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INDONESIA
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.
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Articles 179 Documents
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ESTROGEN RECEPTORS OF HAIRS BLACKS AND WHITES Laswati, Hening; Pangkahila, Jahja Alex
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Aging is termed as same as degenerative process, in which all part of tissue organs retarted the microstructure either macrostructure, forming and function even the colour, including black hair change to white hair. Several researchers have been recommended that estrogen hormone be able ease black to white hair, but hormone without any presenting of receptor won’t be work properly. The main aim of this study were to determine amount of estrogen receptor contents in famales and males black and white hairs included the microscopically structure. Method: Twelve females and males there were 50 -56 years old each pairs black and white head hairs were plucked along with follicles. This estrogen receptors analyzed using radioreceptor binding assay there were 5mm eah hair follices including the root cutted and each pair put its in 2 ml glass tube already filled in with 500 µl 125I-estradiol and incubated in 37oC for 3 hrs. Following times were over the tube flushed twice carefully the hair won’t be flushed. Then count by putting in the gamma counter chamber for 1 minute each. The values that shown in the monitor as CPM (count per minute), recorded as receptor of estradiol. Results: Mean (±SD) sum estrogen receptor in females black and white hairs were 479.3 ± 37.5 and 387.7 ± 33.0, but significantly decreased in male black hair was 316.9±17.8 and 274.0 ± 19.8. All those pairs significantly different either female black and white hairs or male black and white hair and also significantly different among groups. Conclusion: The lowest estrogen receptors recorded in male white hairs and microstructure decreasing of melanin contents.
TRAUMATIC GASTRIC RUPTURE FOLLOWING BLUNT TRAUMA ABDOMEN: A Case Series Hota, P. K.; Babu, M.; Satyam, G.; Praveen, and Ch.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Abstract

Background: Gastric rupture following blunt injury abdomen is a rare presentation with a reported incidence of 0.02-1.7% in current literature. History of recent meal has been implicated in traumatic gastric rupture. Commonly traumatic gastric rupture is associated with other injuries like splenic injury and fractures. Prompt diagnosis and early intervention reduces mortality and morbidity. Primary two layered closure can be done for a better surgical outcome. We report 2 cases of blunt injury abdomen with gastric rupture, one with road traffic accident and other being from a fall from a height, which were managed successfully without any post operative morbidity and mortality.
Correlation between Nerve Growth Factor (NGF) with Brain Derived Neurotropic Factor (BDNF) in Ischemic Stroke Patient Widodo, Joko; Asadul, Andi; Wijaya, Andi; Lawrence, Gatot
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: The neurotrophins nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) is a family of polypeptides that play critical role during neuronal development, appear to mediate protective role on neurorepair in ischemic stroke. Naturally in adult brain neurorepair process consist of: angiogenesis, neurogenesis, and neuronal plasticity, it can also be stimulated by endogenous neurorepair. In this study we observed correlation between NGF and BDNF ischemic stroke patient’s onset: 7-30 and over 30 days. Methods: This is cross sectional study on 46 subjects aged 38 – 74 years old with ischemic stroke from The Indonesian Central Hospital of Army Gatot Subroto Jakarta. Diagnosis of ischemic stroke was made using clinical examination and magnetic resonance imaging (MRI) by neurologist. Subjects were divided into 2 groups based on stroke onset: 7 – 30 days (Group A: 19 subjects) and > 30 days (Group B: 27 Subjects). Serum NGF levels were measured with ELISA method and BDNF levels were measured using multiplex method with Luminex Magpix. Results: Levels of NGF and BDNF were significantly different between onset group A and B (NGF p= 0.022, and BDNF p=0.008), with mean levels NGF in group A higher than group B, indicating that BDNF levels is lower in group A than group B. There was no significant correlation between NGF and BDNF levels in all groups. Conclusion: The variations in neurotrophic factor levels reflect an endogenous attempt at neuroprotection against biochemical and molecular changes after ischemic stroke. NGF represents an early marker of brain injury while BDNF recovery is most prominent during the first 14 days after onsite but continuous for more than 30 days. There is no significant correlation between NGF and BDNF in each group.
