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Medical Journal of Indonesia
Published by Universitas Indonesia
ISSN : 08531773     EISSN : 22528083
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)
Articles
1236
Articles
Corrigendum: Perception of the Zika virus infection and its influence on Zika prevention practices by pregnant women at the Region 5 Health Promotion Center in Thailand

Siramaneerat, Issara ( Department of Social Science, Faculty of Liberal Arts, Rajamangala University of Technology Thanyaburi )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

[no abstract available]

Relative hypoxia and oxidative stress in spleen lymphocytes of immunized Balb/c mice as indicated by HIF-1α, HIF-2α, Nrf2 expression, and glutathione peroxidase activity

Praditi, Citra ( Master Program in Biomedical Science, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Prijanti, Ani R. ( Center of Hypoxia and Oxidative Stress Studies, Department of Biochemistry and Molecular Biology, Faculty of Medicine, Jakarta ) , Jusman, Sri W.A. ( Center of Hypoxia and Oxidative Stress Studies, Department of Biochemistry and Molecular Biology, Faculty of Medicine, Jakarta ) , Sadikin, Mohamad ( Center of Hypoxia and Oxidative Stress Studies, Department of Biochemistry and Molecular Biology, Faculty of Medicine, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: Lymphocytes activated by immunization must increase their metabolism to meet the energy requirements for mitosis, differentiation, and protein synthesis, which may subject the cell to conditions of relative hypoxia and oxidative stress. This study was conducted to investigate the increase in the levels of transcription factors involved in both conditions.Methods: Male Balb/c mice were divided into the following four groups, each consisting of six animals: the control and three experimental groups. The experimental groups were immunized by injection of 0.2 ml of 2% sheep red blood cells (SRBC) suspended in phosphate-buffered saline (PBS). Lymphocytes were harvested from the spleens of each group at time intervals of 24-, 48-, and 72-h post-immunization. The buffy coat from splenocytes was separated using Ficoll Histopaque as the medium. The lymphocytes were separated from adherent cells by incubating the purified splenocytes in microtubes for 2-h. Cells were lysed by three freeze–thaw cycles (−80°C and 37°C) and used to analyze the levels of HIF-1α and HIF-2α (mRNA and protein), Nrf2 (protein), and glutathione peroxidase (GPx) activity.Results: The treatment caused an increase in GPx activity and HIF-1α protein concentration 24-h post-immunization, whereas the HIF-1α mRNA levels remained static. Elevated Nrf2 protein levels were detected within 48-h after treatment. Meanwhile, the HIF-2α mRNA and protein levels increased within72-h after immunization.Conclusion: Immunization with SRBC suspension induced relative hypoxia, elevated reactive oxygen species (ROS), and oxidative stress in the lymphocytes as indicated by the increase in both HIF-1α and HIF-2α protein and mRNA levels, GPx activity, and Nrf2 protein levels.

The effect of albendazole toward anemia in children with soil-transmitted helminths infection in a remote and endemic area

Sungkar, Saleha ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Tambunan, Fitry B.J. ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Gozali, Meutia N. ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Kusumowidagdo, Gladys ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Wahdini, Sri ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: Soil-transmitted helminths (STH) infections lead to nutritional disorder and anemia among children. Albendazole 400 mg is used to control STH, although it has a low cure rate for Trichuris trichiura. The effectiveness of albendazole could be increased by giving a dose of 400 mg for 3 consecutive days. The aim of the study was to investigate the effectiveness of the triple-dose albendazole 400 mg course in decreasing STH and anemia prevalence.Methods: This study used an experimental comparative design conducted in July 2016 and January 2017 in Perobatang Village, Southwest Sumba, Indonesia. Children aged 1–15 years were asked to collect fecal samples to be examined using a Kato-Katz method. Hemoglobin level (Hb) was tested using a rapid test diagnostic strip. STH positive subjects were given 400 mg of albendazole for 3 days witnessed by the researchers. Six months after, the stool samples and Hb levels were re-examined (post-test).Results: From the 156 subjects examined (pretest), the prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm were 65.4%, 55.8%, and 15.4%, respectively, and the prevalence of anemia was 71.2%. On post-test, the prevalence of A. lumbricoides, T. trichiura, and hookworm decreased to 8.3%, 12.8%, and 0%, respectively, and the prevalence of anemia decreased to 25%. There was a significant difference in the prevalence of STH infection and anemia before and after the administration of triple-dose albendazole (p=0.001).Conclusion: The triple-dose albendazole is effective in reducing the prevalence of STH and anemia in children with STH infection.

