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INDONESIA
Medical Journal of Indonesia
Published by Universitas Indonesia
ISSN : 08531773     EISSN : 22528083     DOI : 10.13181
Core Subject : Health,
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
Assessing Endothelial Function in Normotensive Overweight Adolescent Using Dundee Step Test
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.383

Abstract

Aim Normotensive overweight adolescents may have endothelial dysfunction which is not clinically detected in a routine clinical examination. The purpose of this study was to detect endothelial dysfunction in normotensive overweight using Dundee step test. Methods Sixty two subjects consist of 31 normoweight and 31 overweight group participated in this study. Blood pressure measurement was taken at rest and after 3 minutes Dundee step test. Hyper-responder was defined if systolic blood pressure reach 180 mmHg or more after 3 minutes exercise. Results Mann-Whitney test showed that overweight subjects had significantly higher resting systolic blood pressure, post exercise blood pressure anf magnitude of SBP change (Δ SBP) compared to control subjects (116.5 vs 112.8; 163.8 vs 142.7 vs; and 47.3 vs 29.9; P<0.05). Twenty six percent of overweight was diagnosed as hyper-responder. Conclusion There was significant association between overweight and ExSBP indicating endothelial dysfunction in normotensive overweight adolescents. (Med J Indones 2010; 19:52-6) Keywords: adolescent, Dundee step test, endothelial dysfunction, overweight, systolic blood pressure
The Relationship Between Retinol/Retinol Binding Protein 4 ratio, resistin and inflammation in non diabetic obese Indonesian men
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.384

Abstract

Aim To verify the correlation between Retinol/RBP4 Ratio, and resistin with inflammation (represented by hsCRP) in non-diabetic obese Indonesian men Methods This was a cross sectional study using 125 subjects. Measured parameters were retinol, RBP4, resistin, and hsCRP. Correlation between retinol, RBP4, resistin, hsCRP and Retinol/RBP4 Ratio was calculated. Cut off point of hsCRP were classiied as follows: <1 mg/l for low risk of inflammation, 1-3 mg/l for moderate risk, and 3-10 mg/l for high risk (according to CVD risk). The Retinol/RBP4 ratio was dichotomized into high (>0.9) and low ratio (≤0.9). The cross tabulation test was performed to predict the inflammation trends described by Retinol/RBP4 Ratio and resistin. Results Retinol was found strongly correlated with RBP4 and resistin (r=0.53; p<0.01). A positive but not significant correlation was found between resistin and Retinol/RBP4 Ratio with hsCRP. In high ratio group, 17.6% subjects were found with low risk inflammation, 26.4% with moderate risk, and 20.8% with high risk, in low ratio group, 8% subjects were low risk inflammation, 20% moderate risk, and 7.2% high risk. Combination between ratio and resistin showed that in “high ratio and low resistin” group, 12% subjects have low risk of inflammation and 8% have high risk. Meanwhile in “low ratio and high resistin” group, 3.2% subjects were found having low risk and 13.6% high risk of inflammation. Conclusions Combination between Retinol/RBP4 Ratio and resistin showed better description about the inflammation risk in non-diabetic obese subjects compare to the ratio itself. (Med J Indones 2010; 19:57-63) Keywords: Retinol, RBP4, resistin, hsCRP, obesity, inflammation
Epidemiology of human avian influenza in Indonesia, 2005-2009: a descriptive analysis
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.385

