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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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ANTI-MÜLLERIAN HORMONE AND INHIBIN-B LEVEL PROFILE IN CERVICAL CANCER PATIENTS TREATED WITH PACLITAXEL AND CISPLATIN COMBINATION Abdullah, Nusratuddin; Kouwagam, Anggrainy Dwifitriana; Andina, A.
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Abstract

Background: The age of nulliparous women has increased in developed countries and the 5-year survival rate for the late stage does not exceed 58%. Moreover, as more women are delaying childbearing, preservation of fertility and reproductive function is a major concern when young women are counseled with regard to the effects of treatment for cervical cancer. Objective: To determine the effect of the combination chemotherapy on serum levels of Anti-Mullerian Hormone (AMH) and inhibin B. Methods: This study is a prospective cohort study in 16 cervical cancer patients aged 28-48 years who received Paclitaxel-Cisplatin chemotherapy. AMH and inhibin B levels were examined before and after third series chemotherapy. Statistical analysis used the Wilcoxon test with a level of significance selected at 0.05. Results: There is a significant decrease in median serum levels of AMH and inhibin B patients between before and after Paclitaxel–Cisplatin chemotherapy with p=0.000 (P<0.05). Similarly, a decrease in the median value of serum levels of AMH and inihibin B after Paclitaxel-Cisplatin chemotherapy in each series of chemotherapy was significant with p=0.000 (P<0.05). Conclusions: Serum levels of AMH and inhibin B in cervical cancer patients who received the combination chemotherapy decreased dramatically after 3 months of chemotherapy and the factors that contribute to the diminution is age.
Unripe Papaya (Carica papaya L.) Seed Hexane Fraction Extract Inhibits Male Mice (Mus musculus) Spermatogenesis Stronger Than Unripe Papaya Seed Methanolic Extract Satriyasa, Bagus Komang
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Men and women have the same rights and obligations in family planning program. Practically, participation in family planning program is still predominated by women while participation of men is still low. Low participation of men in family planning program is due to very limited choices in male contraceptive method. In recent years, studies have been refocused on investigating traditional plants as antifertility herbal medicine for men. Studies on antifertility effects of unripe papaya seeds have been done. However, similar studies on hexane fraction extract have not yet been done. In this study, unripe seeds were collected from local Balinese papaya (Carica papaya) fruits. Objective: This study was aimed to assess the effect of unripe papaya seeds hexane fraction extract on spermatogenesis and the testosterone level of male mice. Hexane fraction extract of unripe papaya seeds contains glycosides and triterpenoids, which is assumed to have an antifertility property, so it can be used as a male contraceptive, although the mechanism of action remains to be elucidated. Method: This study used pre-test and post-test control group design, using 30 male mice of balb C strain, 12 weeks of age, weighing 20-22 gram, which were randomly grouped into 3 groups, each consisting of 10 male mice. One control group (P0 = control group) was given double-distilled water, and two treatment groups were given hexane fraction extract of unripe Carica papaya seeds 20 mg/20gram/day, and methanolic extract of unripe Carica papaya seeds 20 mg/20 gram/day (P1 and P2, respectively). After 36 days of treatment, evaluation of the testes and blood of the male mice was conducted. Results: Data were analysed by normality test of Kolmogorov-Smirnov Goodness of Fit, homogeneity test, and Anova test. This study showed that spermatogonia A, primary pachytene spermatocytes, spermatid and Sertoli cells were decreased significantly (p < 0,05) but Leydig cells and testosterone levels were not decreased significantly (p > 0,05). Conclusion: It can be concluded that hexane fraction extract of unripe Carica papaya seeds can decrease the mean number of spermatogonia A cells, spermatocyte of primary pachytene spermatocytes, spermatid and Sertoli cells better than methanolic extract of unripe Carica papaya seeds.
