Indonesian Journal of Medicine
Indonesian Journal of Medicine (IJM) is an international, open-access, and double-blind peer-reviewed journal, focusing on the intersection of biomedical science, clinical medicine, and community medicine. The journal began its publication on August 20, 2015, and is published online three times yearly. It is academically designed for all physicians, health researchers, and health care professionals, regardless of their medical specialties, or type of employment.
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<![CDATA[Comparison of Pain in the Kocher and Midline Incisions in Patients with Post Cholecystectomy ]]>
<![CDATA[Yulianto, Agus]]>;
<![CDATA[Raharjo, Agus]]>;
<![CDATA[Alifianto, Untung]]>;
<![CDATA[Supraptomo, RTH]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Incision techniques that are often used in cholecystectomy laparotomy are the Kocher incision and midline incision. This study was carried out to compare the pain in the Kocher's incision and midline incision in patients with postoperative cholecystectomy laparotomy.Subjects and Method: : This study was an observational randomized controlled trial double sampling study conducted at the Department of Surgery Dr. Moewardi Hospital Surakarta in October 2018 to February 2019. The sample of this study was 30 patients aged 18-65 years old who were diagnosed with symptomatic cholelithiasis based on clinical, laboratory, and radiological tests. The samples were selected by simple random sampling. The dependent variable of this study was the pain. The independent variables were the Kocher and midline incision techniques. The pain was measured on a 24-hour postoperative VAS scale, range 1-10. Data were analyzed by t-test.Results: There was no significant difference in pain level between the Kocher group (Mean= 2.33; SD=0.72) and the midline group (Mean= 2.20; SD=0.97) with p=0.192.Conclusion: There is no difference in pain level due to the Kocher incision technique and the midline incision technique.Keywords: pain, incision, kocher, midline, cholecystectomyCorrespondence: R. Th. Supraptomo. Anesthesia dan Intensive Therapy Department Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132 Jebres, Surakarta, Central Java 57126. Email: ekasatrio@gmail.com. Mobile: 081229229567Indonesian Journal of Medicine (2020), 05(03): 240-245https://doi.org/10.26911/theijmed.2020.05.03.09 ]]>
<![CDATA[Management of Laparoscopic Surgery in Intraoperative Subcutaneous Emphysema: A Case Report ]]>
<![CDATA[Supraptomo, RTH]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Over the past 50 years, laparoscopy has evolved from a limited gynecological surgical procedure that is only used for diagnosis and tubal ligation to become the main surgical tool used for many gynecological indications. Many studies have shown that laparoscopy is safer, more affordable, and has a shorter recovery time than laparotomy. This study aimed to report the management of laparoscopic surgery in intraoperative subcutaneous emphysema.Case Presentation: The subject of the study was a 37-year-old woman with adenomyosis and chocolate cyst of sinistra with a surgery plan for resection of adenomyosis and per laparoscopic cystectomy with the physical status of the ASA II Plan GAET. The surgery was carried out on October 15, 2018, with surgery for 5 hours. At the intraoperative, subcutaneous emphysema was found from the diaphragm to the thorax. In this condition, the peritoneal insufflation was reduced to 10-12 mmHg. The head down was returned to a position that made it easier for the patient's condition to reduce the occurrence of decreased lung compliance. The patient's postoperative condition was good, the hemodynamic was stable, her breath was spontaneous, and the saturation was 99% with oxygen supplementation via Nasal Kanul 3 lpm. The subcutaneous emphysema gradually disappeared 24 hours postoperatively. Conclusion: Subcutaneous emphysema may occur in the laparoscopic procedures. The close monitoring during surgery and the expertise of the anesthesiologist in diagnosing and intervening is crucial in controlling this condition.Keywords: subcutaneous emphysema; laparoscopy; intraoperative interventionCorrespondence: RTH. Supraptomo. Department of Anesthesiology and Intensive Therapy, Dr. Moewardi Hospital, Surakarta, Central JavaIndonesian Journal of Medicine (2020), 05(03): 206-213https://doi.org/10.26911/theijmed.2020.05.03.05 ]]>
<![CDATA[Clinical Improvement after Surgical Debridement and Synovectomy on 4 Year Old Girl with Chronic Septic Arthritis of the Hip ]]>
<![CDATA[Utomo, Pamudji]]>;
