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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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IMMUNOMODULATOR, GROWTH PERFORMANCE AND HEMATOLOGICAL PROFILES OF VIUSID VET SUPPLEMENTATION ON PIGLETS Ardana, Ida Bagus Komang; Soma, I Gede; Subawa, Anak Agung Ngurah; Putra, Dewa Ketut Harya
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Immunity system plays important roles in maintaining health status in human as well as in animals.This work aims to study the effect of supplementation of food supplement Viusid vet 90 on growth performance, morbidity and mortality rates, hematological profile, and on antibody titer which may indicate its possible role as an immunomodulator. Methods: Sixty (60) piglets were used as the experimental animals divided into 2 groups, namely group without Viusid supplementation as the control group and that with Viusid supplementation starting from 3 days of age until 13 days of age (10 days of treatment). The dose of supplementation in the feed was 5 cc of Viusid given twice a day. At day 7 of age, the piglets were vaccinated intramuscularly with Hog cholera vaccine and it repeated at day 14 of age. The animals were weighed at the beginning of the experiment and again at Day 15 and then at the end the experiment at Day 30. At 20 days of age all animals were bled using vacuum tube containing anticoagulant EDTA. Subsequently the bloods were examined for hematological profiles using Manual ABC VET Automated blood counter. Finally, at 30 days of age they were all bled again for the assessment of their antibody titer against Hog cholera following ELISA method. Results: supplementation of Viusid vet 90 to piglets improves performance by reducing morbidity and mortality rates. As hematological profile and differential leucocyt count did not showed any abnormality then it may concluded that supplementation of Viusid is effective and safe for piglets. Moreover, the percentage Plate Count (PC) value for Hog cholera was seropositive (54.69%) and significantly higher than control (41.32%) and this could indicate that Viusid vet 90 act as a strong immunmodulator.
Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia. Windiani, I Gusti Trisna; Soetjiningsih, S.; Adnyana, I Gusti Agung Sugitha; Lestari, Kadek Apik
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired reciprocal social interaction and communication, and by a restricted, repetitive or stereotyped behavior. Early detection of autism is recommended on all toddlers from the ages of 9 months because of increasing in prevalence. The Modified Checklist for Autism (M-CHAT) in Toddlers, a Revised with Follow-Up (M-CHAT-R/F) is a 2-stage parent-report screening tool to assess a risk for ASD and it demonstrates an improvement compared to the original M-CHAT. It is translated to Indonesian language by Soetjiningsih and colleagues, and it needs to be validated. Methods: This is a diagnostic accuracy study conducted at Sanglah Hospital, Bali, conducted from March 2015 to December 2016. We included children 18-48 months in this study. The parents of the outpatient children in the growth and development clinic of Sanglah Hospital were asked to fill out the Indonesian M-CHAT-R/F form. In the same visit, the Autism Spectrum Disorder (ASD) assessment according to the DSM-5 as a gold standard was done by the researchers, without knowing the M-CHAT -R/F result. The assessment comparison based on M-CHAT-R/F and DSM-5 was analyzed to obtain the AUC intersection on ROC curve that gives the best sensitivity and specificity. Results: We found 10.71% of our outpatient was diagnosed with autism according to DSM 5, when they are 18-24 months old. The Indonesian version of M-CHAT-R/F as an ASD screening tool has 88.9% in sensitivity and 94.6% in specificity. Conclusion: Our results suggest that the Indonesian translation of the M-CHAT-R/F is an effective screening instrument for ASD, particularly when a two-step screening process is used.
GENOTYPE DIFFERENCE OF –572 G>C AND -174 G>C IL-6 GENE POLYMORPHISM BETWEEN BALINESE POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS AND WITHOUT OSTEOPOROSIS Yulianto, E.; Astawa, P.; Siki-Kawiyana, and K.
