Journal Medical Journal of Indonesia

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Purnama Fajri, Ari Estuningtyas, Melva Louisa, Hans-Joachim Freisleben
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1829

Abstract:Background: Recently, there is no agent available for the prevention of iron overload (IO) in thalassemia patients. Previous studies showed that Mangifera foetida L. leaf extracts reduced the levels of iron in IO in vitro and in vivo models. The present study aimed to determine the efficacy of Mangifera foetida L. leaf extract in the prevention of IO induced in rats.Methods: Thirty male Sprague-Dawley rats were divided into 5 groups: control (untreated), IO, 3 treatment groups with leaf extract equivalent to 50, 100, and 200 mg of mangiferin per kg BW. Fe-dextran (15 mg) was administered intraperitoneally twice a week for 4 weeks to all groups except control (IO, DSM50, DSM100, and DSM200). Urine and blood samples were taken before and after treatments. After 4 weeks of treatment, rats were terminated, and samples of spleen, liver, and heart were taken. Ferritin and mangiferin levels and SOD activities were determined in plasma. Iron levels were measured in plasma, urine, and spleen.Results: Experimental IO increased plasma Fe content 4.23 times and plasma ferritin levels 6.9 times vs normal. Mangifera foetida L. leaf extract DSM50 resulted in the highest blood levels of 212 ng mangiferin per mL and moderately, although not significant, prevented increased plasma ferritin levels and IO in organs and protected against oxidative stress.Conclusion: Aqueous Mangifera foetida L. leaf extract may be useful to prevent IO and oxidative stress in thalassemia patients.
Amino V.A. Kusuma, Apon Z. Mustopa, Wike Z. Mustafawi, SUHARSONO SUHARSONO
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.2162

Abstract:Background: Merozoite surface protein 1 (MSP-1) is a major protein used by the Plasmodium during red blood cells invasion in malaria. MSP-119, one of MSP-1 is highly conserved, and it is a potential malaria vaccine candidate because the monoclonal antibodies are capable blocking erythrocyte invasion in vitro. The aim of this study was to produce MSP-119 gene construct and the recombinant protein in Lactococcus lactis.Methods: Usp45-MSP-119, derived from codon optimization and the synthetic gene, was inserted into the pMAT cloning vector. A vector expressing MSP-119 included usp45 has been constructed by the manipulation of recombinant DNA using restriction enzymes. The MSP-119 protein was expressed to 45% ammonium sulfate precipitation and purified using Sephadex-G50 gel filtration chromatography. The expressed protein was characterized by SDS-PAGE and dot blot.Results: usp45-MSP-119 gene was amplified using specific primers and inserted into the multiple cloning sites in the expression vector pNZ8148 with size 3,538 bp as a recombinant vector. The protein of MSP-119 was successfully expressed in L. lactis with molecular weight of 10.45 kDa. The dot blot was tested in 3 different comparisons between the host cells, non-induced cells, and induced cells with 10 ng/ml nisin. The results showed that 10 ng/ml nisin gave a positive reaction as detected by dot blot assay.Conclusion: This study confirmed that the usp45-MSP-119 gene was successfully inserted into the multiple cloning sites of the pNZ8148 expression vector and the MSP-119 protein expressed in the NICE system of the L. lactis host cell.
Steven Tandean, Marsal Risfandi, Iskandar Japardi
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1472

Abstract:Gunshot is a rare subset of penetrating head injury, and generally the victim dies before arriving at the hospital. This paper reported a case of an intracranial gunshot injury in a 12 year-old boy that was shot by his friend, whose primary intention was to play around, using a revolver. A missile projectile penetrated from mid frontal and came out from right occipital. Vital signs were stable with GCS 8 from physical examination. A rational management strategy should permit a good outcome. The only complications that occured were hydrocephalus, yet it was managed by VP–shunt. Skull defect was closed using titanium mesh. A two-year follow-up showed a good result. The patient was able to do daily activity and back to school again.
Twidy Tarcisia, Lia Damayanti, Radiana D. Antarianto, Yefta Moenadjat, Jeanne A. Pawitan
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1755

