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 struggles of regional journals to gain international visibility <p>[No abstract available]</p> Sri Widia Azraki Jusman Copyright (c) 2022 Sri Widia Azraki Jusman 2022-08-31 2022-08-31 31 2 85 6 10.13181/mji.ed.226297 Current condition of social security administrator for health (BPJS <em>Kesehatan</em>) in Indonesia: contextual factors that affected the national health insurance <p>[No abstract available]</p> Ali Ghufron Mukti Citra Jaya Rizki Lestari Suhardi Copyright (c) 2022 Ali Ghufron Mukti, Citra Jaya, Rizki Lestari Suhardi 2022-08-26 2022-08-26 31 2 87 90 10.13181/ Novel and simple method using cable ties to induce intestinal strangulation in a rat model <p><strong>BACKGROUND</strong> The pathogenesis of intestinal fibrosis after strangulation in abdominal surgery is not fully understood. Developing an experimental and reliable method is needed to overcome this problem. This study aimed to develop an effective method for intestinal strangulation leading to fibrosis, which might induce intestinal obstruction.</p> <p><strong>METHODS</strong> This study was conducted from 2018 to 2019 at the Department of Pharmacology, Faculty of Medicine, Universitas Indonesia. A total of 24 Sprague Dawley rats were used in this study. Artificial intestinal strangulation using cable ties made of durable plastic, which is generally used to ligate objects, was applied, and rats were further classified into control, 6-hour, and 24-hour strangulation groups. At the end of the study, the rats were sacrificed, intestinal tissues were collected, and histomorphological changes were observed using hematoxylin and eosin stain. Moreover, Masson’s trichome staining was used to assess collagen density.</p> <p><strong>RESULTS</strong> Median collagen density score of the 24-hour strangulation group was higher than the control. A significant difference in collagen density was found between the submucosal layer of the 24-hour strangulation group and the control (45.4 [11.4] <em>versus</em> 32.4 [14.0], <em>p</em>&lt;0.001) and between the mucosa of the 6- and 24-hour strangulation groups and the control (26.9 [17] <em>versus</em> 6.46 [4.3], <em>p</em> = 0.01 and 24.9 [8] <em>versus</em> 6.46 [4.3], <em>p</em> = 0.004, respectively).</p> <p><strong>CONCLUSIONS</strong> The simple use of cable ties adequately promotes intestinal strangulation.</p> Agi Satria Putranto Fransiscus Dhyanagiri Suyatna Vivian Soetikno Yefta Moenadjat Copyright (c) 2022 Agi Satria Putranto, Fransiscus Dhyanagiri Suyatna, Vivian Soetikno, Yefta Moenadjat 2022-06-13 2022-06-13 31 2 91 5 10.13181/mji.oa.225799 Thromboelastographic method for early decision on anticoagulant therapy in moderate to severe COVID-19 patients <p><strong>BACKGROUND</strong> Coagulopathy is a serious COVID-19 complication that requires rapid diagnosis and anticoagulation. This study aimed to determine the role of coagulation examination using thromboelastography (TEG) on the decision-making time of anticoagulant therapy in COVID-19 patients and its clinical outcomes.</p> <p><strong>METHODS</strong> A prospective observational study was conducted in Cipto Mangunkusumo Hospital, Indonesia, from October 2020 to March 2021. We consecutively recruited moderate and severe COVID-19 patients in the high and intensive care units. Turnaround time, time to anticoagulant therapy decision, and clinical outcomes (length of stay and 30-day mortality) were compared between those who had a TEG examination in addition to the standard coagulation profile examination (thrombocyte count, PT, APTT, D-dimer, and fibrinogen) and those who had only a standard coagulation profile laboratory examination.</p> <p><strong>RESULTS</strong> Among 100 moderate to severe COVID-19 patients recruited, 50 patients had a TEG examination. The turnaround time of TEG was 45 (15–102) min versus 82 (19–164) min in the standard examination (<em>p</em>&lt;0.001). The time to decision was significantly faster in the TEG group than the standard group (75 [42–133] min versus 184 [92–353] min, <em>p</em>&lt;0.001). The turnaround time was positively correlated with time to decision (r = 0.760, <em>p</em>&lt;0.001). However, TEG did not improve clinical outcomes such as length of stay (10.5 [3–20] <em>versus</em> 9 [2–39] days) and 30-day mortality (66% <em>versus</em> 64%).</p> <p><strong>CONCLUSIONS</strong> The TEG method significantly enables quicker decision-making time for moderate to severe coagulation disorder in COVID-19 patients.