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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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Peripheral blood and hemoglobin electrophoresis pattern in beta thalassemia major patients receiving repeated blood transfusion
Medical Journal of Indonesia Vol. 13 No. 1 (2004): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i1.129

Abstract

One hundred and fifteen beta thalassemia major outpatients attending the Thalassemia Center Department of Child Health, Medical School University of Indonesia Dr. Cipto Mangunkusumo General Hospital for routine blood transfusion and hematology examination, participated in this study. There was a negative correlation between the size of the spleen and the peripheral blood parameters. All peripheral blood parameters tend to decrease with the enlargement of the spleen, and the condition is reversed after splenectomy. We observed that hypersplenism starts when the spleen is as big as S (V –€“ VI). The hemoglobin electrophoresis pattern from beta thalassemia major patients receiving repeated blood transfusion did not show a dense HbF fraction, 90 patients showed a normal hemoglobin electrophoresis pattern. A hemoglobin analysis of both parents could be useful to confirm the diagnosis of beta thalassemia major for patients receiving repeated blood transfusion. In order to get a definite diagnosis, a genetic analysis by bio molecular technique is needed. (Med J Indones 2004; 13: 8-16) Keywords: β thalassemia major, hematology parameter, hemoglobin electrophoresis
Protein C, protein S, antithrombin III, and hyperfibrinogenemia in deep vein thrombosis (DVT) among patients who underwent high risk orthopaedic surgery
Medical Journal of Indonesia Vol. 13 No. 1 (2004): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i1.130

Abstract

Post operative DVT is believed to be rare in Indonesia, and so is trombophilia. It is necessary to know the incidence of postoperative DVT in Indonesia and thrombophlia profile (protein C, S, AT III deficiency and hyperfibrinogenemia) in DVT and non DVT patient who underwent orthopedic surgery involving the hip and knee (high risk surgery). A cross sectional study was conducted in 20 patients who underwent surgery involving the hip (total hip replacement and fixation of proximal femoral fracture) and knee (total knee replacement and fixation of distal femoral fracture). Protein C, protein S, antithrombin III, and fibrinogen were examined in day 5 post operative, as well as with compression/Doppler USG between day 10 to 21 post operative, and confirmed by venography if USG findings was positive. Post operative DVT were found in 5 of 20 patients (25%). Deficiency of protein C (P= 0.46) protein S (P= 0.81), antithrombin III (P= 0.46), and hyperfibrinogenemia (P= 0.0547) did not correlate to post operative DVT. However, hyperfibrinogenemia was found to be a risk factor to post operative DVT (attributable risk= 1). Other confounding factor such as diabetes mellitus (P= 1.0), obesity (P= 0.28), hypertention (P= 1.0), hypertrigliseridemia, and hypercholesterolemia did not correlate to post operative DVT. The study suggested the existence of postoperative DVT cases in Indonesia. Hyperfibrinogenemia is a risk factor to promote post operative DVT. Deep vein thrombosis did not correlate to protein S, protein C, and antithrombin III deficiency. (Med J Indones 2004; 13: 24-30) Keywords: Thrombophilia, hip, knee, venography
Shortening procedure : A choice for tuberculous kyphosis correction
Medical Journal of Indonesia Vol. 13 No. 1 (2004): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i1.131

Abstract

Tuberculous kyphosis is an unstable lesion that tends to progress and lead to many problems.Various corrective osteotomies for kyphosis have been described for various conditions, but not for tuberculosis. This articles proposed shortening procedure to correct tuberculous kyphosis. The preexperimental study was conducted in 49 patients with tuberculous kyphosis treated surgically at Cipto Mangunkusumo and Fatmawati hospital since June 1996 till June 2001. All patients were evaluated radiographically in the preoperative period, postoperative period, and at the latest follow-up (6-36 months). Neurological deficit risk of operation was also evaluated by Frankel grading. The kyphosis were classified into three group, group A (kyphosis 30° - 59°) group B (60° - 89°) and group C (90° - 120°). The average postoperative kyphosis correction was 30.82° (67.5%); in group A 28° (75.49%), in group B 42.3° (62.43%), and in group C 27° (23.36%). Anova test gave significant difference in persentage of postoperative correction. Paired t-test also gave significance postoperative correction in all groups. Neurological complication was found in 6 patients (12.2%); 4 (11,8%) in group A dan 2 (40%) in group C, and no statistical difference between the two groups concerning this complication (p=0.1023). We concluded that shortening procedure for tuberculous kyphosis gave significant correction. In TB-kyphosis > 90° shortening procedure still gave significant correction although a potential risk of serious neurologic complication. (Med J Indones 2004; 13: 47-52) Keywords: Shortening procedure, tuberculous kyphosis
Oxidant and antioxidant status of police officer in the city and rural area
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.132