Poor treatment compliance leads to a higher mutation for rifampicin resistance in multibacillary leprosy patients

Siskawati, Yulia ( Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Effendi, Evita H. ( Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Legiawati, Lili ( Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Menaldi, Sri L. ( Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: Multidrug therapy (MDT) is a safe and effective drug combination for leprosy treatment that can prevent drug resistance. Mycobacterium leprae resistance, especially to rifampicin, is a serious problem as it potentially thwarts the worldwide leprosy-elimination program by the World Health Organization (WHO). One of the suspected causes of rifampicin resistance is poor treatment compliance. It was necessary to assess the association between the treatment compliance and the occurrence of mutation rifampicin resistance in multibacillary (MB) leprosy patients.Methods: A comparative, analytical, cross-sectional study was performed in MB leprosy patients who had completed treatment at the Dermatovenereology Outpatient Clinic in Cipto Mangunkusumo Hospital and the Sitanala Center for Leprosy Hospital from Oc­tober 2012 to April 2013. Based on treatment regularity and history of drug discontinuation, the subjects were classified as either having good or poor compliance. Skin smear from a slit skin smear (SSS) examination was further analyzed by using the polymerase chain reaction (PCR) sequencing technique to detect rifampicin resistance.Results: Fifty-seven study subjects were enrolled in this study. In the good treatment compliance group (29 subjects), only 1 case of mutation for rifampicin resistance was found. Meanwhile, in the poor drug compliance group (28 subjects), 8 cases of mutation for resistance (29%) were found. This difference in mutation rate was statistically significant (OR=11.2; 95% CI=1.296–96.787; p=0.012).Conclusion: This study revealed that the risk of occurrence of M. leprae resistance to rifampicin in patients with poor drug compliance was significantly higher than in those with good drug compliance.

Effective and safe pharmacotherapy for pediatric population: a call for academia to conduct clinical research

Louisa, Melva ( Departement of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

[no abstract available]

Early mannitol administration improves clinical outcomes of pediatric patients with brain edema

Sekarningrum, Putu A. ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali ) , Wati, Dyah K. ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali ) , Suwarba, IGN Made ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali ) , Hartawan, I Nyoman B. ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali ) , Mahalini, Dewi S. ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali ) , Suparyatha, IB Gede ( Department of Pediatric, Faculty of Medicine, University of Udayana/Sanglah Hospital, Bali )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: Mannitol 20% is used to treat patients with decreased consciousness and as the first line of treatment to reduce intracranial pressure (ICP). However, its application in pediatric patients is still based on minimal evidence. This study was performed to determine the predictive factors of clinical outcomes in pediatric patients with brain edema in the pediatric intensive care unit (PICU).Methods: This prospective cohort study was conducted in the PICU, Sanglah Hospital Denpasar, Bali, Indonesia. The subjects were chosen by consecutive sampling from July 2016 to July 2017. The primary outcome variable was the patient’s clinical outcome. A chi-square test was used to evaluate the association between the timing of mannitol administration and the patient’s clinical outcome. Multivariate analysis was performed on all variables with p≤0.25.Results: Forty-one patients were included in the study, 65% of them were male, 65% had good nutritional status, 90% had non-traumatic brain injury, and 73% had confirmed intracranial infection. The risk of sequelae or death for patients in a coma was 1.8 times greater than that of non-comatose patients (p=0.018; CI 95% 1.119–3.047). Based on the timing of mannitol administration from the onset of decreased consciousness, the risk of sequelae or death in patients who received mannitol after 24 hours was 2.1 times higher than that in patients who received mannitol within 24 hours (p=0.006; CI 95% 1.167–3.779). Based on multivariate analysis, only two variables were associated with the patient’s clinical outcome: pediatric Glasgow coma scale (PGCS) ≤3 (p=0.03) and timing of mannitol administration >24 hours (p=0.01).Conclusion: Early administration (<24 hours) of mannitol and high PGCS are related to favorable outcomes in patients with brain edema in the PICU.

Total serum IgE levels among adults patients with intermittent and persistent allergic asthmas

Rengganis, Iris ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Rambe, Dirga S. ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Rumende, Cleopas M. ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Abdullah, Murdani ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: Obesity with knee osteoarthritis (OA) is related to chronic pain causing physical inactivity that leads to decreased cardiorespiratory endurance and quality of life. Aquatic and land-based exercises are effective in improving physical activity. The aim of this study is to compare between aquatic and land-based exercise to improve cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis.Methods: A single-blind, randomized, controlled trial was conducted on thirty-three obese patients with knee OA who visited Obesity Clinic of Medical Rehabilitation Cipto Mangunkusumo Hospital, from October 2016 to January 2017, subjects were divided into aquatic or land-based exercise group. Aerobic and knee-strengthening exercises were given. Cardiorespiratory endurance was assessed using the Borg Scale, whereas both the BORG CR-10 and SF-36 questionnaires were used to assess quality of life.Results: After intervention, there were significant improvements in the land-based exercise group in the rating of perceived exertion (p=0.02), role limitations due to physical health (p=0.024), role limitations due to emotional problems (p=0.041), energy/fatigue (p=0.016), and the decline in pain (p=0.049) parameters. While in the aquatic exercise, there were significant improvements in leg fatigue (p=0.016), energy/fatigue (p=0.025), emotional well-being (p<0.001), and general health (p=0.045) parameters. Despite this, there were no significant differences between two groups regarding cardiorespiratory endurance and quality of life.Conclusion: This study found that patients could start aquatic exercise to reduce leg fatigue and enhance general health and energy. After that, exercise could be continued in land-based settings to improve cardiorespiratory endurance and quality of life.

