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Articles 16 Documents
Search results for , issue "Vol 40, No 01 (2008)" : 16 Documents clear
Diabetic retinopathy diagnostic with ophthalmoscope by trained doctor Hartono, Imam Masduki Angela Nurini Agni
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Universitas Gadjah Mada

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Introduction. Diabetes mellitus patient is in high risk to be complicated by retinopathy. Visual loss and decrease of visual acuity become a significant social burden. Early detection is essensial for treatment. Ophthalmoscopy was highly effective for screening, easily used and accessed by ophthalmologist and other physician and has been applied in many developed countriesPurpose : This study was aimed to know the validity of ophthalmoscopic test done by a trained doctor in diagnosing diabetic retinopathy..Materials and methods : The subjects were diabetic patients without cataracts. The examiner was a resident of Internal Medicine Department who had been trained in ophthalmoscopy. After the training, the resident was assessed and the result was compared with the trainer and showed agreement with kappa 1.00.Results: The study was done from February to May 2007. Total subjects were 98 patients (196 eyes I consisted of 50 females (51%1 and 48 males (49%1 with mean age of 61 :t7.92 years old. Mean diabetes duration was 6.6:t 5.94 years and all of them were diabetes type 2. Some patients had hypertension (44.9%1, dyslipidemia (17.7%1, heart disease (6.1%), and kidney disease (5.1%1. From 196 eyes, 6 (6.1 %1 eyes had cataract and were excluded. Mean visual acuity was 0.7726 :to.31 08. Diabetic retinopathy was found in 41 eyes among 190 eyes (21.57%1, consisted of 22 eyes with mild NPDR (53.65%1, 7 eyes with moderate NPDR (17.07%), 7 eyes with severe NPDR (17.07%1, 5 eyes with advance PDR (12.19%1. Sensitivity, specificity, PPV, NPV and accuracy resulted by 5 hour trained doctor examinations were 63.41%, 67.78%, 36.62%, 67.78%, and 66.78% respectively R (+1 and LR (-I were 1.968 and 0.5397, respectively.Conclusion: Direct ophthalmoscopic examination by a trained doctor to detect retinopathy is promisalble in Indonesia.Keywords : diabetic retinopathy, direct ophthalmoscopy, diagnostic value, traineddoctor
Validity of BI-RADS System Mammography to detect breast cancer at Dr Sardjito Hospital Yogyakarta Teguh Aryandono, Indrasto Histopaedianto Lina Choridah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Universitas Gadjah Mada

