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WMJ (Warmadewa Medical Journal)
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Published by Universitas Warmadewa
ISSN : 25274627     EISSN : 25799010     DOI : doi.org/10.22225/wmj
Core Subject : Health,
Health Professions Medicine & Pharmacology
WMJ (Warmadewa Medical Journal) is the Journal of Medicine & Health, contains scientific articles (Original/ Research Articles, Review Articles, Case Reports) by academic community of the Faculty of Medicine and Health Sciences Warmadewa University, other Faculties of Medicine and Health Sciences and other related Institutions. It is the medium for hardskill and softskills development as an integral part of the Tri Dharma Perguruan Tinggi (Education, Research, Public Service) and health services in the forms of media of communication, information, scientific education, as a subsystem of Medicine and Health holistic and comprehensive services.
Arjuna Subject : -
Articles 117 Documents
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The Association Between Treatment Failure of Bacterial Vaginosis with Metronidazole and the Incidence of the Maternal–Perinatal Composite Index Kennedy Winartan; I Gusti Ayu Sri Anjani; Anak Agung Raka Budayasa
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.13975.17-21

Abstract

There is high incidence of Bacterial vaginosis (BV) in pregnancy and increasing rate of treatment failure with metronidazole, the drug of choise in BV in pregnancy. The occurrence of bacterial vaginosis in pregnancy results in morbidity and complications for both the mother and the fetus, especially in untreated cases or cases of treatment failure. This study aims to determine the association between treatment failure and the incidence of the maternal–perinatal composite index (preterm labour, PPROM, low birth weight ). This is a cohort  study,  conducted at Sanjiwani Hospital, Gianyar, from September 2024 to April 2025.  involving 52 pregnant less than 20 weeks  diagnosed with BV who received metronidazole therapy, divided into two groups, 26 pregnant woman with successful treatment and 26 pregnant woman  with treatment failure.The results demonstrated that pregnant women with treatment failure of bacterial vaginosis had a 5.33-fold higher risk of maternal–perinatal complications (OR 5.33; 95% CI = 1.008–28.209; p = 0.049) compared to those with successful treatment.
Potensi Fitolarvasida Ekstrak Daun Sirsak dan Umbi Bawang Putih terhadap Larva Aedes aegypti Wahyu Denny Setioko; Listiana Masyita Dewi
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14096.9-16

Abstract

Dengue Hemorrhagic Fever (DHF) is a disease caused by the bite of Aedes sp. mosquitoes carrying the dengue virus. One of the current efforts to control DHF is through abatement using temephos. However, long-term use of temephos can lead to the development of insecticide resistance, thereby reducing its effectiveness. As an alternative, efforts are needed to develop larvicides derived from natural plant-based ingredients, such as soursop leaves and garlic bulbs. This study aimed to compare the effectiveness of ethanol extracts of soursop leaves and garlic bulbs on the mortality of Aedes aegypti larvae. This study was a true experimental study with a post-test only control group design. The experiment was conducted in three replications using 25 Aedes aegypti instar III–IV larvae in 12 groups, consisting of one positive control group, one negative control group, and five treatment groups for each extract at concentrations of 0.05%, 0.1%, 0.2%, 0.4%, and 0.8%. Based on the Post Hoc Mann-Whitney statistical analysis, each tested extract showed the highest larvicidal effect at a concentration of 0.8%, with comparisons to the positive control showing a p-value > 0.05. The LC50 values of the soursop leaf and garlic bulb extracts were 0.102 and 0.116, respectively. Thus, it can be concluded that ethanol extracts of soursop leaves and garlic bulbs are effective as phytolarvicidal agents against Aedes aegypti larvae; however, the ethanol extract of soursop leaves had a stronger effect than that of garlic bulbs.
KORELASI WAIST TO HEIGHT RATIO WHtR DENGAN LEMAK VISERAL PADA OBESITAS Putu Gizha Satrya Gautama M; I Made Pande Dwipayana
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14312.30-38

