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> |&nbsp;<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>&nbsp;| <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:&nbsp;<a href="https://www.ebscohost.com/titleLists/a9h-journals.htm" target="_blank" rel="noopener">EBSCO host</a>,&nbsp;<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>,&nbsp;<a title="BASE" 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Serial Directory</a>,&nbsp;<a href="https://oaister.worldcat.org/search?q=pb%3AFaculty+of+Medicine+Universitas+Indonesia&amp;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> Faculty of Medicine Universitas Indonesia en-US Medical Journal of Indonesia 0853-1773 <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="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> Social responsibility of medical journal: a concern for COVID-19 pandemic https://mji.ui.ac.id/journal/index.php/mji/article/view/4629 <p>[No abstract available]</p> Agus Rizal Ardy Hariandy Hamid Copyright (c) 2020 Agus Rizal Hamid http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 1 3 10.13181/mji.ed.204629 Visit to Singapore Medical Journal during COVID-19 outbreak: learning “beyond” the expectation https://mji.ui.ac.id/journal/index.php/mji/article/view/4615 <p>[No abstract available]</p> Felix Firyanto Widjaja Windu Cahyaningrum Handayani Notonagoro Suryaningrat Copyright (c) 2020 Felix Firyanto Widjaja, Windu Cahyaningrum Handayani Notonagoro Suryaningrat http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 3 5 10.13181/mji.ed.204615 Air pollution impacts on human health and policies to reduce air pollution https://mji.ui.ac.id/journal/index.php/mji/article/view/4579 <p>[No abstract available]</p> M. R. Karliansyah Copyright (c) 2020 M. R. Karliansyah http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 6 7 10.13181/mji.com.204579 Air pollution and human health https://mji.ui.ac.id/journal/index.php/mji/article/view/4572 <p>[No abstract available]</p> Agus Dwi Susanto Copyright (c) 2020 Agus Dwi Susanto http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 8 10 10.13181/mji.com.204572 A systematic review of respiratory infection due to air pollution during natural disasters https://mji.ui.ac.id/journal/index.php/mji/article/view/4390 <p><strong>BACKGROUND</strong> Wildfire and volcano eruption occurred in Indonesia due to its geographical location, climate change, global warming, and human behavior. Various substances produced an increased risk of experiencing health problems, including respiratory infection. Evidence about the effect of pulmonary infection during natural disasters is still limited. This study was aimed to review and elaborate on previous studies to determine the effect of air pollution exposure during natural disasters and respiratory infection.</p> <p><strong>METHODS</strong> Literature searches were conducted on PubMed, EBSCOhost, and Google Scholar, and was limited to the 10 last years, human studies, and the English language. Inclusion criteria were articles with representation for clinical questions, review articles, population studies, and the full-text article was available. Exclusion criteria were articles that only discussed the exposure to and not the association with the effect of the respiratory infection. The Oxford Center for Evidence-Based Medicine tools appraised six relevant articles.</p> <p><strong>RESULTS</strong> Air pollution during a natural disaster enhances particulate matter to 10–70 μg/m<sup>3</sup> and more than 5 times the aerosol optical depth measurement compared with the tolerated air concentration. The air level was consistently related to acute respiratory infection, pneumonia, bronchitis, and bronchiolitis admissions in wildfire smoke and volcanic eruption in this review. Nevertheless, there was a diverse result for upper respiratory infection cases.</p> <p><strong>CONCLUSIONS</strong> Natural disasters increased the level of ambient air pollution that exceeded the levels recommended by the World Health Organization air quality guideline. Air pollution may play an important role in respiratory tract infection, especially among population with high exposure.