Journal Medical Journal of Indonesia

1,159 articles
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Dwi A. Pujianto, Hajizah Hajizah, Indra G. Mansur, Amarudin Amarudin
Medical Journal of Indonesia, Volume 27, pp 3-11; doi:10.13181/mji.v27i1.1429

Abstract:Background: The etiology of unexplained infertility has not been fully understood. This study aimed to determine the effect of antisperm antibody (ASA) from infertile women on viability, motility, plasma membrane integrity, and status of tyrosine phosphorylation in the human spermatozoa.Methods: An experimental in vitro study was conducted at the Department of Biology, Faculty of Medicine, Universitas Indonesia from February to November 2014. Spermatozoa from normal fertile donors was incubated with serum containing ASA from infertile women at several dilutions (1/1000, 1/100, 1/10, and without dilution) for 1 and 2 hours. The plasma membrane integrity was assessed with hypoosmotic swelling (HOS) test, whereas the status of tyrosine phosphorylation was analyzed using Western immunoblotting and immunocytochemistry.Results: After 1 hour incubation time, ASA caused a decrease in sperm viability, motility, plasma membrane integrity, and inhibit sperm tyrosine phosphorylation. ASA caused a decrease in viability, motility, sperm plasma membrane integrity, and tyrosine phosphorylation of sperm after 1 hour incubation time.Conclusion: ASA from infertile women reduced the sperm viability, motility, plasma membrane integrity, and capacitation in dose and time dependent manner.
Sri Hartati, Chie Aoki, Muhammad Hanafi, Marissa Angelina, Pratiwi Soedarmono, Hak Hotta
Medical Journal of Indonesia, Volume 27, pp 12-8; doi:10.13181/mji.v27i1.2189

Abstract:Background: Hepatitis C virus (HCV) is a leading cause of chronic liver diseases. Drug resistance to the regimen is also increasing. Hence, there is a need for new anti-HCV agents that are less toxic and more efficacious. The aim of this study is to evaluate the possibility of A. pauciflorum extracts can be a antiviral drug.Methods: Huh-7it cells were infected with the HCV genotype 2a strain JFH-I in the presence of methanol extracts of Archidenron pauciflorum. The methanol extract further partition used n-hexane, ethyl acetate, n-butanol, and water showed in which butanol extracts exerted the strongest IC50 (6.3 g/ml). Further, the butanol fraction was fractionated and yielded into 13 fractions.Results: The methanol extract of the leaves of A. pauciflorum exhibited concentration dependent inhibition against the JFH1 strain of HCV genotype 2a with an IC50 is 72.5 μg/ml. The butanol fraction exhibited the highest anti-HCV activity with an IC50 is 6.3 μg/ml. The butanol fraction was fractionated which yielded 13 fractions. Fractions 5 and 13 exhibited high anti-HCV activities with IC50 is 5.0 μg/ml and 8.5 μg/ml and a time-of-addition study demonstrated that fraction 5 inhibited viral infection at the post-entry step, whereas fraction 13 primarily inhibited the viral entry step.Conclusion: The extract A. pauciflorum can be used as a herbal-based antiviral drug.
Wiwi A. Kartolo, Jeanne A. Pawitan, Alida R. Harahap, Septelia I. Wanandi
Medical Journal of Indonesia, Volume 27, pp 19-25; doi:10.13181/mji.v27i1.1596

Abstract:Background: Thrombocytosis in breast cancer (BC) patient was thought to play a role in the invasiveness of breast cancer stem cells (BCSCs). Modification of tumor microenvironment was proposed to increase the efficacy of anticancer therapy. This study was aimed to analyze the effect of platelet lysate (PL) as well as its PDGF-AB content as a tumor microenvironment on (CD24-/CD44+) BCSC proliferation.Methods: This was an experimental study that treated culture of BCSCs with PL from breast cancer (BC) patients or healthy donors. Venous blood from all subjects were subjected to prior hematology test and then processed to obtain platelet rich plasma (PRP). Platelet counts in PRP were determined. PRP was processed to obtain PL. PDGF-AB contents in PL were measured. PL at concentrations of 0.01% (v/v) was supplemented into DMEM-F12 medium and used for culturing BCSCs (CD24-/CD44+ cells). After 48 hours, total cell count, population doubling time (PDT), and cell viability were calculated and their correlation with platelet count and PDGF-AB levels were analyzed.Results: BC patients (n=5) had higher platelet counts and PDGF-AB levels in PL compared to healthy donors (n=15), (p=0.02). PL from BC patients could stimulate the proliferation of BCSCs higher than healthy donors (p<0.001) and showed lower PDT value (p=0.001). Cell proliferation and PDT showed strong correlation with PDGF-AB level. This observation suggests that PDGF-AB has a role on BCSCs proliferation. PL showed no effect on BCSCs viability.Conclusion: Breast cancer patient platelet lysate stimulated BCSC proliferation.
Pustika A. Wahidiyat, Sudigdo Sastroasmoro, Suthat Fucharoen, Iswari Setianingsih, Siti A. Putriasih
Medical Journal of Indonesia, Volume 27, pp 26-32; doi:10.13181/mji.v27i1.1779

