Medical Journal of Indonesia <p><a href="">ABOUT JOURNAL</a> | <a href=";hl=en" target="_blank&quot;">CITATIONS</a> | <a href="">STATISTIC</a> | <a href="/journal/index.php/mji/submit">SUBMISSIONS</a> | <a href="/journal/index.php/mji/indexing">ABSTRACTING &amp; INDEXING</a></p> <hr> <p>This quarterly medical journal is an official scientific journal of the Faculty of Medicine Universitas Indonesia in collaboration with German-Indonesian Medical Association (DIGM).</p> <p>Abstracted and indexed in: <a title="EBSCO host" href="" target="_blank" rel="noopener">EBSCO host</a>, <a title="ACI" href=";id=9" target="_blank" rel="noopener">ASEAN Citation Index</a>, <a title="BASE" href="*;refid=dclink" target="_blank" rel="noopener">BASE</a>, <a title="CABI" href=";letter=M#SerialsCited" target="_blank" rel="noopener">CABI</a>, <a title="CiteFactor" href="" target="_blank" rel="noopener">CiteFactor</a>, <a title="CNKI" href=";rt=Journal" target="_blank" rel="noopener">CNKI</a>, <a 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first publication with the work simultaneously licensed under a <a title="CC BY NC" href="" target="_self">Creative Commons Attribution-NonCommercial License</a> that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.</span></li> <li class="show">Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.</li> </ol> The importance of registry for systematic review and clinical trial <p>[None]</p> Vivian Soetikno Copyright (c) 2021 Vivian Soetikno 2021-06-30 2021-06-30 30 2 87 8 10.13181/mji.ed.215620 Analysis of SARS-CoV-2 nucleocapsid protein sequence variations in ASEAN countries <p><strong>BACKGROUND </strong>Nucleocapsid (N) protein is one of four structural proteins of SARS-CoV-2<span class="Apple-converted-space">&nbsp; </span>which is known to be more conserved than spike protein and is highly immunogenic. This study aimed to analyze the variation of the SARS-CoV-2 N protein sequences in ASEAN countries, including Indonesia.</p> <p><strong>METHODS </strong>Complete sequences of SARS-CoV-2 N protein from each ASEAN country were obtained from Global Initiative on Sharing All Influenza Data (GISAID), while the reference sequence was obtained from GenBank. All sequences collected from December 2019 to March 2021 were grouped to the clade according to GISAID, and two representative isolates were chosen from each clade for the analysis. The sequences were aligned by MUSCLE, and phylogenetic trees were built using MEGA-X software based on the nucleotide and translated AA sequences.</p> <p><strong>RESULTS </strong>98 isolates of complete N protein genes from ASEAN countries were analyzed. The nucleotides of all isolates were 97.5% conserved. Of 31 nucleotide changes, 22 led to amino acid (AA) substitutions; thus, the AA sequences were 94.5% conserved. The phylogenetic tree of nucleotide and AA sequences shows similar branches. Nucleotide variations in clade O (C28311T); clade GR (28881–28883 GGG&gt;AAC); and clade GRY (28881–28883 GGG&gt;AAC and C28977T) lead to specific branches corresponding to the clade within both trees.</p> <p><strong>CONCLUSIONS </strong>The N protein sequences of SARS-CoV-2 across ASEAN countries are highly conserved. Most isolates were closely related to the reference sequence originating from China, except the isolates representing clade O, GR, and GRY which formed specific branches in the phylogenetic tree.</p> Mochammad Rajasa Mukti Negara Ita Krissanti Gita Widya Pradini Copyright (c) 2021 Mochammad Rajasa Mukti Negara, Ita Krissanti, Gita Widya Pradini 2021-06-18 2021-06-18 30 2 89–95 89–95 10.13181/mji.oa.215304 A systematic review of intracavernosal injection of mesenchymal stem cells for diabetic erectile dysfunction <p><strong>BACKGROUND </strong>As current erectile dysfunction (ED) treatments are limited, other treatment such as stem cells should be explored. Hence, this study aimed to review the sources, method of administration, and therapeutic effect of mesenchymal stem cells (MSCs) for diabetic ED treatment.