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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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TUBERCULUM SELLAE MENINGIOMA Vs. MACROADENOMA: How to differentiate preoperatively? Mardjono,, I.; Arifin, M. Z.; Sidabutar, R.; Singh, and, A.; Sevline, E. O.
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Sellar region tumors may origin from a various number of structures and each of themhave a specific clinical and radiological appearance. Among these pathological processes, one of themost challenging is to distinguish between tuberculum sellae meningioma (TSM) and macroadenomahypophysis (MH). Differentiating these two entities preoperatively is very important to decide whichapproach will be most suitable and beneficial. The purpose of this study is to produce a simplepreoperative scoring system to differentiate these two that can be applied in specific conditions whereMRI is not available or could not be performed. Methods: This analytical retrospective cohort studycontains data obtained from patients treated in Neurosurgery Department of Dr. Hasan SadikinGeneral Hospital-Bandung from 1 January 2008 until 31 December 2010. There were 34 patientsenrolled in this study, in which 15 of them were diagnosed with MH and 19 patients diagnosed withTSM confirmed with pathology examination. Results: From clinical presentation we found that theevent of endocrinopathy occurs significantly in macroadenoma hypophysis (p=0.002). Whereas fromradiological evaluation there were 7 parameters that significantly distinguish these two entitiesincluding hyperostosis, sellar floor configuration, homogeneity of mass, contrast agent enhancement,waist configuration, peritumoral edema, and dural attachment. From these findings, we propose asimple scoring system to differentiate macroadenoma hypophysis and tuberculum sellae meningiomawith a 84.2% sensitivity and 100% specificity. Conclusion: although MRI is the modality of choice indifferentiating macroadenoma hypophysis and tuberculum sellae meningioma but our scoring systemcan be used as an aid in choosing best surgical approach.
PEUTZ JEGHERS SYNDROME PRESENTING WITH ACUTE INTESTINAL OBSTRUCTION: A RARE CASE REPORT WITH REVIEW OF LITERATURES Hota, P. K.; Reddy, G. Narasimha; Rajasekhar, G.; Mohan, C. Nalini
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Peutz-Jeghers syndrome is a rare genetic disorder presenting in young age with mucocutaneous pigmentation and hamartomatous polyposis. Method: We report a case of PeutzJeghers syndrome in a 16 year old boy presenting with acute intestinal obstruction. Results: Imaging studies revealed intussusception. He had mucocutaneous pigmentation and multiple hamartomatous polyps which were diagnosed histologically. The unusual presentation of the case and its successful management has prompted us to report the case with literature review.
OSTEOPOROSIS IN A SEVENTH YEAR OLD BOY WITH ACUTE LYMPHOBLASTIC LEUKEMIA (Case Report) Salim, H; Ariawati, K.; Bikin-Suryawan, W.; Arimbawa, and I. M.
BALI MEDICAL JOURNAL Vol 2 No 3 (2013): Vol.2, No.3, September-December 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Osteoporosis in children is rare and usually secondary to an underlying disease process whose diagnosis may be difficult to detect. It can be a manifestation of acute lymphoblastic leukemia (ALL). About a-quarters of children with ALL will have signs and symptoms of osteoporosis. We report the case of a seventh-year-old boy with back pain. His antero-posterior pelvic radiograph showed the osteoporotic bone. The bone age study revealed six-year-old bone. Review of peripheral blood smear showed normochromic anemia with thrombocytopenia. Immunophenotyping of peripheral blood revealed no dominant marker was seen, but the bone marrow aspiration confirms the diagnosis of ALL (L2).
