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 title="Crossref" href=";publication=Medical+Journal+of+Indonesia" target="_blank" rel="noopener"> Crossref </a>, <a title="Dimensions" href="" target="blank">Dimensions</a>, <a title="DOAJ" href="{%22query%22:{%22query_string%22:{%22query%22:%22faculty%20of%20medicine%20universitas%20indonesia%22,%22default_field%22:%22index.publisher%22,%22default_operator%22:%22AND%22}}}" target="_blank" rel="noopener">DOAJ</a>, <a title="Electronic Journals Library" href=";colors=7&amp;lang=en&amp;jq_type1=KT&amp;jq_term1=medical+journal+of+indonesia" target="_blank" rel="noopener">Electronic Journals Library</a>, <a title="Embase" href="" target="_blank" rel="noopener">Embase</a>, <a title="ESCI" href=";Full=medical%20journal%20of%20indonesia" target="_blank" rel="noopener">ESCI</a>, <a title="GARUDA" href="" target="_self">GARUDA</a>, <a title="Google Scholar" href=";btnG=&amp;hl=en&amp;as_sdt=0%2C5" target="_blank" rel="noopener">Google Scholar</a>, <a title="Hinari" href="" target="_blank" rel="noopener">Hinari</a>, <a title="IMSEAR" href="" target="_blank" rel="noopener">IMSEAR</a>, <a title="ISC" href="" target="_blank" rel="noopener">ISC</a>, <a title="J-Gate" href="" target="_blank" rel="noopener"> J-Gate </a>, <a title="JournalTOCs" href=";subAction=pub&amp;publisherID=2793&amp;journalID=29425&amp;pageb=1&amp;userQueryID=&amp;sort=&amp;local_page=1&amp;sorType=&amp;sorCol=1" target="_blank" rel="noopener">JournalTOCs</a>, <a title="Microsoft Academic" href="" target="_blank" rel="noopener">Microsoft Academic</a>, <a title="MENDELEY" href="" target="_blank" rel="noopener"> MENDELEY </a>, <a title="PKP INDEX" href="">PKP index</a>, <a title="ProQuest" href=";productID=445&amp;productName=ProQuest+Health+%26+Medical+Complete&amp;IDString=445&amp;format=formatHTML&amp;issn=issn&amp;prflag=prflag&amp;cit=cit&amp;abs=abs&amp;pmid=pmid&amp;combined=combined" target="_blank" rel="noopener">Proquest</a>, <a title="ROAD" href="" target="_blank" rel="noopener"> ROAD </a>, <a title="Scilit" href="" target="_blank" rel="noopener">Scilit</a>, <a title="Scopus" href="" target="_blank" rel="noopener">Scopus</a>, <a title="SINTA" href="" target="_blank" rel="noopener">SINTA</a>, <a title="Ulrichsweb Global Serial Directory" href="" target="_blank" rel="noopener">Ulrichsweb Global Serial Directory</a>, <a title="WorldCat" href=";fq=&amp;dblist=239&amp;se=%24d&amp;sd=desc&amp;fc=yr:_25&amp;qt=show_more_yr%3A&amp;cookie" target="_blank" rel="noopener">WorldCat</a>.</p> <p>Accredited (2016-2020) by the Directorate General of Research and Development Strengthening of the Ministry of Research, Technology and Higher Education of the Republic of Indonesia (No:21/E/KPT/2018).</p> en-US <p>Authors who publish with Medical Journal of Indonesia agree to the following terms:</p> <ol> <li class="show"><span lang="EN-GB">Authors retain copyright and grant Medical Journal of Indonesia right of 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> (Med J Indones) (Novi) Fri, 01 Jan 2021 20:27:30 +0700 OJS 60 Burden of metabolic diseases in Indonesia: an even more critical issue during COVID-19 pandemic <p>[No abstract available]</p> Dicky Levenus Tahapary, Pradana Soewondo Copyright (c) 2020 Dicky Levenus Tahapary, Pradana Soewondo Tue, 29 Dec 2020 00:00:00 +0700 The challenges of metabolic disorders in Indonesia: focus on metabolic syndrome, prediabetes, and diabetes <p>[No abstract available]</p> Ketut Suastika Copyright (c) 2020 Ketut Suastika Tue, 29 Dec 2020 00:00:00 +0700 Association between SOX2 and OCT4 expression and the chemoradiation therapeutic response in undifferentiated non-keratinizing nasopharyngeal carcinoma <p><strong>BACKGROUND</strong> Self-renewal ability of cancer stem cells (CSS) is one of the possible causes for nasopharyngeal carcinoma (NPC) to relapse and metastasize. SOX2 and OCT4 are markers for expression of the embryonic stem cells and crucial for the progression of various malignancies. This study was aimed to analyze the association between SOX2 and OCT4 expression and chemoradiation therapeutic response in undifferentiated non-keratinizing NPC.