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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.
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Articles 9 Documents
 1 
Search results for , issue "Volume 2 Number 1, January-April 2013" : 9 Documents clear
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
Publisher : BALI MEDICAL JOURNAL

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Abstract

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%).
CORRELATION BETWEEN RESPECT, RESPONSIBILITY, INTERPERSONAL RELATIONSHIP, SUPERVISION, AND COMPENSATION TO THE PERFORMANCE OF OFFICIAL RECORDER AT STATE HOSPITALS BUKITTINGGI WEST-SUMATRA INDONESIA Alhamda, Syukra
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Primary survey was conducted on November 10, 2012 at The State Hospitals Bukittinggi, with randomly selected of 100 hospital medical records. There were incomplete contents of 61.66% and 48.33% of late files. This issue is very disturbing process for management of recording medical data. Therefore, it will disrupting functions of medical recorders. Method: This study applied cross-sectional study to determine the correlation between respect, responsibility, interpersonal relations, supervision and compensation for the performance of official recorders at The State Hospitals Bukittinggi West-Sumatra Indonesia. Questionnaires from the subjects were proceed and computed by applying chi-square test. Results: The results showed that there were significant correlation between the performance of official award recorders (p = 0.003 and OR = 9.208), responsibilities (p = 0.012 and OR = 6.094), interpersonal (p = 0.0025 and OR = 5.417), performance of official (p = 0.012 and OR = 6.094), and compensation of official recorders (p = 0.025 and OR = 5.417) to recorders performance. Conclusion: In this research, we observed that there was a significant correlation between respect, responsibility, interpersonal relations, supervision and compensation to the performance of official recorders. A greater attention should be considered in order to produce a good performance of the medical recorder.
GROUP-B STREPTOCOCCUS IN PREGNANT WOMEN: Prevalence of Colonization and Sensitivity Pattern in Denpasar during June 2007?May 2008 Sri-Budayanti,, N; Hariyasa-Sanjaya, and, N
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Group-B Streptococci (GBS) are Gram-positive cocci that are the most common cause of early onset neonatal sepsis. The mortality rate of early onset neonatal sepsis has been reported up to 50%. One of the major risks of early onset neonatal sepsis is GBS colonization in birth canal of pregnant women that can infect the baby during process of vaginal delivery. Antibiotic chemoprophylaxis for pregnant women that is colonized by GBS can reduce the risk of early onset neonatal sepsis. The detection of GBS colonization needs Todd Hewitt (TH) enrichment medium to reduce false negative result. Until now, there is no report about either prevalence of colonization or sensitivity pattern of Group B Streptococcus among pregnant women in Denpasar. The aims of this research were to determine the prevalence of GBS colonization and sensitivity pattern of GBS among pregnant women with Todd Hewitt enrichment medium. Method: This research was a descriptive cross-sectional study. Vaginal swab specimens from 35-37 weeks gestation pregnant women were collected and 32 samples that met the inclusion criteria were cultured on Blood agar (BA) plates, Chromagar (CA) plates, and Todd Hewitt (TH) broth. The GBS colonization that grew in culture medium was followed by antibiotic sensitivity test. Results: In the present study, we found that the prevalence of GBS colonization in pregnant women detected with culture method using BA and CA without TH broth was 9.4%, whereas the prevalence with culture method using BA and CA enriched by TH broth was 31.3%. Moreover, GBS showed resistance to penicillin, erythromycin, and cefazolin. It is indicated that TH enrichment medium seems to be promising as a screening method for GBS colonization in pregnant women in Bali. Conclusion: There was an enrichment detection of GBS prevalence colonization in pregnant women detected the swab with culture method using BA and CA enriched by TH compare to BA and CA without TH broth. Moreover, GBS showed resistance to penicillin, erythromycin, and cefazolin. It is indicated that TH enrichment medium seems to be promising as a screening method for GBS colonization in pregnant women in Bali.
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
Publisher : BALI MEDICAL JOURNAL