</p> <p><strong>METHODS </strong>All relevant articles regarding the use of MSCs for diabetic ED were searched in PubMed and Google Scholar databases from December 15, 2019 to January 1, 2020 published in the past 10 years. The keywords were “mesenchymal stem cells” and “diabetic ED”. The selection and critical appraisal of the studies were discussed. Diabetic ED was evaluated for functional and structural outcome. Functional outcome in animal studies was assessed by intracavernosal pressure/mean arterial pressure (ICP/MAP) ratio, meanwhile the structural outcome was done microscopically. In human study, the assessments were done using international index of erectile function score (IIEF-5) to erection hardness score and penile Doppler ultrasonography.</p> <p><strong>RESULTS </strong>There were 10 animal studies and 3 human studies. The studies used MSCs from adipose (n = 6), bone marrow (n = 4), placenta (n = 1), umbilical cord (n = 1), and muscle tissue (n = 1). The MSCs were administrated through intracavernosal injection in all studies. In all animal studies, functional outcome was improved, shown in higher ICP/MAP ratio. Microscopically, there were an increase of cavernosal endothelial cells, vascular endothelial growth factor, nitric oxide synthase, and smooth muscle cells. In human studies, IIEF-5 and erection hardness score were improved. Peak systolic velocity was also higher.</p> <p><strong>CONCLUSIONS </strong>MSCs may be a promising therapy for diabetic ED; however, long-term safety concerns still need further investigations.</p> Gampo Alam Irdam Febriyani Nur Rasyid Akmal Taher Copyright (c) 2021 Gampo Alam Irdam, Febriyani, Nur Rasyid, Akmal Taher 2021-05-19 2021-05-19 30 2 96–105 96–105 10.13181/mji.oa.204475 Efficacy and safety of platinum chain and gold weight implants for paralytic lagophthalmos: a systematic review <p><strong>BACKGROUND </strong>Surgery has been proposed as a treatment of paralytic lagophthalmos. However, no consensus has been reached on the best treatment. This study was aimed to investigate the efficacy and safety between platinum chain and gold weight implants to treat paralytic lagophthalmos.</p> <p><strong>METHODS </strong>This study used all randomized controlled trials or observational studies (prospective or retrospective) using platinum chain and gold weight implants for paralytic lagophthalmos surgery that were published from 1990 to 2020 in the PubMed, Cochrane, and Google Scholar databases. Efficacy was indicated by the reduction of ≥3 in lagophthalmos, and safety was measured based on complications after surgery.</p> <p><strong>RESULTS </strong>The efficacy of platinum chain and gold weight implants were 60–100% and 10–93.6%, respectively. The complications of platinum chain implant were 0–2.9% of extrusion and 0–3.3% of migration. However, gold weight implant had 0–13.3% of migration.</p> <p><strong>CONCLUSIONS </strong>Both platinum chain and gold weight implants have similar efficacy to treat paralytic lagophthalmos. However, gold weight implant has a higher rate of complication.</p> Yunia Irawati Tjahjono Darminto Gondhowiardjo Hardyanto Soebono Copyright (c) 2021 Yunia Irawati, Tjahjono Darminto Gondhowiardjo, Hardyanto Soebono 2021-06-30 2021-06-30 30 2 106 15 10.13181/mji.oa.214683 Delivery routes in pregnancy with COVID-19 and the risk of intrapartum vertical transmission: a meta-analysis <p><strong>BACKGROUND </strong>Mode of delivery has become an important highlight in managing pregnancy with coronavirus disease 2019 (COVID-19) due to the possible risk of viral transmission from mother to baby, especially during the peripartum period. This study aimed to review the mode of delivery and the possible risk of vertical transmission related to delivery routes in pregnant women with COVID-19.