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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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BMI and WC cut offs for the risk of comorbidities of obesity in a population in Indonesia
Medical Journal of Indonesia Vol. 13 No. 4 (2004): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i4.159

Abstract

Over the last few years health care providers have become more aware of the consecquences of obesity as well as the comorbidities of obesity. The body mass index (BMI) and waist circumference (WC) became universally accepted measures to determine the degree of overweight. it is necessary to have cut off points for BMI and WC for the risk factors of the comorbidities of obesity in Indonesia. This study has a cross sectional design with a total of 6318 subjects, that comprised of 5216 males (82.6%) and 1102 females (17.6%). The highest percentage of comorbidities both in males and females were high cholesterol and triglyceride level. The risks of comorbidities were increased at BMI 24.38 kg/m2 and WC 86.25 cm for fasting blood glucose and BMI 24.91 kg/m2 and WC 89.25 cm for triglyceride level. (Med J Indones 2004; 13: 241-5)
Combined traditional medicine and pharmacological antihypertensive drugs in a rural community of West Java, Indonesia
Medical Journal of Indonesia Vol. 13 No. 4 (2004): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i4.160

Abstract

Some hypertensive subjects in Indonesia consume traditional herbal medicines in addition to the usual pharmacological drugs. This paper studied the relationship between several traditional herbal medicines, such as morinda, star fruit, garlic, or jamu, believed to control hypertension and the risk of current pharmacological antihypertensive drug users in subjects with stage 1 and 2 hypertension in a rural community West Java, Indonesia. The data were obtained from 3 field studies by the second year medical students of the Faculty of Medicine, University of Indonesia conducted in 2001, 2002, and 2003 in a subdistrict of the Bogor regency. The subjects were selected randomly from neighborhood clusters. Interviews and blood pressure measurements were conducted at the houses of the subjects by specially trained second year medical students supervised by faculty members. There were 496 subjects with stage 1 or 2 hypertension, with 11.5% under current antihypertensive drugs. Compared with the hypertension stage 1 subjects, hypertension stage 2 subjects were 5.4 times more likely to be currently taking pharmacological antihypertensive medication (adjusted odds ratio = 5.44; 95% confidence interval = 2.64-11.27). The combined of current antihypertensive medication with traditional medicines were cucumber which being the most dominant followed by star fruit and morinda. Reasons for this were probably the strong influence of culture, the limited medical facilities, and high cost of the antihypertensive drugs. It was concluded that in a rural Indonesia, it was common for hypertensive subjects to take pharmacological drugs as well as traditional medicine for antihypertensive therapy. (Med J Indones 2004; 13: 246-51)
Asia Pacific menu patterns in relation to lipid abnormalities: An Indonesian perspective
Medical Journal of Indonesia Vol. 13 No. 4 (2004): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i4.161

Abstract

Countries in the Asia-Pacific region differ widely with respect to their nutritional intake and nutritional status. The highest daily energy and proportion of fat intakes of the population is shown by the New Zealanders (total energy 3475 Kcals; fat proportion 37.2% or 1293 Kcals), while the lowest is the Siamese (total energy 2288 Kcals; fat proportion 13.1% or 300 Kcals). The Indonesian on the other hand, is at the third from the bottom (total energy 2631 Kcals; proportion of fat is 14.5% or 381.9 Kcals). Animal fat contributes to 29.7% (1033 Kcals) of the total daily energy intake of the New Zealanders (total 3475 Kcals), and the mortality rate coronary heart disease (CHD) is also the highest (228 per 100,000 populations for men and 173 for women). In contrast, the proportion of animal fat in Indonesian menu is only 1.47% (38.7 Kcals) of the total daily energy intake, while the CHD mortality rate is still below 50 per 100,000 for both men and women. Compared to the same values fifteen years before, animal fat intake of the New Zealanders has a decrease of 90%, Australian 88%, Philippines 99%, however the Indonesian on the other hand, has an increase of 157%. In New Zealand and Australia, the proportion of mortality attributed to cardiovascular disease (CVD) for men accounts for over 40% of total mortality. Japan however, the proportion mortality rate for CVD is only less than 30% of total mortality. In this level, Japan places itself among less industrialized group such as Malaysia and the Philippines. In the case of cerebrovascular (stroke) mortality however, Japan belongs to the highest category group. It seems that apart of high fat intake, stress and possibly also other factors play a major role in the development of stroke. The mean Indonesian total energy intake is 2631 Kcals, consisting of 8.7% protein (228.9 Kcals, 52.2 g), 76.8% carbohydrate (2020 Kcals, 505 g), and 14.5% fat (381.9 Kcals, 42.4 g). Animal fat intake is only 4.3 g/day (38.7 Kcals) which is 1.47% of the total energy intake. Although appears to be low, but it has a 157% increase if compared to the same value fifteen years before. Indonesian CHD mortality rate is still relatively low (below 50 per 100,000), however it is only a matter of time that the this value will soon increase in line with the increase of fat (especially animal fat) and total energy intakes. (Med J Indones 2004; 13: 252-7)Keywords: Asia Pacific, Indonesia, menu pattern, energy, protein, fat, animal fat, mortality rate, cardiovascular disease, coronary heart disease, cerebrovascular disease
Skin abnormality and hairloss: the reproductive endocrinological viewpoint
Medical Journal of Indonesia Vol. 13 No. 4 (2004): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v13i4.162

