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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.
Arjuna Subject : -
Articles 179 Documents
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Progesterone Therapy for the Prevention of Preterm Labor in Women with Single Risk-factor: A Systematic Review and Meta-analysis Ara, Kefayat Chaman; Bahrami, Mohammad Amin; Bahrami, Elham; Bahrami, Sima; Bahrami, Mohammad Nabi; Moosazadeh, Mahmood; Barati, Omid
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Preterm labor is a common complication of pregnancy which has become a main health concern around the world due to its negative consequences. Objective: To investigate the efficacy of progesterone therapy in the prevention of preterm labor in women with single risk factor. Search strategy: A PubMed, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Science Direct, Scopus, OVID, EMBASE, SID, Magiran and Google Scholar search (date last searched April 2016) without any time, language and location restriction was done. Inclusion criteria: All randomized clinical trials of singleton pregnancies with single risk factor (prior preterm labor without short cervical length or short cervical length without prior preterm labor) which were randomized to progesterone and control groups were included in our meta-analysis. Primary outcome: Our primary outcome was gestational age at delivery. Results: 13 studies (1259 subjects and 2653 control women) were included in the meta-analysis. Using random effect model showed that mean gestational age at delivery of progesterone group is 0.74 (0.41-1.06) month longer than that of control group with CI=95% which is significant statically. Conclusions: Progesterone therapy is an effective intervention for the prevention of preterm labor in women with single risk factor.
CLINICAL-IMMUNOLOGICAL ASSESSMENT FAILURE ON INITIAL COMBINATION USE OF ZIDOVUDINE-LAMIVUDINENEVIRAPINE IN CHILDREN WITH HIV/AIDS AT SANGLAH HOSPITAL BALI R., Niruri; Maharani, A. A. S.; Kumara, K. D.; Rahajeng, I. M.
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Abstract

Background: Assessing clinical progression and CD4+ level were important in determining the efficacy of antiretroviral (ARV) and switching to other regimens, especially when viral-load data were not available. This research aims to assess combination of zidovudine-lamivudine-nevirapine (Co-ZLN) failure using WHO 2010 criteria on clinical failure (CF) and immunological failure (IF), single or together, to determine correlation between CF and IF; and to evaluate two failure categories (CF alone and combination of CF-IF) in making decision to switch to second-line of ARV. Methods: Children at Sanglah General Hospital, who gain initial treatment of Co-ZLN in period of March 2006–March 2013 were selected. Cross sectional study was applied. The ARV response was assessed twice. First period (P1) and second period (P2) of evaluation were conducted after patients received the Co-ZLN at least 6 and 12 months. Results: Forty five patients were included in this study. After at least 6 and 12 months of therapy, more patients showed IF (10 and 9 children in P1 and P2) than those in CF (4 and 2 patients in P1 and P2). Only one child met to CF-IF category in P2. The low clinical condition (HIV stage 4) did not always associate with deteriorating immunologic marker in the treatment-failure (TF). The patients who fit on CF and CF-IF based decision to switch regimen criteria were different. In resource-limited hospital, CF-IF based decision could give a better picture of patients’ condition and be used as an indicator to assess TF compared to single CF criteria.
Fetal Sex Determination Using Cell-Free Fetal Dna (cffDNA) in Maternal Blood Sanjaya, I Nyoman Hariyasa; Suwardewa, Tjok Gde Agung; Arijana, I G. Kamasan N.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Prenatal test has routinely performed in antenatal care and has become a part of the obstetric care feature in many countries. Prenatal test is divided into screening and diagnostic test. Recently, the early noninvasive method in order to found and lessen the risk factors of pregnancy loss, has been studied. One of the methods is molecular test using cffDNA which has many screening purpose such as sex determination, aneuploidy, paternal inherited genetic disorder, fetus rhesus, and performed early at 7 weeks of pregnancy. Objective: The purpose of this study is to measure diagnostic value of cffDNA in determining fetal sex prenatally. Methods: In a diagnostic test study, 18 randomized samples were selected and divided based on fetal gender confirmed at birth. The group consisted of 9 pregnant women with male babies and 9 pregnant women with female babies. CffDNA then isolated from maternal blood sample and specific region in Y chromosome termed SRY is detected by PCR and electrophoresis. The data obtained analyzed both descriptively for baseline characteristic and analytically to determine its diagnostic value. Results: This study found significant correlation between SRY detection in cffDNA with male fetal phenotype (p<0.05). The sensitivity of the method is 100% with 89% specificity. In addition, we found 9.09 values for positive likelihood ratio (LR+) and 0 for negative likelihood ratio (LR-). Moreover, the result yielded 100% positive predictive value (PPV+) and 88.8% of negative predictive value (PPV-). Conclusion: This study proofed that cffDNA have a great diagnostic value to determine fetal sex prenatally. However, further study with several group of gestational age mother and better matching is required to further confirm the diagnostic potential of cffDNA.
OPERATION TECHNIQUE OF ANTERIOR MENINGOENCEPHALOCELE: Transcranial Combined with Anterior Resection (Case Report) Muhammad-Zafrullah, A.; Yudoyono, F.; Mirna-Sobana, A.; Faried, and A.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Abstract

