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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.
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Articles 104 Documents
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Qualitative Study: High-Risk Sexual Behavior and Prevention of STD and HIV/AIDS Among Female Sellers at Sindhu Market Sanur, Bali Luh Gede Pradnyawati
WMJ (Warmadewa Medical Journal) Vol 4 No 1 (2019): May 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.972.14-20

Abstract

Previous Research showed that having multiple sex partners was a risk-taking behavior that caused the susceptibility of getting STD and HIV/AIDS among female sellers in the market. However, this high-risk behavioral pattern has not been explained. The aim of this study was to understand the pattern of risky sexual behavior and the pattern of prevention of STD and HIV/AIDS among female sellers. This study was conducted by qualitative method, and the respondents were chosen by purposive sampling method. Twenty female sellers in Sindhu Market aged 18 to 45 years old who were sexually active agreed to be the key informants for this study. Data on risky sexual behaviours and pattern of prevention of STD and HIV/AIDS were collected by in-depth interview and were analysed thematically. Results showed thath 7 out of 20 female sellers conducted risky sexual behavior by doing premarital sex and having multiple sex partners without using condom. Most of the informants used vaginal wash and betel soap to prevent STD and HIV/AIDS, and some even checked themselves to the health center for medication.
Distribution of Hepatitis B Virus Genotypes Among Patients at Internal Medicine Unit, Dr. Soetomo General Hospital, Surabaya Citrawati Dyah Kencono Wungu; Mochamad Amin; Ulfa Kholili; Gwenny Ichsan Prabowo; Poernomo Boedi Setiawan; Soetjipto Soetjipto; Retno Handajani
WMJ (Warmadewa Medical Journal) Vol 4 No 1 (2019): May 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.1032.6-13

Abstract

Background: Hepatitis B virus (HBV) infection is a major health problem worldwide, especially in developing countries. The study of HBV genotypes is important to find out the diversity of HBV genotypes related to the severity of the disease, response to therapy, and clinical symptoms. Objective: This study was aimed to detect HBV genotypes in patients at Hepatology Outpatient Clinic, Dr. Soetomo Hospital Surabaya. Methods: This study was conducted on new patients at Hepatology Outpatient Clinic of Dr. Soetomo General Hospital, Surabaya in one month. Nested PCR was performed by targetting HBV surface genes. Samples with positive HBV DNA were sequenced and analysed further. Results: In this study, a total of 27 samples were obtained. The prevalence of HBV infection shown by positive HBsAg in patients with symptoms of liver disease was 55.55% (15/27 patients). Based on the results of electrophoresis from PCR products, positive HBV DNA was obtained in these 15 patients (100%). After sequencing samples with positive HBV DNA, genotype B of Indonesian strain was found to be predominant genotype (100%). Subgenotype analysis showed that 7/15 samples had B3 subgenotype (46.67%). Conclusion: In patients at Hepatology Outpatient Clinic of Dr. Soetomo General Hospital, Surabaya, the prevalence of HBV infection was high (55.55%) and genotype B was predominant. In Surabaya, HBV genotype infection still remained like the previous pattern, although in Indonesia there have been many inter-island and ethnic migration. Further similar studies are needed to obtain the diversity of other HBV genotypes.
Evaluating Helminth to Treat Type 2 Diabetes – A Review Made Dharmesti Wijaya; Anak Agung Gede Indraningrat
WMJ (Warmadewa Medical Journal) Vol 4 No 1 (2019): May 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.1042.21-29

Abstract

Type 2 diabetes (T2D) is characterized by lacking production of insulin and impaired insulin sensitivity. Despite the availability of antidiabetic drugs on the market, exploration of new therapeutic drugs for treating T2D from nature remains necessary. This review provides insights on the potential of helminths and helminth derived products to modulate immune response for treating T2D. We discussed several helminths that are under investigation in animal models for treating T2D namely Schistosoma mansoni, Nippostrongylus brasiliens, Litomosoides sigmodontis, and Strongyloides stercoralis. Finally, application of Schistosoma mansoni soluble egg antigens (SEA) in T2D treatment is also examined.
Empowering Students as Health Ambassadors in SMA Negeri 1 Kuta Utara Putu Nita Cahyawati
WMJ (Warmadewa Medical Journal) Vol 4 No 1 (2019): May 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.805.1-9

