(Available online: 1 August 2016)
Vol 5, No 2 (2016): (Available online: 1 August 2016)
Laskar Pradnyan Kloping Purwati Purwati Mouli Edward
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Correlation between Nerve Growth Factor (NGF) with Brain Derived Neurotropic Factor (BDNF) in Ischemic Stroke Patient
Joko Widodo Andi Asadul Andi Wijaya Gatot Lawrence
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Cinnamon Extract Effect on Osteoblast Activity in Diabetic Wistar Rats
Fahrin Ramadan Andiwijaya Fundhy Sinar Ikrar Prihatanto Hermawan Susanto
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Relative Humidity of 40% Inhibiting the Increase of Pulse Rate, Body Temperature, and Blood Lactic Acid During Exercise
Nengah Sandi Alex Pangkahila Putu Gede Adiatmika
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High Ki-67 and Vascular Endothelial Growth Factor (VEGF) Protein Expression as Negative Predictive Factor for Combined Neoadjuvant Chemotherapy in Young Age Stage III Breast Cancer
I Wayan Sudarsa Ida Bagus Tjakra Wibawa Manuaba Sri Maliawan I Wayan Putu Sutirtayasa
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Cosmetic Outcome of Tubularized Incised Plate Depends on The Type of Hypospadias: A Case Control Study
Gede Wirya Kusuma Duarsa Teguh Dwi Nugroho Tjokorda Gede Bagus Mahadewa Anak Agung Gde Oka Ketut Putu Yasa Ida Bagus Made Suryawisesa
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Anti-Inflammatory Effect of Red Piper Crocatum Leaves Extract Decrease TNF-α and IL-6 Levels in Wistar Rat with Atherosclerosis
Sri Wahjuni I.W. Wita I N. Mantik Astawa
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The accuracy of histopathologic examination compared with polymerase chain reaction to diagnose human papillomavirus infection in the uterine cervix
I G.A.S. Mahendra Dewi
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Correlation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia
Made Wiryana I Ketut Sinardja Tjokorda Gde Agung Senapathi I Made Gede Widnyana Putu Agus Surya Panji I Wayan Aryabiantara Marilaeta Cindryani
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Antihypertensive and Antioxidant Potential of Purple Sweet Potato Tuber Dry Extract in Hypertensive Rats
I Made Jawi I W Putu Sutirta Yasa Agung Nova Mahendra
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Administration of Leptin Increases the Level of Follicle Stimulating Hormone (FSH) and Development of Ovarian Follicles in Postpartum Anestrus of Bali Cattle
Indira Laksmi Tjok G.O. Pemayun I Made Damriyasa N.S. Dharmawan
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Betel Leaf Extract (Piper betle L.) Antihyperuricemia Effect Decreases Oxidative Stress by Reducing the Level of MDA and Increase Blood SOD Levels of Hyperuricemia Wistar Rats (Rattus norvegicus)
I Made Sumarya Nyoman Adiputra Putra Manuaba Dewa Sukrama
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Relation between Fiber Diet and Appendicitis Incidence in Children at H. Adam Malik Central Hospital, Medan, North Sumatra-Indonesia
Boyke Damanik Erjan Fikri Iqbal Pahlevi Nasution
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Fetal Sex Determination Using Cell-Free Fetal Dna (cffDNA) in Maternal Blood
I Nyoman Hariyasa Sanjaya Tjok Gde Agung Suwardewa I G Kamasan N. Arijana
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Unripe Papaya (Carica papaya L.) Seed Hexane Fraction Extract Inhibits Male Mice (Mus musculus) Spermatogenesis Stronger Than Unripe Papaya Seed Methanolic Extract
Bagus Komang Satriyasa
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The Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste
Valente Da Silva Suryadi Tigeh Nyoman Wirawan Made Bakta
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Association of Epidermal Growth Factor Receptor (EGFR) with Tumor Location and Clinicopathological Aspect in Head and Neck Squamous Cell Carcinoma
I Nyoman Diwiya Abdi Nuratna Ida Bagus Made Surya Wisesa
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Lactate Clearance: Predictor for Mortality and Therapeutic Response on Severe Sepsis Patient
Edwin Saleh Siregar Andriana Purnama Reno Rudiman
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Hospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian teaching hospital
Ali Janati Jafar Sadegh Tabrizi Firooz Toofan Khadijeh Nadim Algalandis Reza Ebrahimoghli
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Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia
I Gusti Ayu Trisna Windiani Soetjiningsih Soetjiningsih I Gusti Agung Sugitha Adnyana Kadek Apik Lestari
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Older Age and Worse Nutritional State Were Related with Impaired Inflammatory Response in Elderly Patients
R.A. Tuty Kuswardhani Gede Sukrawan Ketut Suastika
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Dietary Iron Intake and Serum Interleukin-6 Levels of Obese Children With and Without Iron Deficiency
Lanang Sidiartha I Made Bakta I Made Wiryana I Wayan Putu Sutirtayasa Damayanti R. Sjarif
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The Correlation of Nurses' job Burnout and Their Social Responsibility Considering the Role of Control Locus
Reyhane Izedi Mohammad Amin Bahrami
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Caspase-3 Expression Correlation with Cell Differentiation Grade, Stage, and Residual Tumor Size in Epithelial Ovarian Cancer
I Nyoman Gede Budiana
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SpO2/FiO2 Ratio as an Oxygenation Parameter in Pediatric Acute Respiratory Distress Syndrome
Dinna Auliawati Ida Bagus Gede Suparyatha Dyah Kanya Wati I Nyoman Budi Hartawan Ida Bagus Subanada
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Pheno-genotypic profile of Vibrio cholerae hemolysin (hlyA) isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia
I Dewa Made Sukrama Rian Ka Praja Ni Nengah Dwi Fatmawati
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Intra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient
Terawan Agus Putranto Irawan Yusuf Bachtiar Murtala Andi Wijaya
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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Novel Markers for Diagnosis of Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis
Mohammad Amin Bahrami Abdollah Ansari Kefayat Chaman-Ara Elham Bahrami Sima Bahrami Mohammad Nabi Bahrami Omid Barati Mahmood Moosazadeh Rauf O˘ guzhan Kum
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Safety Procedure for Biosafety and Controlling a Communicable Disease: Streptococcus Suis
Deasy Ayuningtyas Tandio Amertha Putra Manuaba
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Evaluation and Prioritization of Service Quality Dimensions Using Dematel and Topsis (A Case Study in Iran)
Khatere Khanjankhani Sima Rafiei Mohammad Ranjbar Ezzatabadi Roohollah Askari Fatemeh Abooee Milad Shafii
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High Level of Soluble FMS-Like Tyrosine Kinase-1 (sFlt-1) Serum in Pregnancy as a Risk Factor of Preeclampsia
I Gede Mega Putra I Gede Putu Surya A.A Sagung Istri Mas Pratiwi
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Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014
Ryan Saktika Mulyana Anak Agung Ngurah Jaya Kusuma I Nyoman Hariyasa Sanjaya Endang Sri Widiyanti
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Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang
Iriana Maharani Rus Suheryanto Endang Retnoningsih
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The Characteristics of Cervical Cancer Patients Who Underwent a Radical Hysterectomy at Sanglah Hospital Denpasar in 2015
I Nyoman Bayu Mahendra
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Treatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum
I Wayan Megadhana
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Brain Metastasis as Initial Manifestation of Melanoma (A Case Report)
Vitorino Modesto Santos Renata Faria Silva Viviane Vieira Passini Mayza Lemes Duarte Leandro Pretto Flores
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Management of Spinal Tuberculosis (TB) in Developing Country
Tjokorda GB Mahadewa
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Gallbladder Ascariasis: A Successful Conservative Treatment in a Rarely Found Case
Suma Wirawan Bayu Indratama
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Asymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection
Ni Putu Veny Kartika Yantie Eka Gunawijaya I Wayan Suradipa I Wayan Gustawan
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In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient "
Moh Hasan Machfoed Fritz Sumantri Usman Jimmy Barus Budi Riyanto Wreksoatmodjo Dede Gunawan Andi Kurnia Bintang Dodik Tugasworo Gatot Subroto Rusdi Lamsudin Harsono Harsono Riza Sulthan
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The Healing Effect of Cuttlefish Bone on Fractured Bone in Rat Model
Laskar Pradnyan Kloping, Purwati Purwati, Mouli EdwardThe Healing Effect of Cuttlefish Bone on Fractured Bone in Rat Model
Background: Fractured bone healing requires three to nine months, which prolongs the patients’ morbidity. Long bone fracture is considered to be difficult due to the dependence of bodily mobility and freedom. Bone tissue engineering materials includes hydroxyapatite (HAp), titanium, alumina, and polymers. HAp is found to be heavily abundant in cuttlefish. This study is conducted to prove that the cuttlebone has an effect of accelerating the fractured long bone healing process. Methods: This is an experimental study using a total of 32 samples of Rattus norwegicus. The Treatment Group received the cuttlebone extract + 0.9% NaCl while the Control Group received only NaCL 0.9%. Both groups were fractured beforehand. On the 14th day the fractured area was harvested and assigned for histopathology and radiographic exam. Results: The Treatment Group was found to have thicker callus formation and more osteoblasts. Conclusions: The cuttlebone extract application caused thicker callus and higher osteoblast production, proving an accelerated fractured bone healing process.
