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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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Brain Metastasis as Initial Manifestation of Melanoma (A Case Report) Santos, Vitorino M.; Silva, Renata F.; Passini, Viviane V.; Duarte, Mayza L.; Flores, Leandro P.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Melanoma is a malignancy derived from the neural crest, constituted of melanocytes found in the basal layer of epidermis, with the main function of melanin production. Case: A 64-yearold woman was admitted with headache and dyslalia and reported some episodes of vertigo and falls in the last six months. A superficial red and dark skin discoloration in the scalp and a node in the right parotid gland were observed. Computed tomography of the brain showed nodular lesions in the left parietal and right temporal and occipital lobes with hemorrhagic features, in addition to mass effect. Furthermore, PET-CT images were suggestive of brain, lung, and adrenal metastasis. The patient evolved with intracranial hypertension and a neurosurgery was performed. Histopathological and immunohistochemistry studies revealed metastatic melanoma. Conclusions: She underwent schedules of radiation therapy and chemotherapy, but developed uncontrolled sepsis and died in spite of clinical management and intensive care support. Cutaneous primary site of this malignancy in the scalp was previously neglected; therefore, neurological disturbances were the initial manifestations of melanoma. Immunohistochemistry findings allowed ruling out the main differential hypotheses.
HIGH ARTERIAL BLOOD LACTATE AS SIRS PREDICTOR IN PATIENTS WITH SEVERE HEAD INJURY Lengkong, L. R. M.; Maliawan, S.; Mahadewa, and T. G. B.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objectives:  Lactate is one of the prognostic factor for evaluation of clinical severe head injury patients outcome. Lactate is also known as a factor to support diagnostic and prognosis of SIRS cases. Severe head injury is a head traumatic case frequently found in Emergency Units, where some cases result in mortality. Based on Glasgow Coma Scale (GCS), severe head injury is define as a head injury with GCS score between 3 and 8. This study aims to determine whether high arterial blood lactate can be used as predictor that causes the occurrence of SIRS. Method. A Cohort prospective study applied in this research to determine arterial blood lactate as a predictor that causes the occurrence of SIRS. This study was conducted at Sanglah General Hospital Bali-Indonesia from May 2013 to July 2013 with 40 patients who fulfilled the inclusive criteria. Data were presented in tables and analyzed by applying Chi Square Test with CI 95% and p <0.05 was considered significant. Results: From 40 samples, 27 were male (62.5%) and 17 female (37.5%) at the age of 0-10, 2 people (5%), 10-20 years 7 people (17.5%), 20-40 years 14 people (35%), 40-60 years 12 people (30%) and over 60 years 5 people (12.5%). On the first day, patients with normal level blood arterial lactate 2 (5%), and high 38 (95%) causing SIRS (+) 39 (97.5%) and SIRS (-) 1 (2.5%) samples to occur. Using bivariate analysis between arterial blood lactate level and the amount occurrence of SIRS, we obtain p < 0.05 and variable control using multivariate analysis we obtained variable of liver dysfunction that give significant value with level arterial blood lactate with p < 0.05). Conclusion: From 40 samples of Severe head injury, there were 38 (95%) whose blood arterial lactate level increased on the first day, 2 (5%) in normal limit and 39 (97.5%) with SIRS on the third day when p < 0.05) so that high level arterial blood lactate can be used as predictor that causes SIRS to occur.
Anti Tuberculosis Activity of Forest Kedondong (Spondias pinnata) Stembark Extract Against Multiple Drug Resistance (MDR) Strain of Mycobacterium Tuberculosis Dwija, I.B.N. Putra; Anggraeni, Mita; Ariantari, Ni Putu
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Forest Kedondong (Spondias pinnata) traditionally known as “loloh cemcem” and commonly used as a chronic cough remedy. Previous research showed that methanol extract of Forest Kedondong leaves active against MDR strain of Mycobacterium tuberculosis. The aim of this study were to determine the phytochemical constituent and anti tuberculosis activity of stem bark extract of this plant against MDR strain of M. tuberculosis. Method: Coarsely powder of Forest Kedondong stem bark was extracted successively with n-hexane, chloroform and 80% ethanol. Anti tuberculosis assay of chloroform and ethanol extract was conducted using proportion method with Lowenstein-Jensen medium within 3 different concentration of extract of 1, 10, and 100 mg/mL. Activity was evaluated by inhibition of extract against M. tuberculosis growth, which was calculated by mean reduction in number of colonies on extract containing medium compared to control. Results and Discussion: Phytochemical test showed that chloroform extract contains terpenoid and flavonoids. Ethanol extract contains terpenoid, polyphenols and flavonoids. These extracts were active against MDR strain of M. tuberculosis with 100% inhibition at concentration of 100 mg/mL. Chloroform extract has higher inhibition against M. tuberculosis growth than Ethanol extract. Conclusions: These extracts were potentially developed to an anti tuberculosis constituent from natural product.
INTESTINAL DUPLICATION CYST PRESENTING AS VOLVULUS: A Rare Case Report Praveen, Chanumolu; Hota, Prasan Kumar; Kumar, Ch.V. Pavan; Babu, K. Maruthi
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Abstract

