono Soekarjo Hospital and Banyumas Regional General Hospital were recruited consecutively. Psoriasis type, diagnosis, onset, and disease severity were assessed by dermatologists. HLA-Cw6 allelic expression was identified by DNA isolation, quantitative testing, and HLA-Cw6 genotyping. Fisher’s exact and chi-square tests were used to evaluate the association of HLA-Cw6 with age, clinical type, disease severity, onset, and gender. RESULTS The HLA-Cw6 allele positivity was identified at 297 base pairs (bp), while control showed at 618 bp bands. Among 60 subjects, 13 subjects (22%) showed HLACw6 positivity, and 47 subjects (78%) were HLA-Cw6 negative. HLA-Cw6 genotypes were similarly distributed concerning age, onset, gender, clinical type, and disease severity in psoriasis patients of Javanese ethnic (p > 0.05). CONCLUSIONS HLA-Cw6 expression type may not have influence to the characteristics of patients with psoriasis.
Cranberries for women with recurrent urinary tract infection: a meta-analysis
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.v28i3.3299

Abstract

BACKGROUND Cranberries are the most widely used nonantibiotic prophylaxis for recurrent urinary tract infection (rUTI) in women; however, their efficacy still remains uncertain. Hence, this meta-analysis was aimed to assess the effectiveness, safety, and adherence of cranberry as a prophylactic drug for treating rUTI. METHODS Literature search was conducted using PubMed, EBSCO, Science Direct, Scopus, Cochrane, and Google Scholar. Studies were screened for duplication, inclusion and exclusion criteria, and then reviewed by two authors independently. This included all randomized controlled trials of cranberry derivatives versus placebo and antibiotic prophylaxis. Cochrane risk-of-bias assessment tools were used to evaluate the quality of the study. Quantitative analysis was performed using the Review Manager 5.0 software. RESULTS Nine studies were included. Among 1,542 participants, cranberry consumption reduced incidence of rUTI in women compared with placebo (p = 0.02). The subgroup analysis revealed that only cranberry capsules were superior to placebo (relative risk [RR] = 0.67, 95% confidence interval [CI] = 0.45-0.98), but not for cranberry juice (RR = 0.85, 95% CI: 0.7-1.04). Antibiotics had better outcome than cranberry for rUTI (RR = 0.83, 95% CI = 0.70-0.98). Most of the participants experienced minor adverse events such as rash and gastrointestinal symptoms. There was also a good adherence rate, ranging from 90.3-99% monthly dose. CONCLUSIONS Cranberry, especially cranberry capsule consumption, had a significant effect in reducing the incidence of rUTI compared with placebo, with good adherence rates, and minor adverse events. In contrast, although antibiotic use had a greater efficacy, it was associated with a higher risk of severe adverse events.
Association between axillary lymph node involvement and clinicopathological features of breast cancer among Indonesian women
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.193306

Abstract

BACKGROUND Some clinicopathological features play roles in the spread of breast cancer to axillary lymph node (ALN). However, their roles as predictive factors are not well-established. This study was conducted to determine the correlation between the clinicopathological features of breast cancer and the risk of ALN involvement in Indonesian women. METHODS This cross-sectional study was conducted in Margono Soekarjo Hospital using archival data from January 2017 to June 2018. All subjects with breast cancer who had undergone modified radical mastectomies without any evidence of distant metastasis were included. Chi-square and Fisher’s exact tests were performed to assess the relationship between ALN involvement and age, menopausal status, laterality, tumor size, tumor stage, histological type, tumor grade, lymphovascular space invasion (LVSI), skin or nipple infiltration, perineural invasion, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. The odds ratio of each variable was evaluated using ordinal regression analysis. RESULTS Stage 3 breast cancer had the worst status of ALN involvement compared with stage 1 (OR = 3.49; 95% CI = 1.51–8.08) and stage 2 (OR = 3.04; 95% CI = 1.32–6.98). Likewise, positive LVSI also had the worst status of ALN involvement compared with negative LVSI (OR = 8.68; 95% CI = 4.23–17.81). CONCLUSIONS Tumor stage and LVSI could be considered as independent predictive factors of ALN involvement in patients with breast cancer, especially among Indonesian women.
Perception of internet addiction among psychiatric residents in an urban area in 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.v28i4.3316

