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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Paediatrica Indonesiana JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia

Nyoman Golden

Departemen/ SMF Ilmu Bedah Universitas Udayana, RSUP Sanglah, Denpasar

Author-ID : 3756171

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Initial Clinical Findings as a Predictor of Abnormal Scan on Minor Head Injury Patients at Sanglah General Hospital, Bali-Indonesia -, Ade-Chandra; Niryana, W; Golden, N
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (55.083 KB)

Objective: Minor Head Injury (MHI) patients should not cause severe sequelae. In fact, many studies had reported that some MHI patients had abnormal scan, clinical deteoritation, and many of them have had neurosurgical intervention. This study analyzed correlations between clinical signs with abnormal scan, clinical deteoritation and surgery intervention on minor head injury patients. Methods: A series of 364 MHI patients were prospectively enrolled in this study. In all cases clinical data were collected and a CT Scan was obtained. The relationship between clinical findings (loss of conciousness, amnesia, seizure, vomiting, headache, cepalhameatome, skull fracture, age more than 60 years),were identified as independent risk factors in corelations to abnormal scan, clinical deteoritation and surgery intervention using bivariate and logistic regresion multivariate analitycs with 95 % CI. Results: the incidence of abnormal scan was 13.8% (48 patients), 3.3% (12 patients) with clinical deteoritation, and incidence of surgery intervention was 3.8% (14 patiens). Lost of conciousness, amnesia, cepalhematoma, skull fracture, and age more than 60 years old are independent variabels had statisiticly significant with abnormal scan. Amnesia, cepalhematome, skull fracture are independent variables which had statisitc significantly with clinical deterioritation and surgical intervention. Conclusions: Clinical variables which had statistic significanly can be used as predictors of abnormal scan, clinical deteoritation, and surgical intervension. Avoiding systematic CT Scan indication implies a rate of misdiagnosis, but liberal scan can be increasing the cost of patients.

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
Publisher : BALI MEDICAL JOURNAL

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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.

THE EFFECTIVENESS OF NETILMICIN SULPHATE INSTILATION ON THE URETHRA CATHETER REMOVAL PROCEDURE IN REDUCING THE INCIDENCE OF CATHETER ASSOCIATED URINARY TRACT INFECTION Darma-Kusuma, I.G.; Duarsa, G.W.K.; Golden, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (60.352 KB)

Objective: Catheter associated urinary tract infection (CAUTI) is the most common complication of short-term indwelling catheters. The risk of this complication is increase along with the length of catheter insertion. There is no complete agreement of intravenous administration of prophylaxis antibiotic in reducing the incidence of CAUTI. Currently, antibiotic instilation into bladder was developed, however it is still a controversial issue. Therefore in this study we would like to see the effectiveness of this procedure in reducing the risk of CAUTI. Method: Single blind randomized controle trial was conducted on 40 eligible male patients treated at surgical ward, Sanglah Hospital between March and August 2012. Twenty patients had netilmicin sulfate instilation and anathor 20 patients treated without instilation procedure. Urine culture was taken before and after catheter removal. The number of colonies were analyzed according to the WHO criteria. In this study WHO critirion 3 was used with a significant bacteriuria of more 10 5 CFU / mL. Data were analyzed with Chi-square table and processed statistically with SPSS. Significance was set at p value <0.05 with 95% CI. Results: The mean age was 50.07 (SD 15.49) years. The avarage length of urinary catheterization was 5 days (range from 4 to 14 days). CAUTI was observed in 18 patients (45%); symptomatic was 11 patients (61.1%) and asymptomatic was 7 patients (38.9%). Statistic analysis showed that netilmicin sulfate insilation significantly reduced the risk of CAUTI (OR 0.028 ; CI 0.004 - 0.172). Conclusion: Netilmicin sulfate instilation prior to catheter removal significantly reduced the risk of CAUTI after short-term indwelling catheter.

