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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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DIFFERENCES OF TUMOR MASSES AND HEMOGLOBIN LEVELS IN CERVICAL CANCER SQUAMOUS CELL TYPE PATIENTS TREATED WITH COMBINATION OF PACLITAXEL AND CARBOPLATIN CHEMOTHERAPY Noviyani, R.; Suwiyoga, K.; Lesmana, I.; Niruri, R.; Tunas, K.; Budiana, and I N. K.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Paclitaxel and carboplatin are standard operating procedure for chemotherapy treatment of cervical cancer squamous cell carcinoma at Sanglah General Hospital, Bali-Indonesia. Chemotherapy improves outcome of cancer treatment. However, chemotherapy brings also a variety of adverse effects and complications. This study aims to evaluate the therapeutic and adverse effects of chemotherapy in patients with squamous cell cervical cancer. Methods: This is a case study of six patients with cervical cancer underwent chemotherapy paclitaxel and carboplatin 3-series at Sanglah General Hospital, Bali-Indonesia during January to November 2013. The therapeutic effect of chemotherapy was assessed from cervical cancer tumor mass measured before and after chemotherapy 3-series. The adverse effect of chemotherapy was determined from hemoglobin levels measured before and after chemotherapy. Data were analyzed using a paired t-test with a level of confidence of 95% using the SPSS to find out the differences. Results: In this study we found that there is a difference between tumor mass pre and post 3 series chemotherapy within p < 0.05. In term of toxic effect, we also obtained that there were difference of hemoglobin between pre and post of treatment within p < 0.05. Conclusion: Paclitaxel carboplatin as a chemotherapy drug in patients with cervical cancer is highly recomended when seen from the effects of reduced tumor size, and has a low side effect of anemia (anemia grade 1).
Intra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient Putranto, Terawan Agus; Yusuf, Irawan; Murtala, Bachtiar; Wijaya, Andi
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Muscle strength impairment in stroke patient affect the patient daily life, especially when it occurs on the extremities muscles. Manual Muscle Testing (MMT) is an examination method to measure muscle strength using standardized scoring. Objective: To find possible improvement of Manual Muscle Test (MMT) Score after administration of Intra Arterial Heparin Flushing in chronic ischemic stroke patient. Method: This is an experimental study using pretest-posttest group design, with randomized controlled clinical trial, conducted among patients in Cerebrovascular Center Unit in Army Central Hospital Gatot Soebroto starting from February 2014. With 75 patients included in this study. The examination of muscle strength was done by trained physicians. The MMT score were taken before and after the IAHF procedure is conducted. Results: This study found higher score of MMTMRC scoring system on chronic stroke patient with IAHF procedure (mean MMT-MRC Score = 6,05 point. With p
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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Abstract

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.
THE OUTCOME OF ANTIBIOTIC THERAPY AMONG CHILDREN WITH SEVERE COMMUNITY ACQUIRED PNEUMONIA Usman, M. R.; Wati, D. K.; Subanada, I. B.
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: The effect of human immunodeficiency virus (HIV) status on the evolution of community acquired pneumonia (CAP) is still controversial. There are controversies regarding antibiotic treatment outcome of CAP in HIV infected children. Objective: The aim of this study was to investigate possible differences in hospital outcomes, with compared the outcome of the treatment in severe CAP among HIV infected and HIV uninfected children which had an empiric antibiotic therapy. Methods: A case control study of 80 patients with severe CAP in Department of Child Health, Sanglah General Hospital, Bali-Indonesia. We evaluated clinical features for seeing the effectiveness of the antibiotic therapy according to Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia between HIV infected and HIV uninfected patients. Results: 58% patients in failure treatment and 45% patients in favorable treatment were HIV infected. There were similar characteristics from both groups, except malnutrition condition was statistically significant contribute the outcome (OR 2.87 (95% CI 1.098 to 7.500, p= 0.031). There was no significantly statistic difference of the outcome in HIV infected as compared to HIV uninfected patients with severe CAP (OR 1.65 (95% CI 0.683 to 4.002, p= 0.263). Conclusion: HIV infection was not gave an effect on the outcome of severe CAP patients which had an antibiotic therapy based on Department of Child Health, Sanglah General Hospital’s clinical pathway for severe pneumonia.
Application Anti Microbial Activity Test and Direct Inoculation of Urinary Specimen Test to Increase the Quality of Results and Decrease the Production Cost in Clinical Microbiology Laboratory, Sanglah General Hospital Hospital, Bali-Indonesia Sri-Budayanti, N.; Sukrama, I. D. M.; Aditarini, M.; Sukardika, I. K.; Suata, I.K.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
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Abstract

