bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ERGONOMICS PROBLEM IN TROTOIR CONSTRUCTION
Authors: Sutjana I Dewa Putu
Published: December 2022

Trotoir construction has become as one of the priorities of development in every town inBali Province; it is in accordance with the evaluation criteria of successful town development.The functions of trotoir are to provide comfortable and safety path for pedestrians and toprevent the traffic jam. But, unfortunately it has not yet met to the purpose. In relation to theproblem the study had been done to the trotoir condition along the street in Denpasar town. Theresults sowed that in general the trotoir (old and new construction) are not flat, too height, notcontinued, blocked by tree, traffic light pole, or holy building etc. These conditions produceunsafety and uncomfortable for the pedestrians especially to the elderly, handicapped (eye orleg) persons, wheel chair, baby trolley. In some trotoirs the accidents had been happened.Therefore, it is suggested that the trotoir must be constructed flatly, continued, not too height,synchronized with drainage system, street construction, electricity and telephone net work, andtree plantation for the green peace program.
BALINESE AGRICULTURE IN A CHANGING WORLD
Authors: Sutjana I.D.P.
Published: December 2022

Agriculture has been and continues to be one of the economic foundations of Bali and to be a major livelihood for Balinese people. The wide of agricultural area or rice field to be a symbol of community prosperity. It is accepted that in the region which consists of wide of rice fields is considered as a rich region and their inhabitants consequently have a better standard of living, due to having enough food. Because the agricultural sector capable to enhance the community prosperity the people should give effort to own more rice field (build or bought). All of agricultural activities influenced the daily community activity and become community cultural as well as organization, work tool, household tool, value system, plant which are cultivated, ceremony etc. always related to the agriculture. Agricultural technology (machine or method) used by the Balinese farmers still simple and inherited from generation to generation. It seems to be no development or progress resulted in that
IODINE LEVEL OF IODIZED SALT REQUIRED IN ENDEMIC AREA
Authors: Gunung I Komang
Published: December 2022

Iodized salt had been used in many countries for long term iodine deficiency disorders (IDD) control program. Several things should be considered related to iodine loss in iodized salt, e.g. iodine loss during cooking that may effect the effectivity of the program. Too high iodine level on the other hand, will cause health problems such as iodine-induced hyperthyroidism (IIH) and autoimmune thyroiditis. The purpose of this study was to know the level of iodine in iodized salt required in endemic area to meet the iodine recommended daily allowance (RDA) of 150 ?g/person/day. This study was a field trials using treatment by subyect design. Ten schoolchildren were selected systematically to get ten clusters of schoolchildren families. All members of the families were 33 persons (2 families were droped out). Urine examination showed the mean of urine iodine excretion (UIE) 84.8 Â± 32.11 ?g/L and 208.1 Â± 89.24 ?g/L of non-iodized salt and iodized salt consumption respectively. Salt intake was 6.64 g/person/day and iodine loss during cooking was 25%. Iodine level of iodized salt required in mild endemic area was 22 ppm at consumer level or 32 ppm at production level. This result wasÂ slightly higher than the minimum range (30 ppm) and much lower than the maximum range (80 ppm) was the level of iodine in iodized salt that was detemined by the government (30-80 ppm). Based on this finding, the range of iodine level in iodized salt production should be rivised according to the endemicity of area (mild, moderate, and severe).
RISKS FOR PERIPHERAL ARTERIAL DISEASE IN THE ELDERLY WITH TYPE 2 DIABETES MELLITUS : Their Correlation with High Sensitivity C-reactive Protein and Ankle-Brachial Index
Authors: Ayu Tuty Kuswardhani Raden , Wita Wayan , Bakta Made , Santosa Anwar
Published: December 2022

The Indonesian elderly population has been projected to increase up to about four-fold inthree decades (1990-2020). As a consequence of this population trend, the increased prevalence ofdegenerative diseases would be inevitable; this would include the prevalence of peripheral arterialdisease.This study aims to identify the correlation of diverse risk factors, either traditional or nontraditional,with the ankle-brachial index scores, and the correlation of novel non-traditional riskfactor, e.i. high sensitive C-reactive protein with the prevalence of perioheral arterial disease in theelderly, age 60-80 years old, with type 2 diabetes mellitus.Among the 146 elderly patients with type 2 diabetes mellitus, and based on measurement ofthe ABI score, approximately 30.9% of them had PAD. Some traditional and non-traditional riskfactors having a significant correlation with the ankle-brachial index score, were age (r = -0.396, p <0.001 for right ABI; r = -0.509, p < 0.001 for left ABI), supine systolic blood pressure (r= -0.268, p =0.012 for right ABI; r = -0.267, p = 0.013 for left ABI), 2-hour post-prandial blood glucose (r= -0.252, p = 0.018 for right ABI), and hsCRP (r = -0.280, p = 0.011 for right ABI; r = -0.402, p <0.001 for left ABI); whereas other risk factors like obesity based on waist circumference and BMI,non-supine systolic blood pressure, fasting blood glucose, HbA1C, duration of diabetes, plasma lipidsdid not show statistically significant different odd ratios. After linear regression test for risk factorshaving significant correlations with ABI, age and hsCRP were found to influence the ABI scores.Based on a case-control study, risk factors which, to some extent, had statistically significant valuesas risk factors, include older age (? 70 years old; OR = 7.737 [CI = 2.515-23.805]; p < 0.001),relatively high supine diastolic blood pressure (? 90 mmHg; OR = 6.882 [CI = 0.789-60.060]; p =0.048), and high concentration of hsCRP (> 3 mg/L; OR = 4.420 [CI = 1.287-15.181]; p = 0.013).Among these statistically significant risk factors, after logistic regression test analysis, only the age ofthe patient appeared to have significant influence on the prevalence of PAD.In conclusion, this study demonstrates a negative correlation between hsCRP and ABI score;and high levels of hsCRP appeared to be a risk factor for PAD. The age of the patient, however,appeared to be the strongest risk factor for PAD.
INTERVAL RUNNING EXERCISE REDUCES RUNNING TIME OF 800 METERS DASH WITHOUT CAUSING INCREASED LEVEL OF SGOT â€“ SGPT IN MALE STUDENTS OF THE FACULTY OF SPORTS SCIENCES, MANADO STATE UNIVERSITY
Authors: Galatang Alprodit , Alex Pangkahila Jahja , Ngurah Nala I Gusti , Tirtayasa Ketut
Published: December 2022

