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Journal of the Indonesian Medical Association
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Journal of the Indonesian Medical Association - Majalah Kedokteran Indonesia
Articles
508
Articles
Ethical Use of Animals in Medical Research

Ridwan, Endi ( Faculty of Medicine University of Indonesia/ Cipto Mangunkusumo Hospital, Jakarta )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
Publisher : Journal of the Indonesian Medical Association

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Abstract

Test material (drug) which will be utilized in humans must pass complete test in the laboratory and continue with animal studies to determine its appropriateness and safety.Animal experiment is required in order to observe and assess the reactions and interactions of all test materials provided, as well as their impacts completely and deeply. Appropriateness of the use of experimental animals in research must be assessed by comparing the risks faced by animal experiments with their potential benefits for humans. Any research using experimental animals ethically should apply the general principles of health research ethics and principles of the 3 R’s: replacement, reduction and refinement. The way treating experimental animals should be outlined in detail as study protocol to serve as informed consent in humans. J Indon Med Assoc. 2013;63:112-6Keywords: animal experiments, research ethics, risks, benefits

Vascular Endothelial Growth Factor in Tears as Risk Factor to Pterygium Recurrence

Saerang, Josefien Saartje Marie ( Faculty of Medicine Universitas Sam Ratulangi/Prof. R. D. Kandau Hospital, Manado )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: The recurrence of pterygium is a major post-surgerycal problem. Surgical techniques and Vascular Endothelial Growth Factor (VEGF) are thought to have influence on this phenomenon. The aim of the study was to analyze the role of VEGF as risk factor to the pterygium recurrence.Methods: The study design is a nested case control study. The total number of samples with 53patients with a total of 56 eyes. A number of 56 eyes operated on using the technique of limbalconjunctival Autograft (CLAG) technique using fibrin glue. Examination of Enzyme-linkedImmunosorbent Assay (ELISA) was performed on 30 eyes, while 26 eyes had not do periodicchecks for various reasons.Results: Of the 30 eyes were examined by ELISA, the results obtained by 23 eyes with high VEGF levels with 20 of them having pterygium regrowth. Meanwhile, the seven eyes with low VEGF levels, four of which are experiencing regrowth.Conclusion: Based on these results, we can conclude that the tears levels of VEGF that the tears level of VEGF are not significance to the eccurence of pterygium regrowth. J Indon Med Assoc. 2013;63:100-5.Keywords: Pterygium, recurrence, VEGF level

The Effect of Red Fruit Oil Toward NF-kB Expression on Colitis-Associated Cancer Mice Model

Adhika, Oeij Anindita ( Faculty of Medicine, Universitas Kristen Maranatha, Bandung ) , Sujatno, Muchtan ( Faculty of Medicine, Universitas Padjadjaran, Bandung ) , Farenia, Reni ( Faculty of Medicine, Universitas Padjadjaran, Bandung )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: Colorectal cancer has provided a paradigm for the association between inflammation and cancer. Activation of nuclear factor-kB (NF-kB) is associated with various type of cancers due to its key role in innate immunity, inflammation, cell proliferation, and cell survival. Red Fruit (Pandanus conoideus Lam.) which contains large amount of antioxidant has been considered as phytopreventive agent. The aim of this research is to examine the effect of buah merah oil towards NF-kB expression in colitis-associated cancer (CAC) mice model.Methods: BALB/c male mice were divided into four groups (n=6). The negative control and red fruit control groups were given aquabidest and red fruit oil, respectively, without CAC induction. The azoxymethane (AOM)/dextran sulfate sodium (DSS) control and red fruit treatment groups were given AOM followed by DSS to induce CAC. The AOM/DSS control group were given aquabidest while the red fruit treatment group were given buah merah oil. NF-kB colon level was measured using Western blot method. Data were analyzed by One-Way ANOVA continued with Tukey HSD (a=0.05).Result: The result showed that the average NF-kB level of red fruit treatment group was significantly decreased compared to the AOM/DSS control group (p<0.000).Conclusion: Red fruit oil decreased NF-kB level in CAC mice model.J Indon Med Assoc.2013;63:106-11Keywords: inflammation, colorectal cancer, NF-kB, red fruit

The Potency of Xanthones as Antioxidant and Antimalarial, and their Synergism with Artemisinin in Vitro