Abstract

Excessive androgen production may cause changes in female skin, such as hirsutism and acne. The administration of antiadrogenic hormone such as cyproteron acetate, may eliminate the hyperandrogenic effect on the skin. Hairloss may also caused either by hyper-androgenemia or by low estrogen level. The administration of either antiandrogen or estrogen may reduce hairloss. Virilization, which includes excessive growth of hair and clitoris enlargement, deepened voice, muscle hypertrophy and mammary hypoplasia are also associated with hyperandrogenemia. Antiandrogen treatment could eliminate these impacts of virilization. In contrast, cellulite was supected to be due to androgen deficiency, and the use of topical testosterone could eliminate it. It is concluded that skin and/or hairloss are associated with hormonal changes in women. The treatment with antiandrogenic hormones may reduce or cure these abnormalities. (Med J Indones 2004; 13: 258-63)Keywords: Hirsutism, virilization, acne, cellulite, hairloss, androgen, estrogen
Does VEGF concentration in pre-eclamptic serum induce sVCAM-1 production in endothelial cell culture?
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.163

Abstract

Serum concentrations of VEGF (Vascular Endothelial Growth Factor) are elevated in preeclampsia. In addition to inducing mitosis and increase permeability of endothelial cells, VEGF was reported to activate endothelial cells to produce cell adhesion molecules. Cell adhesion molecules play an important role in the inflammation process by inducing adherence of leukocytes in blood stream to the endothelial cells. The aim of this study is to investigate the effect of VEGF in serum from preeclamptic patients on sVCAM-1 (soluble vascular adhesion molecules-1) production in endothelial cell culture. Twelve sera from women with preeclampsia and 11 from women with normal pregnancy (controls) in 20% concentration were added to human umbilical vein endothelial cell culture (HUVEC) and incubated for 24 hours. All subjects have agreed to participate in this study and signed the informed consent form. sVCAM-1 concentration in the supernatant was measured by ELISA. VEGF concentration tends to be higher in preeclamptic serum than control, but the difference is not stastitically significant. The production of sVCAM-1 by endothelial cells exposed to preeclamptic serum was significantly higher than the production by endothelial cells exposed to serum from control (p<0.05). No correlation was found between the difference in VEGF concentrations in preeclamptic and control sera, and sVCAM-1 production by endothelial cell culture. (Med J Indones 2005; 14: 3-6) Keywords: endothelial cell, preeclampsia, VCAM, VEGF
Assessment of clinical and laboratory parameters that reflect inflammatory response and organ function in sepsis
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.164