</p> Erlina Burhan Ummul Mukminin Copyright (c) 2020 Erlina Burhan, Ummul Mukminin http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 11 8 10.13181/mji.oa.204390 A randomized controlled trial of high parenteral protein feeding in septic children: the role of tumor necrosis factor-alpha-308 polymorphism https://mji.ui.ac.id/journal/index.php/mji/article/view/2104 <p><strong>BACKGROUND</strong> Septic children cause high protein degradation and inadequate nutritional intake would worsen the outcomes. In addition, there are conflicting results of association between tumor necrosis factor-α (<em>TNFA</em>)-308 polymorphism and poorer outcomes. This study was aimed to investigate the impact of high protein feeding in septic children and to examine the role of the <em>TNFA</em>-308 polymorphism in outcome of sepsis.</p> <p><strong>METHODS</strong> In this randomized controlled trial, septic children were randomly assigned to receive either high protein feeding (amino acid of 4 g/kg of body weight [kgBW]/day) or standard nutrient (amino acid of 2 g/kgBW/day) for three days in the pediatric intensive care unit of four hospitals in Indonesia. The patient’s enrollment was done between April 2016 and May 2017. The primary outcome was the pediatric logistic organ dysfunction (PELOD) score. <em>TNFA</em>-308 polymorphism was investigated using restriction fragment length polymorphism method in both groups. PELOD score was analyzed as mean differences and gene polymorphism was analyzed with mortality in a subgroup.</p> <p><strong>RESULTS</strong> There were 40 children in each group. PELOD score on day-1 (22.4 <em>versus</em> 20.5, <em>p</em> = 0.429), day-2 (20.5<em> versus</em> 19.8, <em>p</em> = 0.815), and day-3 (18.8 <em>versus</em> 19.8, <em>p</em> = 0.772) were not lower in high protein feeding compared to standard feeding. <em>TNFA</em>-308 polymorphism had no role in mortality of both groups (high protein, <em>p</em> = 0.426; standard, <em>p</em> = 0.456).</p> <p><strong>CONCLUSIONS</strong> From this study, researchers concluded that a high protein intervention did not significantly decrease the PELOD score, length of stay, and duration of ventilator use in both groups.</p> Gema Nazri Yanni Amir Sjarifuddin Madjid Aryono Hendarto Sri Widia Azraki Jusman Zakiudin Munasir Hindra Irawan Satari Iswari Setianingsih Munar Lubis Sudigdo Sastroasmoro Copyright (c) 2020 Gema Nazri Yanni, Amir S. Madjid, Aryono Hendarto, Sri Widia A. Jusman, Zakiudin Munasir, Hindra Irawan, Iswari Setianingsih, Munar Lubis, Sudigdo Sastroasmoro https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 19 25 10.13181/mji.oa.192104 Prognosis of advanced stage non-small-cell lung cancer patients receiving chemotherapy: adenocarcinoma <em>versus</em> squamous cell carcinoma https://mji.ui.ac.id/journal/index.php/mji/article/view/3787 <p><strong>BACKGROUND</strong> In Indonesia, lung cancer is one of the most prevalent solid cancer with the highest mortality rate. However, studies to identify prognostic factors associated with mortality are lacking. Thus, this study was aimed to determine the association of histological subtypes and prognosis of advanced stage non-small-cell lung cancer (NSCLC) patients receiving chemotherapy.</p> <p><strong>METHODS</strong> This study focused on a retrospective cohort consisting of 60 patients with advanced stage NSCLC and treated with chemotherapy. Patients with NSCLC stage IIIB or stage IV, age ≥18 years, and good performance status were recruited. The outcomes were one-year mortality and treatment response. Gender, age, body mass index, staging, and performance status were evaluated. Chi-square and Fisher’s exact tests were used.</p> <p><strong>RESULTS</strong> Two common histological subtypes, adenocarcinoma (68.3%) and squamous cell carcinoma (31.7%), were observed among all subjects. Four patients (6.7%) died during one-year observation period. Mortality rate was higher in squamous cell carcinoma (10.5%) patients than in adenocarcinoma (4.9%). Underweight patients had higher risk of death (relative risk [RR] = 1.09, 95% confidence interval [CI] = 1.00–1.19) and disease progression (RR = 1.30, 95% CI = 1.12–1.51). In adenocarcinoma, metastasis was a risk for progressive disease (RR = 1.35, 95% CI = 1.09–1.66). In squamous cell carcinoma, men had a lower risk of disease progression (RR = 0.11, 95% CI = 0.03–0.41).