</p> <p><strong>METHODS </strong>Literature research was conducted using PubMed, Scopus, Embase, and EBSCO database with the following keywords: SARS-CoV-2, COVID-19, pregnancy, vertical transmission, and delivery. The extracted data were as follows: author, country, study design number of cases, maternal age, mode of delivery, and the SARS-CoV-2 status in neonates.</p> <p><strong>RESULTS </strong>Of 11 studies found, vaginal birth was reported in 218 cases (34.53%) and cesarean delivery was reported in 385 women (65.47%). The indication for cesarean delivery was majority due to COVID-19 related condition (53.61%). In total, 8 neonates who confirmed positive for COVID-19 by real-time polymerase chain reaction assay were reported. The pooled odds ratio (95% confidence interval) for SARS-CoV-2-positive neonates in cesarean delivery compared with vaginal birth was 0.622 (0.237–1.633) with <em>p</em> = 0.335.</p> <p><strong>CONCLUSIONS </strong>Cesarean delivery is more common than vaginal delivery in patient with SARS-CoV-2 infection. Any delivery route is not related to possible risk of intrapartum vertical transmission, and cesarean delivery should be carried out based on the obstetric indication.</p> Razmaeda Sarastry Crismanto Layarta Ussisti Aladini Besari Adi Pramono Copyright (c) 2021 Razmaeda Sarastry, Crismanto Layarta, Ussisti Aladini, Besari Adi Pramono 2021-06-30 2021-06-30 30 2 116 22 10.13181/mji.oa.214779 Accuracy of pediatric advanced life support method for predicting the depth of endotracheal tube in Indonesian children <p><strong>BACKGROUND</strong> The pediatric advanced life support (PALS) method can predict the depth of endotracheal tube (ETT) in pediatric patients easily, but it has limitations due to variations in the children’s characteristics, especially the racial consideration. This study compared the accuracy of ETT depth prediction based on the PALS methods in Indonesian children.</p> <p><strong>METHODS</strong> Patients aged 0–12 years, who underwent elective surgery with oral intubation, were recruited consecutively based on their ages: 0–24 months and 25 months–12 years for this cross-sectional study in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to August 2014. Bland–Altman analysis was used to compare the two measurement methods: PALS method to predict the ETT depth accuracy and auscultation method to confirm the position of the ETT. Furthermore, correlation analysis was done to examine the relationship of age, weight, height, and ETT internal diameter with ETT depth.</p> <p><strong>RESULTS</strong> 50 patients were recruited in each group. Bland–Altman test of ETT depth in the 0–24 months age group showed a 1.18 cm mean difference from confirmation using the auscultation method (limits of agreement −0.71 to 3.08). The 25 months–12 years age group showed a 1.11 cm mean difference with limits of agreement were −0.95 to 3.17 from confirmation using the auscultation method. Age and weight had the strongest correlation value to ETT depth in the 25 months–12 years age group (<em>R</em><sup>2</sup> = 62.3%).</p> <p><strong>CONCLUSIONS</strong> The PALS method is inaccurate for predicting ETT depth in Indonesian children aged 0–12 years old compared with the auscultation method.</p> Andi Ade Wijaya Ramlan Adhrie Sugiharto Agus Mutakim Copyright (c) 2021 Andi Ade Wijaya, Adhrie Sugiharto, Agus Mutakim 2021-06-11 2021-06-11 30 2 123–8 123–8 10.13181/mji.oa.203835 Treatment delay of cancer patients in Indonesia: a reflection from a national referral hospital <p><strong>BACKGROUND</strong> Cancer is a complex disease requiring a multidisciplinary approach in establishing prompt diagnosis and treatment. Treatment in a timely manner is crucial for the outcomes. Hence, this study aimed to provide information on treatment delay including patient and provider delays and its associated factors.