eJournal Kedokteran Indonesia
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Family Acts in Cases Management In Primary Care through The Five Family Oriented Question
No full textFamily oriented in primary care sees family as supporting resources/inhibiting case management accomplishment. The aim of this study was describing cases in primary care and family perception of the patient through the five family oriented question (FFOQ). Interviews were conducted in 162 patients from public health centers and clinics in DKI Jakarta year 2015–2016. Data were collected through questionnaires consisted of patient’s characteristics and 5 FFOQ questions. Qualitative and quantitative analysis was conducted. Most cases in primary care services were non-infectious diseases (82.7%) and the highest age proportion was >40 years (76.5%). Patient and family’s perception about causal of the disease and how to cope still vary. Parents, spouses, and children were the family members who were most concern about the patient. A total of 71.6% of respondents felt there were stressors in the family. Stressor sources vary such as socio-economic, family, work, and him/herself. Emotional and financial support were given to patient by family members according to each capacities. In conclusion, the family acts as an inhibiting factor as well as support in primary care case management to support more patient and family oriented case management
The Role of CYP4502E1 Genetic Polymorphism on Benzene Metabolism
No full textThe carcinogenic effect of benzene is associated with metabolites produced in benzene metabolism such as phenol, catechol, quinones, muconic acid (tt-MA), and phenyl mercapturic acid (s-PMA). The role of CYP4502E1 enzyme in benzene metabolism is very important, which is determined by its genetic polymorphism. This cross-sectional study is aimed to obtain the distribution of frequency of s-PMA concentration in workers who had been low exposure of benzene based on CYP4502E1 genetic polymorphism. The study was conducted between September 2007 and April 2010. Data were collected by methods of interviews, physical examinations, laboratory examinations, and direct observation on the work place. The variables studied were CYP4502E1, benzene exposure at the work place, age, type of work, history of work, length of work, body mass index (BMI), antioxidants intake, behavior and management, and s-PMA concentration in the urine. The distribution of CYP4502E1 genetic polymorphism in workers is 87.8% wild type homozygote, 11.3% heterozygote and 0.9% mutant homozygote. There was no significant difference in the proportion of s-PMA concentration based on CYP4502E1 genetic polymorphism (p=0.595; ORraw=0.98; 95% CI=0.95-1.01). There were also no differences of age, type of work, length of work, BMI, antioxidants consumptions, behavior and management of subjects with s-PMA. Further study should be conducted on CYP4502E1 genetic polymorphism in various Indonesian races at different workplace with low-level benzene
Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital
No full textThe aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG) result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9%) and 31 benign cases (19.3%). Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%), follicular (3%), medullary (0.7%), and anaplastic (6%). The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6%) or clinical findings and FNAB (87%). Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98%) and malignant probability (92%) is high.  
