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Acta Medica Indonesiana

Iris Rengganis
Low adult vaccination coverage in Indonesia may contribute to a recent outbreak of diphtheria in Indonesia. Although well known as a pediatric vaccine, diphtheria vaccination should be administered as booster to adolescence and adults for longer prevention. Adult vaccine differs from pediatric vaccine but have similar protection. Additionally, there is special recommendation to vaccinate pregnant women and elderly people aged 65 years or more.
July 2018: Acta Medica Indonesiana
Denita Biyanda Utami, Ardi Findyartini
BACKGROUND: diabetes has become a major public health concern with an estimated 180 million cases worldwide. Nutritional changes are one of the key aspects in the management of type 2 diabetes mellitus. Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in type 2 diabetes mellitus, however the relationship is not well established. The aim of this report is to perform a critical appraisal to analyze whether plant-based diet reduces the HbA1c level compared to conventional diet...
July 2018: Acta Medica Indonesiana
Hikmat Permana, Guntur Darmawan, Ervita Ritonga, Maya Kusumawati, Miftahurachman Miftahurachman, Nanny Natalia Soetedjo
Adrenocortical carcinoma (ACC) is a rare solid tumor with an incidence of 0.5 to 2 cases per million per year. It affects women more commonly than men with a ratio of 1.5:1. Ectopic ACC are considered to be extremely rare with no exact incidence data yet. We report an interesting case of hepatic ACC in a young woman with clinical signs of virilization.A-21-year old Sundanese woman visited our endocrine clinic with progressive hirsutism over the face, body, and extremities starting 14 years previously. She had irregular, heavy periods when she was 7 years old...
July 2018: Acta Medica Indonesiana
Wardhana Wardhana, Achmad Rudijanto
Uric acid as the final result of purine bases metabolism. In high level condition, uric acid enters the cell and act as oxidant, and acts as independent risk factor and predicts the incident of type 2 diabetes mellitus (T2DM). It may directly inactivate or through oxidative reaction that lower the nitric oxide (NO) level. Lower NO level will reduce insulin uptake in tissues and reduce in GLUT4 translocation in cell that will effect the blood glucose level. The High level of uric acid or hyperuricemia makes oxidative stress by inducing the production of reactive oxygen species (ROS) which interferes the insulin signalling pathway,creates inflammatory  state that reduced the insulin sensitivity,blood glucose uptake and metabolism, also reducing the insulin production from pancreatic islet cells...
July 2018: Acta Medica Indonesiana
Anti Dharmayanti, Dalima Astrawinata
A 31-year-old patient came to visit the outpatient clinic at the hospital for his routine twice-weekly hemodialyis (HD) session. During HD, the patient suddenly developed a fever with shivering. At that time, a diagnosis of catheter-related blood stream infection (CR-BSI) was developed, HD catheter or the catheter double lumen (CDL) was uninstalled and the patient was hospitalized. Results of culture withdrawn through the tip of catheter lumen and peripheral blood revealed identical microorganism, i.e. the Enterobacter cloacae...
July 2018: Acta Medica Indonesiana
Gan Wee Leng, Ruslinda Mustafar, Lydia Kamaruzaman, Rozita Mohd, Rizna Abdul Cader, Kong Wei Yen, Pau Kiew Bing
Managing primary or even secondary glomerulonephritis remains a challenge to many nephrologists. In primary focal segmental glomerulosclerosis (FSGS) with heavy proteinuria, renin aldosterone system blockade and high dose of oral prednisolone is the mainstay of treatment. Other immunosuppressive medications like Cyclophosphamide, Cyclosporine A and Mycophenolate Mofetil (MMF) are warranted if a complete remission is not achieved.  We illustrate a case of 21 year old gentleman with primary FSGS that was difficult to achieve remission despite on high dose steroid and oral Cyclophosphamide...
July 2018: Acta Medica Indonesiana
Pustika Amalia Wahidiyat, Stephen Diah Iskandar, Damayanti Sekarsari
BACKGROUND: routine blood transfusion in transfusion-dependent-thalassemia (TDT) causes iron accumulation in various organ. Serum markers of iron overload, serum ferritin and transferrin saturation, are sensitive but not specific. MRI T2-star (T2*) is valuable for detecting iron level in organs. This study aimed to explore the degree of iron overload in various organs, iron deposition difference between children and adults, also its correlation with serum marker of iron overload. METHODS: this was a cross-sectional study of TDT patients who had been evaluated by MRI T2* examination in Cipto Mangunkusumo Hospital from 2014 to 2018...
