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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Published by Universitas Gadjah Mada
ISSN : 01261312     EISSN : 23563931     DOI : http://dx.doi.org/10.19106/JMedSci005303202101
Core Subject : Science,
Immunology & microbiology Neuroscience
Journal of the Medical Sciences (JMedSci) or Berkala Ilmu Kedokteran (BIK) is an international, open-access, and double-blind peer-reviewed journal, published by Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia. JMedSci aiming to communicate high-quality articles in the areas of biomedical science from basic to clinical sciences.The journal welcomes papers from original articles, case reports, reviews, and book reviews. All papers published in JMedSci are freely available as downloadable pdf files. The journal began its publication on March 1973 and published quarterly (January, April, July, and October). JMedSci is abstracted and indexed in DOAJ, Crossref, Google Scholar, Sinta, Indonesia One Search. JMedSci is accredited by Directorate of General Higher Education, the Ministry of Research, Technology, and Higher Education, Indonesia
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 8 Documents
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Search results for , issue " Vol 34, No 04 (2002)" : 8 Documents clear
Serologic test vs antigenemia assay as diagnostic marker for cytomegalovirus infection in children. Agnes Yunie, Agnes Yunie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Objective: To determine the level IgG and IgM anti-CMV in children clinically suspected to be infected by Cytomegalovirus (CMV) and to determine the diagnostic value of IgG dan IgM anti-CMV as diagnostic tools for active CMV infection with antigenemia assay as the gold standard.Material and methods: Diagnostic test, observational cross sectional study. All children suspected to have CMV infection who were hospitalized or who visited neurology outpatient clinic in Sardjito Hospital in March 1" - September 11" 2002 were enrolled in this study. Serologic test for IgG and IgM anti-CM- and antigenemia assay were conducted to confirm the diagnosis of active CMV infection.Results: Nine of 82 specimens (12%) were confirmed to have active CMV. The cut off point of IgG was 265.75 AU/ml, with the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 67% (95% CI: 31-91%), 70% (95% CI: 58-80%), 21% (95% CI: 9-42%), 94% (95% CI: 84-99%), respectively, and likelihood ratio (LR) 4.5. The cut off point of IgM was 0.445, with the sensitivity, specificity, PPV and NPV of 56% (95% CI: 23-85%), 67% (95% CI: 55-77%), 17% (95% CI: 7-37%) and 93% (95% CI: 81-98%), respectively and LR 1.7. There was no significant relation between the level of IgG or IgM above cut off point and antigenemia (p=0.06 and p =0.27). Level of IgG combined with IgM had a significant relation with antigenemia (p 0.04), with the sensitivity 75% (95% CI: 22-99%), specificity 81% (95% CI: 66-91%), PPV 27% (95% CI: 7-61%), NPV 97% (95% CI: 84100%) respectively. LR was 5.3. Most of the children (40 patients) had psychomotor disorder (60%). There was significant relation between trombocytopenia and antigenemia (p =0.04).Conclusions: An increased level of IgM combined with IgG above cut off point is a significant diagnostic tool for active CMV infection. Psychomotor disorder is the clinically sign mostly found in active CMV infection. Thrombocytopenia can be used to detect active CMV infection.Key words: active CMV infection - antigenemia - IgM & IgG anti-CMV - IgM anti-CMV - diagnostic test
The combined treatment of vitamin A eye drops, oral vitamin A , and oral doxycycline in meibomian gland dysfunction. Suhardjo, Suhardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Background: The frequency of meibomian gland dysfunction (MGD) patients is increasing in elderly and especially in female. Meanwhile the relationship of dry eye with meibomian gland dysfunction is close. Dry condition of eye will result in epitheliopathy, susceptibility to superinfection, scarring sequelae, and neovascularization in ocular surface. Vitamin A can prevent epitheliopathy and disturbance of tear film stability. Oral doxycycline inhibits lipase activity of any attendant microorganism.Objective: To evaluate the effect of systemic combined therapy vitamin A and doxycycline with vitamin A eye drops versus vitamin A eye drop and oral doxycycline in the management of meibomian gland dysfunction.Methods: The design of study was double blind randomized clinical trial. Setting was at Dr Sardjito Eye Clinics. The subjects were 60 MGD patients aged 50-79 years old, male and female were enrolled in this study and divided into two groups. The group I received vitamin A eye drops and oral doxycycline of 100 mg for 4 weeks. The group