Intestinal duplication cyst is a rare congenital anomaly occurring anywhere along the alimentary tract, from mouth to anus. They can present with numerous complications like perforation, bleeding or intestinal obstruction. We report a rare case of intestinal duplication cyst of ileum with acute intestinal obstruction due to volvulus with review of literature.
Safety Procedure for Biosafety and Controlling a Communicable Disease: Streptococcus Suis Tandio, Deasy Ayuningtyas; Manuaba, Ida Bagus Amertha Putra
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: Streptococcus suis infection is a zoonotic disease which cause fatal outbreak. Infection case is related to animal handling and dry season. Health workers on Timor island need to understand more about biosafety procedure and increase awareness of the disease as a potential causes of meningitis. Objective: To provide a simple yet comprehensive reading material for the health workers that is exposed to meningitis. Method: This is a descriptive explorative study, to search about Streptococcus suis in the James Cook University OneSearch library search engine and biosafety procedure in WHO and CDC database. The information in accessed articles were compiled into a review piece. Conclusion: The biggest risk factor for a Streptococcus suis outbreak is inappropriate pig carcass handling. The cocci infect via micro-lesion on the handler skin. Public awareness about an appropriate way to handle meat needed to be raised. Suspected case need to be referred to the nearest centre with an ability to conduct a PCR test. It is essential that people, especially health workers understand that the principles of biosafety cover the basics of the containment system, including the practice, and the correct laboratory techniques, safety equipment, laboratory facilities to protect workers, the environment, and the public from exposure to infectious microorganisms.
HIGH SERUM C-REACTIVE PROTEIN AS PREDICTOR OF SYSTEMIC INFLAMATORY RESPONES SYNDROME IN SEVERE HEAD INJURY PATIENTS Bomba, G. I. B; Maliawan, and, S; Mahadewa, T. G. B
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Abstract

Objectives: Despite the fact that many studies have shown that the role of high sensitivity C-reactive protein (Hs-CRP) in inflammation diseases, the role of this molecule in severe head injury (SHI) has not been understood clearly. Severe head injury was defined as a trauma to the head frequently found in Emergency Units where some cases result in mortality. Severe head injury was defined as Glasgow Coma Scale (GCS) score between 3 and 8. Based on this data, we felt that it was important to determine the role of Hs-CRP as a predictor of SIRS in SHI patients. Method: This was a Cohort prospective study about the role of serum Hs-CRP as a predictor for Systemic inflammatory response syndrome (SIRS) in SHI patients at Sanglah General Hospital, Bali-Indonesia from August 2012 to February 2013. A number of 60 patients fulfilled the inclusive criteria. The data were analyzed descriptively to show the characteristics of the samples and was analyzed using univariate and multivariate analysis to determine the predictor factors for SIRS in SHI patients. A confidence interval of 95% (p < 0.05) was applied. Results: From 60 samples collected, there were 43 males (71.7%) and 17 females (28.3%), the majority age of the samples were 20-40 years old (21 samples, 35%). On the first day 49 samples (81.6%) had elevated serum Hs-CRP levels. Fifty seven samples (95%) had SIRS, and only 3 samples (5%) did not have SIRS. Bivariate analysis between Hs-CRP level and SIRS was significant (p = 0.001). Multivariate analysis showed that pneumonia and high Hs-CRP serum levels were significant predictor factors for SIRS in SHI patients. Conclusion: High serum Hs-CRP levels could be used as a reliable predictor factor for SIRS in SHI patients.
LOW MOLECULAR MASS POLYPEPTIDE AND TRANSPORTER ANTIGEN PEPTIDE GENES POLYMORPHISM AS THE RISK FACTORS OF CERVICAL CANCER WHICH CAUSED BY HUMAN PAPILLOMAVIRUS TYPE-16 INFECTION IN BALI Mahendra, I Nyoman Bayu
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
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Abstract

Background: Until recently, cervical cancer is one of the major problem in women’s health issue related to its high incidence and mortality rate. The etiology of cervical cancer is the high risk oncogenic group of Human Papillomavirus (HPV), especially HPV-16 and 18 and its phylogenies. Meanwhile in Bali, more than 50% of infection are caused by HPV-16 infection. The main objective of this study was to investigate the role of LMP-2, LMP-7, TAP-1 and TAP-2 gene polymorphism as the risk factor in the cervical cancer carcinogenesis that is caused by HPV-16 infection. Method: A nested non-paired case-control study was conducted at Obstetric and Gynecologic Department Sanglah General Hospital, Bali Indonesia from March 1 until August 31, 2013. Laboratory testing was carried out at Laboratory of Histopathology Leiden University Medical Centre, Netherlands,. Results: A total of 40 samples were collected, consist of 20epithelial cervical cancer patients with positive HPV-16 infection as the case group and 20 non-cervical cancer patients with positive HPV-16 infection as the control group. Women infected by HPV-16 with LMP-7 gene polymorphism had a higher risk (OR=7.36, CI 95%=1.38-40.55, p=0.013) to be diagnosed with cervical cancer. Balinese women who were infected by HPV-16 with TAP-2 gene polymorphism had a higher risk (OR= 9.33, CI 95%=2.18-39.96, p=0.001) to be diagnosed with cervical cancer. Meanwhile, Balinese women who were infected by HPV-16 with LMP-7 and TAP-2 genes polymorphism had a higher risk (OR=12.67, CI 95%=1.40-114.42, p=0.020) to be diagnosed with cervical cancer. As the result, it was shown that both of this gene polymorphism was working synergistically. Conclusion: TAP-2 and LMP-7 genes polymorphism play a role in the carcinogenesis mechanism of cervical cancer that is caused by HPV-16 infection in Bali. Meanwhile, LMP-2 and TAP-1 genes polymorphism were not found to play a role in the immunology pathway of cervical cancer that is caused by HPV-16 infection.
Inhibition of Bifidobacterium Cell Wall 51.74 kDa Adhesin Isolated from Infants Feces Towards Adhesion of Enteric Phatogen E. Coli on Enterocyte Balb/C Mice Sukrama, I D. M.
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Abstract