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Correlation between Nerve Growth Factor (NGF) with Brain Derived Neurotropic Factor (BDNF) in Ischemic Stroke Patient
Joko Widodo, Andi Asadul, Andi Wijaya, Gatot LawrenceCorrelation between Nerve Growth Factor (NGF) with Brain Derived Neurotropic Factor (BDNF) in Ischemic Stroke Patient
Background: The neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) is a family of polypeptides that play critical role during neuronal development, appear to mediate protective role on neurorepair in ischemic stroke. Naturally in adult brain neurorepair process consist of: angiogenesis, neurogenesis, and neuronal plasticity, it can also be stimulated by endogenous neurorepair. In this study we observed correlation between NGF and BDNF ischemic stroke patient’s onset: 7-30 and over 30 days. Methods: This is cross sectional study on 46 subjects aged 38 – 74 years old with ischemic stroke from The Indonesian Central Hospital of Army Gatot Subroto Jakarta. Diagnosis of ischemic stroke was made using clinical examination and magnetic resonance imaging (MRI) by neurologist. Subjects were divided into 2 groups based on stroke onset: 7 – 30 days (Group A: 19 subjects) and > 30 days (Group B: 27 Subjects). Serum NGF levels were measured with ELISA method and BDNF levels were measured using multiplex method with Luminex Magpix. Results: Levels of NGF and BDNF were significantly different between onset group A and B (NGF p= 0.022, and BDNF p=0.008), with mean levels NGF in group A higher than group B, indicating that BDNF levels is lower in group A than group B. There was no significant correlation between NGF and BDNF levels in all groups. Conclusion: The variations in neurotrophic factor levels reflect an endogenous attempt at neuroprotection against biochemical and molecular changes after ischemic stroke. NGF represents an early marker of brain injury while BDNF recovery is most prominent during the first 14 days after onsite but continuous for more than 30 days. There is no significant correlation between NGF and BDNF in each group.
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Cinnamon Extract Effect on Osteoblast Activity in Diabetic Wistar Rats
Fahrin Ramadan Andiwijaya, Fundhy Sinar Ikrar Prihatanto, Hermawan SusantoCinnamon Extract Effect on Osteoblast Activity in Diabetic Wistar Rats
Background: Diabetes is clinically known to cause prolongation to bone fracture healing. This research aims to find the effect of cinnamon in the process of bone remodeling, and changes in the activity of osteoblast cells in diabetic bone after giving cinnamon as a supplement in diabetic rats. Method: The design employed was experimental with randomized post-test group design research. A total of 24 Wistar Rats was randomly divided into four groups, which consist of normal without treatment, normal with treatment, diabetic without treatment and diabetic with treatment. Treatment of 300 mg/kg cinnamon extract was given per-orally. Upon euthanizing the samples, femur samples were taken and processed to histopathological slides. All slides were analyzed under light microscopes to find the osteoblast cells. The Kruskal-Wallis method was used to test the results; due to the population of sample was not normally distributed. Results: The osteoblast cells found were scored in mean ranks. The normal group mean rank 12.25, normal with treatment group 12.17, diabetic without treatment group 8.58, and diabetic with treatment group 17.00. Asymptotic significance was 0.195. Conclusion: This research concludes that there is no significant increase in osteoblast activity in diabetic Wistar rats after the administration of 300 mg/kg cinnamon extract.
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Relative Humidity of 40% Inhibiting the Increase of Pulse Rate, Body Temperature, and Blood Lactic Acid During Exercise
Nengah Sandi, Alex Pangkahila, Putu Gede AdiatmikaRelative Humidity of 40% Inhibiting the Increase of Pulse Rate, Body Temperature, and Blood Lactic Acid During Exercise
Background: Excessive sweating of the body is a reaction to decrease the heat caused by prolonged exercise at high relative humidity (RH). This situation may cause an increase in pulse rate (PR), body temperature (BT), and blood lactic acid (BLA) workout. Objective: This study aimed to prove that a RH of 40% better than a RH of 50% and 60% RH in inhibiting the increase of PR, BT, and BLA during exercise. Methods: The study was conducted on 54 samples randomly selected from the IKIP PGRI Bali students. The samples were divided into three groups, and each group was given cycling exercise with a load of 80 Watt for 2 x 30 minutes with rest between sets for five minutes. Group-1 of cycling at 40% of RH, Group-2 at a RH of 50%, and the Group-3 at a RH of 60%. Data PR, BT, and BLA taken before and during exercise. The mean difference between groups before and during exercise were analyzed by One-way Anova and a further test used Least Significant Difference (LSD). Significance used was α = 0.05. Results: The mean of PR during exercise was significantly different between groups with p = 0.045, the mean of BT during exercises was significantly different between groups with p = 0.006, and the mean of BLA during exercises was significantly different between groups with p = 0.005 (p <0.05). Also found that PR, BT, and BLA during exercise at 40% RH was lower than 50% RH and 60% RH (p <0.05). Conclusion: Thus, the RH of 40% was better than RH of 50% and 60 % in inhibiting the increase of PR, BT, and BLA during exercise. Therefore, when practiced in a closed room is expected at 40% relative humidity.
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High Ki-67 and Vascular Endothelial Growth Factor (VEGF) Protein Expression as Negative Predictive Factor for Combined Neoadjuvant Chemotherapy in Young Age Stage III Breast Cancer
I Wayan Sudarsa, Ida Bagus Tjakra Wibawa Manuaba, Sri Maliawan, I Wayan Putu SutirtayasaHigh Ki-67 and Vascular Endothelial Growth Factor (VEGF) Protein Expression as Negative Predictive Factor for Combined Neoadjuvant Chemotherapy in Young Age Stage III Breast Cancer
Background: Breast cancer was, in general, a heterogeneous disease with diverse biological characteristics, types, subtypes and clinical behavior. Its treatment and management need to be personalized and individualized. Breast cancer in young ages, although rare, is usually a unique and more aggressive cancer associated with poorer prognosis. The combination of young age and advanced stages of breast cancer would make this particular breast cancer harder to treat and cure. Unfortunately, majority of Breast Cancer Patients in Bali were in younger ages, and at advanced stages, that the mainstay of treatment was neo-adjuvant chemotherapy followed by other treatment modalities. Improve prognosis only, those patients who had had a complete pathological response involving primary tumor and regional lymph nodes in the axilla. Several factors had been studied and contributed to breast cancer response to combined neo-adjuvant chemotherapy. Usually, younger patients, was associated with high proliferation rate represented by Ki-67 and early distant metastasis represented by VEGF, which also had role as prognostic markers. The purpose of this study was to determine whether high Ki-67 and VEGF expression correlate with response to NAC and hence, they would be important predictive factors for response to NAC. Method: This study was a cross-sectional and a nested case-control study of stage III breast cancers affecting patients 40 years of age or less, at Sanglah General Hospital and Prima Medika Hospital, conducted from September 1st, 2012 until March 31st, 2014. Clinical and pathology reports were traced and recorded from both hospitals; routine Immunohistochemistry (IHC) examinations were performed by both pathology labs. Statistical analysis was performed using Chi-Square test, Odds Ratio (OR), and logistic regression analysis with p<0.05. Results: There were 66 Stage III young breast cancer patients, where 35 (53%) showed no or negative response and 31 (47%) showed a positive response. Cross-sectional analysis showed that there was a significant correlation between positive Ki-67 protein expression and response to NAC (p<0.05; OR 5.538; 1.856 – 16.524; 95% C.I.) and between positive VEGF protein expression and response to NAC (p<0.05; OR. 3.455; 1.251-9.539; 95% C.I.). In Case-Control study, bivariate analysis from 62 samples had shown that higher Ki-67 expression in the study group compared to control group (p=0.004; OR. 4.747; 1.575-14.312; 95% C.I.). Bivariate analysis also showed that VEGF expression was also higher in the study group compared to control group (p=0.042; OR.2.879; 1.026-8.074; 95% CI.). Multivariate analysis had shown that an adjusted OR. 4.747 (1.575-14.312; 95% C.I.; p=0.006) for Ki-67, and an adjusted OR. 2.553 (0.860-7.582; 95% C.I.; p=0.091) for VEGF. Conclusion: We concluded that high Ki-67 and VEGF protein expression was associated with less response to combined neo-adjuvant chemotherapy/NAC and that high Ki-67 protein expression was an independent risk factor for poorer response to NAC in Stage III young age breast cancer. The possible role of high VEGF expression as a risk factor for less responsive breast cancer in younger patients had to be considered.