Abstract

Obesity is a major global health problem associated with an increased risk of cardiovascular and metabolic diseases. Visceral fat is central to this risk; however, its direct measurement requires expensive equipment that is not widely available in clinical practice. The waist-to-height ratio (WHtR) is a simple, low-cost anthropometric tool previously associated with cardiovascular and metabolic risk. This study aimed to determine the correlation between WHtR and visceral fat measured by bioelectrical impedance analysis (BIA) in adults with obesity (defined as BMI ?25.0 kg/m² according to WHO Asia-Pacific criteria) at Ngoerah Hospital, Bali, Indonesia. A cross-sectional study was conducted at Ngoerah Hospital, Denpasar, Bali, from November 2018 to January 2019. A total of 160 adults with obesity (BMI ?25.0 kg/m² according to WHO Asia-Pacific criteria) were enrolled using total sampling. Visceral fat was estimated using BIA. Waist circumference and height were measured using standardized measuring tape, and WHtR was calculated as waist circumference divided by height (both in centimeters). Data were analyzed using Spearman’s correlation test after normality testing with the Shapiro–Wilk method. Of the 160 subjects, 87 (54.4%) were male and 73 (45.6%) were female, with a median age of 33 years (range: 22–57). Both waist circumference (r = 0.658, p < 0.001) and WHtR (r = 0.676, p < 0.001) showed statistically significant positive correlations with visceral fat, with the magnitude of correlation classified as moderate to strong. Height alone was not significantly associated with visceral fat (r = 0.098, p = 0.217). WHtR demonstrates a moderate-to-strong positive correlation with visceral fat as measured by BIA in obese adults. These findings support the use of WHtR as a practical and accessible screening tool for visceral adiposity in clinical settings, particularly in populations with limited access to advanced body composition measurement technologies.
Antenatal Sildenafil Citrate for Fetal Growth Restriction: Updated Evidence on Fetoplacental Pulsatility Indices and Perinatal Outcomes — Systematic Review and Meta-analysis I Kadek Irwan Setiawan; I Gusti Putu Ayu Susilawati Wida Lestari; Febriyanti Angghita Putri Duarsa; I Gusti Ketut Winata Adnyana
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14507.39-53

Abstract

The aim of this study is to evaluate the impact of antenatal sildenafil citrate on fetoplacental pulsatility indices and perinatal outcomes in pregnancies complicated by FGR. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched up to October 2025. Randomized controlled trials (RCTs) comparing sildenafil citrate with placebo in FGR pregnancies were included. Primary outcomes included umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices, birth weight, gestational age at delivery, and stillbirth rate. Secondary outcomes included neonatal mortality, major morbidity, and NICU admission. Random-effects models were used to calculate pooled mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). Twelve RCTs involving a total of 1,083 pregnant women with FGR were analyzed. Sildenafil citrate significantly reduced UA-PI (MD = ?0.22; 95% CI ?0.33 to ?0.11; p < 0.0001) and increased mean birth weight (MD = 178.39 g; 95% CI 61.48–295.30; p = 0.003). However, it showed no significant effects on MCA-PI, gestational age, stillbirth, neonatal mortality, severe intraventricular hemorrhage, or NICU admission. Conversely, an increased risk of persistent pulmonary hypertension of the newborn (PPHN) was observed (OR = 4.37; 95% CI 1.49–12.80; p = 0.007). Antenatal sildenafil citrate may improve selected fetoplacental hemodynamic parameters and birth weight in FGR pregnancies, but its association with increased PPHN risk warrants caution. Further large-scale RCTs are needed to confirm efficacy and neonatal safety.
Association of Insight, Age, and Education Level with Relapse Rates in Schizophrenia Patients Rahmad Dhani Rujito; Erna Herawati; Sahilah Ermawati; Siti Soekiswati
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14516.22-29

