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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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The association of plasminogen activator inhibitor-1 level with ischemic stroke (preliminary study)
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.v19i3.403

Abstract

Aim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke. Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago. Results High PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 - 12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 - 58 years old) than in the older subjects (60 - 84 years old) (20% vs. 9.8 %) (p=0.004). Conclusion The result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association. (Med J Indones 2009;19:158-63)
Combine proper exercise and regular taking antihypertensive medicine was better to lower diastolic blood pressure among diastolic prehypertensive and hypertensive subjects
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.v19i3.404

Abstract

Aim To prove that proper exercise and taking antihypertensive medicine may reduce diastolic blood pressure (DBP) by ≥ 5 mmHg. Method A quasi-experimentation study was done on employees of a government bureau in Jakarta, for 8 weeks from March to August 2008. All prehypertensive and hypertensive subjects were detected through a survey prior to the quasi-experimentation study. A talk was given at the beginning of the quasi-experimentation study, and weekly counseling sessions on exercise, taking medications, and other related topics continued for 8 weeks. Cox regression was used for calculating relative risk. Results A total 1,016 employees out of 1,300 were involved in this blood pressure survey. Of these, 318 subjects had a DBP of 80 mmHg or more. Out of 120 subjects who voluntarily participated, 104 subjects completed the quasi-experimentation study. Compared to those who did not exercise properly and did not take antihypertensive medicines, subjects who did exercise properly and took medicines regularly had a lower diastolic blood pressure DBP ≥5 mmHg by more than 12-fold [adjusted relative risk (RRa) = 12.32; 95% confidence interval (CI) = 0,65-234,54; P = 0.095. However subjects who exercised properly or took antyhypertensive medicines irregularly were found to lower their DBP ≥5 mmHg by almost 11 fold [adjusted relative risk (RRa) = 10.94; 95% confidence interval (CI) = 2.04-58.74]; P = 0.005. Subjects with DBP = 90-99mmHg had a decrease of DBP ≥5 mmHg 4.8 fold (RRa = 4.75; 95% CI = 1.19-18.65) compared to those with DBP = 80-89mmHg. Compared to the normal subjects, the obese, resting pulse rate bradycardia, and high average pulse pressure subjects had less probability of lowering DBP ≥ 5mmHg, by 87%, 90%, and 65%, respectively. Conclusion Combine proper exercise and taking antihypertensive medicine was reduce DBP by ≥5 mmHg among DBP (pre-) hypertensive subjects. The obese, bradycardia, or high pulse pressure subjects failed to lowering their DBP ≥5 mmHg by proper exercise and taking antihypertensive medicine. (Med J Indones 2009;19:191-8)
Diagnostic test of predicted height model in Indonesian elderly: a study in an urban area
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.v19i3.405

Abstract

Aim In an anthropometric assessment, elderly are frequently unable to measure their height due to mobility and skeletal deformities. An alternative is to use a surrogate value of stature from arm span, knee height, and sitting height. The equations developed for predicting height in Indonesian elderly using these three predictors. The equations put in the nutritional assessment card (NSA) of older people. Before the card which is the first new technology in Indonesia will be applied in the community, it should be tested. The study aimed was to conduct diagnostic test of predicted height model in the card compared to actual height. Methods Model validation towards 400 healthy elderly conducted in Jakarta City with cross-sectional design. The study was the second validation test of the model besides Depok City representing semi urban area which was undertaken as the first study. Result Male elderly had higher mean age, height, weight, arm span, knee height, and sitting height as compared to female elderly. The highest correlation between knee height and standing height was similar in women (r = 0.80; P < 0.001) and men (r = 0.78; P < 0.001), and followed by arm span and sitting height. Knee height had the lowest difference with standing height in men (3.13 cm) and women (2.79 cm). Knee height had the biggest sensitivity (92.2%), and the highest specificity on sitting height (91.2%). Conclusion Stature prediction equation based on knee-height, arm span, and sitting height are applicable for nutritional status assessment in Indonesian elderly. (Med J Indones 2010;19:199-204)
Incretin-based therapies for type 2 diabetes mellitus in Asian patients: Analysis of clinical trials
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.v19i3.406

Abstract

Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin) for the treatment of type 2 diabetes mellitus in Asian population. Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used. Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian). It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid) compared to the effects observed in studies with Caucasian population, with comparable safety profile. Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12)
Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.407

Abstract

Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1 (PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice.Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 control healthy subjects. HDL type was classifi ed into antiatherogenic and  proatherogenic based on the levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method, PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined by homogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levels of ApoA-I, PON-1, Neopterin andHDL-cholesterol as independent variables. Proatherogenic/ antiatherogenic HDL type was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios.Results: Patient’s age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/ dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterin successively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed that OR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 – 217.382), 1.647 (95% CI : 0.412 – 6.586), 4.317 (95% CI : 1.098 – 16.977). Using scoring system, we concluded that total score > 18 was proatherogenic HDL type, and total score < 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenic HDL type in ACS population.Conclusions: Dysfunctional HDL or proatherogenic/anti atherogenic  HDL type can be predicted by using ApoA-I– PON-1–Neopterin–HDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenic HDL type, and those with score of > 18 were having proatherogenic HDL type. (Med J Indones 2010; 19:228-34)Keywords: ApoliproteinA-I (ApoA-I), HDL-cholesterol, neopterin, paraoxonase-1 (PON-1), proatherogenic/antiatherogenic HDL
Simultaneous detection of Legionella species and Legionella pneumophila by duplex PCR (dPCR) assay in cooling tower water samples from Jakarta, Indonesia
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.408

