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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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RENAL FUNCTION TEST ON THE BASIS OF SERUM CREATININE AND UREA IN TYPE-2 DIABETICS AND NONDIABETICS Singh, P.; Khan, S.; Mittal, and R. K.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Abstract

Background: Type-2 diabetes mellitus has quickly become a global health problem due to rapidly increasing population growth, aging, urbanization and increasing prevalence of obesity and physical inactivity. Diabetic nephropathy is one of the major causes of chronic renal failure. Both serum urea and creatinine are widely used to assess the function of kidney. This study was conducted to observe the impaired renal function in type 2 diabetics and compare with non-diabetics controls. Method: To determine the incidence of renal dysfunction in diabetics in Nepalgunj medical college and Hospital , Nepalgunj , Banke, Nepal , blood samples from 100 diabetic subjects and 100 non-diabetic controls were taken between the period 1st February  , 2012  to  31st January , 2013 for investigation of  plasma glucose fasting(FPG), blood urea and serum creatinine. These biochemical parameters were determined by using a fully automated clinical chemistry analyzer. Results: Our findings showed that the level of blood urea (P<0.0001, 95%Cl) and serum creatinine (P?0.0004,95%Cl ) were significantly higher in type 2 diabetics as compared to non-diabetics in both male and female. There was no significant difference between diabetic male and female. 15 out of 100 diabetes samples have high urea level whereas 7 out of 100 had increased creatinine level. In control only 3 samples had high urea value and 1 had high creatinine level. There was statistical signi?cant increased in urea level with increased in blood sugar level. Conclusion: Blood urea and creatinine is widely accepted to assess the renal functions. Good control of blood glucose level is absolute requirement to prevent progressive renal impairment.
Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang Maharani, Iriana; Suheryanto, Rus; Retnoningsih, Endang
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5. Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %). From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway.
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.
ANNUAL BALI INTERNATIONAL COMBINED CLINICAL MEETING Svigos, John
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: This valuable collaboration between Adelaide and Bali was first convened by Prof. I G. Surya, the late Prof. Made Kornia and Associate Prof. John Svigos in May 2011 at Sanglah General Hospital, Bali-Indonesia. This is a three day clinical meeting consisting of a daily Plenary Session for formal presentations running along with a Concurrent Session predominantly for “hands on” and interactive teaching. The meeting has a multidisciplinary focus which is in tune with contemporary Maternal Fetal Medicine practice and consists of obstetricians, midwives, neonatologists and obstetric anaesthetists from both cities sharing their respective experiences. From an initial modest meeting with 80 registrants this has now grown to over 300 registrants in 2015. A fourth day was trialed in 2014 in which a Field Day was incorporated into the program and enabled the overseas participants to gain some first hand experience in the workings of an orphanage (Anak Anak Bali Kids), a midwife obstetric unit (Bumi Sehat) and a level two hospital (Sanjiwani Hospital, Gianyar). Further Field Days are anticipated at future meetings. The Visiting Faculty from Australia are predominantly from the Women’s and Children’s Hospital with input from The Lyell McEwin Hospital both in Adelaide, The Royal North Shore Hospital and the Royal Prince Alfred Hospital in Sydney and the King Edward Memorial Hospital in Perth. The broader strategic aspects of the collaboration have seen the rotation of three MFM Trainees from the Trigonum (Denpasar, Surabaya and Malang) through Adelaide for two months in 2011 and 2012 as part of their MFM training. Unfortunately AusAID funding has not been forthcoming for further rotations to occur but in 2016 a multidisciplinary group from Sanglah General Hospital will be making a one week visit to the Women’s and Children’s Hospital as a forerunner to further visits. Meantime the collaborations with the Dr. Soetomo Hospital, Surabaya and the Saiful Anwar Hospital, Malang are being further strengthened with members of the Visiting Faculty also visiting the MFM units at these hospitals prior to the BICCM. The Convenors for the 2016 BICCM meeting in May will be Dr. Ryan Mulyana assisted by Dr Jaya Kusuma, Feto Maternal Division, Sanglah General Hospital and Dr Rosalie Grivell assisted by Associate Prof John Svigos, MFM Service, Women’s and Children’s Hospital.
Correlation Between Full Outline Unresponsiveness Score and Glasgow Coma Scale for Severe Head Injury Patients at Prof. dr. R. D. Kandou General Hospital, Manado-Indonesia Jusuf, W. R. A.; Prasetyo, E; Oley, M. C.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
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Abstract

