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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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High Ki-67 and Vascular Endothelial Growth Factor (VEGF) Protein Expression as Negative Predictive Factor for Combined Neoadjuvant Chemotherapy in Young Age Stage III Breast Cancer Sudarsa, I. W.; Manuaba, I. B. Tjakra W.; Maliawan, Sri; Sutirtayasa, I. W. P.
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Breast cancer was, in general, a heterogeneous disease with diverse biological characteristics, types, subtypes and clinical behavior. Its treatment and management need to be personalized and individualized. Breast cancer in young ages, although rare, is usually a unique and more aggressive cancer associated with poorer prognosis. The combination of young age and advanced stages of breast cancer would make this particular breast cancer harder to treat and cure. Unfortunately, majority of Breast Cancer Patients in Bali were in younger ages, and at advanced stages, that the mainstay of treatment was neo adjuvant chemotherapy followed by other treatment modalities. Improve prognosis only, those patients who had had a complete pathological response involving primary tumor and regional lymph nodes in the axilla. Several factors had been studied and contributed to breast cancer response to combined neo-adjuvant chemotherapy. Usually, younger patients, was associated with high proliferation rate represented by Ki-67 and early distant metastasis represented by VEGF, which also had role as prognostic markers. The purpose of this study was to determine whether high Ki-67 and VEGF expression correlate with response to NAC and hence, they would be important predictive factors for response to NAC. Method: This study was a cross-sectional and a nested case-control study of stage III breast cancers affecting patients 40 years of age or less, at Sanglah General Hospital and Prima Medika Hospital, conducted from September 1st, 2012 until March 31st, 2014. Clinical and pathology reports were traced and recorded from both hospitals; routine Immunohistochemistry (IHC) examinations were performed by both pathology labs. Statistical analysis was performed using Chi-Square test, Odds Ratio (OR), and logistic regression analysis with p
IPOMOEA BATATAS SYRUP DECREASE MALONDIALDEHYDE AND INCREASE NITROUS OXIDE PLASMA LEVELS AMONGST MODERATE SMOKER WORKERS AT DENPASAR Dwi-Primayanti, I D. A. I.; Aman, I G. M.; Agus-Bagiada, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
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Abstract

Objective: Cells and tissues are continuously damaged by reactive oxygen species. Cigarette smoke is one of an exogenous source of free radical containing more than 4000 chemical compounds, that triggering the formation of free radicals related to diseases and aging process. Anthocyanins are potent antioxidants that are widely distributed in fruit, vegetables, red wines and Ipomea batatas. The aim of this study was to determine the effect of Ipomea batatas as a source of antioxidants in decreasing levels of malondialdehyde (MDA) and increasing of Nitrous oxide (nitrite/nitrate/NOx) plasma in moderate smokers of workers at Denpasar. Method: This was an experimental study with a pretest-posttest control groups design. There are 33 moderate smokers who were divided into three groups, control group (placebo), treatment group with 15 ml purple sweet potato syrup (P1) and 30 ml (P2), for 14 days. All groups were performed the laboratory examinations for MDA and NOx plasma before and after the treatment. Results: This study showed that there were significant differences (p <0.05) both in MDA and NOx plasma levels in the control group, P1 and P2. The decrease of MDA levels on P1 was 35.39% and on P2 was 49.87%. The increase of NOx plasma levels was 7.78% for P1 and 14.68% for P2. Conclusion: From this study, it can be concluded that Ipomea batatas syrup contains of 8mg/mL anthocyanins, probably play a role in reducing the free radical and thus reducing the risk of disease and slowing the aging process.
PENTAMETHYLCARBOXYLATE RUTHENOCENE BASED ANTITUMOUR AGENT Wahjuni, Sri; Puspawati, Ni Made; Williams, Michel
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Unlike iron ruthenium is not an essential element for life. However, the behavior of ruthenium compounds in biological systems and, in particular their use as antitumour agents has attracted much attention recently. This study aims to determine antitumour properties against human tumour cell line HeLa of pentamethylcarboxylate ruthenocene. Methods: This is an in vitro study by applying an experimental within post only control group design. Cisplatin, a clinical used medicine was applied for control. The human tumour cell line Hela was used for the test. The cells were cultured at 370C in 5% CO2/air in Roswell Park Memorial Institute Medium 1640 and seeded overnight in 96 well microtitre plates. The penthamethylcarboxylate ruthenocene was dissolved in 1,2 dimethoxy ethane and diluted with culture media. The plates were assays by measuring optical density in the range of 490-655 nm. The D37 values were then calculated. Results: The pentamethylcarboxylate ruthenocene compound tested was found to be more cytotoxic than cisplatin (with D37 = 422 nM compare to D37 = 705 nM for cisplatin). Conclusions: The compound tested, pentamethylcarboxylate ruthenocene was found more potent as an antitumor compare to cisplatin a clinical used antitumor for curing testicular carcinoma.
The Characteristic of Central Serous Chorioretinophaty Patients at Sanglah General Hospital Bali-Indonesia Lienderi-Wati, N. M.; Budhiastra, P.; -, Ari-Andayani
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
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Abstract