Risk Factors for Neuroworsening of Moderate Head Injury Cases in Emergency Department Sanglah General Hospital Bali-Indonesia Sasongko, J; Niryana, W; Golden, N
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
Publisher : BALI MEDICAL JOURNAL

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Objectives: To determine risk factors such as hypoxia, hypotension, age >40 years old, amount of focal lesion, low GCS upon arrival, and female associated with neuroworsening of moderate head injury cases. Method: The study was a cohort study on 152 cases of moderate head injury admitted in Surgery Department/Udayana University Faculty of Medicine/Sanglah General Hospital from April 2010 – March 2011. The variables were analyzed using multiple logistic regression model (p<0.05). Results: The multivariate analysis showed age group ?40 years old {OR 4,490 (CI 95%: 1,750 – 11,521) p=0,002}, male sex {OR 2,276 (CI 95%: 0,810 – 6,395) p=0,119}, initial GCS 9-12 {OR 2,905 (CI 95%: 0,097 – 24,440) p=0,048}, hypoxia {OR 13,582 (IK 95%: 4,315 – 42,750) p=0,000}, hypotension {OR 5,179 (CI 95%: 1,097 – 24,440) p=0,038}, and multiple focal lesion {OR 5,674 (CI 95%: 2,008 – 16,038) p=0,001} were risk factors for neuroworsening in moderate head injury cases. Area Under Curve value was 84.7% from the Receiver Operator Curve. Conclusions: This study showed that hypoxia, multiple focal lesion, age ?40 years old, and hypotension were risk factors for neuroworsening in moderate injury cases.

THE RISK FACTOR OF NEUTROPENIA ON LOCALLY ADVANCED BREAST CANCER PATIENTS TREATED WITH FIRST CYCLE CYCLOPHOSPHAMIDE, DOXORUBICINE, 5- FLUOROURACIL CHEMOTHERAPY AT SANGLAH GENERAL HOSPITAL DENPASAR, BALI-INDONESIA Keswara, M.A.; Sudarsa, I.W.; Golden, N.
BALI MEDICAL JOURNAL Volume 1, Number 3, September-December 2012
Publisher : BALI MEDICAL JOURNAL

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Objective: Breast cancer is the most common type of cancer found in women, in the United States breast cancer is the number one cancer in women and the second highest cause of cancer deaths after lung cancer. This study aims to determine the incidence of neutropenia and tested several clinical risk factors of neutropenia in locally advance breast cancer/LABC patients who obtain first cycle cyclophosphamide, doxorubicine, 5-fluorouracil neoadjuvant chemotherapy at Sanglah Hospital in Denpasar. Method: The study was a prospective cohort involving 62 LABC patients conducted between February to June 2012. Clinical factors such as age, chronic obstructive pulmonary disease, hypertension, nutritional status, and hemoglobin levels in patients were recorded. Neutrophil level were recorded on day 7 and 12 of first cycle neoadjuvant chemotherapy. Bivariate analysis was done to see the strengths of each risk factor for neutropenia followed by multivariate logistic regression analysis to determine the most significant risk factor for the occurrence of neutropenia. Relative risk with 95% confidence interval was recorded. The level of significance was set at value of less than 0,05. Results: Neutropenia was found in 17 patients (27,4%). Bivariate analysis showed that age older than 60 years old, hypotensive, under nourished, and anemic are significant risk factors of neutropenia. However, in multivariate logistic regression age (RR 20,225; 95% CI 1,804-226,776) and nutritional status (RR 35,328; 95% CI 3,108-401,524) remained significant clinical risk factors of neutropenia. Conclusion: Neutropenia incidence was 27,4%. Patients older than 60 years old and under nourished status are the significant clinical factors causing neutropenia and can be used as a predictor to predict neutropenia.

LIPID PEROXIDATION AFTER INTRACORTICAL INJECTION OF FERRIC CHLORIDE INCREASES THE INCIDENCE OF SEIZURES IN YOUNG RATS Golden, Nyoman; Agus Bagiada, Nyoman; Darmadipura, Sajid
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 2 Juli 2009
Publisher : Udayana University

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Clinical studies have shown that the incidence of early posttraumatic seizures ishigher in children than in adults and it has been proposed that iron-induced lipidperoxidation has an important role in the development of epileptogenic foci. In this study,we examined some of the hypothesized reasons for the difference in the incidence ofearly posttraumatic seizures between young and adult rats. Twelve young and twelveadult rats were randomized into 4 groups. Group 1 and 2 were control groups, eachcomprising of 6 young rats and 6 adult rats respectively and were given intracorticalinjections of normal saline. Group 3 and 4 were injury groups, again comprising 6 youngrats and 6 adult rats respectively and were given intracortical injections of FeCl3. All ratswere observed for 6 hours post injection for the occurrence of seizures and were thenkilled. The injected hemispheres were extirpated and tested for malondialdehyde (MDA)level and superoxide dismutase (SOD) activity as indices of oxidative damage. Resultsshowed that seizures were observed only in Group 3. Increased MDA level and decreasedSOD activity were observed in Group 3 (ANOVA, p<0.001). Increased MDA levels anddecreased SOD activity were significantly higher in rats with seizures (Group 3) than inthose without seizures (independent t-test, p<0.001). We conclude was that differentlevels of lipid peroxidation induced by intracortical ferric chloride injection may accountfor the different seizure incidence between young and adult rats

