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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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Viral and bacterial infection among hospitalized-suspected influenza A/H5N1 patients in Indonesia, 2008-2009
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.v21i2.485

Abstract

Background: Since a lot of suspected H5N1 cases with severe ARI manifestation were hospitalized and negative for H5N1, it raised a concern to investigate the other etiologies among hospitalized-suspected H5N1 cases. The aim of present study is to investigate the other respiratory pathogens of hospitalized-suspected H5N1 cases in which will provide valuable insight in the etiologies and epidemiology data of ARI. Methods: We tested the archived respiratory clinical specimens (nasal or throat swab, tracheal aspirate and bronchoalveolar lavage) that were already confirmed as negative H5N1 for 16 viruses and 8 bacteria existence by Multiplex PCR and Real-Time PCR from 230 hospitalized-suspected H5N1 cases received in July 2008 to June 2009. Results: Of the 230 hospitalized-suspected H5N1 cases, Klebsiella pneumoniae was the most dominant bacterial pathogen in children and adult. Moreover, the common viral pathogens in children was influenza A (non H5), while it was varied in adults as influenza A (non H5), Enterovirus, HRV A/B, Coronavirus 229E/NL63 were found very low. Bacterial mix infection of Klebsiella pneumoniae, Streptococcus pneumoniae and Haemophillus influenzae mainly occurred in children while co-infections of Klebsiella pneumoniae and Streptococcus pneumoniae were frequently found in adults. In addition, the major bacterial-viral mix infection found among children was influenza A and Klebsiella pneumoniae. Conclusion: From all of the samples tested, bacterial infections remain the most common etiologies of ARI in adults and children although there were infections caused by viruses. Mix infection of bacterial and viral also found among adults and children. (Med J Indones. 2012;21:77-82) Keywords:
Benign schwannoma of the radial nerve mimicking cervical radicular pain
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.v21i2.486

Abstract

Radicular pain on the arm often referred to cervical disc problems. If cervical MRI is normal, then it is necessary to rule out peripheral nerve tumor. A 54-year old man presented with radicular pain in his left arm, investigated for cervical disc problems, with normal cervical MRI. Examination shows a positive Tinel's sign on the proximal part of his left arm. Focal MRI revealed a lobulated tumor in the radial nerve 1.5 cm in diameter. The patient was operated and the tumor was completely removed. Histopathology confirmed the diagnosis of schwannoma. (Med J Indones. 2012;21:118-20)
Budi Iman Santoso Assessment (BISA): a model for predicting levator ani injury after vaginal delivery
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.v21i2.487

Abstract

Background: There have been no attempts or studies to integrate various risk factors that can be utilized to predict levator ani injury caused by vaginal delivery. This study was aimed to establish an index measurement system by using various risk factors for predicting levator ani injury in vaginal delivery. Methods: A prospective cohort was conducted at two hospitals in Jakarta between 2010 and 2011. The subjects were nulipara pregnant women without levator ani injury during pregnancy and vaginal birth. Levator ani injury was evaluated using 4D USG during pregnancy and three months after delivery. The variables studied were age, body mass index, mode of delivery, fetal birth weight, episiotomy, perineum rupture and duration of second stage labor. Prediction model was analyzed using logistic regression analysis. Results: There were 182 recruited subjects of which 124 subjects were eligible and only 104 subjects could be analyzed. Incidence of levator ani injury at three months after delivery was 15.4% (95% CI: 8.6-23%). Two prediction models were obtained. The first consisted of fetal birth weight (OR= 5.36, 95% CI: 1.08-26.59), episiotomy (OR= 5.41, 95% CI: 0.94-31.18), and duration of second stage labor (OR= 15.27, 95% CI: 3.15-73.96). The second model consisted of duration of second stage labor (OR= 9.51, 95% CI: 1.23-68.10) and perineum rupture (OR= 142.70, 95% CI: 14.13-1440.78). Conclusion: Fetal birth weight, episiotomy and duration of second stage labor could predict levator ani injury for model 1; while the variables of prediction for model 2 were duration of second stage labor and perineum rupture. (Med J Indones. 2012;21:102-7)
Paracentesis as an initial intervention in Malay Indonesian eyes with acute primary angle closure
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.v21i2.488