Objective: to describe characteristics of central serous chorioretinophaty (CSC) patients in Sanglah General Hospital, correlation between visual acuity and foveal thickness before and after oral acetazolamide theraphy, the differences of visual acuity and foveal thickness of CSC’s patients before and after oral acetazolamide theraphy. Methods: This study is a descriptive study, than followed by cross sectional study. Data were collected retrospectively from medical report of CSC patients who came to Sanglah General Hospital during period Januari 1st 2010 until December 31st 2011. Results: Central serous chorioretinopathy were found in 22 patients (22 eyes), male predominance (72.7%), majority were in age group 30-40 years (54.55%), and all of cases were unilateral. Most of CSC patients worked as private employees (77.3%). Mean onset patients presented to the hospital was 14.64±5.68 days, with the most common symptom was decreasing vision (86.4%). Mean of follow ups in CSC patients were 64.11±6.15 days. There was correlation between visual acuity and foveal thickness before and after oral acetazolamide theraphy, respectively r=0.76; p=0.001 and r=0.73; p=0.001 (Spearman test). The differences between visual acuity of CSC patients before and after oral acetazolamide theraphy was significant (0.55±0.26 logMAR vs 0.11±0.12 logMAR; p=0.001; Wilcoxon test). The differences between foveal thickness of CSC patients before and after oral acetazolamide theraphy  was also significant (484.23±6.42 vs 258.41±4.21; p=0.001; Wilcoxon test). Conclusions: CSC patients was male predominance, majority in decade 3-4, all of cases were unilateral and most of the patients worked as private employees. There is a strong correlation between visual acuity and foveal thickness before and after oral acetazolamide theraphy. A significant differences found in visual acuity and foveal thickness of CSC’s patients before and after oral acetazolamide theraphy. In this study, the role of oral acetazolamide in clinical resolution improvement of CSC’patients can not be concluded. Further study with control group needed to find it’s role.
CHANGES OF mRNA CASPASE-3 AFTER FIRST CYCLE OF CHEMOTHERAPY AS BIOMARKER ASSOCIATE TO CHEMOTHERAPY NEGATIVE RESPONSE IN LOCALLY ADVANCED BREAST CANCER Widiana, I. K.; Manuaba, I. B. T. Wibawa; Kawiyana, K. Siki; Yasa, I W. P. Sutirta
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Problems caused by behaviour of biology molecular in locally advanced breast cancer still unpredictable. This study aims to identify the mRNA caspase-3 as a predictive biomarker associated to chemotherapy sensitivity following neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer. Methods: Open biopsy before and core biopsy after first cycle neoadjuvant chemotherapy of 62 locally advanced breast cancer patients was analysed for mRNA caspase-3 by Reverse Transcription - Polymerase Chain Reaction (RT-PCR) and this was correlate with response to NAC using American Joint Committee on Cancer (AJCC) creteria. Results: The total mean of mRNA caspase-3 expression before chemotherapy was 12.51±3.03 and after chemotherapy was 11.64±3.13. Negative response to chemotherapy was 44 (70.96%) and positive response was 18 (29.03%). The result of data with Phi and Cramer’s V analysed showed that decrease of mRNA caspase-3 after chemotherapy first cycle as a risk factor to chemotherapy negative response in patients with locally advanced breast cancer was significantly (p = 0.007). Conclusion: Decrease of mRNA caspase-3 after chemotherapy first cycle correlated with chemotherapy negative response in patients with lacally advanced breast cancer.
DIAGNOSTIC VALIDITY OF CYTOLOGICAL IMPRINT IN THYROID FOLLICULAR NEOPLASM Pustaka, I G. N.; Sudarsa, I W.; Golden, and N.
BALI MEDICAL JOURNAL Vol 2 No 3 (2013): Vol.2, No.3, September-December 2013
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Abstract

