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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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EYE TUMOR PATIENTS AT TUMOR DIVISION EYE CLINIC SANGLAH GENERAL HOSPITAL BALI-INDONESIA Yuliawati, P.; Piliantari-Meigawati, and N. L.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Tumors in the eye are type of tumors that could afflict eyeball and adnexa. Even though, the incidence is rare, these tumors that usually are secondary tumors cause by cancer spread from other parts of the body, especially the breast, lung, bowel or prostate. Two types of primary tumors arise within the eye itself are known as retinoblastoma in children and melanoma in adults. This study aims to obtain basic figure of eye tumor patients at Sanglah General Hospital Bali-Indonesia, in which these data can be used as a reference for further research. Methods: Descriptive and retrospective methods were applied to observe the patient who came during the period of 1 January 2005 until 30 September 2010. The numbers were taken from the medical records. Results: There were 44 patients recruited, consisting of 59.1% male and 40.9% female. A number of 29.5% of them are between 61-70 years old, 34.1% are from Denpasar, and 34.1% are farmers. There were 95.5% of the patients suffered from an eye lump, and 40.9% of them came with 0.00 logMar of visual acuity. About 47.7% of the tumor grew in the superior palpebra. Pathology anatomy test shows 20.5% Squamous Cell Carcinoma (SCC), 11.4% Basal Cell Carcinoma (BCC), and 11.4% papilloma. Conclusions: The patients at tumor division, eye clinic of Sanglah General Hospital were mostly male, with major age range of 61-70 years old that mainly live in Denpasar as farmers. Their major complaint was the eye lump, which mainly found in the superior palpebra. The pathology anatomy result shows that SCC and BCC was the top and second most found illness. This study can be used as a reference for future research.
CHARACTERISTICS OF HYPOSPADIAS CASES IN SANGLAH GENERAL HOSPITAL, BALI-INDONESIA: A DESCRIPTIVE STUDY Duarsa, Gede Wirya Kusuma; Nugroho, Teguh Dwi
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Abstract

Background: Hypospadias is one of the most common congenital anomalies. The purpose of this study is to assess the characteristics of hypospadias patients in Sanglah General Hospital, and the type of hypospadias repair and the outcome. Methods: The data is collected retrospectively from the hypospadias patients’ medical records who undergone a hypospadias repair between January 2009 to April 2012. The data is analyzed descriptively to describe the characteristics of hypospadias patients, the procedures taken, and the outcomes. Results: From 42 patients, type of hypospadias are 33.3% (n=14) penoscrotal; 21.4% (n=9) scrotal; 14.3% (n=6) corona; 26.2% (n=11) penile; 2.4% (n=1) subcoronal; 2.4% (n=1) and perineal. Chordee was present in 67.9% cases (n=36), and cryptorchidism present in 3.7 % case (n=2). The urethroplasty techniques applied: TIP 55.6% (n=15); Duckett Preputial Island Flap 14.8% (n=4); MAGPI 14.8% (n=4); 14.8% (n=4) two stages urethroplasty. Complication rate of Duckett is 50% (n=2) urethra cutaneous fistula; MAGPI 25% (n=1) meatal stenosis; TIP 20% (n=3), 2 urethrocutaneous fistula, 1 urethral stricture; 2 stages urethroplasty 0% (n=0). Conclusion: The findings suggest a different frequency of the proportion of the type of hypospadias in this study when compare to the readily available literature. The age of the patients undergone hipospadias repair was higher compare to other studies. TIP technique was the most preferred in Sanglah Hospital.
Pregnancy Exercise Increase Enzymatic Antioxidant In Pregnant Women Wagey, F. W.
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Abstract