Abstract

Background: Acute primary angle closure (APAC) is one of the causes of blindness in Department of Ophthalmology Cipto Mangunkusumo General Hospital. Management of APAC is still controversial. Laser peripheral iridotomy is difficult to be done due to corneal edema as a result of persistent high intraocular pressure (IOP). It is believe that paracentesis will lower IOP immediately. The objective of the study was to assess outcome of paracentesis as the initial management in Malay Indonesian eyes with APAC. Methods: This intervention study was conducted at the Eye Clinic of Cipto Mangunkusumo Hospital and Jakarta Eye Center commencing in January 2005 until December 2007. Malay Indonesian eyes with APAC were included in this study in accordance with the new Asia Pacific consensus. All APAC eyes underwent paracentesis to lower IOP. The presenting and post-paracentesis IOP and peripheral anterior synechiae were noted. The outcome was termed as good when IOP was ≤ 21 mmHg and poor when IOP was > 21 mmHg. Results: A total of 45 APAC eyes were recruited. Thirty-eight of these belonged to women; mean age was 54.6 ± 1.56 years. Meanwhile, average duration of symptoms was 13.15 ± 7.4 days and mean of extent of peripheral anterior synechiae (PAS) was 7.7 ± 3.1 hours. There was a strong correlation regarding duration of symptoms to the formation of PAS (r = 0.672; p < 0.001). The mean presenting IOP was 55 ± 13.37 mmHg and mean post-paracentesis IOP was 27 ± 12.78 mmHg. A decrease of 49% in IOP ( p < 0.001) was observed after paracentesis with good outcome in 19 eyes and poor outcome in 26 eyes. Conclusion: Paracentesis as an initial intervention in APAC eyes reduces the IOP immediately, but only as a temporary response. (Med J Indones. 2012;21:113-7)
The accuracy of warfarin dosage based on VKORC1 and CYP2C9 phenotypes in a Chinese population
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.v21i2.489

Abstract

Background: The aim of this study is to assess the accuracy of warfarin dosage based on VKORC1 and CYP2C9 genotype in Chinese population. Methods: Blood samples were taken from 37 patients. We compared the warfarin dosage obtained from genotype (according to www.warfarindosing.org) and treatment dosage with international normalized ratio (INR) value within 2.0-3.0. Results: The majority of Chinese people in our study are VKORC1 homozygous AA (89.2%), rarely VKORC1 heterozygous AG and we cannot find a patient with homozygous GG. For CYP2C9 genotype, most patients have the wildtype variants (CYP2C9*2 CC and CYP2C9*3 AA). The warfarin dosage for patients with VKORC1 AA and CYP2C9*3 AC is lower than for patients with other genotype variants. Conclusion: There is no significant difference between pharmacogenetic algorithm (www.warfarindosing.org) and our treatment dosage. Our conclusion is that the pharmacogenetic algorithm is accurate to predict the warfarin dose. (Med J Indones. 2012;21:108-12)
Acalypha indica Linn root extract improved hippocampal cell viability and increased brain-derived neurotrophic factor (BDNF) in hypoxic condition
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.490

Abstract

Background: This study was done to determine the effect of root extract of Acalypha indica Linn (akar kucing) in protecting neuron viability of the rat hippocampus on tissue culture in hypoxic condition. Methods: This is an experimental study of in vitro primary cell culture of hippocampus of Sprague Dowley adult rat. The cultures were group into control (C) and exposure to root extract of Acalypha indica Linn with dose of 10 mg/mL, 15 mg/mL, and 20 mg/mL for 72 hours. The cultures were then exposed to hypoxic gas (5% oxygen, 5% carbondioxide, nitrogen balance) for 24 hours. After that, relative cell viability was measured by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT), cell proliferation by 5-bromo2’-deoxy-uridine (BrdU), and Brain-derived Neurotrophic Factor (BDNF) levels by BDNF ELISA kit. Results: The result showed MTT viability (C: 99.7%, A indica L 10: 326.3%, A indica L 15: 411.7%, A indica L 20: 445.9%), BrdU absorbance (C: 0.07, A indica L 10: 0.10, A indica L 15: 0.12, A indica L 20: 0.13) of the exposured hippocampal cell were significantly higher than the control group (p < 0.01) accompany by increased level of BDNF (C: 11.3 pg/mL, A indica L 10: 12.5 pg/mL, A indica L 15: 23.1 pg/mL, A indica L 20: 18.1 pg/mL). Conclusion: The root extract of Acalypha indica Linn is able to improve rat hippocampal cell viability and endogenous BDNF levels in hypoxic condition. (Med J Indones. 2012;21:141-6)
Correlation between hypoxia inducible factor -1α and renin expression in rats kidney induced by cobalt chloride
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.491

Abstract

Background: Cobalt chloride can be used as an agent to stabilize hypoxia inducible factor-1α (HIF-1α) and to imitate hypoxia without low levels of oxygen inside the body. We intended to investigate if there was any regulation of renin expression by HIF-1α. Therefore, we conducted several studies to clarify this possibility starting with the induction of hypoxic mimicry in rats by intra-peritoneal (IP) injection of cobalt chloride (CoCl2) to obtain the levels and pattern of HIF-1α and renin mRNA and protein expression. Methods: Twenty-four rats were randomly divided into four groups, control group and incubation groups 2, 8, and 24 hours after intra-peritoneal injection of 30 mg CoCl2 per kg BW. After the rats were sacrificed, kidneys were excised, weighed and kidney weight compared to BW. Tissue parameters were measured such as RNA concentration, HIF-1α protein by ELISA, and renin mRNA by RT-PCR. Results: Differences between the groups in the ratios of kidney weight to BW and in the concentrations of HIF-1α protein were statistically not significant (p > 0.05). Relative expression of renin mRNA increased markedly starting 8 hours after CoCl2 IP injection (30 times over controls) and further rising until 24 hours (2465 times over controls). Correlation between HIF-1α and renin mRNA by Pearson analysis was strongly positive, but not significant (R = 0.91; p = 0.09). Conclusion: Renin gene regulation in renal hypoxic mimicry strongly correlates withHIF-1α. (Med J Indones. 2012;21:128-32)
Correlation between oxidative stress and tumor grade in glioma cells from patients in Jakarta
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.492

