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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 1,639 Documents
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Laparoscopic Tenckhoff catheter insertion technique with Alken telescopic metal dilator in pediatric population Situmorang, Gerhard Reinaldi; Alfarissi, Fekhaza; Raharja, Putu Angga Risky; Rodjani, Arry; Wahyudi, Irfan
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257670

Abstract

BACKGROUND End-stage renal disease (ESRD) is a major public health concern worldwide, with peritoneal dialysis (PD) offering a key alternative to hemodialysis. Flow restriction due to catheter migration is a common complication, affecting 7–26% of patients with PD. This study aimed to reduce complications in pediatric patients by examining a novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator. METHODS In a prospective observational study conducted between September 2018 and October 2022, 33 pediatric patients with ESRD underwent laparoscopic Tenckhoff catheter insertion using a combination of laparoscopic and Seldinger techniques with Alken dilators. This approach involves rectus sheath tunneling using a nephrostomy puncture needle, wire insertion, and dilatation of up to 15 Fr using Alken telescopic metal dilators under laparoscopic guidance. Survival analysis was used to assess catheter survival and complication rates. RESULTS The mean (standard deviation [SD]) patient age was 11.92 (3.7) years, with a median follow-up of 21.3 months. Catheter survival was 84.8%, with 5 catheter withdrawals due to infections (4 cases) or obstruction (1 case). Early and late complications, including exit-site infection, peritonitis, and catheter obstruction, occurred annually at rates of 0.10, 0.03, and 0.02 episodes per patient, respectively. No pericatheter leakage occurred. CONCLUSIONS This novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator become a simple and minimally invasive method, and associated with high catheter survival and low complication rates. Therefore, further comparative studies are recommended.
Extracorporeal shockwave therapy in managing lower urinary tract dysfunction: a scoping review Handayani, Yoshimi; Yufika, Amanda; Lestari, Lazulfa Inda; Setiono, Steven
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.rev.257696

Abstract

Extracorporeal shockwave therapy (ESWT) exerts a range of biological effects, including anti-inflammatory, immunomodulatory, angiogenic, proliferative, and differential responses, as well as promoting nerve regeneration, enhancing membrane permeability, inducing stem cell attraction, and triggering the release of exosomes. It facilitates both interstitial and extracellular responses that support tissue regeneration by transferring energy into tissues. It may also reduce pain through hyperstimulation analgesia and attenuate inflammatory responses, making it a promising non invasive approach for various lower urinary tract dysfunction (LUTD) conditions, such as underactive bladder, overactive bladder, chronic pelvic pain syndrome, stress urinary incontinence, and interstitial cystitis. This study aimed to explore the efficacy and mechanisms of ESWT in managing LUTD.
Tumor apparent diffusion coefficient value and ratio in magnetic resonance imaging on cervical cancer Siregar, Trifonia Pingkan; Wanandi, Septelia Inawati; Darmiati, Sawitri; Kusuma, Fitriyadi; Sekarutami, Sri Mutya; Lisnawati; Prihartono, Joedo; Ilyas, Muhammad; Amalia, Ginva; Elfahmi, Khalida Ikhlasiya Tajdar Gefariena
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257715

Abstract

BACKGROUND Diffusion-weighted magnetic resonance imaging (DW-MRI) is a noninvasive, non-contrast sequence for cancer detection. Research involving DW-MRI in cervical cancer has revealed lower apparent diffusion coefficient (ADC) values. This study aimed to evaluate the difference in tumor ADC values and ADC ratios (tumor-to-urine and tumor-to-muscle) with respect to tumor staging (early versus late) and histopathology (squamous cell carcinoma versus adenocarcinoma). METHODS This retrospective study included 56 patients with cervical cancer, divided into early- and late-stage groups. DW-MRI was performed in all patients, and the tumor ADC value, ADC ratio between the tumor and urine (ADC ratiot−u), and ADC ratio between the tumor and gluteal muscle (ADC ratiot−m) were measured. Statistical methods were employed to assess the difference in the tumor ADC value, ADC ratiot−u, and ADC ratiot−m with respect to cervical cancer stages and histopathological findings. RESULTS The median tumor ADC value was lower in the early-stage group than in the late-stage cervical cancer (0.75 × 10−3 mm²/s versus 0.8 × 10−3 mm²/s, p = 0.022). However, no differences were observed in ADC ratiot−u and ADC ratiot−m concerning the tumor staging, nor in ADC value, ADC ratiot−u, and ADC ratiot−m concerning histopathological findings (p = 0.29, 0.67 and 0.35, respectively), with no significant differences in the ADC ratiot−u (p = 0.153) and ADC ratiot−m (p = 0.260). In receiver operating characteristic analysis, the tumor ADC value was 75.0% sensitive and 50.0% specific in predicting late-stage cervical cancer with a cut-off value of 0.750 × 10−3 mm2/s. CONCLUSIONS The median tumor ADC value in early-stage patients was significantly lower than in the late-stage patients, suggesting that tumor ADC value has valuable potential for characterizing cervical cancer staging.
Prevalence and factors associated with frailty among hospitalized geriatric patients at a tertiary hospital in Egypt Elsorady, Khalid Elsayed; Al Adrosy, Taha Ibrahim
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257760