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Abstract

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.
INCREASE OF SERUM BCL-2 CONCENTRATION IN SEVERE HEAD INJURY: The Role of ACTH4-10Pro8Gly9Pro10 and HMG Co-A Reductase Inhibitor Suzy-Indharty, Rr
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: ACTH4-10Pro8Gly9Pro10 and HMG Co-A reductase inhibitor had a well-known neuroprotective effects. One important process happened in head injury is apoptotic neuronal death. Bcl-2 is one of anti-apoptotic protein inhibits the intrinsic pathway of apoptosis. This study aimed to compare the effect of standard therapy, ACTH4-10Pro8Gly9Pro10, and HMG Co-A reductase inhibitor on serum Bcl-2 levels and the potential effect to a better outcome and reduction of hospital stay. Method: Subjects of severe head injury without any indication for surgery were taken consecutively (n=60) and separated into three groups of; standard treatment only (control group), standard treatment combined with ACTH4-10Pro8Gly9Pro10, and standard treatment combined withInhibitor HMG CoA Reductase. Blood samples were taken on day-1 and day-5 from each subject for measurement of Bcl-2 concentration. Barthel index and MMSE were measured at discharge and hospital length of stay was noted. Results: Bcl-2 serum levels in control group was 1.49±1.01 ng/mL on day one and 1.64±0.61 ng/mL on day five; and 1.72±1.40 ng/mL on day one and 4.02±1.19 ng/mL on day five after treatment with ACTH4-10Pro8Gly9Pro10. In the HMG Co-A reductase inhibitor group, Bcl-2 serum level was 1.55±0.98ng/mL on day one and 2.00±0.90ng/mL on day five. The correlation of outcome (Barthel Index and MMSE) with serum Bcl-2 levels was not significant. We found the length of stay in the ACTH4-10Pro8Gly9Pro10 group was significantly shorter (p<0.05; CI 95%). Conclusion: ACTH4-10Pro8Gly9Pro10 significantly increased serum Bcl-2 concentration in head injury. Although we didn’t find any correlation between serum Bcl-2and outcome (Barthel Index and MMSE), therapy with ACTH4-10Pro8Gly9Pro10 resulted in a significantly shorter hospital length of stay.
TUBERCULUM SELLAE MENINGIOMA Vs. MACROADENOMA: How to differentiate preoperatively? Mardjono,, I.; Arifin, M. Z.; Sidabutar, R.; Singh, and, A.; Sevline, E. O.
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Sellar region tumors may origin from a various number of structures and each of themhave a specific clinical and radiological appearance. Among these pathological processes, one of themost challenging is to distinguish between tuberculum sellae meningioma (TSM) and macroadenomahypophysis (MH). Differentiating these two entities preoperatively is very important to decide whichapproach will be most suitable and beneficial. The purpose of this study is to produce a simplepreoperative scoring system to differentiate these two that can be applied in specific conditions whereMRI is not available or could not be performed. Methods: This analytical retrospective cohort studycontains data obtained from patients treated in Neurosurgery Department of Dr. Hasan SadikinGeneral Hospital-Bandung from 1 January 2008 until 31 December 2010. There were 34 patientsenrolled in this study, in which 15 of them were diagnosed with MH and 19 patients diagnosed withTSM confirmed with pathology examination. Results: From clinical presentation we found that theevent of endocrinopathy occurs significantly in macroadenoma hypophysis (p=0.002). Whereas fromradiological evaluation there were 7 parameters that significantly distinguish these two entitiesincluding hyperostosis, sellar floor configuration, homogeneity of mass, contrast agent enhancement,waist configuration, peritumoral edema, and dural attachment. From these findings, we propose asimple scoring system to differentiate macroadenoma hypophysis and tuberculum sellae meningiomawith a 84.2% sensitivity and 100% specificity. Conclusion: although MRI is the modality of choice indifferentiating macroadenoma hypophysis and tuberculum sellae meningioma but our scoring systemcan be used as an aid in choosing best surgical approach.
EFFECT OF CONJUNCTIVA-LIMBUS TRANSPLANTATION WITH FIBRIN GLUE COMPARE TO SUTURE TECHNIQUE ON STABILITY OF THE GRAFT ATTACHMENT IN PTERYGIUM SURGERY Sutyawan, E; Niti, S; Widiana, and R
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Abstract

Objective: Pterygium is a growth that develops on the conjunctiva or mucous membrane covers the white part of eye. It is a benign or noncancerous growth that is often shaped like a wedge. This study aims to assess the efficacy and safety attachment graft on conjunctiva-limbus autograft transplantation using fibrin glue compared with suture technique in pterygium patient. Method: Single-blind randomized clinical trials. The samples were all pterygium patients with grade two or more who underwent pterygium surgery at the eye clinic and central operating theatre Sanglah General Hospital Denpasar, Bali-Indonesia and met the eligibility criteria. Samples were divided into suture and fibrin glue groups based on permutation-block randomization. Mann-Whitney U test and repeated measurement of ANOVA Analyses were performed to determine the different between two treatments. Results: There were no significant differences in the stability of graft’s attachment between the two groups either on the first day, first week and first month despite fibrin glue technique showed lower results in the first week and first month (p = 0.787, p = 0.233, and p = 0.475). The average time it takes the fibrin glue technique 21.80 ± 2:37 minutes, much shorter than 41.67 ± 6.99 min in the suture technique (p = 0.001). Postoperative comfort in the fibrin glue group showed lower scores on the first day, first week and first month compared with the suture group (p = 0.000, p = 0.000 and p = 0.035). During the follow-up period no complications were found. Conclusion: The stability of graft attachment between the fibrin glue and suture technique is not significantly different.  Fibrin glue could be chosen as an alternative method in the conjunctiva-limbus autograft and helpful in shortening the operating time and improve comfort postoperatively.
BACTERIOLOGICAL ANALYSIS AND ITS ANTIBIOGRAM PROFILE OF PHARYNGITIS CASES FROM THE PATIENTS ATTENDING REFERRAL HOSPITAL, SIKKIM, INDIA Moirangthem, and, A; Gurung, K
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Abstract

