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INDONESIA
BALI MEDICAL JOURNAL (BMJ)
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
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
SERUM HOMOCYSTEINE CONCENTRATIONS INVERSELY CORRELATES TO INTIMA-MEDIA THICKNESS OF CAROTID ARTERIES: AN IMPACT TO ENVERSE EPIDEMIOLOGY IN PRE-DIALYTIC CHRONIC KIDNEY DISEASE Raka-Widiana, I G.; Suwitra, K.; Elyshanti, E.; Sutarka, and N.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Background: In normal population, serum homocysteine (Hcy) is considered as a marker of atherosclerotic and cerebro-cardiovascular diseases.  It is not clear whether this phenomenon also occurs in chronic kidney disease particularly among pre-dialytic population. This study aims to determine relationship between serum Hcy concentrations and carotid arteries intima-media thickness (CA-IMT) of pre-dialytic chronic kidney disease (CKD) patients. Method: A cross-sectional study was carried out on pre-dialytic CKD patients. Morning fasting blood samples were taken for lipid profile, blood sugar, blood urea nitrogen, serum creatinine concentrations. Total fasting serum Hcy concentrations were measured using chemiluminescent assay. CA-IMT of patients were measured by USG B-Mode Logiq-5 (General Electric), with 7.5 MHz linear transducer at both left and right, common and bifurcation of carotid arteries. Results: Ninety (74 males, 16 females) of pre-dialytic patients, age 54 ± 7 years, SBP 137±20 mmHg, DBP 78±13 mmHg, BMI 23.9±4.4 kg/m2 FBS 94±16 mg/dL and 2h pp BS 125±31 mg/dL, total-C 201±65 mg/dL, LDL-C 129±62 mg/dL, HDL-C 40±13 mg/dL, TG 144±81 mg/dL, phosphate 3.8±1.3 mg/dL, calcium 8.7±1.1, and CaXP 32±8, and total serum Hcy 17.11±6.91 µmol/L, e-GFR (CG formula) 36±17 ml/minutes were included in this study.  There were significant negative correlation between Hcy concentrations and left common CA-IMT (r = 0.28; B = -11.01; p = 0.02) and right bifurcation CA-IMT (r =0.26; B = -11.01; p=0.042). While there were a trend of negative correlation between total serum Hcy and right common CA-IMT (r= 0.21; B = -8.27; p=0.10) and left bifurcation CA-IMT (r= 0.20; B=-6.69; p=0.11). Conclusion: There is a negative association between total serum Hcy concentrations and atherosclerotic process in carotid arteries. The inverse relationship may support phenomenon of inverse epidemiology among pre-dialytic CKD patients and seemed that serum Hcy reflects nutritional marker rather than a marker of cardiovascular disease.
The Effects of Platelet-Rich-Plasma (PRP) Injection On Ligament Injury Kloping, Yudhistira P.; Desnantyo, Andre T.; Rehatta, Nancy M.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Background: Soft tissue injuries are becoming a problem especially among active people and athletes, thus doctors are focusing on PRP injection however variety of study results are making the beneficial effects of PRP towards soft tissue healing unclear. The purpose of this study is to clarify the effects of PRP injection on the healing aspect of a ligament injury. Methods: The experimental study used European rabbit (Oryctolagus cuniculus), which was divided into the control and treated group. The 22 samples, ankle ligaments were injured. The treated group was injected with 4 ml PRP taken autologously. On the 2nd day the samples were examined for hematoma. 4 samples from each group were also examined histopathologically. On the 2nd week, the ligament thickness of the remaining samples from each group was examined ultrasonographically. Results: The clinical result showed lower presence of hematoma on the group injected with PRP compared to the control group. The Capillary dilation was less on the treated group compared to the control group. The Inflammatory cells were less on the treated group compared to the control group. The Fibroblasts Cells was less on the treated group compared to the control group. The fibrocytes was more abundant on the treated group compared to the control group. The average of Ligament Thickness was thicker on the treated group compared to the control group. Conclusion: The Injection of PRP is beneficial to a ligament injury based on its effect on enhancing healing on the inflammation, regeneration, and remodeling phases.