Abstract:Background: β-thalassemia/HbE presents with a variety of clinical symptoms, from asymptomatic to severe, requiring routine transfusion. However, there is currently no agreed classification system to stratify patients based on clinical severity of β-thalassemia/HbE in the Indonesian population. Thailand has already established a classification system, and this study aimed to identify the applicability of the Thailand clinical scoring criteria to determine the severity of β-thalassemia/HbE in the Indonesian population.Methods: This descriptive study was conducted by evaluating patients with β-thalassemia/HbE, who were classified into mild, moderate, or severe groups based on the Thailand clinical scoring criteria.Results: A total of 293 subjects with β-thalassemia/HbE were included. Based on this clinical scoring criteria, it was found that only 21.5% of patients were classified as mild, and the remaining 35.5% and 44% were classified as moderate and severe respectively. Approximately 68.2% of the subjects in the severe group received transfusion at <4 years old, while only 10% of those in the mild group were transfused at the same age. In the mild group, only 10% of the subjects underwent routine transfusion, compared to 98.4% of the subjects in the severe group. In addition, only 27% of the subjects in the mild group showed stunted growth, while that in the moderate and severe groups were 54.5% and 86.8%, respectively.Conclusion: Thailand clinical scoring criteria is able to determine the severity of Indonesia thalassemia patient which needs further management, i.e. transfusion and observation of stunted growth. This scoring system will help provide the provision of the most ideal management for the groups of patients based on their requirements.
Komang A. Irianto, Muhammad Z. Chilmi, Gana Adyaksa
Medical Journal of Indonesia, Volume 27, pp 33-7; doi:10.13181/mji.v27i1.2078

Abstract:Background: The fatality rate of unstable pelvic fracture is still high (20–50%) due to acute phase hemorrhage or late multiple organ failure. The assurance for 100% survival in acute phase had been reported if the emergency room team have the right technique, right timing, and right protocol. The aim of this study was to evaluate and to date factors that influence the non-survival unstable pelvic fracture within 2x24 hours.Methods: This retrospective study was conducted in emergency unit of Dr. Soetomo General Hospital Surabaya during 2012–2016 for unstable pelvic fracture with unstable hemodynamic, without concomitant head or thoracic injury and admitted within 4 hours after the incident. All patients were handled according to the protocol for resuscitation and C-clamp insertion immediately. X-ray was taken after the insertion to check the C-clamp position and to confirm the diagnosis. The 2x24-hour data were taken whether the patient survive or not survive, including mean arterial pressure (MAP) pre-and post, heart rate (HR) pre-and post, and initial hemoglobin and platelet count. Data were analyzed with independent t-test and multiple regression analysis.Results: Twenty two patients were recorded as the inclusive criteria, separated into 17 survivors and 5 non-survivors. They were comprised of 14 males and 8 female patients, with an average of 31.9±15.3 years old. The MAP post, HR pre-and post, and platelet count were significantly different. The factor that influenced the survival within 2x24 hours was the MAP post C-clamp (>70 mmHg) (p<0.05).Conclusion: The acute phase 2x24-hour outcome after C-clamp insertion and resuscitation was significantly influenced by MAP post C-clamp and resuscitation.
Luh G.A.P. Dewi, Ni P.V.K. Yantie, Eka Gunawijaya
Medical Journal of Indonesia, Volume 27, pp 38-43; doi:10.13181/mji.v27i1.2284