Abstract:Background: Disintegration of skin tissue can lead to disability and death. Recent studies on wound therapy applied stem cells and adipose derived stem cell conditioned medium (ADSC-CM) to improve wound healing. However, the role of ADSC-CM in wound healing mechanism in terms of angiogenesis, quantity of collagen, and epithelialization is not fully understood. Therefore, this study aimed to analyze the levels of growth factors (VEGF and EGF) in ADSC-CM and histological features of angiogenesis, epithelialization, and collagen density after skin incision in Sprague Dawley rats.Methods: Thirty rats were injured at the back (full thickness wound) and treated topically with ADSC-CM, culture medium, basal medium, and without treatment. Mice were sacrificed on days 3, 7, 14, 21 and 28. After sacrificed, tissue samples were examined microscopically to assess angiogenesis, epithelialization, and collagen density. Concentrations of VEGF and EGF in ADSC-CM were measured by ELISA.Results: Clinically, wound that was treated with ADSC-CM showed improvement in wound healing process. ADSC-CM treated wound showed the highest epithelialization ratio and the fastest wound closure.Conclusion: There were no statistical significant differences between groups that were treated with ADSC-CM and not. However, topical ADSC-CM treated wound revealed a better clinical improvement in epithelialization.
Samsriyaningsih Handayani, Susilowati Andajani, Lilik Djuari
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1398

Abstract:Background: Offering free HIV screening service for pregnant women in primary health center in Surabaya has become obligatory since 2014, but only 70% used the service. Prior studies on HIV screening mostly focused on Voluntary Counseling and Testing.Methods: This was a cross-sectional study. Interviews were conducted with 150 pregnant women attending antenatal care in 1 of 9 public health centers (PHCs) in Surabaya and offered HIV screening within the same PHC. The eligibility criterium was pregnant women attending antenatal care in PHCs. The exclusion criteria were having been counseled for HIV prior to the interviews and/or experiencing an obstetric emergency. Using PRECEDE Framework with the concept of a comprehensive framework, this study focuses on identifying determinants of HIV PITC service use in PHCs in Surabaya. Binary logistic regressions and multiple binary logistic regressions were used in analyses.Results: The service use was associated with self-confidence of getting blood drawn for the test (p<0.001, adjusted OR=12.368, 95% CI=3.237–47.250) and past use of midwife private service for current pregnancy (p=0.029, adjusted OR=3.902, 95% CI=1.150–13.246). Self-confidence of getting blood drawn for HIV test mediated the effect of past use of midwife’s private service on HIV screening use.Conclusion: Past use of midwife’s private service affected self-confidence of getting blood drawn for HIV test on HIV screening use, and self-confidence affected the use of HIV PITC. This study results suggest that more midwives’ private practices are needed to increase the use of HIV PITC screening in PHC.
Hartono Gunardi, Soedjatmiko Soedjatmiko, Rini Sekartini, Bernie E. Medise, Anthony C. Darmawan, Rilie Armeilia, Ruth Nadya
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1819

Abstract:Background: In Indonesia, approximately 35.5% of children under five years old were stunted. Stunting is related to shorter adult stature, poor cognition and educational performance, low adult wages, lost productivity, and higher risk of nutrition-related chronic disease. The aim of this study was to identify parental socio-demographic risk factors of declined linear growth in children younger than 2 years old.Methods: This was a cohort-prospective study between August 2012 and May 2014 at three primary community health care centers (Puskesmas) in Jakarta, Indonesia, namely Puskesmas Jatinegara, Mampang, and Tebet. Subjects were healthy children under 2 years old, in which their weight and height were measured serially (at 6–11 weeks old and 18–24 months old). The length-for-age based on those data was used to determine stature status. The serial measurement was done to detect growth pattern. Parental socio-demographic data were obtained from questionnairesResults: From the total of 160 subjects, 14 (8.7%) showed declined growth pattern from normal to stunted and 10 (6.2%) to severely stunted. As many as 134 (83.8%) subjects showed consistent normal growth pattern. Only 2 (1.2%) showed improvement in the linear growth. Maternal education duration less than 9 years (RR=2.60, 95% CI=1.23–5.46; p=0.02) showed statistically significant association with declined linear growth in children.Conclusion: Mother with education duration less than 9 years was the determining socio-demographic risk factor that contributed to the declined linear growth in children less than 2 years of age.
Ira Ariyati, Rahmad Mulyadi, Ponco Birowo, Budi Wiweko, Joedo Prihartono
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1623