July 2018: Acta Medica Indonesiana
Lucky Aziza Bawazier, Suhardjono Suhardjono
BACKGROUND: in Indonesia, majority of hemodialysis centers use reusable dialyzer for cost efficiency reason. Currently, there is no available data regarding the quality of life of the end stage-renal disease patient'who use reusable dialyzer measured by a standardized questionnaire, as it was stated that at molecular level, reusable dialyzer could worsen leukocyte activity and could affect patients' complaints and symptoms. METHODS: this was a retrospective cohort study which involved 39 subjects...
July 2018: Acta Medica Indonesiana
Aulia Rizka, Siti Setiati, Kuntjoro Harimurti, M Sadikin, Indra G Mansur
BACKGROUND: Alphacalcidol, a vitamin D analog, shows immune regulatory potency as it works on the macrophage and T cell to control inflammation and T cell dysregulation in elderly. None has been known about its effect on elderly with various states of frailty syndrome, which have different level of chronic low grade inflammation. This study aimed to determine the effect of alphacalcidol on inflammatory cytokines (IL-6, IL-10, g-IFN ) and T cell subsets (CD4/CD8 ratio and CD8+ CD28-) of elderly with various stages of frailty syndrome...
July 2018: Acta Medica Indonesiana
Anggi Gayatri, Nafrialdi Nafrialdi, Rahajuningsih D Setiabudy, Raymond R Tjandrawinata, Andika Rachman, Melva Louisa
BACKGROUND: DLBS1033 is a bioactive protein fraction extracted from Lumbricus rubellus, with fibrinogenolytic, fibrinolytic and anti-aggregation activities reported in an in vitro study. Plasma half-life is an important parameter to calculate its dose. This study was conducted to evaluate the biological half-life of DLBS1033 by measuring serial plasmin-antiplasmin (PAP) complex. PAP complex is a stable and inactive compound as a result of fibrinolysis process. METHODS: this was an open-label clinical trial in healthy adult subjects...
July 2018: Acta Medica Indonesiana
Harrina Erlianti Rahardjo, Firtantyo Adi Syahputra, Putri Iradita Islianti, Faisal Abdi Matondang
BACKGROUND: urinary tract infection (UTI) is often treated in daily practice as overactive bladder (OAB) by giving anticholinergic, the recommended treatment options of OAB. However, anticholinergic application for UTI symptoms relief has never been investigated. To our knowledge, this study was the first randomized trial which investigate anticholinergic use for UTI treatment. This study aimed to evaluate whether additional anticholinergic is beneficial alongside an empiric antibiotic therapy in reducing symptoms and tolerable for females with uncomplicated UTI...
July 2018: Acta Medica Indonesiana
Leonard Nainggolan, Candra Wiguna, Irsan Hasan, Esthika Dewiasty
BACKGROUND: plasma leakage is defined as ≥20% elevation of hematocrit from baseline or decrease in convalescence or evidence of plasma leakage such as pleural effusion, ascites or hypoproteinaemia/hypoalbuminaemia. These signs of plasma leakage, in the early phase, are usually difficult to ascertain by physical examination and laboratory tests where the patient is only reflecting a mild degree of plasma leakage. This study aimed to investigate whether gallbladder wall thickening (GBWT) in the early phase of the disease can be used to detect the occurrence of plasma leakage in dengue patients...
July 2018: Acta Medica Indonesiana
Irma Wahyuni Anwar, Ika Prasetya Wijaya, Lugyanti Sukrisman, Sally A Nasution, Cleopas M Rumende
BACKGROUND: with the increasing number of patients with acute coronary syndrome (ACS) with complex coronary lesion and the increasing needs of coronary artery bypass grafting (CABG) procedures, there is an increasing need for a tool to perform early stratification in high-risk patients, which can be used in daily clinical practice, even at first-line health care facilities setting in Indonesia. It is expected that early stratification of high-risk patients can reduce morbidity and mortality rate in patients with ACS...