EFFECT OF PROPHYLACTIC ANTIBIOTIC ON SURGICAL SITE INFECTION AFTER TENSION-FREE HERNIOPLASTY Saskia-Javi, Y.; Sudartana, I K.; Raka-Widiana, and I G.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Abstract

Objective: prophylactic antibiotics were remains applied for hernioplasty treatment at Sanglah General Hospital Bali-Indonesia. On the other hand, there were no comprehensive infection incidence data gathered. This research aims to determine incidence differences of post operative infection in patients underwent tension-free hernioplasty and received prophylactic antibiotics compared to those who received placebo. The general purpose of this research is to determine the necessity of prophylactic antibiotics in the hope of setting new procedural standards in elective hernia procedures thus reducing cost and bacteria resistance. Patients and Method: This was an open label randomized clinical trial conducted at Sanglah General Hospital Department of General Surgery from October 2011. The target population was all patients who underwent tension-free hernioplasty  procedure, in Sanglah General Hospital. The acquired data was analyzed after an independent t test was performed. a Mann-Whitney U test, Fisher’s exact test, and Two-Sample Kolmogorov-Smirnov test  were used to determine the correlations between variables, where p < 0.05 was regardless of significant. Results: From 54 subjects 3 (5.6%) of them were found to have a slight erythema around the operation wound, on the 7th,14th,21th, and 28th day no signs of erythema were found. From the three subjects two (7.4%) were from the placebo group and one (3.7%) from the antibiotic group. All clinical assessment of post operative wound was made using Southampton Wound Assessment Scale, where erythema is a grade 1C, all subjects healed primarily. Conclusion: An Open Label Randomized Clinical Trial comparing SSI in post tension-free hernioplasty patients who were given prophylactic antibiotics and placebo. No significant difference were found.
BINGE ALCOHOL ADMINISTRATION ON PREGNANT RATS RESULTS IN DECREASING OF INSULIN LIKE GROWTH FACTOR-1 AND ALDEHYDE DEHYDROGENASE, INCREASING APOPTOSIS INDEX, AND FETAL ALCOHOL SYNDROME IN OFFSPRINGS. Suherman, Sutjahjo; Soetjiningsih, S.; Suastika, Ketut; Astawa, I Nyoman Mantik
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Addiction of alcoholic beverage by early pregnancy women results in fetal alcohol syndrome of her baby. This study aims to investigate fetal alcoholic syndrome due to binge alcoholic drinking by the early pregnant of wistar rat. Methods: This is an experimental study applying posttest only control group design. Wistar Rats were in preconditioning for pregnancy and divided into two groups, i.e. one group was fed with normal feeding and the other group was fed with normal feeding and 40% of ethanol. The off spring then were observed and divided into three groups, i.e. normal fetal, normal fetal from the mother fed with ethanol, and fetal alcoholic syndrome. Insulin like growth factor (IGF-1), aldehyde dehydrogenase (ALDH), apoptosis index, pathology of their brain and heart were observed. The different of all these parameters were then compared by applying one way anova, and considered significant at p < 0.05. Results: In this study we found that there were fetals alcoholic syndrome (FAS) due to the mother of the Wistar Rat fed with ethanol during their pregnancy. There were also a significant different of IGF-1, ALDH, apoptosis index between these three groups (p < 0.05), i.e. normal baby, normal fed with ethanol, and FAS. IGF-1 for these three groups were 56.59±0.52 ng/ml, 55.17±2.41 ng/ml, and 36.64±4.86 ng/ml, respectively. ALDH for the groups were 21.41±2.38 ng/ml, 21.16±4.77 ng/ml, and 17.05±2.68 ng/ml, respectively. Their brain apoptosis indexes were 4.56±0.78, 4.58±1.17, and 7.86±1.31, respectively. Heart apoptosis indexes were found 2.81±1.18, 5.36±1.37, and 7.50±1.43, respectively. Conclusion: Binge alcohol drinking during pregnancy of Wistar Rat results in FAS and identified by decrease of IGF-1, ALDH and increase of brain apoptosis index and heart apoptosis index of the off spring.
Risk Factors for Neuroworsening of Moderate Head Injury Cases in Emergency Department Sanglah General Hospital Bali-Indonesia Sasongko, J; Niryana, W; Golden, N
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Abstract

Objectives: To determine risk factors such as hypoxia, hypotension, age >40 years old, amount of focal lesion, low GCS upon arrival, and female associated with neuroworsening of moderate head injury cases. Method: The study was a cohort study on 152 cases of moderate head injury admitted in Surgery Department/Udayana University Faculty of Medicine/Sanglah General Hospital from April 2010 – March 2011. The variables were analyzed using multiple logistic regression model (p<0.05). Results:  The multivariate analysis showed age group ?40 years old {OR 4,490 (CI 95%: 1,750 – 11,521) p=0,002}, male sex {OR 2,276 (CI 95%: 0,810 – 6,395) p=0,119}, initial GCS 9-12 {OR 2,905 (CI 95%: 0,097 – 24,440) p=0,048}, hypoxia {OR 13,582 (IK 95%: 4,315 – 42,750) p=0,000},  hypotension {OR 5,179 (CI 95%: 1,097 – 24,440) p=0,038}, and multiple focal lesion {OR 5,674 (CI 95%: 2,008 – 16,038) p=0,001} were risk factors for neuroworsening in moderate head injury cases. Area Under Curve value was 84.7% from the Receiver Operator Curve. Conclusions: This study showed that hypoxia, multiple focal lesion, age ?40 years old, and hypotension were risk factors for neuroworsening in moderate injury cases.