CHARACTERISTIC OF PATIENTS WITH REFRACTIVE DISORDER AT EYE CLINIC OF SANGLAH GENERAL HOSPITAL DENPASAR, BALI-INDONESIA Handayani-Ariestanti, T.; Supradnya-Anom, I G.N; Pemayun-Dewayani, C.I.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: Refractive disorders are one of the most common causes of visual impairment worldwide and become the second leading cause of blindness that can be cured. This study aims to know the characteristic of refractive errors patients in Sanglah General Hospital in the period of 1st January until 31st December 2011. Method: This is a retrospective analytical descriptive study. Data were collected retrospectively from patient’s medical records with refractive errors and shown as frequency and percentage. Visual acuity before and after corrections were investigated and analyzed using McNemar Test. Results: from 579 patients, the most common diagnosis was astigmatism (40.1%), 63% were woman, 39.7% were older than 40 years old, and 60.2% live in Denpasar. In myopia cases, 69.7% patients were woman and 25.1% were between 11-20 years old. In astigmatism cases, 63.4% were woman, 57% were older than 40 years old. Of the hypermetropic cases, 61,3% were woman, 79.5% were older than 40 years. Among presbyopia cases, 53.2% patients were woman with 84.4% were older than 40 years. In McNemar test, there were a significant difference between visual acuity before and after correction in both eyes (p=0.0001). Most astigmatism was with the rule cases on both eyes. On the right eye 54.3% shows mild astigmatism, whereas on the left eye 50.8% shows moderate astigmatism. In hypermetropic cases 92.4% are mild degrees. While 55.5% presbyopic patients need additional glasses of +1.00 D up to +2.00 D. About 97.9% patients with refractive error were given glasses prescription. Conclusion: mostly refractive errors patient are woman and the most common diagnosis is astigmatism. There were significant differences of visual acuity before and after correction on both eyes (p=0.001).
SPILANTHES ACMELLA AND PHYSICAL EXERCISE INCREASED TESTOSTERONE LEVELS AND OSTEOBLAST CELLS IN GLUCOCORTICOID-INDUCED OSTEOPOROSIS MALE MICE Laswati, Hening; Subadi, Imam; Widyowati, Retno; Agil, Mangestuti; Pangkahila, Jahya Alex
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Glucocorticoid-induced osteoporosis is leading cause of secondary osteoporosis by decreasing formation activity and increasing resorption activity. Spilanthes acmella, is one of Indonesia medicinal plants that contain of polyphenol and flavonoids. Previously in vitro study showed that buthanol and water fraction from this plant have increased alkaline phosphatase that known as marker of bone formation. The objective of this study to analyze the effect of Spilanthes acmella and physical exercise in increasing testosterone and osteoblast cells of femoral’s trabecular glucocorticoid-induced osteoporosis male mice. Method: This study using a posttest control group design, 36 male healthy mice (5 months old) were randomizely devided into 6 groups, there are : 1.Healthy control group (without induction dexamethaxone), 2.Osteoporosis groups (induction with dexamethaxone without treatment), 3.Positive control receive suspension alendronat, 4.70% Ethanol extract of Spilanthes acmella group, 5.Combination group of 70% extract ethanol of Spilanthes acmella and exercise, and 6.Exercise group (walking using mice treadmill 10m/minute, 5-12 minutes 3 times a week). All of the intervention were given for 4 weeks. The serum levels of testosterone were determined using immunoserology (ELISA) and osteoblast cells were determined histomorphometry by light microscopy. All statistical test were carried out using SPSS 23 and statistical significance was set at p
Epilepsy Surgery in Indonesia: Achieving a Better Result with Limited Resources Muttaqin, Zainal
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
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Abstract

