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The Landscape of Condyloma Acuminata and Concomitant STIs in Denpasar: A Retrospective Analysis with Implications for Public Health Strategies Ni Putu Wina Widyastuti; Ni Made Dwi Puspawati; I Gusti Ayu Agung Elis Indira; Aditya Permana
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1345

Background: Condylomata acuminata (CA) is a prevalent sexually transmitted infection (STI). Research into the risk factors and characteristics associated with CA is crucial for developing effective prevention strategies. This study aimed to determine the prevalence and characteristics of CA patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital in Denpasar, Bali, Indonesia. Methods: A retrospective cross-sectional study was conducted using medical records of CA patients attending the STI and Dermatology Clinic at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from January 2021 to December 2023. Data collected included patient visit status, age, gender, occupation, education, concomitant STIs, sexual orientation, marital status, and use of protective measures. Data were processed descriptively. Results: Of 284 CA patients, 69.7% were male and 30.3% were female. The mean age was 28.99 ± 11.38 years. Married individuals constituted 41.5% of cases. Private employees were the predominant occupation (34.2%). Fifty percent of patients had no concomitant STIs, while HIV was present in 37.7% of the total sample (75.4% of those with any concomitant STI). A significant proportion (49%) reported not using protective measures during sexual intercourse. Conclusion: The prevalence of CA at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, was 40 per 1000 visits during the study period. CA was predominantly observed in adult males who were married, heterosexual, had completed high school, worked as private employees, and did not use protective measures during sexual intercourse. These findings underscore the need for targeted public health interventions.

Gonococcal and Non-Gonococcal Urethritis in a Global Travel Hub: A Retrospective Analysis of Syndromic Management, Suboptimal Cefixime Monotherapy, and the Public Health Crisis of Patient Retention in Bali, Indonesia Andrew Wicaksono; I Gusti Ayu Agung Elis Indira; Ni Made Dwi Puspawati; Aditya Permana; Nyoman Suryawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1447

Background: The inexorable rise of antimicrobial resistance (AMR) in Neisseria gonorrhoeae represents a formidable threat to global public health, jeopardizing the efficacy of last-line treatments for gonococcal urethritis (GO). Southeast Asia is a recognized epicenter for the emergence and dissemination of AMR, yet granular surveillance data from many high-risk localities remain critically sparse. This study aimed to provide a comprehensive characterization of the clinical epidemiology, frontline management practices, and patient outcomes of male urethritis at a tertiary referral center in Bali, Indonesia—a major international crossroads for tourism and migration. Methods: A retrospective, cross-sectional analysis was conducted on the medical records of male patients diagnosed with urethritis at the Dermatology and Venereology Polyclinic of Ngoerah Hospital between January 1st, 2021, and December 31st, 2024. A rigorous screening process of 215 initial records was undertaken to identify eligible cases. Data on sociodemographics, behavioral risk factors, clinical presentation, syndromic diagnosis, prescribed pharmacotherapy, and follow-up adherence were systematically extracted and analyzed using descriptive and comparative statistics. Results: From the initial cohort, 58 male patients met the final inclusion criteria. The cohort was predominantly diagnosed with GO (n=39, 67.2%) over non-gonococcal urethritis (NGO) (n=19, 32.8%). Patients were primarily of productive age (25–44 years, 58.6%) and reported high-risk behaviors, including multiple sexual partners (65.5%). A critical deviation from international treatment guidelines was identified: 97.4% (38/39) of GO patients received oral cefixime 400 mg monotherapy, a regimen no longer recommended for first-line use due to AMR concerns. Furthermore, a profound fracture in the care cascade was evident, with an overall loss-to-follow-up rate of 58.6% (34/58). This failure was most pronounced in the GO cohort, where 76.9% (30/39) of patients did not return for scheduled follow-up, a rate significantly higher than the 21.1% (4/19) observed in the NGO cohort (p<0.001). Conclusion: The clinical management of gonorrhoea at this major Indonesian referral center is defined by two systemic failures: the routine prescription of a suboptimal antimicrobial monotherapy and a near-total collapse of patient follow-up. This combination, situated in a high-transience international hub, creates an unmonitored, high-risk environment for the selection, amplification, and global dissemination of antimicrobial-resistant N. gonorrhoeae. These findings signal an urgent imperative to align local therapeutic protocols with evidence-based global standards and to implement robust, innovative strategies to ensure patient retention and verify the cure.

