Journal Of The Indonesian Medical Association 2021-04-17T10:39:09+07:00 Evi Suprapti, S.E Open Journal Systems <p>Journal Of The Indonesian Medical Association (JInMA) atau Majalah Kedokteran Indonesia (MKI) merupakan jurnal ilmiah kedokteran yang berada dibawah naungan Pengurus Besar Ikatan Dokter Indonesia (PB IDI) dan jurnal terakreditasi Kemenristek DIKTI.&nbsp;</p> <p>MKI JInMA memuat beberapa tipe artikel yaitu artikel penelitian, laporan kasus,<em> evidence-based case reports</em> (EBCR), tinjauan pustaka, dan editorial.</p> <p>MKI JInMA saat ini terbit dengan frekuensi per dua bulan.&nbsp;</p> <p>&nbsp;</p> Family Conference In Primary Care Practice 2021-04-17T10:38:25+07:00 Retno Asti Werdhani Dhanasari Vidiawati Trisna <pre><em>From the Epidemiology Triangle, we can see that a person’s health status is influenced by 3 factors: host, agent, and the environment. The environment plays the biggest role as the cause of health problems, one of which is the family environment. Family can become a supporting factor or inhibiting factor in the successful management of patient’s cases. Therefore, a primary care physician/family physician needs to conduct family meetings to discuss and agree on solutions with the patient’s family by paying attention to inhibiting and supporting factors and find common solutions for the benefit of the patient.</em></pre> 2021-01-20T18:08:49+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association Indonesia Determinant Analysis of Career Choices for Internsip Doctors in DKI Jakarta Province 2021-04-17T10:39:09+07:00 Irma Yunita Rustam Maman Saputra Yolanda Handayani Roy Okto Maradona Farhannuddin Rusdi Anhari Achadi <p><em><strong>Introduction</strong>: Research on the motivation to choose medicine as a profession and future career plans as a doctor are very important for policy makers and educators. The study of doctor’s career choice has been carried out in many countries so that it can provide an overview of the proportion of career choices from various perspectives. Objective: Analyzing career choices and determinants of career choice for internship doctors in DKI Jakarta Province.</em><br><em><strong>Methods</strong>: This research is a quantitative study using a descriptive observational design that is a cross-sectional study. This research was conducted on Internship Doctors in DKI Jakarta Province in 2020 with a sample of the study was the Internship Doctors of DKI Jakarta Province Batch III, totaling 154 people. Multivariable logistic regression analysis was used to determine the relationship between the career choice of interns and the determinants of career choice.</em><br><em><strong>Results</strong>: The results of the study found that 77.3% of internships chose a career as a specialist and only 16.2% were general practitioners. As many as 72.1% of internship doctors chose to work in hospitals and only 5.2% at Puskesmas. The results of the bivariate analysis with the chi-square test showed that the choice of place of work, prospect income, economic and professional work had a significant relationship with the career choice of an internship doctor. The results of multivariate analysis with multinominal logistic regression test showed that there were several independent variables that had a statistically significant relationship to the internship doctor’s career choice, including gender, university origin, place of work, income, lifestyle and family demands.</em><br><em><strong>Conclusions</strong>: There are more external determinants that are significantly related to the doctor’s career choice than the internal determinants.</em></p> 2021-01-20T00:00:00+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association PaO2, SaO2, and PaO2/FiO2 Ratio as A Predictor Disease Severity in Hospitalized COVID-19 Patients 2021-04-17T10:37:46+07:00 Ngakan Putu Parsama Putra Aditya Sri Listyoko Anthony Christanto <p><em><strong>Introduction</strong>: Currently COVID-19 continues to show an increase in prevalence and mortality. Fever, dry cough, fatique and progression to dyspnea even respiratory failure and ARDS are the symptoms of COVID-19. “Happy hypoxia” is an indication that certain patients do not express breathlessness but have impaired oxygenation. It is important to determine the degree of oxygenation an all COVID-19 patients that will predict the severity of the disease and provide an outline of further management plans.Objective: This study aimed to describe the parameters of blood gas analysis in hospitalized patients and analyze its correlation with degree of severity of the disease</em><br><em><strong>Methods</strong>: We conducted observational analysis, cross sectional, single-center study including 71 laboratory-confirmed patients in Dr. Saiful Anwar General Hospital, Malang, Indonesia from April-Juni 2020. Statistical analysis was performed to determine the determine the relation of blood gas analysis with disease severity. </em><br><em><strong>Result</strong>: Subjects were divided to 25 patients (35,21%) in the mild-moderate group and 46 patients (64,79%) in severe group. Analysis of demographic and clinical characteristic showed that age, history of smoking, dyspnea and oxygen delivery were associated with disease severity (p&lt;0,005). Statistical analysis of blood gas analysis showed associated degree of oxygenation with disease severity which is assessed by PaO2, SaO2 BGA, PaO2/FiO2 and original PaO2 (p&lt;0,005). </em><br><em><strong>Conclusion</strong>: In our cross sectional study we found that degree of oxygenation was associated with disease severity in hospitalized COVID-19 patients.</em></p> 2021-01-21T16:04:14+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association Procalcitonin and White Blood Cells as an Infection Marker in Children with Diabetic Ketoacidosis 2021-04-17T10:36:24+07:00 Nur Rochmah Muhammad Faizi Yudhi Kurniawan Latifatu Choirunisa Anang Endaryanto Soetjipto <p><em><strong>Introduction</strong>: Diabetic ketoacidosis (DKA), an acute complication of type 1 (insulin dependent) diabetes mellitus (T1DM), can be precipitated by infection. Procalcitonin (PCT) is an accurate marker of bacteremia, sepsis, and inflammation, however white blood cells (WBC) are still often used by clinicians. We aimed to analyze PCT levels and WBC counts in children with DKA.