Association of P53 Protein Overexpression with Clinicopathological Features of Oral Squamous Cell Carcinoma Patients in Bali Winata, A.; Manuaba, I. B. Tjakra. W.; Sudarsa,, I. W.; Mahadewa, Tjok G. B.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Oral cancer was a major health problem with a high incidence rate worldwide. Oral Squamous Cell Carcinoma (OSCC) in Bali, ranked as the second most common cancer after cervix carcinoma. Our understanding of OSCC hasn’t yielded a satisfactory clinical outcome; therefore, further studies about the role of biomolecular markers in OSCC are still needed. One of the biomolecular markers for prognosis and predictor for OSCC that has been a topic of research to date is p53. Method: This is a cross-sectional analytical study of 36 samples to determine the correlation between p53 overexpression with age group, tumor location, tumor stage, and tumor grade in OSCC patients. Data was processed descriptive and analytical using Chi-Square/Fisher 's Exact Test methods with a significance value of p
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
Publisher : BALI MEDICAL JOURNAL

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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 ROLE OF GLOMERULOSCLEROSIS AND TUBULAR ATROPHY AS DETERMINING FACTOR FOR REDUCED KIDNEY FUNCTION IN KIDNEY STONE DISEASE Oka, A. A. G.; Widiana, I G. Raka
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Kidney fibrosis including glomerulosclerosis (GS) and tubulointerstitial fibrosis (TIF) or tubular atrophy (TA) may be predictor of kidney dysfunction. Estimated glomerular filtration rate (eGFR) is a common laboratory examination to estimate the kidney function. The aim of this research is to determine relationship between histologic features namely glomerulosclerosis (GS) and tubular atrophy (TA), and estimated glomerular filtration rate (eGFR) in kidney stone disease. Methods: A cross-sectional study in a total of the 63 patients with kidney stone consisted of 25 (39.7 %) males and 38 (60.3 %) females, aged (51 ± 11 years), Blood urea nitrogen (BUN) 16 (8-62) mg/dl, serum creatinine 1.26 ( 0.47- 6.76 ) mg/dl and eGFR 61.4 ± 32.1 ml/min. Histologic features showed GS index 6 (0-30) and TA index 892 ± 333. There was significant correlation between eGFR and GS index dan TA index(r -0,577; p=0.001 and 0,514;p = 0,001, consecutively). Multivariate regresion equations were eLFG = 67,21 -1.63 (GS index) and eLFG = 67,21 + 0,01 (TA index). Estimated GFR may be used as a marker of glomerulosclerosis and tubular atrophy in obstructive nephropathy of kidney stone patients.
Langerhans Cell Histiocytosis: A Case Report Suzy-Indharty, Rr.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Langerhans Cell Histiocytosis (LCH) is a rare proliferative disorder of a distinct cell type that is similar to Langerhans cell. Prevalence is estimated at 1:200.000/year in children. Clinical presentations are variable, ranging from a single location in the bone to severe multivisceral involvement leading to dysfunction of vital organs. Therefore, objective of this study was to explore LCH based on clinical findings, skull x-ray, head CT-Scan, cytology, histopathology. and Immunohistochemistry. Method: We report a case of Langerhans Cell Histiocytosis of a 3-year-old boy. Fine needle aspiration biopsy was performed from a nodule in parietal area on the scalp; dry fixation was made and stained with Giemsa. Immunohistochemistry examination was performed with CD1a and S100. Histopathology examination was done post-operatively and cytology examination were consistent with LCH, composing Langerhans cells with complex, clefted, grooved, irregular or convoluted nuclei with fine chromatins and one or more small nucleoli and moderate to abundant quantities of eosinophilic cytoplasm, mixed with multinucleated eosinophils. Results:  The finding of pentalaminar Birbeck granules by electron microscope is diagnostic of LCH, but this examination cannot be performed in our institution, so diagnosis was supported by immunohistochemistry with CD1a and S 100. Conclusions: Based on clinical findings, skull x ray, Head CT-Scan, cytology, histopathology and Immunohistochemistry, this case was concluded as a Langerhans Cell Histiocytosis.
Cost Minimization Analysis of Hypnotic Drug: Target Controlled Inhalation Anesthesia (TCIA) Sevoflurane and Target Controlled Infusion (TCI) Propofol Wiryana, Made; Aribawa, I Gusti Ngurah Mahaalit; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Hartawan, I Gusti Agung Gede Utara; Sucandra, Made Agus Kresna; Parami, Pontisomaya; Putra, Kadek Agus Heryana; Sutawan, IB Krisna Jaya; Arimbawa, IGNA Putra; Jaya, Ketut Semara; Semarawima, Gede
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Cost minimization analysis is a pharmaco-economic study used to compare two or more health interventions that have been shown to have the same effect, similar or equivalent. With limited health insurance budget from the Indonesian National Social Security System implementation in 2015, the quality control and the drug cost are two important things that need to be focused. The application of pharmaco-economic study results in the selection and use of drugs more effectively and efficiently. Objective: To determine cost minimization analysis of hypnotic drug between a target controlled inhalation anesthesia (TCIA) sevoflurane and a target controlled infusion (TCI) propofol in patients underwent a major oncologic surgery in Sanglah General Hospital. Methods: Sixty ASA physical status I-II patients underwent major oncologic surgery were divided into two groups. Group A was using TCIA sevoflurane and group B using TCI propofol. Bispectral index monitor (BIS index) was used to evaluate the depth of anesthesia. The statistical tests used are the Shapiro-Wilk test, Lavene test, Mann- Whitney U test and unpaired t-test (? = 0.05). The data analysis used the Statistical Package for Social Sciences (SPSS) for Windows. Results: In this study, the rate of drug used per unit time in group A was 0.12 ml sevoflurane per minute (± 0.03) and the group B was 7.25 mg propofol per minute (±0.98). Total cost of hypnotic drug in group A was IDR598.43 (IQR 112.47) per minute, in group B was IDR703.27 (IQR 156.73) per minute (p>0.05). Conclusions: There was no statistically significant difference from the analysis of the drug cost minimization hypnotic drug in a major oncologic surgery using TCIA sevoflurane and TCI propofol.