Background: Preoperative fine needle aspiration biopsy/FNAB examination, imprint cytology and frozen section intraoperative has big implications for diagnosis and surgical strategy of thyroid nodules with follicular neoplasm cytology. FNAB and frozen section has its limitations, it is difficult to detect the presence of capsular and/or vascular invasion of thyroid follicular carcinoma. Whereas imprint cytology can preserve cellular overview (especially the cell nucleus), including the capsular and/or vascular invasion. In addition, imprint cytology is faster than frozen section. Frozen section examination could not indicate the presence of capsular and/or vascular invasion in most cases so that imprint cytology is used to replace frozen section as an alternative. Method: This research is a diagnostic test study using a descriptive design. This is a prospective study to assess the sensitivity, specificity, NPV, and PPV of imprint cytology in patients with thyroid follicular neoplasm cytology. Results: In our study; sensitivity, specificity, PPV, NPV, and accuracy of imprint cytology for follicular neoplasm was found as 84.21%, 95.45%, 94.12%, 87.50% and 90.24% respectively. The outcome was based on likelihood ratio value of 18.21 and the ROC curve, area under the curve obtained at 0.879 and Kappa value of 0.802. Conclusion: Imprint cytology has a value of a good diagnostic validity in the diagnosis of follicular neoplasm of thyroid nodules with sensitivity and specifity values of 84.21% and 95.45%. Imprint cytology is a technique that is simple, inexpensive, and has good reliability so that it can be used instead of frozen section.
Dynamics of Human Mesenchymal Stem Cells, M1 Microglia/Macrophage, and Fractalkine in Ischemic Stroke Patients Herminawati, Lucia; Wijaya, Andi; Arief, Mansyur; As’ad, Suryani
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: About 85% of strokes are ischemic strokes, caused by occlusion of cerebral artery that induced brain inflammation. A deep understanding of ischemic stroke mechanism will lead to better neurorestorative treatment. Objective: This study investigates the dynamics of human mesenchymal stem cells, fractalkine, and M1 microglia/macrophage in ischemic stroke patients. Results: We found the same fractalkine levels and M1 microglia/macrophage cells on patients with stroke onset 0 to 14 days, then decrease until 30 days of stroke onset. MSCs was increase 7 days after stroke onset, peaked by 14 days, then decreased until 30 days after stroke ischemic onset. Conclusions: This study found an interaction between microglia/macrophage, fractalkine, and MSCs on ischemic stroke patients, so therapeutic strategy could be developed.
ROLE OF HEPCIDIN IN MECHANISM OF ANEMIA CHRONIC DISEASE PATIENTS Suega, Ketut
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Abstract

Background: Anemia chronic disease (ACD) is an anemia found in certain chronic disease states, typically marked by the disturbance of iron homeostasis or hypoferremia. This condition leads to shortage of iron for hemoglobin synthesis but the iron storage in bone marrow is left undisturbed. The discovery of hepcidin and its role in iron metabolism has given new insights in anemia chronic disease management. Consecutive sampling method was applied to choose ACD patients at Sanglah General Hospital, Bali-Indonesia. Questionnaire was constructed to note demographic aspect and disease or clinical condition underlies ACD (inflammation, infection, malignancy and others). Hepcidin, Serum IL-6 and CRP level were measured. Sample size and Path analysis mediation method were used to define hepcidin’s role on mechanism how anemia develop in ACD patients in which the direct and indirect effects of IL-6 and CRP to hemoglobin (Hb) were counted partially or combined through hepcidin mediation variable. The cumulative influence of IL-6, CRP and hepcidin on anemia (Hb) was only 0.12 or about 12% of hemoglobin level was influenced by IL-6, CRP and hepcidin together whereas the other 93% was influenced by another unknown and unclear factors. Hepcidin could be used as a mediation variable for the development of anemia because the direct influence of IL-6 as exogenous factor was less than its indirect influence through hepcidin. It was not proven for CRP as exogenous variable because the direct influence of CRP to hemoglobin was stronger than the influence of CRP through hepcidin.
In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient " Machfoed, Moh Hasan; Usman, Fritz Sumantri; Barus, Jimmy; Wreksoatmodjo, Budi Riyanto; Gunawan, Dede; Bintang, Andi Kurnia; Tugasworo, Dodik; Subroto, Gatot; Lamsudin, Rusdi; Harsono, H.; Sulthan, Riza
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29,entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient ", herewith, please allow us to do reviews of the study discussion. By assessing the discussion, it can be proved whether there are references that support the results of study.
ELEVATION OF SERUM C-REACTIVE PROTEIN AS A PREDICTOR FOR SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IN CERVICAL SPINAL CORD INJURY PATIENTS Oliver, Stanley-Ketting; Mahadewa, T. G. B.; Maliawan, and S.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Abstract

Objectives: Spinal cord injury has been an important medical issue with high incidence, complications, and mortality rate. For the past 2 decades, there have been a number of researches about the role of inflammatory mediators in trauma patients. However, up to now, there were limited references about the role of CRP as a predictor of SIRS in cervical spinal cord injury. Methods: This was an analytical prospective cohort study of 28 patients to determine the role of increase CRP serum as a predictor for SIRS in cervical spinal cord injury in Sanglah General Hospital, Bali-Indonesia. The data were descriptively analyzed by applying univariate and multivariate analysis to determine the role of increase CRP serum with SIRS in cervical spinal cord injury. Results were considered significant if p < 0.05. Results: From 28 samples collected, 18 samples (64.28%) were male, 12 samples were in >50 years old age group (42,86%), and the most frequent spinal cord injury scale was ASIA A (12 samples, 42,86%). Both univariate and multivariate analysis showed that increased serum CRP and ASIA Score were significant predictors of SIRS in cervical spinal cord injury patients. Conclusion: Increase in serum CRP value can be used as a reliable predictor for SIRS in cervical spinal cord injury patients.

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