Abstract

This study was designed to investigate the biochemical alteration in human caused by free radical accumulation due to air pollution. The policemen recruited were 60 country policemen consisting of 30 non smokers (group I) and 30 smokers (group II); 30 smoking policemen with administrative work in Jakarta (group III) and 30 smoking traffic policemen from Jakarta (group IV). Our results show that the plasma malondialdehyde (MDA) contents of groups I, II, III, IV, respectively were : 3.34 ± 0.81 umol/l; 4.28 ± 0.77 umol/l; 5.20 ± 0.66 umol/l and 5.12 ± 0.78 umol/l which were statistically different (p < 0.01) among each others, except between groups III and IV. The activity of superoxide dismutase (SOD) of the groups respectively, were: 16.75 ± 9.80 U/mg protein; 22.83 ± 6.82 U/mg protein; 26.10 ± 8.50 U/mg protein and 26.90 ± 9.34 U/mg protein, which were statistically different (p < 0.05) between group I vs the other groups. The catalase activity of the groups respectively were : 106.25 ± 47.47 U/mg protein; 118.84 ± 42.73 U/mg protein; 119.83 ± 35.35 U/mg protein and 145.57 ± 61.85 U/mg protein. The statistical difference (p < 0.05) was found between group I & IV. Administration of vitamins C (500 mg) and E (300 mg) daily for 30 days to the policemen with high oxidant stress caused a decreased in the activities of SOD from 27.34 ± 10.05 U/mg protein to 16.91 ± 6.51 U/mg protein (p < 0.05) and catalase from 134.29 ± 53.28 U/mg protein to 67.07 ± 25.26 U/mg protein (p < 0.05). This study shows us that the oxidant status of city policemen was higher than that of rural policemen and that a combination of vitamins C & E could reduce the oxidant stress to a certain extent. (Med J Indones 2004; 13: 77-80) Keywords: malondialdehyde, superoxide dismutase, catalase, population study.
Sinonasal lymphomas in Indonesia: immunophenotype and Epstein-Barr virus association
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.133

Abstract

Sinonasal lymphoma is a rare disease with NK/T-cell (NKTC) or B-cell immunophenotype. Previous study revealed the geographic difference in frequency of NKTC lymphoma (NKTCL) and almost constant association with Epstein-Barr virus (EBV) infection. Through review of 41 cases with sinonasal lymphoproliferative diseases registered in the Department of Anatomical Pathology, University of Indonesia during the period 1994 to 2002, thirty-five were accepted as sinonasal lymphoma. Immunohistochemistry revealed that 20 cases (57%) were NK/T-cell type and 15 (43%) B-cell type with large cell morphology, i.e.,diffuse large B-cell lymphoma. NKTCL showed a marked male preponderance (M/F= 4:1) and younger onset of disease (median age, 37 years), and B-cell lymphoma showed a relative female preponderance (1:1.5) and older disease onset (median age, 49 years). In situ hybridization using EBER-1 probe revealed that 90% of NKTCL were EBV-positive, but none of B-cell lymphoma were EBV-positive. This is the first report on sinonasal lymphoma in Indonesia showing relative predominance of B-cell lymphoma compared to other Asian countries and Peru (14-24%). Lack of EBV-association in Indonesian sinonasal B-cell lymphoma showed a marked contrast to that in other Asian countries (EBV positive rate, 25-41 %). Predominance of sinonasal B-cell lymphoma without EBV genome might suggest presence of specific etiologic factors in Indonesia. (Med J Indones 2004; 13: 71-6) Keywords: sinonasal lymphoma, B-cell, NK/T-cell, Epstein-Barr virus, Indonesia
The clinical, laboratory, and microbiological profile of patients with sepsis at the Internal Medicine Inpatient Unit of Dr. Cipto Mangunkusumo National General Hospital, Jakarta
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.134

Abstract

At the moment, the diagnosis of sepesis is established based on the criteria of the presence of a clinical manifestation of systemic inflammatory response syndrome/SIRS, infection, and organ dysfunction. In the last two years, the idea to add several additional parameters to these criteria has developed, with the proposition to use the acronym PIRO (P: predisposition, I: infection, R: response, and O: organ failure). Clinical manifestations of sepsis at each hospital or treatment unit may differ according to the severity of sepsis, the focus of infection, comorbidity, and organ dysfunction or failure. This study evaluated the demographic, comorbidity, source of infection, SIRS manifestation, organ dysfunction, and microbiological profile of sepsis at the Internal Medicine Inpatient Ward of Dr. Cipto Mangunkusumo National General Hospital, Jakarta. A correlative, cross-sectional, descriptive study was performed on 42 subjects with sepsis, severe sepsis, and septic shock. The study was performed at the Inpatient Ward of Dr. Cipto Mangunkusumo NAtional General Hospital, Jakarta, in the year 2002. Clinical and laboratory (hematological, biochemical, and blood gas analysis) data, as well as results of aerobic cultures of the blood and other specimens were recorded. The criteria of sepsis used were based on that of the American College of Chest Physician and the Society of Critical Care Medicine in 1992. The results of the study demonstrated a proportional distribution of sepsis based on age and sex, with comorbidity in 88% of subjects, consisting of diabetes mellitus and other chronic diseases. The most common sources of infection were the lungs, skin-soft tissue, abdomen, and urinary tract, with Gram-negative bacteria more commonly found than Gram-positive bacteria. SIRS manifestation was found among over 70% of subjects, with the most common manifestations being tachycardia and tachypnea. The most common manifestations of organ dysfunction were reduced consciousness, metabolic acidosis, renal dysfunction, and a lower mean arterial pressure. There was a correlation between these parameters and the degree of sepsis. (Med J Indones 2004; 13:90-5)Keywords: sepsis, clinical manifestation, microbiology
Comparison of urinary excretion of Deoxypiridinoline and value of serum Osteocalcin within the Knee Osteoarthritis grading
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.135