</p> <p><strong>METHODS</strong> This cross-sectional study used archival data from Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital from January 2014 to December 2016. The outcomes were classified into good-response (complete and partial response) and poor-response groups (progressive and stable disease) based on response evaluation criteria in solid tumors (RECIST). SOX2 and OCT4 immunohistochemistry staining was performed using the initial specimen (before chemoradiation therapy) and positively expressing tumor cells were counted. Staining intensity was graded as: strong, moderate, weak, and negative. Strong and moderate staining was considered positive expression.</p> <p><strong>RESULTS</strong> 33 males and 8 females were included; 48% were ≥50 years old. Most of the patients had stage IV (n = 35) and several patients had stage II (n = 3) and III (n = 3). More cells expressed OCT4 in the good-response group than the poor-response group (61.3% <em>versus</em> 37.0%, <em>p</em> = 0.009). Meanwhile, there were less cells expressing SOX2 in the good-response group than the poor-response group (36.3% <em>versus</em> 61.1%, <em>p</em> = 0.097).</p> <p><strong>CONCLUSIONS</strong> This study suggests that OCT4 is a potential predictive marker for therapeutic response in patients with NPC.</p> Lisnawati Rachmadi, Kusmardi, Monik Ediana Miranda, Maria Mayella Vianney Copyright (c) 2020 Lisnawati Rachmadi, Kusmardi Kusmardi, Monik Ediana, Maria Mayella Vianney Tue, 29 Dec 2020 00:00:00 +0700 A randomized clinical trial of freeze-dried amniotic membrane transplantation and conjunctival-limbal graft for pterygium excision and evaluation of conjunctival inflammation marker in tears <p><strong>BACKGROUND</strong> Minimizing inflammation on the ocular surface after pterygium surgery is essential to prevent recurrence. Currently, limited data are available for the comparison between freeze-dried amniotic membrane (FD-AM) and conjunctival–limbal graft (CLG). Therefore, this study aimed to assess conjunctival inflammation and the interleukin (IL)-6 levels in tears after pterygium excision between both techniques.</p> <p><strong>METHODS</strong> This prospective, single-blinded, randomized clinical trial included 26 eyes of 26 patients with primary or recurrent pterygium and who were indicated for pterygium surgery at Cipto Mangunkusumo Hospital, Indonesia from October 2017 until February 2018. The patients were scheduled for pterygium excision with FD-AM or CLG based on block randomization. Conjunctival inflammation and the level of IL-6 in tears were measured on day-7 and -28 after surgery.</p> <p><strong>RESULTS</strong> The 26 eyes (13 in each group) were subjected to a complete 1-month follow-up period. Day-7 after the surgery, severe inflammation occurred in 4/13 (31%) eyes having FD-AM and 8/13 eyes (62%) having CLG (<em>p</em> = 0.59). The IL-6 tear level increased similarly in FD-AM (22.85 pg/ml) and CLG (23.51 pg/ml) in (<em>p</em> = 0.78). No severe adverse events occurred.</p> <p><strong>CONCLUSIONS</strong> Pterygium excision using FD-AM yield a milder inflammation than CLG on day-7 and -28 after surgery. The tear IL-6 levels similarly increased on day-7.