Medical Journal of Indonesia

Parasitic infection and carcinogenesis

Agnes Kurniawan — 2024-02-23

[No abstract available]

Bone growth evaluation in collagen-hydroxyapatite implant locations using digital radiography: an animal model

Laela Sari — 2024-02-05

BACKGROUND Digital radiography has been used to evaluate the progress of bone growth with a collagen-hydroxyapatite implant in rabbit tibias. This study aimed to introduce digital radiography methods that provide comprehensive data availability for continuous information retrieval from the implant preparation to the cultivation period.

METHODS 38 digital radiographs were divided into 3 treatment groups, namely a single defect without implant (control), single-implant, and three-implant. Radiographic acquisitions were performed at preparation time and post-implantation from 0 to 56 days. Observations were concentrated on the implantation site, followed by creating a lateral profile. The prediction of implantation growth was determined using relative bone density (RBD) percentage.

RESULTS Based on the profile, the recovery process consisted of implant absorption and new bone tissue deposition. The absorption process was highly influenced by the defect size. In the control and single-implant groups, regardless of the different recovery processes, similar recovery results were observed 56 days post-implantation, with an RBD value of approximately 90%. Meanwhile, the three-implant group only had an RBD value of 62%.

CONCLUSIONS Radiography can evaluate absorption and new bone growth during implantation in New Zealand white rabbits. Radiographs, which can be obtained at any time during cultivation, offered more information on the recovery implantation process than the other method that relies on data obtained after sacrificing the animals.

DNA quality and quantity in adipose tissue: a comparison of the effects of bomb explosion

Leonardo — 2024-02-07

BACKGROUND Adipose tissue is often overlooked in DNA testing due to misconceptions about its DNA content. However, its shock-absorbing qualities may be useful for high-pressure scenarios like bomb blasts. This study aimed to evaluate DNA quality and quantity in adipose tissue affected by blasts compared to that in unaffected tissue.

METHODS 10 adipose tissue samples were taken from regions near and far from the blast, representing the blast-exposed and non-blast-exposed groups. The adipose tissue was stored at a low temperature for 5 days, after which an organic extraction method was applied. The purity of the DNA extract was assessed using a NanoDrop spectrophotometer, and its integrity was evaluated using 0.8% concentration gel electrophoresis at 60 V for 90 min. DNA typing was conducted using the GlobalFiler™ kit, and DNA quantity was determined with the Quantifiler™ Trio DNA Quantification kit.

RESULTS Of 20 DNA extracts from adipose tissue, all samples demonstrated purity, integrity, and complete typing results. Adequate integrity was found in 90% of samples in both groups. A 50% incidence of allele shifting was observed at the D7S820 locus within the blast-exposed group.

CONCLUSIONS DNA from blast-exposed adipose tissue exhibited no significant quality or quantity differences from non-blast-exposed tissue. This suggested adipose tissue’s potential as an alternative DNA source in a bomb explosion.

Effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation in rat lung tissue

Indah Puji Lestari — 2024-02-05

BACKGROUND A high-calorie diet increases the risk of obesity. Accumulation of fat causes inflammation, as seen by the increased ratio of pro- to anti-inflammatory macrophages in a high-calorie diet. The pro-inflammatory shift in macrophage polarization may result in hypoxia, fibrosis, emphysema, and asthma. This study aimed to determine the effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation.

METHODS This experimental study used in vivo test in 16 male Sprague-Dawley rats aged 10–12 weeks. The rats were divided into high-calorie and normal diet groups for 16 weeks. Obesity in rats was defined as having a body mass index (BMI) of >0.68 g/cm². Examination of lung fat accumulation was done through oil red O staining, while pro- to anti-inflammatory macrophage ratio was tested through CD11c and CD206 expressions by immunohistochemical method.

RESULTS The high-calorie diet group had higher BMI (0.72 [0.02] versus 0.62 [0.03]; p<0.001), lung fat accumulation (32.73 [10.55] versus 0.37 [0.38]; p<0.001), and pro- to anti-inflammatory macrophage ratio (0.83 [0.02] versus 0.24 [0.006]; p<0.001). The higher the fat accumulation, the higher the pro- to anti-inflammatory macrophage ratio (r = 0.933; p<0.001).

CONCLUSIONS The ratio of pro- to anti-inflammatory was higher in the high-calorie diet group, indicating polarization of macrophages toward pro-inflammatory macrophages.

