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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Medical Journal of Indonesia MNJ (Malang Neurology Journal) Bali Journal of Anesthesiology The Indonesian Journal of Infectious Diseases Callosum Neurology Journal : Jurnal Berkala Neurologi Bali ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Kedokteran Neurosains Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Archives of Biomedical Research (InABR) Cermin Dunia Kedokteran Magna Neurologica Neurona
Raka-Sudewi A. A.
Udayana University, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Journal : BALI MEDICAL JOURNAL (BMJ)

 1 
IMMUNE RESPONSE AND COST ANALYSIS OF INTRADERMAL RABIES VACCINATION FOR POST-EXPOSURE PROPHYLAXIS REGIMEN IN HUMAN Budayanti, N. S.; Susilawathi, N. M.; Darwinata, A. E.; Dwija, I. B. P.; Fatmawati, N. D.; Wirasandhi, K.; Subrata, K.; Susilarini, N. K.; Wignall, F. S.; Sudewi, A. A. R.; Mahardika, and G. N. K.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

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Background The outbreak of rabies in human in Bali-Indonesia is causing an extraordinary pressure for the government in providing adequate doses of anti-rabies vaccine for post-exposure prophylaxis (PEP). Here, we directly compare the immune response and benefit of the intradermal (ID) protocol for rabies vaccine delivery with the intramuscular (IM) route. Methods: Sixty health workers who were willing to participate in this study have been randomly selected and grouped into ID, IM, and control groups, each with 20 volunteers. The Thai Red Cross ID- and Zangreb IM-protocols have been applied to the respective group. The sera of the volunteers were collected at day 0, week 1, week 3, week 4, month 3, month 6, month 9, and month 12 after the first vaccination. Anti-rabies virus IgG was detected using PlateliaTM Rabies II Kit (Bio-Rad). Results: Anti-rabies IgG could be detected in the ID-group at one week. The ID-vaccine delivery induced a slightly higher maximum antibody titer compared to IM, though not statistically significant (p>0.05). ID vaccination caused less adverse reactions and produces longer lasting protective immune response. Cost minimization analysis (CMA) on the provincial and national PEP data in 2009-2011 shows that the ID-delivery will reduce the total cost for a completed regimen by USD 28.5, and would have saved the Indonesian government budget approximately USD 3.6 and 4.3 million for complete regimens in Bali and Indonesia, respectively. Conclusion: The ID administration of anti-rabies vaccine induces a similar immune response compared to that of intramuscular injection. It also produces longer lasting protective immune response. It offers additional advantages of potential net cost savings as well as decreasing the pressure on vaccine availability due to the high number of dog bite cases.
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.
Co-Authors Adinda Putra Pradhana Agung Bagus S. Satyarsa Agus Eka Darwinata Akira Ito Anak Agung Bagus Ngurah Nuartha Anak Agung Ngurah Subawa Angelia Carolin Bagiada I N. A. Christine Ekawati, Christine Christopher Ryalino Cokorda Istri Dyah Sintarani Sintarani Dedi Silakarma Desak Gde Diah Dharma Santhi Dewa Ngurah Suprapta Djoenaidi Widjaja Ernesta Ginting F. S. Wignall Ge Aris Geson Ginting, Ernesta Gitari, Ni Made I Dewa Made Sukrama I Gde Raka Widiana I Gede Ketut Sajinadiyasa I Gusti Kamasan Nyoman Arijana I Gusti Ngurah Kade Mahardika I Ketut Suastika I Made Jawi I Nyoman Adi Putra I Putu Eka Widyadharma I Wayan Niryana I Wayan Putu Sutirta Yasa I. B. P. Dwija Ida Ayu Jasminarti Dwi Kusumawardani Ida Ayu Sri Wijayanti Ida Bagus Ngurah Rai Imelda, Yuliana Monika Ivan Elisabeth Purba K. Subrata K. Wirasandhi Kade Agus Sudha Naryana Kazuhiro Nakaya M Wiryana Made Nyandra Made Wiryana N ADIPUTRA, N N. K. Susilarini NFN Moestikaningsih Ni Luh Putu Eka Arisanti Ni Made Adi Tarini Ni Made Susilawathi Ni Nengah Dwi Fatmawati Ni Nyoman Sri Budayanti Ni Putu Sriwidyani Ni Wayan Candrawati Oka Adnyana Pangkahila W Paramita, Dyah Pradnya Pramitasuri, Tjokorda Istri Pusaka, Semerdanta Putra Martin Widanta IGN Putu Yogi Pramana Sanjaya, Feliani Senja Decy Ningrum Sri Maliawan Sukmawati, Ni Made Dewi Dian Suryapraba, Anak Agung Ayu Susilawathi, Ni Made Thomas Eko Purwata Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Tjokorda Istri Pramitasuri Toni Wandra Vania, Aurelia Widanta IGN, Putra Martin Yasuhito Sako Yuliana Monika Imelda