Abstract

SMA Negeri 1 Kuta Utara is one of the senior high schools located in North Kuta District, Badung Regency. This school does not only focus on the academic field but also non-academic sector. It is approved by the diverse extracurricular activities at this school. Some of them are student council (OSIS), Paskibraka, scouts, Red Cross youth volunteer (PMR), school security, the student association of environmental and adventure activities, and sports clubs (volleyball, basketball, karate, table tennis, tennis). On the other hand, the tight schedule of the extracurricular activities causes many students to have dense activities after school which often leads to various health issues including fainting caused by fatigue and swelter. Based on that situation, this activity aims to empower students together with the teachers who are involved in the PMR as health ambassadors for handling minor health problems in the form of early injury management and minor injuries which commonly occur in schools. This program included a talk from an expert, interactive discussions, pretest and posttest, simulations, training and mentoring which in its implementation; we were assisted by medical assistance team (TBM) from Faculty of Medicine and Health Sciences, Warmadewa University. Participants have played an active role in each activity with a percentage of attendance and active participation of 100% as the results of this program. The training and mentoring activities have been able to increase students' knowledge as it was shown in the increasing average value of post-test and pre-test by 77%. Through this activity, participants were expected to be able to train and transfer the skills acquired to other team members so that a sustainable process occurs.
Empowering Groups of Farmer Exposed to Pesticides Pollution in Jembrana District Ratna Juwita
WMJ (Warmadewa Medical Journal) Vol 4 No 1 (2019): May 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.1.971.30-38

Abstract

Pesticides are chemicals that are regularly used by farmers to manage pests. The adverse effects of pesticides affect not only pests but also farmers working without proper and correct personal protective equipment (PPE). The Eastern (Kangin) and Western (Kauh) groups of local farmer association, called the Tegal Wani Subak, in the Jembrana sub-district are farmer the groups that use pesticides regularly. Several health symptoms related to pesticides/ organophosphates exposure such as skin redness, eye irritation, dry throat and dizziness have frequently occurred. Based on field observation and discussion with participants, none of the farmers completely equipped with PPE and the farmers was exposed to pesticides contamination. Occupational Health and Safety (OHS) induction program was conducted to increase awareness, knowledge and practices of the farmers on the hazards of pesticides, early detection of pesticide poisoning and preventive interventions based on OHS approach. This program was an interventional study with a pre-post test approach which was participated by seven farmers and evaluated for one month. The pre-test results showed an improvement in the participants’ knowledge from 28.7 %, to 84.3 %. The general results of Focused Group Discussion (FGD) revealed that participants had a good understanding of pesticides; however, the understanding of PPE remained low. Weekly observations and assessments showed that the use of PPE had increased by 100%, except for boots use (71% ); all health symptoms decreased to 0%, except those related to nervous systems which actually increased from 71% to 76% (45% reported of hyperhydration/hypersalivation and 71% reported of headaches). The sustainable and active involvement of OHS officers in primary health centre (Puskesmas) is very important to overcome the problem of organophosphate use in a wider population of farmers.
Penggunaan Metode Role playing Meningkatkan Nilai Ujian Akhir Mahasiswa Blok Profesionalisme Kedokteran Luh Gede Sri Yenny; I Made Wandia
WMJ (Warmadewa Medical Journal) Vol 1 No 1 (2016): Mei 2016
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.1.1.6.17-23