The profile of codon 200 β-tubulin gene of Ascaris lumbricoides L. and Trichuris trichiura L. from infected people in Nangapanda Sub-district, East Nusa Tenggara

Yuliana, Yuliana ( Department of Parasitology, Faculty of Medicine, Universitas Trisakti, Jakarta ) , Djuardi, Yenny ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta ) , Supali, Taniawati ( Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: The mass administration of anthelmintic such as albendazole is one of the strategies for eliminating soil-transmitted helminth (STH) infection. The widespread and long-term use of anthelmintics can cause resistance. The research on animals shows that factor that the single-nucleotide polymorphism (SNP) codon 200 β-tubulin gene of the worms is one of the factors that can cause the decreased efficacy of anthelmintics. This study aimed to determine the bases of codon 200 in A. lumbricoides and T. trichiura, which infect the people in Nangapanda, East Nusa Tenggara.Methods: The worm samples were obtained from the intestinal helminth-infected patients from Nangapanda Sub-district. The DNA from the worm tissues were isolated, amplificated by polymerase chain reaction (PCR), and sequenced. The sequencing results were aligned to the reference sequence to obtain the codon bases in the 200 β-tubulin gene.Results: TTC constitute the codon bases in the 200 β-tubulin gene found in two A. lumbricoides and one T. trichiura.Conclusion: The SNP codon 200 β-tubulin gene was absent in A. lumbricoides or T. trichiura worms that were examined in this study.

HemoCue against Coulter LH-750 in the estimation of hemoglobin levels of blood donors in mobile collection settings: a comparative study

Saghir, Sultan A.M. ( Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Medical Sciences, Al-Hussein Bin Talal University, Ma`an ) , Almaiman, Amer A. ( Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam ) , Shatar, Aishah K.A. ( Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam ) , Naim, Norris ( Pusat Darah Negara, Kuala Lumpur ) , Baqir, Huda S. ( Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: The fast and outpatient setting for a determination of the hemoglobin (Hb) level is a well-recognized prerequisite to detect anemia in blood donors. This study aimed to evaluate the performance of the HemoCue methods (HemoCue B-Hb and HemoCue-301) against Coulter LH-750 as a reference method for Hb determination.Methods: This study was an experimental cross-sectional study. It includes 455 blood samples that were collected from volunteer blood donors between January 15, 2010 and February 15, 2011. The performance of the three methods and their comparisons were assessed using the analysis of coefficients of variation (CV), linear regression, and mean difference. Correlation coefficient and Bland–Altman plots were drawn to compare the two HemoCue measurements and the automated cell analyzer against each other and to evaluate their results. The Hb concentrations were compared using the concordance correlation coefficient.Results: The findings exhibited that the CV for the three methods Coulter LH-750, HemoCue B-Hb, and HemoCue-301 were 0.60%, 0.72%, and 0.92%, respectively. A statistically significant difference was observed between the means of the Hb measurements for the three methods (p<0.001). The HemoCue B-Hb and HemoCue-301 methods showed the best agreement, and the Coulter LH-750 method gave a lower Hb value compared with the two HemoCue methods. The results showed a positive correlation of HemoCue Hb results compared with the reference method.Conclusion: All three methods provide a good agreement for Hb determination. The new device HemoCue-301 was found to be more accurate compared with HemoCue B-Hb and Coulter LH-750.

Anxiety and depression among caregivers of hemodialysis patients at the Indonesian national referral hospital

Bawazier, Lucky A. ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta ) , Stanley, Ignatius ( Jakarta Medical Center Hospital, Jakarta ) , Sianipar, Wicensius ( Jakarta Medical Center Hospital, Jakarta, ) , Suhardjono, Suhardjono ( Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta )

Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: In Indonesia, chronic kidney disease (CKD) is primarily managed by hemodialysis (HD) because limited resources rule out the possibility of renal transplantation. HD patients are commonly accompanied by caregivers. However, most studies have neglected the health of caregivers, who play an important role in the survival of HD patients. This study aimed to determine the proportion of caregivers who suffer from anxiety and depression and the factors involved.Methods: This was a cross-sectional study involving 100 caregivers in the HD unit of Cipto Mangunkusumo Hospital, Jakarta. This study used the hospital anxiety depression scale (HADS) to determine the extent of anxiety and depression among caregivers. All caregivers were asked to fill out the questionnaire without assistance.Results: A total of 28% and 18% of caregivers were found to be anxious and depressed respectively. The caregiver’s relationship with the patient, whether the caregiver was being paid or unpaid, the total duration of care, and income were not associated with levels of anxiety and depression. However, the proportion of each 24-hour period spent on care was significantly associated with anxiety (p=0.037) and depression (p=0.015). The time spent on care every 24 hours was also a significant predictor of anxiety (p=<0.001) and depression (p=0.021).Conclusion: One-third of caregivers were found to be anxious and/or depressed. The time spent on care every 24 hours was a strong predictor of both anxiety and depression.

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