Abstract

Abstract Schizophrenia is a chronic mental disorder with a high tendency for relapse, which worsens the patient's prognosis and increases the burden of care. Clinical factors such as insight, as well as demographic factors including age and education level, are thought to play a crucial role in influencing treatment adherence and relapse risk. This study aims to analyze the association between insight, age, and education level with relapse rates in schizophrenia patients at RSJD dr. Arif Zainudin Surakarta. This was an analytic observational study with a cross-sectional design. Subjects were selected using purposive sampling, totaling 96 patients. Data were analyzed using Chi-Square test, Fisher’s Exact test, and Logistic Regression. The results showed a significant association between insight (p=0.045) and education level (p=0.046) with relapse rates. Meanwhile, age (p=0.588) was found to have no significant association with relapse incidence. It is concluded that insight and education level are associated with relapse rates, although no single factor emerged as a dominant independent predictor in the multivariate model. Improving patient insight through psychoeducation is recommended to prevent relapse.
Diagnostic Accuracy of the New Trauma Score and Revised Trauma Score for Predicting in-Hospital Mortality in Adult Multiple Trauma Patients: A Single-Center Study at Prof. Dr. I.G.N.G. Ngoerah General Hospital I Made Oka Wahyantara; I Wayan Periadijaya; Gede Wirya Kusuma Duarsa
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14636.1-8

Abstract

Multiple trauma remains a significant contributor to morbidity and mortality within emergency departments, necessitating rapid and precise initial assessments to prioritize treatment and predict patient prognosis effectively. This study evaluates the prognostic validity of the New Trauma Score (NTS) compared to the Revised Trauma Score (RTS) in predicting in-hospital mortality among multiple trauma patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital. A single-center, retrospective cohort study was conducted involving a total of 61 multiple trauma patients selected via consecutive sampling rom patients admitted between January and December 2022. Statistical analyses were performed to determine the Area Under the Curve (AUC) of the Receiver Operating Characteristic for both scoring systems. Validity parameters encompassed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy. The optimal cut-off thresholds were established at 6.285 for the RTS and 15.5 for the NTS. Both the NTS and RTS demonstrated significant predictive performance regarding mortality in multiple trauma cases. The AUC was calculated at 0.885 for the NTS and 0.865 for the RTS, indicating robust discriminative capabilities for both metrics. While both scoring systems exhibited equivalent sensitivity, the NTS consistently outperformed the RTS in terms of specificity, PPV, NPV, and overall accuracy. These findings indicate that the NTS serves as a superior prognostic tool for predicting mortality among multiple trauma patients compared to the RTS. Furthermore, this study underscores the critical importance of local validation for trauma scoring systems and highlights the potential clinical utility of the NTS in optimizing emergency decision-making.
Biologic Augmentation in Lumbar Spinal Fusion: A Systematic Review of Recombinant Bone Morphogenetic Protein-2, Mesenchymal Stem Cells, and Platelet-Rich Plasma I Gusti Lanang Agung Wiradinata; Ida Bagus Giri Sena Putra; I Kadek Yuris Wira Artha; I Gusti Lanang Ngurah Agung Artha Wiguna
WMJ (Warmadewa Medical Journal) Vol 11 No 1 (2026): May 2026
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.11.1.14712.63-75

Abstract

Achieving solid arthrodesis remains a key challenge in lumbar spinal fusion, particularly in patients at increased risk of pseudarthrosis. Biologic augmentation has been introduced to enhance fusion biology; however, its clinical value remains incompletely defined. To systematically review the clinical evidence on biologic augmentation in adult lumbar spinal fusion, focusing on radiographic fusion, clinical outcomes, and safety. A systematic search of PubMed, the Cochrane Library, and ScienceDirect was conducted in accordance with PRISMA guidelines. Comparative clinical studies evaluating rhBMP-2, mesenchymal stem cells, or platelet-rich plasma in lumbar fusion were included. Data were synthesized qualitatively because of clinical and methodological heterogeneity. Six studies met the inclusion criteria. Biologic augmentation was consistently associated with higher fusion rates or faster radiographic fusion compared with conventional grafting methods. However, improvements in patient-reported outcomes, including pain and functional scores, were generally comparable between the biologic and control groups. Complication rates were also similar, with no consistent safety concerns directly attributable to the biologic agents. The findings suggest that biologic augmentation primarily enhances fusion biology rather than clinical recovery. Differences among biologic agents reflect distinct mechanisms of action and may influence the timing of fusion rather than long-term outcomes. Biologic augmentation improves radiographic fusion in lumbar spinal surgery but does not consistently improve clinical outcomes. Careful patient selection and further high-quality trials are warranted.

Page 12 of 12 | Total Record : 117

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