EVALUATION OF CSF FERRITIN AS AN EARLY MARKER FOR DIFFERENTIATING MENINGITIS IN PEDIATRIC PATIENTS Sharma, Shikha; Dabla, Pradeep Kumar
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Background and Objectives: - Bacterial meningitis is a medical emergency with a potential for serious neurological damage or even death. Rapid diagnosis is important and henceforth critical for the early intervention by antibiotic therapy to prevent complications. Therefore the aim of the present study was to evaluate CSF ferritin levels in children with different etiologies of meningitis. Materials and Methods: - 65 children (1-124 months) with suspected meningitis admitted at Chacha Nehru BalChikitsalya hospital were included in the study. CSF sample was analyzed for glucose, protein, cell count, ferritin, gram stain and culture. Results: - Based on the laboratory findings the 65 children were classified into 3 groups: 21 cases had bacterial meningitis, 18 had aseptic (viral) meningitis and 26 cases as the no-meningitis group. A significant relationship was observed between age and ferritin level in the non-meningitis group (p<0.05). CSF ferritin in bacterial meningitis group was 34.80 ±11.20 ng/mL and was significantly higher than the aseptic meningitis group. Cut off value of ferritin to differentiate meningitis vs. no-meningitis group was estimated at 18.2ng/ml with a sensitivity of 94.9% and specificity of 96.2 %. However on differentiating bacterial from aseptic meningitis cutoff value was 20.3 ng/mL with a sensitivity of 98% and specificity of 33.3%. Conclusion: - CSF ferritin levels were found to be significantly different between the meningitis and the no-meningitis groups. However due to low specificity it may not prove useful for the early differentiation of different types of meningitis. Further studies are required on a larger sample size before we can substantiate our findings.
Relation between Fiber Diet and Appendicitis Incidence in Children at H. Adam Malik Central Hospital Medan North Sumatra-Indonesia Damanik, Boyke; Fikri, Erjan; Nasution, Iqbal Pahlevi
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Background: Appendicitis is the most occurred acute abdominal case found in children.1 In United States of America alone, there were 250,000 cases annually. The ratio between boys and girls are 3:2, with most cases caused by late diagnosis and the morbidity factor. Previous studies found that there’s a relation between eating patterns, fiber diet and food hygiene as risk factors for appendicitis.1, 2 At the time this paper is written, there hasn’t been any study that explains the relation between appendicitis and the diet pattern of children from various places in Indonesia. Another condition that further motivates this study is a common conception that children hate to consume vegetables and fruits, which contain the much-needed fiber. Obstruction of the appendix lumen is the main cause of inflammation in the appendix. Fecalith makes up one third of appendicitis cases, which is consists of fats (coprosterols), inorganic salts (calcium phosphate), and organic residual (fibers).3 Other causes including obstruction process by hypertrophy of mural lymphoid follicle as a response from the inflammation of the appendix lumen.3 Obstruction of appendix lumen can be caused by low fiber diet, which causes fecalith to build up in appendix lumen.4 The mechanism of lumen appendix inflammation can be caused by lymphoid hyperplasia, fecalith buildup, foreign object or parasite.4 Therefore, a study needs to be done to determine the mortality prediction easier, more efficient, and not static, in which it’s harder to measure the therapeutic response. In this case, lactate clearance is hoped to have the capability to determine the mortality rate in patients with severe sepsis. Method: This research is an analytic with cross-sectional design. The subjects were 35 child patients with appendicitis in RSHAM which fulfilled the criteria of severe sepsis diagnosis, and were receiving treatment in the period of January-December 2014. Results: Male children are the majority of the patients (62.9%) with average age of 11.89 ± 4.16. Laparotomy is the most administered treatment (54.3%), and most of the subjects have low-fiber diet (54.3%). 19 of the subjects have perforated appendicitis (54.3%). Conclusion: There’s a significant correlation between low-fiber diet with appendicitis incidence (p=0.0001). From the 19 patients with low-fiber diet, 14 of them (73.7%) have acute appendicitis. Meanwhile only 2 of the patients (12.5%) with high-fiber diet have acute appendicitis.
PREVALENCE AND QUALITY OF LIFE OF PEMPHIGUS PATIENTS AT SANGLAH GENERAL HOSPITAL BALI-INDONESIA Wardhana, and, M.; Rusyati, L. M.