II was treated with oral vitamin Aof 6000 IU two times per day for 3 weeks, vitamin A eye drops, and oral doxycycline of 100 mg for 12th weeks. Both groups were followed at 4, 8, and 12 weeks for clinical signs, tear production (Schirmer test), quality of mucine (ferning test), and quality of ocular surface (rose bengal test).Results: Improvement was obtained in both group, in clinical signs of MGD as well as in tear production, quality of mucine, and ocular surface condition. There was no significant difference between both groups (p=0.58, RR =0.86, 95%, CI 0.21-3.50). The combined treatment of oral vitamin A, vitamin A eye drops and oral doxycycline of 100 mg in 12 weeks results in similar improvement with treatment by vitamin A eye drops and oral doxycycline in 4 weeks in MGD patients. The side effect of doxycycline was gastrointestinal problem in 2 patients.Conclusion: The result of this study supports that four weeks treatment is sufficient in achieving improvement of meibomian gland dysfunction patients.Key words: Vitamin A - doxycycline - meibomian gland dysfunction - four weeks
Absolute and relative lymphocyte counts in dengue infection Bambang Ardianto, Bambang Ardianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Dengue infection is one of Indonesias health problems. Lymphocytes are thought to be involved in dengue pathogenesis.Objectives: To determine whether there were any differences on absolute and relative lymphocyte counts between dengue and non-dengue febrile patients and among dengue fever (DF), dengue hemorrhagic fever without shock (DHF, dengue shock syndrome (DSS), and non-dengue (ND) patients.Methods: A cross-sectional study was conducted on dengue and non-dengue patients hospitalized at "Empat Lima" Hospital, Yogyakarta, during the period of November 23, 2001-January 22, 2002. The diagnosis of dengue infection was confirmed by HI test. Absolute and relative lymphocyte counts were obtained from serial peripheral blood films stained with Giemsas staining.Results: Thirty-eight DF, 10 DHF, 16 DSS, and 86 ND patients were involved in this study. Absolute and relative counts of each degree were compared each other from the third day until the eighth day after the onset of fever. Absolute lymphocyte counts of dengue patients were higher than those of non-dengue patients on day 5 (p=0.047) and 6 (p =0.022). Absolute lymphocyte counts of DHF patients were higher than those of DF, DSS, and ND patients on day 5 (DF vs. DHF, p =0.003; DHF vs. DSS, p=0.001; ND vs. DHF, p(0.001).Absolute lymphocyte counts of DHF patiens were higher than those of ND patiens on day 6(p=0.018).Relative lymphocyte counts of Df patiens were higher than those of DSSpatiens on day 6(p=0.023), while relative lymphocyte counts of ND patiens were higher than those of DSS patiens on day 7 (p=0.026).Conclution:there were significant differences in absolute lymphocyte counts between dengue and nondengue patiens, DF and DSS patiens, and ND and DSS patiens.Key words:lymphocyte count, dengue infection, dengue shock syndrome, non-dengue infection
The frequence of human papillomavirus (HPV) DNA on cervical cancer patients from several hospitals in Yogyakarta by PCR test. Titik Nuryastuti, Titik Nuryastuti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Background : Cancer of the uterine cervix (cervical cancer) is one of the most common malignant neoplasm in women in developing countries and remains a major public health problem worldwide. Several studies have proved the role of HPV as an agent STD (sexually transmitted disease), in the pathogenesis of Cervical cancer, beside the other risk factors.Objective : The aim of this study was to know the frequence of HPV infection in Yogyakarta.Material and Methods : 44 samples of Cervical cancer biopsies were collected from Sardjito General Hospital, Bethesda Hospital and private doctors, and stored frozen. DNA isolated from the biopsies of cervical cancer was amplified by PCR using consensus primer (CP I and CP IIG) from El ORF (188 bp) of HPV.Result : HPV DNA was detected in 84.1 % of the samples. In CIN I, 20 % samples were infected with HPV, 100 % in Ca epidermoid, 66.4 % in adeno Ca and 0 % in Ca adenosquamosaConclusion : The frequency of HPV in cervical Ca biopsies of certain histopathological status in Yogyakarta by PCR method was proved to be very high.Key words : HPV infection - cervical Ca - biopsy - PCR