<![CDATA[Adriansyah, Denny]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Incidence of septic arthritis in children less than 5 years old about 5 from 100,000 cases every year and adult above 64 years old about 8.4 cases every 100,000 people every year. The diagnosis of the chronic septic arthritis, especially in hip joint is still challenging, even for skilled doctor in musculoskeletal. Delayed diagnosis and inadequate treatment can lead to permanent joint damage and impairment.Case presentation: In this case we discuss about clinical improvement of chronic septic arthritis in a 4 year old girl with hip pain that had been felt since 2 months before admission. Physical examination, laboratory examination, and ultrasonography examination was done and the diagnosis had been made.Results: A surgical debridement and synovectomy was done with addition antibiotic therapy. The patient not only felt the pain was relieved but also can return into good function of hip joint.Conclusion: Diagnosis with proper early treatment is expected to reduce permanent joint loss and improve the clinical outcome for the patient.Keywords: septic arthritis, hip, synovectomy, surgical debridementCorrespondence: Pamudji Utomo. Prof DR R Soeharso Orthopaedic Hospital, Pabelan, Kartasura, Surakarta, Central Java. Email: scapoid@yahoo.com.Indonesian Journal of Medicine (2020), 05(03): 253-258https://doi.org/10.26911/theijmed.2020.05.03.11]]>
<![CDATA[The Effects of Slow Stroke Back Massage and Lavender Aromatherapy on Blood Pressure in Hypertensive Patients ]]>
<![CDATA[Sani, Fakhrudin Nasrul]]>;
<![CDATA[Irdianty, Mellia Silvy]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Elderly is an age group which is extremely susceptible to suffer from health problems such as hypertension. Hypertension among the elderly is instigated by structural and functional changes in blood vessels. The changes include atherosclerosis, loss of connective tissue elasticity, and decreased vascular muscle relaxation that it reduces the distension and tensile strength of blood vessels. One of the therapies that may be implemented to elderly with hypertension is slow stroke back massage (SSBM) and lavender aromatherapy. The study aims to discover the effects of slow back massage (SSBM) and lavender aromatherapy toward the reduced blood pressure among hypertensive elderly.Subjects and Method: It was a quasi-experiment study with no control group which had been conducted in Posyandu (Integrated Health Post) Kamboja, Plesungan, Gondangerjo, Karanganyar, Central Java, in July 2019. A sample of 40 elderlies was selected by using total sampling. The dependent variables were systolic and diastolic blood pressure. The independent variables were slow stroke back mass-age (SSBM) and lavender aromatherapy. Blood pressure was measured by sphygmomanometer. The data were analyzed by using Wilcoxon. Results: The average systolic blood pressure post slow stroke back massage therapy and la-vender aroma therapy was (Mean=133.63; SD= 7.34) compared with prior therapy was (Mean= 167.80; SD= 6.12) with the value of p<0.001. The average diastolic blood pressure post slow stroke back massage therapy and lavender aroma therapy was (Mean= 68.28; SD= 4.25) compared with the prior therapy was (Mean= 68.88; SD= 5.72) with the value of p<0.001. Conclusion: Slow stroke back massage (SS-BM) lavender aromatherapy may lower down blood pressure of hypertensive elderly.Keywords: Hypertension, slow stroke back massage, Lavender aromatherapy, elderlyCorrespondence: Fakhrudin Nasrul Sani. School of Health Sciences Kusuma Husada, Surakarta. Email: fakhrudin_ns@ymail.com.Indonesian Journal of Medicine (2020), 05(03): 178-184https://doi.org/10.26911/theijmed.2020.05.03.01]]>
<![CDATA[The Differences of Folliculogenesis between Treated with Letrozole and Letrozole-Electroacupuncture in Women with Polycystic Ovary Syndrome ]]>
<![CDATA[Yulyanti, Yulyanti]]>;
<![CDATA[Budihastuti, Uki Retno]]>;
<![CDATA[Melinawati, Eriana]]>;
<![CDATA[Sulistyowati, Sri]]>;
<![CDATA[Nurwati, Ida]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that most often causes infertility. It occurs due to the failure of folliculogenesis, thus causing non-ovulation. Letrozole is a 3rd generation drug of non-steroidal aromatase inhibitors, which can increase ovulation rates. Electroacupuncture is the insertion and manipulation of needles into acupuncture points (acupoints) that are selected specifically based on the meridian system and connected to the electrode stimulator. This study aimed to determine the differences of the effects of letrozole and letrozoleelectroacupuncture (letrozole-EA) on the improvement of folliculogenesis in women with PCOS.Subjects and Method: This was an analytic observational study with a case-control design. This study was conducted at the Gynecology Polyclinic and Sekar Clinic, Dr. Moewardi Hospital, Surakarta. A sample of 30 infertile women aged 20-45 years was selected by fixed disease sampling. The criteria of the PCOS were determined based on Rotterdam criteria. The