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Objectives: Pemphigus vulgaris (PV) is an autoimmune-blistering disease of the skin and mucous membranes caused by auto-antibodies against desmoglein-3 (Dsg-3) on the keratinocyte cell surface of squamous stratified epithelia. Pemphigus is a life-threatening autoimmune bullous disease resulting in the widespread denudation of skin and mucous membrane and severe impact of quality of life. The purpose of this study was to evaluate retrospectively the prevalence of pemphigus and to elucidate the clinical variants, clinical course, prognosis and quality of life (QOL) of pemphigus patients after discharge from hospitalized. Method: Observational non analytical retrospective study was conducted by observation of the medical records of all the newly registered patients with pemphigus at Sanglah General Hospital in Bali-Indonesia during the period of January 1995 and December 2002, and analyzed with regard to personal statistic, history of the diseases including onset, site of affected, symptoms, clinical diagnosis, severity, associated illness, therapy, and quality of life based on the Finlay’s methods. Results: During the 8-year periods studies, 33 pemphigus patients were admitted, represented 5.8 % of  all patients admitted in our in-patient ward during the periods. Our patients consist of female 20 patients (60.6 %) and male 13 patients (39.4 %). The most common of clinical type was pemphigus vulgaris 26 patients (78.78 %), followed by pemphigus foleaceous and pemphigus vegetans. Six patients (18.18 %) of 16 severe patients with severe condition at the clinical course of the diseases was death during the course of hospitalized. A number of 2 patients, in this study were observed with severe impact of quality of life. Conclusion: Our finding showed that pemphigus vulgaris is common type of our cases has a relatively high prevalence our hospital (5.8 %), and relatively high death rate (18.18 %). In our study, systemic corticosteroid was still applied until present for life saving drug for Pemphigus.
Lactose-Astaxanthin Increases Green Jungle Fowl’s Sperm Motility and Reduces Sperm DNA Fragmentation During 5o Celsius Storage Bebas, Wayan; Pemayun, Tjok Gede Oka; Damriyasa, I Made; Astawa, I Nyoman Mantik
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
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Background: Good quality of semen is required for artificial insemination technology in ex-situ conservation efforts of green jungle fowl. This study was aimed to investigate semen quality of green jungle fowl during storage at 5oC for 48 hours with the addition of combination lactose astaxanthin in egg yolk phosphate dilution. Method: The semen used in the study was collected from eight healthy male green jungle fowls by using massage techniques. The semen quality was analyzed with macroscopic and microscopic examinations. The semen was diluted with egg yolk phosphate with the addition of 0.6% lactose, 0,004% astaxanthin and combination 0.6% Laktose-0,004% astaxanthin, and was stored at 5oC for 48 hours. Following 48-hour treatment, the semen quality was evaluated based on its progressive motility, and DNA fragmentation. Data were firstly analyzed by using analysis of variance (ANOVA), and were then proceeded by using Duncan Multiple Range test. Results: The results showed that the progressive motilities of semen diluted in 0.6% lactose combined with astaxanthin 0.004% %, (79,66 + 1.50%) was significantly higher than those diluted in 0.6% lactose (66,77 + 2.16%,) and in astaxanthin 0.004% (68,11 + 3.01 %). The DNA fragmentation of semen diluted inn 0.6% lactose combined with astaxanthin 0.004% %, (7,55 + 1,66%) was significantly lower than those diluted in 0.6% lactose (12,33 + 1,93%) and in astaxanthin 0.004% (13,55 + 1,81%). Conclusions: In conclusion, the combination of l 0.6% lactose -astaxanthin 0.004% showed the best results for progressive motility, and DNA fragmentation.