</p> Komang Ayu Ferdiana Andi Ade Wijaya Ramlan Ratna Farida Soenarto Anas Alatas Copyright (c) 2022 Komang Ayu Ferdiana, Andi Ade Wijaya Ramlan, Ratna Farida Soenarto, Anas Alatas 2022-07-14 2022-07-14 31 2 96 101 10.13181/mji.oa.225890 Efficacy and side effects of Blacksoap® as adjuvant therapy of scabies: a randomized control trial <p><strong>BACKGROUND</strong> Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy.</p> <p><strong>METHODS</strong> This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-parametric tests.</p> <p><strong>RESULTS</strong> The cure rate of the intervention group was lower than the control in the first week with 75% <em>versus</em> 81% but higher in the fourth week with 97% <em>versus</em> 92%. There was no significant difference in the scores of pruritus VAS and TEWL, as well as side effects between the two groups.</p> <p><strong>CONCLUSIONS</strong> The efficacy and safety of scabies treatment were similar between Blacksoap® and placebo adjunctive to standard treatment. Blacksoap®, on top of standard scabies treatment, might benefit patients by providing a higher cure rate in 4 weeks without any considerable adverse effects.</p> Lidwina Anissa Wresti Indriatmi Larisa Paramitha Wibawa Sandra Widaty Copyright (c) 2022 Lidwina Anissa, Wresti Indriatmi, Larisa Paramitha Wibawa, Sandra Widaty 2022-07-14 2022-07-14 31 2 102 7 10.13181/mji.oa.225965 Intravenous magnesium sulfate <em>versus</em> intravenous meperidine to prevent shivering during spinal anesthesia <p><strong>BACKGROUND</strong> Shivering is a frequent event during neuraxial anesthesia due to impaired central and peripheral thermoregulation control. Meperidine and MgSO<sub>4</sub> are effective in lowering the shivering threshold. Hence, this study aimed to compare the efficacy of MgSO<sub>4</sub> and meperidine to prevent shivering in patients undergoing spinal anesthesia.</p> <p><strong>METHODS</strong> This was a double-blind randomized clinical trial of 100 patients divided into 2 groups. One group had MgSO<sub>4</sub> 30 mg/kg, and the other group had meperidine 0.5 mg/kg intravenously in 100 ml of 0.9% NaCl before undergoing spinal anesthesia. Participants were non-pregnant patients aged 18–65 years and had physical status I or II (based on the American Society of Anesthesiologist). Shivering was considered significant if it occurred in grade 3 or 4. Patient characteristics, shivering degree, tympanic membrane temperature, and side effects were recorded.</p> <p><strong>RESULTS</strong> Shivering occurred 10% in the MgSO<sub>4</sub> group and 19% in the meperidine group, with <em>p</em> = 0.23. Both groups had similar side effects of nausea, vomiting, and hypotension.</p> <p><strong>CONCLUSIONS</strong> MgSO<sub>4</sub> 30 mg/kg was not superior to meperidine 0.5 mg/kg intravenously in preventing shivering in patients undergoing spinal anesthesia.</p> Pryambodho Sidharta Kusuma Manggala Magdalena Sihombing Copyright (c) 2022 Pryambodho, Sidharta Kusuma Manggala, Magdalena Sihombing 2022-07-05 2022-07-05 31 2 108 14 10.13181/mji.oa.225886 Kidney function profile before, during, and after Ramadan fasting in healthy elderly: a prospective cohort study <p><strong>BACKGROUND</strong> Kidney function profile is one of the important parameters in determining the health of the elderly. In Indonesia, no study has been conducted on kidney function profile during Ramadan fasting to determine the safety of Ramadan fasting in the elderly. This study aimed to determine the kidney function profile in the elderly who fasted during Ramadan.</p> <p><strong>METHODS</strong> This study used a prospective cohort design. The inclusion criteria were elderly aged &gt;60 years undergoing Ramadan fasting in Jatinegara, Jakarta from April to July 2019. Patients with end-stage renal failure who had an acute infection, hypertension crisis, or refused to participate in the study were excluded. Patients who did not fast for 3 consecutive days were dropped out. The kidney function profile was calculated by the estimated glomerular filtration rate (eGFR) using the CKD-EPI formula 1 week before the first day of Ramadan, 3 weeks after the first day of fasting, and 2 weeks after the last day of fasting. Decreased eGFR was defined as having a minimum of 20% eGFR decline during or after the fasting period. Bivariate analysis was performed using McNemar or Cochran tests.</p> <p><strong>RESULTS</strong> 2 patients had eGFR decline during fasting, and 7 patients had eGFR decline after fasting. The median eGFR before, during, and after fasting were 81.5, 88.7, and 76.8 ml/min/1.73 m², respectively. A total of 1.4% of subjects had decreased eGFR during Ramadan, while 9.1% had decreased eGFR after Ramadan. However, the changes were not statistically significant.