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All Journal Kertha Desa BALI MEDICAL JOURNAL (BMJ) Sport and Fitness Journal Buletin Udayana Mengabdi E-Jurnal Medika Udayana Kebijakan, Promosi Kesehatan dan Biostatiskik Indonesian Journal of Urology The Indonesian Biomedical Journal Panggung Master Bahasa JBN (Jurnal Bedah Nasional) Callosum Neurology Journal : Jurnal Berkala Neurologi Bali ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Pendidikan dan Kebudayaan Missio Bioscientia Medicina : Journal of Biomedicine and Translational Research Majalah Kedokteran Neurosains JCER (Journal of Chemistry Education Research) Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Qaumiyyah: Jurnal Hukum Tata Negara Journal of Global Pharma Technology Physical Therapy Journal of Indonesia
Tjokorda Gde Bagus Mahadewa
Departemen Bedah Saraf, Fakultas Kedokteran, Universitas Udayana, Denpasar
Religion Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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PERAN ANTIBIOTIKA PROFILAKSIS MENINGITIS PADA FRAKTUR BASIS KRANII Tjokorda GB Mahadewa*, Sri Maliawan*, AA Raka Sudewi**
NEURONA Vol 29 No. 2 Januari 2012
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

INTRODUCTION ONE OF THE MOST COMPLICATION OF SKULL BASE FRACTURE IS CEREBROSPINAL LEACKAGE WHICH CAUSE THE RISK OF MENINGITIS UNTIL 50 THERES STILL CONTROVERSY WEATHER IT NEEDS PROFILAXIS ANTIBIOTICS OR SURGERY TO AVOID THE HAZARD OF MENINGITIS
High Serum Prostate Specific Antigen as A Risk Factor for Moderate-Severe Prostate Inflammation in Patient with Benign Prostatic Hyperplasia Duarsa, Gede Wirya K.; Lesmana, Rika; Mahadewa, Tjokorda G. B.
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

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Background: Benign Prostatic Hyperplasia (BPH) is one of the most common degenerative disease found in men. Theories have been delivered to elucidate etiology, one of them is the theory of inflammation, and PSA is considered as one of risk factor for prostate inflammation. Undetected chronic inflammation could be a problem in BPH due to the obstructive and irritative symptoms it causes. Assessing risk factor could provide a better treatment outcome. Methods: A retrospective case control study in Sanglah Hospital, Indonesia. 70 men with BPH who underwent TURP in 2014, prostate inflammation is evaluated histologically from prostate specimens by one pathologist to avoid subjectivity. Those without inflammations and with mild inflammations are categorized as control group (n=35), and those with moderate and severe inflammations are categorized as case group (n=35). Preoperative total serum PSA retrieved from medical record Results: Median PSA is higher in case group, 2,83 compared to 14,12, with odd ratio 1,18 (p
HIGH BLOOD LEVELS PROCALCITONIN AS SYSTEMIC IMFLAMATORY RESPONSE SYNDROME PREDICTOR IN SEVERE AND MODERATE HEAD INJURY Sinaga, B.; Mahadewa, T. G. B.; Maliawan, and S.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background Numerous studies have shown that procalcitonin (PCT) was not related to degree of trauma. High PCT serum levels have been found in patients with bacterial or fungal infection and also in acute phase of trauma. Currently, there has been no research discussed about changes in serum levels of PCT in particular head injuries and severe head injuries. Moderate and severe head injuries were common trauma cases in Emergency Room (ER) and had high mortality rate. Based on Glasgow Coma Scale (GCS), moderate and severe head injuries were scored between 3 and 13. This research aim to determine whether high blood levels PCT can be used as a predictor of the occurrence of SIRS. Method: A cohort prospective study was applied in this research to determine high blood levels of PCT as a predictor for SIRS in moderate and severe head injury. This study was conducted from June 2013 - August 2013 at Sanglah General Hospital with 40 research subjects. Data was presented in tables and analyzed with Chi Square test at 95% CI and p <0.05% was considered significant. Results: From the 40 samples, there were 34 males (85%) and 6 females (15%), 18 samples (45%) had moderate head injury and 22 samples (65%) had severe head injury. One sample (2.5 %) was 0-10 years old, 15 samples (37.5%) were 10-20 years old, 13 samples (32.5%) were 20-40 years old, 7 samples (17.5%) were 40-60 years old and 4 samples (10%) were>60 years old. PCT levels in the blood obtained on day first were normal in 6 samples (15%) and elevated in 34 samples (85%), SIRS (+) were found in 35 samples (87.5%) and 5 samples (12.5%) were SIRS (-). Using bivariate analysis between PCT levels and SIRS showed p = 0.000 (p < 0.05), and multivariate analysis of the control variables showed no significant correlation between variables with PCT levels. Conclusion: From 40 samples moderate head injury and severe head injury, there were 34 samples (85%) with elevated PCT level on the first day, while 35 samples (87.5%) had SIRS on the third day (p=0,000, CI=95%). Elevated PCT level could be used as a predictor for SIRS in moderate and severe head injury patients.
