Medical Journal of Indonesia

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https://imsear.searo.who.int/handle/123456789/147053

Editor: Nafrialdi

ISSN: 0853-1773(Print)

Frequency: Quarterly

Language: English

Published by Faculty of Medicine Universitas Indonesia

Peer-reviewed open access journal indexed in Index Medicus

Web site: https://mji.ui.ac.id/v2/

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Now showing 1 - 20 of 567

Ability of prostate specific antigen to predict bone scan result in prostate cancer patients.
(2004-07) Tenggara, Taufan; Umbas, Rainy
The objective of this study is to assess the relation between serum prostate specific antigen (PSA), clinical tumor stage, tumor grade, and bone scan result in an attempt to seek the ability of serum PSA to predict bone metastases in newly diagnosed prostate cancer patients. A retrospective analysis was conducted on clinical files of prostate cancer patients which were diagnosed in our institutions between January 1995 and December 2003. Patients on which initial serum PSA were obtained after urethral manipulation or after receiving therapy were excluded. The results of bone scans were related to levels of serum PSA, clinical tumor stage, and tumor grade. Of 103 patients who were included in this investigation, 61 patients (59.2%) had a positive bone scan and 42 patients (40.8%) had a negative bone scan with mean PSA value 471.13 ± 853.34 ng/ml and 61.00 ± 124.47 ng/ml respectively (p < 0.05). The risk of having a positive bone scan increased with advancing serum PSA levels, clinical tumor stage, and tumor grade (p < 0.05). Using receiver operating characteristic curves, PSA had the best correlation with bone scan results (the area under curve was 0.812). Bone scan results were predicted best by the combination of serum PSA, clinical tumor stage, and tumor grade. Bone scans were positive in 5 of 19 patients with PSA level < 10 ng/ml. None of 8 patients with PSA levels < 10 ng/ml, clinical tumor stage T1 or 2 and tumor grade 1 or 2 had a positive bone scan. In conclusion, we suggest that routine bone scan examination may not be necessary in patients with newly diagnosed, untreated prostate cancer, who have serum PSA level < 10 ng/ml with clinical tumor stage T1 or 2 and tumor grade 1 or 2.
Acalypha indica Linn root extract improved hippocampal cell viability and increased brain-derived neurotrophic factor (BDNF) in hypoxic condition.
(2012-08) Ibrahim, Nurhadi; Rahadian, Julia; Suniarti, Dewi F
Background: This study was done to determine the effect of root extract of Acalypha indica Linn (akar kucing) in protecting neuron viability of the rat hippocampus on tissue culture in hypoxic condition. Methods: This is an experimental study of in vitro primary cell culture of hippocampus of Sprague Dowley adult rat. The cultures were group into control (C) and exposure to root extract of Acalypha indica Linn with dose of 10 mg/mL, 15 mg/mL, and 20 mg/mL for 72 hours. The cultures were then exposed to hypoxic gas (5% oxygen, 5% carbondioxide, nitrogen balance) for 24 hours. After that, relative cell viability was measured by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT), cell proliferation by 5-bromo2’-deoxy-uridine (BrdU), and Brain-derived Neurotrophic Factor (BDNF) levels by BDNF ELISA kit. Results: The result showed MTT viability (C: 99.7%, A indica L 10: 326.3%, A indica L 15: 411.7%, A indica L 20: 445.9%), BrdU absorbance (C: 0.07, A indica L 10: 0.10, A indica L 15: 0.12, A indica L 20: 0.13) of the exposured hippocampal cell were significantly higher than the control group (p < 0.01) accompany by increased level of BDNF (C: 11.3 pg/mL, A indica L 10: 12.5 pg/mL, A indica L 15: 23.1 pg/mL, A indica L 20: 18.1 pg/mL). Conclusion: The root extract of Acalypha indica Linn is able to improve rat hippocampal cell viability and endogenous BDNF levels in hypoxic condition.