The Effects of Syphilis Infection on CD4 Counts and HIV-1 RNA Viral Loads in Blood: A Cohort Study Among MSM with HIV Infection in Sanglah Hospital Bali-Indonesia Somia, I Ketut Agus; Merati, Ketut Tuti Parwati; Sukmawati, Dewi Dian; Phanuphak, Nittaya; Indira, IGAA Elis; Prasetia, Made Yogi Oktavian; Amijaya, Komang Agus Trisna; Sawitri, AA Sagung
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Men who have sex with men (MSM), particularly those with HIV infection, are at high risk for contracting syphilis. However, little is known about the effect of syphilis on HIV-1 RNA and CD4 count among HIV infected MSM. Methods: MSM were enrolled into the MSM-VCT study cohort at Sanglah Hospital in Bali between June 22 nd 2011 to February 13 rd 2012. All participants had anti-HIV test and VDRL test at baseline, with TPHA confirmation for reactive VDRL results. Plasma HIV-1 RNA levels and CD4 counts were measured at baseline and month 6 visits. T-test or non-parametric Mann-Whitney test were used to compare changes in CD4 counts and HIV-1 RNA levels between those with and without syphilis. To analyze difference of baseline and 6 month visit in each group, we used paired students t-test. Results: HIV positive MSM with syphilis co-infection had significantly higher mean baseline CD4 count than those without syphilis (P=0.017). No difference was seen for median baseline plasma HIV-1 RNA between HIV positive MSM with and without syphilis (P=0.885). Mean change in CD4 count from baseline to month 6 was similar between HIV positive MSM with syphilis (n=11) and without syphilis (n=20) (P=0.860). Similarly, no significant difference in median HIV-1 RNA change was identified between those with (n=8) and without syphilis (n=11) (P=1.000). Conclusions: HIV positive MSM with syphilis co-infection had higher CD4 cell counts. However, syphilis influences the changes of CD4 cell count and HIV-1 RNA 6 months after HIV diagnosis, but not statistically significance.
REGIONAL ANESTHESIA CONTINUOUS BRACHIAL PLEXUS BLOCK WITH ULTRASONOGRAPHY GUIDANCE A., Senapathi T. G.; M., Wiryana; P., Astawa; M., Astawa N.; S., Maliawan; M., Bakta; T., Suryadi N.; M., Sukrama D.; D., Satoto; B., Mahadewa T. G.; Ekaputra, Ekaputra; A., W.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Background: Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p
NON NEUROLOGICAL OUTCOME COMPARISON OF EARLY AND DELAYED SURGICAL STABILIZATION IN C-SPINE FRACTURES Mahadewa, T. G. B.; Subawa, and D. M.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Abstract

Background: Non neurological outcome postsurgical stabilization in C-spine injury has not been reported. Non neurological outcome i.e. the risk of lung infection (pneumonia), systemic inflammation response syndrome (SIRS), length of postoperative care (LOPOC) which can compromise the recovery process and treatment period. This study aims to investigate non neurological outcome comparison after early surgical stabilization (ESS) and delayed surgical stabilization (DSS) in patients with C-spine fractures. Methods: The author retrospectively reviews 59 of 108 consecutive patients who met the inclusion criteria with C-spine fractures who underwent surgical stabilization at the Sanglah General Hospital, between 2007 and 2010. Consisting of 25 patients underwent ESS and 34 patients were treated by DSS. The last follow up period range was 3-36 months. Non neurological outcome were evaluated and compared; the risk of pneumonia, SIRS and LOPOC. Results: Significant statistically between ESS and DSS in; the risk of pneumonia (ESS: DSS= 1:9) by Chi-square-test (p=0.023); the risk of SIRS (ESS: DSS= 1:11) by Chi-square-test (p=0.008); and the LOPOC (ESS: DSS= 6.84:9.97) by independent t-test (p=0.000). Application of ESS for C-spine fractures could provide early mobilization, prompt treatment and facilitate early rehabilitation thus significantly reduces complications due to prolong immobilization and reduces LOPOC. Conclussion: It can be concluded that the ESS strategy is effective and efficient thus may propose an option of surgical timing in C-spine fractures.