Relationship between Inhaled Corticosteroid Adherence and Airway Obstruction Severity among Persistent Asthma Patients
No full textInhaled corticosteroid is the foundation therapy in controlling persistent asthma in order to reduce inflammation and prevent deterioration of lung function. There were 75% of asthma patients in RSUD Dr. Soedarso with uncontrolled asthma. Low adherence to inhaled corticosteroid therapy was suspected. This research was conducted to assess relationship between inhaled corticosteroid adherence and severity of airway obstruction through forced expiratory volume1/forced expiratory volume1prediction value and forced expiratory volume1/vital lung capacityprediction ratio. This was an analytic study with cross-sectional design. Data were taken from July 2014 until March 2015. There were 35 subjects who met the criteria. Patient identity, Medication Adherence Report Scale for Asthma score, and spirometry test were obtained directly from the samples. Variables including inhaled corticosteroid adherence, Forced Expiratory Volume (FEV1)/FEVprediction1 value and FEV1/Functional Vital Capacity (FVCpredictio)n ratio were observed. Marginal Homogeneity analysis of the data found significant proportion difference between inhaled corticosteroid adherence and Forced Expiratory Volume1/Forced Expiratory Volumeprediction1 value (p<0.001) and significant proportion difference between inhaled corticosteroid adherence and VEP1/KVP prediction ratio (p<0.001). Low adherence to inhaled corticosteroid therapy causes failure in inflammation suppression and leads to airway remodelling which in turn lead to deterioration of lung function
Glaucoma Therapy Using Diode Micropulse Trans-Scleral Cyclophotocoagulation Laser
No full textMicropulse Trans-Scleral Cyclophotocoagulation (MP-TSCPC) Laser omits a fractioned continuous wave diode laser that targets the ciliary body, which produces aqueous humor, in order to reduce the Intraocular Pressure (IOP). It is commonly used for refractory glaucoma that is difficult to treat using medication or surgery. This case series assessed the effect of MP-TSCPC in five glaucomatous eye from patients in Cipto Mangunkusumo Hospital in March-May 2017. An inclusion criteria in this case includes glaucomatous eyes with IOP more than 21 mmHg that is non-responsive to glaucoma medication or surgery. MP-TSCPC was considered successful if the IOP reduced more than 30% from the initial IOP. There were two absolute Primary Closed Angle Glaucoma (PCAG), two moderate and severe Primary Open Angle Glaucoma (POAG) and one secondary glaucoma case. Initial mean IOP was 36 ± 107 mmHg, in which one month after MPTSCPC the mean IOP reduced to 19,6 ± 5,1 mmHg. All of the patients in this case series had reduced IOP more than 30% with no loss of visual acuity nor phthisis bulbi. This method was successful in reducing IOP in glaucomatous eye without any side effect, only post-operative pain was complained by the patients after the procedure, in which it was relieved using analgesic medication
Efficacy Quotient of ESWL Piezolith Richard Wolf 3000 Machine in Patientswith Ureteral Stones in Dr. Cipto MangunkusumoNational Hospital 2008 - 2011
No full textExtracorporeal shockwave lithotripsy (ESWL) is the most common method of ureteral stone management. Since 2008, RSCM has ben using ESWL piezolith 3000 richard wolf and efficacy quotient (EQ) value have not yet studied. The study aims was to determine the efficacy quotient (EQ) of ESWL using piezolith richard wolf 3000 machine for ureteral stone by analyzing free-stone rate with location of stones, number of stones, stone burden, stone opacity, obstruction and kidney function. This cross sectional study was carried out in January 2008-December 2011, with multivariate analytical study. Ninety five percent (n=113) of 119 patients were declared stone free after the first ESWL. EQ value was 0.89. Stone size was the correlated with stone free rate (p<0.05). It is concluded that ESWL procedure using richard wolf piezolith 3000 machine patients had better EQ and better stone-free rate than previous reports using similar machines
Methods of Nucleic Acid Transfer as Basic Gene Therapy
No full textThe advancement of molecular biology provides benefit in the field of medicine to develop genetherapy. The aim of gene therapy is to repair the genetic damage or to replace damaged gene with thenormal gene. Delivery of gene is carried out by transfection technique, a technique to transfer nucleic acidinto eukaryote cells either using viral vectors (known as transduction), and also using non viral methodsuch as chemical substance, lipid and physical method. Some of the viral vectors used in the transductionare retrovirus, adenovirus, Adeno-associated virus (AAV) and Herpes Simplex Virus (HSV). The success oftransfection is determined by various factors which can be assessed using several reporters such as GreenFluorescence Protein (GFP)
