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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
 57   58   59   60   61 
Mycophenolate mofetil versus cyclophosphamide for therapy of lupus nephritis: an evidence-based case report from systematic reviews and meta-analyses
Medical Journal of Indonesia Vol. 21 No. 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i1.474

Abstract

Background: The aim of this case study is to compare the effectiveness between cyclophosphamide and mycophenolate mofetil to achieve remission of lupus nephritis in an evidence-based case report from meta-analyses. Methods: Method in this case study is evidence-based case report using meta-analyses. Clinical question used in this paper is; which immunosuppressant gives better result in achieving remission in lupus nephritis patient: cyclophosphamide or mycophenolate mofetil? To answer this question, we search the evidence from PubMed with the keywords: “lupus nephritis AND mycophenolate mofetil AND cyclophosphamide“ with inclusion criteria of meta-analysis, written in English, and focused comparing cyclophosphamide and mycophenolate mofetil. Results: From the searching method, we found 11 articles which is relevant. One has been excluded since it written in Hebrew, 4 articles excluded since are not focus answering the clinical question. At the end, 6 studies were included to the critical appraisal step. Conclusion: Based on the evidences, mycophenolate mofetil is non-inferior to cyclophosphamide in achieving remission in lupus nephritis patients, but with the better safety profile. Patient in our case study get mycophenolate mofetil and shows better clinical condition towards remission as she are evaluated in the outpatient clinic. (Med J Indones 2012;21:44-51) Keywords: Cyclophosphamide, evidence-based case report, lupus nephritis, meta-analysis, mycophenolate mofetil, remission, systematic review
Microbes profile from blood stream infection cases and their relationship to those of environment in Neonatal unit
Medical Journal of Indonesia Vol. 21 No. 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i1.475

Abstract

Background: Hospital Acquired Infection (HAI)-Blood Stream infection (BSI) cause considerable morbidity, mortality and health care costs. This study aimed to assess the HAI-BSI in neonates with birth weight 1000-2000 g in Neonatal Unit Cipto Mangunkusumo National Hospital (RSUPNCM), Jakarta, during 4 months period (Oct 2010-Jan 2011), and to review the possibility of sources and transmission of environment microbes to the presence of HAI-BSI in the unit. Methods: Subjects of this study were neonates (birth weight 1000-2000 g) with clinically sepsis and within 48 hours or more being hospitalized, no clearly focal infection detected, with catheter lines. Two blood specimens from two separate venipunctures, drawn simultaneously, were cultivated. Identification and antimicrobial susceptibility tests were performed for each isolates. Cultures from environment in the unit and other suspected clinical specimens were also examined. Results: From 29 neonates with 39 episodes of sepsis, 5 positive isolates from blood cultures were obtained i.e. Enterobacter asburiae (2), Enterobacter cloacae (1), Pseudomonas aeruginosa (1) and Klebsiella oxytoca (1). The laboratory confirmed HAI-BSI was 12.8%, and HAI-BSI rate was 1.46 per 1000 catheter line days during 4 months period (Oct 2010-Jan 2011). Cultures performed for environment specimens gave yield some species which were as those from clinical specimens. Antibiogram analysis showed those of environment isolates i.e E. asburiae and P. aeruginosa shared similarity to those of neonates’ blood isolates. Conclusion: Gram-negative bacteria were responsible to the occurrence of HAI-BSI in the Neonatal Unit RSUPNCM. Despite of low HAI-BSI rate found in this study, analysis of antibiogram profiles of the isolates originated from neonates’ blood and environment strongly suggested that cross infection was present in the unit. (Med J Indones 2012;21:32-7) Keywords: Antibiogram, blood stream infection, hospital acquired infection, neonates
Hypertension in Indonesian air force pilots
Medical Journal of Indonesia Vol. 21 No. 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i1.477