Anti-Inflammatory Effect of Red Piper Crocatum Leaves Extract Decrease TNF-? and IL-6 Levels in Wistar Rat with Atherosclerosis Wahjuni, Sri; Wita, I W.; Astawa, I N. Mantik
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: This research aims to find a cure for anti-inflammation, based on the utilization of red piper crocatum. The research was started with descriptive study to explore active components of red piper crocatum leaf and followed by experimental study to investigate red piper crocatum activity of the leaf extract in anti-inflammation induced Wistar rat. In this research observed three dominant components: caryophyllene bicyclo [5.2.0] none, 2 methylene-4,8,8-trimethyl-4-vinyl; phytol; 5,9-propano-5H- benzocycloheptene, 6,7,8,9-tetrahydro-7,11-bis(methylene); 4,4-ethynedioxy-2-hexadecen-15-15 olide 1,4,9-trioxaspiro [4,15] eic os-6-en-8-one, 10 methyl; 1H-1,2,4-triazole-5(H)-thione,4-allyl-3-(3-furyl); Benzofuran,2,3-dihydro-2-methyl-7-phenyl which are possibly active to inhibit anti-inflammation to atherosclerosis. Bad eating habits also can cause various health problems, such as obesity, dyslipidemia, inflammation to atherosclerosis. This study was conducted to investigate of red piper crocatum leaves extract as an anti-inflammation through decrease of biochemistry markers TNF-? and IL-6 levels. Method: This is a true experimental with randomized pre-test and post-test control group design, using 50 Wistar rats that are divided into 5 groups: control group using 0 mg/kg B red piper crocatum leaves extract, treatment group 1 using 50 mg/kg BW red piper crocatum leaves extract, treatment group 2 using 100 mg/kg BW red piper crocatum leaves extract, treatment group 3 using 150 mg/kg BW red piper crocatum leaves extract, and treatment group 4 200mg/kg BW red piper crocatum leaves extract. Results: It was observed that intake of 150 mg/B red piper crocatum leaves extract results in the highest significance decrease of 45.63% of TNF-? levels from (28.62 ± 1.25 to 15.56 ± 7.20 ?g/mL) and a significance decrease of 15.42% of IL-6 level from (134.64 ± 1.98 to 113.87 ± 4.30 ?g/mL). Conclusion: It can be concluded that intake of red piper crocatum leaves extract acts as antiinflammation for Wistar rats with atherosclerosis through decrease of TNF-? and IL-6 levels. Further research is required to determine whether the application of red piper crocatum leaves extract on human will result in similar effects of anti-inflammation.
BACTERIOLOGICAL ANALYSIS AND ITS ANTIBIOGRAM PROFILE OF PHARYNGITIS CASES FROM THE PATIENTS ATTENDING REFERRAL HOSPITAL, SIKKIM, INDIA Moirangthem, and, A; Gurung, K
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Abstract

Objective: Infections of throat have a tremendous impact on public health. This present study aims to find out the bacterial load in throat infections as well as their susceptibility pattern in patients attending Central Referral Hospital, Tadong, Sikkim. Method: A total of 55 symptomatic patients having throat infections attended Central Referral Hospital Sikkim, among which 28 were males and 27 were females. A total of 55 throat swabs were collected from the patients with symptoms of pharyngitis. Results: Out of 55 samples, culture was positive in 37 samples. Twenty one strains of Staphylococcus aureus, 13 strains of Streptococcus pyogenes, 1 strain of Pseudomonas aeruginosa and 2 strains of Proteus spp. were isolated. The isolation rate of Staph.aureus was found to be statistically significant when compared between the isolation rate of Ps.aeruginosa, Stp. pyogenes and Proteus spp. 3 isolates of Staph. aureus were sensitive to penicillin, 1 isolate was moderately sensitive and 17 isolates were resistant. 12 strains of Staph.aureus were sensitive to methicillin. Methicillin resistant was seen in 9 strains of Staph. aureus. The strains of Stp. pyogenes isolated were either moderately sensitive or resistant to the used antibiotics, it was not sensitive to any of the used antibiotics. It was moderately sensitive to amoxiclave, clarithromycin, erythromycin and resistant to clindamycin and cefuroxime. 100% strains of Ps. aeruginosa were resistant to ciprofloxacin, gentamicin, piperacillin, ticarcillin, tobramycin and the strains were sensitive only to imipenem (100%). Further 100% strains of Proteus spp.were sensitive to cefuroxime, azithromycin, amoxicillin and cephalexin. Conclusion: Our study showed a high rate of monomicrobial infection. The control of throat infections demands the availability of primary care and appropriate treatment.  

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