Abstract

Pendidikan profesionalisme kedokteran merupakan  salah satu komponen kurikulum yang sangat penting dalam kurikulum pendidikan dokter. Pengembangan dan perbaikan modul Blok Profesionalisme Kedokteran merupakan jembatan untuk menghasilkan lulusan kedokteran yang mampu bersikap dan berperilaku professional. Pengembangan modul dapat dilakukan dengan berbagai cara salah satunya yaitu dengan menerapkan metode role playing. Penerapan metode role playing dilakukan pada Blok Profesionalisme Kedokteran 2012 dan dibandingkan dengan Blok Profesionalisme kedokteran 2011 dimana pada saat itu metode role playing belum diterapkan. Penelitian ini bertujuan untuk mengetahui apakah terjadi peningkatan nilai ujian akhir mahasiswa, jumlah lulusan dan motivasi mahasiswa untuk belajar mandiri. Didapatkan kelulusan yang lebih tinggi pada Blok Profesionalisme Kedokteran 2012 dibandingkan dengan Blok Profesionalisme Kedokteran 2011 yaitu 83.7%: 32.2%. Terdapat hubungan yang bermakna antara penggunaan metode role playing dengan nilai ujian akhir mahasiswa (p<0.05) dan dengan kelulusan (p<0.05). Sebagian besar mahasiswa merasa lebih termotivasi untuk belajar profesionalisme kedokteran (94.55%). Penggunaan metode role playing dapat meningkatkan nilai ujian akhir, jumlah lulusan dan motivasi mahasiswa untuk belajar mandiri Blok Profesionalisme Kedokteran 2012.Kata Kunci: role playing, profesionalisme kedokteran, pendidikan kedokteran.[Role Playing Increases Students’ Scores of Final Examination in the Block Medical Professionalism].Medical professionalism education is one of very important curriculum components in medical education. Development and improvement of the module of the Block Medical Professionalism are the bridge to yielding a good, capable and professional medical doctor. The development of the module can be conducted in various ways, one of which is by applying the method of role playing. Role playing method applied at Block Medical Professionalism of 2012 was compared to Block Medical Professionalism of 201in which role playing was not applied This research aimed to assess if there was  increase of the result score of the students’ final test, total  number of passing students, and students’ self motivation to study  individually. The study results showed a higher number of passing students   in medical professionalism block of 2012  as compared to medical professionalism block of 2011 (83.7% vs 32.2%). There was a significant correlation between role playing and the mean score of the students’ final test (p<0.05) and with the number of passing students (p<0.05). Most student felt more motivated to learn medical professionalism (94.55%). Application of role playing method can improve the final test score, total number of passing students, and students’ self motivation to study medical professionalism of 2012.Key words: role playing, medical professionalism, medical education.
Hemophilia A yang Didapat: Suatu Tinjauan tentang Diagnosis dan Manajemen I Made Bakta
WMJ (Warmadewa Medical Journal) Vol 2 No 2 (2017): November 2017
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.2.2.230.44-51