Abstract:Background: Grown-up congenital heart disease (GUCH) patients are unique and challenges especially at developing country. The numbers of diagnostic as well as interventional cardiac catheterization procedures in GUCH patients are growing. The aim of this study was to report the outcome of cardiac catheterization including intervention procedure in GUCH.Methods: The descriptive study was conducted at Sanglah Hospital, Denpasar, Bali, Indonesia. All patients (age of more than 12 years) who underwent cardiac catheterization from 2011 until 2017 were included in this study. Patients, characteristic, types of catheter procedures, immediate complications, and outcomes were documented.Results: A total 54 subjects were included with median age of 23 years and 70% were female. The first symptom that brought patients to hospital is dyspnea 46% and palpitation 32%. Five subjects underwent a diagnostic catheter procedure and 49 (91%) diagnostic and catheter based interventions. Transcatheter interventions procedures included atrial septal defect (ASD) (success rate of 20 per 21), patent ductus arteriosus (PDA) (success rate of 16 per16), ventricular septal defect (VSD) (success rate of 9 per 9), pulmonal stenosis (PS) (success rate of 1 per 2), and aortic stenosis (AS) (success rate of 1 per 1). The complications encountered were transient dysrhythmias in 15 subjects, device embolization in 4 subjects, massive bleeding in 1 subject, and overall mortality in 2 subjects.Conclusion: The number of the catheterization interventions in GUCH was 91% and ASD device closure was the most common procedure. Transcatheter intervention has a high procedural success rates (96%) and low procedural-related complications.
Listya T. Mirtha, Rini Sekartini
Medical Journal of Indonesia, Volume 27, pp 44-53; doi:10.13181/mji.v27i1.1745

Abstract:Background: Physical exercise was hypothesized to be able to improve the behavior of children with attention deficit/hyperactivity disorder (ADHD) by improving attention and concentration. Several studies mentioned that physical exercise could make ADHD children calmer, not only as a supportive therapy, but also as a therapeutic therapy. The aim of this study was to evaluate the effects of physical exercise to the behavior of ADHD patients and to analyze the effects of Senam Kesegaran Jasmani 1988 (SKJ 88) exercise compliance to the cardiorespiratory endurance in ADHD children.Methods: This study was an experimental study with 40 subjects from a special needs school in Tangerang, Indonesia. Subjects were given SKJ 88 exercise for 8 weeks, and the level of cardiorespiratory endurance was assessed with 600 m run before and after intervention.Results: 21 subjects (52.5%) were compliant, and the rest were very compliant. Although statistical analysis showed that there was no significant difference in cardiorespiratory endurance before and after intervention, the mean results of cardiorespiratory endurance test before intervention was higher than after. Mean time spent in the 600-m run before intervention was 497.9 seconds (SD 73.53), and after intervention was 313.7 seconds (SD 43.28).Conclusion: Based on the statistical test, we concluded that there was significant decrease of time spent for cardiorespiratory endurance test (p<0.001). The reduction of time taken to run 600 m by 184.3 seconds (SD 73.33) showed the improvement of cardiorespiratory endurance after the treatment.
Alia Arianti, Yunia Irawati
Medical Journal of Indonesia, Volume 27, pp 54-61; doi:10.13181/mji.v27i1.1959

Abstract:A 14-years-old boy came with chief complaint of epiphora and history of globe rupture repair surgery due to facial trauma one year ago. Patient got complications from the trauma, including nasolacrimal duct obstruction, phthisis bulbi, enophthalmos, facial deformities, and ptosis. Multidisciplinary approach was performed simultaneously in one session surgery which included oral mucosal graft for non-irritative phthisis bulbi, silicone block implant for blowout fracture, external dacrycystorhinostomy for obstructed nasolacrimal duct, fascia lata brow suspension/frontalis sling for ptosis, and septorhinoplasty for nasal augmentation. After the surgery, symptoms of epiphora had resolved and aesthetical improvement of facial deformities was also prominent. Management of old orbital fracture poses additional challenges due to the complications that have occurred over time. Loss of functionality may seem impractical to manage because no function can be pertained. Nevertheless, it is important to still perform surgical repair for aesthetic purposes due to the psychological effect on their daily lives.
Putu E.P. Kefani, Ida B.A.D. Putra, Ratna R.N. Roosseno
Medical Journal of Indonesia, Volume 27, pp 62-8; doi:10.13181/mji.v27i1.1457

Abstract:Various studies have been widely reintroduced honey as a wound dressing in chronic wound treatment. However, its utilization in Indonesia is still very limited. This study reported the effect of honey in stimulating the epithelialization and granulation on chronic wound treatment in our center. Two chronic wound cases, diabetic foot ulcer patient and gangrenous extravasation due to sodium bicarbonate, were daily treated with honey applications. After six-week evaluation, clinically the tissue granulation and epithelization were seen at the edge of the observed wounds and decreased the wound size significantly with no reported side effects. Honey clinically stimulates the epithelialization and granulation on chronic wound treatment.
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