Abstract

The identification of molecular markers, which reflects differences in disease progression rates in Osteoarthritis (OA), would greatly facilitate clinical studies. Urinary Deoxypyridinoline (UDPD) and serum osteocalcin (OC) had been widely used for marker of bone metabolism, but the use for molecular marker in OA was lack of data. Recent studies show that there were conflicted results between urinary excretion of DPD and serum OC value within knee OA grading. The aim of this study is to compare of urinary excretion of DPD and the level of serum OC as destructive parameter of cartilage within the knee OA grading. This cross sectional study comprise of 69 patients with OA of knee joints. Kellgren and Lawrence scale was use for grading of OA. Group of patients with knee OA grade 2 call as group of early OA and group of patients with knee OA grade 3 and 4 calls as group of late OA. DPD in urine was measured using Immuno-chemilunescence, serum osteocalcin was measured using Elisa method. The mean value of urinary concentrations of DPD in OA patients was higher than normal value (9.79 ± 7.28 nM DPD/mM Creatinin), and the mean value of serum OC within normal value (8.49 ± 4.68 ng/mL). There were no significant differences of age, body mass index (BMI), duration of illness, urinary excretion of UDPD and serum OC level between early and late OA. In conclusion, there is no significant difference of urinary excretion of DPD and serum OC level within knee OA grading. The use of urinary DPD and serum OC as molecular markers of progression of OA needed to be explored by other longitudinal study. (Med J Indones 2004; 13: 96-101) Keywords: Knee osteoarthritis, deoxypiridinoline, osteocalcin
Interleukin-18 levels in adult dengue fever and dengue hemorrhagic fever
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.136

Abstract

Interleukin (IL)-18 ( interferon-γ inducing factor) is one of cytokines, produced by macrophage, take part in differentiation T-helper (Th) to Th1 and interferon γ producing. T helper1 play role in cellular immunity especially in viral infection include dengue. A descriptive correlative study has done to know the correlation between IL-18 levels and disease severity in admitted dengue fever (DF) and dengue hemorrhagic fever (DHF) patients. In 42 subjects consist of 20 (47.6%) DF and 22 (53.3%) DHF (grade I to IV WHO criteria, 1999) showed that IL-18 levels significantly higher in DHF than DF patients. There are significant correlation between IL-18 levels and hematocrit and low platelet value. This study supports the possible role of IL-18 in pathogenesis DHF in adults. (Med J Indones 2004; 13: 86-9)Keywords: dengue, dengue hemorrhagic fever, IL-18, cytokine, pathogenesis
Skin test in drug eruption Five years experience at Dr. Cipto Mangunkusumo General Hospital, Jakarta
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.137

Abstract

Side effect of a drug should always considered by the physician in prescribing the drug for patients. Drug eruption could be very severe and re-exposure to traces of possible causative drugs may induce the same or even fatal clinical type of skin lesion. The aim of the study was to evaluate the role of skin test, an alternative in-vivo methods, in determining the cause of drug eruption. A retrospective study on results of skin test (patch and prick test) in drug eruption was conducted during 5 years period (1998-2002), with special interest on clinical type of lesion. The most prominent clinical type were fixed drug eruption(FDE), urticaria, eczematous eruption, exanthematous eruption, and erythroderma. Skin test was done on 125 out of 746 patients with drug eruption, and 34.4% gave positive results. In some mild cases of urticaria and FDE oral provocation test was done with special precaution. The results showed that skin test could be considered as an alternative, safe and relatively easy way to the oral challenge test to find the causative drug in drug eruption, especially the severe form. (Med J Indones 2004; 13: 81-5)Keywords: skin test, drug eruption, cutaneous adverse drug reaction (CADR).
Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002
Medical Journal of Indonesia Vol. 13 No. 2 (2004): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i2.138

Abstract

Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107-12) Keywords : nosocomial infection, surveillance, resistance pattern

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