Abstract

BACKGROUND Frailty is a geriatric syndrome linked to poor clinical outcomes. Certain diseases and biomarkers may serve as indicators of frailty. This study aimed to assess the prevalence and factors associated with frailty among hospitalized geriatric patients. METHODS This cross-sectional study was conducted on 206 older adults at a tertiary care geriatrics hospital in Egypt. A comprehensive geriatric evaluation was conducted to identify geriatric syndromes. Clinical history and laboratory tests were performed. The clinical frailty scale (CFS) and the mini-mental state examination (MMSE) assessed frailty and cognitive abilities, respectively. Pressure injury (PI) was identified through physical examination. Prehospitalization medications were checked and counted. Polypharmacy was defined as the daily use of ≥5 medications. The Charlson comorbidity index (CCI) was used to determine multimorbidity. Potential frailty biomarkers included red cell distribution width, serum C-reactive protein/albumin ratio, and neutrophillymphocyte ratio. Logistic regression and Spearman’s correlation analyses were performed. RESULTS Frailty was prevalent among 59.2% of the participants and associated with older age, female sex, higher CCI, lower MMSE scores, and lower serum total proteins. Significant geriatric syndromes included dementia, PI, incontinence, polypharmacy, and falls. A history of stroke was a significant comorbidity. Dementia was associated with the highest odds of frailty (odds ratio: 15.695, p<0.001). CFS was negatively correlated with MMSE scores (r = −0.314, p = 0.002) and positively correlated with CCI (r = 0.227, p = 0.003). CONCLUSIONS Frailty is a prevalent geriatric syndrome associated with dementia, falls, multimorbidity, incontinence, PI, malnutrition, and polypharmacy. Novel biomarkers may indicate frailty at mild stages.
Association between high serum levels of soluble vascular cell adhesion molecule-1 and obesity in women Musafer, Karar Nadhum Jawad; Mohammed, Amera Kamal; Al-Thuwaini, Tahreer Mohammed; Huyop, Fahrul; Bradosty, Sarwan Wasman
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257801

Abstract

BACKGROUND Obesity and metabolic disorders are associated with persistent low-level inflammation connected to soluble vascular cell adhesion molecule-1 (sVCAM-1). Recent research highlights its connection to endothelial dysfunction in female obesity. This study aimed to investigate the relationship between sVCAM-1 levels and obesity-related risk factors in women from Kirkuk City, Iraq. METHODS A case-control study was conducted on 90 women aged 20–50, including 43 participants with obesity and 47 healthy controls. Blood samples were collected, processed, and analyzed to measure various biochemical markers, including sVCAM-1. Logistic regression analysis was utilized to examine the association between sVCAM-1 levels and obesity-related parameters. Correlation analysis was performed to assess associations with body mass index (BMI). Statistical analysis was conducted using SPSS software version 23.0. RESULTS Correlation analysis revealed that BMI was significantly correlated with alanine aminotransferase (r = 0.37, p = 0.011), uric acid (r = 0.30, p = 0.04), insulin (r = 0.37, p = 0.01), homeostatic model assessment of insulin resistance (r = 0.47, p = 0.002), and sVCAM-1 (r = 0.53, p = 0.001). These results suggest that elevated sVCAM-1 levels may serve as predictive biomarkers for increased insulin resistance in obese individuals. These findings indicate that sVCAM-1 is strongly linked to female obesity and insulin resistance. CONCLUSIONS This study confirms the potential use of sVCAM-1 as a prognostic biomarker for obesity-related metabolic disturbances and its role in identifying individuals with a higher risk of developing insulin resistance.
Comparison between free and pedicled anterolateral thigh flaps and surgical outcomes in soft tissue reconstruction Hamid, Agus Roy Rusly Hariantana
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258140

Abstract

BACKGROUND The anterolateral thigh (ALT) flap, harvested either as a free flap with microsurgical anastomosis or as a pedicled flap with an intact blood supply, is widely used to repair soft tissue defects. This study aimed to evaluate the ALT flap, both free and pedicled variants, as a reliable option for reconstruction, focusing on flap viability and complications. METHODS This cross-sectional study included 30 patients who underwent free or pedicled ALT flap reconstruction at IGNG Ngoerah Hospital, Bali, between 2020 and 2024. Inclusion criteria were complete medical records and confirmed vascular flow on preoperative Doppler ultrasound. Statistical analysis was performed using Fisher’s exact test for bivariate analysis. The primary outcomes evaluated were the incidence of complications and their association with the type of flap. RESULTS ALT flaps were used as free flaps in 60% of cases and as pedicled flaps in 40%. Most patients were adult males, with flap placements mainly in the abdomen (36.7%). Wound dehiscence and necrosis occurred in 13.3% of cases. Wound dehiscence and complications requiring follow-up occurred more frequently in patients undergoing free flap procedures (38.9% versus 8.3%, p<0.001; 22.2% versus 0%, p = 0.001). In contrast, the incidence of necrosis was comparable between the two flaps (16.75% versus 8.3%, p = 0.632). CONCLUSIONS The free ALT flap showed a higher risk of partial flap necrosis and required more intensive monitoring. Pedicled ALT flap demonstrated a lower complication rate and more straightforward postoperative care, suggesting a more favorable option.
Toward contextualized excellence in clinical practice Prasetyono, Theddeus Octavianus Hari
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.ed.258286