Abstract

Aim: Since culture method is time-consuming and has low sensitivity, we developed a duplex PCR (dPCR) assay for the detection of Legionella sp. and L. pneumophila in cooling tower samples. We used culture method as a gold standard. Methods: Optimization of dPCR method was performed to obtain an assay with high sensitivity and specifi city. The optimized method was used to detect Legionella sp. dan L. pneumophila in 9 samples obtained from 9 buildings in Jakarta. For culture method, the bacteria were grown or isolated on selective growth factor supplemented-buffered charcoal yeast extract (BCYE) media. Results: Of 9 samples tested by dPCR assay, 6 were positive for Legionella species,1 was positive for L. pneumophila, and 2 showed negative results. For the same samples, no Legionella sp. was detected by the culture method. Conclusion: dPCR assay was much more sensitive than the culture method and was potentially used as a rapid, specifi c and sensitive test for routine detection of Legionella sp. dan for L. pneumophila in water samples. (Med J Indones 2010; 19:223-7)
The differences in metabolic responses between dietary orotate and adenine in lipid profiles of serum and liver tissues
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.409

Abstract

Aim: Objectives to evalate the differences in metabolic responses between dietary orotic acid and adenine in lipid profiles of serum and liver tissues.Methods: Rats were paired-fed 1.0 % orotic acid (orotic acid group) and 0.25 % adenine (adenine group) diets or a non-supplemented diet (control group) for 10 days. Serum lipid concentrations were measured using enzyme assay kits. Lipids of liver tissues were extracted and the lipid contents were  determined.Results: Serum lipid concentrations (in mg/dL) of adenine group tended to increase whereas those levels decreased in orotic acid group compared to control group. The serum triglyceride (TG) concentrations of control, orotic acid, and adenine groups were (78.1±14.9), (69.0±23.6), and (136.1±21.6); phospholipids (PL): (109.2±11.5), (93.3±10.5), and (131.3±11.0); total cholesterol: (53.7±4.6), (42.9±6.5), and (68.1±5.8); and high-density lipoprotein (HDL)-cholesterol: (35.4±2.7),(33.0±3.0), and (44.7±2.7), respectively. Furthermore, liver TG content of orotic acid group markedly increased. The increase was approximately by 10-fold in comparison to other groups (P<0.05). The lipid contents of liver tissues (in mg/g tissue) in ordinarily of those three groups for TG were (11.4±1.3), (123.5±15.2), and (11.9±1.2); PL: (27.1±0.8), (25.4±1.3), and (30.7±0.6); and the total cholesterol: (2.73±0.09), (2.34±0.12), and (2.91±0.08), respectively. The liver PL and cholesterol content of adenine group increased by 21% and 25% than that of orotic acid group, but both lipid levels of the latter group increased by 7% and 15%, respectively, than that of the control group.Conclusion: Dietary adenine enhances the serum TG, PL, cholesterol, and HDL-cholesterol and the liver PL and cholesterol but without alters the liver TG levels. Dietary orotic acid, however, attenuates these serum lipid levels but retains those lipids  synthesized in liver cells, mainly TG. (Med J Indones 2010; 19:217-22)Keywords: Adenine, liver lipids, lipogenesis, orotic acid, serum  lipids
Analysis of fatty acids in Ghee and olive oil and their probable causal effect in lipoid pneumonia
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.410

Abstract

Aim: To analyze and identify the fatty acids found in homemade ghee and in olive oil and compare those to fatty acids found in bronchoalevolar lavage of children with lipoid pneumonia. Methods: The fatty acids found in homemade fat "Ghee" and olive oil were analyzed by gas chromatography. Methyl ester derivatives suitable for GC analysis were prepared directly from olive oil or from Ghee using anhydrous methanolic-HCl. Bronchoscopy and bronchoalevolar lavage was performed in eight children aged between 2 and 4 years, all with history of using homemade ghee and/or olive oil in the recumbent position. Results: The analysis of fatty acids in Ghee and olive oil show similar gas chromatographic pattern as those of bronchoalevolar lavage. Conclusion: The three fatty acids responsible for the deleterious effects of lipoid pneumonia were identified. Lipoid pneumonia should be one of the differentials diagnosis in children presenting with respiratory distress. (Med J Indones 2010; 19:252-7)
Colorectal cancer among young native Indonesians: A clinicopathological and molecular assessment on microsatellite instability
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.411

Abstract

Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities – Jakarta, Makassar, and Bandung - were reviewed. The “native” ethnic groups were selected from those originating from Java, Makassar (South Celebes),  Minangkabau (West Sumatra). Ethnicity of 121 colorectal  carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as  immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability and. (Med J Indones 2010; 19:245-51)Keywords: colorectal cancer, microsatellite instability, MLH1, MSH2, native Indonesian, SMAD4
The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia
Medical Journal of Indonesia Vol. 19 No. 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i4.412

Abstract

Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients. Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements. Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6 ±14.6 mg/dL). Dyslipidemia was reported in 60% (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most common complication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territory Conclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in Indonesia. (Med J Indones 2010; 19:235-44) Keywords: DiabCare, DiabCare Indonesia, Diabetes complications, Dyslipidaemia, Glycaemic control, Hypertension.

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