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Cosmetic Outcome of Tubularized Incised Plate Depends on The Type of Hypospadias: A Case Control Study
Gede Wirya Kusuma Duarsa, Teguh Dwi Nugroho, Tjokorda Gede Bagus Mahadewa, Anak Agung Gde Oka, Ketut Putu Yasa, Ida Bagus Made SuryawisesaCosmetic Outcome of Tubularized Incised Plate Depends on The Type of Hypospadias: A Case Control Study
Background: Recent studies show Tubularized Incised Plate (TIP) urethroplasty, commonly used for distal hypospadias repair, can be used in proximal hypospadias with a decent success rate. It was contented that the age of the patient when undertook the surgery influences the outcome, with young age gaining more favourable outcome than the older. One the objectives of hypospadias repair is the cosmetic outcome, which can be evaluated using Hypospadias Objective Penile Evaluation (HOPE) questionnaires. Our objective is to compare the proportion of the young and the older patients based on the cosmetic surgical outcome. Methods: In Sanglah General Hospital, Denpasar, 38 patients who had undergone a TIP urethroplasty from January 2012 until December 2015 were evaluated using HOPE questionnaires. Results: The sample are divided into two equally-numbered groups based on the HOPE total score. The median of the age of the subjects when they undergone the surgery is 4.8 years (1.89-18.10). The proportion of the over 5 year old in the cosmetically unsatisfying group (case) is the same as the proportion in the cosmetically satisfying group (control), 52.63%, EOR=1 (p>0.05). The proportion based on the year of surgery are different, but not statistically significant (p>0.05). Based on the type of hypospadias, the proportion of subjects with proximal hypospadias in the case group is more than in the control group, EOR=14.95 (p<0.05). It shows proximal hypospadias is a risk factor for cosmetically unsatisfying result post TIP urethroplasty. Conclusions: It should be taken into account that TIP in proximal hypospadias has a greater risk to produce an unsatisfying cosmetical result.
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Anti-Inflammatory Effect of Red Piper Crocatum Leaves Extract Decrease TNF-α and IL-6 Levels in Wistar Rat with Atherosclerosis
Sri Wahjuni, I.W. Wita, I N. Mantik AstawaAnti-Inflammatory Effect of Red Piper Crocatum Leaves Extract Decrease TNF-α and IL-6 Levels in Wistar Rat with Atherosclerosis
Background: This research aims to find a cure for anti-inflammation, based on the utilization of red piper crocatum. The research was started with descriptive study to explore active components of red piper crocatum leaf and followed by experimental study to investigate red piper crocatum activity of the leaf extract in anti-inflammation induced Wistar rat. In this research observed three dominant components: caryophyllene bicyclo [5.2.0] none,2 methylene-4,8,8-trimethyl-4-vinyl; phytol; 5,9-propano-5H-benzocycloheptene,6,7,8,9-tetrahydro-7,11-bis(methylene); 4,4-ethynedioxy-2-hexadecen-15-15 olide 1,4,9-trioxaspiro [4,15] eic os-6-en-8-one, 10 methyl; 1H-1,2,4-triazole-5(H)-thione,4-allyl-3-(3-furyl); Benzofuran,2,3-dihydro-2-methyl-7-phenyl which are possibly active to inhibit anti-inflammation to atherosclerosis. Bad eating habits also can cause various health problems, such as obesity, dyslipidemia, inflammation to atherosclerosis. This study was conducted to investigate of red piper crocatum leaves extract as an anti-inflammation through decrease of biochemistry markers TNF-α and IL-6 levels. Method: This is a true experimental with randomized pre-test and post-test control group design, using 50 Wistar rats that are divided into 5 groups: control group using 0 mg/kg BW red piper crocatum leaves extract, treatment group 1 using 50 mg/kg BW red piper crocatum leaves extract, treatment group 2 using 100 mg/kg BW red piper crocatum leaves extract, treatment group 3 using 150 mg/kg BW red piper crocatum leaves extract, and treatment group 4 200mg/kg BW red piper crocatum leaves extract. Results: It was observed that intake of 150 mg/BW red piper crocatum leaves extract results in the highest significance decrease of 45.63% of TNF-α levels from (28.62 ± 1.25 to 15.56 ± 7.20 рg/mL) and a significance decrease of 15.42% of IL-6 level from (134.64 ± 1.98 to 113.87 ± 4.30 рg/mL). Conclusion: It can be concluded that intake of red piper crocatum leaves extract acts as anti-inflammation for Wistar rats with atherosclerosis through decrease of TNF-α and IL-6 levels. Further research is required to determine whether the application of red piper crocatum leaves extract on human will result in similar effects of anti-inflammation.
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The accuracy of histopathologic examination compared with polymerase chain reaction to diagnose human papillomavirus infection in the uterine cervix
I G.A.S. Mahendra DewiThe accuracy of histopathologic examination compared with polymerase chain reaction to diagnose human papillomavirus infection in the uterine cervix
Introduction: In Indonesia and other developing countries cancer is still a health problem besides infectious disease. Cervical cancer is the second most common after breast cancer. Early detection of high risk Human Papillomavirus (HPV) infection as the causative agent is very important, so that cervical lesions do not develop into precancerous lesions and cancer. Polymerase Chain Reaction (PCR) at this time is still not yet possible be used as a screening program in the wider community because the cost is quite expensive. An easier, cheaper and simpler method of examination is needed to detect earlier infection, but still has accuracy close to gold standard. This study aims to determine the accuracy of histopathologic examination compared with PCR to diagnose HPV infection in the uterine cervix.
Methods: This is a cross-sectional diagnostic test, with predictor variable is conventional histopathology examination and outcome variable is PCR examination. The samples in this study were tissue biopsy or surgery of patients with clinically diagnosed have cervical lesion. A 2x2 table was created to calculate the sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).
Result: A total of 39 samples were observed in this study. The sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were 72.73%, 58.82%, 69.57% and 62.50%, respectively.
Conclusion: This study found the accuracy of histopathologic examination compared with PCR to diagnose HPV infection in the uterine cervix is more than 50%.
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Correlation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia
Made Wiryana, I Ketut Sinardja, Tjokorda Gde Agung Senapathi, I Made Gede Widnyana, Putu Agus Surya Panji, I Wayan Aryabiantara, Marilaeta CindryaniCorrelation Between Protein Intake and Nitrogen Balance of Surgical Patients in Anesthesiology and Intensive Care Installation, Sanglah General Hospital, Denpasar, Bali, Indonesia
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.
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Antihypertensive and Antioxidant Potential of Purple Sweet Potato Tuber Dry Extract in Hypertensive Rats
I Made Jawi, I W Putu Sutirta Yasa, Agung Nova MahendraAntihypertensive and Antioxidant Potential of Purple Sweet Potato Tuber Dry Extract in Hypertensive Rats
Background: Purple sweet potato tuber extract in liquid form has been shown to lower blood pressure of hypertensive rats and hypertensive patients. Liquid dosage form increasingly unstable when stored for long periods, thus it is necessary to find a more stable dosage form. The objective of this research was to prove that dry extract of purple sweet potato tuber has the same effects with liquid extract in hypertensive rats. The is a randomized pre-test and post-test control group design study. Thirty hypertensive model rats were divided into 5 groups (6 animals for each group). Group 1 was treated as a control group. Group 2 to group 5 were treated as treatment groups. Treatment groups were given liquid extract at a dose of 3 ml, dry extract with the dose of 200 mg, dry extract that stored in a certain time with a dose of 200 mg and given a mixture of dry extract with a carrier substance (capsule formula) with a dose of 200 mg, respectively, for 4 weeks. Variables observed were blood pressure, SOD and MDA level of the blood. The results showed that the group given the purple sweet potato tuber extract lowers blood pressure were significantly in liquid extract or dry extract (p <0.01). The group that was treated with capsule formula showed more decrease in blood pressure than dry extract group (p <0.01). The similar results happened on MDA and SOD level in blood. Thus, it can be concluded that dried extract of purple sweet potato tubers has the same effectiveness with liquid extract, both as an antihypertensive and also antioxidant. Capsules formula is more effective than liquid extract and dry extract.