Abstract:Background: Varicocele is a condition characterized by elongation, dilatation and tortuousity of spermatic vein in pampiniform plexus. Approximately 50% of infertility cases among men are caused by varicocele. The varicocele may affect the components of sperm. This study aimed to determine the association between varicocele grade based on ultrasound Doppler examination and sperm concentration, sperm motility, and sperm morphology based on semen analysis examination.Methods: This was a descriptive, cross-sectional study which used secondary data from 85 patients that visited Department of Urology, Cipto Mangunkusumo Hospital, then underwent ultrasonography examination at Department of Radiology, Cipto Mangunkusumo Hospital and semen analysis examination at Department of Obstetrics and Gynecology, Cipto Mangunkusumo General Hospital.Results: Varicocele grade was significantly associated with sperm morphology, concentration and motility (all p<0.05). Significant association was found between maximum condition and semen analysis component.Conclusion: Varicocele grade may affect semen analysis component.
Ratna Sitompul, Yeni D. Lestari, Simon Siregar, Asti Ayudianingrum, Isfiyanto Isfiyanto, Gladys Kusumowidagdo, Della P. Sari, Eiko B. Matiur, Saleha Sungkar
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1808

Abstract:Background: Prevalence estimates of ocular diseases in a given district are important to plan the programs of eye care services. This study aimed to describe the burden of ocular diseases as an initial step in improving eye care services in underdeveloped areas in Indonesia.Methods: A cross-sectional study was performed among residents of Perobatang Village in Southwest Sumba district in July 2016. Eye examinations were conducted by ophthalmologists, and visual acuity was measured by optometrists. Participants were provided with appropriate treatment according to diagnosis. Surgical services were offered two months after the examination.Results: After eximining a total of 667 of 1,459 (46%) residents, the result showed that the most frequent ocular problems were presbyopia (30.8%), cataract (12.8%), refractive error (11.3%), and pterygium (10.7%). The proportion of myopia was 5.9%, hyperopia was 5.0%, and astigmatism was 2.2%. Moreover, the proportion of blindness was 10%. Cataract caused blindness in 44 participants. Other causes of blindness included age-related macular degeneration, retinopathy, optic atrophy, glaucoma, retinal detachment and trauma.Conclusion: The burden of ocular problems in Perobatang Village, Southwest Sumba, Eastern Indonesia was high. These findings showed the importance of public health action from local government and non-governmental organizations to improve eye care services in Southwest Sumba district.
Kusworini Handono, Tri W.I. Dantara, Elvira S. Dewi, Mirza Z. Pratama, Nurdiana Nurdiana
Medical Journal of Indonesia, Volume 26; doi:10.13181/mji.v26i4.1899

Abstract:Background: B cells play a key role in systemic lupus erythematosus (SLE). Targeting B cells as SLE therapy is a plausible approach. This study investigated the potential effects of Bryophyllum pinnatum leaves with ethanol extract in decreasing percentages of maturation, increasing percentages of apoptosis, and decreasing NF-κB p65 expressions of SLE BALB/c mice B cells.Methods: Culturing B cells from pristane induced SLE BALB/c mice’s spleen will resulted in this in vitro study. B cells were activated by BAFF, LPS, IL-4, and anti-CD40 yielding CD19+ >80%. B cells were cultured by adding those stimulants with and without B. pinnatum leaves (0, 0.02, 0.1, or 0.5 µg/ml) for 72 hours at 37°C. Flow cytometry was performed to determine The Percentages of maturation (CD19+CD38+) and apoptosis (Annexin V+PI+) of B cells. Further analysis to determine the expressions of transcription factor of maturation and apoptosis of B cells, NF-ĸB p65, were performed using immunocytochemistry. Data were analyzed using SPSS version 22.Results: Flow cytometry assay showed significant decrease in percentages of maturation of B cells in all doses and significant increase in percentage of apoptosis of B cells in dose 0.5 µg/ml. Immunocytochemistry results showed significant decrease expressions of NF-ĸB p65 in all doses. Percentages of maturation, apoptosis, and expressions of NF-ĸB p65 of B cells were significantly correlated.Conclusion: This in vitro study revealed that B. pinnatum leaves with ethanol extract decreased the percentages of maturation, increased the percentage of apoptosis, and decreased NF-κB p65 expressions of SLE BALB/c mice B cells significantly.
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