Tjahjani, Susy ( Faculty of Medicine niversitas Kristen Maranatha, Bandung ) , Widowati, Wahyu ( Faculty of Medicine Universitas Kristen Maranatha, Bandung )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: Artemisinin in artemisinin based combination therapy (ACT) was used to overcome the resistance caused by free radical overproduction. Xanthone as antioxidant can also inhibit in vitro heme polymerization, therefore it is predicted has anti-malaria activity. The aim of this study is to evaluate the potency of alpha mangostin, gamma mangostin, garcinone C, and garcinone D as antioxidant by determination of DPPH scavenging activity, falciparum antimalarial, and their synergism with artemisinin as antimalarial falciparum in vitro.Method: Diphenylpicrylhydrazyl (DPPH) scavenging activity was examined according to Unlu,et al.’s technique and the IC50 was determined by correlation regression analysis. Antimalarialactivity of each xanthone and its combination with artemisinin was evaluated in P. falciparumstrain 3D7 culture according to Budimulja, et al. Their IC50 was calculated by probit analysis and FIC50 was counted according to the formula.Results: All of these xanthones had IC50 of DPPH scavenging activity <200 μM. Alpha mangostin, gamma mangostin, and garcinone C had anti-malaria activity with IC50<1 μg/ml, but garcinone D had IC50 1-10 μg/ml. FIC50 of all xanthone and artemisinin combinations were <1.Conclusions: All of xanthones have antioxidant potency by determination of DPPH scavengingactivity, antimalarial potency and work synergisticaly with artemisinin as falciparum antimalarialin vitro. J Indon Med Assoc. 2013;63:95-9.Keywords: xanthone, DPPH, falciparum antimalarial, artemisinin, synergism

The Needs of Schizophrenic People

Dewi, Sulistiana ( Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Hospital, Jakarta ) , Elvira, Sylvia Detri ( Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Hospital, Jakarta ) , Budiman, Richard ( Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Hospital, Jakarta )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: Assessing the needs of people with schizophrenia is an important task for allstakeholders to reduce the impairment in physical, psychological, or social function. This studywas aimed to assess the needs of people living with schizophrenia based on the patient and thecaregivers.Method: Ninety subjects with schizophrenia and ninety of their caregivers in outpatient clinic were included in this research using consecutive sampling. Instruments which was used was Camberwell assessment of need short appraisal schedule (CANSAS).Result: Using CANSAS instrument, the mean total of needs reported for schizophrenic people and their caregivers reported 9 and 12 needs respectively. Both schizophrenic people and their caregivers agreed that the need on physical health was higher than other needs.Conclusion: Assessment of the needs of schizophrenic people and their caregivers must focus not only in the needs of psychotic symptoms, but also in their physical needs as well.J Indon Med Assoc. 2013;63:84-90Keyword: needs, schizophrenic people, caregiver

The Effect of Fixed Dose Combination of Antituberculosis Agens to Uric Acid Levels in Patients with Pulmonary Tuberculosis

Diana, Diana ( Faculty of Medicine Universitas Sam Ratulangi, Manado ) , Karema-Kaparang, Adeodata Maria Caroline ( Faculty of Medicine Universitas Sam Ratulangi, Manado ) , Matheos, Julia Cornelia ( Faculty of Medicine Universitas Sam Ratulangi, Manado )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
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Abstract

Introduction: Tuberculosis (TB) is caused by Mycobacterium tuberculosis. First line antituberculosis drugs are isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin which are also known as 4 fixed dosed combination (4FDC). Pyrazinamide can cause hyperuricemic by its metabolite (pyrazinic acid) which decrease the secretion of uric acid in renal. Most hyperuricemic condition is asymptomatic. The aim of this study is to know the descriptive of 4FDC affected the level of uric acid in serum of tuberculosis patients in BLU RSUP Prof. Dr. R. D. Kandou Manado.Method: This was Quasi experimental design - time series experiment. Data of uric acid levelwas collected in baseline, 4th week, 8th week, 12th week. Statistic analysis used were Shapiro - Wilk for distribution test and T-test couple for comparison test.Results: In 6 month of observation we found 41 TB patients consist of 24 males dan 17 females. Mean of baseline uric acid level was 5,0098 (2.6-6.9); mean in 4th week was 10.5707 (5.7-18.7); 8th week was 10.5488 (6.1-16.3) and mean in intensive phase was 6.3098 (3.3-10.1). Increased level of uric acid was significant from baseline to 4th week (p<0.05). Increased of uric acid serum level in 4th week and 8th week was not significant (p>0.05). Decreased of uric acid level on 8th week and 12th week was significant (p<0.05).Conclusions: Mean of uric acid level increased in intensive phase of tuberculosis therapy, especially in 4th week and relatively consistent in 8th week. Mean of uric acid level decreased in continuation phase, 12th week although it hasn’t achieved the baseline level. J Indon Med Assoc. 2013;63:91-4Keywords: tuberculosis, fixed dose combination, antituberculosis, uric acid

Media vs. Medical Professionals to Fight Low Health Literacy

Nasution, Kholisah ( The University of Sydney )

Journal of the Indonesian Medical Association Vol. 63 No. 3 March 2013
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Abstract

Recently a girl named Dera was reported by journalistsin Indonesia famously. It was stated that she was abandonedby several local hospitals that her parents broughther along to until she died eventually. Everyone put commentson the hospital cruelty, including health professionalinside, and then generalizes how health system works yetknowing what and how the health system and hospital isworking. Moreover, Dera is not the only case of commonpeople’ lack of understanding and knowledge about healthin general and specifically health system in the country.

