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INDONESIA
BALI MEDICAL JOURNAL (BMJ)
Published by Universitas Udayana
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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.
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Articles 179 Documents
REPRODUCTIVE HEALTH IN RICKSHAW DRIVERS: Occupational Exposure to Environmental Stressor Nabi, Ghulam; Amin, Muhammad; Khan, Ayaz Ali
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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Background: In urban environment, exposure to the emission of motor vehicles is common. In urban peoples it is a very difficult task to distinguish among peoples with different grades of momentous period exposure to such pollutants. Objective: The objective of this study was to determine the effects of diesel exhaust, gasoline emission, Particulate Matter (PM) noise and heat on the reproductive health of rickshaw drivers. Methods: Adult married male individuals were recruited randomly in the study from Btkhella, Malakand agency, Khyber Pakhtunkhwa, Pakistan. Two groups were made, control (n=45) and rickshaw drivers (n=50). A special questionnaire was designed about occupational activities, socio-demographic and clinical characteristics. From both groups 5 mL of the blood was collected and was analyze for serum total testosterone and cortisol using Biocheck (USA) and Antibodies-online GmbH (Germany) kits. Results: In control group the Mean±SEM of total serum testosterone was 657.6±16.84 ng/dl and cortisol was 443.8±14.67 mU/L. In rickshaw drivers the Mean±SEM of total serum testosterone was 577.1±11.42 ng/dl and cortisol was 595.1±8.879mU/L. In rickshaw drivers there was a significant reduction in total serum testosterone (P 0.0002) but a significant increase in serum cortisol level (P < 0.0001) at 95% confidence interval. Conclusions: Reproductive health problems like decreased libido, erectile dysfunction, absent morning and nocturnal erection, ejaculatory problems, primary infertility and secondary infertility were prevalent in rickshaw drivers but, no such problems were found in control group. Chronic exposure to pollutants such as diesel exhaust, gasoline emission, Particulate Matter (PM) noise and heat negatively regulate Hypothalmo-Pituitary Gonadal axis (HPG) leading to reproductive problems. 
The Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste Silva, Valente Da; Suryadhi, Tigeh; N., Wirawan; Bakta, ade
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Background: TB treatment dropout is one causes of treatment failure, which could increase drug resistant cases. Drug resistant cases of TB were reported by the Ministry of Health of East Timor in 2008 (3 cases), 2009 (3 cases), and in 2010 (6 cases). With drug resistant emerging, TB will require longer treatment time. According to the WHO report (2013) the results of pulmonary tuberculosis BTA (+) treatment were reported: Year 2010 the number of failure of treatment was (0.53%); Died of TB (3.53%); Drop out of treatment (4.05%); Outmigration (3.98%); In 2011 cases of treatment failure (0.50%) Died of TB (3.36%); Drop out of treatment (3.36%); Outmigration (1.92%); In 2012 cases of treatment failure (1.03%); Died of TB (3.49%) Drop out of treatment (4.59%) and migration, (2.26%). According to the National Statistics Directorate (NSD) in 2011, that the East Timorese people still live mostly 70.4% in the rural areas. While access to health services remains a challenge, since the people of Timor Leste proclaimed the restoration of its independence. Objective: This study aimed to determine whether there is a relationship between the variables of education, family income, and job with cases of TB medication discontinuation. Methods: This study was conducted using descriptive correlation method. The sample was determined by Ridwan & Akdon (2010) formula. The total of samples was 100 people who met the inclusion and exclusion criteria, and selected randomly. This research was conducted in District Manatuto and Liquica Timor-Leste on March 28, 2015. Results: The correlation test showed a strong positive relationship level if r = 0.51 until +1. Analysis of significance value of r xy = 0.671 and p = 0.000 indicates that there is a significant relationship between the variables of education, job and income with variable discontinuation of treatment. Conclusion: Based on the results of research and data analysis, it can be concluded that the results of this study are as follows: There was a significant relationship between the variables of education, household income, and jobs to the discontinuation of TB treatment.
MEDICATION AND APPROPRIATE PHYSICAL THERAPY OF COMPLEX REGIONAL PAIN SYNDROME PATIENTS AFTER TRAUMA Elizabeta, P. R.; Anastasika, P.; Leonid, and R.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Objective: Treatment of patients with complex regional pain syndrome (CRPS) after trauma needs a complex physical and medical therapy, according of the stage of condition. The patient with trauma is coming to rehabilitation department, after surgery treatment. The aim of our study is to represent the effect of complexity physical therapy and medical support in treatment of patients with CRPS with evaluation of decrease of pain and increase of function in affected region. Method: we are treating 35 patients overage 35-70 years with 2 including criteria, clinical reaction of CRPS and radiological changes of osteoporosis. Medication includes non steroidal anti-inflammatory drugs, tricycle anti-depressants, vasoactive drugs and calcitonin. Physical therapy is consisting of electro therapy, sonophoresis and paraffin. Results: The evaluation was made with observation and measurement of pain, swelling and color of skin and movements of the joint. Conclusion: the goodness of the condition with whole time of rehabilitation 3-6 months was significant p < 0.01.