Abstract

Background: To investigate the association between aircraft noise and blood pressure. Methods: A nested case-control study was conducted on Indonesian Air Force pilots doing annual medical check-ups at the Saryanto Institute for Aviation and Aerospace Health (LAKESPRA) from 2003 – 2008. The data extracted from medical records were age, total flight hours, type of aircraft, fasting blood glucose and cholesterol levels, waist circumference, height and weight (Body Mass Index), and blood pressure. Results: There were 549 pilots, 49 were found to be hypertensive, with SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Helicopters pilots were at an almost 2 fold risk of hypertension compared to pilots of the fixed wing aircrafts. Pilots with more than 1400 hours of flight had more than 2 fold risk of being hypertensive compared to those with 1400 flight hours or less. Conclusion: The type of aircraft, which is related to the noise generated, may be a risk factor for developing hypertension in pilots. Increased total flight hours also increased the risk of hypertension. (Med J Indones 2012;21:38-43) Keywords: Aircraft noise, hypertension, pilots
Accurate diagnoses, evidence based drugs, and new devices (3 Ds) in heart failure
Medical Journal of Indonesia Vol. 21 No. 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i1.478

Abstract

Heart failure becomes main problem in cardiology because of increasing of heart failure patients, rehospitalization rate, morbidity, and mortality rate. The main causes of increasing heart failure problems are: (1) Successful treatment of acute myocardial infarction can be life saving, but its sequelae can cause heart failure. (2) Increasing life expectancy rate grows along with incidences of ageing related heart failure. (3) High prevalence of infection in Indonesia can cause rheumatic heart disease post Streptococcal beta hemolyticus infection, viral myocarditis, infective endocartitis, and tuberculoid pericarditis. (4) Many risk factors for coronary heart disease are often found in heart failure patients, for examples smoking, diabetes, hypercholesterolemia, hypertension, and obesity. Indonesia joined international multicentered registry in 2006. Acute Decompensated HEart failure REgistry is a web based international registry to record patient with acute decompensated heart failure treated in emergency room. It was found that heart failure patients in 5 big hospitals in Java and Bali island that joined this registry are younger, sicker and late to seek treatment. The median hospital length of stay was 7 days and in hospital mortality rate was 6.7%. The aim of this article is to give summary about essential things in diagnosing and treating heart failure patients. 3D (accurate diagnoses, evidence based drugs, and new devices) are the most important but what to do and what not to do in dealing with heart failure is also useful for your daily practice. (Med J Indones 2012;21:52-8)Keywords: Devices, diagnostic, drugs, heart failure
Establishment of human sperm-specific voltage-dependent anion channel 3 recombinant vector for the production of a male contraceptive vaccine
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.479

Abstract

Background: The aim of this study was to construct a recombinant vector of human sperm specific VDAC3 gene for production of VDAC3 antibody, which is potential as male contraception vaccine. Methods: Target fragment sequence of VDAC3 gene was obtained through amplification of human sperm VDAC3 cDNA with primers covering exon 5 to exon 8. Its PCR product in size of 435 bp was cloned to the pET101/D-TOPO expression vector (5753 bp). E. coli bacteria were transformed with this vector. Cloning of VDAC3 fragment gene to the vector was confirmed by the using of XbaI restriction enzyme and PCR colony method with primers covering exons 5-8 of the human VDAC3 gene. Results: Alignment analysis of amplified fragment covering exon 5 to exon 8 of VDAC3 gene showed 94% homology to human VDAC3 gene from databank. After cloning to the expression vector and transformation to E. coli competent cells, twelve colonies could grow in culture media. Gel electrophoresis of sliced VDAC3 recombinant vector showed a single band in the size of 6181 bp in 8 colonies. After application of PCR colony and amplicon sequencing, the result showed a single band in the size of 435 bp and fragment sequence with 94% identity to human VDAC3 gene. Conclusion: The construction of human sperm specific VDAC3 gene recombinant vector was established in this study. In the future, this recombinant vector will be used to produce VDAC3 antibody for the development of a male contraception vaccine. (Med J Indones. 2012;21:61-5)
Applicability of an oligonucleotide probe in radioisotope 32P-based dot blot hybridization for detection of hepatitis C virus in large sample numbers: a preliminary study
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.480