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Administration of Leptin Increases the Level of Follicle Stimulating Hormone (FSH) and Development of Ovarian Follicles in Postpartum Anestrus of Bali Cattle
Indira Laksmi, Tjok G.O. Pemayun, I Made Damriyasa, N.S. DharmawanAdministration of Leptin Increases the Level of Follicle Stimulating Hormone (FSH) and Development of Ovarian Follicles in Postpartum Anestrus of Bali Cattle
Background: Leptin is a metabolic signal that plays a role in reproduction through the hypothalamic-pituitary - ovary axis. The aim of this study is to determine the effect of leptin on the levels of FSH and development of ovarian follicles of post-partum anestrus in Bali cattle. Postpartum anestrus in Bali cattle were divided into three groups of nine; group 1 (control) was injected with physiological saline, group 2 (treatment I) and group 3 (treatment II) were injected with recombinant o-leptin 100 µg and 200 µg/head respectively. Injection was done twice with an interval of 12 hours. Blood sample was collected via the jugular vein at intervals of 12 hours before the start of treatment until the appearance signs of estrus. Follicle diameter performance was measured using ultrasonography before treatment and during the appearance of estrus. The results showed the average levels of FSH before treatment for group 1, group 2, and group 3 were 11.3 + 0.36 mIU/ml, 11.6 + 0.40 mIU/ml, and 11.4 + 0.28 mIU/ml respectively. While at the end of the research, the levels of FSH were 11:02 + 0.39 mIU/ml, 13.0 + 0.48 mIU/ml, and 13.47 + 1.05 mIU/ml respectively. Ovarian follicle diameter for group 1, group 2, and group 3 before treatment were 5.10 + 0.41 mm, 5.21 + 0.36 mm, and 5.00 + 0.37 mm respectively. Whereas at the end of the research, the ovarian follicle diameters were 4.92 + 0.40 mm, 8.37 + 0.43 mm, and 8.45 + 0.38 mm respectively. In conclusion, administration of o-leptin in postpartum anestrus of Bali cattle increases the level of FSH and ovarian follicle development.
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Betel Leaf Extract (Piper betle L.) Antihyperuricemia Effect Decreases Oxidative Stress by Reducing the Level of MDA and Increase Blood SOD Levels of Hyperuricemia Wistar Rats (Rattus norvegicus)
I Made Sumarya, Nyoman Adiputra, Putra Manuaba, Dewa SukramaBetel Leaf Extract (Piper betle L.) Antihyperuricemia Effect Decreases Oxidative Stress by Reducing the Level of MDA and Increase Blood SOD Levels of Hyperuricemia Wistar Rats (Rattus norvegicus)
Background: Betel leaf extracts (Piper betle L.) antioxidant activity and enzyme inhibitors of XO. Hyperuricemia cause oxidative stress by increasing the formation of reactive oxygen species (ROS) cause lipid peroxidation and oxygenation of low-density lipoprotein cholesterol (LDLc). Objective: The aim of this research was to determine the betel leaf extract as an anti hyperuricemia that can lower the blood uric acid levels and oxidative stress by lowering the levels of MDA and increase the SOD of hyperuricemia of the rat’s blood. Method: Experimental research was conducted with the design of The Randomized Post Test Only Control Group Design, on normal Wistar rats (Rattus norvegicus), administered with oxonic potassium (hyperuricemia) and the hyperuricemia rats either given betel leaf extract and allopurinol. After the experiment of uric acid levels, MDA and SOD in rat blood determined. Results: The results showed that the betel leaf extract significantly (p <0.05) lower uric acid levels, MDA and increase levels of SOD in rat blood. There is a positive correlation between the levels of uric acid with MDA levels and a negative correlation, although not significantly with SOD (p >0.05). Conclusion: It can be concluded that the betel leaf extract as an anti-hyperuricemia can lower the uric acid levels and decreases oxidative stress by lowering the levels of MDA and increasing the SOD.
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Relation between Fiber Diet and Appendicitis Incidence in Children at H. Adam Malik Central Hospital, Medan, North Sumatra-Indonesia
Boyke Damanik, Erjan Fikri, Iqbal Pahlevi NasutionRelation between Fiber Diet and Appendicitis Incidence in Children at H. Adam Malik Central Hospital, Medan, North Sumatra-Indonesia
Background: Appendicitis is the most occurred acute abdominal case found in children.1 In United States of America alone, there were 250,000 cases annually. The ratio between boys and girls are 3:2, with most cases caused by late diagnosis and the morbidity factor. Previous studies found that there’s a relation between eating patterns, fiber diet and food hygiene as risk factors for appendicitis.1, 2 At the time this paper is written, there hasn’t been any study that explains the relation between appendicitis and the diet pattern of children from various places in Indonesia. Another condition that further motivates this study is a common conception that children hate to consume vegetables and fruits, which contain the much-needed fiber. Obstruction of the appendix lumen is the main cause of inflammation in the appendix. Fecalith makes up one third of appendicitis cases, which is consists of fats (coprosterols), inorganic salts (calcium phosphate), and organic residual (fibers).3 Other causes including obstruction process by hypertrophy of mural lymphoid follicle as a response from the inflammation of the appendix lumen.3 Obstruction of appendix lumen can be caused by low fiber diet, which causes fecalith to build up in appendix lumen.4 The mechanism of lumen appendix inflammation can be caused by lymphoid hyperplasia, fecalith buildup, foreign object or parasite.4 Therefore, a study needs to be done to determine the mortality prediction easier, more efficient, and not static, in which it’s harder to measure the therapeutic response. In this case, lactate clearance is hoped to have the capability to determine the mortality rate in patients with severe sepsis. Method: This research is an analytic with cross-sectional design. The subjects were 35 child patients with appendicitis in RSHAM which fulfilled the criteria of severe sepsis diagnosis, and were receiving treatment in the period of January-December 2014. Results: Male children are the majority of the patients (62.9%) with average age of 11.89 ± 4.16. Laparotomy is the most administered treatment (54.3%), and most of the subjects have low-fiber diet (54.3%). 19 of the subjects have perforated appendicitis (54.3%). Conclusion: There’s a significant correlation between low-fiber diet with appendicitis incidence (p=0.0001). From the 19 patients with low-fiber diet, 14 of them (73.7%) have acute appendicitis. Meanwhile only 2 of the patients (12.5%) with high-fiber diet have acute appendicitis.
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Fetal Sex Determination Using Cell-Free Fetal Dna (cffDNA) in Maternal Blood
I Nyoman Hariyasa Sanjaya, Tjok Gde Agung Suwardewa, I G Kamasan N. ArijanaFetal Sex Determination Using Cell-Free Fetal Dna (cffDNA) in Maternal Blood
Background: Prenatal test has routinely performed in antenatal care and has become a part of the obstetric care feature in many countries. Prenatal test is divided into screening and diagnostic test. Recently, the early noninvasive method in order to found and lessen the risk factors of pregnancy loss, has been studied. One of the methods is molecular test using cffDNA which has many screening purpose such as sex determination, aneuploidy, paternal inherited genetic disorder, fetus rhesus, and performed early at 7 weeks of pregnancy. Objective: The purpose of this study is to measure diagnostic value of cffDNA in determining fetal sex prenatally. Methods: In a diagnostic test study, 18 randomized samples were selected and divided based on fetal gender confirmed at birth. The group consisted of 9 pregnant women with male babies and 9 pregnant women with female babies. CffDNA then isolated from maternal blood sample and specific region in Y chromosome termed SRY is detected by PCR and electrophoresis. The data obtained analyzed both descriptively for baseline characteristic and analytically to determine its diagnostic value. Results: This study found significant correlation between SRY detection in cffDNA with male fetal phenotype (p<0.05). The sensitivity of the method is 100% with 89% specificity. In addition, we found 9.09 values for positive likelihood ratio (LR+) and 0 for negative likelihood ratio (LR-). Moreover, the result yielded 100% positive predictive value (PPV+) and 88.8% of negative predictive value (PPV-). Conclusion: This study proofed that cffDNA have a great diagnostic value to determine fetal sex prenatally. However, further study with several group of gestational age mother and better matching is required to further confirm the diagnostic potential of cffDNA
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Unripe Papaya (Carica papaya L.) Seed Hexane Fraction Extract Inhibits Male Mice (Mus musculus) Spermatogenesis Stronger Than Unripe Papaya Seed Methanolic Extract
Bagus Komang SatriyasaUnripe Papaya (Carica papaya L.) Seed Hexane Fraction Extract Inhibits Male Mice (Mus musculus) Spermatogenesis Stronger Than Unripe Papaya Seed Methanolic Extract
Background: Men and women have the same rights and obligations in family planning program. Practically, participation in family planning program is still predominated by women while participation of men is still low. Low participation of men in family planning program is due to very limited choices in male contraceptive method. In recent years, studies have been refocused on investigating traditional plants as antifertility herbal medicine for men. Studies on antifertility effects of unripe papaya seeds have been done. However, similar studies on hexane fraction extract have not yet been done. In this study, unripe seeds were collected from local Balinese papaya (Carica papaya) fruits. Objective: This study was aimed to assess the effect of unripe papaya seeds hexane fraction extract on spermatogenesis and the testosterone level of male mice. Hexane fraction extract of unripe papaya seeds contains glycosides and triterpenoids, which is assumed to have an antifertility property, so it can be used as a male contraceptive, although the mechanism of action remains to be elucidated. Method: This study used pre-test and post-test control group design, using 30 male mice of balb C strain, 12 weeks of age, weighing 20-22 gram, which were randomly grouped into 3 groups, each consisting of 10 male mice. One control group (P0 = control group) was given double-distilled water, and two treatment groups were given hexane fraction extract of unripe Carica papaya seeds 20 mg/20gram/day, and methanolic extract of unripe Carica papaya seeds 20 mg/20 gram/day (P1 and P2, respectively). After 36 days of treatment, evaluation of the testes and blood of the male mice was conducted. Results: Data were analysed by normality test of Kolmogorov-Smirnov Goodness of Fit, homogeneity test, and Anova test. This study showed that spermatogonia A, primary pachytene spermatocytes, spermatid and Sertoli cells were decreased significantly (p < 0,05) but Leydig cells and testosterone levels were not decreased significantly (p > 0,05). Conclusion: It can be concluded that hexane fraction extract of unripe Carica papaya seeds can decrease the mean number of spermatogonia A cells, spermatocyte of primary pachytene spermatocytes, spermatid and Sertoli cells better than methanolic extract of unripe Carica papaya seeds.
