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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Air Pollution and Human Health (Commentary)</text>
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                <text>Pollution is still the main environmental problem in the world. Air, water, soil, chemical, metal, and work-related pollution are often found in the environment. Among these pollutants, air pollution is the most &#13;
important cause of death. Air pollution is a complex mixture of gases and particles whose source and composition are varied by place and time.² Air pollution has occurred since prehistoric times, which began when humans came to know fire. Concerns about the effects of air pollution have a long history. Complaints about its impact on human health and the environment were first voiced by the citizens of Athens and ancient &#13;
Rome. During the industrial revolution, urban air quality deteriorated due to the widespread use of coal in factories in Britain, Germany, the United States, and other countries that were leading to a “smog era”. Although there has been a major impact of air pollution on public health, various initial laws and regulations for controlling pollution are generally weak and ineffective. After the Great Smog air pollution in London in 1952, &#13;
people became more aware of its detrimental impact on human health, so strict laws enforcement was made to reduce pollution. Therefore, cities in industrialized countries were cleaner.</text>
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                <text>Agus Dwi Susanto</text>
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                <text>Fakultas Kedokteran Universitas Indonesia</text>
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                <text>Sri Wahyuni</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Social Responsibility of Medical Journal: A Concern for COVID-19 Pandemic (Editorial)</text>
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                <text>Social responsibility can be defined as an ethical framework for contribution in community welfare. The Universal Declaration on Bioethics and Human Rights, especially on the Article 14, has explained the issue of social responsibility and health. However this statement only focused on the government’s obligation to execute this. Thus, The United Nations Educational, Scientific and Cultural Organization (UNESCO) &#13;
published “Report of the International Bioethics Committee of UNESCO (IBC) on social responsibility and Health” in 2010 which adopted and expanded this statement. “All sectors of society” should participate &#13;
in the health promotion and social development as a social responsibility. Hence, a medical journal should be considered as a part of the society which also has a social responsibility. Lundberg has explained many &#13;
social responsibilities in medical journal editing. World Association of Medical Editor emphasized at least two social responsibilities of medical journal editors. Besides publishing the high-quality articles, the medical &#13;
journal editors should consider the improvement of the human condition and safeguard the integrity of sciences to maintain ethical issues for benefit of the community.</text>
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                <text>Agus Rizal Ardy Hariandy Hamid</text>
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                <text>Fakultas Kedokteran Universitas Indonesia</text>
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                <text>Sri Wahyuni</text>
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                <text>ISSN : 0853-1773</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Wilms’ Tumor 1 Protein Expression in Embryonal and Alveolar Rhabdomyosarcoma and Its Association with Clinical Prognostic Factors: A Cross-Sectional Study</text>
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                <text>alveolar, embryonal, prognostic factor, rhabdomyosarcoma, Wilms tumor</text>
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                <text>BACKGROUND 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 &#13;
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.&#13;
METHODS 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, &#13;
and location were collected. All cases were stained by WT1 immunohistochemistry. The expression was assessed semiquantitatively using histoscore (H-score) formula. An independent t-test was used to compare WT1 expression between ERMS and ARMS. Correlation analysis was used to evaluate the relationship between WT1 expression and &#13;
prognostic factors. &#13;
RESULTS All ERMS and ARMS cases expressed WT1 in diffuse, moderate to strong staining. ERMS show higher WT1 expression than ARMS (H-score 179.9 versus 149.5) (p = 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.&#13;
CONCLUSIONS WT1 expression was higher in ERMS cases than in ARMS cases, which the expressions were similar in different age, tumor size, and location groups. </text>
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                <text>Aina Angelina, Nurjati Chairani Siregar, Riesye Arisanty</text>
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                <text>Fakultas Kedokteran Universitas Indonesia</text>
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                <text>Sri Wahyuni</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Multifocal Recurrence of Medulloblastoma: A Long Follow-Up Case Study</text>
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                <text>intra-axial mass, long follow-up, medulloblastoma, recurrence</text>
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                <text>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 &#13;
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 &#13;
β-catenin. A long follow-up is essential to diagnose the recurrence and elucidate the progression of medulloblastoma.</text>
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                <text>Benny Zulkarnaien, Edwin Suharlim, Eka Susanto, Soehartati Argadikoesoema Gondhowiardjo</text>
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                <text>Sri Wahyuni</text>
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Consumption of Growing up Milk and Stunting among Indonesian Toddlers (Correspondence)</text>
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                <text>THE AUTHOR REPLY : We thank the correspon�dents for their concerns. The World Health Organization defines stunting as short-stature (stunted) due to chronic malnutrition. Stunting is used as a marker of &#13;
chronic undernutrition (energy and protein deficiency) that further impairs brain development (decreased intelligence up to 13.1 points)1&#13;
 and alters hormonal balance triggering degenerative diseases. Therefore, &#13;
numerous preventive measures are important, especially those affecting linear growth.</text>