Risk factors of childhood constipation Dyah Kurniati, Dyah Kurniati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Despite it is not considered as a dangerous situation in children older than 2 years old, but attantion is important in young infant. Improper treatment in constipation may contributed to the raise of anxiety, emotionally disorder either for the children or its relatives.Objective: To determine what factors related to constipation in children.Design and Methods: A case control study was conducted for all of children who were admitted to ambulatory polyclinic and inpatient clinic of Sardjito Hospital during January 2001 - December 2001. A questionaire was obtained by the researcher or assistant by direct interview to the parents or guardian. Results: We enrolled 86 children, consisted of 43 children in constipation group and the 43 children as control. There was significant difference (p<0.01) when reported having toilet training disturbance, daily fluid intake, the variety of daily meals (vegetables, fruits) and sweetened foods. Relative risk of having constipation due to toilet training disturbance in constipations group is 0.14 (CI: 0.06 - 0.38).Conclusion: Toilet training disturbance, daily fluid intake, the variability of daily meals and sweetened foods are risk factors of constipation in childhood. Key words: children - constipation - clinical findings - risk factors
Pattern of secondary sexual development of elementary school female students in Yogyakarta Municipality Anik Puryatni, Anik Puryatni
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Adolescence is a part of the growth cycle, characterized by significant changes in physical, cognitive and psychosocial aspects. Improvement in nutritional status and the influence of sexual hormons in the adolescent period cause an acceleration in maturation and the emerging of secondary sexual characteristics.Objective: To examine the beginning of secondary sexual development in female students of elementary school in Yogyakarta Municipality, and the correlation of nutritional status and secondary sexual development.Design: Cross sectional.Materials and methods: Subjects consist of 250 female students, through proportional population multi stage random sampling from all elementary school students in Yogyakarta. The age of menarche and the secondary sexual characteristics were determined using standardized questionaire. Nutritional status was determined based on z-score of body weight to age, body height to age, and body mass index (BMI). Results: The average age of the beginning of mammary enlargement was 11.35 years, and the start of pubic hair growth happened at 11.12 years of age. A larger proportion of the students (70.4%) had not experienced menarche yet, and the average age of menarche was 11.16 (± 0.95) years old. Most of the students had good nutritional status (88%) and normal body height (90%) based on the z-score, and can be categorized as normal based on the BMI (58%). Mammary growth was faster in students with better nutritional status based on body weight/age (p=0.0001), on body height/age (p =0.0002), and based on BMI (p=0.0005). The same result was observed on pubic hair growth of students with better nutritional status: p =0.043 based on body weight/age, and p =0.038 based on body height/age. The age of menarche of students with better nutritional status was younger (p =0.015) based on body weight/age, p=0.033 based on body height/age, and p<0.0001 based on BMI; 15.2% students had never received information concerning sexual development, the source of information mostly were parents, school-mates, books or magazines, and the role played by the teachers was still minimal.Conclusion: The average of mammary growth is 1135 years old, and the average age of pubic hair growth was 11.12 years old. And menarche nutritional status has positive influence on the secondarysexual development. Key words: female secondary sexual development, menarche, nutritional status
Knowledge of Junior High School teachers upon adolescent reproductive health in Yogyakarta Municipality Ratni Indrawanti, Ratni Indrawanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Objective: The aim of this study was to know the knowledge of Junior High School teacher upon adolescent reproductive health and the influencing factors.Materials and Methods: The study population is the teachers of Junior High Schools in Yogyakarta Municipality, 280 teachers were enrolled. Data on the characteristics and the knowledge upon the adolescent reproductive health were collected by questionnaire.Results: The teachers knowledge on the maturation of the female reproductive showed a statistical difference between the teacher group involved in the reproductive health teaching and the univolved group (p = 0.0004); the knowledge on the maturation of the male reproduction showed a statistical difference between the teacher group who had been in charge for more than 20 years compared to less than 20 year teacher (p = 0.015), likewise between the teacher group involved in the reproductive health teaching compared to the uninvolved (p = 0.0005); on the woman fertile period only 50% of the teachers