</p> <p><strong>CONCLUSIONS</strong> Although most elderly had lower eGFR following Ramadan fasting compared to before and during Ramadan, only individuals with several comorbidities had significant changes of kidney function.</p> Murdani Abdullah Edy Rizal Wahyudi Pringgodigdo Nugroho Andi Alfian Copyright (c) 2022 Murdani Abdullah, Edy Rizal Wahyudi, Pringgodigdo Nugroho, Alfian Andi 2022-08-31 2022-08-31 31 2 115 9 10.13181/mji.oa.225730 A case report of tuberculous constrictive pericarditis as a sole manifestation of tuberculosis in a male adolescent <p>Constrictive pericarditis is a rare type of pericardial disease that can be caused by various factors. Tuberculosis (TB) is one of the most common causes of this abnormality in Indonesia. Interestingly, tuberculous constrictive pericarditis can occur in the absence of acute pericarditis, pulmonary, or extrapulmonary TB. This case described a male adolescent with refractory right-sided heart failure symptoms who developed a rapidly progressive tuberculous constrictive pericarditis. Various imaging modalities, such as echocardiography, chest computed tomography (CT) scan, cardiac magnetic resonance imaging, and incidental PET/CT scan, were used to diagnose the pericardial abnormality. Histopathological findings in pericardial tissues confirmed the diagnosis. Complete surgical pericardiectomy, in conjunction with anti-TB drugs, diuretics, and colchicine, resulted in a significant clinical improvement.</p> Michael Jaya Arif Sejati Hariadi Hadibrata Leonardo Suciadi Copyright (c) 2022 Michael Jaya, Arif Sejati, Hariadi Hadibrata, Leonardo Suciadi 2022-06-28 2022-06-28 31 2 120 5 10.13181/ Placenta accreta spectrum disorder in a primigravida with angular pregnancy: a case report <p>Placenta accreta spectrum (PAS) is characterized by abnormal invasion of placental tissue into the underlying uterine muscles and has an incidence of 1/533–1/251. The incidence of complications includes uterine rupture (14–29%), PAS (6–10%), and retained placenta or incomplete placenta removal (4%). Here, we described a rare case of PAS and angular pregnancy, including how to diagnose and manage it preoperatively. A 32-year-old primigravida diagnosed at 24 weeks of gestation with a right angular pregnancy was admitted due to preterm premature rupture of membrane (PPROM) with a singleton fetus. We decided to perform hysterotomy because of the PPROM and intrauterine infection. Intraoperatively, we found PAS in the right angular pregnancy; therefore, we performed uterine conservative management with wedge resection on the right uterine fundus. Intraoperative bleeding was 1,600 cc. Histopathological examination revealed placenta increta. The maternal prognosis was good, while the fetus was poor, with an APGAR score of 1/1/0.</p> Abarham Martadiansyah Nuswil Bernolian Putri Mirani Peby Maulina Lestari Citra Dewi Wim Theodorus Pangemanan Ahmad Kurdi Syamsuri Muhammad Hatta Ansori Cindy Kesty Copyright (c) 2022 Abarham Martadiansyah, Nuswil Bernolian, Putri Mirani, Peby Maulina Lestari, Citra Dewi, Wim Theodorus Pangemanan, Ahmad Kurdi Syamsuri, Muhammad Hatta Ansori, Cindy Kesty 2022-08-31 2022-08-31 31 2 126 31 10.13181/ A review of pathobiological mechanisms and potential application of medicinal plants for vascular aging: focus on endothelial cell senescence <p>Endothelial cell (EC) senescence plays a pivotal role in aging and is essential for the pathomechanism of aging-related diseases. Drugs targeting cellular senescence, such as senolytic or senomorphic drugs, may prevent aging and age-related diseases, but these bullets remain undeveloped to target EC senescence. Some medicinal plants may have an anti-senescence property but remain undiscovered. Deep learning has become an emerging approach for drug discovery by simply analyzing cellular morphology-based deep learning. This precious tool would be useful for screening the herb candidate in senescent EC rejuvenescence. Of note, several medicinal plants that can be found in Indonesia such as <em>Curcuma longa</em> L., <em>Piper retrofractum</em>, <em>Guazuma ulmifolia Lam</em>, <em>Centella asiatica</em> (L.) Urb., and <em>Garcinia mangostana</em> L. might potentially possess an anti-senescence effect. This review highlighted the importance of targeting EC senescence, the use of deep learning for medicinal plant screening, and some potential anti-senescence plants originating from Indonesia.</p> Agian Jeffilano Barinda Wawaimuli Arozal Shinsuke Yuasa Copyright (c) 2022 Agian Jeffilano Barinda, Wawaimuli Arozal, Shinsuke Yuasa 2022-08-26 2022-08-26 31 2 132 40 10.13181/mji.rev.226064 Front & Back Matter Medical Journal of Indonesia Copyright (c) 2022-08-31 2022-08-31 31 2