Orbital rhabdomyosarcoma I Putu Wijana; Ida Bagus Mudita; I Nyoman Golden; Agus Kusumajaya; I Ketut Mulyadi
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

we report a case of orbital rhabdomyosa-rcoma in a 2.5 year-old female child.

Validitas Rasio Neutrofil Limfosit pada Apendisitis Komplikata di RSUP Sanglah Denpasar Dewi Prima Christian; I Gede Suwedagatha; Nyoman Golden; I Ketut Wiargitha
JBN (Jurnal Bedah Nasional) Vol 1 No 1 (2017): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: untuk mengetahui validitas rasio neutrofil limfosit (RNL) pada apendisitis komplikata. Metode: penelitian dilakukan secara observasional analitik dengan menggunakan desain studi kohort dengan mengambil sampel penderita apendisitis akut yang menjalani apendisektomi di RSUP Sanglah Denpasar, periode Oktober-Desember 2015. Data dikelompokkan menjadi dua kelompok, yaitu RNL dengan cut of point >5 dan RNL dengan cut of point ?5 dan kemudian disesuaikan dengan temuan pemeriksaan histopatologi anatomi sebagai standar baku emas, komplikata dan non-komplikata. Data tersebut kemudian dianalisis dengan analisis statistik deskriptif, analisis kurva ROC, dan uji diagnostik. Hasil: pada penelitian ini diperoleh 62 sampel, dengan median umur 23 tahun, 32 orang penderita laki-laki, 30 orang penderita perempuan, 28 apendisitis non-komplikata, dan 34 apendisitis komplikata. Dari area under curve ROC 0,6229 dengan 95% CI didapatkan cut of point RNL >5 pada apendisitis komplikata, RNL ?5 pada apendisitis non-komplikata. Uji diagnostik didapatkan nilai sensitivitas 85,3%, spesifisitas 39,3%, dan tingkat akurasi 64,5%. Simpulan: RNL merupakan tolak ukur sederhana yang lebih baik untuk meramalkan apendisitis akut dibandingkan dengan penilaian Alvarado Score dan USG abdomen serta valid untuk membedakan apendisitis komplikata dan non-komplikata melalui cut of point RNL.

Perbandingan Jumlah Sel Mononuklear, Jumlah Sel Fibroblas, Ukuran Fibrosis, dan Perlengketan Klinis Pada Jaringan Peridural Antara Non-Absorbable Mesh dan Absorbable Barrier Mesh Pada Tikus Wistar dengan Cedera Otak Traumatika yang Dilakukan Decompressive Craniectomy Ida Bagus Yudha Prasista; I Wayan Niryana; Nyoman Golden
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: Penelitian ini bertujuan untuk membandingkan dua jenis mesh yaitu non-absorbable mesh dan absorbable barrier mesh terhadap sel mononuklear, fibroblas, ketebalan fibrosis dan perlengketan klinis pada jaringan peridural tikus wistar dengan traumatic brain injury. Metode: Studi ini menggunakan model hewan coba dengan desain Randomized post Test-Only Control Group. Penelitian melibatkan dua puluh sampel. Sebanyak sepuluh sampel yang menggunakan non-absorbable mesh masuk dalam kelompok kontrol dan sepuluh sampel yang menggunakan absorbable barrier mesh masuk dalam kelompok perlakuan. Untuk pemeriksaan jumlah sel mononuklear (MN), jumlah sel fibroblas dan ukuran fibrosis, serta perlengketan klinis pemeriksaan dilakukan di laboratorium setelah sebelumnya dilakukan euthanasia setelah hari ke-14. Uji T independen dan uji Mann Whitney dilakukan untuk menguji hipotesa dengan skala data numerik serta uji Fisher’s exact untuk menguji hipotesa dengan skala data kategorik. Hasil: Rerata jumlah sel mononuklear (MN) per lapang pandang (LP) pada kelompok dengan perlakuan lebih rendah daripada kelompok kontrol (10,6±5,6 vs 13,8±5,6 per LP). Jumlah rerata sel fibroblas per LP pada kelompok perlakuan lebih rendah dibandingkan dengan kontrol (13,6±4,3 vs 20,2 ±7,3 per LP). ketebalan ukuran fibrosis juga menunjukkan perbedaan rerata yang signifikan lebih rendah pada kelompok perlakuan (183,4 ± 87,7 vs 458,5±247,1). Resiko relative terjadinya perlengketan klinis pada non-absorbable mesh juga 3 kali lebih besar dibadingkan dengan absorbable barrier mesh. Simpulan: Penggunaan absorbable barrier mesh secara bermakna menyebabkan rerata jumlah sel fibroblas, ukuran fibrosis, dan risiko perlengketan klinis yang lebih rendah paska tindakan decompressive craniectomy.