</p> <p><strong>CONCLUSIONS</strong> Squamous cell carcinoma had comparable one-year mortality and disease progression rate with adenocarcinoma type in advanced stage NSCLC. However, underweight patients had a higher risk of mortality and disease progression.</p> Noorwati Soetandyo Arif Riswahyudi Hanafi Sri Agustini Dian Triana Sinulingga Copyright (c) 2020 Noorwati Soetandyo, Arif R Hanafi, Sri Agustini, Dian Triana Sinulingga https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 26 31 10.13181/mji.oa.203787 Association between axillary lymph node involvement and clinicopathological features of breast cancer among Indonesian women https://mji.ui.ac.id/journal/index.php/mji/article/view/3306 <p><strong>BACKGROUND</strong> Some clinicopathological features play roles in the spread of breast cancer to axillary lymph node (ALN). However, their roles as predictive factors are not well-established. This study was conducted to determine the correlation between the clinicopathological features of breast cancer and the risk of ALN involvement in Indonesian women.</p> <p><strong>METHODS</strong> This cross-sectional study was conducted in Margono Soekarjo Hospital using archival data from January 2017 to June 2018. All subjects with breast cancer who had undergone modified radical mastectomies without any evidence of distant metastasis were included. Chi-square and Fisher’s exact tests were performed to assess the relationship between ALN involvement and age, menopausal status, laterality, tumor size, tumor stage, histological type, tumor grade, lymphovascular space invasion (LVSI), skin or nipple infiltration, perineural invasion, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. The odds ratio of each variable was evaluated using ordinal regression analysis.</p> <p><strong>RESULTS</strong> Stage 3 breast cancer had the worst status of ALN involvement compared with stage 1 (OR = 3.49; 95% CI = 1.51–8.08) and stage 2 (OR = 3.04; 95% CI = 1.32–6.98). Likewise, positive LVSI also had the worst status of ALN involvement compared with negative LVSI (OR = 8.68; 95% CI = 4.23–17.81).</p> <p><strong>CONCLUSIONS</strong> Tumor stage and LVSI could be considered as independent predictive factors of ALN involvement in patients with breast cancer, especially among Indonesian women.</p> Dody Novrial Gita Nawangtantrini Hidayat Sulistyo Henida Dwi Sari Wahyu Djatmiko Copyright (c) 2020 Dody Novrial, Gita Nawangtantrini, Hidayat Sulistyo, Henida Dwi Sari, Wahyu Djatmiko https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 32 7 10.13181/mji.oa.193306 First trimester maternal upper arm circumference correlated to placental size and neonatal anthropometry https://mji.ui.ac.id/journal/index.php/mji/article/view/2950 <p><strong>BACKGROUND</strong> First maternal nutrition, represented by anthropometrics, is an important factor for fetal growth. This study aimed to determine the correlation between maternal nutritional status of first trimester pregnant women with placental size and neonatal anthropometry.</p> <p><strong>METHODS</strong> A retrospective cohort study (N = 134) was conducted in Jakarta and Riau during August–September 2017. Correlation between first trimester maternal nutritional status, placental size (placental weight and volume), and neonatal anthropometry (birth weight, birth length, head circumference, and abdominal circumference) were examined using Spearman correlation test.</p> <p><strong>RESULTS</strong> High maternal body mass index and upper arm circumference (UAC) are weakly correlated with high birth weight (<em>r</em> = 0.281, <em>p</em>&lt;0.001 and <em>r</em> = 0.271, <em>p</em>&lt;0.001), birth length (<em>r</em> = 0.176, <em>p</em> = 0.022 and <em>r</em>= 0.238, <em>p</em> = 0.002), head circumference (<em>r</em> = 0.251, <em>p</em> = 0.001 and <em>r</em> = 0.297, <em>p</em>&lt;0.001), abdominal circumference (<em>r</em> = 0.227, <em>p</em> = 0.003 and <em>r</em> = 0.226, <em>p</em> = 0.003), placental weight (<em>r</em> = 0.198, <em>p</em> = 0.01 and <em>r</em> = 0.228, <em>p</em>&lt;0.001), and placental volume (<em>r</em> = 0.194, <em>p</em> = 0.01 and <em>r</em> = 0.203, <em>p</em> = 0.008). In addition, high maternal height is also weakly correlated with high birth weight (<em>r</em> = 0.157, <em>p</em> = 0.043) and birth length (<em>r</em> = 0.158, <em>p</em> = 0.041).