Objectives: To determine 51.74 kDa adhesin of Bifidobacterium sp cell wall isolated from infants feces as an anti adhesion of E. coli on enterocyte mice. Methods: Randomized Posttest-Only Control Group Design was employed to investigate adherence ability of this adhesin towards E.coli adhesion on mice entherocyte. Results: In this research, it was obtained, that the 51.74 kDa adhesin cell wall of Bifidobacterium sp has an ability to inhibit adhesion of E. coli on mice enterocyte. The ability was increased as an increase of adhsein concentration. Conclusions: that can be drawn from this research is the finding of 51.74 kDa adhesin cell wall of Bifidobacterium sp isolated from infants feces that can inhibit adhseion of E. coli on mice enterocyte. Future work that can be carried out are further researches concerning whether these protein can be applied to inhibit adherence of other pathogen bacteria.
Self-Medication and Contributing Factors: A Questionnaire Survey Among Iranian Households Ezzatabadi, Mohammad Ranjbar; Rafiei, Sima; Shafiei, Milad; Tafti, Arefeh Dehghani; Saghafi, Fatemeh; Bahrami, Mohammad Amin; Abdarzadeh, Nadia
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Self-medication is a serious danger in every health sector which potentially brings harmful side effects for the society. The aim of this research was to investigate self-medication and its contributing factors among residents of Yazd province in Iran in 2014. Methods: A descriptive, cross sectional study was conducted in 2014 using a self-constructed questionnaire. A total of 580 families living in Yazd in the time period of study were contributed to fill out the questions organized in two sections of demographic and self-medication factors. Data were analyzed by SPSS software version 16 through appropriate descriptive and analytical statistical tests. Results: Self-medication was reported in 53.4% of the cases. The most frequent self-prescribed medications were related to pain killer drugs (26.6%). There was a significant statistical relation between self-medication and households’ age, occupation and income, level of parents’ education, number of children and place of residence. Among different reasons for self-medication the most important one was reported to be accessibility (3.44+1.3). Conclusion: Due to the considerable prevalence of self-medication and its harmful effects on every society, such an issue should be appropriately controlled through legal regulations particularly in the area of selling dangerous drugs. Furthermore, provision of proper information and warning the population about harmful side effects can be helpful in this regard.
COMPARATIVE IMMUNE RESPONSES OF CHILDREN AFTER INTRADERMAL AND INTRAMUSCULAR RABIES VACCINATION Subawa, A. A. Ngurah; Sutirta Yasa, I Wayan Putu; Astawa, Nyoman Mantik
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
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Abstract

Background: Rabies is a cause of death to people within 100% of Case Fatality Rate. Approximately 55.000 people died because of rabies each year, the vast majority of these deaths happen in Asia and Africa. This study aims to find out comparative immune responses of intradermal (ID) and intramuscular (IM) vaccination in children. Method: This was an experimental study to determine antibody response of ID and IM rabies vaccines with randomized pre and posttest control group design. ID and IM vaccination were carried out in 4 replication for each group. A number of 16 children were recruited for each group. Enzyme Linked Immunosorbent Assay (ELISA) was applied to determine titers antibody on day 0, 7, 21, and 28 after vaccination. Results: This study found that titer antibody induced by ID vaccination was lower than IM vaccination. However, the different is not statistically significant in both groups  (p > 0.05). Titers antibody on day 7 after vaccination were 3.08 ± 2.09 IU/ml intradermally and 4.22 ± 3.02 IU/ml intramuscularly. On day 21 and 28 after intradermal vaccination, titers antibody were 6.78 ± 3.52 IU/ml and 12.53 ± 5.92 IU/ml, respectively. Intramuscularly, antibody titers were 9.76 ± 4.86 IU/ml on day 21 and 14.98 ± 7.76 IU/ml on day 28. Conclusion: ID vaccination is safe and can be used as an alternative vaccination for rabies in human. In addition, 0, 7, 21 ID vaccination methods can be recommended for use to control rabies cases in Indonesia because that methods induce protective immune response.

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