Abstract

Front & Back Matter of Indonesia, Medical Journal
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Indonesia-INTERASPIRE study: an Indonesian cross-sectional multicenter survey on cardiovascular secondary prevention in coronary heart disease Ambari, Ade Meidian; Hasan, Harris; Dwiputra, Bambang; Desandri, Dwita Rian; Hamdani, Rita; Krevani, Citra Kiki; Syaoqi, Muhammad; Ridwan, Muhammad; Anandini, Hesti; Fitra, Maha; Arso, Irsad Andi; Anggraeni, Vita Yanti; Hartopo, Anggoro Budi; Siregar, Yasmine Fitrina; Tjahjono, Cholid Tri; Tiksnadi, Badai Bhatara; Febrianora, Mega; Tarsidin, Najmi Fauzan; Arityanti, Dean; Qhabibi, Faqrizal Ria; Makes, Indira Kalyana; Susilowati, Eliana; Erwan, Nabila Erina; Hergaf, Indah Widyasari; Raynaldo, Abdul Halim
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257833

Abstract

BACKGROUND Cardiovascular disease (CVD) is projected to affect more than 23.3 million people by 2030. Therefore, CVD prevention strategies were established to decrease morbidity and mortality while enhancing overall well-being. The Joint European Societies (JES) guidelines on CVD prevention were developed to enhance preventive cardiology practices. This study aimed to evaluate the adherence to JES guidelines for cardiovascular prevention in routine clinical practice for secondary prevention. METHODS This multicenter cross-sectional study was conducted in 7 centers between August 2020 and June 2021. Patients under 80 years old who had undergone percutaneous transluminal coronary angioplasty, coronary artery bypass graft, percutaneous coronary intervention, or experienced acute coronary syndrome were identified from medical records and interviewed a year later. Descriptive statistics were used to calculate the occurrence of risk variables, medication use, and index events associated with low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c, and blood pressure (BP). RESULTS A total of 402 participants (13.9% female) were interviewed, and their medical records were reviewed. Among the study population, 74.4% had a smoking history, 35.4% had dyslipidemia, 33.1% did not meet the BP target, and only 28.4% achieved the LDL-C target. Additionally, less than half (43.8%) participated in physical activity for >150 min/week. Only 15.6% of the patients among the centers who had scored >8 for the guideline-based target score. CONCLUSIONS Most patients did not meet the guidelines for secondary prevention, primarily due to the high prevalence of dyslipidemia and physical inactivity, although some achieved the LDL-C target.
Comparing suturing techniques and materials in hypospadias repair: a prospective cohort study Nainggolan, Ebram; Raharja, Putu Angga Risky; Situmorang, Gerhard Reinaldi; Rodjani, Arry; Wahyudi, Irfan
Medical Journal of Indonesia Online First
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257921

Abstract

BACKGROUND Various techniques are available for hypospadias surgery, but the most effective suturing techniques and suture materials remain debated. This study aimed to evaluate the outcomes of hypospadias repair using various suturing techniques and materials. METHODS This prospective cohort study was conducted from August 2023 to August 2024 and included all patients who underwent hypospadias surgery at Cipto Mangunkusumo Hospital. We compared the outcomes of 2 suturing techniques (interrupted versus continuous) and 2 suture materials (6-0 polydioxanone [PDS] versus poliglecaprone 25) used for neourethra suturing. Follow-up assessments were conducted at 1, 2, and 4 weeks postoperatively, and subsequently every 3 to 6 months, focusing on complications. RESULTS 162 participants were included, with a mean age of 6.27 (3.99) years and a mean follow-up period of 20.39 (14.25) weeks. Complications occurred in 31 patients (19.1%), with a significant association between hypospadias type and complication occurrence (p = 0.039). Complication rates were 9.4% in distal, 12.5% in midshaft, and 26.8% in proximal cases. No significant differences were found between suturing techniques (interrupted: 19% versus continuous: 12%, p = 0.429) or suture materials (6-0 PDS: 22% versus 6-0 poliglecaprone 25: 9%, p = 0.998). Subgroup analyses by hypospadias type also showed no significant differences by suture type or technique (all p>0.05), although a trend toward significance was noted in proximal cases (p = 0.062). CONCLUSIONS The choice of suturing techniques and suture materials does not affect complication rates in hypospadias repair, allowing surgeons to decide based on personal expertise and preference.

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