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The Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste
Valente Da Silva, Suryadi Tigeh, Nyoman Wirawan, Made BaktaThe Relationship Between Education, Job, and Family Income with TB Medication Dropouts in Timor-Leste
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.
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Association of Epidermal Growth Factor Receptor (EGFR) with Tumor Location and Clinicopathological Aspect in Head and Neck Squamous Cell Carcinoma
I Nyoman Diwiya Abdi Nuratna, Ida Bagus Made Surya WisesaAssociation of Epidermal Growth Factor Receptor (EGFR) with Tumor Location and Clinicopathological Aspect in Head and Neck Squamous Cell Carcinoma
Backgroud: Head and neck squamous cell carcinoma (HNSCC) is the most common type of head and neck cancer. Most patients came with advanced disease which results in suboptimal treatment. EGFR is one of prognostic factors that play important role in HNSCC pathogenesis and progression. Unraveling the expression profile of EGFR in anterior and posterior HNSCC and its comparison would provide physician with better information regarding EGFR based treatment or its prognostic value. Methods: An observational cross sectional analytic study was conducted to compare EGFR expression between anterior and posterior HNSCC. The association between EGFR expressions with clinicopathological aspects (tumor stadium and histological grade) of HNSCC which analyzed separately. Baseline characteristic and each variables was first analyzed descriptively. Comparative analysis was conducted using Chi-Square and Fisher exact test with p value less than 0.05 was considered significant. Result: 48 samples were used in this study. Most of the subjects were elderly (b3.2%), men (72.9%) and came with advanced disease (Clinical Stadium III-IV) (83.3%). Most of the subjects were EGFR (+) (93%). In anterior region group, low expression of EGFR was found in 6 patients (25%) and high expression in 18 patients (75%). Meanwhile in posterior region group we found low expression in 10 patients (41.7%) and 14 patients with high expression of EGFR (58.3%). We found no association between EFGR and HNSCC location (anterior or posterior) (p=0.221). Insignificant association also reported between EGFR expression with clinical stage of anterior (p=0.625) and posterior (p=0.283) HNSCC as well as histopathological grade of both location (p=0.33 for anterior group and p=0.371 for posterior group). Conclusion: We concluded that EGFR was diffusely expressed in HNSCC but there was no association between EGFR expression and clinicopathological characteristics and location of HNSCC.
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Lactate Clearance: Predictor for Mortality and Therapeutic Response on Severe Sepsis Patient
Edwin Saleh Siregar, Andriana Purnama, Reno RudimanLactate Clearance: Predictor for Mortality and Therapeutic Response on Severe Sepsis Patient
Background: Severe sepsis and septic shock are at high mortality rate. This high mortality persists as important aspect in the term of patient treatment which take account in determining aggressiveness of relevant therapy. Lactate level consideration was considered important among patient under shock, septicemia, post-operative, acute lung injury, and critical condition. Lactate concentration in static blood was widely studied and suggested as prognostic value among severe sepsis and septic shock patient due to the nature of lactate as the result of anaerobic metabolism. Several study documented the use of lactate as prognostic indicator for shock condition. The increase of lactate concentration could be useful as the indicator of inadequate oxygen delivery and the existence of anaerobic metabolism. Lactate clearance investigation is more superior therapeutic target compared with others oxygen derivate variables. Methods: This research is a cohort observational study involving secondary data which was collected from laboratory examination results of study subjects. The research held from August 2015 to December 2015 in Digestive Division, Surgery Department, Hasan Sadikin Hospital. 42 patient involved in this study. Results: Comparative test results revealed significant lactate clearance based on mortality in LCH (6) (p = 0.000) and H (24) (p =0.000) as well. The level of LC H (6) and H (24) seemed lower in died patient compared with life patient. Conclusion: This study concluded that lactate clearance in died patient was lower in comparison with life patient.
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Hospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian teaching hospital
Ali Janati, Jafar Sadegh Tabrizi, Firooz Toofan, Khadijeh Nadim Algalandis, Reza EbrahimoghliHospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian teaching hospital
Background: program evaluation is an integral and expected component in the development of any healthcare program. It helps decision-makers to base their decisions on facts. Objective: This paper analyzes the effect of accreditation on three indicators related to patient safety and hospital care quality in ICU wards of an Iranian teaching hospital. Methods: This interventional study was accomplished based on executive management and scientific methods such as plan-do-check-act (PDCA) cycle and audit to improve quality and safety. We used data reported from ICU wards of the hospital to analyze the effect of accreditation on the three selected indicators. (SPSS) version 22.00 was used for the statistical analysis. Results: In total, 6997 patients were analyzed. The accreditation interventions appeared to be effective at reducing pressure ulcer incidence average (from an average of 6.8 percent to 4.1 percent) (p=0.045). The accreditation also. The average stay of the patients during the study also positively changed from an average of 1.58 days to 10.13 days (1.45 improvements)(p=0.0303). In relation to hospital acquired infection but, unexpectedly, its effect on hospital was negative, then it considerably increased and rose from 1.5 percent to 8.1 percent (p=0.001). However this increasing was due to enhanced infection incident report system. Conclusion: hospital accreditation has presented ample opportunity a significant positive effect on hospitals.
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Indonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia
I Gusti Ayu Trisna Windiani, Soetjiningsih Soetjiningsih, I Gusti Agung Sugitha Adnyana, Kadek Apik LestariIndonesian Modified Checklist for Autism in Toddler, Revised with Follow-Up (M-CHAT-R/F) for Autism Screening in Children at Sanglah General Hospital, Bali-Indonesia
Background: Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired reciprocal social interaction and communication, and by a restricted, repetitive or stereotyped behavior. Early detection of autism is recommended on all toddlers from the ages of 9 months because of increasing in prevalence. The Modified Checklist for Autism (M-CHAT) in Toddlers, a Revised with Follow-Up (M-CHAT-R/F) is a 2-stage parent-report screening tool to assess a risk for ASD and it demonstrates an improvement compared to the original M-CHAT. It is translated to Indonesian language by Soetjiningsih and colleagues, and it needs to be validated. Methods: This is a diagnostic accuracy study conducted at Sanglah Hospital, Bali, conducted from March 2015 to December 2016. We included children 18-48 months in this study. The parents of the outpatient children in the growth and development clinic of Sanglah Hospital were asked to fill out the Indonesian M-CHAT-R/F form. In the same visit, the Autism Spectrum Disorder (ASD) assessment according to the DSM-5 as a gold standard was done by the researchers, without knowing the M-CHAT-R/F result. The assessment comparison based on M-CHAT-R/F and DSM-5 was analyzed to obtain the AUC intersection on ROC curve that gives the best sensitivity and specificity. Results: We found 10.71% of our outpatient was diagnosed with autism according to DSM 5, when they are 18-24 months old. The Indonesian version of M-CHAT-R/F as an ASD screening tool has 88.9% in sensitivity and 94.6% in specificity. Conclusion: Our results suggest that the Indonesian translation of the M-CHAT-R/F is an effective screening instrument for ASD, particularly when a two-step screening process is used.