Acalypha indica root extract increases post-hypoxic rat hippocampal tissue culture cell viability via phospholipase A2 inhibition.
(2013-08) Yolanda, Sophie; Andraini, Trinovita; Kusuma, Indra
Background: Phospholipase A2 (PLA2) is involved in inflammation and cell death following stroke, and inhibition of its activity may promote neuroregeneration. This study aimed to observe the influence of Acalypha indica Linn root extract towards relative cell viability and PLA2 enzyme level in post-hypoxic hippocampal tissue culture. Methods: Experimental in vitro study using 24 primary neuronal cell cultures obtained from Sprague Dawley rat exposed to hypoxia with 5% O2 / 5% CO2 / N2 balanced gas for 24 hours. Post-hypoxia, Acalypha indica Linn root extract was added at doses of 10, 15, and 20 mg/mL to three treatment groups. No treatment was given to the control group. Each group consists of six samples. After 72 hours of incubation, relative cell viability was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) examination, and phospholipase A2 enzyme level was determined using ELISA. Results: PLA2 enzyme level of rat hippocampal tissue culture treated with Acalypha indica Linn root extract at 10, 15, and 20 mg/mL were significantly lower than that of control (5.55 ng/mL, 6.85 ng/mL, and 7.42 ng/mL vs 7.96 ng/mL, p < 0.05). Conclusion: Acalypha indica Linn root extract increases the relative cell viability and decreases the PLA2 enzyme level of post-hypoxic mouse hippocampal tissue with the optimal dose of the extract at 10 mg/mL.
Accelerated neuroregulation for therapy of opiate dependency.
(2004-01) Sunatrio, S; Rachmat, L; Darmansyah, G; Thedja, Y
Acute weaning from chronic opioid abuse during general anesthesia is usually followed by adrenergic outflow effects. This article is to report our experience with accelerated neuroregulation that reverses the physical and psychological dependency. After a comprehensive psychological and medical examination, 361 heroin dependent patients were admitted to ICU to be hospitalized for a full 24 or 36 hours, including a 6 hour pre-procedure medication process (solbutamol, clonidine, diazepam, ranitidine, omeprazole, vitamin C, octreotide, and ondansetron). Anesthesia was induced with midazolam and propofol iv and maintained with propofol infusion. Naltrexon, clonidine, octreotide, and diazepam were then administered. Anesthesia was maintained for 3 ½ - 5 hours depending on severity of withdrawal symptoms precipitated by naltrexone. Analgetics and sedatives were given as needed afterwards. Upon discharge on the following day, patient was prescribed a regimen of oral naltrexone for 10-12 months. All 361 patients were successfully detoxified without any adverse anesthetic events. The side effects encountered were fatigue, insomnia, drowsy, shivering, abdominal pain, nausea, diarrhoea, myalgia, goose bumps and uncomfortable feeling. In most of the patients these symptoms disappeared without any treatment. Symptomatic treatments were needed in 32.7% of patients. In all 166 patients who completed their naltrexone maintenance treatment, craving disappeared in the 10th month. The main problem was the low patient compliance to oral naltrexone, so that only 45.9% of the patients completed their therapy. Conclusion: Accelerated neuroregulation which includes naltrexone maintenance treatment (10-12 months) was highly effective to detoxify and to abolish craving in the heroin dependent patients.
Access to health information may improve behavior in preventing Avian influenza among women.