</em><br><em><strong>Methods</strong>: A cross-sectional study was conducted in Dr. Soetomo General Hospital, Surabaya, Indonesia, between 2015 and 2019. T1DM and DKA diagnosis was based on the International Society for Pediatric and Adolescent Diabetes. PCT levels and WBC counts were measured in samples from patients with and without DKA, and were compared using the Mann-Whitney test.</em><br><em><strong>Results</strong>: A total of 41 samples were included, with 15 samples (36.6%) from children with DKA, and 26 (63.4%) from children without DKA. PCT levels and WBC counts were significantly higher in those with DKA (p&lt;0.001). The receiver operating characteristic curve analysis of WBC was lower than PCT (0.849 vs. 0.982). PCT had a higher sensitivity and spesificity as an infection marker than WBC (93.3 vs. 86.7; 92.3 vs. 88.5, respectively).</em><br><em><strong>Conclusion</strong>: PCT is a better infection marker in children with DKA than WBC</em></p> <p>&nbsp;</p> 2021-01-23T00:00:00+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association The Role of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio and Relative Eosinophil Count in Atopic Dermatitis Patients 2021-04-17T10:35:44+07:00 Stephanie Djuanda Stefanus Lembar Inneke Jane Hidajat Dani Djuanda <p><em><strong>Introduction</strong>: Atopic Dermatitis (AD) is an inflammatory skin disorder characterized by chronically relapsing inflammation accompanied by pruritus and itching. Inflammatory mechanism and many body immune responses are involved in AD. There are several diagnostic tests to diagnose AD. NLR, MLR and relative eosinophil count are parameters that can be obtained easily and cheap from the economic side. The purpose of this study is to determine the role of neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and relative eosinophil count in AD patients with analyzing the sensitivity and specificity.</em><br><em><strong>Methods</strong>: This research is done by a cross-sectional method with peripheral blood smear. The number of sample taken were 61 patients with AD who had fulfilled the inclusion and exclusion criteria and 61 healthy controls. The data is then analyzed using Komolgorov-Smirnov and Saphiro-Wilk normality test, Independent T test, Mann-Whitney U.</em><br><em><strong>Result</strong>: The data analysis result shows a not statistically significant relationship between NLR in AD patients and healthy controls, p=0,858. This study also shows a significant relationship between MLR and relative eosinophil count in AD patients and healthy controls with p=0,000 and p=0,013. The cut-off point of MLR and relative eosinophil count each are &lt; 0,0488 (sensitivity 70,5%, specificity 72,1%, AUC 72,5%) and &gt; 2,25 (sensitivity 70,5%, specificity 77%, AUC 78%).</em><br><em><strong>Conclusion</strong>: MLR and relative eosinophil count can be proposed as diagnostic tools in assisting the diagnosis of AD, however NLR can not be used as AD diagnostic tool</em></p> 2021-01-23T20:17:54+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association Transmission of COVID-19, Case Report of an Obstetrics and Gynecology Resident 2021-04-17T10:35:01+07:00 Yuyun Lisnawati Dwiana Ocviyanti Diyah Septiti Wulan <p><em>Since COVID-19 first broke out in Jakarta in early March 2020, the infection rate has been slowly but surely increasing. Health workers who work directly to serve patients, including the resident, are vulnerable to infection. The following is a story of a Obstetrics and Gynecology resident who was infected with COVID-19 and managed to recover after going through a period of independent isolation. In March 2020, the resident who at that time served in the Obstetrics polyclinic at a COVID-19 referral hospital in Jakarta, experienced myalgia, fever, headache, sore throat, cough and runny nose. Due to the condition causes PPDS to be rested. Complaints improved within a few days, after taking medication and multivitamin supplementation. One week later, the resident with the other resident and staff conducted a nasopharyngeal swab examination at the hospital, then the samples were sent to Litbangkes for reverse transcription polymerase chain reaction (RT-PCR) examinations against SARS-CoV-2. The results were obtained 20 days later and the resident was declared positive. When the results came out, PPDS who already felt healthy were undergoing rotation in another hospital. </em><br><em>Undergo a 2-week self-isolation protocol, nutritious intake, supplementation, exercise, positive thinking and continued prayer. Transmission of COVID-19 may occur while serving patients, social distancing and wearing less awake masks when with PPDS friends, midwives, nurses and staff. The long duration of the RT-PCR swab results makes it difficult for tracing, the risk of widespread transmission and delays in efforts to break the chain of transmission of COVID-19 besides disrupting education rotation.</em></p> 2021-01-23T20:43:10+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association Oromotor Problem in Premature Infants: An Overview 2021-04-17T10:37:03+07:00 Melda Warliani Nilla Mayasari Ferius Soewito <p><em>Indonesia ranked 5th within the countries with highest premature infant rate, with numbers of premature delivery is 675.700. The number is equal with the born rate 15.5 per 100 delivery each year. In premature infants some problem can be found, including oral feeding. Oral feeding problems in infant is caused by immature organ system, such as cardiopulmonal, central nervous system, oral muscles, et cetera. Proper treatment will prevent further complications and assist infants on their optimal growth and development.</em></p> 2021-01-23T00:00:00+07:00 Copyright (c) 2021 Journal Of The Indonesian Medical Association