</p> <p><strong>CONCLUSIONS</strong> UAC can be reliably used to assess the nutritional status of pregnant women and to predict placental and newborn sizes.</p> Noroyono Wibowo Rima Irwinda Lazuardy Rachman Copyright (c) 2020 Noroyono Wibowo, Rima Irwinda, Lazuardy Rachman https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 38 41 10.13181/mji.oa.192950 Validation of the Indonesian version of the graded chronic pain scale 2.0 in pain-related temporomandibular disorders https://mji.ui.ac.id/journal/index.php/mji/article/view/1790 <p><strong>BACKGROUND</strong> Pain associated with oral problems is one of the most frequent chronic pain of temporomandibular disorders (TMDs). This study was conducted to analyze the psychometric properties of the Indonesian version of the graded chronic pain scale 2.0 (GCPS-ID) in Indonesian patients with TMDs.</p> <p><strong>METHODS</strong> The English version of the GCPS version 2.0 was translated and back-translated according to international guidelines. This study conducted from June to December 2016 at the Dental Hospital, Faculty of Dentistry, Universitas Indonesia, and the participants were 202 TMDs patients who had never undergone temporomandibular joint surgery or suffered facial pain for more than 6 months. The evaluation of the GCPS-ID included the internal consistency test, test-retest reliability, and construct validity tests.</p> <p><strong>RESULTS</strong> The GCPS-ID had a high internal consistency (Cronbach’s alpha = 0.896). The intraclass correlation coefficient of the pain intensity and the disability score were 0.789 and 0.706, respectively. The convergent validity demonstrated a moderately positive correlation between the GCPS-ID and the Indonesian version of oral health impact profile for TMD for pain (<em>r</em> = 0.595; <em>p</em>&lt;0.001) and disability (<em>r</em> = 0.488; <em>p</em>&lt;0.001). The discriminant validity between GCPS-ID and the subjective patient’s quality of life revealed a weak positive correlation (<em>r</em> = 0.195; <em>p</em> = 0.191).</p> <p><strong>CONCLUSIONS</strong> GCPS-ID is a reliable and valid assessment tool for evaluating TMD pain in Indonesia.</p> Ira Tanti Vivi Vidya Waty Wira Yenni Pragustine Laura Susanti Himawan Nina Ariani Copyright (c) 2020 Ira Tanti, Vivi Vidya Wira, Yenni Pragustine, Laura Susanti Himawan, Nina Ariani https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 42 6 10.13181/mji.oa.191790 Wilms’ tumor 1 protein expression in embryonal and alveolar rhabdomyosarcoma and its association with clinical prognostic factors: a cross-sectional study https://mji.ui.ac.id/journal/index.php/mji/article/view/3326 <p><strong>BACKGROUND</strong> Embryonal rhabdomyosarcoma (ERMS) and alveolar rhabdomyosarcoma (ARMS) are the two major histological types commonly found in the pediatric population, which have different morphology and genetic profile. Wilms’ tumor 1 (WT1) is an antigen highly expressed in solid tumors, including rhabdomyosarcoma, and a potential immunotherapy target. Only a few studies have attempted to determine WT1 expression in rhabdomyosarcoma. This study was conducted to demonstrate WT1 expression in ERMS, ARMS and associate it with established prognostic factors.</p> <p><strong>METHODS</strong> A cross-sectional study was conducted at the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta using archival data from January 2011 to December 2017. 30 from 102 ERMS cases and 16 from 28 ARMS cases were included in this study. Data of age, tumor size, and location were collected. All cases were stained by WT1 immunohistochemistry. The expression was assessed semiquantitatively using histoscore (H-score) formula. An independent <em>t</em>-test was used to compare WT1 expression between ERMS and ARMS. Correlation analysis was used to evaluate the relationship between WT1 expression and prognostic factors.