Medical Journal of Indonesia https://mji.ui.ac.id/journal/index.php/mji <p><a href="http://mji.ui.ac.id/journal/index.php/mji/aboutbrief">ABOUT JOURNAL</a> | <a href="http://scholar.google.com/citations?user=4rXbpKoAAAAJ&amp;hl=en" target="_blank&quot;">CITATIONS</a> | <a href="https://mji.ui.ac.id/journal/index.php/mji/stat">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="https://www.ebscohost.com/titleLists/a9h-journals.htm" target="_blank" rel="noopener">EBSCO host</a>, <a title="ACI" href="http://www.asean-cites.org/index.php?r=contents%2Findex&amp;id=9" target="_blank" rel="noopener">ASEAN Citation Index</a>, <a title="BASE" 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Journal of Indonesia right of first publication with the work simultaneously licensed under a <a title="CC BY NC" href="http://creativecommons.org/licenses/by-nc/4.0/" 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 role of medical journal in health service transformation https://mji.ui.ac.id/journal/index.php/mji/article/view/6647 <p>[No abstract available]</p> Bambang Budi Siswanto Copyright (c) 2022-12-22 2022-12-22 31 3 141 2 10.13181/mji.ed.226647 RAGE and HMGB1 expressions in fetal membranes of premature rupture of membranes patients https://mji.ui.ac.id/journal/index.php/mji/article/view/6099 <p><strong>BACKGROUND</strong> Premature rupture of membranes (PROM) often occurs in pregnancy. The fetal membrane weakening is caused by inflammation involving receptor activation for advanced glycation end-products (RAGE) and high mobility group box protein 1 (HMGB1). The associations between RAGE and HMGB1 with PROM are rarely studied. Hence, this study aimed to determine those associations in fetal membranes with PROM occurrence.</p> <p><strong>METHODS</strong> This case-control study was conducted at Dr. Ramelan Central Naval Hospital, Surabaya, Indonesia, from August to November 2019. The subjects, determined using a non-probability sampling method (a saturated sample), were divided into PROM and normal pregnancy with intact fetal membranes (control) groups. Fetal membrane specimens were collected during vaginal and cesarean section deliveries. The expressions of RAGE and HMGB1 were determined using the immunohistochemical method and further analyzed using the Mann–Whitney <em>U</em> test.</p> <p><strong>RESULTS</strong> The expression of RAGE in fetal membranes with PROM was significantly higher than the control (52.74% <em>versus</em> 14.9% expression/mm<sup>2</sup>, <em>p</em>&lt;0.001), as well as the expression of HMGB1 (45.9% <em>versus</em> 8.5% expression/mm<sup>2</sup>, <em>p</em>&lt;0.001).</p> <p><strong>CONCLUSIONS</strong> The higher expressions of RAGE and HMGB1 in fetal membranes were associated with PROM.</p> Ketut Edy Sudiarta Cindy Jennilyn Candra Joan Khan Rahadianto Fitri Handajani Copyright (c) 2022 Ketut Edy Sudiarta, Cindy Jennilyn Candra, Joan Khan, Rahadianto, Fitri Handajani http://creativecommons.org/licenses/by-nc/4.0 2022-09-22 2022-09-22 31 3 143 7 10.13181/mji.oa.226099 Stress among healthcare workers during the COVID-19 pandemic and the determinant factors: a cross-sectional study https://mji.ui.ac.id/journal/index.php/mji/article/view/6030 <p><strong>BACKGROUND</strong> During the COVID-19 pandemic, there has been an increase in workload, as well as greater vigilance and compliance at work. Healthcare workers must perform their duties while facing the fear of COVID-19, which can trigger and/or aggravate stress. This study aimed to obtain the determinant factors of stress among healthcare workers during the pandemic by emphasizing the change in the psychosocial situation at the hospital.</p> <p><strong>METHODS</strong> This cross-sectional study was conducted from January to March 2021 using an online questionnaire consisting of personal and occupational questionnaires, as well as the validated stressor and stress questionnaires using validity and reliability tests (Cronbach’s alpha 0.8 and 0.9). For the multivariate analysis, multiple logistic regression was used to identify the determinant factors (<em>p</em>&lt;0.05). Data were analyzed using SPSS software version 20 (IBM Corp., USA).