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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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Family history of hypertension is associated with exaggerated cardiovascular reactivity to mental, but not to physical test
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.v19i2.393

Abstract

Aim To investigate whether normotensive young adults with family history of hypertension demonstrate exaggerated cardiovascular responses to both mental and physical stimuli as compared to normotensive young adults withoutfamily history of hypertension. Methods Normotensive undergraduate students of normotensive parents (n = 40) and of hypertensive father/ mother/ both (n = 40), aged 20 - 30 years, performed serial subtraction test in a sitting position for three minutes. After taking a rest, subjects performed cold pressor test in ninety seconds. In each test, blood pressure and pulse rate were recorded in pre-test, during test, and post-test using an automated oscillometric device. Changes score rather than absolute scores were analyzed using independent t-test or Mann-Whitney. Results There were no significantly differences in age, body mass index, fasting blood sugar, and plasma creatinine between the two groups. Normotensives of hypertensive parents had significantly higher offi ce systolic blood pressure (108.33 ± 1.6 vs 103.00 ± 1.6 mmHg) and delta change score of cardiovascular reactivity to serial subtraction test (MABP 19.13 ± 1.4 vs 15.5 ± 1.0 mmHg, P = 0.04), but not to cold pressor test (MABP 24.26 ± 1.7 vs 21.74 ± 1.7 mmHg) than those of normotensive parents. Conclusion Normotensive young adults with family history of hypertension demonstrated exaggerated cardiovascular reactivity to mental test but not to physical test. As compared to normotensive young adults without family history of hypertension However, this familial difference in cardiovascular reactivity to mental test is confused with office blood pressure. (Med J Indones 2010; 19:118-23)
Antibody anti-H5N1 detection in poultry farmers and workers in poultry collection facilities in Indonesia, 2007
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.v19i2.394

Abstract

Aim Between July 2005 and May 2008, Indonesia reported 133 H5N1 confirmed human cases with a case fatality proportion of 81%. Fifty-four percent of cases had a history of direct contact with poultry (chickens). Therefore, it is important to define the detection of antibody of H5N1 among people who have intensive contact with poultry have been exposed to H5N1 viruses. Methods We collected sera from healthy poultry-collecting-facility (PCF) workers in Jakarta and healthy poultry-farmers in Sukabumi which have close contact with poultry. Anti-H5N1 antibodies were tested with modified Haemagglutination Inhibition (HI) assay using A/Ck/Banten/05-1116/05(H5N1) antigen and with Neutralization (NT) assay using A/H5N1/Indo/05/IBCDC-RG virus. Results Among the 216 PCF worker sera and the 495 poultry-farmer sera that we collected, we found that all poultry-farmers were seronegative and one percent of poultry-collecting-facilities workers were seropositive by both HI and 1% by NT assays. Conclusions This study detected asymptomatic H5N1 virus infection among poultry workers in PCFs with intensive contact with various types of different poultry who had different titers of antibody, but no antibodies were detected among poultry farmers. (Med J Indones 2010; 19:124-9)
At what age group blood pressure discontinue to increase? An assessment using change-point analysis
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.v19i2.395

Abstract

Aim To study at what age group blood pressure ceases to increase for women and men. Methods Applying change-point technique, we used our existing database - mega base-line cross-sectional Hulu Langat Health Study that was initiated in 2000 - to locate the most appropriate age limit in planning promotive, preventive and controlling strategies against systolic hypertension. Results Systolic hypertension was found to be constantly increasing for both gender right from the early age until the middle age group. However, women achieved the systolic peak 15 years earlier (at 41-45 years old) than men (at 56-60 years old). Systolic blood pressure was steadily declined after the peak. Conclusions Hypertension intervention, we recommend age before 40 (women) and 55 (men) be the most appropriate period to apply various public health intervention, after that, the action must be exclusively curative. (Med J Indones 2010; 19:136-41)
Risk factors for bacterial vaginosis among Indonesian women
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.v19i2.396

Abstract

Aim To identify risk factors for bacterial vaginosis (BV) among Indonesian women. Methods This is a cross sectional study involving 492 women with age ranged 15-50 years. Vaginal discharge was collected. Whiff test and Nugent scoring were utilized to identify BV. Settings are Puskesmas Karawang, Pedes, Cikampek,Tempuran, Batalyon 201 Clinic Cijantung, Faculty of Medicine University of Indonesia and Cipto Mangunkusumo Hospital. Results Age of the subjects were 15-25 years old (26.8%), 26 - 40 years old (59.1%), and > 40 years old (14%). The mean age was 30.9 years. Marital status of the subjects were not-married (16.9%), married (76.4%), married more than once (6.7%). Prevalence of bacterial vaginosis in this study was 30.7% according to Nugent's score. Age > 40 years old (OR=3.15 IK 95% = 1.15-1.48) and uncircumcised couple (OR=6.25, IK 95% = 2.54 - 15.38) were independently and significantly associated with incidence of BV (p<0.05). Conclusions Prevalence of BV in this study was 30.7%. Determinant risk factors of BV were age and uncircumcised sexual partner. (Med J Indones 2010; 19:130-5)
A second generation of RT-PCR assay for detection of human immunodeficiency virus type 1 (HIV-1) infection
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.397