Dekompresi Mikrovaskular pada Neuralgia Trigeminalis dan Spasme Hemifasialis Sri Maliawan; Tjokorda G.B. Mahadewa; Nyoman Golden; Wayan Niryana
Jurnal llmu Bedah Indonesia Vol. 35 No. 2 (2007): Desember 2007
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibiikabi.v35i2.129

Pendahuluan : Menurut konsesus spesialis bedah saraf pada The 5th International Meeting of The Society for Microvascular Decompression Surgery, 2002, di Matsumoto, Jepang, terapi terpilih untuk neuralgia trigeminalis dan spasme hemifasialis adalah melakukan operasi dekompresi mikrovaskular (DMV). Tujuan penulisan ini untuk mengetahui hasil operasi DMV pada penderita dengan neuralgia trigeminalis (NT) dan spasme hemifasialis (SHF) di RS Sanglah (RSS), Denpasar. Metode : Studi kohort tanpa kelompok kontrol dilakukan terhadap data rekam medis penderita NT dan SHF di RS Sanglah (RSS), Denpasar, yang menjalani DMV selama periode tahun 1991-2006. Prosedur DMV terdiri atas tindakan memperbaiki posisi pembuluh darah yang menekan dan membebaskan sumbu nervus trigeminus dengan meletakkan teflon di antara nervus dan pembuluh darah. Subjek dievaluasi dalam kurun waktu antara 1 sampai 12 tahun pascoperasi. Data dianalisis untuk memperoleh angka kesembuhan segera, tingkat kepuasan pasien, angka kesembuhan tidak sempurna, angka kekambuhan, dan komplikasi operasi. Hasil : Dari 37 orang subjek terdapat 30 orang dengan NT dan 7 orang dengan SHF. Kesembuhan segera setelah operasi 93,3% pada NT dan 85,7% pada SHF. Subjek merasa puas dengan tindakan yang dilakukan sebanyak 83,3% pada NT dan 71,4% pada SHF. Kesembuhan tidak total 10% pada NT dan 14% pada SHF. Gangguan pendengaran pascaoperasi 13,3% pada NT dan 14% pada SHF. Diskusi : Teknik reposisi pembuluh darah yang menekan nervus trigeminus atau nervus fasialis sebagai prosedur DMV dapat memberikan hasil yang memuaskan untuk mengobati NT dan SHF.

Co-Authors Ade-Chandra - Agus Kusumajaya D.P.W. Wardhana Danny Zefanya Mooy Desy Permatasari Dewi Prima Christian Gede Wirya Kusuma Duarsa Giovani Fatrio Odo I G. N. Pustaka I Gede Parwata I Gede Suwedagatha I Gusti Ngurah Purnomo I Ketut Mulyadi I Ketut Wiargitha I Made Bagus Wirawan I Made Darmajaya I Made Sukarya I Putu Wijana I Putu Yuda Prabawa I W. Sudarsa I Wayan Niryana I.G. Darma-Kusuma Ida Bagus Mudita Ida Bagus Yudha Prasista J Sasongko K.K. Putra Kadek Adi Wiguna Ketut Sudartana Ketut Sudiasa Krishna Kurnia Pratama M.A. Keswara Made Agus Dwianthara Sueta Mira Dewi Prawira Nyoman Agus Bagiada Putu Eka Mardhika S. Awyono Sajid Darmadipura Sri Maliawan Tjokorda Gde Bagus Mahadewa

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