(2011-02) Endarti, Ajeng T; Shah, Shamsul A
Background: Improving human behavior toward Avian influenza may lessen the chance to be infected by Avian influenza. This study aimed to identify several factors influencing behavior in the community. Method: A cross-sectional study was conducted in July 2008. Behavior regarding Avian influenza was measured by scoring the variables of knowledge, attitude, and practice. Subjects were obtained from the sub district of Limo, in Depok, West Java, which was considered a high risk area for Avian influenza. The heads of household as the sample unit were chosen by multi-stage sampling. Results: Among 387 subjects, 29.5% of them was had good behavior toward Avian influenza. The final model revealed that gender and access to health information were two dominant factors for good behavior in preventing Avian influenza. Compared with men, women had 67% higher risk to have good behavior [adjusted relative risk (RRa) = 1.67; 95% confidence interval (CI) = 0.92-3.04; P = 0.092]. Compared to those with no access to health information, subjects with access to health information had 3.4 fold increase to good behavior (RRa = 3.40; 95% CI = 0.84-13.76; P = 0.087). Conclusion: Acces to health information concerning Avian influenza was more effective among women in promoting good behavior toward preventing Avian influenza.
Accuracy of frozen-section combined with imprint and fine needle aspiration biopsy in thyroid nodules.
(2007-04) Makes, Benyamin
Thyroid malignancy can be found on 5% of thyroid nodules. In order to better managed of thyroid nodules, skills to differentiate benign from malignant cases were needed. Fine needle aspiration biopsy (FNAB) was done preoperatively while frozen section (FS) and imprint cytology (IC) should be done intra-operatively. The objective of this research paper is to evaluate the diagnostic accuracy of FNAB versus frozen section combined with imprint cytology (FS+IC) in thyroid nodules at the Anatomic-Pathology Department FMUI-CM Hospital, Jakarta. This diagnostic test, used data from clinico-pathological records in Anatomic Pathology Department, Faculty of Medicine University of Indonesia / Dr.Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during 1999-2003. Specimens with complete data of FNAB results, data of FS and slides of IC. All formalin fixed`specimens were reevaluated and used as the golden standard. Sensitivity, spesificity and accuracy of FS+IC were higher than FNAB (86.8% vs 73.7% ; 99.0% vs 83.9% ; 94.8% vs 80.5% respectively). If the results of FNAB were concordant with the result of FS+IC, the combined examination yields accuracy of 95.1%. The evaluation of frozen section combined with imprint cytology is very useful, because this examination significantly showed high accuracy in diagnosing thyroid malignancy.
The accuracy of warfarin dosage based on VKORC1 and CYP2C9 phenotypes in a Chinese population.
(2012-05) Wijaya, Agustinus; Bo, Jiang T; Jun, He; Ping, Jiang W; Bin, Jiang; Jie, Chen H; Wen, Yang B; Zhu, Xu M; Cheng, Qiu Q
Background: The aim of this study is to assess the accuracy of warfarin dosage based on VKORC1 and CYP2C9 genotype in Chinese population. Methods: Blood samples were taken from 37 patients. We compared the warfarin dosage obtained from genotype (according to www.warfarindosing.org) and treatment dosage with international normalized ratio (INR) value within 2.0-3.0. Results: The majority of Chinese people in our study are VKORC1 homozygous AA (89.2%), rarely VKORC1 heterozygous AG and we cannot find a patient with homozygous GG. For CYP2C9 genotype, most patients have the wildtype variants (CYP2C9*2 CC and CYP2C9*3 AA). The warfarin dosage for patients with VKORC1 AA and CYP2C9*3 AC is lower than for patients with other genotype variants. Conclusion: There is no significant difference between pharmacogenetic algorithm (www.warfarindosing.org) and our treatment dosage. Our conclusion is that the pharmacogenetic algorithm is accurate to predict the warfarin dose.
Accurate diagnoses, evidence based drugs, and new devices (3 Ds) in heart failure.