THE ROLE OF RECOMBINANT IL-10 ON THE SERUM LEVEL OF TNF-?, ONE HOUR POST TRAUMATIC BRAIN INJURY OF THE WISTAR RAT Adhimarta, Willy; Islam, Andi Asadul; Maliawan, Sri; Lowrence, Gatot S.; Patellongi, Ilhamjaya
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Brain injury often occurs not only primary brain injury, but often also occur secondary brain injury. Inflammation is a process that occurs immediately after trauma characterized by activation of the mediator substance. TNF-? is a major cytokinee involved in the inflammatory processes that have adverse effects if the serum level are excessive. There needs to be a balance of the inflammatory process in the brain injury so things that harm does not occur. As anti-inflammatory IL- 10 plays an important role in maintaining the balance. The objective of this study is to determine the effect of IL-10 intervention as an anti -inflammatory will decrease the serum level of TNF-? in traumatic brain injury. Material And Method: Experimental Study in the Rattus Wistar rats, post test control group design, male, aged 3-4 months, with body weight (BW) 300-400g, were obtained from the Laboratory Animal Faculty of Medicine, University of Hasanuddin as much as 24 tails, which is the result of breeding. Subjects were divided into four groups, each group of six rats, treated with controlled cortical impact model (Feeney’s weight-drop) of traumatic brain injury. Blood taken with capillary tube in retro-orbita plexus or sinus.This study has approved by ethical clearance for research. Results: Levels of TNF-? group of rats 1 hour post-trauma without administration of recombinant IL-10 (28.58 ± 7.28) pg / mL; was significantly higher (p
DEBRIDEMENT WITH FASCIOTOMY ON DIABETIC FOOT REDUCES TUMOR NECROSIS FACTOR ALPHA AND INCREASES VASCULAR ENDOTHELIAL GROWTH FACTOR PLASMA WITH CLINICAL IMPROVEMENT Yasa, K. P.; Siki-Kawiyana, K.; Budhiartha, A.A. G.
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Clinical and animal studies find out any increase of TNF-? and decrease of VEGF level in tissues of diabetic foot ulcers. Levels and abnormal activity of VEGF related to hypoxia and increase of TNF-? in diabetic tissue lead to impaired healing of ulcers. This study aims to determine debridement with fasciotomy simultaneously reduce TNF-? and increases VEGF plasma level and clinical improvement of diabetic foot ulcers. Methods: A clinical study by a randomized pretest - posttest control group design was carried out. Patients were divided into two groups of debridement without fasciotomy as a control group and group of debridement with fasciotomy as the treatment group. Sixty patients of diabetic foot ulcer Wagner II, III, and IV classification met inclusion and exclusion criteria, 28 patients were selected as control group and 32 as treatment group. Clinical improvement of ulcers was observed every week for 4 weeks using the instrument of Leg Ulcer Measurement Tool (LUMT) score. Result: Plasma TNF-? pretest was 422.30±17.05 (pg/ml) on control group and 424.47±12.02 (pg/ml) on treatment group. Plasma TNF-? posttest was 390.91±12.85 (pg/ml) on control group and 290.26±16.42 (pg/ml) on treatment group (p<0.05), with ? TNF-? (pg/ml) was 31,40±17,98 on control group and 134.21±14.50 on treatment group (p<0.05). Plasma VEGF level (pg/ml) pretest was 282.50±11.58 on control group and 286.74±10.19 on treatment group. Plasma VEGF level (pg/ml) posttest was 289.19±21.91 on control group, 338.70±20.11 on treatment group (p<0.05), with ? VEGF (pg/ml) was 15.23±10.73 on control group and 51.96±13.54 on treatment group (p<0.05). There was significant clinical improvement of ulcer on treatment group on 2nd , 3rd, and 4th week of treatment (p<0.05) There was average increase pressure (13-21 mmHg) on all foot compartments of the two groups Conclusion: debridement with fasciotomy simultaneously decreases TNF-? and increases VEGF plasma level accompanied clinical improvement of diabetic foot ulcer. Increase of foot compartment pressure may support phenomenon of microvascular permeability on diabetic patients, therefore fasciotomy on diabetic foot to become rational as adjunct of treatment.

Page 12 of 18 | Total Record : 179

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