Abstract

Background: The goal of this study was to analyze the correlation of oxidative stress in human glioma cells with tumor grade in order to explore the role of oxidative stress as a marker in determining the tumor progression. Methods: Samples were 21 brain tumors and 5 normal brain tissues from glioma patients. Oxidative stress was analyzed by measuring malondialdehyde (MDA), carbonyl and 8-hydroxy-2’-deoxyguanosine (8-OhdG). Additionaly, we analyzed MnSOD expression by measuring the MnSOD mRNA using real time RT-PCR and MnSOD enzyme activity using RanSOD kit. Tumor grade was determined by histopathologic examination. Data was statistically analyzed using t-test and Pearson correlation. Results: Levels of MDA, carbonyl and 8-OHdG reflecting oxidative stress in glioma cells were significantly higher than in normal brain tissue. The MDA and carbonyl levels were significantly correlated with tumor grade. Relative expression of MnSOD mRNA and specific enzyme activity in glioma cells were significantly higher than in normal brain cells. The relative expression of MnSOD mRNA increased significantly in accordance with the tumor grade. Surprisingly, MnSOD specific activity was significantly lower in high grade than in low grade glioma indicating a discrepancy between mRNA synthesis and its enzyme specific activity. Furthermore, there was a positive correlation between MnSOD mRNA and MDA levels. Conclusion: The high level of oxidative damage in human glioma cells was significantly correlated with tumor grade. The high level of MnSOD expression in human glioma cells was correlated with the high level of oxidative damage. (Med J Indones. 2012;21:122-7)
Correlation of hypoxia inducible factor-1α and vascular endothelium growth factor in rat myocardium during aerobic and anaerobic exercise
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.493

Abstract

Background: Exercise increases the need for oxygen to generate ATP through oxidative phosphorylation. If the high energy demand during exercise is not balanced by sufficient oxygen supply, hypoxia occurs in skeletal muscle tissue leading to upregulation of hypoxia inducible factor-1α (HIF-1α). The activity of HIF-1α increases the expression of various genes in order to reduce the metabolic dependence on oxygen and to increase oxygen supply to the tissue, e.g., VEGF which plays a role in angiogenesis. In myocardium, it is unclear whether exercise leads to hypoxia and whether HIF-1α and VEGF play a role in the mechanism of hypoxic adaptation. This study aimed to investigate the correlation of HIF-1α and VEGF in heart muscle tissue of rats during aerobic and anaerobic exercise.Methods: A rat treadmill was used with a specific exercise program for 1, 3, 7 and 10 days. The concentrations of HIF-1α and VEGF were measured the myocardium.Results: Both, HIF-1α protein and VEGF were increased (p < 0.05) in the groups with aerobic and anaerobic exercise. Concentrations of HIF-1α were highest on the first day of activity, being higher in the anaerobic than in the aerobic group (156.8 ± 33.1 vs. 116.03 ± 5.66). Likewise, the highest concentration of VEGF in the group with anaerobic exercise occurred on the first day (36.37 ± 2:35), while in the aerobic group, VEGF concentration was highest on day 3 (40.66 ± 1.73). The correlation between the myocardial tissue consentrations of HIF-1α and VEGF is moderate (r = 0.59) in the aerobic group and strong in the anaerobic group (r = 0.69).Conclusion: Aerobic and anaerobic exercise increase HIF-1α and VEGF concentrations in rat myocardium in specific patterns. The anaerobic condition triggers vascularization stronger and obviously earlier than aerobic exercise. (Med J Indones. 2012;21:133-40)Keywords: Exercise, HIF-1α, myocardium, VEGF
Current trend of maternal health in Indonesia
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.494

Abstract

Background: Achievement of Millennium Development Goals (MDGs) will be assessed in the next three years (2015). Several parameters in the area of maternal health are evaluated continuously. The aim of this paper is to formally summarize and report the state of maternal health in Indonesia based on the data from Basic Health Survey (Riskesdas) 2010. Methods: This paper utilizes tertiary data obtained from the latest Riskesdas (2010). Results: Data that is available in the report covers data about marriage, reproduction health, abortion, access to health care for pregnancies, place of labor, health care provider, as well as rate of the first postpartum period visit. Conclusion: The latest data shows improvement in the maternal health area, nevertheless large effort in maintaining and improving the condition is still needed. Continuous evaluation is also proven to be essential in achieving the goals. (Med J Indones. 2012;21:179-83)

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