</p> <p><strong>METHODS</strong> Cancer patients were recruited conveniently in the outpatient clinic of Department of Radiation Oncology, Cipto Mangunkusumo Hospital, Indonesia between May and August 2015. All patients were asked to fill a questionnaire and interviewed in this cross-sectional study. Treatment delay was explored and categorized into patient delay and provider delay. Patient delay could be happened before (patient-delay-1) or after (patient-delay-2) the patient was diagnosed with cancer. Provider delay could be due to physician, system-diagnosis, and system-treatment delays.</p> <p><strong>RESULTS</strong> Among 294 patients, 86% patient had treatment delay. Patient delay was observed in 153 patients, and 43% of them had a history of alternative treatment. An older age (<em>p</em> = 0.047), lower educational level (<em>p</em> = 0.047), and history of alternative treatment (<em>p</em>&lt;0.001) were associated with patient delay. Meanwhile, 214 patients had provider delay, and 9%, 36%, and 80% of them experienced physician, system-diagnosis, and system-treatment delays, respectively. All types of provider delay were associated with patient delay (<em>p</em>&lt;0.001).</p> <p><strong>CONCLUSIONS</strong> Most of the patient had treatment delay caused by either patient or provider.</p> Soehartati Gondhowiardjo Sugandi Hartanto Sigit Wirawan Vito Filbert Jayalie Ida Ayu Putri Astiti Sonar Soni Panigoro Sri Mutya Sekarutami Andhika Rachman Adang Bachtiar Copyright (c) 2021 Soehartati Gondhowiardjo, Sugandi Hartanto, Sigit Wirawan, Vito Filbert Jayalie, Ida Ayu Putri Astiti, Sonar Soni Panigoro, Sri Mutya Sekarutami, Andhika Rachman, Adang Bachtiar 2021-06-30 2021-06-30 30 2 129 37 10.13181/mji.oa.204296 Impact of metabolic syndrome on lower urinary tract symptoms in patients with benign prostate hyperplasia <p><strong>BACKGROUND </strong>Studies evaluating the relationship between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) in men with benign prostate hyperplasia (BPH) are lacking in Indonesia. This study aimed to discover the association of LUTS and MetS in men with BPH.</p> <p><strong>METHODS</strong> Subjects who underwent biopsy were recruited from Cipto Mangunkusumo Hospital, Jakarta, Indonesia from January 2014 to January 2018, but only men who had biopsy-proven BPH were included. Body mass index, waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein, prostate volume (PV), and international prostate symptom score (IPSS) were collected before the biopsy. MetS criteria were based on the National Cholesterol Education Program Adult Treatment Panel III. IPSS was assessed for LUTS and consisted of irritative and obstructive symptoms and quality of life (QoL). Independent <em>t</em>-test or Mann–Whitney test was used to analyze numerical data.</p> <p><strong>RESULTS </strong>Of 227 men with biopsy-proven BPH, 87 (38.3%) were diagnosed with MetS. PV was similar in men with or without MetS (54.4 [20.3–100] <em>versus</em> 49.9 [19.5–100] cm<sup>3</sup>, <em>p</em> = 0.239). Men with MetS generally had more LUTS (15 [1–30] <em>versus</em> 11 [0–35], <em>p</em> = 0.005), more irritative symptoms (8 [0–20] <em>versus</em> 6 [0–20], <em>p</em> = 0.007), and lower QoL (4 [0–6] <em>versus</em> 3 [0–6], <em>p</em> = 0.018).</p> <p><strong>CONCLUSIONS </strong>BPH patients with MetS had greater LUTS, particularly irritative symptoms and QoL score.