</p> <p><strong>RESULTS</strong> All ERMS and ARMS cases expressed WT1 in diffuse, moderate to strong staining. ERMS show higher WT1 expression than ARMS (H-score 179.9 <em>versus</em> 149.5) (<em>p</em> = 0.014). Strong WT1 expression mostly found in patient age &lt;20 years and non favourable location. Moderate WT1 expression mostly found in cases with tumor size &gt;5 cm.</p> <p><strong>CONCLUSIONS</strong> WT1 expression was higher in ERMS cases than in ARMS cases, which the expressions were similar in different age, tumor size, and location groups.</p> Aina Angelina Nurjati Chairani Siregar Riesye Arisanty Copyright (c) 2020 Aina Angelina, Nurjati Chairani Siregar, Riesye Arisanty https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 47 52 10.13181/mji.oa.193326 Periodic acid-Schiff and alcian blue immunohistochemistry to detect mucin in mucinous breast carcinoma https://mji.ui.ac.id/journal/index.php/mji/article/view/2768 <p><strong>BACKGROUND</strong> Detection of mucins has been shown to correlate with several clinicopathological characteristics in patients. Currently, periodic acid-Schiff (PAS) and alcian blue staining methods are the histochemistry staining techniques that are frequently used to detect mucin. This study was aimed to evaluate PAS and alcian blue staining in differentiating mucin characteristics between invasive carcinoma of no special type (ICNST) with mucinous degeneration and mucinous carcinoma.</p> <p><strong>METHODS</strong> This cross-sectional study of 33 cases included biopsies of mucinous breast carcinoma and ICNST with mucin degeneration that were histologically verified using hematoxylin and eosin (H&amp;E) staining. The PAS and alcian blue staining were conducted in the Laboratory of Histochemistry, Department of Anatomical Pathology, Cipto Mangunkusumo Hospital. Data were recorded using SPSS software, version 21 (IBM Corp, USA).</p> <p><strong>RESULTS</strong> There were 17 cases of ICNST with mucinous degeneration and 16 cases of mucinous carcinoma with age varied from 27 to 75 years. PAS had sensitivity of 87.5% and specificity of 41.2%. Alcian blue had sensitivity of 43.8% and specificity of 82.4%.</p> <p><strong>CONCLUSIONS</strong> PAS staining method is better than the alcian blue staining method in distinguishing between ICNST with mucinous degeneration and mucinous carcinoma. In the limited setting laboratory, PAS staining alone can be considered to detect mucin.</p> Primariadewi Rustamadji Jason Wibowo Belinda Murtani Christy Magdalena Copyright (c) 2020 Primariadewi Rustamadji, Jason A. Wibowo, Belinda J. Murtani, Christy Magdalena https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 53 7 10.13181/mji.oa.192768 Health consequences of thick forest fire smoke to healthy residents in Riau, Indonesia: a cross-sectional study https://mji.ui.ac.id/journal/index.php/mji/article/view/4321 <p><strong>BACKGROUND</strong> Indonesia forest fire in 2015 emitted a huge amount of pollutants into the air. This study was aimed to assess the health consequences of forest fire smoke in healthy residents in Riau during forest fire disaster in 2015.</p> <p><strong>METHODS</strong> This cross-sectional study was performed in healthy residents who lived in Pekanbaru, Riau Province, Sumatera, for at least 6 months during forest fire disaster in 2015, and data were taken in October 2015. Questionnaires consisting of respiratory and non-respiratory symptoms were collected. Lung function was assessed by spirometry (MIR II Spirolab™ spirometer, Medical International Research, Italy) and exhaled carbon monoxide (CO) was assessed using piCO+ Smokerlyzer®. Heart rate at rest and oxygen saturation in the room air were measured using Onyx 9591 Pulse Oximeter®.</p> <p><strong>RESULTS</strong> A total of 89 subjects were mostly female (75.3%), housewife (37.7%), nonsmoker (86.5%) with mean age of 38.9 years old. The non-respiratory and respiratory symptoms were reported in 84.7% and 71.4% subjects, respectively. Lung function was impaired in 72.6% subjects, mostly with mild obstruction and mild restriction. Exhaled CO was highly detected over normal values (mean [standard deviation] = 32.6 [9.97] ppm) with predicted carboxyhemoglobin (COHb) of 5.74 (1.56).