SUSCEPTIBILITY OF RIFAMPICIN-ISONIAZID RESISTANT MYCOBACTERIUM TUBERCULOSIS ISOLATES AGAINST LEVOFLOXACIN Kurniawan, Alvin Hartanto; Mertaniasih, Ni Made; Soedarsono, S.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Background: Tuberculosis (TB) is a high burden disease in Indonesia with multidrug-resistant (MDR) TB incidence started to increase. Treatment success of MDR-TB globally was low in number than it was targeted which was especially caused by fluoroquinolone resistance. One of the fluoroquinolone is levofloxacin, an antibiotic that has been widely used irrationally as antimicrobial treatment. Therefore, this study investigated the sensitivity and MBC of MDR Mycobacterium tuberculosis isolates against Levofloxacin. Method: The susceptibility test for MDR -Mycobacterium tuberculosis on levofloxacin by standard method with levofloxacin were on concentrations 0,5 ?g/ml, 1 ?g/ml, and 2 ?g/ml. Sample of 8 strains MDR-Mycobacterium tuberculosis were cultured with each concentrations on Middlebrook 7H9 for 1 week incubation. Next, each of the incubated concentration was subcultured on solid media Middlebrook 7H10 for 3 weeks incubation. Colonized agar plates after 3 weeks incubation were confirmed with acid-fast stain. Results: On MB 7H10 with levofloxacin concentration 2 ?g/ml showed bactericidal effect 100% by no MDR Mycobacterium tuberculosis colony grew (0/8) while the MB 7H10 with levofloxacin concentration 1 ?g/ml and 0,5 ?g/ml showed the bactericidal effect 37,5% and 25% respectively. The colonized agar plate implied that the MDR Mycobacterium tuberculosis with levofloxacin concentration 1 ?g/ml (5/8) and 0,5 ?g/ml (6/8) grew well. Conclusion: Levofloxacin concentration 2 ?g/ml was susceptible on MDR Mycobacterium tuberculosis. The concentration 2 ?g/ml of levofloxacin could be considered as MBC.
Hyaluronic Acid Caused of Wider Epithelialization Compare to Normal Saline in Severe Diabetic Ulcer Sudarsa, I W; Semadi, I N; Riasa, N P
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Objectives: Diabetic ulcer, one of chronic complications of diabetes mellitus (DM), showed a high morbidity and mortality rate. The main treatment modality for diabetic ulcer was debridement, followed by wound treatment as local control to promote wound healing. This study aims to compare efficacy of hyaluronic acid (HA) and 0.9% sodium chloride (NaCl) in severe diabetic ulcus two after debridement. Method: This study was a randomized clinical study to compare the efficacy of HA and NaCl 0.9% in severe diabetic ulcer two weeks post debridement. Thirty six severe diabetic ulcer (Wagner ?3) samples were collected using consecutive sampling method and divided into 2 treatment groups: standard wound treatment using NaCl 0.9% and using hyaluronic acid. T-independent test was applied for statistical analysis data and  p<0.05 was consider a statisticalle significant. Results: The two treatment groups showed insignificant difference in characteristics and laboratory findings. The mean tissue epithelialization width after two weeks of wound treatment using NaCl 0.9% was 17,22 ± 3,25 and using HA was 27,33 ± 2,43. Statistical analysis using t-independent test showed t = 10.59, p = 0.001 for both treatment groups. Conclusions: HA improves wound healing rate in severe diabetic ulcer 2 weeks post debridement compared to 0.9% NaCl.
High Interleukin-6 Level Increases Depression Risk on Geriatric Population in Denpasar, Bali-Indonesia Purnamasidhi, Cokorda Agung Wahyu; Kuswardhani, R.A. Tuty
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Background: High interleukin-6 (IL-6) serum level was responsible in inflammatory regulation through the interaction within macrophage, glial melatonin production and regulation of methyl CpG- binding protein 2 (MeCP2) and influenced neuro-inflammation process, thus, it increased the risk of depression. The aim of this study was to determine whether high interleukin-6 serum level increased the risk of depression in geriatrics. Methods: A case control was performed as the design of this study. Geriatric populations with depression enrolled as the case group and without depression as control group. Assessment of IL-6 serum level was conducted by the patient’s venous blood. The IL-6 serum> 10 pg/ml was categorized as high. Results: In this study, 30 cases and 30 controls who met the criteria included as samples. There were 20 males (66.7%) and 10 females (33.3%). Factors associated with an increased risk of depression in geriatric were a high level of serum interleukin-6 (OR=3.60; CI95%: 1.22-10.64, p=0.018) and a marital status (OR=3.50; CI95%: 1.11- 1.02, p=0.028). High level of interleukin-6 was a significant and an independent risk factor of depression in geriatric (OR=3.60; CI95%: 1.22-10.64, p=0.021) in multivariate analysis. Conclusion: This study concluded that high IL- 6 serum level increased the risk of depression in geriatric.