(2012-02) Siswanto, Bambang B
Heart failure becomes main problem in cardiology because of increasing of heart failure patients, rehospitalization rate, morbidity, and mortality rate. The main causes of increasing heart failure problems are: (1) Successful treatment of acute myocardial infarction can be life saving, but its sequelae can cause heart failure. (2) Increasing life expectancy rate grows along with incidences of ageing related heart failure. (3) High prevalence of infection in Indonesia can cause rheumatic heart disease post Streptococcal beta hemolyticus infection, viral myocarditis, infective endocartitis, and tuberculoid pericarditis. (4) Many risk factors for coronary heart disease are often found in heart failure patients, for examples smoking, diabetes, hypercholesterolemia, hypertension, and obesity. Indonesia joined international multicentered registry in 2006. Acute Decompensated HEart failure REgistry is a web based international registry to record patient with acute decompensated heart failure treated in emergency room. It was found that heart failure patients in 5 big hospitals in Java and Bali island that joined this registry are younger, sicker and late to seek treatment. The median hospital length of stay was 7 days and in hospital mortality rate was 6.7%. The aim of this article is to give summary about essential things in diagnosing and treating heart failure patients. 3D (accurate diagnoses, evidence based drugs, and new devices) are the most important but what to do and what not to do in dealing with heart failure is also useful for your daily practice.
Acute eye irritation study of a mixture of glyphosate isopropylamine salt and 2,4 D-isopropylamine.
(2003-07) Suyatna, F D; Darmayanti, S
This is an acute irritation study of the eye of a mixture of herbicides containing 240 g/l of glyphosate isopropylamine and 2,4 D-isopropylamine in the rabbits. This study was conducted according the methods as dercribed by the United States Environmental Protection Agency (EPA). Our results show that the combination of the herbicides causes mild conjunctivitis, mild chemosis, eye discharge and corneal injury. The ocular alteration, however, was reversible in nature.
Acute mountain sickness.
(2001-04) Sharma, Ashok
Acute mountain sickness, HAPE (high altitude pulmonary edema) and HACE (high altitude cerebral edema) are associated with acute exposure to altitudes greater than 8000 ft. Although usually self limiting, they can be life threatening. We are not yet clear abour the pathophysiological processes in acute mountain sickness. Descent to lower elevation is the definitive treatment for altitude illness. There is no unanimity of opinion regarding other modes of therapy. Treatment consists of bed rest, orygen inhalation and judicious use of morphine, diuretics, steroids and niftdipine as vasodilator therapy.
Adiponectin, total anti-oxidant status, and high sensitivity C-reactive protein in Indonesian men with metabolic syndrome.
(2009-10) Sartika, Cynthia R; Lukito, Widjaja; Wijaya, Andi
Aim: To examine biochemical markers of adiponectin, total anti-oxidant status (TAOS) and high sensitvity C-reactive protein (hsCRP) in individuals with and without metabolic syndrome (MetS). Methods: A cross-sectional study on 36 non-MetS and 36 MetS subjects was undertaken in Jakarta. Measured indicators were adiponectin, TAOS and hsCRP, apart from weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG). Odds ratio (OR) of adiponectin, TAOS and hsCRP were calculated to assess risk for the development of MetS. Median values were determined as cutoffs to define high and low values of each parameter. Relationships between adiponectin, TAOS and hsCRP with WC were analyzed by using Spearman correlation analysis, and the contributions of all indicators to the development of MetS were analyzed by using logistic regression. Results: Adiponectin dan hsCRP differed signifi cantly between non MetS and MetS subjects (4.2 + 1.4 vs 3.1 + 1.0 ug/mL) dan (0.97 + 0.92 vs 3.35 + 3.43 mg/L) (p < 0.01), but no signifi cant difference was found in TAOS (1.24 + 0.1 vs 1.28 + 0.2 mmol/L). Adiponectin associated negatively with WC (rs= -0.436; p < 0.01), while TAOS and hsCRP associated positively with WC (rs= 0.286, p = 0.02 and rs= 0.597, p < 0.01). The odds ratios (ORs) of adiponectin and hsCRP for the development of MetS were 4 (p = 0.01) and ~6,8 (p < 0.01), respectively; while the risk of subjects with adiponectinhs CRP ratio of ≤ 2.31 to develop MetS was 25 times (p < 0.01) those with adiponectin-hsCRP ratio > 2.31. Conclusion: The use of adiponectin-hsCRP ratio increases the predictive power for the occurrence of MetS by 4-6 times the predictive power of adiponectin or hsCRP alone.