</p> Made Susiyanti, Manoa Panjaitan, Grace Wangge, Tjahjono Darminto Gondhowiardjo Copyright (c) 2020 Manoa Panjaitan, Grace Wangge, Tjahjono D. Gondhowiardjo, Made Susiyanti Tue, 29 Dec 2020 00:00:00 +0700 Retinal vascular caliber changes after laser photocoagulation in diabetic retinopathy <p><strong>BACKGROUND</strong> Diabetic retinopathy causes vascular dilatation caused by hypoxia, whereas oxygen tension improvement leads to retinal vessels narrowing. Given that laser photocoagulation aims to increase the oxygen tension in the retina, we hypothesized that the narrowing of vessel caliber after the treatment could be possibly demonstrated. This study aimed to assess the changes in the caliber of retinal vessels before and after laser photocoagulation in diabetic retinopathy.</p> <p><strong>METHODS</strong> This research was a prospective cohort study on the treatment of diabetic retinopathy by laser photocoagulation, and it was conducted at Universitas Hasanuddin Hospital, Makassar, Indonesia between November 2017–April 2018. Retinal vascular caliber changes were analyzed before and 6–8 weeks after photocoagulation in 30 diabetic eyes. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were measured using the vessel assessment and measurement platform software for images of the retina (VAMPIRE) manual annotation tool.</p> <p><strong>RESULTS</strong> A significant decrease of CRVE was observed after laser photocoagulation (<em>p</em>&lt;0.001), but CRAE was not reduced significantly (<em>p</em> = 0.067). No difference was recorded between CRVE and CRAE post-laser photocoagulation (<em>p</em> = 0.14), implying a reduction in vein caliber toward normal in the treated eyes.</p> <p><strong>CONCLUSIONS</strong> Laser photocoagulation decreases the CRVE in diabetic retinopathy despite the absence of changes in the grade of diabetic retinopathy.</p> Habibah Setyawati Muhiddin, Idayani Panggalo, Andi Muhammad Ichsan, Budu, Emanuele Trucco, John Ellis Copyright (c) 2020 Idayani Panggalo Tue, 29 Dec 2020 00:00:00 +0700 Tear hypoxia-inducible factor-1α expression, lactate dehydrogenase, and malate dehydrogenase activity changes in soft contact lens wear <p><strong>BACKGROUND</strong> Soft contact lens (SCL) wear can lead to a corneal hypoxia. However, there is a lack of studies looking for corneal hypoxia biomarkers in tear. This study aimed to investigate corneal hypoxia among SCL wearers based on hypoxia-inducible factor-1α (HIF-1α) expression, tear lactate dehydrogenase (LDH), and malate dehydrogenase (MDH) activities.</p> <p><strong>METHODS</strong> A nonrandomized clinical trial was conducted on two groups. SCLs were prescribed for 2 months to a group of new wearers. Meanwhile, SCL wear was discontinued for 1 month in a group of long-term wearers. Tear samples were then collected on days 1, 7, 14, 28, and 56 after treatment. Repeated-measures analysis of variance and Friedman’s test with post-hoc statistical analysis were used to evaluate biomolecular changes (HIF-1α concentration, LDH, and MDH activities) in both groups.</p> <p><strong>RESULTS </strong>A total of 14 subjects (28 eyes) were enrolled in each group. In new wearers, there was a significant decrease in MDH level (<em>p</em> = 0.010) and no effect on HIF-1α level. In long-term wearers, HIF-1α and LDH levels tended to decrease (<em>p</em> = 0.054). A significant decrease on MDH level was noted on days 7 (<em>p</em> = 0.003), 14 (<em>p</em> = 0.026), and 28 (<em>p</em>&lt;0.010). Long-term wearers had a higher LDH baseline level than new wearers (<em>p</em> = 0.04).</p> <p><strong>CONCLUSIONS</strong> Corneal hypoxia was not proven after 2 months of SCL wear using biomarkers. However, LDH and MDH activities in tears were found to be decline after SCL discontinuation.</p> Tri Rahayu, Tjahjono Darminto Gondhowiardjo, Widya Artini, Septelia Inawati Wanandi Copyright (c) 2020 Tri Rahayu, Tjahjono Dharminto Gondhowiardjo, Widya Artini, Septelia Inawati Wanandi Tue, 29 Dec 2020 00:00:00 +0700 Amniotic membrane transplantation for infectious corneal ulcer treatment: a cohort retrospective study <p><strong>BACKGROUND</strong> Corneal ulcer is one of the most common causes of corneal blindness. This study aimed to describe the outcomes of amniotic membrane transplantation (AMT) in patients with infectious corneal ulcer.