Abstract

Background: This study aimed to design and analyze the applicability of an oligonucleotide probe in radioisotope 32P-based dot blot hybridization for detection of hepatitis C virus. Methods: Forty-six of plasma samples were used. The plasma was extracted to obtain viral RNA genome as template for RT-PCR and the amplicon was used for nested PCR. Twenty-four HCV genomes were retrieved from GeneBank DNA sequence and alignment was performed by Bio Edit Software version 7.0.9.0. An oligonucleotide probe was designed based on a highly conserved region that is located on internal sequence between two primers used for nested PCR. Blast analysis on GeneBank was performed to obtain homology of the oligonucleotide for HCV. The oligonucleotide was then labeled with 32P and dot blot hybridization was applied for nested PCR products. DNA Sequencing was performed to confirm the amplicon and dot blot hybridization results. Results: Blast analysis showed high homology (100%) for HCV. Nested PCR resulted in three patterns of DNA fragments representing HCV genotypes 1, 2, and 3, respectively. The primers used in nested PCR were not specific and resulted in DNA fragments difficult to be interpreted. Dot blot hybridization using the designed oligonucleotide showed high intensity dots. All nested PCR fragments showed the dot blot positive. The dot blot results were in accordance with DNA sequencing that confirmed three patterns of DNA fragments as different HCV genotypes. Conclusion: The oligonucleotide showed excellent bioinformatically criteria. 32P-based dot blot hybridization yielded high intensity dots and was easier to be interpreted than nested PCR assay. (Med J Indones. 2012;21:71-6)
Diagnostic accuracy and cytomorphology analysis of fine-needle aspiration of salivary glands
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.481

Abstract

Background: Fine-needle aspiration (FNA) is an effective and safe procedure for analyzing salivary gland lesions. Various morphological and overlapping cytomorphology features can bring difficulty in diagnosis of the salivary gland lesions. This study aimed to evaluate the diagnostic accuracy of fine needle aspiration cytology of salivary glands lesions. Methods: There were 107 cases of cytology and 39 cases of histopathology of salivary gland lesions collected and reviewed from the archives of Anatomical Pathology Department, Faculty of Medicine, Universitas Indonesia / Cipto Mangunkusumo Hospital from 2005-2009. Seven cases of cytology were excluded, due to unsatisfactory specimens. Diagnostic test was applied to analyze the 39 pairs of cytology-histopathology cases. Results: There were 100 cases of salivary gland lesions cytology obtained, consisted of 27 negatives, eight cases inconclusive and 65 cases of neoplastic lesions. Of the 39 pair cases, fourteen cases showed result discrepancies between cytology and histopathology, with 3 false-negative cases and 1 false-positive case. The sensitivity and specificity of cytology analysis in differentiating malignant from non-malignant lesions were 82.35%, and 95.45% respectively, NPV 87.5% and PPV 93.34%. Conclusion: This study showed diagnostic accuracy of FNA cytology salivary gland lesions was varied, with 82.35% sensitivity and 95.45% specificity in differentiating malignant from non-malignant hence this information can still be used for case management. (Med J Indones. 2012;21:92-6)
Schizonticidal effect of a combination of Amaranthus spinosus L. and Andrographis paniculata Burm. f./Nees extracts in Plasmodium berghei-infected mice
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.482