</p> <p><strong>RESULTS</strong> Determinant factors of the occurrence of moderate–severe stress were the alteration of stressors including age (aOR = 1.9), working hours (aOR = 1.9), work zone (aOR = 2.7), limited facilities and resources (aOR = 6.2), risk of disease transmission (aOR = 0.3), and personal work demands (aOR = 2.1).</p> <p><strong>CONCLUSIONS</strong> In addition to the younger age, the determinant factors of the incidence of moderate–severe stress in healthcare workers during the COVID-19 pandemic at the hospitals were work-related conditions. However, they remained controllable to prevent stress among healthcare workers in the peak load work situations such as a pandemic.</p> Muhammad Reza Aditya Muchtaruddin Mansyur Muhammad Ikhsan Mokoagow Nuri Purwito Adi Dewi Yunia Fitriani Heriani Tobing Jean Marc Pujo Hatem Kallel Copyright (c) 2022 Muhammad Reza Aditya, Muchtaruddin Mansyur, Muhammad Ikhsan Mokoagow, Nuri Purwito Adi, Dewi Yunia Fitriani, Heriani Tobing, Jean Marc Pujo, Hatem Kallel http://creativecommons.org/licenses/by-nc/4.0 2022-11-10 2022-11-10 31 3 148 54 10.13181/mji.oa.226030 Factors associated with global cognitive impairment in epilepsy patients: a cross-sectional study in Mataram, Indonesia https://mji.ui.ac.id/journal/index.php/mji/article/view/6118 <p><strong>BACKGROUND</strong> Cognitive impairment is a major complication of epilepsy. This study aimed to investigate the factors associated with the prevalence of cognitive impairment in patients with epilepsy in Mataram, Indonesia.</p> <p><strong>METHODS</strong> This cross-sectional study involved 155 consecutive outpatients with epilepsy at Mataram General Hospital, Mutiara Sukma Mental Hospital, and Siti Hajar Hospital, Mataram, Indonesia between September 2017 and August 2020. Data on the patient’s demographic characteristics, epilepsy, treatment variables, and global cognitive status were collected. The association between the determinants of epilepsy-associated cognitive impairment and the prevalence of epilepsy-associated global cognitive impairment was analyzed using logistic regression.</p> <p><strong>RESULTS</strong> The prevalence of epilepsy-associated global cognitive impairment was 83.9% and related to a low level of education (odds ratio [OR] = 5.24, 95% confidence interval [CI] = 1.93–14.20), early age at onset (OR = 7.85, 95% CI = 0.82–33.79), and long duration of epilepsy (OR = 8.47, 95% CI = 1.95–36.88).</p> <p><strong>CONCLUSIONS</strong> A high prevalence of epilepsy-associated global cognitive impairment was observed in Mataram and was associated with a low level of education, early age at onset, and long duration of epilepsy.</p> Herpan Syafii Harahap Mohammad Rizki Deasy Irawati Copyright (c) 2022 Herpan Syafii Harahap, Mohammad Rizki, Deasy Irawati http://creativecommons.org/licenses/by-nc/4.0 2022-11-10 2022-11-10 31 3 155 9 10.13181/mji.oa.226118 Comparison of ultrasonography and fluoroscopy as guides for extracorporeal shock wave lithotripsy in nephrolithiasis patients: a systematic review https://mji.ui.ac.id/journal/index.php/mji/article/view/6140 <p><strong>BACKGROUND</strong> Extracorporeal shock wave lithotripsy (ESWL) is one of the first-line treatment options for patients with renal stones &lt;2 cm. The large variability in ESWL results may be due to the stone visualization methods using ultrasonography (USG), fluoroscopy, or a combination of both. This study aimed to review the efficacy and safety of the stone visualization method on the stone-free rate (SFR) and postprocedural complications in nephrolithiasis patients.</p> <p><strong>METHODS</strong> We conducted a systematic review of USG and fluoroscopy on ESWL until July 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We assessed and collected summaries of the screened papers. The main outcomes assessed were the SFR of renal stones and postprocedural complications between imaging modalities.