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BALI MEDICAL JOURNAL (BMJ)
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Bali Medical Journal (BMJ), P-ISSN 2089-1180, E-ISSN 2302-2914 is an international and peer-reviewed journal published quarterly in print and online by Sanglah General Hospital in collaboration to Indonesian Physician Forum and Indonesian College of Surgeon, Bali-Indonesia which was founded in 2011. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship, and to encourage a vigorous dialogue between medical scholars and practitioners. The Journal welcomes contributions which promote the exchange of ideas and rational discourse between practicing educators and medical researchers all over the world.
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Articles 9 Documents
 1 
Search results for , issue "Volume 1, Number 3, September-December 2012" : 9 Documents clear
PREVALENCE OF ANTI-STREPTOLYSIN O ANTIBODIES AT BANKE REGION NEPAL Khan, S.; Singh, P.; Siddiqui, A.H.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Serum levels of anti-streptolysin O antibodies (ASO) in the routine evaluation of patients with rheumatic conditions. Prevalence of elevated serum ASO titer in patients which were coming in OPD & IPD of Nepalgunj Medical College & teaching hospital with various clinical conditions. Method: This was a retrospective cross sectional study, which was performed in the central laboratory of Microbiology at Nepalgunj Medical College and teaching Hospital, Banke, Nepal during the period of September 2010 to April 2012. The serum samples were tested for Antistreptolysin O (ASO) antibodies by latex agglutination test. Results: Total 308 patients including 40.91% male and 50.09% female  were tested for ASO serum levels.140 were positive and 168 were negative .In 140 positive cases 57 were male and 83 were female. In 168 negative cases 69 were male and 99 were female. Conclusion: The prevalence of Anti-streptolysin O (ASO) antibody in total cases was 45.45%.In male was 45.24% and in female was 45.60%.the highest percentage was found in age group 0-21years. The presence of elevated streptococcal antibody titers in such a population, which probably re?ects a high background prevalence of streptococcal infections, should be taken into consideration when evaluating the role of the group A streptococcus in non-purulent complications of infections.
THERE IS NO DIFFERENCE OF SURGICAL SITE INFECTION BETWEEN SINGLE-DOSE AND MULTIPLE-DOSE OF PROPHYLAXIS ANTIBIOTIC IN OPEN APPENDECTOMY OF NON-PERFORATED ACUTE APPENDICITIS Tiono, B.G.; Sudartana, K.; Widiana, R.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Acute appendicitis is the most common surgical emergency encountered compared with other non-traumatic acute abdomens. Sanglah General Hospital recorded there were 470 cases of acute appendicitis in the year 2006. This study  aims to determine the effectiveness of a single-dose antibiotic prophylaxis in prevention of surgical site infection in open appendectomy of non-perforated acute appendicitis. Method: A single blind randomized controlled trial in 110 non-perforated acute appendicitis patients that underwent open appendectomy at Sanglah General Hospital emergency operating theatre from April to June 2012 was conducted. Cefazolin 1 g and Metronidazole 500 mg were administered intravenously prior operation. Samples were divided into two groups by permuted block. Following operation, the single-dose group was administered placebo, while the multiple-dose group received two additional doses of antibiotics. Surgical site infection (SSI) of both groups in every week for one month was evaluated. Surgical site infection was determined based on Hulton’s criteria. Risk of surgical site infection of both groups was analyzed with Relative Risk (chi-square). Results: In the single-dose group 49.1% were males and 50.9% were females with a mean age of 28.71 years old, and in the multiple-dose group 40% were males and 60% were females with a mean age of 29.07 years old. Risk of SSI in single-dose group was 7.3% and multiple-dose group was 5.5% with Relative Risk (RR) = 1.33% (95% CI RR: 0.31-5.68, p= 1.000). Conclusion: There is no difference of SSI risk between single and multiple-dose antibiotic prophylaxisinopen appendectomy of non-perforated acute appendicitis.