</p> <p><strong>METHODS</strong> A retrospective cohort study based on medical records of patients who underwent an adjuvant AMT procedure over a 2-year period (2015–2017) was conducted at Cipto Mangunkusumo Hospital Jakarta. Uncorrected visual acuity (UCVA) was measured with the Snellen chart. Treatment success was marked by complete healing (disappearance of corneal infiltrates, epithelial defect closure, and corneal scar formation). Healing time was the duration from AMT surgery to complete healing.</p> <p><strong>RESULTS</strong> 50 cases of infectious corneal ulcer, 12 of which had perforation were included. Gram-positive cocci (18%), gram-negative rods (14%), fungi (4%), and <em>Acanthamoeba</em> (2%) were isolated from culture specimens. Successful results were observed in 90% of cases (20/21 moderate cases and 25/29 severe cases). Healing time was 21 (14–63) days in moderate cases and 28 (14–90) days in severe cases. Baseline UCVA improved from 2.48 (0.22–2.80) logMAR to 1.30 (0–2.80) logMAR within 3–4 weeks postoperatively and to 0.94 (0–2.80) logMAR at the last follow-up. Post-AMT complications included recurrent perforation in 4 eyes, persistent epithelial defects in 2 eyes, amniotic membrane infection in 1 eye, and membrane retraction in 1 eye.</p> <p><strong>CONCLUSIONS</strong> AMT was successfully used to treat moderate and severe infectious corneal ulcer, particularly in nonresponsive and some perforated cases. AMT provides biochemical and mechanical support for corneal wound healing with good visual outcomes.</p> Vega Casalita, Rina La Distia Nora, Lukman Edwar, Made Susiyanti, Ratna Sitompul Copyright (c) 2020 vega casalita Wed, 30 Dec 2020 00:00:00 +0700 Acute pediatric peritoneal dialysis: impact of an opt-out model and adaptable methods in a hospital in Nigeria <p><strong>BACKGROUND </strong>Despite efforts to scale peritoneal dialysis (PD) uptake, access is still limited in Sub-Saharan Africa, including Nigeria. Thus, this study evaluated access to PD, cost-effectiveness, complications, and in-hospital mortality rate following the adoption of a local opt-out model approach for all children with acute kidney injury (AKI) that required PD.<span class="Apple-converted-space">&nbsp;</span></p> <p><strong>METHODS </strong>This work was a retrospective review of 33 children with AKI that required dialysis between December 2014 and November 2016. PD was carried out using locally adaptable consumables in place of commercially produced consumables. All patients that required renal replacement therapy (RRT) were offered an option to opt-out irrespective of their financial status. Patients’ relevant data were retrieved from the case notes and analyzed.<span class="Apple-converted-space">&nbsp;</span></p> <p><strong>RESULTS </strong>The median age was 7 years (range 3–12). 23 patients (70%) were males. Of the 33 patients that required RRT, 29 had PD. The children had an access rate of 88% (95% CI = 76.77–99.03). The access rate was not related to gender (<em>p </em>= 1.000), age group (<em>p </em>= 0.240), or socioeconomic status (<em>p </em>= 0.755). Complications were pericatheter leakage of fluid (n = 7, 24%), catheter malfunction (n = 5, 17%), abdominal wall edema (n = 3, 10%), scrotal edema (n = 2, 7%), and peritonitis (n = 1, 3%). In-hospital mortality was 3/29 (10%; 95% CI = 2.2–27.3). Cost analysis revealed that the cost of consumables was reduced by 88.5%.<span class="Apple-converted-space">&nbsp;</span></p> <p><strong>CONCLUSIONS </strong>An opt-out model with the use of locally adaptable consumables improved PD access (88%) with a low in-hospital mortality rate.