</p> <p><strong>RESULTS</strong> A total of 7 studies were assessed, including 6 comparative assessments of USG versus fluoroscopy and 1 comparative assessment of USG and fluoroscopy versus fluoroscopy only. Although all studies showed that USG had a higher SFR than fluoroscopy, only 1 study showed a significant difference (<em>p</em> = 0.008). Additionally, superior results were obtained using a combination of USG and fluoroscopy compared with fluoroscopy only. Most studies agreed that USG was not inferior in post-ESWL complication results.</p> <p><strong>CONCLUSIONS</strong> Overall, the use of USG is comparable to fluoroscopy because it does not provide a significant difference in the SFR and complications. In most cases, USG is preferred because of the absence of radiation. The combination of fluoroscopy and USG also provides more promising results than a single modality.</p> Gede Wirya Kusuma Duarsa Christian Nurtanto Putra Kevin Ivandi Kadek Adit Wiryadana Pande Made Wisnu Tirtayasa Firman Pribadi Copyright (c) 2022 Gede Wirya Kusuma Duarsa, Christian Nurtanto Putra, Kevin Ivandi, Kadek Adit Wiryadana, Pande Made Wisnu Tirtayasa, Firman Pribadi http://creativecommons.org/licenses/by-nc/4.0 2022-10-05 2022-10-05 31 3 160 9 10.13181/mji.oa.226140 Mental health problems and coping strategy among pulmonary resident physicians during the COVID-19 pandemic in a tertiary respiratory hospital in Indonesia: a serial cross-sectional study https://mji.ui.ac.id/journal/index.php/mji/article/view/6263 <p><strong>BACKGROUND</strong> Pulmonary resident physicians are part of the frontline workers for COVID-19 in the hospital and might require a suitable coping strategy to manage stress. Here, we described their mental health status and coping strategy during the COVID-19 pandemic.</p> <p><strong>METHODS</strong> A cohort study was done to evaluate stress, anxiety, depression, and coping strategies among pulmonary resident physicians in a tertiary referral hospital. Questionnaires were administered in 4 time points between August 2020 and June 2021. The DASS-21 questionnaire measured depression, anxiety, and stress, while Brief COPE instrument qualified the coping strategy.</p> <p><strong>RESULTS</strong> The total respondents who filled the questionnaire in 4 time points in August 2020, October 2020, February 2021, and June 2021 were 60, 93, 96, and 94 resident physicians with mean stress levels of 4.3, 6.1, 5.4, and 6.3, respectively. Depression, stress, and anxiety were less frequent during the study period, mostly mild or moderate. However, moderate anxiety slightly increased in June 2021 when the pandemic reached its peak. Most of them (95.8%) had effective coping strategies related to religious beliefs.</p> <p><strong>CONCLUSIONS</strong> Effective coping strategies might preserve the pulmonary resident physicians’ mental health during the pandemic. Furthermore, the sociodemographic and cultural background might affect the coping strategy. Practicing religion and praying or meditating might be essential factors in coping with psychological distress and a key to adapt to the COVID-19 pandemic.</p> Sita Laksmi Andarini Jamal Zaini Triya Damayanti Tribowo Tuahta Ginting Sugihen Hana Khairina Putri Faisal Copyright (c) 2022 Sita Laksmi Andarini, Jamal Zaini, Triya Damayanti, Tribowo Tuahta Ginting Sugihen, Hana Khairina Putri Faisal http://creativecommons.org/licenses/by-nc/4.0 2022-12-02 2022-12-02 31 3 170 7 10.13181/mji.oa.226263 Characteristics of patients with rheumatic heart disease in a national referral hospital in Indonesia https://mji.ui.ac.id/journal/index.php/mji/article/view/6150 <p><strong>BACKGROUND</strong> Rheumatic heart disease (RHD) is one of the most common cardiovascular problems in Indonesia. Comprehensive data regarding patient characteristics are critical in planning optimal treatment strategies to relieve the burden of RHD. This study aimed to describe the clinical and echocardiographic characteristics of patients across several types of valvular lesions in RHD in the Indonesian population.