Abstract

BACKGROUND In the last two years, many suspected cases of internet addiction have been reported by the media. However, many physicians do not have comprehensive knowledge of internet addiction. Currently, there has been no study conducted among psychiatric residents. This study was aimed to determine the perception of internet addiction among psychiatric residents. METHODS This cross-sectional study was done from April to May 2018. Subjects were recruited by a total sampling method consisting of all psychiatric residents of the Faculty of Medicine, Universitas Indonesia. Perceptions of internet addiction were measured using the illness perception questionnaire revised version for addiction. The calculation of subscales was based on the algorithms available for this instrument. The Mann–€“Whitney U test was used to determine the association of different years of psychiatric education and the perception of internet addiction. RESULTS Fifty-two subjects completed the survey, and 85% of them reported feeling that they did not have adequate knowledge of internet addiction. They believed that their current knowledge was not sufficient to make diagnosis and management decisions. Junior residents had significantly lower consequence scale scores, with mean (standard deviation) scores of 4.1 (0.54) for juniors and 4.4 (0.48) for seniors (p = 0.021). CONCLUSIONS Psychiatric residents perceived internet addiction as emotionally stressful, understandable, and cyclical, but difficult to control. Senior psychiatric residents had a better perception internet addiction consequences compared with their juniors, who have received only basic knowledge about addiction without clinical exposure, but the perceptions could still be improved.
Safety profile of Td vaccination in Indonesian pregnant women: a post-marketing surveillance study
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.v28i4.3321

Abstract

BACKGROUND The Indonesian Expanded Program of Immunization has implemented tetanus and diphtheria (Td) vaccination to replace the tetanus toxoid vaccine in pregnant women since the year 2016. Td vaccine is administered to protect against diphtheria and tetanus to the mother and her baby as well. This prospective study was conducted to assess the adverse reactions after Td immunization; besides, a retrospective study was conducted to observe the presence of severe local reaction (Arthus reaction), premature birth, and low birth weight history in the medical records of pregnant women who had received Td immunization in the past year. METHODS A prospective observational study was conducted in 200 pregnant women. Local reactions and systemic events occurring within 28 days after immunization were recorded in the diary card and were confirmed by the health worker in the follow-up visit. A retrospective study was also conducted to evaluate 750 medical records of pregnant women who had received Td immunization. The study was conducted from September 2017 to January 2018. The study has been registered at ClinicalTrials.gov ID: NCT03383653. RESULTS In 185 pregnant women who completed the study, the most common local reaction was pain, occurring in 33.5% of subjects within 24 hours after vaccination. Fever, other systemic reactions, and serious adverse events were not reported during the observation. In the retrospective study, 647 medical records were validated. No Arthus reaction was observed. The prevalence of premature birth was 1.24%, and that of low birth weight was 2.63%, which were below the normal rates. CONCLUSIONS Td vaccination in pregnant women was safe and well-tolerated.
Wilms’ tumor 1 protein expression in embryonal and alveolar rhabdomyosarcoma and its association with clinical prognostic factors: a cross-sectional study
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.193326

Abstract

BACKGROUND Embryonal rhabdomyosarcoma (ERMS) and alveolar rhabdomyosarcoma (ARMS) are the two major histological types commonly found in the pediatric population, which have different morphology and genetic profile. Wilms’ tumor 1 (WT1) is an antigen highly expressed in solid tumors, including rhabdomyosarcoma, and a potential immunotherapy target. Only a few studies have attempted to determine WT1 expression in rhabdomyosarcoma. This study was conducted to demonstrate WT1 expression in ERMS, ARMS and associate it with established prognostic factors. METHODS A cross-sectional study was conducted at the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta using archival data from January 2011 to December 2017. 30 from 102 ERMS cases and 16 from 28 ARMS cases were included in this study. Data of age, tumor size, and location were collected. All cases were stained by WT1 immunohistochemistry. The expression was assessed semiquantitatively using histoscore (H-score) formula. An independent t-test was used to compare WT1 expression between ERMS and ARMS. Correlation analysis was used to evaluate the relationship between WT1 expression and prognostic factors. RESULTS All ERMS and ARMS cases expressed WT1 in diffuse, moderate to strong staining. ERMS show higher WT1 expression than ARMS (H-score 179.9 versus 149.5) (p = 0.014). Strong WT1 expression mostly found in patient age <20 years and non favourable location. Moderate WT1 expression mostly found in cases with tumor size >5 cm. CONCLUSIONS WT1 expression was higher in ERMS cases than in ARMS cases, which the expressions were similar in different age, tumor size, and location groups.
Patient assessment of constipation quality of life questionnaire: validity and reliability for Indonesian population
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.v28i4.3353