<span class="Apple-converted-space">&nbsp;</span></p> Michael Abel Alao, Olayinka Rasheed Ibrahim, Olajide Olusegun Abiola, Daniel Adedosu Gbadero, Adanze Onyenonachi Asinobi Copyright (c) 2020 Michael Abel Alao, Olayinka Rasheed Ibrahim, Olajide Olusegun Abiola, Daniel Adedosu Gbadero, Adanze Onyenonachi Asinobi Wed, 30 Dec 2020 00:00:00 +0700 Comparison of a set of cognitive ability screening test for primary school-aged children in Indonesia <p><strong>BACKGROUND</strong> Monitoring children’s intellectual development is important to align their educational needs. This study compared nonverbal intelligence subtest of the cognitive test battery for Individuals with or without intellectual disability (CIID) to measure visual logical reasoning, verbal intelligence subtest (verbal fluency [VF]–animal test) to assess vocabulary and semantic memory, and the modified Indonesian version of Hopkins verbal learning test (IHVLT) to assess learning ability and episodic memory, against the Wechsler intelligence scale for children (WISC) as an alternative cognitive screening tool in school-aged children.</p> <p><strong>METHODS</strong> A cross-sectional study was conducted in 145 grade 1–6 elementary school students in Jakarta between March and May 2017. Performance on the CIID subtest, VF, and modified IHVLT was assessed by a pediatrician, and the WISC test was performed by a psychologist. The associations between variables were evaluated using nonparametric Spearman’s rank correlations, regressions, and box plots.</p> <p><strong>RESULTS</strong> The correlation between total intelligence quotient (IQ) WISC and CIID was 0.42 (<em>p</em>&lt;0.001) and 0.34 (<em>p</em>&lt;0.001) for both IHVLT and VF. Box plots suggested possible discriminative capacity of CIID but insufficient specificity. However, CIID was associated with stunting (height) and health (weight) independent of age, sex, father’s education, or income.</p> <p><strong>CONCLUSIONS</strong> The CIID subtest series, VF, and modified IHVLT correlated with total IQ WISC. However, CIID may be better to test predictors of poor cognitive performance in primary school-aged children than an IQ screening test.</p> Meitha Togas, Hartono Gunardi, Rini Sekartini, Sri Redatin Retno Pudjiati, Eef Hogervorst Copyright (c) 2020 Hartono Gunardi Wed, 30 Dec 2020 00:00:00 +0700 Factors related to pain management adequacy in patients receiving palliative care: data from a tertiary hospital in Indonesia <p><strong>BACKGROUND</strong> Adequate pain management must be applied to improve the quality of life, particularly in patients receiving palliative care. Thus, this study aimed to determine the factors related to pain management adequacy in patients receiving palliative care.</p> <p><strong>METHODS</strong> This cross-sectional study included all patients sent for consultation to the palliative care team complaining of pain in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from 2016 to 2018. All data such as gender, age, employment status, disease type, primary cancer location, pain intensity, analgesic drug treatment duration, and the presence of anxiety and depression were retrieved from medical records. Pain management adequacy was evaluated using the pain management index. Logistic regression included all variables with <em>p</em>&lt;0.25 related to pain management adequacyin bivariate analysis.</p> <p><strong>RESULTS</strong> Out of 175 patients with pain, 85.7% reported having adequate pain management. Pain was more adequately treated in patients with employment (<em>p</em> = 0.001), milder pain intensity (<em>p</em>&lt;0.001), those using opioids (<em>p</em>&lt;0.001), and those who did not experience anxiety (<em>p</em> = 0.05). Factors related to pain management adequacy were opioid use (OR = 3.23, 95% CI = 1.71–6.13) and milder pain (OR = 11.15, 95% CI = 3.89–31.99).</p> <p><strong>CONCLUSIONS</strong> Most of the patients received adequate pain management which related to opioid use and milder pain.