Objective: Urinary tract infection (UTI) is the most common bacterial infection in general practice and in hospitals. Fast and accurate urine culture and sensitivity test are needed for adequate therapy. Anti Microbial Activity test (AMA test) that is used to detect the presence of antibiotics in urine specimens is not commonly used in clinical microbiology laboratories. Some laboratories are still using indirect inoculation technique using enriched media before inoculating onto the agar media. The aim of this research is to compare results of urinary examination of direct inoculation technique with AMA test with indirect inoculation technique without AMA test. Methods: A number of 210 urine specimens were collected in Clinical Microbiology Laboratory at Sanglah General Hospital within a time period between 16 June until 16 July 2009. Results: Antibiotics were detected in 40% of the urinary specimens; whereas 48.1% showed no evidence of UTI, that is negative AMA test and sterile urinary culture or colony growth < 105 CFU/ml. Only 11.9% of the specimens indicates urinary tract infections. The examination can be completed within 2-3 days which is shorter than indirect inoculation test which require 5-7 days. Direct inoculation technique can reduce the cost of production three-fold the costs require for an indirect inoculation test. Conclusions: Application of AMA test and direct inoculation technique can give results more rapidly, reliable and useful for clinicians. This also decrease the laboratory’s cost of production.
RECURRENT PERI-OP HAEMATURIA IN REPEAT LOWER SEGMENT CAESAREAN SECTION: an unusual Presentation of Renal Cell Carcinoma in Pregnancy (A Case report with Literature Review) Hota, Basanta Manjari; Naaz, Nabila; Pujitha, M.; Banoth, Swathi Bai; Basavaih, Prabhakar Gowdar Channa
BALI MEDICAL JOURNAL Vol 4 No 2 (2015)
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Abstract

Background: Trauma to urinary bladder is the commonest cause of haematuria in repeat lower segment caesarean section. However, recurrent post op haematuria draws the attention to other aetiologies. Case: A 27 year old lady, G2P1L1, post caesarean pregnancy at term gestation, underwent elective caesarean section and tubectomy. She developed haematuria in perioperative period in episodic manner. Abdominal and pelvic ultrasound revealed a solid mass lesion in the upper pole of right kidney of size 5.8x4.6mm, which was confirmed by CECT of abdomen to be renal cell carcinoma. She was managed with radical nephrectomy in the urology centre without any adverse event. This rare presentation of the case and its successful management, prompted us to present this case with available literatures review.
THE ADDITION OF CAFFEINE IN EARLE’S BALANCED SALT SOLUTION MEDIA WITH WASHING UP METHOD INCREASE MEMBRANE INTEGRITY AND ACROSOMAL SPERM Satriyasa, Bagus Komang; Mahendra, Agung Nova
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
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Abstract

Background: caffeine, a methylxanthine derivate, appears to inhibit phosphodiesterase, thereby inhibiting the break down of cAMP and increasing its concentration inside cell. This study aims to assess the effect of caffeine addition in Earles’s Balanced Salt Solution (EBSS) on the increase in membrane integrity and acrosome reaction of spermatozoa using swim up method Methods: This study was carried out at the Clinic of Sexology and Andrology, Sanglah Public Hospital at Denpasar Bali-Indonesia. This study was an experimental study using the design of pre and post test paired control group design. The samples were sperm specimens of eighteen infertile couple male or volunteers who were infertile with age ranged between 20-40 years old. The samples were divided into two groups: treatment group (caffeine + EBSS) and control group (EBSS). The data were analysed statistically by normality test (Kolmogorov - Smirnov Goodness of Fit Test), Homogeneity test, and Paired Student’s t test. Results: The results showed that the caffeine addition in EBSS medium could increase significantly (p<0.05). The integrity of the sperm membrane obtained were from 81.30 % to 86.60 % and acrosomal reaction from 82.60% to 89.60% evaluated by hypo-osmotic swelling test (HOS). The conclusion of this study is that addition of caffeine in EBSS medium increases significantly membrane integrity and acrosomal reaction of the human sperm.
BILATERAL PARAMEDIAN THALAMIC AND MIDBRAIN INFARCTION: A Case Report Andaka, D.; Nuartha, and A. A. B. N.
BALI MEDICAL JOURNAL Vol 2 No 3 (2013): Vol.2, No.3, September-December 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Bilateral paramedian thalamic and midbrain infarct is rare and present with varying symptoms. The occlusion of a rare arterial variant called the artery of Percheron results in bilateral thalamic infarcts, with or without midbrain involvement. To this date, the diagnosis of ischemic infarction due to occlusion of the artery of Percheronhas was uncommon. Case: We reports a 50 year-old man with acute ischemic infarcts of both paramedian thalami and midbrain, presenting with complete ophthalmoplegia, arreactive mydriasis pupils, and altered mental status (somnolent and fluctuating hypersomnia).Conclusions: Based on clinical and neuroimaging findings, we concluded this case as acute ischemic infarctions due to occlusion of the artery of Percheron.
Analysis of Glial Fibrillary Acidic Protein (GFAP) Serum Levels on Spontaneous Intracerebral Hemorrhage Non-Lesion Patients Indharty, Suzy; Japardi, Iskandar; Fadhli, Muhammad
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Stroke is one of the root causes of brain disorders at the height of the productive age and ranks second cause of death after heart disease in most countries in the world. Fairly large-scale study conducted by ASNA (ASEAN Neurological Association) in 28 Hospitals in Indonesia. This study was conducted in patients with acute stroke who were treated in hospital (hospital-based study) and conducted a survey of factors - risk factors, treatment duration and mortality and morbidity. Method: This is a cross sectional study, with intracerebral hemorrhage Head CT scan examination then examined serum levels of plasma GFAP her at the time of patient entry from RSUP. H. Adam Malik Medan from March 2014 -May 2014. Results: In this research, we found the frequency of male patients as many (62.5%), while as many women (37.5%). Predominant age range in patients encountered in this study were 46-51 years old and are the dominant ethnic Batak tribe (43.8%). Conclusion: There were no significant differences between groups in serum GFAP levels with bleeding volume ? 30 cc compared to those with bleeding volume

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