Advances in the practice of microsurgery: focusing on free anterolateral thigh perforator flap.
(2007-10) Prasetyono, Theddeus O H
The purpose of this paper was to discuss an overview of the current clinical practice of microsurgery with a specific use of free anterolateral flap as one of the commonest flaps used in reconstructive surgery. A systematic review was performed through all English publication that goes to Pubmed during the period of 1997 to 2006 using keywords: “anterolateral thigh perforator flap.” The studies involved were retrospective case reviews on using microsurgical technique and involves free anterolateral thigh flap only without muscle involvement. Evaluation was done to search the indications, contraindications, area or organ to reconstruct, the cause of defects need reconstructive surgery, morbidities, functional and aesthetic results, techniques in regard of suture material, and instruments. Using 7th edition EndNote program, 230 abstracts were successfully retrieved in term of “anterolateral thigh perforator flap” of ANY FIELD and Boolean logic OR. Fifty six abstracts from many journals matched the criteria. Due to our limitation to get all of those articles, finally, 8 articles from Plastic and Reconstructive Surgery became the resources of this paper. The overall success rate in terms of flap viability is 98% (525 from 535 flaps) with partial necrosis is as low as 2.2% (12 from 535 flaps). Thinning procedure is commonly applied with regards of the thin flap needed. The recipient sites from 8 articles varies and can be any part of the body includes facial, neck, pharyngoesophagus, breast, upper and lower extremity. Four out of 8 papers mentioned functional evaluation and all stated satisfactory to excellent outcome. There are also 4 papers mentioning the aesthetic evaluation. Overall evaluation was mentioned as good to excellent. It is concluded that free anterolateral thigh perforator flap is a well established choice in most soft tissue reconstruction. It can be indicated to any area needed reconstruction especially head and neck, extremity, and go beyond conventional for breast reconstruction. It has also superior result in pharyngoesophageal reconstruction.
Age, body posture, daity working load, past antihypertensive drugs and risk of hypertension: A rural Indonesian study.
(2001-01) Basuki, Bastaman; Setianto, Budhi
Indonesia has about 210 million inhabitans and most of them live in rural areas, therefore in rural community it is estimated that a big number of hypertensive people can be found. However, few rural community-based studies have been conducted to identify hypertensive risk factors. This study aims to identfy some risk factors related to hypertension in rural areas. The data for this study came from the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta. The study was conducted on July 12, 2000 at 10:00 AM to 1:00 PM in a rural area, the Cijeruk subdistrict in Bogor regency. The subjects were selected randomly using neighborhood cluster. Interviews and blood pressure were taken at the houses of the subjects. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 17-39 year old group, and the risk was most prominent among the 55-59 year group (adjusted odds ratio = 21.62; 95% confidence intervals (CI) = 4.10-113.97). Compared to the subjects with normal body posture, those who were obese had more than 6.3-folds increase in the risk to be hypertensive (adjusted OR = 6.33: 95% CI = 2.62-15.29). In addition, those who discontinued antihypertensive drugs had almost 12-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR = 11.92; 95% CI = 4.61 -30.80). This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs, and whom had light daily working load to prevent hypertension.
Age, duration of work, noise and vibration in inducing hearing and balance impairments.