Abstract

Aim The study set out to better understand the epidemiology, natural history, therapeutic management and outcomes associated with confirmed human cases of Avian Influenza (AI) in Indonesia. Methods This observational study utilized data from 93 cases with laboratory-confirmed H5N1 Influenza between September 2005 and August 2009. Cases were identified through records obtained from the Ministry of Health, as well as the Provincial health office and district health office records. Categorical data were analyzed with frequency tables, chi-square tests, and relative risks, and continuous data were analyzed using univariate statistics and Wilcoxon tests. Results Most subjects (54%) first presented to a physician’s office or clinic. All of the subjects were hospitalized, and the vast majority (85%) had respiratory symptoms as their predominant symptom at presentation. There was no clear association of any of these case characteristics with survival. Cases with direct poultry exposure were 2.8 times more likely to receive oseltamivir treatment than those without direct exposure (RR = 2.89, 95% CI 1.44 – 5.78). While the overall number of survivors was small, cases with documented oseltamivir treatment were approximately 24% more likely to survive than cases for which oseltamivir treatment was not documented (RR 1.24; 95% CI: 0.34-4.58). In oseltamivir treated cases, the median time from symptom onset to start of antiviral treatment was 2.5 days in survivors compared to 7.0 days for those who died. Fatality, therefore, may be related to delay in initiation of treatment after presentation. Conclusions The data suggest that early treatment with the antiviral drug oseltamivir may play an important role in survival. However, a low clinical suspicion of disease likely remains an important impediment to early diagnosis. Therefore, a clear policy for the protocol of early diagnosis & treatment of febrile illness including influenza is necessary. (Med J Indones 2010; 19:64-70) Keywords: human avian influenza, antiviral drugs, oseltamivir, survival, Indonesia
Prevention of Venous Thrombo-Embolism in Non-surgical Hospitalized Patients
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.386

Abstract

Venous thromboembolism (VTE) is commonly found in hospitalized patients, considered as complication not only in surgical patients but also in medical patients. The vast majority of hospitalized patients with VTE or pulmonary embolism have not undergone any recent surgery. Several large randomized, double-blind, placebo controlled trials including MEDENOX, PREVENT and ARTEMIS have confirmed the efficacy and safety of VTE thromboprophylaxis for acutely ill medical inpatients. The American College of Chest Physicians (ACCP) Guidelines 2008 recommend a risk assessment at the time hospital admission for every medical patients and VTE prophylaxis using either anticoagulant medications or mechanical prevention should be applied for those who have high risk condition. Other studies showed that many cases of VTE in medical patients occur after hospital discharge, but still no clinical trials and current recommendation evaluating VTE prophylaxis for medical outpatients have been published yet. In this article, we attempt to review the literatures on importance of risk assessment and VTE prophylaxis for hospitalized medical patients. (Med J Indones 2010; 19:71-7)Keywords: venous thromboembolism, hospitalized patients, risk assessment, thromboprophylaxis
Development of multiplex-PCR assay for rapid detection of Candida spp.
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.387

Abstract

Aim Candida spp. infection commonly occur in immunocompromised patients. Biochemical assay for identification of Candida spp. is time-consuming and shows many undetermined results. Specific detection for antibody, antigen and metabolites of Candida spp. had low sensitivity and specificity. In this study, we developed a rapid diagnostic method, Multiplex-PCR, to identify Candida spp. Methods Five Candida spp. isolates were cultured, identified with germ tube and API®20 C AUX (BioMerieux®SA) kit. Furthermore, DNA was purified by QIAamp DNA mini (Qiagen®) kit for Multiplex-PCR assay. Results DNA detection limit by Multiplex-PCR assays for C. albicans, C. tropicalis, C. parapsilosis, C. krusei and C. glabrata were 4 pg, 0.98 pg, 0.98 pg, 0.5 pg and 16 pg respectively. This assay was also more sensitive than culture in that Multiplex-PCR could detect 2.6-2.9 x 100 CFU/ml, whereas culture 2.6-2.9 x 102 CFU/ml. Conclusion Multiplex-PCR is much more sensitive than culture and thus, can be recommended as a sensitive and specific assay for identification of Candida spp. (Med J Indones 2010; 19:83-7)
The influence of zinc deficiency on chronic pain in Sprague Dawley rats
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.388