Objective: Glasgow Coma Scale (GCS) has been widely used to assess level of consciousness related to trauma, however, its use have a limitation especially in intubated patients. Full Outline Unresponsiveness Score (FOUR) consists of four components (eye, motor, brainstem, and respiration) and each component has a maximal score of 4 and total score 17. This study aims to evaluate correlation between FOUR score and GCS to evaluate level of consciousness in severe head injury patients. Methods: This is a prospective study with correlation approach. We prospectively studied all severe head injury patients at surgical emergency department Kandou Hospital, Manado from March to May 2010. Level of consciousness was assessed using GCS and FOUR score. Data were analysed with Pearson correlation coefficient. Results: From March to May 2010 at surgical emergency department there were 27 severe head injury patients (24 males and 3 females) with average range of age 10-20 years old (29,6%). The highest distribution of GCS in severe head injury patients were GCS 8 (33.3%) and GCS 3 (22.2%) while in FOUR score were 8 (33.3%) and 7 (14.8%). Conclusions: we concluded that FOUR score can be used as important tools to assess level of consciousness of severe head injury patents. FOUR score provides greater neurological detail than GCS which can assess brainstem reflexes, breathing pattern, and herniation.
Tomato (Lycopersicum commune) Juice and Physical Exercise Increase Number of Neurons and ER? expression in Post-Ovariectomy Rats Brain Laswati, Hening; Subadi, Imam; Andriana, Meisy; Kurniawati, Patricia Maria; Pangkahila, Jahya Alex
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Estrogen deficiency condition can degrade the quality of life, decline in cognitive function will be more severe trough age. Phytoestrogen compounds can be found in pegaga leaf extract, tomatoes, and papaya is an easy and inexpensive way to increase estrogen levels in post menopause women through extra gonadal estrogen induction. Therefore, the aims of this study were to examine the effect of tomato juice, physical exercise, and combination of these treatments on promoting neurons and ER? expression in somatosensory cortex that contribute to cognitive function of post-ovariectomy rats. Method: Twenty-eight female healthy Wistar rats (Rattus novergicus), 8-10 weeks old, from Laboratory of Biochemistry, Faculty of Medicine Airlangga University include in this experiment. The animals were housed in the animal-care facility with ad libitum food and water. The temperatur was maintained at 18°C-24°C. The treatments were done 2 weeks after ovariectomy. Tomato were made in Laboratory of Pharmacognocy and Phytochemistry, Faculty of Pharmacy, Airlangga University, from inner part of the tomato fruits (mucous like substance) with freeze dry method (-40°C). Results: The weight of white rat Rattus norvegicus post ovariectomy in this study was between 133-170 gram with a mean weight 154.32 ± 9.72 gram. Hematoxylin/eosin staining showed neuronal deficit in the control rats brain. In figure 1, the tomato group showed the largest of neurons number (145.43 ± 17.728), followed the combination group (140.57 ± 22.449), the exercise group (136.86 ± 23.104) and the smallest number in the control group (96.43± 28.965). Four weeks after treatments the number of neurons increased significant in the tomato group (p=0.001), exercise group (p=0.004) and combination group (p=0.002) from the control group. This study showed no significant different between tomato and exercise group (p=0.500), tomato and combination group (p=0.701) and between exercise and combination group (p=0.769). Conclusions: In conclusion, our data demonstrated that post ovariectomy rats showed deficit numbers of neurons and decreased ER? in the somatosensory cortex. Treatment with physical exercise, tomato juice, and combination of these treatments increased the number of neurons and ER? expression in the somatosensory cortex.
The Role of Multiplex Polymerase Chain Reaction in Detecting Etiological Causes of Bacterial Prostatitis Associated Benign Prostatic Hyperplasia Rosadi, Bramastha A; Mahadewa, Tjokorda G. B.; Duarsa, Gede Wirya K.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Background: Benign Prostatic Hyperplasia (BPH) has been correlated with chronic prostatitis according recent study. Chronic pelvic pain is the chief complain of BPH followed by prostatitis. The gold standard of the etiological diagnosis is urine culture, but the negativity rate is still high. Multiplex polymerase chain reaction (PCR) as a diagnostic tool in search of etiological causes could identify microorganism on DNA level. This research aims to find out the role of multiplex polymerase chain reaction as diagnostic tools on prostatitis patients. Material and Method: A total of 12 samples collected during the TURP procedure in Sanglah General Hospital Denpasar – Bali from February until May 2015. All of the samples has been diagnosed prostatitis clinically and perform urine culture test. The prostate specimen taken was sent to the Pathological anatomy for histopathology diagnostic and underwent multiplex PCR for etiologic diagnostic. Result: 12 samples have been declared as prostatitis based on histopathology examination, and then were analyzed using multiplex PCR. 10 samples were positive (6 were E. coli, 2 were C. trachomatis, the rest were N. gonorrhea and P. aeruginosa). The urine culture revealed 9 positive, within the result 6 were E. coli, and the others were P. aeruginosa, M. morganii and A. haemolyticus. Conclusion: In prostatitis patient, the etiological diagnostic was important. Multiplex PCR as diagnostic tools could detect the microorganism on a negative urine culture. The combination of the urine culture test and multiplex PCR revealed a better result on etiologic diagnosis which leads to a better management of the disease.
CORRELATION OF CYSTOSTOMY TO LOW URETHROCUTANEOUS FISTULA INCIDENT IN HYPOSPADIA SURGERY Laura, S. F.; Duarsa, G. W. K.; Mahadewa, T. G.
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
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Abstract