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Background: Breast cancer is the second most common cancer among women worldwide and the sixth common cause of mortality in Indonesia. The diagnosis of breast cancer may be established by physical and imaging examinations, but definitive diagnosis should be verified by histopathologic examination. Mammography is an easy non-invasive imaging method to detect breast cancer with good accuracy. The lack of uniformity in mammography reporting has led to confusion as to the interpretation and management recommendation. The American College of Radiology Breast Imaging Reporting and Data System (BIRADS) has provided a standardized reporting system for mammography. The validity of this system at Dr Sardjito Hospital Yogyakarta has not been evaluated.Objective: To know the sensitivity, specificity, positive and negative predictive values, and accuracy of the BI-RADS System Mammography in diagnosing breast cancer.Methods: This study was a diagnostic test with cross sectional design on breast cancer diagnosis based on BI-RADS system mammography. All medical record files of patients with breast lump who underwent mammography and histopatologic examination, at Dr Sardjito Hospital Yogyakarta between December 2003-March 2008, were included in the analysis.Results: BI-RADS System Mammography at Dr Sardjito Hospital Yogyakarta had sensitivity of 87.5%, specificity of 93.7%, positive predictive value of 96.5%, negative predictive value 78.95%, positive likelihood ratio 14, negative likelihood ratio 0.13, prevalence 66.6%, and accuracy 89.6%.Conclusion: Mammography examination using BI-RADS System in Sardjito Hospital Yogyakarta was favourable in detecting breastcancer.Key words: breast cancer - BI-RADS mammography - histopathology - diagnostic value
The Effecttiveness of topical cyclosporine 0.05% compared to topical fluorometholone 0.1% in the therapy of vernal keratoconjunctivitis Agus Supartono, Edy Ariston Suhardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Vernal keratoconjunctivitis (VKCI is a chronic and often severe form of bilateral tarsal and or bulbar conjunctivitis. Several studies have reported that topical corticosteroid therapy was effective and cyclosporine was very effective in the treatment of moderate and severe VKC. In this study we wanted to know the effectiveness of topical cyclosporine 0.05% compared to topical fluorometholone 0.1 % in VKCObjective: The objective of this research was to know the effectiveness and side effect on the raise of intraocular pressure of 0.05% cyclosporine eyedrop compared 0.1 % fluorometholone on patients suffered from vernal keratoconjunctivitisMethods: A double blind randomized controlled trial was performed on the subjects suffered from vernal keratoconjunctivitis who fulfilled inclusion and exclusion criteria. The subjects were allocated into two groups by block randomization. The first group was given 0.05% cyclosporine eye drops, whereas on the other group was given 0.1 % fluorometholone eye drop. All the subjects were examined for the clinical symptoms and signs, intraocular pressure, eosinophil count with Giemsa staining before and one month after treatment. The cyclosporine group consisted of 21 subjects whereas the 0.1 % fluorometholone group was 22 subjects. The ages of both groups were within the age range of 4-36 years old.Results: Both groups showed improvement of symptoms and signs and were not statistically significant difference (p = 0.311; 95% CI: 0.102-0.3131. xxxx The use of 0.1% fluorometholone eyedrops for one month was not associated with any increase of lOP compared to 0.05% cyclosporine (p = 0.11 and p = 0.12). There was improvement in the eosinophil count in both groups and no statistical significant difference (p = 0.301. The side effect of pain was more in 0.05% cyclosporine administration and the difference was statistically significant (p=0.0011 with number needed to harm (NNHI of 2.69.Conclusion: It was concluded that the use of 0.05% cyclosporine eyedrop was as effective as the use of 0.1 % fluorometholone but the side effect of pain occured more often. No statistical difference was found between either the intraocular pressure increase or the eosinophil count in the use of 0.05% cyclosporine eyedrop compared to 0.1 % fluorometholone.Keywords: Vernal keratoconjunctivitis - cyclosporine 0.05% - fluorometholone 0.1 % - side effects, eosinophil count
Effect of vitamin C and vitamin E supplementation on lipid peroxide of lactating woman Endang Sri Sunarsih, Prasetyastuti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Vitamin C and vitamin E are antioxidants that trapp free radical that is continuously formed in aerobic organism as an effect of aerobic respiration in mitochondria and substrate oxidation. The quantity and quality of breast feeding (ASH are influenced by nutritional status and health of the mother. The ASI vitamin C level is very much related to everyday intake and plasma vitamin C of the mother.Objective: To know the effect of vitamin C and vitamin E supplementation on peroxide lipid (MDA) of lactating women.Methods: This was pretest and post test experimental design. The subjects were twenty three lactating women who live in Pakem District, Sleman 19-38 year olds they received 75 mg vitamin C and 2 mg vitamin E every two days for a period of one month. Blood sample was taken from cubit vein before and after supplementation. Determination of vitamin E level used spectrofluorometer, whereas vitamin C and MDA level were determined by spectrophotometer. The data was analyzed with Pearson correlation test Results: the correlation of vitamin C vs MDA; vitamin E vs MDA and vitamin C together with vitamin E vs MDA were r - 0.528; r square 0.276 and p = 0.05; r -0.671, r square 0.451, p = 0.009 and r 0.690; r square 0.476 and p= 0.028, respectivelyConclusion: the effect of vitamin E to MDA was stronger than vitamin CKeyword.: vitamin C - vitamin E - peroxide lipid - free radical - lactating mother
High number of granzyme B expressing CTLs predicts worst prognosis of nasopharygeal carcinoma patients Harijadi, Harijadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Nasopharyngeal carcinoma (NPC) characteristically harbors many tumor-infiltrating lymphocytes. In biopsies of Hodgkin or anaplastic large cell lymphoma many activated CTLs are related to a very poor clinical outcome, suggesting that in these cases with a strong CTL mediated anti-tumor cell response, selection occurs for tumor cells that have become resistant to CTL and chemo and/or radiotherapy induced apoptosis. Only activated CTLs and natural killer cells express granzyme B.Objective. Since, similar to lymphomas, the prognosis of NPC patients depends primarily on the sensitivity of tumor cells to radio- and/or chemotherapy, this study investigated whether the presence of many tumor-infiltrating activated CTLs in tumor biopsies also predicts poor prognosis in NPC patients.Methods: The study investigated 39 specimens of Indonesian NPC patients that fulfilled the following criteria; no evidence of distant metastases at the time of diagnosis, and complete remission following complete radio- and/or chemotherapy. Number of tumor-infiltrating activated CTLs was detected using a combination of antibodies against granzyme Band CD3, CD8 and CD56.Results: The presence of a high number of tumor infiltrating activated CTLs expressing granzyme B appeared to be a very strong predictor of a rapid fatal clinical outcome. Its prognostic value was stronger than and independent from the other prognostic makers; age and clinical TNM stage at presentation. Prognosis was found to decline strongly with increasing percentage of activated CTLs. The most informative cut-off value was found to be 25%. The median overall survival time of patients with
he Role of red blood cell indices to identify iron deficiency in anemic pulmonary tuberculosis patient Tri Ratnaningsih, Tri Ratnaningsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: iron deficiency anemia (IDA) is often associated with infectionlinflammation disease, such as pulmonary tuberculosis. The biochemical parameters tests of iron metabolism are expensive relatively and not always available in some health centers.Objective: The aim of this study was to know the role of red blood cell indices to identify iron deficiency on pulmonary tuberculosis patient with anemia using a sTfR-based biochemical classification of ACD and ACD with iron deficiency (COMB!).Methods: The patient population consisted of 68 consecutive anemic pulmonary tuberculosis patients at the Sardjito Hospital and Balai Pengobatan Penyakit Paru-Paru 0.1. Yogyakarta, Indonesia.Result: Of 68 subjects, 53 had anemia of chronic disease (ACD) and 15 had iron deficiency anemia (COMBI). It was founded a significant difference between ACD group and COMBI group. There were significant correlations between red blood cell indices and sTfR. The most valid parameter to diagnose 10 is MCHC < 31.55 g/dL (Sn= 67%, Sp= 75%), followed by MCV < 81.65 fL (Sn= 62%, Sp= 73%), MCH < 25.75 pg (Sn= 67%, Sp= 70%), and lastly ROW> 14.95 (Sn= 73%, 57%). The diagnostic performances of this parameter at levels commonly used: MCV < 76 fL (Sn= 13%, Sp= 85%), MCH < 27 pg (Sn= 100%, Sp= 45%), MCHC < 31g/dL (Sn= 13%, Sp= 85%), and RDW > 15 (Sn= 67%, 60%).Conclusion: The usage of red blood cell indices can help us to identify iron deficiency in anemic pulmonary tuberculosis patients. For practical reason, more convenience if we use the value that is widely accepted. However, the red blood cell indices cannot be used solely, but must be combined for a greater accuracy.Keywords: red blood cell indices - soluble transferrin receptor - iron deficiency - anemia - pulmonary tuberculo
Herpes simplex encephalitis (A review) Satiti Retno Pudjiati, Herning Setijowati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Universitas Gadjah Mada