</p> Hamzah Shatri, Ratih Arianita Agung, Vera Abdullah, Dina Elita, Rudi Putranto, Mizanul Adli, Cosphiadi Irawan Copyright (c) 2020 Hamzah Shatri, Ratih Arianita Agung, Vera Abdullah, Dina Elita, Rudi Putranto, Mizanul Adli, Cosphiadi Irawan Wed, 30 Dec 2020 00:00:00 +0700 A case of pica in childhood with intellectual disability: focus on non­-psychopharmacology management <p>Non-psychopharmacology management is crucial in pica in childhood with intellectual disability. This case report shows the effectiveness of pica management centered on behavioral therapy over the use of pharmacotherapy in improving the patient’s symptoms. A-7-year-old girl had been eating plastic bags since she was 3. In the last 6 months, this behavior worsened and coupled with emotional and behavioral problems. Her intellectual function showed that she had a moderate intellectual disability, which was confirmed by her intelligence quotient test result. She also had iron deficiency anemia and constipation. Non-psychopharmacological management was delivered to the patient and family. The patient was treated with a reinforcement strategy of behavioral therapy, involving parental education during the process to stimulate desirable behavior, discourage unwanted behavior, and improve parent-child interaction. After six sessions of behavioral therapy and parental psychoeducation, the patient showed improvement as the frequency of eating nonfood substances was decreasing.</p> Fransiska Kaligis, Mirza Hapsari Massarapa, Raden Irawati Ismail Marsubrin, Tjhin Wiguna Copyright (c) 2020 Fransiska Kaligis, Mirza Hapsari Massarapa, Raden Irawati Ismail Marsubrin, Tjhin Wiguna Fri, 16 Oct 2020 00:00:00 +0700 Tyrosine kinase inhibitor resistance in pediatric chronic myeloid leukemia: a case report <p>Pediatric chronic myeloid leukemia (CML) is a hematopoietic malignancy, treated by tyrosine kinase inhibitor (TKI). Previously, imatinib resistance in CML was treated with nilotinib as a second line. However, in Indonesia, where the options of TKIs are limited, no case has been reported. We describe TKI-resistance of a pediatric CML case in Dharmais Cancer Hospital, Jakarta. A 17-year-old boy presented with loss of complete hematologic response after 4 years of imatinib treatment. Diagnosis of relapsed CML with blast crisis was confirmed, and nilotinib was given accordingly. He achieved hematological and optimal response after 2 weeks and 3 months of treatment, respectively. However, in the 12-month evaluation, he failed to achieve major molecular response and acquired the second resistance to TKI. Since imatinib resistance marks the poor prognosis, initial optimal response of nilotinib treatment remains inconclusive to predict the final outcome.</p> Mururul Aisyi, Ayu Hutami Syarif, Nur Asih, Agus Kosasih Copyright (c) 2020 Mururul Aisyi, Ayu Hutami Syarif, Nur Asih, Agus Kosasih Fri, 16 Oct 2020 00:00:00 +0700 Self-medication among health care workers in a tertiary hospital in Southern Nigeria: knowledge, attitude, and practices <p><strong>BACKGROUND</strong> Self-medication is linked to the inappropriate and irrational use of medicines. This study aimed to determine the knowledge, attitude, and practice of self-medication among health care workers (HCWs) in a tertiary hospital in Southern Nigeria.</p> <p><strong>METHODS</strong> In a cross-sectional study carried out between June 2018 and December 2018 at Irrua Specialist Teaching Hospital, Edo State, 206 consenting HCWs were interviewed using validated questionnaires on their knowledge (assessed as good, fair, and poor), attitude (positive and negative), and practice of self-medication. Data analysis was performed using SPSS version 21 (IBM Corp., USA). Bivariate analysis was carried out using chi-square. Statistical significance was set as <em>p</em>&lt;0.05.