(2005-04) Bashiruddin, Jenny
Noisy and vibrating bajaj, a public transportation in Jakarta, is a potential risk in inducing hearing and balance problems. Bajaj drivers in the Jakarta area were chosen by consecutive sampling and examined medically in the Neurotological Subdivision of the ENT Department of the Cipto Mangunkusumo Hospital, Jakarta. Hearing and balance impairments were then diagnosed from audiometric and posturographic tests. The study was carried out from March 2000 until October 2001. A number of 350 bajaj drivers participated in this study. There were 97 subjects without hearing and balance impairments, and 96 subjects suffered from hearing and balance impairments. Compared to drivers aged less than 40 years, those aged 41 years or more had a four-fold increased risk of developing hearing and balance impairments [adjusted odds ratio (OR) = 3.90; 95% confidence interval (CI) = 1.67-9.01. Drivers working 9 hours or more a day had an increased risk 2.3 times of developing hearing and balance impairments compared those working less than 9 hours a day (adjusted OR = 2.32; 95% CI=I.22-4.41). Furthermore, when compared to those who had been working for 1-5 years, those who had been working for 5 years had an increased tendency of developing hearing and balance impairments. Those who had been working 21-30 years had a seven-fold increased risk of developing hearing and balance impairments (adjusted OR = 7.11; 95% CI = 1.88-26.92). To minimize hearing and balance impairments bajaj drivers are recommended to work less than 8 hours a day.
The aging male project.
(2001-04) Saad, Farid
With an increasing life expectancy and a decreasing reproduction rate, the population structure changes. A Jenapharm R & D program investigates the endocrinology of aging men. In men, a decrease in production of sex steroids and other hormones with age can be observed. The typical patterns of daily rhythmicity become less distinct. This is part of a very complex picture in which not only isolated hormones are involved, but also the influence of hormones on each other. Many factors from the external and intemal environment mediated by neurotransmitters constantly affect the highly sensitive hormonal balance. Therefore, aging has also been defined as "the gradual dysfunction of homeostatic processes". Declining testosterone (T) levels are involved in 'andropausal' symptoms in men: loss of libido, erectile dysfunction, insulin receptor resistance, obesity, osteoporosis, disturbances of lipid metabolism, myocardial and circulatory disturbances, impaired well-being and mood. Data are derived from studies in hypogonadal men treated by T replacement. In such parients under T treatment libido increases, fat mass decreases, muscle strenth, bone mineral density and erythropoesis increase. Whether the symptoms of andropause in aging men could successfully be treated by T substitution remains to be investigated. Negative effects of T, especially on the prostate and the cardiovascular system, are under discussion. There is increasing evidence that low T levels seem to be a risk factor for both the prostate and the cardiovascular system. Jenapharm's new testosterone undecanoate formulation for intramuscular injection can be administered every three months. T levels remain within the physiologic range. No supraphysiologic peaks occur. In women, estrogens have beneficial non-genital effects. Studies concentrate on synthetic estrogens for men without feminizing properties such as gynecomastia and reduced testicular size. Several derivatives of 17- alpha estradiol have been synthesized some of which show selectivity for the central nervous system. CNS effects have been demonstrated in female and male animals. Cardiovascular protection by estrogens has been shown in animal and human studies. Atherosclerotic plaque size was reduced after estrogen injections in cholesterol-fed rabbits. Phytoestrogen-fed monkeys had lower total cholesterol and LDL cholesterol and higher HDL cholesterol. Apart from atherosclerotic lesions, coronary artery vascular reactivity was improved. Some of these experimental findings were confirmed in human studies in postmenopausal women with and without estrogen treatment. Whether all of the described estrogenic effects can be seen in men remains to be investigated.
Air movement, gender and risk of sick building headache among employees in a Jakarta office.