BALI MEDICAL JOURNAL Vol 2 No 3 (2013): Vol.2, No.3, September-December 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Osteoporosis is a silent metabolic disease characterized by diminished bone mass and change in bone microstructure which cause increment of fracture risk. Until now, osteoporosis still becomes one of major health problems around the world. In Indonesia, the incidence of osteoporosis is 25%. Previous study have shown the relation between osteoporosis and IL-6 gene polymorphism at -572G>C and -174 G>C. There are some controversies about the correlation between these polymorphism and osteoporosis because of different result between each study. Genotype G polymorphism at -572 G>C of IL-6 gene has been correlated with lower Bone mineral density (BMD) and Genotype G polymorphism at -174G>C of IL-6 gene has been correlated with higher BMD value. In Indonesia, there are still no study about the association between IL-6 gene polymorphism and osteoporosis. In the future this IL-6 gene polymorphism could be used as a genetic marker for osteoporosis in postmenopausal woman. The objective of this study is to determine the difference of genotype of -572G>C and -174G>C polymorphism of IL-6 gene and osteoporosis in Balinese postmenopausal women. Method: This research design is a case control study. Sample was obtained at orthopedic outpatient clinic of Sanglah General Hospital, Bali-Indonesia from June 2012 until November 2012. The diagnosis of osteoporosis is described as BMD value with T score ? -2.5 SD using DEXA. All sample’s peripheral blood are taken to be isolated for DNA and analyzed for IL-6 gene polymorphism at -572G>C and -174G>C using Real Time PCR. Data obtained was analyzed with chi square test using SPSS. Results: This research found 11 osteoporosis sample from total 52 with no difference sample characteristic between case and control (p > 0.05). Using Chi square test, There was a significant differences between genotype -572 G>C; IL-6 gene polymorphism in Balinese postmenopausal woman with osteoporosis and in Balinese postmenopausal woman without osteoporosis (c2 = 41.85 and p = 0.001) and no significant differences between genotype -174 G>C;IL-6 polymorphism in Balinese postmenopausal woman with osteoporosis and in Balinese postmenopausal woman without osteoporosis(c2 = 0.283 and p = 0.518). This study discovered significant differences between genotype -572 G>C; IL-6 gene polymorphism in Balinese postmenopausal woman with osteoporosis and in Balinese postmenopausal woman without osteoporosis. Conclusion: We concluded that ethnic genetic profile variations affect the role of IL-6 gene polymorphism. In the future, this IL-6 gene polymorphism could be used as risk factor for osteoporosis in Balinese premenopausal woman
The Healing Effect of Cuttlefish Bone on Fractured Bone in Rat Model Kloping, Laskar Pradnyan; Purwati, P.; Edward, Mouli
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Fractured bone healing requires three to nine months, which prolongs the patients’ morbidity. Long bone fracture is considered to be difficult due to the dependence of bodily mobility and freedom. Bone tissue engineering materials includes hydroxyapatite (HAp), titanium, alumina, and polymers. HAp is found to be heavily abundant in cuttlefish. This study is conducted to prove that the cuttlebone has an effect of accelerating the fractured long bone healing process. Methods: This is an experimental study using a total of 32 samples of Rattus norwegicus. The Treatment Group received the cuttlebone extract + 0.9% NaCl while the Control Group received only NaCL 0.9%. Both groups were fractured beforehand. On the 14th day the fractured area was harvested and assigned for histopathology and radiographic exam. Results: The Treatment Group was found to have thicker callus formation and more osteoblasts. Conclusions: The cuttlebone extract application caused thicker callus and higher osteoblast production, proving an accelerated fractured bone healing process.
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.
A WOMAN WITH SPORADIC HEMOPHILIA-B DIE BECAUSE OF CEREBRAL BLEEDING: A Rare Case in Bali-Indonesia Suega, Ketut
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Hemophilias are groups of blood clotting disorder caused by deficiency of blood clotting factors which is X-linked recessively inherited and explain why mostly man is the affected victim. But on an extremely rare condition a women can have hemophilia due to several reasons and sporadic hemophilia is used to describe when hemophilia appeared without ascent and decent history of hemophilia. A 38 years old women with a peripheral spontaneous bleeding for two days although an open flap and a cauterization to stop the bleeding has been applied. She was the third child of 7 children in the family, 3 of them were man with normal life and 4 women also have no history of bleeding. Her parent and grand-parent were all dead because of aging problems. She also has 2 sons with ages of 10 and 13 years, respectively, live normally. Results: factor VIII activity 192 seconds (control: 80 seconds), factor IX activity 2 seconds (control: 111 seconds), hence patient was considered suffered from sporadic haemophilia-B due to low level of factor IX 1.8% and bleeding episodes mimicking clinical presentation of classical hemophilia patients while no known history of having hemophiliac family. The different diagnose were Von Willebrand Diisease (VWD), symptomatic carriers, acquired hemophilia. After several admissions and repeatedly bleeding episodes patient died because of intra cerebral bleeding.
Characteristics and Response to Methylprednisolone and Prednisone Treatment of Optic Neuritic Patient at Sanglah General Hospital Denpasar Dita-Rinjani, N. P.; Mas-Putrawati, A. A.; Putra-Manuaba, I. B.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
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Abstract

Objective: Treatment of optic neuritic as recommended by the Optic Neuritic Treatment Trial (ONTT) was intravenous methylprednisolon followed by oral prednisone. This study aims to describe  characteristics and response to intravenous methylprednisolon followed by oral prednisone treatment of optic neuritic patient in Sanglah General Hospital Denpasar. Method: This report is an analytical cross sectional study. Data were collected retrospectively from medical report of optic neuritic patient who came to Sanglah General Hospital during a period of January 1st 2010 until December 31st 2011. Patient characteristics were analyzed with descriptive analyses and presented as frequency, percentage, mean and standar deviation. Visual acuity and contrast sensitivity improvement after intravenous methylprednisolon followed by oral prednisone treatment were statistically analyzed with Wilcoxon test Results:  Optic neuritic were found in twenty-three patients (33 eyes), majority was in age group of 15-40 years (56.5%) with female predominance (65.2%) and unilateral involvement was 56.3%. Mean onset patient presented to the hospital was 21.7±2.21 days and the most common symptom was decreasing vision (87.9%).  The majority of patient presented with papillitis (54.5%), totally color blindness found in 39.4% eyes, and the type of visual field defect at presentation was central scotoma (18.2%). All cases show lesion of optic nerve from visual evoked potential (VEP) examination and magnetic resonance imaging (MRI) shows normal results (39.1% patient). The mean of pretreatment logMAR visual acuity and contrast sensitivity were significant improve after treatment from 1.59±0.47 to 0.59±0.62 (p=0.0001) and 0.31±0.56 to 1.25±0.56 (p=0.0001), respectively. All cases in this study were idiopathic. Recurrence were seen in 2 eyes and none of patient had clinical features suggestive of multiple sclerosis. Conclusions: Visual acuity and contrast sensitivity improvement after intravenous methylprednisolon followed by oral prednisone treatment in this study is good, with lower rate of recurrence and none of cases associated with multiple sclerosis.