Objective: There is around 1.5 million of epileptic in Indonesia within prevalence of 0.5-0.6%. Of these 440,000 will be intractable, and 220,000 of them are potential candidates for epilepsy surgery (ES).  A decade has passed since the first ES performed on July 1999 and the number increases every year reaching of 35-47 ES per year in 2007-2009. Despite  the excellent results, all of these ES were still performed in Semarang (Diponegoro University) while the patients were from all part of Indonesia. The major reason behind the unavailability of ES in most part of the country should be discussed for the sake of future development of ES in Indonesia. Methods: Epilepsy surgery was started in July 1999 with anterior temporal lobectomy for a 34 Y-old female with left mesial temporal sclerosis (MTS) causing a long standing intractable seizures. The number of cases increases every year. Until the end of 2009, there were 238 cases of epilepsy surgery, including 212 anterior temporal lobectomies.  Among these, 106 cases had been follow up more than 36 months, and evaluated for surgical results. To evaluate the patient’s selection and the presurgical evaluation, we divide the ES cases into the first 5 years (56 cases) and the recent 5 years (182 cases). But for the purpose of evaluating surgical results, only those with at least 36 months postoperative follow-up were included (106 cases) and grouped into those operated before or after the age of 25 Y-old (group A and group B), and into those operated before or after the length of epilepsy of 10 years (group I and group II). Results: For the first five years-period, decision to operate were based on MRI and routine interictal EEG in 54 out of 56 TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, since MRI in both patients showed visually normal MRI. For the last five years, decision to operate were based on MRI and routine EEG in 91 out of 156 TLE cases. Long term ictal EEG were performed in 46 patients, subdural grid EEG in 10 patients, PET study in 7 patients, and EcoG in 2 patients. The overall seizure free (SF) rate were 70.75%, but if grouped according to patient’s age at surgery ( less than or over 25 Y-old ), the SF rates were 75.4% vs 66.04% respectively. So did if grouped according to length of disease ( less than or more than 10 years ), the SF rates were 78.72% vs 64.40% respectively. Conclusions: MRI plays very important role to decide the side of the epileptic temporal side, but this role is decreasing as it was 96.4% during the beginning five years to become 58.34% for the last five years. This means that we are working on more difficult epilepsy cases recently. SF rate was significantly higher for those who was operated at younger age and for those with shorter duration of epilepsy. This means that surgery should be offered earlier for those intractable TLE patients with obvious focus on MRI.
Osteogenic Potential Differentiation of Human Amnion Mesenchymal Stem Cell with Chitosan-Carbonate Apatite Scaffold (In Vitro Study) Kamadjaja, Michael J.K.; Salim, Sherman; Rantam, Fedik A.
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Tissue engineering based approaches have received much attention. Incorporation of chitosan and carbonate apatite (CA) improve its capability. Human mesenchymal stem cells (hMSCs) is viable for xenogenic transplantation. The purpose of this study was to fabricate and evaluate the osteogenic potential differentiation of human amnion mesenchymal stem cell with carbonate apatite– chitosan scaffolds (CA-ChSs) for tissue engineering. Method: Human amniotic membrane was procured from using cesarean section. Soncini’s protocol was employed for the isolation procedure. The cells cultured on collagen-coated dishes using Dulbecco's minimal essential medium (DMEM)/F12 (1:1). A chitosan powder of medium molecular weight deacetylated chitin, poly(D(glucosamine) was used and mixed with CA. Immunocytochemistry and flowcytometry used for phenotypic characterization of hAMSC. Result: Amniotic membrane obtained using cesarean section under aseptic condition did not exhibit any growth of cell cultures which were not contaminated. Immunocytochemistry testing revealed that the target cells expressed strong mesenchymal stem cell marker CD 105. Characterization at passage 10 showed that CD44 was the most significant and abundant surface receptors. The number of viable cells in chitosan-carbonate apatite was 66.59%. Scanning electron microscope (SEM) observation revealed that CA-ChSs had three-dimensional structure with many pores and hAMSc could attached and proliferation among the porosity of the scaffold. The formation of calcium in the cell as an indicator of osteoblast cells was detected using Alizarin Red solution. Conclusion: hAMSc harvested from human amniotic membrane seeding in CA- ChSs had the capability for in vitro osteogenesis makes them be the one of the potential options for bone tissue engineering.