Objectives: Pregnancy is a vulnerable condition to all kinds of "stress", resulting in changes of physiological and metabolic functions. This research aims to determine effect of exercise during pregnancy in increasing enzymatic antioxidant marked by increase of superoxide dismutase (SOD), gluthation peroxidase (GSHPx), and catalase (CAT) levels. Methods: Randomized pre and posttest control group design was employed in this study. A number of 66 pregnant women were recruited in this study and grouped into two groups, i.e 30 of them as control group and the rest as treatment group. Pregnancy exercise was performed to all 36 pregnant women from 20 weeks gestation on treatment group. The exercise was performed in the morning for about 30 minutes, twice a weeks. On the other hand, daily activities was sugested for control group. Student’s t-test was then applied to determine the mean different of treatment and control group with 5 % of significant value. Results: This study reveals that there were significantly higher increase of (superoxide dismutase (SOD), gluthation peroxidase (GSHPx), and catalse (CAT) levels of treatment group compare to control group. These enzymatic antioxidant increase among these two group were around 1.36 mg/gHb for SOD; 1.14 IU/gHb for GSHPx; and 0.97 IU/gHb for CAT, (p < 0.05).  Clinical outcomes, such as strengten of pelvic muscle and quality of life of treatment group were significantly better compared to control group (p < 0.05). Conclusions: This means that exercise during pregnancy ages of 20 weeks increase enzymatic antioxidant levels SOD, GSHPx, and CAT higher compare to control group without exercise.
Postoperative Bleeding in CABG Patients: New Study in Southwest of Iran Heidari, Amanollah; Firoozabadi, Mehdi Dehghani; Sheikhi, Mohammad Ali
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: A common complication after Coronary Artery Bypass Grafting (CABG) is postoperative bleeding, which is considered as an important problem. Objective: The aim of this study is to study only patients who have never used drugs above so that it can assess postoperative bleeding in CABG with the absence of high-risk medications related to postoperative bleeding. Method: 50 patients who were candidates for CABG surgery participated in the study. Inclusions criteria included who were candidates for CABG surgery, avoiding the use of blood-clotting drugs before surgery, avoiding the use of immunosuppressant, and the absence of an underlying medical condition such as kidney diseases. Patients with inflammatory, platelet diseases, or any coagulation disorder were excluded. All patients initially tested for hemoglobin, platelets and hemoglobin and INR. In addition to testing for hemoglobin, the amount of bleeding and packed red cell; frozen plasma and platelets were recorded. Results: Fifty patients who were candidates for elective surgery, including 33 men (66%) and 17 women (34%) were enrolled in this study. The mean patient age was 8.70+57.9years old. Test showed that mean hemoglobin level of patients before surgery was pre- operative of 1.5 + 12.4 g/dL, mean platelet was equal to 54.14 + 250.8 thousand/µL and an average international normalized ratio (INR) was equal to 0.12+1.07. The results after surgery also showed that: The total units of given packed red cell; frozen plasma and platelets were (3.14 + 1.90; 2.34 + 2.36 and 0.06 + 0.42). Also, postoperative hemoglobin was 1.30 + 10.30 g/dL, which significantly decreased compared to pre-operative hemoglobin. Bleeding in patients was observed with an average of 537.5 + 973 mL. Of course, the amount of bleeding in any patient was not caused further surgery, Conclusion: that the use of some drugs surgery can be a good way to reduce the risk of bleeding after surgery or on-use of some drugs can reduce the risk of bleeding after surgery with a minimum of morbidity and mortality. It is suggested that other researchers after designing clinical trials and using lower doses for effective drugs such as Clopidogrel and compared to control groups, or different doses of the N-acetylcysteine drug be reported more documentation to improve the bleeding after surgery.
ORODISPERSIBLE TABLET: A Patient Friendly Dosage Form (a Review) K., Rameesa C.; K., Drisya M.
BALI MEDICAL JOURNAL Vol 4 No 1 (2015)
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Abstract

Background: The most common and preferred route of drug administration is through the oral route. Orodispersible tablets are gaining importance among novel oral drug delivery system as they have improved patient compliance and have some additional advantages compared to other formulation. They are also solid unit dosage forms, which disintegrate in the mouth within a minute in the presence of saliva due to superdisintegrants in the formulation. Thus this type of drug delivery helps a proper per oral administration in pediatric and geriatric population where swallowing is a matter of trouble. Various scientists have prepared orodispersible tablets by following various methods. However, the most common method is the direct compression method. Other special methods are Freeze Drying,Tablet Molding, Sublimation, Spray Drying, Mass extrusion, Phase transition process, etc. Since these tablets dissolve directly in the mouth, so, their taste is also an important factor. Various approaches have been taken in order to mask the bitter taste of the drug. A number of scientists have explored several drugs in this field. Like all other solid dosage forms, they are also evaluated in the field of hardness, friability, wetting time, moisture uptake, disintegration test and dissolution test.
ROLE OF ENVIRONMENTAL ALLERGENS ON ATOPIC DERMATITIS Wardhana, M.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
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Abstract