Meningoencephaloceles are a frequent condition characterized by protrusion of meningeal and brain tissue through a skull-base defect. Here, we report three cases of anterior meningoencephalocele operated on one-stage procedure, a combined of transcranial and anterior approach, for invagination removal of non-functional extracranial cerebral tissue with watertight closure of the dural defect; written consent was taken. All cases were nasoethmoid, the congenital anomalies between the nasal bones and the nasal cartilage.
Giant ovarian cyst Santos, Vitorino M.; Santos, Lister A. M.; Modesto, Fabiana R. D.
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
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Abstract

We read the exceedingly rare case study recently described by Hota et al. about giant ovarian cyst in term pregnancy1. The patient was a 25-year-old woman undergoing therapy for hypothyroidism, with history of three previous deliveries (P1L1A1). USG of abdomen and pelvis was normal with respect to gestational age in the second trimester, and ovarian cyst was not seen. However, the USG of control done on the third trimester revealed a left ovarian cyst (21x18 cm), with normal obstetric features. The weight of removed cyst of 29x20 cm was 4.9 kg, and the histopathology diagnosis was ovarian mucinous cystadenoma1. The authors emphasized the rarity of concomitat pregnancy and ovarian cyst, and 15% of these mucinous cysts are malignant1. Huge ovarian cysts are more often benign, and less frequently they are diagnosed in association with normal pregnancies1. Major concerns in this setting should be the early diagnosis, close follow-up of the cyst growing, and appropriate intervention1. Interestingly, in the case herein commented the ovarian cyst was not detected by USG in the first two trimesters of pregnancy.
The Role of Blood Lactate Levels as Outcome Predictor of Isolated Traumatic Brain Injury Patients Laode RA, Djoko W; -, Andi AI; -, Mansyur A; -, Burhanuddin B
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Abstract

Objectives: Traumatic brain injury (TBI) is accompanied by regional alterations of brain metabolism, reduction in metabolic rates and possible energy crisis. This metabolic disturbance reflected by increase and accumulation of the brain lactate levels. Objective of this study was to determine the correlation between abnormalities in lactate metabolism for predicting neurologic outcome after moderate or severe traumatic brain injury. Methods: An observational prospective study in 60 patients with isolated TBI. Blood sample taken from vein of the limbs after underwent initial resuscitation. Serial assessment of the blood lactate level was measured in 1st, 2nd and 7th day with Lact2 Roche Cobas® C-System. Neurologic outcome assessed on 7th days using Modified GCS. Results: On initial assessment, 38.3% of patients with normal lactate (? 2 mMol/L), 61.7% of patients was hyperlactatemia ( > 2 mMol/L). In this study, it was obtained that the lower of GCS level, the higher of blood lactate level, and vice versa (p = 0.033). In both treatment, there was a significant lactate clearance 24-hour as 37.96% ± 32.76 (p = 0.001) and 13.49% ± 40.32 (p = 0.011), respectively. No significant changes between blood lactate level on the 2nd and 7th day, both operative (p = 0.938; p > 0.05) neither conservative (p = 0.280; p > 0.05) patient. While, there was no correlation between neurologic outcome with 24-hour lactate clearance (p = 0.349). The higher of the initial blood lactate level, the patient’s outcome was worsen (p = 0.029). Conclusion: There is a significant correlation between blood lactate level and severity TBI according to GCS level. The lower GCS level, the higher blood lactate level and vice versa. This study also demonstrates that 24-hour lactate clearance did not affect patient’s outcome, but more influence by initial blood lactate level. Therefore, initial blood lactate level can used as an outcome predictor in TBI patients.
Aqueous Extract of Purple Sweet Potato Tubers Decrease MDA and Increase SOD2 in Kidney of Diabetic Rats Satriyasa, Bagus Komang
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Diabetes mellitus (DM) is a metabolic disease characterized by increase of blood glucose levels or hyperglycemia. Hyperglycemia results in oxidative stress and increase of AGEs. Oxidative stress and metabolic stress lead to reduction of endogenous antioxidant activity resulted in various organs injury especially kidney. The complication is caused by the formation of advanced glycation end products (AGEs), and free radicals. Increase free radicals that occur in diabetics accompanied with decline in endogenous antioxidant activity, such as superoxide dismutase (SOD) and catalase. One way to overcome the complications due to oxidative stress is through utilize the foods which possess natural antioxidant such as purple sweet potato. It has been proven in animals that purple sweet potato had antioxidant properties to prevent various complications in DM. Balinese purple sweet potato tubers contain high anthocyanin and it had been researched as antioxidant in rats in vivo. The aims of this research are to determine the effect of aqueous extract of purple sweet potato tubers to decrease malondialdehyde (MDA) and increase SOD2 in kidney of diabetic rats. This experimental study was conducted with randomized posttest only control group design. Research subject is 38 diabetic rats that divided into 2 groups, controlled group and treatment group, with 18 diabetic rats in each group. Treatment was given for 60 days to each group. Treatment group (P1) is diabetic rats group that was given a standard diet and ad libitum drinks, and 4CC/day/rat of purple sweet potato tubers aqueous extract for 60 days. Controlled group (P0) is diabetic rats group as control that was given a standard diet and ad libitum drinks only. After 60 days of treatment, evaluation was performed. The results of this research found that mean MDA in kidney of control and treatment group was 8.40?0.17 and 1.47?0.15, respectively. There was a significant decreae of MDA (p
GIANT OVARIAN CYST IN TERM PREGNANCY - A rare case report Hota, Basanta Manjari; Rukmini, K. Radha; Basavaih, Prabhakar Gowdar Channa
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Ovarian cyst in pregnancy may have a poor feto-maternal outcome. A 25 year old multi gravida, post caesarean pregnancy at term reported with antenatal ultrasonography (USG) diagnosis of giant unilocular ovarian cyst and normal obstetrics findings. Elective lower segment caesarean section (LSCS) with left salpingo-oophorectomy and right partial salpingectomy was done. Left ovarian cyst was 29x20 cm in size with smooth surface, no adhesion, no free fluid in peritoneal cavity and a normal right ovary. Histopathological examination revealed mucinous cystadenoma of ovary. Post-operative period was uneventful. The rarity of the case and its successful management prompted us for reporting along with review of literatures.
CORRELATION OF PARATHYROID HORMONE-1 RECEPTOR EXPRESSION TO BONE METASTASIS OF BREAST CARCINOMA PATIENTS Tusta-Adiputra, P. A.; Wibawa-Manuaba, and I. B. T.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Abstract