Gonococcal and Non-Gonococcal Urethritis in a Global Travel Hub: A Retrospective Analysis of Syndromic Management, Suboptimal Cefixime Monotherapy, and the Public Health Crisis of Patient Retention in Bali, Indonesia Andrew Wicaksono; I Gusti Ayu Agung Elis Indira; Ni Made Dwi Puspawati; Aditya Permana; Nyoman Suryawati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1447

Background: The inexorable rise of antimicrobial resistance (AMR) in Neisseria gonorrhoeae represents a formidable threat to global public health, jeopardizing the efficacy of last-line treatments for gonococcal urethritis (GO). Southeast Asia is a recognized epicenter for the emergence and dissemination of AMR, yet granular surveillance data from many high-risk localities remain critically sparse. This study aimed to provide a comprehensive characterization of the clinical epidemiology, frontline management practices, and patient outcomes of male urethritis at a tertiary referral center in Bali, Indonesia—a major international crossroads for tourism and migration. Methods: A retrospective, cross-sectional analysis was conducted on the medical records of male patients diagnosed with urethritis at the Dermatology and Venereology Polyclinic of Ngoerah Hospital between January 1st, 2021, and December 31st, 2024. A rigorous screening process of 215 initial records was undertaken to identify eligible cases. Data on sociodemographics, behavioral risk factors, clinical presentation, syndromic diagnosis, prescribed pharmacotherapy, and follow-up adherence were systematically extracted and analyzed using descriptive and comparative statistics. Results: From the initial cohort, 58 male patients met the final inclusion criteria. The cohort was predominantly diagnosed with GO (n=39, 67.2%) over non-gonococcal urethritis (NGO) (n=19, 32.8%). Patients were primarily of productive age (25–44 years, 58.6%) and reported high-risk behaviors, including multiple sexual partners (65.5%). A critical deviation from international treatment guidelines was identified: 97.4% (38/39) of GO patients received oral cefixime 400 mg monotherapy, a regimen no longer recommended for first-line use due to AMR concerns. Furthermore, a profound fracture in the care cascade was evident, with an overall loss-to-follow-up rate of 58.6% (34/58). This failure was most pronounced in the GO cohort, where 76.9% (30/39) of patients did not return for scheduled follow-up, a rate significantly higher than the 21.1% (4/19) observed in the NGO cohort (p<0.001). Conclusion: The clinical management of gonorrhoea at this major Indonesian referral center is defined by two systemic failures: the routine prescription of a suboptimal antimicrobial monotherapy and a near-total collapse of patient follow-up. This combination, situated in a high-transience international hub, creates an unmonitored, high-risk environment for the selection, amplification, and global dissemination of antimicrobial-resistant N. gonorrhoeae. These findings signal an urgent imperative to align local therapeutic protocols with evidence-based global standards and to implement robust, innovative strategies to ensure patient retention and verify the cure.

Low Serum Vitamin E Levels Positively Correlate with the Severity of Acne Vulgaris Sutiawan, Indry Salonika; Winaya, Ketut Kwartantaya; Suryawati, Nyoman; Rusyati, Luh Made Mas; Karmila, I Gusti Ayu Agung Dwi; Puspawati, Ni Made Dwi
MAHESA : Malahayati Health Student Journal Vol 4, No 10 (2024): Volume 4 Nomor 10 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i10.15882

ABSTRACT Acne vulgaris (AV) is a common disorder of the pilosebaceous, especially prevalent in adolescents. Acne vulgaris ranks among the top ten most prevalent diseases globally. Although AV may resolve spontaneously, sequelae such as scar formation can persist, causing aesthetic and psychological disturbances. There is an antioxidant to counteract acne-causing oxidative stress, vitamin E, which is an important antioxidant in the human body. Therefore, vitamin E in the skin can reduce the formation of squalene peroxide and prevent the occurrence of AV. This is an analytical observational study using a cross-sectional design. The investigation was conducted at the Dermatology and Venereology Clinic of Prof. Dr. I.G.N.G. Ngoerah Denpasar Hospital and the laboratory of the Faculty of Medicine, Udayana University, from February 2024 until the sample size was fulfilled. The sample consisted of patients aged 12-45 years with acne vulgaris who visited the clinic and were then selected through consecutive sampling according to the inclusion and exclusion criteria. In the non-AV group, the mean serum vitamin E level was 19.3 ± 0.99 µg/ml, whereas in the AV group, it was 4.49 ± 19.1 µg/ml, indicating a significant variance. There was a positive correlation between low vitamin E levels and the severity of AV. The linearity graph shows the direction of the relationship between serum vitamin E levels and the severity of AV, which leads to the lower right, indicating that the higher the severity of AV, the lower the serum vitamin E levels. The mean levels differed significantly between the non-AV and AV groups. A favorable association was found between low vitamin E levels and the severity of AV. Keywords: Acne Vulgaris, Severity, Serum Vitamin E, Reactive Oxygen Species (ROS)

A retrospective study of condyloma acuminata profile in outpatient clinic of dermato-venereology Sanglah General Hospital Denpasar, Bali-Indonesia period 2015-2017 Ni Made Dwi Puspawati; Sissy; Dewi Gotama
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 1 No. 1 (June 2018)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/wcxze973

Introduction: Condylomata acuminata (CA) is human papillomavirus (HPV) infection, and one of the most common sexually transmitted disease, characterized with papul or papillomatous nodule in genital, perineum and anal, this disease can be asymptomatic as well. Some study proved sexually transmitted infection increases the incidence of Human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), and vice versa. Management of CA is Trichloroacetic acid (TCA), Tincture Podophyllin, and Electrocautery. This study aims to determine profile of condyloma acuminata in Dermatovenereology Outpatient Polyclinic Sanglah General Hospital Denpasar Bali period 2015-2017. A retrospective study during three years (2015-2017). Method: Data was obtained from medical record in Dermatovenereology Outpatient Polyclinic Sanglah General Hospital Denpasar Bali period 2015- 2017. Result: Total patient condyloma acuminata is 260 patients (5.48%), male is dominant 70 patients (67.31%), range age 12-35 years old (123%), there was 59 patient who infected with HIV (22.31%), with five pregnancy (1.92%). Most therapy is given trichloroacetic acid (TCA) (79.62%). Conclusion: Men suffered from condyloma acuminata more commonly than women, the most common treatment for this condition is trichloroacetic acid (TCA)