Background: Hypospadia is the most common congenital abnormalities to the penis. The most common post-operative complications and hypospadias is uretherocutan fistula. Uretherocutan fistula is arising from an infected wound, hematoma, urinary extravasations, ischemic necrosis of the flap or graft, technical errors, and postoperative care. Although, reconstruction of the urethra without cystostomy results in patients discharged quickly, some sources still recommend the use of cystostomy in hypospadias surgery. This is because of lower complication rate and more comfortable for the children during the postoperative period. The purpose of this study was to determine the incidence of fistula uretherocutan correlation with cystostomy using hypospadia operation. Methods: This study was carried out with cross-sectional design involving 68 patients, comprising 34 people with operating groups and 34 other people of hypospadias surgery without cystostomy. This is a retrospective study by observing medical record of the patients at Sanglah General Hospital from December 2013 until May 2014. All data obtained were assayed with Chi-square and Person Correlation and considered significant at p < 0.05. Results: This Study reports that the value of r = -0.364, p = 0.034, and PR = 0.16. However, there is a correlation in the use of cystostomy to a lower incidence of fistula in operation uretherocutan hypospadia. In cystostomy surgery, fistula incidence was 2.9% and operating without cystostomy was 17.6%. In operation hypospadia using cystostomy is expected to reduce the incidence of fistula.
ANTI DIABETIC EFFECT OF ORAL ADMINISTRATION OF CINNAMON IN WISTAR ALBINO RATS Kumar, S. S.; Mukkadan, and J. K.
BALI MEDICAL JOURNAL Vol 2 No 3 (2013): Vol.2, No.3, September-December 2013
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Abstract

Background: The present study was undertaken with an objective to observe effectiveness of oral administration of cinnamon extract to hyperglycemic induced rats using alloxan. Male and female Wistar Rats were injected with alloxan to induce hyperglycemia. Methods: This is an experimental study to determine whether cinnamon has an ability to combat hyperglycemic rats. Blood glucose was estimated by GOD-PAP method using diagnostic kit supplied by Agappe diagnostics, Maharashtra. Results: The present experimental study provides further evidence that oral administration of Cinnamon extract for 21 days produced a significant decrease in the blood glucose level in the model of alloxan induced diabetes rats. Conclusion: From this study, we can conclude that the oral administration of Cinnamon extracts have beneficial effect on blood glucose levels. However further pharmacological and biochemical investigations will clearly elucidate the mechanism of action and helpful in projecting these plant extracts as a therapeutic target in diabetes research.
Pre-Storage Leukoreduced Filtration (PLF) Decrease Soluble Human Leukocyte Antigen-I (sHLA-I) Level in Thrombocyte Concentrate Stored for Five Days Herawati, S.; Sutirta-Yasa, I. W. P.; Suega, K.; Subawa, A. A. N.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Thrombocyte concentrate is one of the important blood component to improve patient's clinical condition. In order to provide thrombocyte, concentrate with good therapeutic effect, the preparation process and storage condition should be maintained properly. One attempt to maintain good quality of thrombocyte concentrates is by doing Pre-storage Leukoreduced Filtration (PLF) method during preparation of thrombocyte concentrates. The purpose of this study was to determine the effect of PLF on sHLA-I level in thrombocyte concentrates stored for 1, 3 and 5 days. Methods: This is an experimental study with posttest only Control Group design, enrolling 34 thrombocyte concentrates and randomly assigned into PLF Group and Control Group. Results: It was obtained that PLF Group has lower mean sHLA-I level than Control Group stored for 1, 3 and 5 days and statistically significant. Mean sHLA-I level in PLF Group at day 1 is 2,75±0,82 µg/ml and Control Group is 3,66±0,87 µg/ml, which is statistically significant (p < 0,05). Mean sHLA-I level in PLF Group at day 3 is 3,07±0,75 µg/ml and Control Group is 4,05±1,29 µg/ml, which is statistically significant (p < 0,05). Mean sHLA-I level in PLF Group at day 5 is 3,81±0,97 µg/ml and Control Group is 5,61±3,26 µg/ml, which is statistically significant (p < 0,05). Conclusions: It can be concluded that PLF decrease sHLA-I level in thrombocyte concentrates stored for five days compared with Control Groups.

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