Central line-associated bloodstream infection related with umbilical vein catheterization and peripherally inserted central catheter in preterm infants: a meta-analysis and systematic review

Indra Sandinirwan — 2023-12-29

BACKGROUND Central line-associated bloodstream infection (CLABSI) is a serious complication in preterm infants undergoing catheterization, including umbilical vein catheterization (UVC) and peripherally inserted central catheter (PICC) placement. This study aimed to compare the occurrence rate of CLABSI in preterm infants associated with UVC and PICC.

METHODS We conducted a systematic review and meta-analysis of studies published from 2000 to 2023 using a random effects model from 3 databases (PubMed, ScienceDirect, and Google Scholar). This study was registered with PROSPERO (CRD42023416471).

RESULTS Of 10 articles included in the systematic review, 2 were randomized controlled trials, 3 were prospective studies, and the rest were retrospective. A total of 3,962 UVCs and 2,922 PICCs were incorporated in the meta-analysis. The incidence rate of CLABSI in the UVC group was lower than that in the PICC group (1.23 versus 3.03 per 1,000 catheter days). However, the odds of developing CLABSI for infants with a UVC compared to those with a PICC were not statistically significant (odds ratio: 0.88, 95% confidence interval: 0.54–1.42).

CONCLUSIONS UVCs had a lower incidence rate of CLABSI than PICCs. Therefore, additional prospective studies are required to confirm these results.

Clinical risk factors of recurrent kidney stone disease: a cohort retrospective study in a tertiary referral hospital

Widi Atmoko — 2024-02-02

BACKGROUND Nephrolithiasis or kidney stone disease (KSD) is common worldwide. Despite various effective treatment strategies, KSD recurrence remains a problem. This study aimed to investigate the risk factors of KSD recurrence.

METHODS This retrospective cohort study used medical records of all patients who came to the Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, from January 2014 to December 2019, with asymptomatic and symptomatic KSD. Demographic information, clinical data, exposure to risk factors, and recurrent KSD diagnosis were collected. Univariate and multivariate analyses using logistic regression were performed to determine the significant risk factors.

RESULTS We reported 325 patients with a median age of 52 years. More than half of the patients were males and from Java. Staghorn stone dominated the KSD types found in 181 patients (55.7%). After undergoing percutaneous nephrolithotomy, 214 patients (65.8%) became stone-free. However, about 40.6% of them later developed recurrent KSD. The adjusted odds ratio in recurrent KSD were 1.46 (95% confidence interval [CI] 1.33–1.59) for younger age, 1.86 (95% CI 1.61–2.07) for overweight–obese, 2.13 (95% CI 1.89–2.31) for less fluid intake, 1.81 (95% CI 0.97–2.12) for routine tea consumption, 1.24 (95% CI 1.06–1.84) for routine vegetables consumption, 2.27 (95% CI 1.83–2.84) for a family history of KSD, and 2.08 (95% CI 1.77–2.39) for diabetes mellitus (DM).

CONCLUSIONS Most patients with recurrent KSD were younger, overweight/obese, had less fluid intake, a family history of KSD, and DM. Modifying a healthy lifestyle and a balanced diet is important to prevent KSD recurrence.

Five-year survival of triple-negative breast cancer and the associated clinicopathological factors: a study in an Indonesian tertiary hospital

Erwin Danil Yulian — 2024-02-23

BACKGROUND Triple-negative breast cancer (TNBC) has a worse rate of recurrence, survival, and overall survival. This study aimed to find the survival of TNBC and its clinicopathological factors at Cipto Mangunkusumo Hospital.

METHODS This study used survival analysis based on clinicopathology in 112 TNBC cases at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, diagnosed from 2009 to 2019. Kaplan–Meier and log-rank tests were used for the analysis. Bivariate and multivariate analyses using Cox regression were performed to obtain the hazard ratios (HRs).

RESULTS Most patients were diagnosed at the locally advanced stage (40.2%) compared to the early (33.0%) and metastatic stages (17.9%). The 5-year survival of TNBC was 81.2% with an HR value of 1.372 (p = 0.239) compared to luminal A. Bivariate analyses showed that the older age group with an HR of 6.845 (p = 0.013; CI 1.500–31.243), larger tumor size and extension (T) with an HR of 11.826 (p = 0.001; CI 2.707–51.653), broader regional lymph node involvement (N) with an HR of 8.929 (p = 0.019; CI 1.434–55.587), farther distant metastases (M) with an HR of 3.016 (p = 0.015; CI 1.242–7.322), more lymphovascular invasion with HR of 3.006 (p = 0.018; CI 1.209–7.477), and not operated-on cases with an HR of 9.165 (p<0.001; CI 3.303–25.434) significantly shortened the survival of TNBC. Multivariate analysis found that the only factor worsening the survival was not having surgery, with an HR of 6.175 (p<0.001; CI 1.518–34.288).

