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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 12 Documents
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Search results for , issue "Vol 55, No 1 (2023)" : 12 Documents clear
Facial nerve paralysis in nasopharyngeal carcinoma: a case report Jarod Wahyu Kristiyanto; Muyassaroh Muyassaroh; Dwi Antono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202309

Abstract

Nasopharyngeal carcinoma (NPC) is cancer originating from the mucosal lining of nasopharynx, with the highest predilection in the fossa of Rosenmüller. One-fifth of NPC cases have cranial nerve complications. The location of Rosenmüller's fossa which is adjacent to foramen lacerum and middle base of the cranium allows the tumor to extend directly into the cranium and surrounding cranial nerves. This paper reported a case of facial nerve paralysis in NPC. A 55-year-old man came to the Ear-Nose-Throat (ENT) Clinic at Dr. Kariadi General Hospital, Semarang with complaints of facial pain on the right side, headache, a lump on the left neck, fullness in ears, and nosebleed. However, the patient did not complain of double vision. After a thorough history taking, physical examination, radiology, and histopathology tests, the patient was diagnosed with WHO 3 ECOG I T3N2M0 stage III NPC with House Brackmann III facial nerve paresis at the level of Mastoid segment. The patient was treated using chemotherapy treatment by an ENT specialist with a chemotherapy regimen of paclitaxel-cisplatin for 6 cycles. In conclusion, although rare, NPC can cause facial nerve paralysis.  
Unique truncated and non-synonymous mutations in functional domains of ORF3a SARS-CoV-2 Jeanne Elvia Christian; Hartiyowidi Yuliawuri
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202301

Abstract

Previous studies showed that mutations in the SARS-CoV-2 ORF3a protein can influence viral pathogenesis. Therefore, it is necessary to observe mutations, especially in the functional domain of the protein. We observed the presence of mutations in the ORF3a protein by analyzing 5,131 samples from the GISAID database since it was first discovered in March 2020 until November 2021. The sequence was aligned using Clustal Omega Multiple Sequence Alignment from EMBL-EBI and analyzed using BioEdit version 7.2.5 software using reference sequences NC045512. Samples having the letter N were omitted from the analysis. The effect of point mutations on proteins was analyzed using the Protein Variation Effect Analyzer (PROVEAN) v1.1.3 software. The functional domains of the ORF3a protein were visualized using RasWin software. We identified 312 mutations in the SARS-CoV-2 ORF3a protein. In addition, from 5,131 samples, 915 samples were found to be truncated in the C-terminal region of the protein. These non-synonymous mutations data in functional domains and truncated sequences indicate that amino acid changes in the ORF3a protein require further studies to determine the effect of viral pathogenicity in humans.
Pulmonary vascular resistance/systemic vascular resistance (PVR/SVR) ratio changes after sildenafil therapy in uncorrected congenital heart disease-associated pulmonary arterial hypertension Evita Devi Noor Rahmawati; Putrika Prastuti Ratna Gharini; Anggoro Budi Hartopo; Lucia Kris Dinarti; Dyah Wulan Anggrahini
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202305

Abstract

Pulmonary vascular resistance (PVR) to systemic vascular resistance (SVR) ratio is a prognostic predictor in congenital heart disease (CHD)-associated pulmonary arterial hypertension (PAH) after defect correction. Sildenafil, widely used as a PAH drug, can decrease PVR with minimal or without changes in SVR, resulting in decreased PVR/SVR ratio after treatment. However, there is limited evidence that PVR/SVR ratio reduced after sildenafil therapy in uncorrected CHD-associated PAH patients. This study aimed to investigate the decreasing of the PVR/SVR ratio after ≥ 1-year oral sildenafil therapy in adult uncorrected CHD-associated PAH. A total of 30 uncorrectable CHD-associated PAH subjects derived from the COHARD-PH registry were included in this study. Right heart catheterization (RHC) was performed during the first visit and further evaluations were conducted after ≥1-year oral sildenafil therapy. The PVR/SVR ratio at the baseline and after the evaluation was collected. The primary outcome of this study was the changes in PVR/SVR ratio from baseline to evaluated RHC. Characteristic analysis of subjects with decreased PVR or PVR/SVR ratio was perforemd as the secondary outcome. The mean PVR and SVR were not different from baseline and evaluated RHC (15.98± 10.67 vs. 18.38±13.93 WU, p=0.206 and 36.65±13.99 vs. 39.34±15.46 WU, p=0.262). There was no significant difference in the baseline PVR/SVR ratio and the evaluated PVR/SVR ratio after ≥1-year sildenafil therapy (0.48 ±0.32 vs. 0.49±0.36; p=0.882). As much as 15 subjects (50%) experienced decreased PVR/SVR ratio. However, there was no significant difference in the characteristics, including age, Eisenmenger syndrome, type of shunts, baseline PVR, PAH-specific treatment, and baseline NT-proBNP level (p>0.05). In conclusion, sildenafil therapy does not change PVR/SVR ratio in adults with uncorrected CHD-associated PAH.
Atrial septostomy to prevent pulmonary hypertension crisis in children with ventricular septal defect (VSD) and pulmonary hypertension (PH) underwent cardiac surgery: a case series Haryo Aribowo; Yoga Arditya; Gita Christy Gabriela
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202303