Background: Atopic dermatitis (AD) is a chronic eczematous skin disease that develops in a patient with atopic diathesis, which is characterized by an increased liability to produce IgE antibodies for allergens mostly derived from environmental or inhalant allergens and food allergens. They are produced by cell-mediated allergic contact reactions, and recently contact sensitivity to various environmental allergens has been demonstrated in patients with AD. Atopic patients are recognized by their ability to produce large amounts of specific IgE antibodies to common substances as environmental allergens, i.e. house dust mites, grass pollens, animal danders, molds, food, etc. These antibodies can be detected by skin prick test. The aim of this study was to identify the sensitization against environmental or inhalants allergens through skin prick tests in the patients with atopic dermatitis. Material and Methods: This is a retrospective, descriptive study. We revised all medical records of patients with AD since January 2002 to December 2004 in the Out Patients Unit of Sanglah General Hospital, Bali-Indonesia. The variables studied were: gender, age, work related, diagnosis associates to AD, and prick test of environmental allergens. Results: In 3 years periods we had revised 46 of patients with AD that was done skin prick tests. The median age was 38 years (range 29-54 years), 34/46 (73.9 %) of these were male and 12 (26.1 %) female. Twenty nine patients presented pure AD, and 17 patients had AD with asthma and allergic rhinitis. Only 16 (34.7%) of patients had no history of allergic disease. Thirsty six of 46 (78.20%) of all tested AD patients had a positive skin prick tests against inhalant (aeroallergens) 16 patients and food allergens 21 patients. Sixteen patients with positive of skin test include; dust mite in 12 patients, animal dander in 10 patients, grass pollen in 9 patients and cockroach in 6 patients. Conclusion: We concluded that Environmental work related particularly dust-mite were significant that contributed to symptoms exacerbation and positive skin prick test. The skin prick tests are important methods to determine inhalant allergens in work related that exacerbation of AD patients.
Correlation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia Wiryana, Made; Sinardja, I Ketut; Senapathi, Tjokorda Gde Agung; Widnyana, I Made Gede; Panji, Putu Agus Surya; Aryabiantara, I Wayan; Cindryani, Marilaeta
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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Abstract

Background: A cell injury from surgical stress in a trauma or a non-trauma case will induce a hyper metabolic response in which the protein degradation increases, the somatic protein synthesis decreases and the amino acid catabolism increases. Thus, the pyper metabolic response contributes to nitrogen loss in urine. This response, without an adequate nutrition, will lead an iatrogenic malnutrition and deterioration. A balance nitrogen formula through urinary urea nitrogen is one of many nutrition evaluation methods. This method aids in evaluating the daily nutrition status and it can be the baseline data for daily intake. Objective: To find a correlation between the protein intake and the nitrogen balance of the surgical patients in anesthesiology and intensive care installation, Sanglah General Hospital, Denpasar, Bali. Methods: Fifty-one surgical patients with trauma and non-trauma cases were observed for their protein intake for 2-3 days continuously. Moreover, they were evaluated for their nitrogen balance based on the urinary urea nitrogen per 24 hours for 2-3 days. For statistical analysis, we utilized Shapiro-Francia, Shapiro-Wilk, Spearman Frank correlation, two-sample t test, and multivariate regression analysis in Strata SE 12.1. Results: The correlation between the protein intake and the nitrogen balance on the first day was ra=0.50 (p<0.05), on the second day ra=0.70 (p<0,05), and on the third day ra=0.740 (p<0,05) Conclusions: There is a correlation between the protein intake and the nitrogen balance of surgical patients in Anesthesiology and Intensive Care Installation Sanglah General Hospital Denpasar.
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
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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.
REVIEW OF NASA FIBROMYXOMA: Aggressive Behaviour? (Case Report) Indharty, Rr. Suzy
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
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Abstract

Background: Myxomas are rare benign tumors arising from mesenchymal tissues throughout the body. These tumors are usually seen in the atrium of the heart and the jawbone. Involvement of the skull base with intracranial extension is extremely rare, and only a few cases of primary intracranial myxomas have been described in the literature. This article presents a rare case of primary myxoma of the nasal bone. Methods: The patient underwent a skull base surgery with a pre-diagnosis of possible fibromyxomas. The tumor pathology revealed a diagnosis of myxoma with bone and meningeal involvement. Despite the debulking surgery, the tumor showed a local recurrence in five month. A second debulking surgery in piece meal was required. In the article, the etiology, histological and radiological findings as well as treatment options of this rare entity were briefly discussed under the highlights of the relevant literature. Such a localization and intracranial extension of myxomas is extremely unusual in clinical practice; the diagnosis therefore requires a high degree of suspicion and detailed histopathological examination. The differential diagnosis frequently includes chondrosarcomas, chordoma, metastatic tumors of the skull, hemangiopericytoma, meningioma and other neoplasms of the dura and skull base in this location.
Association of P16 Expression with Clinicopathological Features of Oral Cavity Squamous Cell Carcinoma Patients in Bali Ampur, O. Y.; Sudarsa, I Wayan; Suryawisesa, Ida Bagus
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Abstract

Background: Oral cavity cancer is considered as a major health problem worldwide and has been associated with high recurrence rate and poor prognosis. Oral cavity squamous cell carcinoma (OCSCC) in Sanglah General Hospital Denpasar contributed to 71.7% of all head and neck cancer from 2002-2011 with an increasing trend annually. Advances in our understanding of OCSCC have not improved the outcome in OCSCC management significantly. Therefore, many studies have focused on the roles of biomolecular markers in OCSCC. One of biomolecular marker that has been the focus of many OCSCC studies is p16. Method: This was an analytic cross sectional study with 31 samples to determine the association of p16 expression with age group, tumor location, stage, and grade in OCSCC. Data was analyzed descriptively and the association between variables were evaluated with Chi-Square or Fisher’s Exact Test with a p value

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