</p> <p><strong>RESULTS</strong> Prevalence of self-medication in the last 4 months was 89.3%, and significantly decreased with increasing age (<em>p</em> = 0.04) and holding a positive attitude toward self-medication (<em>p</em>&lt;0.01). Knowledge of self-medication was fair for the majority 111 (53.9%). Most of the medications were used for headache (92.4%), fever (81.5%), diarrhea (75.0%), and respiratory infections (61.4%). Common drugs self-medicated included antimalarials (91.3%), analgesics (81.0%), and antibiotics (71.2%). 39 subjects (21.2%) self-medicated with tranquilizers. Familiarity with the treatment options was the main reason for self-medication for 60.9% of the respondents.</p> <p><strong>CONCLUSIONS</strong> Self-medication was prevalent among HCWs in the study area. Concerted efforts are needed to educate HCWs on responsible self-medication. On a broader scale, restrictions should be enforced on the sale of prescription drugs, such as antibiotics and sleeping pills, and drug dispensers should provide effective counseling before dispensing.</p> Ekaete Alice Tobin, Jovita Erhazele, Martha Okonofua, Chinelo Nnadi, Eucharia Ezenwanyi Nmema, George Odigie Copyright (c) 2020 Ekaete Alice Tobin, Jovita Erhazele, Martha Okonofua, Chinelo Nnadi, Eucharia Ezenwanyi Nmema, George Odigie Wed, 30 Dec 2020 00:00:00 +0700 Predictors of smear non-conversion among new-treatment pulmonary tuberculosis: a single center case-control study in Indonesia <p><strong>BACKGROUND</strong> Previous studies concluded predictors of smear non-conversion pulmonary tuberculosis (TB) globally as well as in Indonesia. However, there is a limited data in hospital setting. This study aimed to explore predictors of smear non-conversion pulmonary TB in hospital setting.</p> <p><strong>METHODS</strong> A case-control study was conducted to explore predictors of smear nonconversion among new-treatment pulmonary TB in Dr. Kariadi General Hospital from 2017 to 2019. Number of cases and controls have been determined consecutively. Data were collected from secondary data accessed in medical records and directly from subjects. Non-conversion status in the case group was defined as a persistent sputum smear-positive after 2 months of intensive phase of treatment. The subjects’ characteristics i.e., age, sex, BMI, education level, occupational status, and predictors of smear non-conversion, i.e., patient’s compliance, smoking status, alcohol consumption, presence of drugs side effects, health care access, first acid-fast bacilli (AFB) smear grading, diabetes mellitus (DM), housing condition, housing density, and household income were observed. Chi-square test and binary logistic regression were used.</p> <p><strong>RESULTS</strong> 35 subjects were determined in the case group while 76 subjects were the control group and involved in the final analysis. Age, sex, first AFB smear grading, smoking status, housing condition, housing density, and DM were involved in the model of logistic regression. DM (OR = 3.4; 95% CI = 1.19–10.00) and first AFB smear grading (OR = 11.2; 95% CI = 3.86–33.00) were concluded as the predictors of smear nonconversion.</p> <p><strong>CONCLUSIONS</strong> DM and first AFB smear grading were the predictors of smear nonconversion among new-treatment pulmonary TB subjects.</p> Arulita Ika Fibriana, Muhamad Zakki Saefurrohim, Akhriyah Atsna Setiana, Mahalul Azam, Avissena Dutha Pratama Copyright (c) 2020 Mahalul Azam, Arulita Ika Fibriana, Muhamad Zakki Saefurrohim, Akhriyah Atsna Setiana, Avissena Dutha Pratama Wed, 30 Dec 2020 00:00:00 +0700 The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults <p><strong>BACKGROUND</strong> Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults.</p> <p><strong>METHODS</strong> This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin.</p> <p><strong>RESULTS</strong> 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, <em>p</em> = 0.043 and r = −0.228, <em>p</em>&lt;0.001), BMI (r = 0.176, <em>p</em> = 0.006 and r = −0.202, <em>p</em> = 0.001), and waist circumference (r = 0.179, <em>p</em> = 0.005 and r = −0.254, <em>p</em>&lt;0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, <em>p </em>= 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, <em>p</em> = 0.109 and r = −0.043, <em>p</em> = 0.500).</p> <p><strong>CONCLUSIONS</strong> This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.</p> Harry Freitag Luglio Muhammad, Satwika Arya Pratama, Dian Caturini Sulistyoningrum, Maya Nurfitriani Hartono, Emy Huriyati, Yi Yi Lee, Wan Abdul Manan Wan Muda Copyright (c) 2020 Harry Freitag Luglio Muhammad, Satwika Arya Pratama, Dian Caturini Sulistyoningrum, Maya Nurfitriani Hartono, Emy Huriyati, Yi Y Lee, Wan Abdul Manan Wan Muda Wed, 30 Dec 2020 00:00:00 +0700 The challenge of the implementation and evaluation of hospital-based cancer registry in Indonesia’s national referral hospital <p><strong>BACKGROUND</strong> To lower the burden caused by cancer, the Ministry of Health of the republic of Indonesia requires valid data collection to plan and evaluate cancer programs. This study aimed to evaluate the challenge of developing a cancer registry (CanReg) in Cipto Mangunkusumo Hospital.</p> <p><strong>METHODS</strong> This was an observational study on the implementation of cancer registration from the initial licensing until the creation of valid and accurate data, also the challenges in implementing hospital-based cancer registry (HBCR) in Cipto Mangunkusumo Hospital.</p> <p><strong>RESULTS</strong> Cancer registry was developed in 2016 using the 2013 Indonesian version of CanReg5 program called SriKandI. We identified some problems in this registry implementation, such as legal and human resources, medical records, electronic health records, and the CanReg5 program. Moreover, this team processed 886,086 raw patients’ data with fairly good topography and age data completeness.</p> <p><strong>CONCLUSIONS</strong> Several obstacles were encountered upon the establishment of HBCR at Cipto Mangunkusumo Hospital from program to bureaucracy and resources. Nevertheless, CanReg data can be used as a basis for decision making by stakeholders.</p> Soehartati Gondhowiardjo, Ericko Ekaputra, Achmad Randi, Vito Filbert Jayalie Copyright (c) 2020 Soehartati Gondhowiardjo, Ericko Ekaputra, Achmad Randi, Sri Mutya Sekarutami Wed, 30 Dec 2020 00:00:00 +0700 Stress during COVID-19 pandemic: mental health condition in Indonesia <p>Pandemics have occurred throughout the decades. The last pandemic was the Spanish flu pandemic in 1918, which infected 500 million people and caused death to as many as 100 million people worldwide. At present, a similar situation is occurring as coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, has infected a few million people worldwide and has been declared a pandemic by the World Health Organization in March 2020. There are various mental health responses in pandemic outbreaks. People’s thought process, behavior, and emotional response to an outbreak vary greatly according to their own backgrounds and the community that they live in. For some people, the misinformation, uncertainty, and fear of contagion may increase stress and anxiety, which can induce mass panic. Mental health education and psychological support from all stakeholders, such as the government, health professionals, and the community, may be valuable during a pandemic.<span class="Apple-converted-space">&nbsp;</span></p> Fransiska Kaligis, Madhyra Tri Indraswari, Raden Irawati Ismail Copyright (c) 2020 Fransiska Kaligis, Madhyra Tri Indraswari, Raden Irawati Ismail Fri, 09 Oct 2020 00:00:00 +0700 Acknowledgment of Reviewers Copyright (c) Thu, 31 Dec 2020 00:00:00 +0700 Front & Back Matter Copyright (c) Thu, 31 Dec 2020 00:00:00 +0700