Abstract

Sepsis is a spectrum of clinical conditions caused by the host immune response to infection or other inflammatory stimuli characterized by systemic inflammation. Clinical response to sepsis could be varies according to compensate or decompensate state, inflammatory process and host condition. Aims of this study is to assess the role of some parameters (clinical and biochemical, hematology, arterial blood gas analysis and coagulation) in supporting the diagnosis of sepsis. A cross-sectional study was performed in the Internal Medicine Inpatient Unit of Dr. Cipto Mangunkusumo National General Hospital, Jakarta, from February to July 2002. Forty-two patients who fulfilled the criteria of sepsis, severe sepsis, and septic shock were enrolled in this study. Clinical details and blood specimens for hematological, biochemical, arterial blood gas analysis and coagulation were collected. There were 42 subjects who participated in the study, aged from 19 to 78 years old. Eleven subjects fulfilled the criteria for early sepsis, 20 severe sepsis and 11 septic shock. Clinical examination showed that the Glasgow coma scale (GCS) was significantly reduced in severe sepsis and septic shock. Heart rate, respiration rate and body temperature were increased in all groups. Hemoglobin levels mostly below 10 g/dl and hematocrite levels below 30 %. The leucocyte counts were increased in more than 80%, mostly above 15.000/mm3. The platelet count were low (below 50.000/mm3) especially in septic shock. The serum creatinine were significantly increased (>2 mg/dl) in severe sepsis and septic shock. Albumin was decreased, lactate dehydrogenase/LDH and procalcitonin were increased. The arterial blood gas analysis showed that: pH and HCO3 were decreased especially in septic shock; the PO2 was lower in severe sepsis and septic shock; and PCO2 was below 32 mmHg in all groups. Coagulation examinations showed that fibrinogen was significantly decreased in septic shock; PT and APTT were prolong in severe sepsis and septic shock more than 18.8 and 48 seconds respectively. The d-dimer was also increased mostly in all groups. In conclusions that clinical examinations include level of consciousness, heart rate, mean arterial pressure, temperature and respiration rate and additional laboratory examinations include hamatological, biochemical, blood gas analysis and coagulation examinations can be used as parameters in diagnosis of sepsis. Some parameters include level of consciousness (Glasgow coma scale), serum creatinine, hemoglobin, platelet count and fibrinogen can differ sepsis according to severity. (Med J Indones 2005; 14: 26-32)Keywords: Clinical response, SIRS, sepsis
Difficult factors in Management of Impacted Dental Prosthesis in Esophagus
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.165

Abstract

A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediateesophagoscopy intervention for removing.The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications.This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. CiptoMangunkusumo General Hospital, Jakarta, Indonesia during a period between January 1997 and December 2003. Neck-chest X-ray and esophagoscopy were performed in all patients to identify the existence of the dental prosthesis as a diagnostic and treatment procedure. The length of time for removing the dental prosthesis was recorded and stated as a less difficult esophagoscopy when it takes time less than 60 minutes and as a difficult esophagoscopy takes 60 minutes or longer. Some risk difficultiesfactors were statistically analyzed.There were 53 patients of ingested dental prosthesis in esophagus. Only 51 cases were analyzed According to the length of time for removingthe dental prosthesis by esophagoscopy, 22 patients were recorded as less difficult cases and 29 patients as difficultcases. Two cases among the cases needed cervicotomy after unsuccessful esophagoscopy removal.The difficultiesto diagnose an impacted dental prosthesis in the esophagus caused by unreliable clinical history, unclear signs and symptoms, unableto be detected by X-ray and was not found during esophagoscopy. The difficulties in treating due to mucosal laceration, edema, bleeding, failure of the first extraction and conformity with the size and shape, the wire outside the dental prosthesis and thelength of time stayed in the esophagus. (Med J Indones 2005; 14: 33-6) Keywords: ingested dental prosthesis, radioluscent foreign body, length of time of esophagoscopy
First-line chemotherapy of advanced or metastatic breast cancer (MBC) with docetaxel and doxorubicin in Indonesia: results from A phase II trial
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.166

Abstract

Doxorubicin and docetaxel as a single agent are known as active cytotoxic agents for the treatment of metastatic breast cancer (MBC). Their combination has also shown to be highly active as a second-line chemotherapy of MBC. This study was design to evaluate the efficacy and safety of docetaxel-doxorubicin combination as first line chemotherapy of MBC patients in Indonesia. Twenty-six female patients between 31-65 years old with advanced or MBC was enrolled. No prior taxane or cumulative doxorubicin of 250 mg/m2 was allowed and patients should not have a heart disease. Treatment consisted of doxorubicin 50 mg/m2 as intravenous (IV) bolus followed one hour later by docetaxel 60 mg/m2 by IV infusion over 1 hour every 3 weeks for 6 cycles. Premedication with oral corticosteroid was administered a day prior to chemotherapy until the second day of each cycle. Left ventricular ejection fraction was recorded at baseline and after the 6th cycle. At the end of study, a total of 156 cycles of chemotherapy have been delivered. Five and 11 patients had a complete response (CR) and partial response (PR), respectively, which accounted for a 61.54% best overall response. Three patients with extensive liver metastases showed complete disappearance after 6 cycles. Most frequent grade 3-4 toxicities were leukopenia (80.77%) and febrile neutropenia (5.77%). Leukopenia was usually short in duration, occurred mainly during the first and second cycle and did not require dose reduction. No patient developed heart failure. There was one death due to progressive disease after 6 cycles. Combination of doxorubicin 50 mg/m2 and docetaxel 60 mg/m2 was sufficiently active as first-line chemotherapy of MBC, especially in patients with liver metastases, with a manageable toxicity profile. (Med J Indones 2005; 14: 20-5) Keywords: docetaxel, doxorubicin, advanced or metastatic breast cancer, phase II trial, anthracycline and taxane combination
Onset response of bupivacaine 0.5% which has been added with sodium bicarbonate on epidural block
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.167