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                <text>Sri Wahyuni</text>
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Epidemiology of Erectile Dysfunction in Men with Diabetes Mellitus: A Study in A Primary Health Care Center in Indonesia </text>
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                <text>BACKGROUND 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.&#13;
METHODS 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 interviewer-assisted questionnaires. The status of ED was measured by the erectile dysfunction intensity scale adapted to the International Index of Erectile Function.&#13;
RESULTS 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 p-value of 0.016 and 0.013, respectively.&#13;
CONCLUSIONS 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.</text>
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                <text>Diana Kusmi Tridiantari, Lintang Dian Saraswati, Ari Udiyono</text>
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                <text>Sri Wahyuni</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Association between Axillary Lymph Node Involvement and Clinicopathological Features of Breast Cancer among Indonesian Women</text>
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                <text> breast cancer, lymph node metastases, lymphovascular space invasion, tumor stage</text>
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                <text>BACKGROUND 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.&#13;
METHODS 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.&#13;
RESULTS 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).&#13;
CONCLUSIONS Tumor stage and LVSI could be considered as independent predictive factors of ALN involvement in patients with breast cancer, especially among Indonesian women.</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
A Systematic Review of Respiratory Infection due to Air Pollution during Natural Disasters</text>
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                <text> air pollution, disasters, respiratory tract infections, volcanic eruptions, &#13;
wildfires</text>
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                <text>BACKGROUND 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.&#13;
METHODS 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.&#13;
RESULTS Air pollution during a natural disaster enhances particulate matter to 10–70 μg/m3 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 &#13;
upper respiratory infection cases.&#13;
CONCLUSIONS 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.</text>
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                <text>Erlina Burhan, Ummul Mukminin</text>
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                <text>Sri Wahyuni</text>
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                <text>ISSN : 0853-1773</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
Visit to Singapore Medical Journal during COVID-19 Outbreak: Learning “Beyond” The Expectation (Editorial)</text>
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                <text>In the end of January 2020, some members of the Editorial Team of Medical Journal of Indonesia (MJI) visited Singapore Medical Journal (SMJ). With the support from Prof. Wilfred CG Peh who is the Editorial &#13;
Board Member of MJI and Past Editor-in-chief of SMJ, it is an honor to get approval from Prof. Poh Kian Keong as the current Editor-in-chief of SMJ for the visit. The SMJ has been published by the Singapore Medical &#13;
Association since 1960, earlier than the MJI. The journal has also been indexed in well-known indexing databases, such as Index Medicus (PubMed) and Web of Science (Clarivate Analytics) with impact factor of &#13;
1.141 in 2018,¹ which means there was an average of 1.14 citations in 2018 from each published article during the period 2016–2017.2 Moreover, the SMJ and the MJI share similar aim and scope in general medicine.</text>
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                <text>Felix Firyanto Widjaja, Windu Cahyaningrum Handayani Notonagoro Suryaningrat</text>
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                <text>Fakultas Kedokteran Universitas Indonesia</text>
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                <text>Sri Wahyuni</text>
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                <text>ISSN : 0853-1773</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020</text>
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                  <text>Medical Journal of Indonesia Vol. 29 No. 1 2020 FKUI</text>
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                <text>Jurnal Internasional Medical Journal of Indonesia FKUI Vol. 29 No. 1 2020&#13;
A Randomized Controlled Trial of High Parenteral Protein Feeding in Septic Children: The Role of Tumor Necrosis Factor-Alpha-308 Polymorphism</text>
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                <text> children, high protein, outcome assessment, sepsis</text>
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                <text>BACKGROUND 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 (TNFA)-308 polymorphism and poorer outcomes. This study was aimed to investigate the impact of high protein feeding in &#13;
septic children and to examine the role of the TNFA-308 polymorphism in outcome of sepsis.&#13;
METHODS 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 &#13;
between April 2016 and May 2017. The primary outcome was the pediatric logistic organ dysfunction (PELOD) score. TNFA-308 polymorphism was investigated using restriction &#13;
fragment length polymorphism method in both groups. PELOD score was analyzed as mean differences and gene polymorphism was analyzed with mortality in a subgroup.&#13;
RESULTS There were 40 children in each group. PELOD score on day-1 (22.4 versus 20.5, p = 0.429), day-2 (20.5 versus 19.8, p = 0.815), and day-3 (18.8 versus 19.8, p = 0.772) were not lower in high protein feeding compared to standard feeding. TNFA�308 polymorphism had no role in mortality of both groups (high protein, p = 0.426; standard, p = 0.456).&#13;
CONCLUSIONS 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. </text>
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                <text>Gema Nazri Yanni, Amir Sjarifuddin Madjid, Aryono Hendarto, Sri Widia Azraki Jusman, Zakiudin Munasir, Hindra Irawan Satari, Iswari Setianingsih, Munar Lubis, Sudigdo Sastroasmoro </text>
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                <text>Fakultas Kedokteran Universitas Indonesia</text>
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                <text>Sri Wahyuni</text>
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                <text>ISSN : 0853-1773</text>
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