Abstract

Aim Zinc (Zn) deficiency remains a problem in most developing countries, including Indonesia, especially in the East Nusa Tenggara (NTT) Islands. Zinc plays a major role in pain through the modulation process by the N-methyl-Daspartate (NMDA) receptors, which also includes neuronal nitric oxide synthase (nNOS) as a pain parameter. The purpose of this study is to reveal the effects of Zn towards pain response and modulation stage at the spinal cord level in rats. Methods Twenty Sprague Dawley (SD) rats were divided into two groups, a deficient group and a normal group. The deficient group was fed on an IRI-OB diet. Every group was further divided into two more groups, the acute pain group (transient noxious stimuli), and the chronic pain group (continuous noxious stimuli). The rats in chronic pain group were subjected to CCI Bennet operation. The pain thresholds in the deficient group and normal group were measured clinically using a modified Ugo Basille plantar test (thermal transient noxious stimuli). Measurement of chronic pain level was carried out by measuring the nNOS level by immunohistochemistry. Results Deficient group showed an insignificant decrease in pain threshold (P= 0.251). However, there is a significant increase in nNOS (P= 0.027) especially in the deficient group with continuous noxious stimulation. Conclusions These results suggest that Zn deficiency increases pain response, especially in chronic pain. (Med J Indones 2010; 19:88-95)
The nerve protection and in vivo therapeutic effect of Acalypha indica extract in frogs
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.389

Abstract

Aim To demonstrate nerve protection and/or treatment effect of Acalypha indica Linn. extract on nerve paralysis induced by subcutaneus injection of pancuronium bromide on frog's back. Methods The study was performed on sixty frogs (Bufo melanostictus Schneider) that divided into two groups, i.e. the neuro-protection and neuro-therapy group. Each group was divided further into 6 sub-treatment groups: negative control group treated by water and positive control group treated by piracetam, treatment groups received the extracts 200, 300, 400, 500 mg/kgBW. Pancuronium bromide 0.2% (1 : 20 dilutions) were injected subcutaneously as muscle relaxant. The protective effect was studied by giving the extract orally, 1 hour prior to injection; while the therapeutic effect of the extract was studied by 10 minute treatment after injecting pancuronium bromide solution. The parameters measured were the onset and duration of paralysis (in minutes) and the recovery time (time needed to recover into normal condition). Results The study showed significantly different protective effect of Acalypha indica Linn. root water extract at 400 and 500 mg/KgBW compared to negative control group and positive control group (piracetam (p < 0.05); while the therapeutic effect was obvious at the dose 200-500 mg/KgBW compared to negative control group (p = 0.000). There was no significant difference compared to positive control group (piracetam), except at 300 mg/KgBW (p = 0.012). Conclusion These results have proven that the water extract of Acalypha indica Linn. root has comparable protective and treatment effect on nerves system, as piracetam, but further studies should be performed to provide more evidences particularly pharmacokinetic and pharmacodynamic studies on two animal models that commonly used. (Med J Indones 2010; 19:96-102)
A comparison of 5 or 7 days of rabeprazole triple therapy for eradication of Helicobacter pylori
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.390

Abstract

Aim A combination of PPI and 1000 mg amoxicillin/500 mg clarithromycin twice daily for 2 weeks has been proven effective in the eradication of H. pylori. Most studies suggested that treatment for 7 and 10 days may be equally effective. Few data are available on the efficacy of 5-day triple therapy. Aim of this study was to compare 5-day and 7-day rabeprazole triple therapy for eradication of H. pylori infection. Methods We prospectively studied 60 consecutive H. pylori-infected patients who came to hospitals in six centres in Indonesia and who underwent upper endoscopy and biopsy. H. pylori infection was confirmed if two rapid urease tests (Pronto Dry) and histology or urea breath test were positive. Patients were assigned to either an open-labelled 5-day or 7-day course of oral amoxicillin 1000 mg b.i.d., clarithromycin 500 mg b.i.d., and rabeprazole 10 mg b.i.d. (RAC). Four weeks after therapy, all patients had a repeated UBT for evaluation of the presence of H. pylori. Results Of the 60 patients (42 males and 18 females) with mean age (± SD) 47.63 ± 13.93 years, range 21-74 years, 25 patients (41.7%) had 5-day treatment and 35 patients (58.3%) had 7-day treatment. With 5-day treatment, 18 patients (72%) and with 7-day treatment 32 patients (91.4%) became negative for H. pylori infection. The eradication failure was found on 7 patients (28.0%) in 5-day treatment and 3 patients (8.6%) in 7-day treatment. Conclusions The study showed that the eradication of H. pylori infection by triple rabeprazole-based treatment in 7-day is still better than in 5-day. (Med J Indones 2010; 19:113-7)
Correlation between F2-Isoprostane with stromal cell-derived factor-1 (SDF-1) and endothelial progenitor cell in nonhypertensive and hypertensive patients
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.391