</p> <p><strong>CONCLUSIONS</strong> Forest fire smoke exposure increased the respiratory and nonrespiratory symptoms among healthy individuals, which showed impairment in lung function, exhaled CO, and predicted COHb. Long term health effects on healthy individuals exposed to forest fire smoke warrant further evaluation.</p> Jamal Zaini Agus Dwi Susanto Erlang Samoedro Vonni Christiana Bionika Budhi Antariksa Copyright (c) 2020 Jamal Zaini, Agus Dwi Susanto, Erlang Samoedro, Vonni Christiana Bionika, Budhi Antariksa http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 58 63 10.13181/mji.oa.204321 Risk factor for <em>Mycobacterium leprae</em> detection in household contacts with leprosy patients: a study in Papua, East Indonesia https://mji.ui.ac.id/journal/index.php/mji/article/view/2962 <p><strong>BACKGROUND</strong> In the era of leprosy eradication, Jayapura is still one of the biggest leprosy pockets in Papua, Indonesia. The trend for leprosy case detection rate has remained relatively stable over recent years. This study was aimed to detect <em>Mycobacterium leprae</em> in household contacts and to evaluate the associated factors with the detection.</p> <p><strong>METHODS</strong> This cross-sectional study recruited household contacts of leprosy patients who were diagnosed consecutively from March to August 2015 in Hamadi Point of Care, Jayapura. The leprosy patients were diagnosed using polymerase chain reaction (PCR). For each leprosy patient, up to four household contacts that had no symptom were included. Every household contact received screening through DNA detection of <em>M. leprae</em> extracted from nasal swab specimens and examined using PCR. Factors for bacteria detection included intensity, time duration and number of contacts living together in the same house, and random blood glucose levels were evaluated. Bivariate analysis was used to associate them with M. leprae detection in household contacts.</p> <p><strong>RESULTS</strong> From 107 household contacts of 35 patients who had leprosy, <em>M. leprae</em> was detected in 19.6%. Household contacts with leprosy patients for &gt;1 year was a risk factor for detection (OR = 12.45; 95% CI = 1.595–97.20; <em>p</em> = 0.002). Blood glucose (<em>p</em> = 0.444), ethnic (<em>p</em> = 0.456), sleeping proximity to leprosy case (<em>p</em> = 0.468) and relatives (<em>p</em> = 0.518) give no effect to M. leprae detection in household contacts.</p> <p><strong>CONCLUSIONS</strong> Among the various risk factors studied, duration of living together with the patient significantly increased the risk of <em>M. leprae</em> transmission.</p> Hana Krismawati Antonius Oktavian Yustinus Maladan Tri Wahyuni Copyright (c) 2020 Hana Krismawati, Antonius Oktavian, Yustinus Maladan, Tri Wahyuni https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 64 70 10.13181/mji.oa.192962 Eating behavior affects cardio-metabolic risk in high school teenagers in a developing country https://mji.ui.ac.id/journal/index.php/mji/article/view/3494 <p><strong>BACKGROUND</strong> Modernization negatively changes lifestyle, characterized by excessive eating and reduced energy consumption, and concurrently increases the cardiometabolic risk. This study was aimed to evaluate the association between eating behavior and cardio-metabolic risk factors including body mass index (BMI) in percentile, blood pressure (BP) in percentile, waist circumference, and heart rate in total subjects and gender sub-groups.</p> <p><strong>METHODS</strong> This analytical cross-sectional study was done from July to November 2018. High schools in four provinces of Indonesia and students were selected using purposive sampling. Subjects’ profiles were collected from interview and cardio-metabolic parameters were measured at the study sites. Data were analyzed with chi-square and independent <em>t</em>-test.