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Older Age and Worse Nutritional State Were Related with Impaired Inflammatory Response in Elderly Patients
R.A. Tuty Kuswardhani, Gede Sukrawan, Ketut SuastikaOlder Age and Worse Nutritional State Were Related with Impaired Inflammatory Response in Elderly Patients
Background: Ageing process is related with multisystem disorders. One of them is immune response impairment. It is imperative to evaluate the association between age and related nutritional status with inflammatory response in elderly patient. Methods: A cross sectional study to evaluate inflammatory response among elderly patients (≥60 years) at Geriatric Out-patient Clinic, Sanglah Hospital was conducted. Seventy-two patients were enrolled in the study. Age, nutritional states (body mass index and mini nutritional assessment), and inflammatory markers (interleukin-2 [IL-2] and C-reactive protein [CRP]) and other anthropometric as well as laboratory parameters were measured in the study. Results: In the study it was revealed that age has a moderately negative correlation with both of plasma IL-2 and serum CRP levels (R= -0.305, p=0.009; and R= -0.413, p=0.005, respectively). Plasma IL-2 levels were positively correlated with several variables like body mass index (R=0.282, p=0.016), mini nutritional assessment (R=0.237, p=0.045), biceps skin fold (R=0.291, p=0.013), and triceps skin fold (R=0.258, p=0.028). While serum CRP levels has positive correlation with lying diastolic blood pressure (R=0.345, p=0.020) and negative correlation with calf circumference (R=-0.312, p=0.037). No significant associations were found between diabetes and hypertension with inflammatory markers. Conclusion: This study concluded that older age and worse nutritional state were related to worse inflammatory response in the elderly patients.
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Dietary Iron Intake and Serum Interleukin-6 Levels of Obese Children With and Without Iron Deficiency
Lanang Sidiartha, I Made Bakta, I Made Wiryana, I Wayan Putu Sutirtayasa, Damayanti R. SjarifDietary Iron Intake and Serum Interleukin-6 Levels of Obese Children With and Without Iron Deficiency
Background: Iron deficiency is more common in obese children. Low dietary iron intake and inflammation are suspected as the cause. This study investigates the dietary iron intake and serum IL-6 levels relationship with the obese children iron status. Methods: Seventy obese children were recruited. Dietary iron intake was calculated using three days’ food record. Serum IL-6 was measured using sandwich ELISA. Iron deficiency was confirmed if iron serum <60 mcg/dl and/or saturation of transferrin <20%. Independent t-test was used to analyze the mean difference of the dietary iron intake between the with and without iron deficiency groups, α=0.05. And, Mann-Whitney for the median difference of the serum IL-6 between the two groups. Results: Forty-six subjects (65.7%) had iron deficiency. Dietary iron intake of the with and without iron deficiency groups were 6.8 mg (SD 3.3) and 6.6 mg (SD 3.8), respectively (p>0.05). The interleukin-6 was 2.7 pg/ml (0.3-16.8) and 1.7 pg/ml (0.8-4.9), respectively (p<0.05). Conclusion: Iron deficiency in obese children was high. It was not associated with low dietary iron intake, but associated with inflammation.
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The Correlation of Nurses' job Burnout and Their Social Responsibility Considering the Role of Control Locus
Reyhane Izedi, Mohammad Amin BahramiThe Correlation of Nurses' job Burnout and Their Social Responsibility Considering the Role of Control Locus
Background: Job burnout is an occupational hazard that reduces physical and mental energy of the staff. This study was aimed to investigate the relationship between the nurses' job burnout and their social responsibility considering the moderating role of control locus. Methods: In an analytical and cross-sectional study we used 3 valid questionnaires including Maslach burnout inventory, Dynson social responsibility and Rotter locus of control in 3 educational hospitals of Yazd, Iran. A total of 246 nurses contributed in the study. Data analysis was done through SPSS19. We used Pearson and Kendall correlation coefficient in data analysis. Findings: The mean scores of job burnout and social responsibility of studied group were 60.75 +8.37 and 71.84+15.47, respectively. Job burnout is negatively correlated with social responsibility statistically (r= -0.250) while locus of control acts as the moderator of this correlation. Conclusion: Our results suggest that creating a supportive work environment for nurses enhances their social responsibility trough affecting their level of job burnout. Also, the approved moderating role of control locus in the relationship of job burnout and social responsibility indicates that the personality traits can be considered as the appropriate criteria for entry to nursing schools.
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Caspase-3 Expression Correlation with Cell Differentiation Grade, Stage, and Residual Tumor Size in Epithelial Ovarian Cancer
I Nyoman Gede BudianaCaspase-3 Expression Correlation with Cell Differentiation Grade, Stage, and Residual Tumor Size in Epithelial Ovarian Cancer
Objective: Ovarian cancer has a high incidence and a high mortality rate, and often found in terminal stage. In ovarian malignancy, one of the important proteins presents in the apoptosis process is Caspase-3. Caspase-3 has an important role in modifying the cell morphologic and several biochemistry condition of the apoptosis process. Our study aims to analyze the correlation between Caspase-3 expression and the cell differentiation grade, the stage of the disease, and the residual tumor size after primary surgery in epithelial ovarian cancer. Method: We conducted a cross-sectional study. The sample was recruited in Dr. Soetomo Hospital Surabaya. They were ovarian cancer patients with complete medical records, which ovarian tumor specimens were deparaffinized in the pathology anatomy laboratory, Faculty of Medicine, Airlangga University, Surabaya, Indonesia. Patients who received a chemotherapy or a radiotherapy before the surgery, or whose paraffin wax embedded tissue was damaged were excluded. The Caspase-3 expression was examined immunohistochemically. The correlation among the variables were analysed using the Spearman and Phi correlation test. Results: From 42 patients, Caspase-3 expression was positive in the 47.6%, while the 52.4% was negative. It was found that most samples with a good grade of cell differentiation showed a positive Caspase-3 expression (r=-0.215, p<0.05). Moreover, in most samples with the early stage of the disease had a positive Caspase-3 expression (φ=-0.583, p<0.05). In addition, most samples with residual tumor less than 1 cm in diameter, also showed a positive Caspase-3 expression (φ=-0.336, p=0.029). Conclusion: A statistically significant negative correlation was present between Caspase-3 expression and the cell differentiation grade, the stage of the disease, and the residual tumor after the primary surgery.
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SpO2/FiO2 Ratio as an Oxygenation Parameter in Pediatric Acute Respiratory Distress Syndrome
Dinna Auliawati, Ida Bagus Gede Suparyatha, Dyah Kanya Wati, I Nyoman Budi Hartawan, Ida Bagus SubanadaSpO2/FiO2 Ratio as an Oxygenation Parameter in Pediatric Acute Respiratory Distress Syndrome
Background: Acute respiratory distress syndrome (ARDS) diagnosis requires an invasive arterial blood sampling to reveal the PaO2and calculate the PaO2/FiO2 ratio. SpO2/FiO2 ratio has been proposed as a non-invasive alternative to identify oxygenation parameter in pediatric patients with ARDS. Objective: To evaluate sensitivity and specificity of SpO2/FiO2 as an oxygenation parameter to detect ARDS. Methods: We conducted a cross-sectional at the Pediatric Emergency and Intensive Care Department, Sanglah General Hospital, Denpasar, Bali. The inclusion criteria were 1 month to 12 years old patient admitted to our PICU and diagnosed with mild or moderate to severe ARDS based on blood gas analysis which fulfilled Berlin definition (ESICM 2012). The exlusion criteria were patient with a chronic lung disease and or a cyanotic heart disease. We collected SpO2/FiO2 ratio and calculated its sensitivity and specificity in detecting ARDS. Results: There were 124 patients enrolled. The most common diagnosis was diseases in respiratory system (62.1%). Based on ROC analysis to determine SpO2/FiO2 ratio needed to detect moderate to severe ARDS, the AUC was 0.76 (95%CI 0.677-0.843) and the cut-off point for SpO2/FiO2 ratio was <196. The sensitivity was 88.5% (95%CI 77.8-95.3) and specificity 44.4% (95%CI 31.9-57.5). Conclusion: SpO2/FiO2 ratio can be used as an oxygenation parameter in ARDS patients.
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Pheno-genotypic profile of Vibrio cholerae hemolysin (hlyA) isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia
I Dewa Made Sukrama, Rian Ka Praja, Ni Nengah Dwi FatmawatiPheno-genotypic profile of Vibrio cholerae hemolysin (hlyA) isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia
Vibrio cholerae is a bacteria that causes foodborne disease that has several virulence factors in causing the disease. This study aims to find out the phenotypic and genotypic profiles of hemolysin (hlyA) V. cholerae isolated from shrimp and shellfish at Kedonganan Fish Market, Bali. The research begins by rejuvenating the stock culture of V. cholerae on TCBS medium. Hemolysis test was performed on medium blood agar (BA) with 5% sheep blood addition, hemolysis profile in BA was then confirmed using Polymerase Chain Reaction (PCR) test. The results showed that 4 out of 9 isolates (44%) were positive producing hemolysins characterized by a hemolytic zone around bacterial colonies grown in BA, whereas based on PCR results obtained 5 of 9 isolates (55%) positive carrying the hlyA gene. A mismatch of hemolysin profile was found in one isolate of UPK12, this isolate did not menghemolisis red blood cells but was detected molecularly carrying hlyA gene. It can be concluded that V. cholerae isolated from Kedonganan Fish Market is phenotypically and genotypically detected carrying hlyA and has potential in causing disease.