dependent variable was the diameter of the follicle. The independent variables were the administration of letrozole and letrozole-EA. Transvaginal ultrasound of Voluson P6 was used to measure the folliculogenesis. The data were analyzed by independent t-test.Results: On the second day after treatment, the diameter of the follicles in the letrozole-EA group (mean= 6.92; SD= 1.60) was bigger than the letrozole group (mean=5.66; SD=1.11), and it was statistically significant (p=0.004).Conclusion: Combination of letrozole and letrozole-EA therapy is more effective in increasing follicular diameter development than letrozole therapy only.Keywords: polycystic ovary syndrome, folliculogenesis, Letrozole, electro-acupunctureCorrespondence: Yulyanti. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. Email: dr.yulyanti@gmail.com. Seluler: +6285264806570.Indonesian Journal of Medicine (2020), 05(03): 214-223https://doi.org/10.26911/theijmed.2020.05.03.06]]>
<![CDATA[A Case Report of Wellens’ Syndrome: An Ominous Sign of Left Anterior Descending Artery Critical Stenosis and Impending Anterior Myocardial Infarction ]]>
<![CDATA[Willim, Herick Alvenus]]>;
<![CDATA[Agustyana, Andini]]>;
<![CDATA[Arilaksono, Dwisetyo Gusti]]>;
<![CDATA[Proklamartina, Nurnajmia Curie]]>;
<![CDATA[Furqon, Muhammad]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Wellens’ syndrome is a potentially life-threatening condition, characterized by biphasic or deeply inverted T-waves changes in electrocardiographic (ECG) precordial leads, which associated with critical stenosis of left anterior descending (LAD) coronary artery and impending anterior myocardial infarction in patients presenting with unstable angina. This syndrome is an important sign for clinicians because delay in coronary angiography and revascularization may lead toanterior myocardial infarction, left ventricular dysfunction, and even death.Case presentation: A 50-year-old woman came to emergency department in a hospital in Bontang, with new onset intermittent typical chest pain lasting since 3 days. She had history of hypertension without regular medication. Physical examination was in normal ranges. An ECG obtained during chest pain-free period showed Wellens’ type A with biphasic T waves in V2-V6 and preserved R-wave progression. Troponin T was slightly elevated. During observation, the ECG pattern changed from Wellens’ type A to Wellens’ type B with deep T-wave inversions in V2-V6 and preserved R-wave progression.Results: The patient was initially treated with conservative treatment. On the next day, she was referred to percutaneous coronary intervention-capable hospital in Samarinda. Coronary angiography revealed 90% stenosis of mid LAD. A drug-eluting stent was successfully implanted with restoration of LAD flow. She was discharged on the following day in good condition with medication of dual antiplatelet therapy, angiotensin-converting enzyme inhibitor, beta-blocker, and statin.Conclusion: Clinicians should be aware of the ECG changes in Wellens’ syndrome, which may occur during pain-free period. Early recognition is crucial to avoid the development of anterior myocardial infarction. Immediate coronary angiography and revascularization is needed.Keywords: Wellens’ syndrome, critical stenosis, myocardial infarctionCorrespondence: Herick Alvenus Willim. Dr. Agoesdjam General Public Hospital, Ketapang, West Kalimantan. Email: herick_alvenus@yahoo.co.id.Indonesian Journal of Medicine (2020), 05(03): 246-252https://doi.org/10.26911/theijmed.2020.05.03.10]]>
<![CDATA[Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models ]]>
<![CDATA[Anggraini, Nutria Widya Purna]]>;
<![CDATA[Sulistyowati, Sri]]>;
<![CDATA[Pramono, Besari Adi]]>;
<![CDATA[Kristanto, Herman]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: nutria_dr@staff.uns.ac.id. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03 ]]>
<![CDATA[The Effect of Mesenchymal Secretome Stem Cell Therapy toward Caspase-3 Expression in Pregnant Mice with Pristan-Induced Lupus Model ]]>
<![CDATA[Adiyana, Febrian Andhika]]>;
<![CDATA[Bachnas, M Adrianes]]>;
<![CDATA[Sulistyowati, Sri]]>;
<![CDATA[Anggraini, Nutria Widya Purna]]>;