had correct knowledge and there was a statistical difference between the teacher group involved in the reproductive health teaching and uninvolved group (p = 0.035). The score of the teachers knowledge that a woman can become pregnant by a single sexual intercouse was inadequate (about 60% of full score) and there was a statistical difference between teacher group involved in the reproductive health teaching and the uninvolved group (p = 0.035); the score of the teachers knowledge that a woman can become pregnant by interrupted sexual intercouse was inadequate (about 50% of full score) and there was a statistical difference between female and male teachers (p = 0.01), between the teacher group who had been in charge for more than 20 years compared to less than 20 year group (p=0.025). The teachers knowledge that woman cannot become pregnant by vaginal rinsing soon after a sexual intercouse was inadequate (about 60% of full score) and the teacher group involved in the Religion, Biology and Physical Health teaching was less than the other group and there was a statistical difference (p = 0.037), likewise between the teacher group who had been in charge for more than 20 years compared to less than 20 year group (p = 0.019), between teacher group involved in the reproductive health teaching and the uninvolved group there was a statistical (p = 0.005). Concerning the knowledge on Herpes infection there was a statistical difference between teacher group involved in the reproductive health teaching and the uninvolved group (p = 0.007); concerning the teachers behaviour on reproductive discussion with the students, the teachers involved in of Religion, Biology and Physical Health teaching or involved in guidance and councelling performed discussion more frequently compared to the other groups and a statistical differences was found (p= 0.00005). It was questionable that 64.8% teachers who were involved in the reproductive health teaching never discussed about the matter with their students. The teachers knowledge on some diseases that can be transmitted by sexual activities was variable: on AIDS and Syphillis nearly 70% teachers knew, on Chlamydia 39.8% and on Herpes less than 15%. Logistic regression analysis to find the influencing factor on the teachers knowledge showed: the involvement in the reproductive health teaching had influence on the knowledge upon the maturation of female and male sexual development more than the length of teaching, it influenced also the behavior to discuss sexual matter to the students. Gender and length of teaching did not influence the teachers knowledge whether a woman can become pregnant by interupted sexual intercouse; the subject of teaching and the involvement that a woman will not become pregnant by rinsing their sexual organ soon after a sexual intercouse.Conclusion: The knowledge and behaviour or the Junior High School teachers in Yogyakarta were inad- equate on some important issues and influenced especially by the subject teaching.Key word : adolescent reproductive health knowledge - Junior High School Teacher - influencing factors
Visual clinical diagnosis of jaundice on normal birthweight infant in Dr. Sardjito hospital Yogyakarta Satyawati, Satyawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Background: Neonatal jaundice is a problem commonly faced by health workers. The visual assessment of jaundice is very subjective and less accurate. Simplified body surface classification is expected to make the assessment easier and more accurate.Objective: To determine diagnostic accuracy of jaundice established visually using a simpler classification.Material and methods: This is an observational cross sectional diagnostic test. The study was performed in Maternal Perinatal Installation Dr. Sardjito Hospital in August 1st - October 31st 2002. Result: The interobserver agreement on jaundice was good (kappa = 0,6) the agreement on jaundice based on body area was good (weighted kappa = 0.75). The median of serum bilirubin level was 1) Face 5.8 mg/dL; 2) Abdomen 10.1 mg/dL; 3) Arms and legs 14 mg/dL; 4) Palms and soles 17.6 mg/dL. Based on 95th percentile serum bilirubin level as cut off point, the sensitivity and specificity was 1) Face 2% (95% CI: 0.1 - 12.2%) and 29% (95% CI :14.9 - 48.2%); 2) Abdomen 5.3 % (95% CI: 0.3 - 28.1%) and 57.4 % (95% CI 44.1 - 69.7%); 3) Arms and legs 33.3 % (95% CI:1,8 - 87.5%) and 70.1% (95% CI: 58.5 - 79.8%) 4) Palms and soles 100 % (95% CI: 5.5 - 100%) and 93.7 % (95%Cl: 85.2 - 97.6%) Conclusion: Simplified visual assessment of the grade of jaundice can not be applied as a diagnostic method for jaundice assessment.Key words: visual assessment - jaundice on normal birthweight - simplified body surface classification.

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