Abstract

Aim A spesific and rapid diagnosis such as RT-PCR assay is the most needed to minimize transmission of HIV-1 infection. Therefore, in this study we developed the RT-PCR assay that was spesific against the gag gene of HIV-1. Methods The developed RT-PCR assay was evaluated against 46 specimens that were obtained from voluntary counseling and testing for HIV (VCT) in Rumah Sakit Umum Pemerintah (RSUP) Sanglah, Bali. To get the sensitivity and specificity of RT-PCR assay, the results of assays were compared with the results of commercially serologic teststhat were commonly used in Indonesia. Results The RT-PCR assay could detect 21 of 26 serologic test-positive specimens and showed 19 negative results of 20 serologic test-negative specimens. There was one specimen that was positive in RT-PCR but negative in serologic assay, which might depict a true yield at particular condition when the serologic assay was unable to detect. Five serologic positive-test specimens were negative by RT-PCR that was possibly caused by low detection level of the assay. Conclusion The RT-PCR assay is potential to be used for the detection of HIV-1 infection with a sensitivity and specificity of 80.8% and 95.0% respectively. (Med J Indones 2010;19:154-7)
Demographic characteristics, risk factors and immunocytochemistry of p16INK4a, Ki-67, MCM5, and survivin as predictors for the progress of cervical precancer lesion
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.398

Abstract

Aim To identify the predictive factors and biomarkers in the progression of cervical precancer lesion or Cervical Intraepithelial Neoplasia (CIN). Methods The study was conducted from August 2007 to September 2008. Design of the study was case-control with stratifications of test dose response. The cases were patients with CIN. Control patients were non CIN patients. Bivariate analysis followed by multivariate analysis was conducted. Results There were 130 patients, consisting of 124 CIN patients divided into CIN 1, CIN 2 and CIN 3, with the following numbers of patients: 30, 41, and 33, respectively and 26 patients without CIN (non CIN). Bivariate analysis showed that age < 41 years, education ≥13 years, sexual partner ≥2, first sexual relationship at age < 22 years, smoking, the presence of sexuallly transmitted infections, positive HPV DNA, high p16INK4a, Ki-67, MCM5 and Survivin expression constituted independent variables for the occurrence of CIN with P value of < 0.05. However, on multivariate analysis, independent variables that emerged were age, education ≥13 years, sexual partner ≥2 persons, positive HPV DNA, and over expression of p16INK4a, Ki-67 and Survivin that showed a P value of < 0.005. Conclusion Younger ages, education age ≥13 years, sexual partner ≥2 persons, positive HPV DNA, high p16INK4a, Ki-67 and Survivin expression constituted the risk factors for the occurrence of the progress of CIN, and was used in the equation to predict the progress of cervical precancer lesion. (Med J Indones 2010;19:147-53)
Angiopoietin like protein 3 (Angptl3), fatty acid binding protein 4 (FABP4) and homeostasis model assessment of insulin resistance (HOMA-IR) among Indonesian obese non diabetic males
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.399

Abstract

Aim To reveal the correlation between Angptl3, FABP4 and HOMA-IR among Indonesian obese non diabetic males. Methods This is a cross sectional study with 133 obese non diabetic males volunteers (characterized by waist circumference > 90 cm; fasting blood glucose < 126 mg/dL; and no diabetic specific symptoms) age between 30-60 years which was done in Jakarta, Indonesia. We measured biochemical markers such as Angptl3, FABP4, FFA, fasting insulin and fasting glucose. We also measured weight, height, waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Correlation between each marker was measured using Pearson and Spearman's analysis. Results Pearson and Spearman's correlation analysis showed significant positive correlation between Angptl3 and FABP4 (r = 0.319; P = 0.000), Angptl3 and FFA (r = 0.171; r = 0.049), FABP4 and HOMA-IR (r = 0.202; P = 0.019), FFA and FABP4 (r = 0.506; P = 0.000), WC and HOMA-IR (r = 0.323; P = 0.000), WC and FABP4 (r = 0.387; P = 0.000), Body Mass Index (BMI) and HOMA-IR (r = 0.270; P = 0.002), BMI and FABP4 (r = 0.362; P = 0.000). Conclusion This study showed positive significant correlations between Angptl3-FABP4, Angptl3-FFA, FFA-FABP4 and FABP4-HOMA-IR. We suggest that Angptl3 can activate lipolysis in adipose tissue (through its correlation with FABP4), and Angptl3 concentration is related to insulin resistance risk among Indonesian obese non diabetic males. (Med J Indones 2010;19:185-90)
Atrial fibrillation ablation guided with electroanatomical mapping system: A one year follow up
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.400