</p> <p><strong>RESULTS</strong> Subjects who were overweight/obese and had high BP accounted for 27.1% and 9.3–12.0% of the total subjects (n = 768), respectively. Subjects who having breakfast tended to have lower BMI (<em>p</em> = 0.006), and the lower consumption of western meals had lower heart rate (<em>p</em> = 0.02). Male subjects had more meal frequency and had less quantity of snacks than female subjects (<em>p</em>&lt;0.001). Male subjects with routine intake of vegetables had low heart rate (<em>p</em> = 0.03). Female subjects with routine breakfast had better BMI (<em>p&lt;</em>0.001), and lower diastolic BP (<em>p</em> = 0.004) and waist circumference (<em>p</em> = 0.02), whereas those who consumed Western meals had higher heart rate (<em>p</em> = 0.046) and waist circumference (<em>p</em> = 0.001).</p> <p><strong>CONCLUSIONS</strong> Eating behaviors are likely to affect cardio-metabolic risk factors, and the effects vary within gender groups.</p> Rita Suhadi Phebe Hendra Dita Maria Virginia Christianus Heru Setiawan Copyright (c) 2020 Rita Suhadi, Phebe Hendra, Dita Maria Virginia, Christianus Heru Setiawan https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 71 81 10.13181/mji.oa.193494 Epidemiology of erectile dysfunction in men with diabetes mellitus: a study in a primary health care center in Indonesia https://mji.ui.ac.id/journal/index.php/mji/article/view/2070 <p><strong>BACKGROUND</strong> Diabetes mellitus (DM) is one of the factors causing erectile dysfunction (ED) and may affect a person's quality of life. This study was aimed to describe the epidemiology of ED in men with DM in a primary health care.</p> <p><strong>METHODS</strong> The study used a cross-sectional study design conducted from January to March 2017 at the Tlogosari Kulon Health Center, Semarang. There were 122 diabetic men who were all included in the study. The data were collected using interviewerassisted questionnaires. The status of ED was measured by the erectile dysfunction intensity scale adapted to the International Index of Erectile Function.</p> <p><strong>RESULTS</strong> The results showed that the prevalence of diabetic men with ED was 84.4%. Most men with ED had age of ≥46 years (91.0%), experienced work stress (88.5%), had low physical activity (93.1%), had obesity (88.0%) of which 86.3% had central obesity, smoking (84.6%), had DM &gt;5 years (91.2%), and took antihypertensive drugs (90.0%). The fasting blood glucose level of respondents ≥126 mg/dl was 86.0%, and 91.7% had sexual desire disorder. The duration of DM and aging are contributing factors of ED in males with DM, with a <em>p</em>-value of 0.016 and 0.013, respectively.</p> <p><strong>CONCLUSIONS</strong> The prevalence of ED in primary health care is still high, and the determining factors were the duration of DM and aging. Public health centers are advised to undertake health promotion on the prevention of factors that can lead to sexual dysfunction in males with DM.</p> Diana Kusmi Tridiantari Lintang Dian Saraswati Ari Udiyono Copyright (c) 2020 Diana Kusmi Tridiantari, lintang dian saraswati, Ari Udiyono https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 82 7 10.13181/mji.oa.192070 <em>Streptococcus suis</em> meningitis related to processing and consuming raw pork during Balinese tradition, <em>Mebat</em> https://mji.ui.ac.id/journal/index.php/mji/article/view/3249 <p><span class="Apple-converted-space"><em>Streptococcus suis</em> is a zoonotic pathogen that can infect humans, especially meningitis. <em>S. suis</em> meningitis has been commonly diagnosed in Bali, which is associated with the consumption of raw pork. We reported case of <em>S. suis</em> meningitis that could have occurred due to the ingestion of undercooked pork during a traditional ceremony, which also involved two more patients with similar symptoms. A 62-year-old male was brought to the emergency unit because of decreased consciousness (Glasgow coma scale 14/15) in the last 8 hours before admission. He also had a headache, high fever, and stiff neck. Examination of cerebrospinal fluid revealed the presence of <em>S. suis</em> infection and was confirmed by polymerase chain reaction. The patient was administered ceftriaxone and showed a clinical improvement on the third day without any hearing problem.