CHARACTERISTIC OF PATIENTS WITH REFRACTIVE DISORDER AT EYE CLINIC OF SANGLAH GENERAL HOSPITAL DENPASAR, BALI-INDONESIA Handayani-Ariestanti, T.; Supradnya-Anom, I G.N; Pemayun-Dewayani, C.I.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Refractive disorders are one of the most common causes of visual impairment worldwide and become the second leading cause of blindness that can be cured. This study aims to know the characteristic of refractive errors patients in Sanglah General Hospital in the period of 1st January until 31st December 2011. Method: This is a retrospective analytical descriptive study. Data were collected retrospectively from patient’s medical records with refractive errors and shown as frequency and percentage. Visual acuity before and after corrections were investigated and analyzed using McNemar Test. Results: from 579 patients, the most common diagnosis was astigmatism (40.1%), 63% were woman, 39.7% were older than 40 years old, and 60.2% live in Denpasar. In myopia cases, 69.7% patients were woman and 25.1% were between 11-20 years old. In astigmatism cases, 63.4% were woman, 57% were older than 40 years old. Of the hypermetropic cases, 61,3% were woman, 79.5% were older than 40 years. Among presbyopia cases, 53.2% patients were woman with 84.4% were older than 40 years. In McNemar test, there were a significant difference between visual acuity before and after correction in both eyes (p=0.0001). Most astigmatism was with the rule cases on both eyes. On the right eye 54.3% shows mild astigmatism, whereas on the left eye 50.8% shows moderate astigmatism. In hypermetropic cases 92.4% are mild degrees. While 55.5% presbyopic patients need additional glasses of +1.00 D up to +2.00 D. About 97.9% patients with refractive error were given glasses prescription. Conclusion: mostly refractive errors patient are woman and the most common diagnosis is astigmatism. There were significant differences of visual acuity before and after correction on both eyes (p=0.001).
IPOMOEA BATATAS SYRUP DECREASE MALONDIALDEHYDE AND INCREASE NITROUS OXIDE PLASMA LEVELS AMONGST MODERATE SMOKER WORKERS AT DENPASAR Dwi-Primayanti, I D. A. I.; Aman, I G. M.; Agus-Bagiada, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: Cells and tissues are continuously damaged by reactive oxygen species. Cigarette smoke is one of an exogenous source of free radical containing more than 4000 chemical compounds, that triggering the formation of free radicals related to diseases and aging process. Anthocyanins are potent antioxidants that are widely distributed in fruit, vegetables, red wines and Ipomea batatas. The aim of this study was to determine the effect of Ipomea batatas as a source of antioxidants in decreasing levels of malondialdehyde (MDA) and increasing of Nitrous oxide (nitrite/nitrate/NOx) plasma in moderate smokers of workers at Denpasar. Method: This was an experimental study with a pretest-posttest control groups design. There are 33 moderate smokers who were divided into three groups, control group (placebo), treatment group with 15 ml purple sweet potato syrup (P1) and 30 ml (P2), for 14 days. All groups were performed the laboratory examinations for MDA and NOx plasma before and after the treatment. Results: This study showed that there were significant differences (p <0.05) both in MDA and NOx plasma levels in the control group, P1 and P2. The decrease of MDA levels on P1 was 35.39% and on P2 was 49.87%. The increase of NOx plasma levels was 7.78% for P1 and 14.68% for P2. Conclusion: From this study, it can be concluded that Ipomea batatas syrup contains of 8mg/mL anthocyanins, probably play a role in reducing the free radical and thus reducing the risk of disease and slowing the aging process.