Abstract

Hemophilia A yang didapat atau acquired hemophilia A (AHA) adalah penyakit perdarahan yang didapat (acquired), suatu penyakit yang jarang,  penyakit autoimun yang ditandai oleh autoantibodi terhadap faktor VIII. Yang khas, penderita tidak menunjukkan riwayat perdarahan sebelumnya, datang dengan keluhan utama perdarahan spontan, terutama perdarahan kulit atau mukosa. AHA lebih banyak terjadi pada umur tua, baik pada laki maupun wanita dan dihubungkan dengan berbagai penyakit, seperti penyakit autoimun (lupus erithematosus sistemik, penyakit limfoproliferatif, artritis rematoid), keganasan atau kehamilan.  Sekitar setengah dari penderita bersifat idiopatik. AHA didiagnosis jika dijumpai penderita tanpa riwayat perdarahan sebelumnya, baik personal atau keluarga, dimana pemanjangan aPTT (activated plasma thromboplastin time) tidak dapat dikoreksi setelah pencampuran dengan sejumlah volume yang sama dari plasma penderita dan plasma normal yang diinkubasi selama 2 – 4 jam pada suhu 37oC. Kadar FVIII:C menurun.  Aktivitas titer inhibitor  FVIII:C yang spesifik dapat dideteksi dan diukur dengan Bethesda assay atau dengan modifikasinya Nijmegen assay. Dalam pengelolaan AHA, pengendalian terhadap perdarahan merupakan prioritas pertama. Pada penderita dengan kadar inhibitor yang rendah, desmopressin dapat digunakan. Tetapi FVIII by passing agents (activated prothrombin complex concentrate atau recombinant FVIIa) diperlukan pada penderita dengan kadar inhibitor yang tinggi atau penderita dengan episode perdarahan yang berat. Secara bersamaan dilakukan eradikasi terhadap inhibitor (autoantibodi) untuk mengurangi risiko perdarahan berikutnya. Dianjurkan terapi lini pertama dengan kortikosteroid atau terapi kombinasi kortikosteroid dengan siklofosfamid. Untuk terapi lini kedua dapat dipakai rituximab, jika terapi lini pertama gagal atau terdapat kontraindikasi.Kata kunci: hemophilia yang didapat, diagnosis, manajemen. (Acquired Hemophilia A: An Overview on Diagnosis and Management)Acquired hemophilia A (AHA) is a rare acquired bleeding disorder, an autoimmune disease characterized by autoantibody directed against factor VIII. Typically, patients with no prior history ofbleeding disorder, present with spontaneous bleeding, especially skin and mucosal bleeding. AHA occurs more frequently in the elderly, both in male and female and may be associated  with several conditions, such as autoimmune diseases (systemic lupus erythematosus, lymphoproliferative disease, rheumatoid arthritis), malignancies and pregnancy.  Around half of the patients are idiopathic. AHA is diagnosed in patients without previous personal or family bleeding history in which prolonged activated partial thromboplastin time  is not corrected after mixing and incubating for 2 – 4 hours at 37oC equal volumes of patient and normal plasma.  FVIII:C levels are reduced  and a specific FVIII inhibiting activity is detected and measured by the Bethesda  assay or its Nijmegen modification. In the management of AHA, control of acute bleeding is the first priority. In patients with low level inhibitor, desmopressin may be used. But FVIII by passing agents (activated prothrombin complex concentrate and recombinant activated FVII) are required for patients with high titre of antibody or with serious bleeding episode. Immediate autoantibody eradication to reduce subsequent bleeding risk should be performed. It is recommended initial treatment with corticosteroid or combination therapy with corticosteroid and cyclophosphamide and suggest second-line  therapy with rituximab if first-line therapy is fails or is contraindicated. Keywords: acquired hemophilia A, diagnosis, management.
Goiter Sebagai Faktor Predisposisi Karsinoma Tiroid Ni Wayan Armerinayanti
WMJ (Warmadewa Medical Journal) Vol 1 No 2 (2016): November 2016
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.1.2.27.42-50

Abstract

Goiter merupakan pembesaran kelenjar tiroid yang dapat berkaitan dengan gangguan primer pada organ tiroid ataupun akibat stimulasi hormonal atau faktor lain terhadap tiroid. Di Indonesia dan di Bali khususnya kasus karsinoma tiroid mengalami peningkatan sejalan dengan peningkatan kasus goiter endemik maupun non endemik. Goiter memiliki faktor risiko sebesar 2,5 kali lipat untuk menimbulkan karsinoma tiroid. Goiter dapat menimbulkan hiperplasia yang bersifat difusa maupun noduler (nodul tunggal dan multipel). Analisis klonal telah membuktikan bahwa hiperplasia merupakan proliferasi yang bersifat poliklonal. Pada tiroid, ditemukan perubahan pola monoklonal pada kelompok nodul yang sebelumnya merupakan nodul hiperplastik. Perubahan poliklonal menjadi monoklonal ini merupakan interaksi antara adanya lesi hiperplastik sebelumnya dengan predisposisi genetik yang selanjutnya menciptakan lingkungan mutagenik, ditandai oleh peningkatan proliferasi sel disertai pembentukan radikal bebas yang memicu adanya mutasi somatiktirosit. Pemberian suplementasi iodium pada kasus goiter endemik, dikatakan berkaitan dengan adanya kandungan iodine radioaktif nantinya justru menimbulkan kerusakan rantai DNA melalui tata ulang RET-TRK.Kata Kunci: goiter, predisposisi, karsinoma tiroid. [Goitre as Predisposing Factor of Thyroid Carcinomas].Goitre is an enlargement of thyroid gland which can be associated with primary thyroid disorders or stimulation of the gland by hormones and other factors. In Indonesia and especially in Bali, increase of Thyroid Carcinoma cases had been associated with either endemic or non endemic goiter. Goitre increases 2.5 fold risk of thyroid carcinoma. Goitre may cause diffuse and nodular hyperplasia (either single or multiple nodules). Clonal analysis has been discovered that hyperplasia is considered to be polyclonal proliferation. Monoclonal alterations had also been found in a subset of thyroid nodules that were previously considered hyperplastic. Alterations of polyclonal to monoclonal pattern was considered as interaction between past history of hyperplastic lesion and genetic predisposition which furthermore forming mutagenic environment such as increases of cell proliferation and also free radicals induce- somatic mutation. Iodine supplementation on endemic goiter related with radioactive iodine content which damaging DNA sequences in the form of RET-TRK rearrangement.Keywords: goitre, predispose, thyroid carcinoma.
Assessment of Water Quality Index of Beratan Lake Using NSF WQI Indicator Ni Made Hegard Sukmawati
WMJ (Warmadewa Medical Journal) Vol 4 No 2 (2019): November 2019
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.4.2.1317.39-43