The Use of Laser for Treatment of Pigmented Lesions in the Cosmetic Field

Dewi, A. A. Sagung Putra ( Faculty of Medicine Universitas Udayana/Sanglah Hospital, Denpasar ) , Indira, I G. A. Elis ( Faculty of Medicine Universitas Udayana/Sanglah Hospital, Denpasar )

Journal of the Indonesian Medical Association Vol. 63 No. 2 February 2013
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Skin pigmentation problem is one of the reasons for consultation with a dermatologist.Although not associated with abnormality and morbidity, pigmentation abnormality often causessignificant effect on appearance. Pigmentation abnormalities are categorized as epidermal lesions, epidermo-dermal lesions, and dermal lesions. For practicality, pigmented lesions can becategorized as laser-responsive and laser-unresponsive lesions. Epidermal lesions with goodresponse to laser include ephelides (freckles), simple lentigo, solar lentigo, melanotic labialmacule, and seborrhoic keratoses. Lesions with poor response to laser include café au laitmacule and nevus spilus. In most cases, epidermo-dermal lesions, such as Becker’s nevus andmelasma, show poor response to laser treatment. J Indon Med Assoc. 2012;63:69-75.Keyword: pigmented lesions, laser, Ota nevus, Hari nevus.

The Effect of Lumbricus rubellus in Treatment of Patient with Typhoid Fever

Purwitanto, Purwitanto ( Faculty of Medicine Universitas Sam Ratulangi, Manado ) , Datau, Euis Alwi ( Faculty of Medicine Universitas Sam Ratulangi, Manado ) , Nugroho, Agung ( Faculty of Medicine Universitas Sam Ratulangi, Manado )

Journal of the Indonesian Medical Association Vol. 63 No. 2 February 2013
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Introduction: Typhoid fever remains a global health problem. A large use of antibiotics can leadto resistance and allergy medications. Treatment with traditional ingredients earthworm has longbeen used to treat typhoid fever. Several studies have proven the earthworm Lumbricus rubellus extract can inhibit the growth of Salmonella typhi in vitro.Objective: To determine the effect of the addition of L. extract ciprofloksasin rubellus on thetreatment of patients with typhoid fever.Methods: A double-blind clinical trials of experimental placebo-controlled trial conducted in RSI Sitti Mariam from January 2012 until July 2012.Results: It was found that 52 samples consisting of 26 treatment and 26 control samples. Therewas no significant difference in the loss of a fever. In the treatment group, the average fever waslost at 39.46 to 34.38 while in control, not significantly different. There is no significant difference in the frequency of use of antipyretics both groups and both groups the number of gastrointestinal symptoms, and laboratory values.Conclusion: The addition of extracts L.rubellus on ciprofloksasin no effect on the long fever,antipyretic administration, gastrointestinal disorders, hemoglobin, leukocyte count, platelet count, SGOT, SGPT, and does not adversely affect the side effects of treatment. J Indon Med Assoc. 2013;63:58-62.Keywords: Typhoid fever, treatment, ciprofloksasin, extract of Lumbricus rubellus

Training on Nutrition Counseling to Pregnant and Lactating Women

Sutanto, Luciana ( Faculty of Medicine Universitas Indonesia, Jakarta ) , Basuki, Endang ( Faculty of Medicine Universitas Indonesia, Jakarta ) , Pusponegoro, Arietta ( Faculty of Medicine Universitas Indonesia, Jakarta ) , Basuki, Dian ( Faculty of Medicine Universitas Indonesia, Jakarta )

Journal of the Indonesian Medical Association Vol. 63 No. 2 February 2013
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Introduction: Counseling carried by trained personnel will provide more effective results. Thepurpose of this study was to examine the effectiveness of an intensive nutritional counselingmodule for pregnant and lactating women given by medical students compared to counselinggiven by health workers.Method: This study used an experimental study design (randomized community trial), two double blind parallel group. Subjects were pregnant and lactating women who came for ante natal care to Jatinegara and Matraman health centers, Jakarta, in October-December 2011 and met the study criteria. Effectivity was examined by assessing knowledge, attitudes and behavior (KAB) of pregnant and lactating women about nutrition for pregnant and lactating women, lactation practice, and the impact on the nutritional status of mothers and infants in intervention and control group.Result: Data analyses were performed on 45 subjects in intervention group and 43 subjects incontrol group. There was a significant difference in the attitude score of the intervention group at the last counseling compared with control group, but not the knowledge and behavior score.There is no significant difference between the nutritional status of pregnant and lactating womenin both groups.Conclusion: This training module is useful to increase the ability of medical students to servecounseling thus equivalent to experienced instructors at the health centers; it is expected to prevent nutritional problems in infants. J Indon Med Assoc. 2013;63:63-70.Keyword: counseling, pregnant and lactating women, medical students

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