(2003-07) Winarti, Margaretha; Basuki, Bastaman; Hamid, Abdulbar
Even though office buildings are usually equipped with ventilation system or air conditioning to create a comfortable working environment, yet there is still found a number of sick building syndrome (SBS) symptoms. One of the symptoms of SBS is SBS headache. Therefore, it is crucial to identify risk factors related to SBS headache. Cases were subjects who have suffered SBS headache, and controls were subjects who did not suffered headache for the last one month. Cases and controls were selected through a survey on all of employees in the said office during the period of May to August 2002. Total respondents were 240 employees including 36 people suffered SBS headache (15%). Compared to the normal air movement, faster air movement decreased the risk of SBS headache by 57% [adjusted odds ratio (OR) = 0.43; 95% confidence intervals (CI): 0.19-0.95]. Female employees, compared to the males ones, had a higher risk of getting SBS headache by almost three times (adjusted OR = 2.96: 95% CI: 1.29-6.75). Employees who had breakfast irregularly, had a lower risk to SBS headache than those who have breakfast regularly (adjusted OR=0.31; 95% CI: 0.09-0.84). Temperature, humidity and smoking habits were not noted correlated to SBS headache. Female workers had greater risk of suffering SBS headache. In addition slower air movement increased the risk of SBS headache. Therefore, it is recommended to improve the progress of air in order to reduce the risk of SBS headache, especially for female workplace.
Alpha-lipoic acid and stem cell approach for chronic diseases.
(2011-05) Simatupang, Abraham
Analysis of fatty acids in Ghee and olive oil and their probable causal effect in lipoid pneumonia.
(2010-11) Mirghani, Zein; Zein, Tayseer; Annoble, Samuel; Winter, John; Mostafa, Randa
Aim: To analyze and identify the fatty acids found in homemade ghee and in olive oil and compare those to fatty acids found in bronchoalevolar lavage of children with lipoid pneumonia. Methods: The fatty acids found in homemade fat ”Ghee” and olive oil were analyzed by gas chromatography. Methyl ester derivatives suitable for GC analysis were prepared directly from olive oil or from Ghee using anhydrous methanolic-HCl. Bronchoscopy and bronchoalevolar lavage was performed in eight children aged between 2 and 4 years, all with history of using homemade ghee and/or olive oil in the recumbent position. Results: The analysis of fatty acids in Ghee and olive oil show similar gas chromatographic pattern as those of bronchoalevolar lavage. Conclusion: The three fatty acids responsible for the deleterious effects of lipoid pneumonia were identifi ed. Lipoid pneumonia should be one of the differentials diagnosis in children presenting with respiratory distress.
Analysis of pulsotypes of salmonella typhi isolates and their clinical profiles in typhoid fever patients.
(2003-01) Soemanto, Retno Kadarsih; Moehario, Lucky Hartati
A study of genotyping (pulsotyping) of Salmonella typhi (S. typhi) isolates using pulse-field gel electrophoresis (PFGE) methods was performed to examine their genetic diversity, and relationship between genetic characteristics and clinical outcomes. Sixty-six S. typhi isolates obtained from sporadic hospitalized typhoid fever cases were used in this study. Four isolates were found identical and the dendogram constructed showed 33 pulsotypes in which 13 of them can be divided into 30 subtypes. Diversity among them were high as shown by the Dice coefficients that ranged from 0.486 to 1.000. Cluster analysis showed 2 main clusters with 65% degree of similarity, suggested that they were not originated from one clone. Further, at 90% degree of similarity, 9 clusters containing at least 3 isolates were determined to explore any possible existence of relationship between genetic profile and particular clinical outcomes. Clinical manifestations ranged from mild to severe were in fact distributed diversely among these clusters. Although the clinical data obtained were incomplete, 2 out of 4 patients infected by the S. typhi belonged to cluster 1 showed an elevation of total bilirubin, whereas it was not found in 19 other patients distributed in other 8 clusters. Even though specific clinical manifestations were apparently not found to relate with particular clusters of genotypes, S. typhi isolates grouped in cluster 1 seemed to show trophism to hepatobiliary system.
An analysis on the delay of cervical cancer patients in seeking medical check up in Dr. Cipto Mangunkusumo National Central General Hospital Jakarta.
(2003-07) Susanti, Ni Nengah; Aziz, M Farid; Bachtiar, Adang
In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %). This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel.

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