Abstract

Severe pulmonary hypertension (PH) was reported in 22.4% of ventricular septal defect (VSD) and it was mainly seen on a large VSD. Atrial septostomy (AS) could improve the hemodynamic condition and long-term survival of PH patients. Here, three VSD and PH cases in children who underwent AS surgery as their early treatment, concomitant with PH-specific pharmacological treatment were reported. Patient’s hemodynamic and general condition improved with no further complications during the follow-up period. Atrial septostomy was usually conducted after all PH-specific pharmacological interventions failed. However, a study found that the survival benefit of AS was significantly increased if it was conducted before PH-specific pharmacotherapies. Most of the patients in this case received immediate hemodynamic and functional improvement. In this case series, it was reported that the AS procedure could lower the pulmonary arterial pressure and be safely conducted without further complications or death >24 hr post-surgery. Considering the clinical benefit, safety procedure, and improved pulmonary arterial pressure, performing AS procedure concomitant with PH-specific pharmacotherapy as an early treatment for PH patients is recommended.
Comparison of cardiac marker profiles in dengue myocarditis Galang Tri Atmaja; Sarah Buntubatu; Conroy Surya Wijaya; Annisa Nurul Pratiwi Sudarmadi; Ida Safitri Laksono; Ratni Indrawanti; Eggi Arguni
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202304

Abstract

Dengue patients may experience some grade of severity. Cardiac involvement is common in severe dengue, therefore cardiac markers could be used to ensure the diagnosis of dengue myocarditis. However, information of the cardiac marker profiles in patients with milder severity of dengue infection is limited. The study aimed to evaluate creatinine kinase (CK), creatinine kinase-MB (CK-MB) and troponin I (TnI) in dengue myocarditis against the spectrum severity of dengue infection in children. This cross-sectional study was conducted using secondary data from medical records of dengue myocarditis patients aged 1-18 yr in Dr. Sardjito General Hospital, Yogyakarta. Fisher’s Exact tests were performed to compare the increase in cardiac markers to the dengue severity. The increase of CK was observed in dengue fever/DF (6 or 75% of patients), dengue hemorrhagic fever/DHF (6 or 67%) and dengue shock syndrome/DSS (16 or 73%). Furthermore, the increase of CK-MB was also observed in DF (6 or 75%), DHF (8 or 87%), and DSS (21 or 95%). No significant difference in the increase of CK and CK-MB proportions was observed in DF compared to DHF groups and in DF compared to DSS (p>0.05). The increase of Tn I was observed in DHF (2 or 22%) and DSS (10 or 45%) groups but not observed in DF group. Significant difference in the increase of Tn I proportion was observed in DF compared to DSS groups (p=0.022). In conclusion, cardiac involvement is common in all dengue severity level. The increment of Tn I corresponds to an increase in the dengue severity level. Further research by observing cardiac markers sequentially is needed.
Evaluation of patients with suspected obstructive sleep apnea in a low-middle income country: Lagos experience Oluwafemi Tunde Ojo; Adeola Olubunmi Ajibare; Akinola Olusola Dada; Rahmon Moronkola; Ayoola Odeyemi; Temitope Fapohunda; Ikechukwu Adolphus Aganweze; Tracy Udoka Ossai; Ifeoluwa Owoeye; Olufunke Olayinka Adeyeye
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202306

Abstract

Obstructive sleep apnea (OSA) is a common chronic disorder that decreases the quality of life of patients. It is an underdiagnosed medical condition in Nigeria. This study aimed to describe the clinical presentations and validate the sleep apnea screening questionnaires with a home sleep study for the diagnosis of patients with suspected OSA seen in Lagos. This was a descriptive cross sectional study carried out on adult patients with suspicion of OSA referred to the Respiratory Clinic of Lagos State University Teaching Hospital. A proforma was used to obtain information and also data from home polysomnography was obtained for each patient. We selected 22 patients. The commonest presentations include snoring (20 or 90.9%), daytime somnolence (16 or 72.7%) and choking while sleeping (12 or 54.5%). The commonest comorbidities were hypertension (16 or 72.7%) and obesity (6 or 27.3%). The STOP-Bang  score identified more patients with a high clinical probability for OSA than the Epworth score (20 and 12 patients respectively). Polysomnography showed evidence of sleep apnea in most suspected patients with severity ranging from mild, to moderate to severe disease (3 or 13.6%, 3 or 13.6%, and 10 or 45.5% respectively). The use of combined Epworth and STOP-Bang questionnaires combination is great tool in identifying patients with suspected cases of OSA based on clinical presentations that will eventually benefit in a resource-limited environment like Lagos. There should be increased awareness of the use of this readily available and cheap questionnaire among physicians in Lagos for ease of OSAS diagnosis for many patients.
The effect of appropriate antibiotic use on the length of hospital stay in deep neck abscess (DNA) patients Hesti Dyah Palupi; Dian Paramita Wulandari; Feri Trihandoko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202308