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Herpes simplex encephalitis (HSEI is an inflammation of the brain caused by herpes simpleks virus (HSVI. HSE includes serious types. HSE can influence all age group, but most common in those under 20 and over 40 years old. Clinical diagnosis based on clinical presentation, laboratory examination of cerebrospinal fluid (CSFI, even by computerized tomography scan (CT-scan)/magnetic resonance imaging (MRII, electro encephalogram (EEGI is difficult that resulted in nonspecific diagnosis. Polymerase chain reaction (PCRI, and brain biopsy are the best diagnostic test. The main treatment of HSE is non spesific i.e. acyclovir. An early management may decrease the risk of mortality from 80% - 25%. While without treatment the mortality.can reach 70-80% and the prognosis might unfavourable.Key words: encephalitis - HSE - CSF - CT-scan - MRI - EEG
The Combination of suprakeloidal flap and pulsed light heat energy in keloid management: a Case report Dwi retno Adiwinarni, Yohanes Widodo Wirohadidjojo Kristiana Etnawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Universitas Gadjah Mada

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The role of chronic tissue hypoxia in the keloid patho-mechanism has been widely accepted. Whereas, the pulsed-light heat energy (LHE) has been developed which has the capacity to generate reactive oxygen species on exposed skin. Although the supra keloidal flap technique has a high recurrence rate, it was used because of its capacity to prevent suturing hypoxia, thereby the formation of lager recurrent keloid after surgery.The combination of supra keloidal flap and pulsed light heat energy was done I the treatment of postvaricella keloid on the right ear lobe of a 9 year old girl. The keloid was excised two times a year ago, but observation one month after the surgery showed a recurrent larger keloid. The performance of supra keloidal technique followed by pulsed-light heat energy treatment in dose 2.5 J/cm2, was administered on day 3r
Herpes simplex encephalitis (A review) Satiti Retno Pudjiati, Herning Setijowati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

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Abstract

Herpes simplex encephalitis (HSEI is an inflammation of the brain caused by herpes simpleks virus (HSVI. HSE includes serious types. HSE can influence all age group, but most common in those under 20 and over 40 years old. Clinical diagnosis based on clinical presentation, laboratory examination of cerebrospinal fluid (CSFI, even by computerized tomography scan (CT-scan)/magnetic resonance imaging (MRII, electro encephalogram (EEGI is difficult that resulted in nonspecific diagnosis. Polymerase chain reaction (PCRI, and brain biopsy are the best diagnostic test. The main treatment of HSE is non spesific i.e. acyclovir. An early management may decrease the risk of mortality from 80% - 25%. While without treatment the mortality.can reach 70-80% and the prognosis might unfavourable.Key words: encephalitis - HSE - CSF - CT-scan - MRI - EEG
The Combination of suprakeloidal flap and pulsed light heat energy in keloid management: a Case report Wirohadidjojo, Yohanes Widodo; Etnawati, Kristiana; Adiwinarni, Dwi Retno
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 40, No 01 (2008)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

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Abstract

The role of chronic tissue hypoxia in the keloid patho-mechanism has been widely accepted. Whereas, the pulsed-light heat energy (LHE) has been developed which has the capacity to generate reactive oxygen species on exposed skin. Although the supra keloidal flap technique has a high recurrence rate, it was used because of its capacity to prevent suturing hypoxia, thereby the formation of lager recurrent keloid after surgery.The combination of supra keloidal flap and pulsed light heat energy was done I the treatment of postvaricella keloid on the right ear lobe of a 9 year old girl. The keloid was excised two times a year ago, but observation one month after the surgery showed a recurrent larger keloid. The performance of supra keloidal technique followed by pulsed-light heat energy treatment in dose 2.5 J/cm2, was administered on day 3r

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