AQUEOUS EXTRACT OF BALINESE PURPLE SWEET POTATO (IPOMOEA BATATAS L.) PREVENTS OXIDATIVE STRESS AND DECREASES BLOOD INTERLEUKIN-1 IN HYPERCHOLESTEROLEMIC RABBITS Jawi, I M.; Indrayani, A. Wiwiek; Sutirta-Yasa, I W. P.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Background: Hypercholesterolemia can cause oxidative stress, endothelial dysfunction and atherosclerosis. Anthocyanin can prevent oxidative stress, it will decrease the inflammation by decreasing the pro inflammatory cytokine in animal models. Purple sweet potato in Bali has been proven of having high anthocyanins content. The aim of these study was to prove the ability of aqueous extract of Balinese purple sweet potato (Ipomoea batatas L.) in decreasing the blood interleukin-1 level in hypercholesterolemic rabbits. Methods: Subjects of this study were 18 male adult rabbits divided into 3 groups with randomized post test only control group design. Group 1 rabbits were given standard diet as a control group. Group 2 rabbits were given high cholesterol diet. Group 3 rabbits were given aqueous extract of Balinese purple sweet potato 4 ml/Kg.BW/day and high cholesterol diet. After 60 days of treatment, the blood level of total cholesterol, MDA and interleukin- 1 were measured as post test examination. The data were analysed by using anova. Results: The results showed significant increases of blood total cholesterol, MDA, and interleukin-1 in group 2 (p
PHYTOCHEMICAL SCREENING AND ANTIBACTERIAL ACTIVITY OF TWO COMMON TERRESTERIAL MEDICINAL PLANTS RUTA CHALEPENSIS AND RUMEX NERVOSUS Kasimala, Madhu Babu; Tukue, Merih; Ermias, Robiel
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
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Abstract

Background: Ruta chalapensis and Rumex nervosus are used as an extensive household remedy for various diseases in Eritrea. The components of these plants are of great interest in medicinal chemistry. Leaves and young stems of Ruta and Rumex have been reported to contain alkaloids, flavonoids, phenols, amino acids, furanocoumarins and saponins. Various solvents like ethanol, acetone and aqueous extracts of the two plants were screened for the presence of bioactive compounds. Methods: The antibacterial activities of these extracts were investigated against Staphylococcus aureus, a gram positive bacteria and Escherichia coli, gram negative bacteria. The antibacterial activity was tested using Muller Hinton Agar medium by disc diffusion method and minimum inhibitory concentration assays. Results: After incubation, zone of inhibition was measured in mm, a good inhibition (>5mm) was observed indicating the effective antibacterial activity of the bioactive compounds in both the plant extracts.
Hospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian Teaching Hospital Janati, Ali; Sadegh, Tabrizi Jafar; Toofan, Firooz; Algalandis, Khadijeh Nadim; Ebrahimoghli, Reza
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: program evaluation is an integral and expected component in the development of any healthcare program. It helps decision-makers to base their decisions on facts. Objective: This paper analyzes the effect of accreditation on three indicators related to patient safety and hospital care quality in ICU wards of an Iranian teaching hospital. Methods: This interventional study was accomplished based on executive management and scientific methods such as plan-do-check-act (PDCA) cycle and audit to improve quality and safety. We used data reported from ICU wards of the hospital to analyze the effect of accreditation on the three selected indicators. (SPSS) version 22.00 was used for the statistical analysis. Results: In total, 6997 patients were analyzed. The accreditation interventions appeared to be effective at reducing pressure ulcer incidence average (from an average of 6.8 percent to 4.1 percent) (p=0.045). The accreditation also. The average stays of the patients during the study also positively changed from an average of 1.58 days to 10.13 days (1.45 improvements) (p=0.0303). In relation to hospital acquired infection but, unexpectedly, its effect on hospital was negative, then it considerably increased and rose from 1.5 percent to 8.1 percent (p=0.001). However, this increasing was due to enhanced infection incident report system. Conclusion: hospital accreditation has presented ample opportunity a significant positive effect on hospitals.

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