EFFECT OF VIBRATION AND HEAT COMBINATION ON PRIMARY DYSMENORRHEA Hoseini, Mansoureh; Gharahtapeh, Sheida Rafiezadeh; Jahazi, Azam
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Background: Primary dysmenorrhoea is a common, idiopathic, chronic pelvic pain syndrome, with unknown aetiology which ? about 50% of women with regular menstrual period suffer. This study was designed to determine the effect of vibration and heat on primary dysmenorrhea. Materials and Methods: In this clinical trial, 75 female students aged 18 22 years old were evaluated for two menstrual cycles. At the first cycle the participants received the routine pain-relief method (synthetic or herbal medicine and traditional remedies). At the second cycle for each participant combined vibration-heat device was applied for ten minutes during ? menstrual pain. The average of perceived leg pain, lumbar pain and abdominal pain scores at two cycles were determined. The data were analyzed based on Wilcoxon and T tests by using SPSS (v 16.0) for Windows. Results: The average of all perceived pain scores at two cycles were significantly different before pain relief and after both routine methods and using the device (p
BLOOD ANTHOCYANIN LEVELS OF HEALTHY AND DIABETIC RATS AFTER FEED WITH A SINGLE DOSE OF PURPLE SWEET POTATO TUBERS AQUEOUS EXTRACT Sutirta-Yasa, I W. P.; Jawi, and I M.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Background: Aqueous extract of purple sweet potato tuber shown to decrease the blood glucose levels and has antioxidant properties in rats with streptozotocin-induced diabetes. The purpose of this study is to prove that an increase in anthocyanin levels in the blood of rats after administration of aqueous extract of purple sweet potato tubers in healthy and diabetic rats. Methods: This is an experimental study with randomized post-test only control group design. The subject of experiments were 72 rats, divided into two major groups, namely  diabetic rats (treatment group 36 rats) and control group (36 healthy rats). Each major group was divided into 6 small groups each 6 rats. The control group was given aqueous extract of purple sweet potato tuber with a dose of 4 ml single dose. The diabetic group were given streptozotocin and followed by aqueous extract of purple sweet potato tuber 4 ml single dose.  Observed variables include: blood glucose levels to define diabetes. To determine the levels of anthocyanin, the blood were taken and the level of anthocyanin were examination by HPLC method, in healthy  and diabetic rats after 30 min, 1 hours, 2 hours, 4 hours, 8 hours and 16 hours of giving single dose of aqueous extract of purple sweet potato tubers. Results: The results showed an increase in blood sugar levels were significant (p < 0.05) in group given streptozotocin compared to control. Anthocyanin levels in the blood of two groups were significantly different from 30 min after administration of the extract to 8 hours after administration of the extract (p < 0.05). Higher anthocyanin levels (p < 0.05) was observed in control group (healthy rats) compared to rats with streptozotocin-induced diabetes. Peak levels of anthocyanin in blood were achieved after 2 hours of feeding. Conclusion: The conclusion of this study is the absorption of anthocyanin in aqueous extract of purple sweet potato tuber better in healthy rats compared to diabetic rats. The peak levels of anthocyanin was reached after 2 hours of aqueous extract of purple sweet potato tubers single dose consumption either in healthy rats and in diabetic rats.
Treatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum Megadhana, I Wayan
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Background: A vaginal obstruction often occurs as a complication in women who had previously undergone an excision of a transverse vaginal septum. The use of a mold coated with membranes in the correction surgery provides a good healing prognosis. Objective: To report a case of a treatment of a recurrent vaginal obstruction with a modified mold after undergoing an excision of a transverse vaginal septum in a 15-year-old woman. Result: A follow-up on the patient, four months after using the modified mold, showed a regular menstrual cycles without a sign of vaginal narrowing, an infection, nor a complaint. Conclusion: The treatment using a modified mold, for a recurrent vaginal obstruction after an excision of a transverse vaginal septum, is a new innovation with a satisfactory result.
ANEMIA DURING PREGNANCY IN THE WOMEN OF WESTERN NEPAL Singh, P; Khan, and, S; Mittal, R. K
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Objective: Anemia is the most common nutritional deficiency disorder in the world. The prevalence of anemia in pregnancy varies considerably because of differences in socioeconomic conditions, lifestyles and health seeking behaviors across different cultures. The aim of this study was to evaluate the prevalence of anemia among pregnant women in western part of Nepal. Method: A hospital based study was carried out in Nepalgunj Medical College, Kohalpur, Banke Nepal to determine prevalence of anemia among pregnant women. A total of 512 pregnant (15-45 years old) were included in this study. Cyanmethaemoglobin method was used to determine the hemoglobin level. The study took place from January 2012 to December 2012. Statistical analyses were carried out by applying percentage and words excel 2007. Results: Out of five hundred twelve pregnant women, 210 (41.02%) pregnant women were anemic and 302 pregnant women were non anemic (58.98%). Also, among these anemic pregnant women, majority (67.14 %) of these women were mildly anemic, whereas 28.57% were moderately and 4.29% were severely anemic. Conclusion: Prevalence of anemia was higher in the pregnant women at the second trimester (51.1%) and also at the 20-35 years age group (62.79%).

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