Abstract

There are many advantages in using epidural anesthesia technique.However, there are also some constraints, such as the relatively long onset, particularly in the case of bupivacaine.Whereas the need of a rapid onset ofanesthesia technique for emergency cares is increasinglately. The objectiveof this studywas to find a method to hasten theonset of bupivacaine. This is a cross sectionalrandomized double blind controlled clinical trial performed on 40 patients who would undergo lower abdomen and extremity surgerywith epidural block.We evaluated the onset of action of bupivacaine which hasbeen added with sodium bicarbonate. Consecutive sampling method was appliedto get the sample. Thecriteria of sample are ASA I –II patient, agedof 20-60 years old, 50-60 kg of weight, 150-170 cm of height. Patients wereallocated randomly into two groups. The treatment group would get epidural block using mixtureof 20 cc of bupivacaine 0,5% + 0.5 cc of sodium bicarbonate 1.4 %, whereas the control group received20 cc bupivacaine 0.5 % + 0.5 cc aqua bides.Time to reach sensoric blockat the level of thoracal 10 dermatomeusing the pinprick methodand time to reach motoric blockade usingthe bromage scalewas recorded. The result of this study showed a significant shortening of theonset of sensory blockade (p<0.05) in the treatment group (10.2+1.4 minutes) compared with the control group (19.5+1.3 minutes). The onset of motor blockade had also a significant shortening (p<0.05) in the treatment group(13.3+1.6 minutes) compared with the control group (23.0+1.2 minutes). It was concluded that the additionof sodium bicarbonate can hasten the onset of bupivacaine on epidural block. (Med J Indones 2005; 14: 7-10) Keywords : onset response, bupivacaine 0.5%, sodium bicarbonate, epidural block
Safety and tolerability of moxifloxacin in the treatment of respiratory tract infections: a post-marketing surveillance conducted in Indonesia
Medical Journal of Indonesia Vol. 14 No. 1 (2005): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v14i1.168

Abstract

Moxifloxacin 400 mg tablet has been marketed in Indonesia for several indications, i.e. acute exacerbation of chronic bronchitis (AECB), community-acquired pneumonia (CAP), and acute bacterial sinusitis (ABS). To assess the safety and tolerability of moxifloxacin, a post-marketing surveillance study was conducted in the year 2001 involving 589 physicians. Clinical efficacy was also evaluated, both by physicians and patients, using a 6-symptom total score, which was scaled 0-12. A total of 1715 patients with acute sinusitis, CAP, AECB, and other infections were treated with oral moxifloxacin 400 mg once daily. There were 151 (8.8%) patients with adverse events (AEs) and 5 (0.29%) patients with serious adverse events (SAEs) that were considered related to moxifloxacin treatment. The most common adverse reactions were nausea (4.96%), dizziness (1.52 %), vomiting (0.64%), headache (0.47%), andweakness (0.47%). Twenty three (1.34%) patients discontinued treatment due to adverse events. Tolerance to treatment was rated very good and good by 647 (37.7%) and 919 (53.6%) of patients, respectively. Based on physicians’ clinical assessment, 57.7% of patients were cured and 39.9% were improved at the end of treatment. Mean total symptom score, as assessed by the patients, decreased from 6.43 on day-1 to 2.76 on day-3. Totally, 95.3% of patients felt better after receiving moxifloxacin and 97.6% of patients had good impression on moxifloxacin treatment. In conclusion, treatment of respiratory tract infections, mainly AECB, CAP and ABS, with moxifloxacin 400 mg once daily in this post-marketing surveillance was shown to be safe and well tolerated. Moxifloxacin was also shown to be highly effective in the treatment of these infections with rapid improvement of symptoms. (Med J Indones 2005; 14: 11-19) Keywords : post-marketing survtillance, PMS, moxifloxacin, respiratory tract infections

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