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Intra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient
Terawan Agus Putranto, Irawan Yusuf, Bachtiar Murtala, Andi WijayaIntra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient
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. Objectives: To find possible improvement of Manual Muscle Test (MMT) Score after administration of Intra Arterial Heparin Flushing in chronic ischemic stroke patient. Methods: 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 MMT-MRC scoring system on chronic stroke patient with IAHF procedure (mean MMT-MRC Score = 6,05 point. With p<0,05). Indicating that IAHF procedure is associated with better muscle strength improvement shown with higher MMT-MRC score on stroke patient, which will have better prognostic outcome in their recovery. Conclusions: Intra Arterial Heparin Flushing have significant effect on chronic stroke patient with decreased muscle strength, which shows a significant increase of MMT-MRC score.
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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Novel Markers for Diagnosis of Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis
Mohammad Amin Bahrami, Abdollah Ansari, Kefayat Chaman-Ara, Elham Bahrami, Sima Bahrami, Mohammad Nabi Bahrami, Omid Barati, Mahmood Moosazadeh, Rauf O˘ guzhan KumNeutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Novel Markers for Diagnosis of Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-analysis
Background: Sudden sensorineural hearing loss (SSNHL) is a common otologic disease characterized by a loss of hearing greater than 30 dB in three consecutive frequencies which occurs in less than 72 hours. Objective: To investigate the role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) on sudden sensorineural hearing loss (SSNHL). Search strategy: A PubMed, Science Direct, Scopus, OVID, EMBASE and Google Scholar search (date last searched April 2016) without any time, language and location restriction was done. Inclusion criteria: All case-control studies, which have been investigated the relationship of NLR and PLR with the occurrence of SSNHL were included in our meta-analysis. Results: A total of 5 case-control studies were included in the study. All 5 studies have been reported NLR of patients and control groups (611 patients and 804 controls). Our analysis showed that the mean NLR of patients is 1.12 (0.82-1.43) unit higher than that of controls with 95% CI which is statistically significant. Also, 3 studies have been reported PLR of patients and control groups (512 patients and 705 controls). Our analysis showed that the mean PLR of patients is 0.57 (0.08-1.05) unit higher than that of controls with 95% CI which is statistically significant too. Conclusions: This meta-analysis confirmed the relationship of NLR and PLR with SSNHL. Therefore, these parameters can be considered as new markers in diagnosis of SSNHL.
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Safety Procedure for Biosafety and Controlling a Communicable Disease: Streptococcus Suis
Deasy Ayuningtyas Tandio, Amertha Putra ManuabaSafety Procedure for Biosafety and Controlling a Communicable Disease: Streptococcus Suis
Background: Streptococcus suis infection is a zoonotic disease which cause fatal outbreak. Infection case is related to animal handling and dry season. Health workers on Timor island need to understand more about biosafety procedure and increase awareness of the disease as a potential causes of meningitis. Objective: To provide a simple yet comprehensive reading material for the health workers that is exposed to meningitis. Method: This is a descriptive explorative study, to search about Streptococcus suis in the James Cook University OneSearch library search engine and biosafety procedure in WHO and CDC database. The information in accessed articles were compiled into a review piece. Conclusion: The biggest risk factor for a Streptococcus suis outbreak is inappropriate pig carcass handling. The cocci infect via micro-lesion on the handler skin. Public awareness about an appropriate way to handle meat needed to be raised. Suspected case need to be referred to the nearest centre with an ability to conduct a PCR test. It is essential that people, especially health workers understand that the principles of biosafety cover the basics of the containment system, including the practice, and the correct laboratory techniques, safety equipment, laboratory facilities to protect workers, the environment, and the public from exposure to infectious microorganisms.
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Evaluation and Prioritization of Service Quality Dimensions Using Dematel and Topsis (A Case Study in Iran)
Khatere Khanjankhani, Sima Rafiei, Mohammad Ranjbar Ezzatabadi, Roohollah Askari, Fatemeh Abooee, Milad ShafiiEvaluation and Prioritization of Service Quality Dimensions Using Dematel and Topsis (A Case Study in Iran)
Background: Hospital services quality plays an increasingly important role in today’s competitive environment. This study aimed to evaluate causal effects of different healthcare quality aspects on quality of services perceived by patients in hospitals affiliated by Shahid Sadoughi University of Medical Sciences using DEMATEL and TOPSIS techniques in 2014. Method: Through literature review and expert opinions, different service quality dimensions in under study hospitals were identified and required data were gathered. In the next step, DEMATEL technique was applied to determine cause and effect relationships between identified quality aspects and quality perceived by service recipients. Also to rank dimensions according to their priorities, TOPSIS method was used. Given the literature review, six quality dimensions including responsiveness, assurance, security, tangibility, communication and patient centeredness were identified. Result: Results obtained from DEMATEL technique introduced patient security as an influential aspect which was ranked in the sixth place in terms of importance. Conclusion: The prioritization of quality dimensions along with their causal effects provides a beneficial insight for hospital managers to effectively plan and make improvement decisions. It is suggested that considering a remarkable impact of security on patients’ perception toward quality of care, this aspect should be regarded in decision makers’ programs with a greater emphasis.
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High Level of Soluble FMS-Like Tyrosine Kinase-1 (sFlt-1) Serum in Pregnancy as a Risk Factor of Preeclampsia
I Gede Mega Putra, I Gede Putu Surya, A.A Sagung Istri Mas PratiwiHigh Level of Soluble FMS-Like Tyrosine Kinase-1 (sFlt-1) Serum in Pregnancy as a Risk Factor of Preeclampsia
Background: Recently, etiology and pathogenesis of preeclampsia remain unknown. One of the theory indicating that hypoxia and ischemic placenta caused by abnormal cytotrophoblast invasion in preeclampsia. Soluble Fms-like tyrosine kinase-1 (sFlt-1) serum as a laboratory marker of hypoxia condition that contributes to the occurrence of endothelial damage and clinical manifestations in preeclampsia. Objective: This study was aimed at proving that high level of soluble Fms-like tyrosine kinase-1 (sFlt-1) serum in pregnancy as a risk factor for preeclampsia. Methods: This study was a case control. Among 58 pregnant women studied, 29 women with preeclampsia as a case group and 29 women with normal pregnancy as a control group. Soluble Fms-like tyrosine kinase-1 (sFlt-1) serum was analyzed in the Prodia Laboratory. Collected data were tested for normality using Kolmogorov-Smirnov, then analyzed with independent sample test. Chi-Square test used to determine soluble Fms-like tyrosine kinase-1 (sFlt-1) serum level in preeclampsia. Results: This research concluded that the average level of soluble Fms-like tyrosine kinase-1 (sFlt-1) serum in preeclampsia were 11231.00 ± 8390.3 pg/mL and 3981.62 ± 4921.5 pg/mL in normal pregnancy. Analysis of significance with independent t-test concluded that the value of t = 4.01 and p = 0.001. This mean the average levels of soluble Fms-like tyrosine kinase-1 (sFlt-1)serum levels in both groups were difference significantly (p <0.05). Based on the cut-off point of sFlt-1 serum levels was 4505.50 pg/mL with 79.3% sensitivity and 82.8% specificity, the relative risk of preeclampsia was 18 times (OR = 18.40, IK 95% = 4.93 to 68.70, p = 0.001). Conclusion: Based on this research, high levels of soluble Fms-like tyrosine kinase-1 (sFlt-1) in pregnancy was proved as a risk factor for preeclampsia.
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Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014
Ryan Saktika Mulyana, Anak Agung Ngurah Jaya Kusuma, I Nyoman Hariyasa Sanjaya, Endang Sri WidiyantiCharacteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014
Background: Pregnant women with a high-risk pregnancy are women with increased risk in pregnancy or childbirth. There is no readily available data available about the characteristics of the high-risk pregnancy in Bali. Objective: Our study aimed to provide a data, to be the base of Sanglah General Hospital resource planning to reduce maternal mortality and morbidity. Method: This was an observational study using medical records of high risk pregnancy patients at Sanglah General Hospital from 2011 to 2014. Inclusion criteria were the patients with complete medical record and exclusion criteria are patient whose medical report incomplete. There was no missing data in this study.Result Over the 4 year study period at Sanglah, there were 1027 high-risk deliveries in 2011, 1590 in 2012, 1590 in 2013, and 948 in 2014. In the 4 years, there were 748 with age ≥ 35 years. The majority were in the age group of 26-30 years. As many as 2932 were multiparous. Overall, 3082 were multigravida and only 197 were grandemultipara. There were 1406 preterm (<37 week). By onset and mode of delivery, 2027 (41.50%) had a caesarean section, There were 9 (0.18%) Breech deliveries and Neonatal outcomes were recorded, showing that 296 (6.29%) had moderate asphyxia and 2189 (4.63%) had severe asphyxia. The multiple pregnancy was 197 (3.82%) twin pregnancies and 5 (0.1%) cases of triplets. The largest group of obstetrics complications in Sanglah hospital was premature rupture of membrane 1652 cases (30.99%). The most common medical disorder of pregnant women at our hospital was anemia, 353 cases (45.43%). The most prevalent congenital anomalies were multiple congenital abnormalities, as many as 18 infants (20.22%).