Abstract

Background: Amaranthus spinosus and Andrographis paniculata are traditionally used as antimalarial herbs, but the combination of both has not yet been tested. The aim of this study was to determine the schizonticidal anti-malaria effect of a combination in Plasmodium berghei-infected mice. Methods: Male mice (Balb/c strain) weighing 28-30 g, 7-8 weeks old, were randomly devided into 5 groups of 4 animals each. Group A: controls (nil) and 4 treatment groups (B, C, D, and E). Group B: Amarathus 10 mg/kgBW, group C: Andrographis 2 mg/kgBW, group D: combination of Amaranthus + Andrographis 10 mg + 2 mg/kgBW. All treatment with plant extracts was administered orally, once per day for 7 days. Group E was given chloroquine 10 mg/kgBW, once a day orally, for 3 days. Results: The body weigh increased only in group D, hemoglobin concentration increased significantly vs controls (p < 0.05) in treatment groups C, D, and E, and blood schizonticidal activity was seen in all treatment groups, highest at almost 90% in groups D and E. Survival rate was 100% in all groups. Conclusion: The combination of Amaranthus and Andrographis (10 mg + 2 mg/kgBW) exerts the same blood schizonticidal activity as chloroquine 10 mg/kgBW. (Med J Indones. 2012;21:66-70)
Study on the influence of adiponectin genetic variants and adiponectin levels among Indonesian women with polycystic ovary syndrome
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.483

Abstract

Background: Insulin resistance and central adiposity are frequent disorders in PCOS women, which are marked by biological marker dysregulation related to this metabolic abnormalities. Association between adiponectin and insulin resistance has been investigated in many studies, while only a few studies were done in PCOS patients. This study is to determine the association of T45G polymorphisms in Indonesian population with PCOS biological markers and their influence to adiponectin serum. Methods: Fifty-two PCOS patients and 52 normal ovulatory women without hyperandrogenism as control subjects were included. Blood samples were collected between day 3 and 5 of a spontaneous menstrual cycle at 7 to 9 am, after overnight fasting. Serum levels of FSH, LH, testosterone, SHBG, glucose, insulin, lipid profile and adiponectin were measured. Insulin resistance was estimated by HOMA-IR, HOMA- β, and SHBG. T45G gene polymorphisms were determined by PCR after genomic DNA was obtained from peripheral blood of patients and control subjects. Results: There were significant difference between PCOS and control group in term of BMI, LH, testosterone, SHBG, and FAI, but not significant to T45G gene polymorphisms frequency distribution. Adiponectin levels were lower in PCOS patients than control. There was an association between insulin resistance with PCOS. Among PCOS patients, no association between adiponectin LH, testosterone, SHBG, and FAI with T45G gene polymorphisms. T45G gene polymorphisms were more frequent in PCOS with low adiponectin levels compared to those with high adiponectin levels, although not significant statistically. Conclusion: T45G gene polymorphisms has no direct association with PCOS biological markers, but its association with adiponectin needs further study. (Med J Indones. 2012;21:83-91)
The effect of alpha fetoprotein on NF-κB translocation in lipopolysaccharide induced monocyte-derived dendritic cell
Medical Journal of Indonesia Vol. 21 No. 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i2.484

Abstract

Background: Alpha fetoprotein (AFP) is a tumor-associated Ag that has a function in both ontogenic and oncogenic growth and its serum level is elevated in patients with hepatocellular carcinoma (HCC). A recent study showed that the immunoregulatory effect of AFP was through impairment of dendritic cell function as antigen presenting cell (APC), a mechanism that is known to hamper efficient antitumor response. However, the underlying intracellular mechanism of action of AFP required elucidation. As an initial step to determine the signaling pathway of AFP, we analyzed whether LPS induced NF-κB translocation occured in AFP-treated monocyte-derived dendritic cell (MDDC), which was induced by lipopolysaccharide (LPS). Methods: Monocytes were cultured in GM-CSF (800 ng/mL) and IL-4 (1000 ng/mL) containing medium and incubated for six days to generate immature MDDCs with or without the presence of AFP. Mature MDDC was generated by stimulation of the immature MDDC with LPS for another 30 minutes. The analysis of NF-κB translocation was measured by fluorescent microscopy. Results: Following activation of MDDC by LPS, the control group showed a marked nuclear staining of NF-κB. However, the AFP-treated group showed negative nuclear staining similar as observed in unactivated MDDC. Conclusion: This study demonstrated that AFP prevented the activation and nuclear translocation of NF-κB and subsequently might cause the impairment of MDDC function as APC. This finding provides a new insight on the role of AFP in the suppression mechanism of anti tumor immune response. (Med J Indones. 2012;21:97-101)

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