Abstract

Aim AF is the most common arrhythmia in clinical practice and associated with an increased long-term risk of stroke, heart failure, and all-cause mortality. Catheter ablation of AF is relatively new modality to convert AF to sinus rhythm. This study was aimed to elaborate efficacy of catheter ablation in mixed type of AF. Methods Thirty patients (age of 52 ± 8 yo) comprised of 19 paroxysmal and 11 chronic AF underwent radiofrequency catheter ablation guided by electroanatomical CARTO™ mapping system. We used step wise ablation approach with circumferential pulmonary vein isolation (PVI) as a cornerstone. Additional ablation comprised of roof line, mitral isthmus line, complex fractionated atrial electrogram (CFAE), septal line and coronary sinus ablation was done respectively if indicated. All patients were followed up to 1 year for AF recurrence. Results Circumferential PVI was successfully performed in all patients but one. Average follow up period was 11.5 months. More than 80% of all patients remain in sinus rhythm at the end of follow period which 62% of them were free from any anti-arrhythmic drug. No major complication in all patients series. Conclusion Radiofrequency ablation guided with electroanatomical mapping is effective and safe in mixed type of AF. (Med J Indones 2009;19:172-8)
Percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic cardiomyopathy: Indonesian initial experience
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.401

Abstract

Aim Percutaneous transluminal septal myocardial ablation (PTSMA), a non-surgical intervention to treat hypertrophic cardiomyopathy (HCM), has been a standard treatment in developed countries. However, this procedure not yet systematically performed in Indonesia. This case series aim to study feasibility, safety and efficacy of PTSMA in National Cardiovascular Center Harapan Kita, Jakarta. Methods Three HCM patients (2 male) with dynamic left ventricle outflow tract (LVOT) pressure gradient of higher than 30 mmHg underwent PTSMA. Left ventricle apex pressure was measured using multipurpose catheter and aortic pressure was measured by means of left coronary guiding catheter simultaneously. Target vessel is confirmed by myocardial echocardiography contrast. Two ml absolute alcohol delivered to the target vessel by means over the wire balloon. Immediate pressure gradient changed 10 minute after alcohol administration was recorded. Continuous ECG monitoring is attemted along the procedure. Results All subject demonstrated more than 50% LVOT pressure gradient reduction. One subject experienced transient total AV block and right bundle branch block which completely recovered 6 hours after procedure. In one patient, target vessel must be changed as it gives perfusion to extensive area of right ventricle. Conclusion PTSMA guided with myocardial echocardiography contrast is feasible, safe and effective to reduce LVOT pressure gradient in HCM patient. (Med J Indones 2009;19:164-71)
Pulmonary dysfunction in obese early adolescents
Medical Journal of Indonesia Vol. 19 No. 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i3.402

Abstract

Aim Obesity leads to various complications, including pulmonary dysfunction. Studies on pulmonary function of obese children are limited and the results are controversial. This study was aimed to determine proportion of pulmonary dysfunction on early adolescents with obesity and to evaluate correlation between obesity degree with pulmonary dysfunction degree. Methods A cross-sectional study was conducted at the Department of Child Health, Medical School, University of Indonesia, from November 2007 to December 2008. Subjects were 10 to 12 year-old adolescents with obesity. Subjects underwent pulmonary function test (PFT) to assess FEV1/FVC, FEV1, FVC, V50, and V25. Results 110 subjects fulfilled study criteria, 83 (75.5%) were male and 27 (24.5%) were female with median BMI 26.7 (22.6-54.7) kg/m2; 92 subjects (83.6%) were superobese. History of asthma and allergic rhinitis were found in 32 (29.1%) and 46 (41.8%) subjects, respectively. 64 (58.2%) subjects had abnormal PFT results consisting of restrictive type in 28 (25.5%) subjects, obstructive in 3 (2.7%), and combined type in 33 (30%). Mean FEV1, FVC, V50, and V25 values were below normal, while mean FEV1/FVC ratio was normal. There was no statistically significant correlation between BMI and PFT parameters. No significant correlation was found between degree of obesity and the severity of pulmonary dysfunction. Conclusions Pulmonary dysfunction occurs in 58.2% obese early adolescents. The most common abnormality was combined type (30%), followed by restrictive (25.5%), and obstructive type (2.7%). There was no correlation between BMI and pulmonary function test parameters. (Med J Indones 2010;19:179-84)

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