Lichen amyloidosis with combined topical therapy: a case report Made Sanitca Indah; Ni Made Dwi Puspawati; Herman Saputra
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 2 No. 2 (December 2019)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/24tjs491

Introduction: Lichen amyloidosis (LA) is a rare case, characterized by circumscribed, highly pruritic, hyperkeratotic, and hyperpigmented papules occurring typically over the shins, outer aspects of upper arms, and on the upper back with amyloid deposits in the papillary dermis. Several therapeutic strategies, including topical steroids, oral antihistamines, cyclosporine, retinoids, laser, phototherapy, cryosurgery, and surgical interventions, have been reported as treatment options for patients with LA, but no standardized treatment has been established. Case report: A 58-year-old man came to the Dermatovenereology Outpatient Department complaints of itchy blackish-brown papules on the shins. Dermatology examination found discrete multiple hyperpigmentation papules and plaque covered with white scale. A scar-like center surrounded by brownish circles or white edges was found from the dermoscopic examination. The histopathological examination found thickened keratin with compact orthokeratosis and hyaline materials in the papillary dermis with dendritic melanophages. The patient diagnosed with LA and treated by combining desoximetasone cream 0.25% with 3% salicylic acid. The papules on the legs had flattened in the patient, with a significant improvement in the severe itching after three weeks. Conclusion: Combination therapy of potent corticosteroids and keratolytic seems to be an appropriate modality and well-tolerated by LA patients. Skin lesion becomes thinner, and pruritus is reduced.

Secondary syphilis with stage III HIV in an adolescent deaf male with a history of sexual relationship with men: a case report Tritya Mudita; Ni Made Dwi Puspawati; I Gusti Ayu Agung Sattwika; Andrew Yoshihiro Wirya
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 4 No. 1 (June 2021)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/vv3kt473

Introduction: Syphilis is an infection caused by Treponema pallidum of the spirochaete family. Case: A 19-year-old Balinese came with a complaint of red spots on the palms of the hands and feet one month ago. The patient has a hearing disability and is currently enrolled in a special-needs school in Denpasar. VDRL examination with reactive results with titer 1:256 and TPHA reactive with TPHA titer 1:5120. The patient received benzathine penicillin G 2.4 million units intramuscularly. Significant improvement was obtained, and the serological test was decreased. Discussion: Syphilis transmits through sexual contact, vertically from pregnant women to their fetuses, through needle sharing. People with hearing disabilities and adolescents are considered vulnerable as objects of harassment and sexual violence. Conclusion: People with disabilities and adolescents are vulnerable to sexually transmitted diseases. Information on reproductive health and sexually transmitted diseases need to be more readily available for people with disabilities. Secondary syphilis therapy with a single dose of benzathine penicillin is effective from clinical or serological observations.

Prevalence and Profile of Adolescents with Sexually Transmitted Infections at the Dermatology and Venereology Polyclinic of Ngoerah Hospital, Bali, Indonesia Intaran, Kadek Devi Aninditha; Puspawati, Ni Made Dwi; Elis Indira, I Gusti Ayu Agung; Pemana, Aditya
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 37 No. 3 (2025): DECEMBER
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikkk.V37.3.2025.190-194

Background: Sexually Transmitted Infections (STIs) have been considered a public health threat in all countries, both in developed and developing countries. STIs have a direct impact on sexual and reproductive health through stigmatization, infertility, cancer, and pregnancy complications that can increase the risk of HIV. Purpose: This study aims to identify cases of adolescent patients with STIs at Ngoerah Hospital, Denpasar, Bali in the period 2021 to 2023. Methods: This study uses a descriptive observational study with a cross-sectional design. The research was conducted at the Dermatology and Venereology Polyclinic and the Medical Record Installation of Ngoerah Hospital, Denpasar, Bali. After the data was collected, it was tabulated in tabular form and grouped descriptively. Result: A total of 46 patient samples were obtained, with an average age of 16.7 years. Adolescents with STIs were more commonly found in female (63%). Based on their last education, the highest number of patients were junior high school graduates (58.7%) with a history of multipartner sexual intercourse (56.5%). Only 15.2% claimed to be married. The most common type of STIs was syphilis (50%), followed by condyloma acuminata (45.6%). A total of 67.4% of adolescents were known to have HIV-positive status. Conclusion: The picture of STIs in teenagers is more common in female with a junior high school education. Most teenagers have multi-partner partners with a history of having sexual relations with commercial sex workers (CSWs). The most common type of STIs in teenagers is syphilis (50%), and 67.4% are infected with HIV.

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