</p> <p><strong>METHODS</strong> This retrospective study was performed between January 2016 and June 2019 at the National Cardiovascular Center Harapan Kita, Jakarta, Indonesia. The study population comprised all patients with significant valve disease aged ≥18 years. Patient characteristics and echocardiographic parameters were collected retrospectively from medical records and hospital information systems. Patients were classified into several groups based on etiologies of valve disease.</p> <p><strong>RESULTS</strong> Of 5,482 patients with significant valve lesions, 2,333 (42.6%) were RHD patients. They were predominantly female (64.1%) and younger (mean [standard deviation] age 42.61 [12.01] years). Atrial fibrillation (AF) was the most frequent rhythm disorder observed in RHD (65.4%). Isolated mitral stenosis was the most common valve lesion in RHD patients (46.5%). Most patients with RHD had preserved left ventricular (LV) ejection fraction. Half of the patients with mitral stenosis had reduced right ventricular (RV) contractility (tricuspid annular plane systolic excursion &lt;17 mm).</p> <p><strong>CONCLUSIONS</strong> Isolated mitral stenosis was the most observed condition of valve lesions in RHD. Characteristics of RHD patients in this study were predominantly female, younger age, had preserved LV function, reduced RV function, and high prevalence of AF.</p> Estu Rudiktyo Annemieke Wind Pieter Doevendans Bambang Budi Siswanto Maarten-Jan Cramer Amiliana Mardiani Soesanto Copyright (c) 2022 Estu Rudiktyo, Annemieke Wind, Pieter Doevendans, Bambang Budi Siswanto, Maarten-Jan Cramer, Amiliana Mardiani Soesanto http://creativecommons.org/licenses/by-nc/4.0 2022-12-23 2022-12-23 31 3 178 85 10.13181/mji.oa.226150 A randomized control trial of platelet-rich plasma in supporting the recovery of postpartum levator ani muscle trauma https://mji.ui.ac.id/journal/index.php/mji/article/view/6115 <p><strong>BACKGROUND</strong> Pelvic floor dysfunction (PFD) is mostly caused by childbirth levator ani muscle (LAM) trauma. We hypothesized that platelet-rich plasma (PRP) therapy could support the recovery of LAM in postpartum trauma.</p> <p><strong>METHODS</strong> A prospective, single-blind, randomized control study was enrolled in primigravid women from November 2016 to July 2019 at 21 health facilities in Jakarta, Indonesia. Subjects were injected with autologous PRP or placebo at LAM during perineorrhaphy after childbirth. The primary outcome was regaining LAM strength and reducing levator hiatal area at 3 months postpartum. The LAM strength was examined by perineometer (cmH₂O), and levator hiatal area was examined by transperineal ultrasound (cm²) at antenatal and 3 months after delivery. Mann–Whitney <em>U</em> test and Wilcoxon signed-rank test were used for analysis. The study was registered in clinicaltrials.gov: NCT03021954.</p> <p><strong>RESULTS</strong> Among 240 women, 58 were eligible for analysis. There were no differences in LAM strength and levator ani hiatal area at 3 months postpartum between the two groups (<em>p</em> = 0.583 and <em>p</em> = 0.185, respectively).</p> <p><strong>CONCLUSIONS</strong> PRP therapy did not show a difference in the muscle recovery healing process.</p> Fernandi Moegni Andhika Rachman Ermita Ibrahim Ilyas Alida Harahap Trika Irianta Ferry Hidayat Dwiana Ocviyanti Budi Iman Santoso Copyright (c) 2022 Fernandi Moegni, Andhika Rachman, Ermita Ibrahim Ilyas, Alida Harahap, Trika Irianta, Ferry Hidayat, Dwiana Ocviyanti, Budi Iman Santoso http://creativecommons.org/licenses/by-nc/4.0 2022-12-22 2022-12-22 31 3 186 92 10.13181/mji.oa.226115 Validity and reliability of the Indonesian version of the new brief job stress questionnaire (short version) for work-related stress screening among office workers https://mji.ui.ac.id/journal/index.php/mji/article/view/6316 <p><strong>BACKGROUND</strong> The short version of the new brief job stress questionnaire (SV-NBJSQ) that is originally in Japanese could evaluate work-related stress in Indonesian office workers. However, it has not been validated in Indonesian. Thus, this study aimed to test the validity and reliability of the Indonesian version of the SV-NBJSQ.