ELEVATION OF SERUM C-REACTIVE PROTEIN AS A PREDICTOR FOR SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IN CERVICAL SPINAL CORD INJURY PATIENTS Oliver, Stanley-Ketting; Mahadewa, T. G. B.; Maliawan, and S.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
Publisher : BALI MEDICAL JOURNAL

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Objectives: Spinal cord injury has been an important medical issue with high incidence, complications, and mortality rate. For the past 2 decades, there have been a number of researches about the role of inflammatory mediators in trauma patients. However, up to now, there were limited references about the role of CRP as a predictor of SIRS in cervical spinal cord injury. Methods: This was an analytical prospective cohort study of 28 patients to determine the role of increase CRP serum as a predictor for SIRS in cervical spinal cord injury in Sanglah General Hospital, Bali-Indonesia. The data were descriptively analyzed by applying univariate and multivariate analysis to determine the role of increase CRP serum with SIRS in cervical spinal cord injury. Results were considered significant if p < 0.05. Results: From 28 samples collected, 18 samples (64.28%) were male, 12 samples were in >50 years old age group (42,86%), and the most frequent spinal cord injury scale was ASIA A (12 samples, 42,86%). Both univariate and multivariate analysis showed that increased serum CRP and ASIA Score were significant predictors of SIRS in cervical spinal cord injury patients. Conclusion: Increase in serum CRP value can be used as a reliable predictor for SIRS in cervical spinal cord injury patients.
Basic Assesment of Neck Spine Injury -, Sri-Maliawan; Mahadewa, T. G. B
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

This study aims to present a review of the basic assessment of spine and spinal cord injury. This is a review of published articles between 1978 and 2005 on the neck spine and spinal cord injury. We present a summary about the basic principles according to the literatures.
LAMINOPLASTY FUSION FOR CERVICAL SPINAL CORD INJURY WITH OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT: Combination technique for better result (Case Series) Mahadewa, T. G. B.
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: This was a retrospective study of 10 cervical spinal cord injury (CSCI), concomitant with ossification of posterior longitudinal ligament (OPLL), that were treated by the author at Sanglah General Hospital-Bali during 2013-2014. The purpose of this study was to evaluate the efficacy of combination technique of laminoplasty with lateral mass screw fusion for canal compression due to OPLL in CSCI. There were 9 male patients of 10, average age was 58,3 years old. American Spinal Cord Injury Association (ASIA) scale preoperative was average in C scale and ASIA scale postoperative was in D. Mean JOA score preoperative was 9,5 and mean Japan orthopedic association (JOA) score postoperative was 13,3. Improvement after surgery using improvement formula of JOA was achieved by mean of 19,16%. All patients survived and improved neurologically, there was no surgical complication and implant failure in this series. No kyphotic deformity was observed in follow up cervical spine x-ray after 6 months. The author present a combination technique of 10 consecutive patients who underwent laminoplasty fusion for OPLL in CSCI with better result.
Blood hsCRP And PGE2 Content With Clinical Outcome Using Modified Fenestratio-Restorative Spinoplasty Better Than Lamonectomy-Fusion In Lumbar Stenosis Mahadewa, T. B. G.; -, Sri-Maliawan; Raka-Sudewi, A. A.; Wiryana, M
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

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Objective: Modified Fenestration-Restorative Spinoplasty (MFRS) technique is an alternative to lumbar stenosis treatment, providing the equal decompression comparing with laminectomy techniques, without the implant, less expensive and complication rates. The purpose of this study was to determine which technique gives better inflammation and clinical outcome based on high sensitive C-Reactive Protein biomarker (hsCRP) and Prostaglandin E2 (PGE2), Visual Analog Scale (VAS) of the day 7th postsurgery and ODI scores 3rd month post surgery. Methods: This study design is an experimental pretest-posttest randomized control group design. Results:  This study results showed that the mean levels of hsCRP day 7th postsurgery were differ significantly between MFRS (23,09 ± 15,3 mg/L) compared to LF (39,53 ± 24,4 mg/L). Likewise for the mean levels of PGE2 day 7th postsurgery were differ significantly between MFRS (491,39 ± 528,5 pg/ml) compared to LF (1103,7 ± 1033,6 pg/ml) at the significance level of p <0.05). MFRS clinical outcomes better than LF (p <0.05), for means of VAS value day 7th postsurgery and ODI score 3rd month postsurgery. Perioperative variable analysis shows that MFRS was better than LF in: length of surgery, blood loss, postsurgery Hb and patient length of stay (p<0,05). Conclusions: MFRS technique is an alternative technique of lumbar stenosis treatment better than the LF, in terms of improved levels of hsCRP and PGE2, leading to faster clinical outcomes improvement, less complications and lower costs. MFRS technique should be used as a treatment of lumbar stenosis.