Evaluation of the Relationship between Mitral Valve Prolapse (MVP) and Body Mass Index (BMI): A Review Article Samim, Hossein; Hosseini, Sara; Jalalyazdi, Majid
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Mitral valve prolapse (MVP) is a valvular heart disease in which the two valve flaps of the mitral valve do not close equally, and part of the mitral valve slips backward loosely into the left atrium during systole. In general, MVP is associated with low body mass index (BMI), as confirmed by several studies. However, the reason for the higher prevalence of MVP in patients with low BMI remains unknown. Objectives: There is no reliable evidence on the role of genetics or pathophysiological factors in this correlation, and the hypothesis that the size of BMI may lead to MVP or vice versa has not yet been established. Materials and Methods: In this study, all the articles were evaluated in terms of the inclusion criteria. In total, we found 546 articles via PubMed and Google scholar, out of which 30 articles were mainly focusing on MVP, MVR as the major complication of MVP, and BMI, which were included in this systematic review. Results: Among these reviewed studies, patients with MVP had a lower BMI score compared to the subjects without MVP. The low and high BMI score were 28±5 kg/m and 31±6 kg/m, respectively. Conclusions: In the present study, we concluded that low BMI is directly associated with the occurrence of MVP.
CORRELATION BETWEEN STRUCTURAL RETINAL NERVE FIBRE LAYER THICKNESS AND FUNCTIONAL VISUAL FIELD LOSS IN PRIMARY OPEN ANGLE GLAUCOMA Arun, A.; A., Sadhana; Dudala, Shankar Reddy
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Background: Glaucoma is characterized by progressive degeneration of retinal ganglion cells and their axons that leads to nerve fiber layer loss, optic disc cupping, and consecutive glaucomatous visual field changes. Study is done in Department of ophthalmology, S.V.R.R Government General Hospital, S.V.Medical College Tirupati. A total of 52 eyes of 29 patients were included in the study. Mean age of the patients included in the study is 64.14+/- 11.43 years. Majority were male patients (68.96%). Female patients were only 31.04%.
OBSTRUCTIVE NEPHROPATHY OF KIDNEY STONE: The Role of Caspase-3, Transforming Growth Factor-? and Tumor Necrosis Factor-? in Kidney Fibrosis Oka, A. A. G.; Suwitra, K.; Soebadi, D. M.
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Abstract

Objective: Kidney stones are one of the causes of obstructive nephropathy and chronic kidney disease (CKD), characterized by the presence of hydronephrosis and kidney dysfunction. The histhopathologycharacteristics of CKD is kidney fibrosis, which consists of glomerulosclerosis (GS), tubulointerstitial fibrosis (TIF) and tubular atrophia (TA).This research aims to find out that the role of caspase-3, TGF-? and TNF-? as risk factors for kidney fibrosis in obstructive nephropathy of kidney stone. Methode: A total of 82 samples of kidney biopsy patientsduring kidney stone surgery in Sanglah General Hospital Denpasar-Bali from February until December 2013 wereapplied match paired based on age and sex divided in to 41 samples as case and 41 samples as control. Determination of caspase-3, TNF-? and TGF-?1 were carried out using Kit Methode and kidney fibrosis stained with Masson's Trichrome. Results: Bivariate analysis test indicates that OR caspase-3 activity and kidney fibrosis were 3.50; 95%CI (2.95-4.19); p=0.001, OR levels of TGF-? an kidney fibrosis were 2.00; 95% CI (1.72-2.34); p=0.04 andOR levels of TNF ? and kidney fibrosis were 0.60; 95% CI (0.53-0.68); p=0.14. On the other hand, multivariate analysis test OR for caspase-3 activity , levels of TGF-?, levels of TNF-? and kidney fibrosis after adjustment of hydronephrosis, eLFG, and Hb were 2.43; 95% CI (0.86 – 6.90); p=0.09, 2.14; 95% CI (0.74-6.18) p=0.16 and 1.12; 95% CI (0.40-3.16); p=0.82. Conclusion: In obstructive nephropathy of kidney stone patients with high activity of caspase-3 have 3.5 fold risk to gain kidney fibrosis and with high levels of TGF-? have a 2 fold risk to gain kidney fibrosis. However, high levels of TNF-? was not as a risk factor to gain kidney fibrosis. These results can be used as a based data to run further research for obtaining new strategy for managing kidney fibrosis.

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