PREVALENCE OF HYPERURICEMIA AT NEPALGUNJ MEDICAL COLLEGE, BANKE-NEPAL Singh, P.; Khan, S.; Mittal, R.K.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: The prevalence of hyperuricemia varied in different populations and it appeared to be increasing in the past decades. Recent studies suggest that hyperuricemia is an independent risk factor for cardiovascular disease. Method: One thousand eighty seven patients, attending Nepalgunj medical college and Teaching Hospital, Banke, Nepal from March 2011 to February 2012 were included in this study. The reference range was 3.5 – 7.0 mg/dL in males and 2.6 – 6.0 mg/dL in females. Hyperuricemia was de?ned as a Serum Uric Acid level of more than 7.0 mg/dL in males and of more than 6.0 mg/dL in females. The uric acid was determined by uricase /PAP method. Test was performed in the central laboratory of Biochemistry, Nepalgunj Medical College & teaching Hospital, Banke, Nepal. Results: A number of 1487 studies were selected, the statistical information of which was collected for systematic analysis. The results showed that the high prevalence of hyperuricemia found in females(22.86%) as compare to males(18.98). It was found that 21-40 age group is on high risk for hyperuricemia.Conclusion: The prevalence of hyperuricemia is different as the period of age and it increases after 21-40 years in male and in female. Serum uric acid level was high in female as compare to male.
MODIFICATION OF THE NUSS PROCEDURE-PREVENTION OF INJURIES OF THE HEART AND MAJOR BLOOD VESSELS Žganjer, Mirko
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: The Nuss procedure is a widely accepted technique for correcting pectus excavatum. Unfortunately, fatal complications such as cardiac perforation and injury of the great blood vessels have been noticed in a few patients.We modified original Nuss technique to be simpler and less dangerous. Methods: We modified Nuss procedure with the sternal elevation to improve sternal depression. Modified Nuss procedure was carried out by applying metal lifter raise sterum until the patient starts to raise from the operating table. The space behind sternum is now wider, and surgery has become safer with less probability of injuries intrathoracic organs. We compared 46 patients operated by the original Nuss method (taking into account the data from the literature on complications of the original method on a large series of patients) with 54 patients operated by a modified Nuss method. Results: Before lifting the sternum depth of the deformity was between 2.9 and 6.2 cm (mean 5.4 cm), and the increase were between 1.5 and 4.0 cm (mean 2.8 cm). The difference of 2.6 cm is large enough, and the width of introducer and bars are about 3 mm for  securely passed along the chest. Conclusions: A modified method of treating pectus excavatum is safer, better and with fewer complications than the original method of Nuss.
THE EFFECTIVENESS OF NETILMICIN SULPHATE INSTILATION ON THE URETHRA CATHETER REMOVAL PROCEDURE IN REDUCING THE INCIDENCE OF CATHETER ASSOCIATED URINARY TRACT INFECTION Darma-Kusuma, I.G.; Duarsa, G.W.K.; Golden, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: Catheter associated urinary tract infection (CAUTI) is the most common complication of short-term indwelling catheters. The risk of this complication is increase along with the length of catheter insertion. There is no complete agreement of intravenous administration of prophylaxis antibiotic in reducing the incidence of CAUTI. Currently, antibiotic instilation into bladder was developed, however it is still a controversial issue. Therefore in this study we would like to see the effectiveness of this procedure in reducing the risk of CAUTI. Method: Single blind randomized controle trial was conducted on 40 eligible male patients treated at surgical ward, Sanglah Hospital between  March and August 2012. Twenty patients had  netilmicin sulfate instilation and anathor 20 patients treated without instilation procedure. Urine culture was taken before and after catheter removal. The  number of colonies were analyzed according to the WHO criteria. In this study WHO critirion 3 was used with a significant bacteriuria of more 10 5 CFU / mL. Data were analyzed with Chi-square table and processed statistically with SPSS. Significance was set at p value <0.05 with 95% CI. Results: The mean age was 50.07 (SD 15.49) years. The avarage length of urinary catheterization was 5 days (range from 4 to 14 days). CAUTI was observed in 18 patients (45%); symptomatic was 11 patients (61.1%) and asymptomatic was 7 patients (38.9%). Statistic analysis showed that netilmicin sulfate insilation significantly reduced the risk of CAUTI (OR 0.028 ; CI 0.004 - 0.172). Conclusion: Netilmicin sulfate instilation prior to catheter removal significantly reduced the risk of CAUTI after short-term indwelling catheter.