Management of Spinal Tuberculosis (TB) in Developing Country Mahadewa, Tjokorda G. B.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Tuberculosis on the spine is involved approximately 1 % of all tuberculosis cases. It is a lethal type of TB skeletal due to highly neurologic compromised because of adjacent medullary compression and incidence kyphotic deformity. Early diagnosis and management of this disease is mandatory to prevent serious complications. Method: Serial case report was conducted in Sanglah General Hospital from January 2014 until December 2015. All patients were diagnosed based on local protocol using appropriate imaging technique. All patients were treated by anti-tuberculosis drugs for 2 weeks followed by functional assessment by MMT, ASIA, and JOA. Result: The author reported 10 patients of spinal TB whom were treated in Sanglah Hospital, Bali between January 2014-Desember 2015. Among pts 8 male and 2 female with location of spinal TB i.e 4 in thoracal, 4 in lumbal and 2 in cervicothoracal. Preoperative ASIA scale was an average scale C and postoperative ASIA scale was in D. The average JOA pre-surgical score was 10.5 and postsurgical was 14.5. Improvement using the formula JOA achieved with an average of 21.6 %. All patients neurologically improved, no complications and surgical implant failures in this series. Conclusions: Surgical management of spinal tuberculosis, if delivered with appropriate indication, proved to be effective in correcting spinal kyphosis. Early management is mandatory in order to ensure better prognosis.
Association of P53 Protein Overexpression with Clinicopathological Features of Oral Squamous Cell Carcinoma Patients in Bali Winata, A.; Manuaba, I. B. Tjakra. W.; Sudarsa,, I. W.; Mahadewa, Tjok G. B.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Oral cancer was a major health problem with a high incidence rate worldwide. Oral Squamous Cell Carcinoma (OSCC) in Bali, ranked as the second most common cancer after cervix carcinoma. Our understanding of OSCC hasn’t yielded a satisfactory clinical outcome; therefore, further studies about the role of biomolecular markers in OSCC are still needed. One of the biomolecular markers for prognosis and predictor for OSCC that has been a topic of research to date is p53. Method: This is a cross-sectional analytical study of 36 samples to determine the correlation between p53 overexpression with age group, tumor location, tumor stage, and tumor grade in OSCC patients. Data was processed descriptive and analytical using Chi-Square/Fisher 's Exact Test methods with a significance value of p
The Role of Multiplex Polymerase Chain Reaction in Detecting Etiological Causes of Bacterial Prostatitis Associated Benign Prostatic Hyperplasia Rosadi, Bramastha A; Mahadewa, Tjokorda G. B.; Duarsa, Gede Wirya K.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Benign Prostatic Hyperplasia (BPH) has been correlated with chronic prostatitis according recent study. Chronic pelvic pain is the chief complain of BPH followed by prostatitis. The gold standard of the etiological diagnosis is urine culture, but the negativity rate is still high. Multiplex polymerase chain reaction (PCR) as a diagnostic tool in search of etiological causes could identify microorganism on DNA level. This research aims to find out the role of multiplex polymerase chain reaction as diagnostic tools on prostatitis patients. Material and Method: A total of 12 samples collected during the TURP procedure in Sanglah General Hospital Denpasar – Bali from February until May 2015. All of the samples has been diagnosed prostatitis clinically and perform urine culture test. The prostate specimen taken was sent to the Pathological anatomy for histopathology diagnostic and underwent multiplex PCR for etiologic diagnostic. Result: 12 samples have been declared as prostatitis based on histopathology examination, and then were analyzed using multiplex PCR. 10 samples were positive (6 were E. coli, 2 were C. trachomatis, the rest were N. gonorrhea and P. aeruginosa). The urine culture revealed 9 positive, within the result 6 were E. coli, and the others were P. aeruginosa, M. morganii and A. haemolyticus. Conclusion: In prostatitis patient, the etiological diagnostic was important. Multiplex PCR as diagnostic tools could detect the microorganism on a negative urine culture. The combination of the urine culture test and multiplex PCR revealed a better result on etiologic diagnosis which leads to a better management of the disease.