Conclusion: There were a significant number of high-risk pregnancies delivered at Sanglah, with nearly 46.85% being high risk deliveries. Characteristics of these high risk pregnancies can be used to plan appropriate care to reduce the maternal mortality rate.Full Article (HTML) | download PDF
Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang
Iriana Maharani, Rus Suheryanto, Endang RetnoningsihAirborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang
Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5. Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %). From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway.
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The Characteristics of Cervical Cancer Patients Who Underwent a Radical Hysterectomy at Sanglah Hospital Denpasar in 2015
I Nyoman Bayu MahendraThe Characteristics of Cervical Cancer Patients Who Underwent a Radical Hysterectomy at Sanglah Hospital Denpasar in 2015
Background: Cervical cancer is the most common gynecologic cancer in women. It is the main cause of cancer-related death in women in developing countries. Cervical cancer in Indonesia is the second most cancer affecting Indonesian women and the prevalence is relatively stable in the last 30 years. Cervical cancer was closely related to the histologic type of itself. A squamous cell carcinoma has a specific route of local spreading and a lymphatic route. The sample of this study are cervical cancer patients who underwent a radical hysterectomy from January 1 to December 31, 2015 in Sanglah Hospital Denpasar, Bali. The aim of this study is to discover the characteristics of the patients by age, parity, education level, marital status, sexual activity, the first symptoms and the early screening done, and the clinical staging. Methods: This descriptive study involved 20 patients in Sanglah Hospital Denpasar who had a radical hysterectomy from January 1 until December 31, 2015. The characteristics are gathered from the patients’ medical record. Results: The most cases done radical hysterectomy between 41-45 years old which proportion was 40%, the most parity was parity 2 (60%), elementary school was the most education level (35%), all of the samples only married once and sexually active, the most first symptom was vaginal bleeding (55%), only 10% had pap smear as early detection, and the most clinical stage was stage IIB (50%).
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Treatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum
I Wayan MegadhanaTreatment of a Recurrent Vaginal Obstruction With a Modified Mold After an Excision of a Transverse Vaginal Septum
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.
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Brain Metastasis as Initial Manifestation of Melanoma (A Case Report)
Vitorino Modesto Santos, Renata Faria Silva, Viviane Vieira Passini, Mayza Lemes Duarte, Leandro Pretto FloresBrain Metastasis as Initial Manifestation of Melanoma (A Case Report)
Background: Melanoma is a malignancy derived from the neural crest, constituted of melanocytes found in the basal layer of epidermis, with the main function of melanin production. Case: A 64-year-old woman was admitted with headache and dyslalia and reported some episodes of vertigo and falls in the last six months. A superficial red and dark skin discoloration in the scalp and a node in the right parotid gland were observed. Computed tomography of the brain showed nodular lesions in the left parietal and right temporal and occipital lobes with hemorrhagic features, in addition to mass effect. Furthermore, PET-CT images were suggestive of brain, lung, and adrenal metastasis. The patient evolved with intracranial hypertension and a neurosurgery was performed. Histopathological and immunohistochemistry studies revealed metastatic melanoma. Conclusions: She underwent schedules of radiation therapy and chemotherapy, but developed uncontrolled sepsis and died in spite of clinical management and intensive care support. Cutaneous primary site of this malignancy in the scalp was previously neglected; therefore, neurological disturbances were the initial manifestations of melanoma. Immunohistochemistry findings allowed ruling out the main differential hypotheses.
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Management of Spinal Tuberculosis (TB) in Developing Country
Tjokorda GB MahadewaManagement of Spinal Tuberculosis (TB) in Developing Country
Background: Tuberculosis on the spine is involved approximately 1 % of all tuberculosis cases. It is a lethal type of TB skeletal due to highly neurologic compromised because of adjacent medullary compression and incidence kyphotic deformity. Early diagnosis and management of this disease is mandatory to prevent serious complications. Method: Serial case report was conducted in Sanglah General Hospital from January 2014 until December 2015. All patients were diagnosed based on local protocol using appropriate imaging technique. All patients were treated by anti-tuberculosis drugs for 2 weeks followed by functional assessment by MMT, ASIA, and JOA. Result: The author reported 10 patients of spinal TB whom were treated in Sanglah Hospital, Bali between January 2014-Desember 2015. Among pts 8 male and 2 female with location of spinal TB i.e 4 in thoracal, 4 in lumbal and 2 in cervicothoracal. Preoperative ASIA scale was an average scale C and postoperative ASIA scale was in D. The average JOA pre-surgical score was 10.5 and postsurgical was 14.5. Improvement using the formula JOA achieved with an average of 21.6 %. All patients neurologically improved, no complications and surgical implant failures in this series. Conclusions: Surgical management of spinal tuberculosis, if delivered with appropriate indication, proved to be effective in correcting spinal kyphosis. Early management is mandatory in order to ensure better prognosis.
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Gallbladder Ascariasis: A Successful Conservative Treatment in a Rarely Found Case
Suma Wirawan, Bayu IndratamaGallbladder Ascariasis: A Successful Conservative Treatment in a Rarely Found Case
Background: Gallbladder ascariasis diagnosis is complicated because it depends on the location of ascaris in the biliary system, causing differences in clinical symptoms. Ascaris invasion into the ampulla of the duodenum causes a biliary colic. Meanwhile, cholangitis symptoms, such as fever, chills, and light jaundice may be present occasionally. The disease may progress into an acute cholangitis, characterized by: very high fever, chills, icterus, and upper abdominal pain. A stool examination will find ascaris eggs. The diagnosis is made by an abdomen ultrasonography (USG) examination, where an ascaris is found in the form of a circular long tubular echogenic structure. The conservative treatment includes hospitalization and anthelmintic drug administration. We report a case of gallbladder ascariasis in a 28-year-old woman with a good recovery after receiving a conservative treatment. Case: A 28-year-old woman visited our Emergency Department with a colic felt in the upper right abdomen, accompanied by nausea and vomiting, general itching, and a 10-day fever. Physical examination was positive for tenderness on the right hypochondrium on palpation. The blood test showed hemoglobin 11.2 g/dL, total white blood count (WBC) 6,200/mm3. An abdomen USG showed a picture of tubular structures engaged in the gallbladder lumen. There was no visible stone, sludge, or a fluid reflected echo in the surrounding. There was a wall dilatation, thickening, and a double (0.45 cm). Conclusions: The patient was diagnosed with gallbladder ascariasis and acute cholecystitis and hospitalized. A broad-spectrum antibiotic, an antispasmodic, and an anthelminthic drug albendazole 400 mg/day were given for 10 days. The abdomen USG on the tenth days showed the gallbladder and the biliary duct lumen were cleared from the nematode, along with the patient physical recovery.
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Asymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection
Ni Putu Veny Kartika Yantie, Eka Gunawijaya, I Wayan Suradipa, I Wayan GustawanAsymptomatic Cardiac Rhythm Abnormality in Children with Dengue Virus Infection
Background: In 2012, the reported number of dengue fever cases in Indonesia were 90.245, with a mortality rate reached 0.88%. Cardiac complications are uncommon in dengue virus infection, but it can be occurring. Myocarditis is the most common cardiac complication reported worldwide. Case: We report 10 cases of dengue virus infections with ECG abnormalities in normal heart structure. Based on ECG test during the covalescent stage, sinus arrhythmias were present in 3 patients, sinus bradycardia in 3 patients, sinus tachycardia without fever in 1 patient, first-degree AV block in 2 patients and mobitz type I second-degree AV block in 1 patient. The ECG abnormalities which were found in all cases did not cause any clinical symptoms, then no medication were needed. Continues clinical monitoring was done in all of our cases, and ECG evaluation showed improvement after several days. Conclusions: Myocarditis following dengue infection was clinically diagnosed in some asymptomatic children and need a ECG evaluation. Continues monitoring needed in patient who develop cardiac rhythm abnormalities and all the patient completely recovery.
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In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient "
Moh Hasan Machfoed, Fritz Sumantri Usman, Jimmy Barus, Budi Riyanto Wreksoatmodjo, Dede Gunawan, Andi Kurnia Bintang, Dodik Tugasworo, Gatot Subroto, Rusdi Lamsudin, Harsono Harsono, Riza SulthanIn connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient "
In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29,
entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient ", herewith, please allow us to do reviews of the study discussion. By assessing the discussion, it can be proved
whether there are references that support the results of study.
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