SIMPLE VIRILIZING CONGENITAL ADRENAL HYPERPLASIA: Presentation in a Female Child with Genital Ambiguity undergoing Genitoplasty (A Case Report) -, Nurhaen; Duarsa, G. W. K.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: our objective was to display the presentation of simple virilizing Congenital Adrenal Hyperplasia (CAH) with genital ambiguity and severe virilization of the external genitalia, influencing growth, height and weight, bone maturation, quality of life and hence undergoing genitoplasty. Surgical treatment was aimed to obtain a more natural psychological and sexual development and the type of surgical repair performed was tailored based on individual patient’s anatomy findings. Case: we report a case of a 3-year old female with simple virilizing CAH, diagnosed due to genital ambiguity, severe virilization, clitoromegaly, external genital pigmentation, precocious pubic hair, previously was under treatment with glucocorticoid replacement therapy for 2 years since newborn and neglected due to discontinuing the hormonal treatment for one year duration, underwent several clinical studies including chromosomal study for sex determining, pelvic ultrasonography for internal anatomical details and bone age study for skeletal maturation, given stress dose steroids pre-operatively and followed by genital reconstructive surgery (genitoplasty). A clitorectomy and labioplasty approach were performed. At time of surgery cystoscopy was carried out prior to the surgical repair. Results: Management of virilizing CAH child with ambiguous genitalia demands multidisciplinary and interdisciplinary approach. The team‘s major challenge is to use the feasible means to make the least bad choice in order to select a gender able to match the individual identity, social identity, and behavioral identity. Surgical option should be tailored, one stage surgery, at early age and performed according to the individual anatomy findings.
THE RISK FACTOR OF NEUTROPENIA ON LOCALLY ADVANCED BREAST CANCER PATIENTS TREATED WITH FIRST CYCLE CYCLOPHOSPHAMIDE, DOXORUBICINE, 5- FLUOROURACIL CHEMOTHERAPY AT SANGLAH GENERAL HOSPITAL DENPASAR, BALI-INDONESIA Keswara, M.A.; Sudarsa, I.W.; Golden, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: Breast cancer is the most common type of cancer found in women, in the United States breast cancer is the number one cancer in women and the second highest cause of cancer deaths after lung cancer. This study aims to determine the incidence of neutropenia and tested several clinical risk factors of neutropenia in locally advance breast cancer/LABC patients who obtain first cycle cyclophosphamide, doxorubicine, 5-fluorouracil neoadjuvant chemotherapy at Sanglah Hospital in Denpasar. Method: The study was a prospective cohort involving 62 LABC patients conducted between February to June 2012. Clinical factors such as age, chronic obstructive pulmonary disease, hypertension, nutritional status, and hemoglobin levels in patients were recorded. Neutrophil level were recorded on day 7 and 12 of first cycle neoadjuvant chemotherapy. Bivariate analysis was done to see the strengths of each risk factor for neutropenia followed by multivariate logistic regression analysis to determine the most significant risk factor for the occurrence of neutropenia. Relative risk with 95% confidence interval was recorded. The level of significance was set at value  of less than 0,05. Results: Neutropenia was found in 17 patients (27,4%). Bivariate analysis showed that age older than 60 years old, hypotensive, under nourished, and anemic are significant risk factors of neutropenia. However, in multivariate logistic regression age (RR 20,225; 95% CI 1,804-226,776) and nutritional status (RR 35,328; 95% CI 3,108-401,524) remained significant clinical risk factors of neutropenia. Conclusion: Neutropenia incidence was 27,4%. Patients older than 60 years old and under nourished status are the significant clinical factors causing neutropenia and can be used as a predictor to predict neutropenia.

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