Abstract

Aim Circulating endothelial progenitor cells (EPCs) are reduced in number and function in patients at risk for cardiovascular diseases. On the other hand, hypertension is related with excess angiotensin II which would lead to oxidative stress. In this study, we investigated the correlation between F2-Isoprostane (as marker of oxidative stress) with Stromal Cell-Derived Factor-1 (SDF-1) and CD34 viable in non hypertension and hypertension subjects. Methods This was a cross sectional study conducted on 54 non hypertension and 64 hypertension subjects visiting Prodia laboratory, Jakarta. F2-Isoprostane (as marker of oxidative stress) and SDF-1 (a strmal cell growth factor) were measured by ELISA method, and CD34 viable (marker of progenitor cell) was measured by flow cytometry. Results F2-Isoprostane concentration was higher in hypertensive subjects compared to non hypertensive subjects, although statistically non significant (mean + SD: 0.13 ± 0.120 vs 0.10 ± 0.16; ρg/mL; p = 0.091). SDF-1 concentration was significantly higher in hypertensive subjects compare to non hypertensive subjects (2821.63 ± 281.94 vs 2623.04 ± 356.28 ρg/mL; P < 0.05). CD34 viable level was significantly lower in hypertensive subjects compare to non hypertensive subjects (1.9 ± 0.9 /μL vs 2.7 ± 1.7; P < 0.05). F2-Isoprostane had negative correlation with CD34 viable in circulation (r = 0.022, p < 0.05) but no correlation with SDF-1 (p > 0.05). Conclusions F2-Isoprostane was higher, but CD34 was lower, in hypertensive subjects compared to non hypertensive. It seems that high F2-Isoprostane impaired the CD34 viable level as shown by negative correlation between F2-Isoprostane and CD34. (Med J Indones 2010; 19:109-12)
Differences between several atherogenic parameters in patients with Controlled and Uncontrolled Type 2 Diabetes Mellitus
Medical Journal of Indonesia Vol. 19 No. 2 (2010): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i2.392

Abstract

Aim to assess the differences between Atherogenic Index of Plasma (AIP), ratio of oxidized-Low Density Lipoprotein (Ox-LDL)/High Density Lipoprotein (HDL) and ratio of Lipoprotein-associated Phospholipase A2 (Lp-PLA2)/HDL in predicting the risk of coronary heart disease (CHD) in patients with controlled and uncontrolled type 2 Diabetes Mellitus (T2DM). Methods The study was done observationally with cross sectional design. A total of 80 patients, consisted of 40 controlled and 40 uncontrolled T2DM. The serum triglyceride (TG), HDL-C, Ox-LDL, Lp-PLA2 were examined in their relationship with T2DM risk. AIP is a ratio calculated as log (TG/HDL-C). Results AIP and ratio of Ox-LDL/HDL were significantly higher in uncontrolled than controlled T2DM (0.72 ± 0.13 vs 0.47 ± 0.22 , p < 0.001) and (1738.8 ± 625.5 vs 1418 ± 535.3, p = 0.02), but no significant difference was found in ratio of Lp-PLA2/HDL (5.09 ± 2.17 vs 5.95 ± 3.11, p = 0.16). Conclusion AIP and ratio of Ox-LDL/HDL value were significantly higher in uncontrolled than in controlled T2DM. These parameters may be beneficial in predicting the risk of atherosclerosis in diabetic patients. (Med J Indones 2010; 19:103-8)

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