Abstract

Deep neck abscess (DNA) is an emergency in the otorhinolaryngology head and neck surgery field due to the formation of abscesses in the potential space between the deep neck fasciae. It is typically caused by the expansion of infection from various sources, including the teeth, mouth, throat, paranasal sinuses, middle ear, and neck. The increase of DNA cases needs for improvement of patient management especially when the patients have comorbidities which lead to an extended length of treatment. The study aimed to evaluate the appropriateness of empirical antibiotics given according to culture results and any comorbid factors that affect the length of hospital stay (LOHS). It was case-control observational study involving 44 cases of DNA patients who treated at Dr. Sardjito General Hospital Yogyakarta in the period of January 2018 to December 2020. The patients were divided into two groups with 22 patients in each group. The first group was the DNA patients with > 7 d LOHS and the second one was those with ≤ 7 d.  No significantly relationship was observed between variables evaluated included the appropriate antibiotic use  (p=0.546). However, dental caries (DC) was significantly related with the LOHS (p=0.015). In conclusion, there is no relationship between the appropriate antibiotic use and the LOHS. However, the DC is risk factor that influence the LOHS in patients with DNA.
Coinfection of COVID-19 and dengue: a case report Fx. Wikan Indrarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202310

Abstract

Dengue hemorrhagic fever (DHF) and corona virus disease 2019 (COVID-19) are two viral infectious diseases that can occur simultaneously and have the potential to complicate each other. Therefore, sustained attention to this phenomenon is required. A 9 y.o. boy was diagnosed with dengue and COVID-19 at the Panti Rapih Hospital in Yogyakarta, Indonesia, in the early phase of the COVID-19 pandemic. Both viral infectious diseases have distinctive clinical and laboratory features. Acute fever, vomiting, weakness, thrombocytopenia, and hemoconcentration that improve from day 5 after infection are typical symptoms of DHF in children. Complaints of fever, runny nose, cough, and pain when swallowing that usually occurs in COVID-19 also appeared. Medical investigations with serological tests for DHF and COVID-19 at the beginning of the COVID-19 pandemic can be used to diagnose these two infections because standard diagnostic tools using the PCR swab test cannot yet be performed. Symptomatic therapy for moderate degrees of these two viral infections is appropriate.
The effect of prophylactic negative pressure wound therapy on infection in obese women after C-section: a meta-analysis Aris Widiyanto; Santy Irene Putri; Asruria Sani Fajriah; Yuly Peristiowati; Agusta Dian Ellina; Joko Triatmojo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202311

Abstract

Most caesarean wounds resulted in infection. This become a huge burden on the health care system, considering the high number of women undergoing this type of surgery. Negative pressure wound therapy (NPWT) has been recommended for a wide variety of lesions including open abdominal wounds. The purpose of this study was to investigate the effect of prophylactic NPWT on infection in obese women after a C-section. This was a systematic review and meta-analysis study that used articles from online databases of EBSCO, Google Scholar, and PubMed which published until 2022. The dependent variable was infections post C-section, while the independent were NPWT and standard wound therapy. The data was analyzed by RevMan 5.3. This study showed that there is no difference in the outcome of superficial site infection (SSI), deep site infection (DSI), wound dehiscence, seroma, and hematoma between women with obesity after caesarean delivery who used NPWT and standard dressing.
The difference in biofilms formations on duration less than 90 d and more than 90 d of tracheotomy cannula usage Pradhana Fajar Wicaksana; Dian Paramita Wulandari; Angga Kusuma; Siswanto Sastrowijoto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 1 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005501202307

Abstract

Currently, prevention of local and systemic infections caused by implantable devices is increasingly improved. Tracheostomy is a surgical action followed by an implantable device called tracheotomy cannula into a trachea to maintain upper airway patenting. The incidence of biofilm-related complications and infections is associated with the length of duration of the attached tracheostomy. The formation and spread of biofilms from distal cannula increase the infection incidence in stoma, tracheitis, and even peripheral pneumonia. However, until now there has been no consensus on when the tracheostomy replacement supposedly conducted. Some manufacturers recommend that cannula replacement supposedly conducted within 30 d, but the data are not yet in agreement and need further study. This study aimed to determine the difference in biofilms formations in a duration of less than 90 d and more than 90 d of tracheotomy cannula usage. It was a cross-sectional study involving patients who underwent a tracheostomy at the Department of Otorhinolaryngology of Dr. Sardjito General Hospital, Yogyakarta. Fisher exact test was applied to analyze the biofilms formations of the two different duration of tracheostomy cannula usage. A total of 20 patients were involved in this study.  Durations of more than 90 d had more biofilms formations compared to less than 90 d, although it was not significantly different (p>0.05). However, the PR value of 6 indicated that subjects who have attached cannula more than 90 d clinically have 6 times higher risk for developing biofilms formations than those less than 90. In conclusion, there is no significant differences in biofilms formations between the less than 90 d and more than 90 d of tracheostomy cannula usage. However, clinically subjects with longer duration of tracheostomy cannula usage have higher risk for developing biofilms formations.

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