</p> <p><strong>METHODS</strong> This study was conducted by linguistic and cultural adaptation of the original Japanese questionnaire into Indonesian and continued with exploratory factor analysis, internal consistency, and reliability test of Cronbach’s alpha. Electronic and paper-based data were collected using total sampling from office workers at two companies in Jakarta from December 2017 to August 2018.</p> <p><strong>RESULTS</strong> A total of 438 respondents filled the questionnaire. The final version of the questionnaire consisted of 63 items, screened based on a loading factor of &gt;0.4 and 13 factors (dimensions). Each factor had a Cronbach’s alpha of 0.628–0.887, while the entire 63 had 0.904 with a total documented cumulative variation of 64.97%.</p> <p><strong>CONCLUSIONS</strong> The Indonesian version of the SV-NBJSQ is valid and reliable. Thus, we may use it as a more suitable, updated, and comprehensive tool to evaluate work-related stress among office workers.</p> Nuri Purwito Adi Ansgar Azurit Virenti Paska Da Lopez Hervita Diatri Retno Asti Werdhani Dewi Sumaryani Soemarko Dewi Yunia Fitriani Copyright (c) 2022 Nuri Purwito Adi, Ansgar Azurit Virenti Paska Da Lopez, Hervita Diatri, Retno Asti Werdhani, Dewi Sumaryani Soemarko, Dewi Yunia Fitriani http://creativecommons.org/licenses/by-nc/4.0 2022-11-02 2022-11-02 31 3 193 201 10.13181/mji.oa.226316 Carotid bypass surgery for a persistent neck tumor after multiple treatments: a case report https://mji.ui.ac.id/journal/index.php/mji/article/view/6130 <p>Carotid artery involvement in head and neck cancer is challenging for surgeons and oncologists, particularly in recurrence or residual disease following multiple treatments. However, carotid artery resection and reconstruction can be safely performed in a carefully selected patient with local and regional control benefits despite the potential morbidity and high-risk complications. We presented a case of primary laryngeal cancer treated with chemoradiotherapy, modified radical neck dissection type I for residual neck node disease, and further chemotherapy. Although the primary laryngeal cancer showed a complete response, the residual neck tumor was still unresolved and even involved the carotid artery. Therefore, carotid resection with a combined saphenous vein graft and free flap reconstruction was the treatment of choice for this patient. It is effective and safe, and the risk of morbidity has been accepted.</p> Izry Naomi Lumbantobing Mohd Razif Mohamad Yunus Arman Zaharil Mat Saad Copyright (c) 2022 Izry Naomi Lumbantobing, Mohd Razif Mohamad Yunus, Arman Zaharil Mat Saad http://creativecommons.org/licenses/by-nc/4.0 2022-09-22 2022-09-22 31 3 202 6 10.13181/mji.cr.226130 A rare case of migration of ballistic projectile from left to right main bronchus https://mji.ui.ac.id/journal/index.php/mji/article/view/6125 <p>A foreign body in the bronchus due to a ballistic projectile is very uncommon. A 45-year-old man presented to the hospital after being accidentally shot. The initial radiographic assessment found a bullet in his left thoracic cavity. With the help of an X-ray, an urgent left posterolateral thoracotomy was conducted, but no foreign body was found. The foreign body had migrated to the contralateral chest cavity, as determined by the C-arm. On the following day, a thorax computed tomography scan was conducted, and it was discovered that the foreign body had already migrated to the right lower bronchus. A right thoracotomy was then performed to remove the foreign body. He was moved to the intensive care unit and discharged with a stable condition. In conclusion, migration of a foreign body in the bronchus is rare. A thorough strategy is required to prevent the object from migrating even further.</p> Edwin Yosef Widjaja Dhihintia Jiwangga Chikita Nur Rachmi Copyright (c) 2022 Edwin Yosef Widjaja, Dhihintia Jiwangga, Chikita Nur Rachmi http://creativecommons.org/licenses/by-nc/4.0 2022-12-02 2022-12-02 31 3 207 10 10.13181/mji.cr.226125 Front & Back Matter https://mji.ui.ac.id/journal/index.php/mji/article/view/6668 Medical Journal of Indonesia Copyright (c) 2022 http://creativecommons.org/licenses/by-nc/4.0 2022-12-23 2022-12-23 31 3