Abstract

BACKGROUND Constipation is a condition commonly encountered by physicians, causing a significant reduction in patients'€™ quality of life. Therefore, successful management of constipation should also include increase the quality of life. The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire is a questionnaire developed to address this issue. However, this questionnaire had not been translated into the Indonesian language. This study was aimed to adapt PAC-QOL into Indonesian culture and perform the psychometric evaluation. METHODS Translation and cultural adaptation were performed based on the linguistic validation guidelines by Acquadro et al in 2012. To perform the psychometric evaluation, a total of 64 subjects in Petamburan district in Jakarta, Indonesia, were recruited from February to March 2018. Test-retest reliability was assessed by completing the PACQOL twice with one-week interval. Subjects also completed the Short Form 36 (SF-36) Health Survey Questionnaire to assess concurrent validity. Internal consistency was analyzed with Cronbach'€™s alpha value (>0.7) and the intraclass correlation coefficient. RESULTS The mean (standard deviation) overall average score was 1.52 (0.66), while the Cronbach's alpha value for the overall average score was 0.910. Concurrently, the intraclass correlation coefficient for the overall score was 0.87. Simultaneously, several experts judged content validity to be adequate. All the questions had significant correlations with their respective domains. Moreover, each domain of PAC-QOL also had a significant correlation with several SF-36 domains. CONCLUSIONS The psychometric evaluation performed in this study demonstrated that the Indonesian version of the PAC-QOL was valid and reliable, suggesting that this questionnaire can be used in daily clinical practice.
A randomized controlled clinical trial of carbohydrate mix-fortified nutrition in type 2 diabetes mellitus patients
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.203398

Abstract

BACKGROUND Liquid meal replacement nutrition (LMRN) contains low glycemic index food (isomaltulose, resistant dextrin, and inulin), which can decrease large blood glucose level fluctuations and reduce food intake. This study aimed to determine the stability of daily blood glucose and the level of appetite sensations after intake of LMRN in type 2 diabetes mellitus (DM) patients. METHODS This randomized, controlled, crossover, and open-labeled study included 30 subjects with type 2 DM. Subjects attended two visit sessions to consume either LMRN or controlled-nutrition solid food (CNSF) for 4 consecutive days. Each subject had 2 days of 24-hour periods of blood glucose measurement using a continuous glucose monitoring system and had a 1-week washout period. Glycemic response (GR) and incremental area under the curve (iAUC) were calculated. The satiety level was measured using a visual analog scale. RESULTS After 48 hours, LMRN reduced GR compared with CNSF with glucose measurements of 13.72 (30.42) and 17.47 (36.38) mg/dl, respectively. The reduction on iAUC after consuming LMRN (36,891 [30,255.8] mg.min/dl) compared with CNSF (40,641 [38,798.9] mg.min/dl) was also noted. Subjects having LMRN felt less hungry and more satiated than those consuming CNSF. The administration of LMRN does not have any serious side effects. CONCLUSIONS LMRN provides a greater reduction of GR and longer term of satiety compared with CNSF without causing any serious side effects.
Tear hypoxia-inducible factor-1α expression, lactate dehydrogenase, and malate dehydrogenase activity changes in soft contact lens wear
Medical Journal of Indonesia Vol. 29 No. 4 (2020): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.203405

Abstract

BACKGROUND Soft contact lens (SCL) wear can lead to a corneal hypoxia. However, there is a lack of studies looking for corneal hypoxia biomarkers in tear. This study aimed to investigate corneal hypoxia among SCL wearers based on hypoxia-inducible factor-1α (HIF-1α) expression, tear lactate dehydrogenase (LDH), and malate dehydrogenase (MDH) activities. METHODS A nonrandomized clinical trial was conducted on two groups. SCLs were prescribed for 2 months to a group of new wearers. Meanwhile, SCL wear was discontinued for 1 month in a group of long-term wearers. Tear samples were then collected on days 1, 7, 14, 28, and 56 after treatment. Repeated-measures analysis of variance and Friedman’s test with post-hoc statistical analysis were used to evaluate biomolecular changes (HIF-1α concentration, LDH, and MDH activities) in both groups. RESULTS A total of 14 subjects (28 eyes) were enrolled in each group. In new wearers, there was a significant decrease in MDH level (p = 0.010) and no effect on HIF-1α level. In long-term wearers, HIF-1α and LDH levels tended to decrease (p = 0.054). A significant decrease on MDH level was noted on days 7 (p = 0.003), 14 (p = 0.026), and 28 (p<0.010). Long-term wearers had a higher LDH baseline level than new wearers (p = 0.04). CONCLUSIONS Corneal hypoxia was not proven after 2 months of SCL wear using biomarkers. However, LDH and MDH activities in tears were found to be decline after SCL discontinuation.

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