Abstract

Beratan Lake is one of the lake in Bali which serves as place for agriculture, aquaculture, as well as tourism and recreational attractions. The growing number of facilities around the lake potentially increases the number of waste discharge to the lake as most of the industry do not equipped with necessary waste management plant. The aim of this study is to assess the water quality in Beratan Lake and later be used to improve the water management. Method: Five stations for water sampling were purposively chosen as representation of each side of the lake. The coordinate locations were recorded by Epicollect. Nine water quality parameters were measured for each water samples from each station: temperature, pH, total dissolved solids (TDS), dissolved oxygen (DO), biochemical oxygen demand (BOD), phosphate, nitrate, turbidity, and fecal coliform. The water quality were calculated based on National Sanitation Foundation Water Quality Index (NSFWQI). Result: NSFWQI for water of Beratan Lake was 78 which indicates good quality. Although this result has been satisfying, fecal coliform and pH showed score lower than 55, thus, the two parameters need to be modified to improve water quality for further use.
THE INFLUENCE OF ACUPRESSURE THERAPY AGAINST BLOOD GLUCOSE LEVELS IN PATIENTS OF DIABETES MELLITUS TYPE 2 IN THE PROLANIS PROGRAM (A STUDY ON HEALTH IN AMBALAWI) musmuliadin mustamin
WMJ (Warmadewa Medical Journal) Vol 3 No 2 (2018): November 2018
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.3.2.804.65-72

Abstract

Acupressure lowers the blood glucose level through a massage at the point of the meridian, which can trigger the calming and uplifting response in the body, having a positive effect on emotions, and causing relaxation and normalizing the body functions. However, the great influence of acupressure in the Prolanis Program has not been seen. This study aims to analyze the effect of acupressure therapy against blood glucose levels in patients of diabetes mellitus (DM) type 2, who joined a program of chronic diseases management called Prolanis Program. With quasi-experiment research design, the study was conducted at the Clinic of Ambalawi, Bima District-Indonesia. As many as 34 patients with DM type 2 who have joined the Prolanis Program were selected as participants in this study, using a purposive sampling method. These participants were divided into two groups: experiment group and control group. Acupressure therapy was given 3 times during 3 weeks. Each group was measured for blood glucose levels on day 6, day 12, and day 18. The data were analyzed using t-test (p= 0.05). Giving therapy for three weeks to people with diabetes mellitus type 2 has a positive effect on lowering their blood sugar levels. Acupressure therapy and Prolanis Program for 3 weeks effecttively lowered the blood glucose levels in patients of type 2 of DM. Acupressure therapy has a more significant effect with p value < 0.005. There are significant differences between the experiment group and the control group by p value (p = 0.00).

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