Immersion of Alginate Impression (Hydrocolloid Irreversible) On Two Percent Glutaraldehyde Prevent Contamination of Mycobacterium Tuberculosis on The Stone Cast Rusmiany, P
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Abstract

Objectives: to observe the effect of alginate impression (hydrocolloid irreversible) immersed on 2% glutaraldehyde on preventing contamination of Mycobacterium tuberculosis contamination on stone cast. Methods: This is an experimental research with post test only control group design, with alginate impression material (hydrocolloid irreversible) is immersed in the 2% glutaraldehyde  for 10, 15, and 25 minutes. Results:  This result shows that there is no Mycobacterium tuberculosis contamination on the stone cast after the immersion of alginate impression material for 10, 15, and 25 minutes. Immersion of alginate impression material (hydrocolloid reversible) in the glutaraldehyde 2% for 10 minutes is effective to prevent Mycobacterium tuberculosis contamination on the stone cast. Conclusions: Immersion of alginate impression on 2% glutaraldehyde for 10 minute was effective to prevent contamination of Mycobacterium tuberculosis
Purandare Hysteropexy Technique in a 28-year-old Female with Pelvic Organ Prolapse Stage III: A Rare Case Report Putra, I Gede Mega; Kawilarang, Stella
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Background: Pelvic organ prolapse is rarely found in reproductive-age women or in women with low parity. However, the finding has be further investigated to determine any risk factor involved, as well as to decide on the most appropriate management. This case report discusses the management of Purandare hysteropexy in a 28-year-old female with pelvic organ prolapse stage III. Case: A conservative surgical management on a reproductive-age woman with pelvic organ prolapse stage III, who wants to preserve her uterus. Result: The patient had an anatomical reconstruction. She had a better quality of life after the Purandare hysteropexy, and had less complains. Conclusion: Purandare hysteropexy is one of the conservative surgical management on reproductive-age women with pelvic organ prolapse who still wants to conserve their uterus or reproductive organ
SPLENIC INFARCTION: an intriguing and important cause of pain abdomen in high altitude Hota, P. K.; Singh, K. J.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Background: Patients with Sickle cell trait (SCT) are usually asymptomatic. They are usually unaware of their condition unless they have a family history. There are specific situations, where these people suffer from the effects of sickle cell trait. Splenic syndrome at high altitude is one of the specific problems. It is usually seen after a patient with SCT has been inducted to high altitude like in case of mountaineers and military personnel deployed in high altitude warfare. Pain abdomen due to splenic infarction in individuals with SCT is one of the manifestations. These patients, if diagnosed in time, they can be spared from unnecessary surgical interventions. We present herewith our experience of splenic infarction due to SCT in high altitude and their management.
HIGH BLOOD LEVELS PROCALCITONIN AS SYSTEMIC IMFLAMATORY RESPONSE SYNDROME PREDICTOR IN SEVERE AND MODERATE HEAD INJURY Sinaga, B.; Mahadewa, T. G. B.; Maliawan, and S.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Background Numerous studies have shown that procalcitonin (PCT) was not related to degree of trauma. High PCT serum levels have been found in patients with bacterial or fungal infection and also in acute phase of trauma. Currently, there has been no research discussed about changes in serum levels of PCT in particular head injuries and severe head injuries. Moderate and severe head injuries were common trauma cases in Emergency Room (ER) and had high mortality rate. Based on Glasgow Coma Scale (GCS), moderate and severe head injuries were scored between 3 and 13. This research aim to determine whether high blood levels PCT can be used as a predictor of the occurrence of SIRS. Method: A cohort prospective study was applied in this research to determine high blood levels of PCT as a predictor for SIRS in moderate and severe head injury. This study was conducted from June 2013 - August 2013 at Sanglah General Hospital with 40 research subjects. Data was presented in tables and analyzed with Chi Square test at 95% CI and p <0.05% was considered significant. Results: From the 40 samples, there were 34 males (85%) and 6 females (15%), 18 samples (45%) had moderate head injury and 22 samples (65%) had severe head injury. One sample (2.5 %) was 0-10 years old, 15 samples (37.5%) were 10-20 years old, 13 samples (32.5%) were 20-40 years old, 7 samples (17.5%) were 40-60 years old and 4 samples (10%) were>60 years old. PCT levels in the blood obtained on day first were normal in 6 samples (15%) and elevated in 34 samples (85%), SIRS (+) were found in 35 samples (87.5%) and 5 samples (12.5%) were SIRS (-). Using bivariate analysis between PCT levels and SIRS showed p = 0.000 (p < 0.05), and multivariate analysis of the control variables showed no significant correlation between variables with PCT levels. Conclusion: From 40 samples moderate head injury and severe head injury, there were 34 samples (85%) with elevated PCT level on the first day, while 35 samples (87.5%) had SIRS on the third day (p=0,000, CI=95%). Elevated PCT level could be used as a predictor for SIRS in moderate and severe head injury patients.

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