</span></p> IGM Ardika Aryasa Ni Putu Ayu Widiasari Ni Made Susilawathi Ni Nengah Dwi Fatmawati I Made Oka Adnyana Anak Agung Raka Sudewi Ni Made Adi Tarini Copyright (c) 2020 IGM Ardika Aryasa, Ni Putu Ayu Widiasari, Ni Made Susilawathi, Ni Nengah Dwi Fatmawati, I Made Oka Adyana, Anak Agung Raka Sudewi, Ni Made Adi Tarini https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 88 92 10.13181/mji.cr.193249 Multifocal recurrence of medulloblastoma: a long follow-up case study https://mji.ui.ac.id/journal/index.php/mji/article/view/3480 <p>Medulloblastoma is the most common malignant brain tumor in pediatric patients. Leptomeningeal dissemination often occurs in the spinal canal and rarely into the supratentorial as an extra-axial lesion. This study followed an 8-year progression of multifocal medulloblastoma recurrence as supratentorial metastasis that mimics an intra-axial mass of the temporal lobe. Pathologic examination of the temporal mass showed densely packed small round blue cells that are distributed in a ribboning pattern with areas of necrosis, rosette formation, and mitosis. Ki-67 immunohistochemical staining of the tumor showed a high proliferation index of 40% and revealed positive results for synaptophysin and negative results for glial fibrillary acidic protein and β-catenin. A long follow-up is essential to diagnose the recurrence and elucidate the progression of medulloblastoma.</p> Benny Zulkarnaien Edwin Suharlim Eka Susanto Soehartati Argadikoesoema Gondhowiardjo Copyright (c) 2020 Benny Zulkarnaien, Edwin Suharlim https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 93 9 10.13181/mji.cr.193480 Genes predisposing to type 1 diabetes mellitus and pathophysiology: a narrative review https://mji.ui.ac.id/journal/index.php/mji/article/view/3732 <p>The possibility of targeting the causal genes along with the mechanisms of pathogenically complex diseases has led to numerous studies on the genetic etiology of some diseases. In particular, studies have added more genes to the list of type 1 diabetes mellitus (T1DM) suspect genes, necessitating an update for the interest of all stakeholders. Therefore this review articulates T1DM suspect genes and their pathophysiology. Notable electronic databases, including Medline, Scopus, PubMed, and Google-Scholar were searched for relevant information. The search identified over 73 genes suspected in the pathogenesis of T1DM, with human leukocyte antigen, insulin gene, and cytotoxic T lymphocyte-associated antigen 4 accounting for most of the cases. Mutations in these genes, along with environmental factors, may produce a defective immune response in the pancreas, resulting in β-cell autoimmunity, insulin deficiency, and hyperglycemia. The mechanisms leading to these cellular reactions are gene-specific and, if targeted in diabetic individuals, may lead to improved treatment. Medical practitioners are advised to formulate treatment procedures that target these genes in patients with T1DM.</p> Tajudeen Yahaya Titilola Salisu Copyright (c) 2020 Tajudeen Yahaya, Titilola Salisu https://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 100 9 10.13181/mji.rev.203732 Consumption of growing up milk and stunting among Indonesian toddlers https://mji.ui.ac.id/journal/index.php/mji/article/view/4566 <p>[No abstract available]</p> Irma Hidayana Tan Shot Yen Dian Hadihardjono Copyright (c) 2020 Irma Hidayana, Tan Shot Yen, Dian Hadihardjono http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 110 1 10.13181/mji.cor.204566 Consumption of growing up milk and stunting among Indonesian toddlers: authors’ reply https://mji.ui.ac.id/journal/index.php/mji/article/view/4630 <p>[No abstract available]</p> Damayanti Rusli Sjarif Klara Yuliarti William Jayadi Iskandar Copyright (c) 2020 Damayanti Rusli Sjarif, Klara Yuliarti, William Jayadi Iskandar http://creativecommons.org/licenses/by-nc/4.0 2020-03-26 2020-03-26 29 1 111 2 10.13181/mji.cor.204630 Front & Back Matter https://mji.ui.ac.id/journal/index.php/mji/article/view/4637 Medical Journal of Indonesia Copyright (c) 2020-03-26 2020-03-26 29 1