July 2018: Acta Medica Indonesiana
Erni J Nelwan
Dengue viral infection remains a major public health problem. As many as 400 million people are infected yearly. Even though the vaccine is available, the use of dengue vaccine is still limited due to some concerns. Among patient infected with dengue viral infection, early recognition of the virus and prompt supportive treatment are important to avoid complication and mortality.The clinical spectrum of dengue viral infection is diverse ranging from undifferentiated fever to dengue shock syndrome characterized by plasma leak and hemoconcentration...
July 2018: Acta Medica Indonesiana
Imam Subekti, Laurentius Aswin Pramono
Graves' disease is an autoimmune disorder which affect thyroid gland. Graves' disease is the most common cause of hyperthyroidism and thyrotoxicosis. Understanding of disease pathophysiology, diagnostic and treatment strategies, and prevention of disease relapse are important for all clinicians especially internal medicine specialist to give optimal and comprehensive management for Graves' disease patients. This article highlights clinical points to treat Grave's disease patients from reviews and latest guidelines from American Thyroid Association (ATA), European Thyroid Association (ETA), and Japan Thyroid Association/ Japan Endocrine Society...
April 2018: Acta Medica Indonesiana
Pustika Amalia Wahidiyat, Mikhael Yosia, Teny Tjitra Sari
BACKGROUND: there are currently three iron chelator readily available for patients Indonesia; deferiprone/DFP (branded as Ferriprox), deferasirox/DFX (branded as Exjade) and deferoxamine/DFO (branded as Desferal). This study aims to determine which iron chelator is the most efficient in reducing cardiac and hepatic iron overload (measured by means of T2* MRI). METHODS: journal search with determined MeSH term was done in PubMed and Scopus. Studies that looked upon thalassemia major patient in all ages with usage of monotherapy iron chelation and its effect on myocardial T2* MRI and/or liver T2* MRI was included...
April 2018: Acta Medica Indonesiana
Eka Ginanjar, Yulianto Yulianto, Simon Salim, Wawan Setyawan
Myocardial infarction simultaneously involving two or more culprit lesions is extremely rare and usually has a poor clinical outcomes including mortality. Management of this complicated condition is challenging and limited time. Nevertheless, autopsy studies revealed that thrombotic occlusion of more than one major epicardium coronary artery is not uncommon. A 68-year-old woman presented with sudden onset of limited breath and chest discomfort since two hours prior to admission. She also felt exert dyspnoea since one month ago...
April 2018: Acta Medica Indonesiana
Harry Freitag Luglio Muhammad
Stunting or short stature in children is a significant nutritional problem in developing and underdeveloped countries. Stunting during childhood might affect brain development and impair development cognitive function. Additionally, this condition associated with the increased risk for obesity during adulthood. Several studies have shown that the increment risk of obesity and overweight in children with a short stature was due to their metabolic efficiency. Children with stunting have lower resting energy expenditure compared to non stunting children...
April 2018: Acta Medica Indonesiana
Pristya Ramadhani, Bramantono Bramantono, Made Putra Sedana
Progressive multifocal leukoencephalopathy (PML) is a rare but fatal disease leading to severe neurological impairments. PML is a clinical manifestation, which is usually associated with John Cunningham virus (JCV) infection. It is also correlated to malignancies that mainly include hematologic malignancies such as chronic lymphocytic leukemia (CLL). Until now, no specific treatment has been established for JCV-induced PML; therefore, the prognosis of this disease is poor.We present a case of a 67-year-old woman who suffered from CLL with a chief complaint of seizure...
April 2018: Acta Medica Indonesiana
Hendra Gunawan, Awalia Awalia, Joewono Soeroso
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with various clinical disorders and frequent exacerbations. Psoriasis vulgaris is a common skin disorder which affect 1-3% of general populations. The pathophysiology regarding the coexistence of these diseases is not fully understood. Therapeutic challenges arise since the treatment one of these diseases may aggravate the other. We reported two cases of SLE with psoriasis vulgaris with clinical manifestations as recurrent erythroderma with photosensitivity...
April 2018: Acta Medica Indonesiana
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