Co-Authors A. Winata, A. Adityas Sukmadi Karjosukarso Adityawarma, Anak Agung Ngurah Agung Harawikrama Agung Bagus S. Satyarsa Akbar Wido Alex Pangkahilla Aluh Sri Yuliana Ulfa Alvin Hendellyn Anak Agung Gede Eka Septian Utama and D. M. Subawa Arasy, Mohd Firdaus Ariyanta, Kadek Deddy Astawa N. M., Astawa N. Astawa P., Astawa B. Sinaga Bagus Komang Satriyasa Bertha Melyana Bianca Jeanne Bramastha A Rosadi, Bramastha A Budiarta, Ida Bagus Chriswidarma, Dewa Gede Cita Rosita Sigit Prakoeswa Citra Aryanti D.P.W. Wardhana Desak Made Wihandani Desak Putu Dewi Kasih Desie Yuliani Dewa Putu Gede Purwa Samatra Dewa Putu Wisnu Wardhana Dwikinta, Made Anindya Dyah Esti Pranwengrum Ekaputra Ekaputra, Ekaputra Fenty Fauziah G. I. B Bomba Gede Andry Nicolas Gede Wirata Gede Wirya Kusuma Duarsa Glen Sandi Saapang Gunawan, Made Favian Budi Gungun Gunardi Hizkia Lumban Gaol I Dewa Made Sukrama I Dewa Putu Sutjana I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Bagus Dharma Prakasa Musti I Gusti Ketut Agung Surya Kencana I Gusti Putu Agung Pratama Putra I Ketut Wedarthana Aditya Prana I Ketut Wiargitha I Komang Yose Antara I Made Bakta I Made Kasmadi Gunawan, I Made Kasmadi I Made Maha Satya Dwi Palguna I Made Mahayasa I MADE MULIARTA . I Made Prema Putra I Made Stepanus Biondi Pramantara I Nyoman Semadi I Putu Adiartha Griadhi I Putu Gede Adiatmika I Putu Gede Sudiartha I W. Sudarsa I Wayan Juli Sumadi I Wayan Niryana I Wayan Yudiana I. B. Tjakra Wibawa Manuaba Ida Ayu Putu Sri Widnyani Inge Kurniawati Intan Permata Wijaya John Nolan K.K. Putra Kadek Biondi Kadek Budi Santosa Kendarini, Ni Putu Yenny Ketut Sudiasa Ketut Tirtayasa Koerniawan, Heru Sutanto Krishna, I Komang O. Kurniyanta, I Putu L. R. M. Lengkong Lauren, Christopher Luh Made Indah Sri Handari Adiputra M Wiryana Made Agus Dwianthara Sueta Made Indra Erlangga Prathiwindya Manuaba, Ida Bagus Tjakra Wibawa Mardliyah, Mumtazah Marleen Marleen Marleen Melissa Krisanty Moses Kharisma Setyawan Muh. Ali Imron Nani Darmayanti Ni Luh Putu Julita Yanti Ni Nyoman Ayu Dewi Niryana, , I Wayan Nova Juwita Nyoman Golden Oka, AA Gde Oka, Anak A.G. Pande Made Wisnu Tirtayasa Paulus Adrianus K. L. Ratumakin Pertiwi, Putu Febry Krisna Pradiptha, I Nyoman Tri Prayuda, Prayuda Putu Astawa Putu Eka Mardhika Putu Eka Mardhika Putu Pramana Suarjaya Rajab Bahry Raka Janitra Raka-Sudewi A. A. Regitha Aulia Putri Rika Lesmana, Rika S Indra Lesmana S. Awyono S. F. Laura, S. F. Satoto D., Satoto Sidemen, IGP Sukrana Sista Satyarsa, Agung Bagus Sista Soetomo, Cindy Thiovany Sri Maliawan Stanley-Ketting Oliver Steven Awyono Sugianto, Ronald Sugijanto - Sulfandi Sulfandi Sunanda Naibaho Suryadi N. T., Suryadi N. Suryawisesa, Ida Bagus Made Susy Purnawati Tito Ade Putra Tjokorda Gde Agung Senapathi Udiyana, Nyoman Dwi Maha W. A., W. Wahyuddin, Wahyuddin Wibawa, I Gusti Agung Bagus Krisna Wildan Wildan Wiryana M., Wiryana Yustinus Robby Budiman Gondowardojo