</p> Dyandra Parikesit Fiastuti Witjaksono Chaidir Arif Mochtar Nur Rasyid Agus Rizal Ardy Hariandy Hamid Copyright (c) 2021 Dyandra Parikesit, Fiastuti Witjaksono, Chaidir Arif Mochtar, Nur Rasyid, Agus Rizal Ardy Hariandy Hamid 2021-06-30 2021-06-30 30 2 138 42 10.13181/mji.oa.214256 Reliability and validity of the Indonesian version of the World Health Organization quality of life-old (WHOQOL-OLD): a Rasch modeling <p><strong>BACKGROUND </strong>The World Health Organization (WHO) has developed the WHOQOL-OLD instrument, specifically measuring the quality of life (QoL) of the elderly, but the Indonesian version of the WHOQOL-OLD has not been available.</p> <p><strong>METHODS </strong>This study was conducted in 2 steps. First, the instrument was translated and pre-tested to 8 elderly respondents from 2 villages in Lembang, West Java, Indonesia. Second, Rasch modeling was used as implemented by the Winstep version 3.73 software to analyze the reliability, validity, value of separation, Wright map analysis, item-fit order, and differential item functioning in elderly respondents (aged ≥60 years old and did not have dementia) from 6 community health centers in Bangka Regency, Bangka Belitung, Indonesia from July to December 2018.</p> <p><strong>RESULTS </strong>Overall, the Indonesian version of the WHOQOL-OLD demonstrated good reliability and validity tests in 175 respondents. The overall value of the person reliability was 0.73 with the Cronbach’s alpha of 0.75, and the value of the item reliability was 0.97. A misconception and bias occurred in the death and dying facet, especially in the demographic categories of age, gender, and marital status.</p> <p><strong>CONCLUSIONS </strong>The Indonesian version of the WHOQOL-OLD module has good psychometric properties to measure the QoL of the Indonesian older population. However, further studies involving various ethnicities, religious groups, and districts in Indonesia should be carried out before the module can be used throughout the country.</p> Sharon Gondodiputro Guswan Wiwaha Melly Lionthina Deni Kurniadi Sunjaya Copyright (c) 2021 Sharon Gondodiputro, Guswan Wiwaha, Melly Lionthina; Deni Kurniadi Sunjaya 2021-06-30 2021-06-30 30 2 143 51 10.13181/mji.oa.215065 A case report of acute Marchiafava-Bignami disease: a rare clinical entity in chronic alcoholism <p>Marchiafava‑Bignami disease (MBD) is a rare neurological disease often associated with a chronic consumption of alcohol and malnutrition, which is characterized by a demyelination and necrosis of the corpus callosum. We present a case of a 21-year-old male with chronic alcoholism who presented with an acute altered sensorium and seizure, which were initially treated as meningoencephalitis. His persistent poor Glasgow coma scale score and ideomotor recovery with encephalitic changes on his electroencephalogram prompted urgent magnetic resonance imaging (MRI) of his brain, which revealed extensive symmetrical hyperintensities in the corpus callosum. The diagnosis of MBD was made because of the typical MRI findings and after the exclusion of other possible diagnosis. The patient was promptly treated with a parenteral thiamine and showed a good recovery at 3 months follow-up. This case highlights the importance of diagnosing and recognizing MBD in a patient with chronic alcoholism as prompt treatment could prevent irreversible damage, which could carry high morbidity.</p> Mohd Arif Abdul Malik Khiew Abdul Hanif Khan Yusof Khan Wei Chao Loh Liyana Najwa Inche Mat Peck Kee Chia Wan Aliaa Wan Sulaiman Fan Kee Hoo Hamidon Basri Copyright (c) 2021 Mohd Arif Abdul Malik Khiew, Abdul Hanif Khan Yusof Khan, Wei Chao Loh, Liyana Najwa Inche Mat, Peck Kee Chia, Wan Aliaa Wan Sulaiman, Fan Kee Hoo, Hamidon Basri 2021-02-05 2021-02-05 30 2 152–6 152–6 10.13181/ Neurological manifestations of COVID-19: a clinical approach <p>Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 which attacks the respiratory tract and has been declared a global pandemic by the World Health Organization. The disease has a very wide clinical spectrum which can be manifested as asymptomatic to critical conditions. SARS-CoV-2 shows a neurotropism proven by its identification in the cerebrospinal fluid and brain vascular endothelial. The complete mechanism of how the virus invades the human nervous system is yet to be identified. Thus, every neurologist needs to follow the progressivity of COVID-19 symptoms involving the nervous system.