Relative Expression of cMyc mRNA in Human Glioma Cells and its Relationship with the Degree of Malignancy
No full textRelative Expression of cMyc85Vol. 5, No. 2, Agustus 2017RESEARCH ARTICLERelative Expression of cMyc mRNA in Human Glioma Cells and its Relationship with the Degree of Malignancy Fidinny I. Hamid,1 Novi S. Hardiany,2* Febrial Hikmah,3 Syaiful Ichwan41Undergraduate Program FM Universitas Indonesia2Department of Biochemistry and Molecular Biology, FM Universitas Indonesia3Biomedical Sciences Program FM Universitas Indonesia4Department of Neurosurgery FM Universitas Indonesia -Dr Cipto Mangunkusumo General Hospital*Corresponding author: [email protected] 10 April 2016; Accepted 23 Agustus 2017DOI: 10.23886/ejki.5.7467AbstractPluripotency of cMyc genes may be one factor for the high glial cell differentiation in glioma thus it can become an alternative therapeutic target. The objective of the study is toanalyze the cMyc mRNA expression and its relationship with the degrees of glioma malignancy. This is a cross-sectional study from 20 glioma samples with different degree of malignancy from Dr. Cipto Mangunkusumo General Hospital, Jakarta during the period of October 2014 until February 2015. The mRNA obtained from glioma samples are converted to cDNA and then amplified. Relative quantification of cMyc mRNA expression is measured by calculating the cycle threshold values of Real Time RT PCR and normalized towards 18s rRNA to predict the relationship between the expression of cMyc and the degree of malignancy. The cMyc expression is increased in accordance with the tumor grade. The cMyc expressions in high grade glioma are 17424.23 folds higher when calibrated to the normal cell, whereas the genes in lower grade tumors are expressed with the rate of 6167.35. Although the values obtained are not statistically significant, this research has strengthened molecular diagnosis, specifically pluripotency as the factor that gives a greater prognostic relevance than the histopathologic diagnosis. As a conclusion, there is a clinical tendency where the relative mRNA expression was higher in in glioma cMyc high degrees compared with low-grade glioma, however it is not statistically significant
Job Stress in Nurses in Hospitals and Primary Health Care Facilities
No full textWork stress is related to accidents, violence in the workplace, organizational strain in the form of absenteeism, decreased work performance, increased injury rates and employee turnover. Nurses are professionals who have high risks of occupational stress. The purpose of this study is to get the prevalens of work stress in nurses in Indonesia and the that influencing factors, using the instrument of ENSS Indonesian version. ENSS is an instrument of stress assessment specifically designed for nurses. ENSS has been adapted to the specific working conditions and culture of Indonesia. A total of 124 nurses were recruited, coming from hospitals and primary healthcare facilities. The higher the level of work stress experienced by nurses, the higher the value of measurement. No relationship was found between demographic characteristics and the level of stress in each subscale in both groups of respondents. 
Retinal Nerve Fiber Layer and Macula Ganglion Cell Thickness in Eyes with Primary Angle Closure
No full textDecreased thickness of retina nerve fiber layer (RNFL) and ganglion cells of inner plexifom layer (GLIPL) in patients with glaucoma suspect can represent early detection of retina nerve defect. This retrospective study aims to determine the thickness of GLCIPL of patients with primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG). All patients who came to Department of Ophthalmology Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital from July to September 2015 were examined for the thickness of RNFL and GLIPL with ocular coherence tomography. Mann Whitney test was performed to analyse the thickness of RNFL and GLCIPL among 3 groups. Seventy six eyes form 40 patients within 75% female were enrolled with the distribution of 23 eyes with PACS, 15 eyes with PAC and 38 eyes with PACG. The mean (standard deviation) thickness of superior RNFL in PACS, PAC and PACG were 120.1(22.2)μm, 119.41(21.05)μm and 88.44(20.02) μm. Significant difference was found between PAC and PACG (p<0.001). The mean (SD) thickness of GLCIPL in the superior sector of PACS, PAC, and PACG were 82.1(6.2)μm, 80.50(6.4)μm and 69.5(4.3)μm, which the GLCIPL thickness between PAC and PACG was significant different (p<0.001). Primary angle closure glaucoma eyes showed the RNFL and GLCIPL was the thinnest, mean while in PAC eyes tend to thinner than PACS. Closed observation should be carried out in PAC eyes, especially in risk factors patients