Background: Bone metastasis is a common complication of metastasis of breast cancer and it is a unique pathobiology process. The Parathyroid Hormone-related Peptide (PTHrP) is a protein which has an important role in breast cancer cells to invade and infiltrate bones or bone marrow and accelerate angiogenetic process. The objective of this study is to reveal the relationship of PTHrP receptor named Parathyroid Hormone-1 Receptor (PTH1R) expression to bone metastasis in breast cancer patients. Methods: This was an analytical cross-sectional study, applying a non probability consecutive sampling. Samples were divided into two groups, i.e. one group of breast cancer metastasis to bone (+others) and another group with non-bone metastasis. Patients were collected from an existed data base (from medical record, cancer register, histopathology), since 2007. The specimen paraffin blocks were re-examined using IHC technique for PTHrP receptor. The data were analyzed and tested with Chi-Square (X2), otherwise it would be tested using Fisher Exact Test. Each group would be allocated minimal of 17 patients/samples. Results: The Chi-Square test failed to show the association between PTH1R expression in breast cancer patients with bone metastasis (p=0.295). The relative prevalence result for positive PTH1R expression was 1.48. There was no proof that positive PTH1R expression was an associated factor for bone metastasis (95% confidence interval). Conclusion: PTH1R expression is not a factor associated with bone metastasis in breast cancer patients.
The Characteristics of Cervical Cancer Patients Who Underwent a Radical Hysterectomy at Sanglah Hospital Denpasar in 2015 Mahendra, I Nyoman Bayu
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Cervical cancer is the most common gynecologic cancer in women. It is the main cause of cancer-related death in women in developing countries. Cervical cancer in Indonesia is the second most cancer affecting Indonesian women and the prevalence is relatively stable in the last 30 years. Cervical cancer was closely related to the histologic type of itself. A squamous cell carcinoma has a specific route of local spreading and a lymphatic route. The sample of this study are cervical cancer patients who underwent a radical hysterectomy from January 1 to December 31, 2015 in Sanglah Hospital Denpasar, Bali. The aim of this study is to discover the characteristics of the patients by age, parity, education level, marital status, sexual activity, the first symptoms and the early screening done, and the clinical staging. Methods: This descriptive study involved 20 patients in Sanglah Hospital Denpasar who had a radical hysterectomy from January 1 until December 31, 2015. The characteristics are gathered from the patients’ medical record. Results: The most cases done radical hysterectomy between 41-45 years old which proportion was 40%, the most parity was parity 2 (60%), elementary school was the most education level (35%), all of the samples only married once and sexually active, the most first symptom was vaginal bleeding (55%), only 10% had pap smear as early detection, and the most clinical stage was stage IIB (50%).

Page 11 of 18 | Total Record : 179

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