</p> Ni Made Susilawathi Kumara Tini Ida Ayu Sri Wijayanti Putu Lohita Rahmawati Dewa Putu Wisnu Wardhana Dewa Gde Purwa Samatra Anak Agung Raka Sudewi Copyright (c) 2021 Ni Made Susilawathi, Kumara Tini, Ida Ayu Sri Wijayanti, Putu Lohita Rahmawati, Dewa Putu Wisnu Wardhana, Dewa Gde Purwa Samatra, Anak Agung Raka Sudewi 2021-05-03 2021-05-03 30 2 157–65 157–65 10.13181/mji.rev.204821 Gastrointestinal disorders in COVID-19 patients: a great imitator <p>Up to this point, the coronavirus disease 2019 (COVID-19) pandemic is still ongoing. Some studies with a large number of cases have reported its clinical manifestations, concluding that the disease is a great imitator. Patients may present with symptoms other than the main symptoms of respiratory tract infections, such as diarrhea, abdominal pain, nausea, or vomiting, which may sometimes cause a delayed treatment in managing COVID-19 patients. Reports of various hospitals have also demonstrated gastrointestinal complaints as a clinical manifestation in those patients. The patients may come with gastrointestinal symptoms as their early clinical manifestation, or the gastrointestinal symptoms may be found in hospitalized COVID-19 patients, which indeed can be explained since the SARS-CoV-2, an etiologic agent of COVID-19 infection, can obviously be found along the gastrointestinal tract. Hence, the virus can be found in fecal and anal, and therefore, rectal swabs can be used as a diagnostic tool for COVID-19 infection.</p> Ari Fahrial Syam Copyright (c) 2021 Ari Fahrial Syam 2021-01-20 2021-01-20 30 2 166–9 166–9 10.13181/mji.bc.204960 High visibility of outdoor tobacco advertisements around health facilities in East Java, Indonesia: a geospatial analysis <p><strong>BACKGROUND</strong> Indonesian tobacco control initiatives are minimal despite having the second-highest adult male smoking prevalence in the world, with less than 10% of districts/cities banning outdoor tobacco advertisements. This research aimed to provide evidence on the presence of outdoor tobacco advertisements near health facilities in Surabaya where there is no outdoor advertising ban.</p> <p><strong>METHODS</strong> Data collection was carried out in Surabaya from October to November 2018. Data of government (public) and private health facilities were obtained from the city health office. Two spatial data analyses were carried out: a buffer analysis near the healthcare facilities and an advertisement hotspot analysis using ArcMap 10.6.</p> <p><strong>RESULTS</strong> From 308 tobacco advertisements that were identified, there were billboards (63%), banners (31%), and videoboards (7%). Of 142 public and 1,242 private health facilities in Surabaya, 26% and 31% had advertisements within 300 m and 63% and 70% were within advertisement hotspots, respectively. Furthermore, 5% of advertisements were within 300 m from public health facilities and 21% of them were within 300 m from private health facilities.</p> <p><strong>CONCLUSIONS</strong> Outdoor tobacco advertisements were widespread throughout the city, prominently around public and private health facilities.</p> Hario Megatsari Ilham Akhsanu Ridlo Dian Kusuma Copyright (c) 2021 Hario Megatsari, Ilham Akhsanu Ridlo, Dian Kusuma 2021-04-28 2021-04-28 30 2 170–4 170–4 10.13181/mji.bc.204177 Front & Back Matter Medical Journal of Indonesia Copyright (c) 2021 2021-07-01 2021-07-01 30 2