CONCLUSIONS The 5-year survival rate of TNBC patients was 81.2%. Not having surgery was a clinicopathological factor that worsened survival outcomes in TNBC.

Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones

Farhan Haidar Fazlur Rahman — 2024-02-23

BACKGROUND Ureteral stones are a common urological condition causing significant discomfort and morbidity. Medical expulsive therapy (MET) is a noninvasive approach to facilitate the passage of stones. This study aimed to compare the efficacy and safety of silodosin and tamsulosin as MET in patients with distal ureteral stones (DUS).

METHODS We searched CINAHL, Cochrane Library, PubMed, and ScienceDirect for randomized controlled trials (RCTs) on the administration of silodosin and tamsulosin for DUS. The primary outcomes analyzed were stone expulsion rates and expulsion times, measured as risk ratio (RR) and mean difference (MD), respectively. Statistical analyses were performed using Review Manager 5.4 and STATA 17.

RESULTS 14 RCTs comprising 1,535 patients (770 received silodosin) met the inclusion criteria. The silodosin group had notably higher stone expulsion rates (RR 1.20, 95% confidence interval [CI] 1.13–1.27, p<0.00001, I² = 37%), shorter expulsion times (MD −2.98, 95% CI −4.35–−1.62, p<0.01, I² = 85%), and fewer colicky pain episodes (MD −0.35, 95% CI −0.59–−0.10, p<0.01, I² = 83%) than the tamsulosin group. Retrograde ejaculation was the only adverse event that had a significant difference between both groups, statistically favoring tamsulosin (RR 1.61, 95% CI 1.12–2.33, p = 0.01, I² = 0%).

CONCLUSIONS Silodosin should be preferred as the first-line MET agent for DUS owing to its better expulsion rate, shorter stone expulsion time, and fewer colicky pain episodes. However, tamsulosin may be used in selected cases where patients experience retrograde ejaculation after receiving silodosin.

Commonly misdiagnosed round pneumonia in a child: a case report

Khai Quang Tran — 2023-12-27

Round pneumonia, a specific radiological finding in children, is often caused by Streptococcus pneumoniae; but it is easily misdiagnosed with some other diseases, causing many difficulties for clinicians. We described a case report of round pneumonia in a 9-year-old boy, with chest pain, following fever, productive cough, left-sided pulmonary consolidation syndrome, tachypnea, no chest indrawing, and a round homogenous lesion about 4 cm in diameter with a clear border in the left upper lobe position on chest X-ray. He was initially misdiagnosed as a lung tumor. He was correctly diagnosed with round pneumonia prior to pneumonectomy and was successfully treated with antibiotics. Therefore, it is important to carefully analyze round pneumonia cases that are often misdiagnosed, resulting in poor therapy.

Breaking the silence: unveiling the intersection of climate change and youth mental health in Indonesia

Fransiska Kaligis — 2024-02-01

In Southeast Asia, home to 362.2 million adolescents, the issue of adolescent mental health is aggravated by climate change. Indonesia, with its large youth population, faces a concerning prevalence of mental health challenges, including anxiety and depression. The intersection of climate change and youth mental health is manifested in the complex interaction of environmental hazards, societal changes, and psychological impact on adolescents and young people. Climate-related hazards exacerbate the existing and give rise to new mental health issues in youths, notably anxiety and post-traumatic stress disorder, and the emerging concepts such as eco-anxiety. Eco-anxiety, a novel concept, amplifies these concerns as youths grapple with climate change-related fears despite not yet being recognized as a formal mental disorder. To address this concern, immediate action should be taken, such as advocating for increased mental health support, youth involvement in climate initiatives, youth advisory committees, increased funding for mental health interventions, and the formulation of a youth-centered mental health policy. This call to action is crucial not only for Indonesia but also provides a framework for addressing similar global challenges, empowering adolescents to confront climate-induced mental health issues while nurturing their resilience.

Acknowledgment of Reviewers

Medical Journal of Indonesia — 2024-02-23

Front & Back Matter

Medical Journal of Indonesia — 2024-02-23