Objective: Infections of throat have a tremendous impact on public health. This present study aims to find out the bacterial load in throat infections as well as their susceptibility pattern in patients attending Central Referral Hospital, Tadong, Sikkim. Method: A total of 55 symptomatic patients having throat infections attended Central Referral Hospital Sikkim, among which 28 were males and 27 were females. A total of 55 throat swabs were collected from the patients with symptoms of pharyngitis. Results: Out of 55 samples, culture was positive in 37 samples. Twenty one strains of Staphylococcus aureus, 13 strains of Streptococcus pyogenes, 1 strain of Pseudomonas aeruginosa and 2 strains of Proteus spp. were isolated. The isolation rate of Staph.aureus was found to be statistically significant when compared between the isolation rate of Ps.aeruginosa, Stp. pyogenes and Proteus spp. 3 isolates of Staph. aureus were sensitive to penicillin, 1 isolate was moderately sensitive and 17 isolates were resistant. 12 strains of Staph.aureus were sensitive to methicillin. Methicillin resistant was seen in 9 strains of Staph. aureus. The strains of Stp. pyogenes isolated were either moderately sensitive or resistant to the used antibiotics, it was not sensitive to any of the used antibiotics. It was moderately sensitive to amoxiclave, clarithromycin, erythromycin and resistant to clindamycin and cefuroxime. 100% strains of Ps. aeruginosa were resistant to ciprofloxacin, gentamicin, piperacillin, ticarcillin, tobramycin and the strains were sensitive only to imipenem (100%). Further 100% strains of Proteus spp.were sensitive to cefuroxime, azithromycin, amoxicillin and cephalexin. Conclusion: Our study showed a high rate of monomicrobial infection. The control of throat infections demands the availability of primary care and appropriate treatment.  
HIGH SERUM C-REACTIVE PROTEIN AS PREDICTOR OF SYSTEMIC INFLAMATORY RESPONES SYNDROME IN SEVERE HEAD INJURY PATIENTS Bomba, G. I. B; Maliawan, and, S; Mahadewa, T. G. B
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Abstract

Objectives: Despite the fact that many studies have shown that the role of high sensitivity C-reactive protein (Hs-CRP) in inflammation diseases, the role of this molecule in severe head injury (SHI) has not been understood clearly. Severe head injury was defined as a trauma to the head frequently found in Emergency Units where some cases result in mortality. Severe head injury was defined as Glasgow Coma Scale (GCS) score between 3 and 8. Based on this data, we felt that it was important to determine the role of Hs-CRP as a predictor of SIRS in SHI patients. Method: This was a Cohort prospective study about the role of serum Hs-CRP as a predictor for Systemic inflammatory response syndrome (SIRS) in SHI patients at Sanglah General Hospital, Bali-Indonesia from August 2012 to February 2013. A number of 60 patients fulfilled the inclusive criteria. The data were analyzed descriptively to show the characteristics of the samples and was analyzed using univariate and multivariate analysis to determine the predictor factors for SIRS in SHI patients. A confidence interval of 95% (p < 0.05) was applied. Results: From 60 samples collected, there were 43 males (71.7%) and 17 females (28.3%), the majority age of the samples were 20-40 years old (21 samples, 35%). On the first day 49 samples (81.6%) had elevated serum Hs-CRP levels. Fifty seven samples (95%) had SIRS, and only 3 samples (5%) did not have SIRS. Bivariate analysis between Hs-CRP level and SIRS was significant (p = 0.001). Multivariate analysis showed that pneumonia and high Hs-CRP serum levels were significant predictor factors for SIRS in SHI patients. Conclusion: High serum Hs-CRP levels could be used as a reliable predictor factor for SIRS in SHI patients.

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