<![CDATA[Respati, Supriyadi Hari]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Systemic lupus erythematosus (SLE) is one of the pregnancy complications which cause an increase in fetal and maternal complications which are mainly caused by placental damage due to chronic inflammation and apoptosis. The rate of apoptosis can be assessed by the high expression of caspase-3 which is the majorexecutioner caspases of apoptosis. The use of Mesenchymal Secretome Stem Cell for SLE therapy has an anti-inflammatory and anti-apoptotic role. This study aimed to examine the effect of mesenchymal secretome stem cell therapy toward caspase-3 expression in pregnant mice with pristan-induced lupus model.Subjects and Method: This study was a randomized controlled trial. This study was conducted at the Prodia ProStem Laboratory, Laboratory of the Faculty of Veterinary Medicine of Airlangga University, and Anatomical Pathology Laboratory, Faculty of Medicine, Airlangga University. A total of 14 healthy BALB/C female mice strain aged 6-8 weeks, with a bodyweight of 20-30 grams, were divided into two groups, (1) 7 pregnant mice who received pristan therapy only, and (2) 7 pregnant mice who received pristan therapy and mesenchymal secretome stem cell.The dependent variable was the caspase-3 expression. The independent variable was the administration of mesenchymal secretome stem cell therapy. The caspase-3 expression was measured by an immunoreactive score. The data were analyzed using independent t-test.Results: After giving mesenchymal secretome stem cell therapy, the mean of the caspase-3 expression in the treatment group (Mean=1.86; SD=0.66) was lower than the control group (Mean=3.30; SD = 1.42), with p=0.031.Conclusion: Mesenchymal secretome stem cell therapy is effective for reducing caspase-3 expression in the placenta of pregnant mice with pristan-induced lupus model.Keywords: Caspase-3 expression, lupus, placentaCorrespondence: Febrian Andhika Adiyana. Department of Obstetrics and Gynecology, Faculty of Medicine, Univesitas Sebelas Maret/Moewardi Surakarta, Indonesia. Email: FebrianAndhika@gmail.com. Mobile: 081215897960.Indonesian Journal of Medicine (2020), 05(03): 224-229https://doi.org/10.26911/theijmed.2020.05.03.07]]>
<![CDATA[High Energy Injury Ankle Fracture-Dislocation without Neurovascular Involvement ]]>
<![CDATA[Utomo, Pamudji]]>;
<![CDATA[Arimuqti, Zarkasyi]]>;
<![CDATA[Santoso, Asep]]>;
<![CDATA[Sibarani, Tangkas SMHS]]>;
<![CDATA[Anwar, Iwan Budiwan]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neurovascular damage are rarely reported.Case presentation: This study present a case of 55-year-old female with open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neurovascular injury treated with emergent debridement, open reduction, and internal fixation.Results: Six months follow-up showed complete bone and soft tissue healing with excellent functional outcome.Conclusion: Emergent debridement, open reduction, and internal fixation is needed to treat tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture.Keywords: high energy injury, ankle joint, fracture dislocationCorrespondence: Asep Santoso. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: asepsantoso@gmail.com.Indonesian Journal of Medicine (2020), 05(03): 259-264https://doi.org/10.26911/theijmed.2020.05.03.12]]>
<![CDATA[Aminoglycocides as An Alternative Antibiotic Therapy Against Urinary Tract Infection in Children due to Extended-Spectrum Β-Lactamase (ESBL) Producing Escherichia Coli in Carbapenem Trends ]]>
<![CDATA[Mapindra, Muhammad Pradhika]]>;
<![CDATA[Mahindra, Muhammad Pradhiki]]>;
<![CDATA[Ramadhan, Muhammad]]>;
<![CDATA[Putri, Apriska Mega Sutowo]]>
<![CDATA[ Indonesian Journal of Medicine Vol 5, No 3 (2020) ]]>
Publisher : <![CDATA[Masters Program in Public Health, Universitas Sebelas Maret, Indonesia ]]>
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<![CDATA[Background: Extended-spectrum β-lactamase (ESBL) is an enzyme produced by certain Escherichia coli and Klebsiella pneumoniae. ESBL can induce theantibiotic resistance for betalactam antibiotics such as penicillin, cephalosporin, etc. Frequent utilization of carbapenem may induce the risk for carbapenem resistant against ESBLs producing microorganisms. This stud aimed to communicate Aminoglycocides as an alternative antibiotic therapy against urinary tract infection in children.Case Presentation: We present a case of 4 years child who was admitted to the state hospital of Madiun with main complaint of 10 days high fever accompanied by phimosis appearance. Laboratory results based on urine culture show the ESBL positive Escherichia coli. Results: We have used aminoglycoside for treating the patient. Clinical presentation in this patient start showing an improved clinical response and negative bacteriuria in the second urine test after the aminoglycoside therapy.Conclusion: Aminoglycosides such as gentamicin can be considered to be one of the best options for treating an ESBL infection beside carbapenem in order to reduce the carbapenem trend In clinical setting of the urinary tract infection caused by ESBL Eschericia coli.Keywords: Aminoglycosides, Carbapenem, Extended-spectrum β-lactamase, Gentamicin, urinary tract infectionCorrespondence: Muhammad Pradhika Mapindra. General Practitioner in State Hospital of Madiun, Easy Java. Email: mpradhika57@gmail.com.Indonesian Journal of Medicine (2020), 05(03): 200-205https://doi.org/10.26911/theijmed.2020.05.03.04]]>