The effort to gain best achievement in sports by means of exercise has twodilemmatic sides, both for the coaches and sport promoters. On one side, exercise shouldbe done intensely and maximally, but on the other side, it is a known fact that excessiveand maximal exercises can damage the body organs. The purposes of this study were toobserve the side effects of interval running exercise of 800 meters, to find out level offatigue by examining lactate acid produced by each model, and to assess the negativeeffects on organs as indicated by the level of SGOT-SGPT. The exercise model appliedin the study comprised interval running of 2 x 800 meters, 4 x 400 meters, 8 x 200meters, 16 x 100 meters and one standard of comparison exercise, which was runningexercise of 2 x 800 meters with passive rest. This study was true experimental usingrandomized pre-test-post-test control group design. Samples of this study were 27 malestudents of the Faculty of Sports Sciences, Manado State University, who were dividedinto five groups. Group 1 was with interval running exercise of 2 x 800 meters. Group 2was assigned to interval running exercise of 4 x 400 meters. Group 3 was with intervalrunning exercise of 8 x 200 meters. Group 4 was with interval running exercise of 16 x100 meters. Group 5 as comparison standard was with running exercise of 2 x 800 meterspassive rest. All the exercise models were carried out for six weeks, each with afrequency of three times a week. Results of the study showed that the five groupsdemonstrated reduction of running time of 800 meters dash (p<0.05), lactate acidproduction differed in some of the groups (p>0.05), levels of SGOT and SGPT of allgroups did not show significant increase (p>0.05). From the above findings, it can beconcluded that all exercise models of interval running 2 x 800 meters, 4 x 400 meters, 8 x200 meters, 16 x 100 meters and 2 x 800 meters with passive rest lowered the runningtime of 800 meters dash and did not increase level of SGOT-SGPT.
THE HIGH PLASMA RETINOL BINDING PROTEIN 4 LEVEL AS A RISK FACTOR CONSEQUENTLY OF TYPE 2 DIABETES MELLITUS OF ABDOMINAL OBESITY
Authors: Budhitresna AAG , Suastika Ketut , Mantik Astawa Nyoman , Santoso Anwar
Published: December 2022

Abdominal obesity (Ab-Ob) related to cardiometabolic risk, that is riskfactor constellation for succeeded cardiovasculer disease and type 2 DiabetesMellitus (DM). That factors such as atherogenic dislipidemia, hypertension,hyperglycemia, protrombotic state, and proinflammation state. Type 2 DMcharacterised by insulin resistance (IR). Plasma levels of retinol binding protein 4(RBP4) that is secreted by adipocytes are increased in insulin resistance (IR) state.Experiment in mice suggest that elevated RBP4 level cause IR. Although theunderlying mechanism is not clearly understood, RBP4 considered playimportance role consequently of type 2 DM in Ab-Ob.This research was carried out to determine the role of high plasma RBP4level as a risk factor consequently of type 2 DM in Ab-Ob. The research wasconducted by cross sectional analytic in 81 patients with Ab-Ob and case controlstudy with matching on 33 patients with Ab-Ob type 2 DM as cases and 33patients with Ab-Ob non type 2 DM as control. The plasma of TNF-Î± , sTNFR1,and RBP4 levels was measured by ELISA. IR status of the patients wasdetermined by HOMA-IR, whereas the Î²-cell function was determined byHOMA-B. Ab-Ob was defined by using criteria for Asian peoples (male WCÂ â‰¥ 90cm; female WCÂ â‰¥ 80 cm). The result of 81 patients with Ab-Ob showed that bothplasma of TNF-Î± and sTNFR1 levels were significant positive correlated withplasma RBP4 level (coeficient correlation r = 0,294; p = 0,008 dan r = 0,458; p =<0,001 respectively). In addition, the plasma of RBP4 level significantly positivecorrelation with HOMA-IR (r = 0,450; p = 0,000) and significantly negativecorrelation with HOMA-B (r = -0,564; p = <0,001). In the matched case-controlstudy, it was shown that mean plasma of RBP4 level of type 2 DM group (76,08 Â±16,84 Âµg/ml) statistically higher than that without type 2 DM group (41,13 Â±14,75 Âµg/ml) (p = <0,001). The odds ratio higher plasma of RBP4 level was 5,426(CI 95%; 1,343 â€“ 21, 928) statistically significant for increases risk type 2 DM (p= < 0,05). It has been proven that RBP4 was a dominant and consisten risk factor(66.9%, p = < 0.001) which influenced the incidence of type 2 DM in Ab-Ob.Â It can be concluded that high plasma of RBP4 level have a greater risk tosuffered from type 2 DM compared to low plasma of RBP4 in Ab-Ob. The highplasma of RBP4 level is most dominant and consistent risk factor consequently of type 2 DM. These mechanism could behind the association between high plasmaof RBP4 level and type 2 DM.
PHYTOCHEMICAL CONTENT AND ANTIOXIDANT ACTIVITY IN TRADISIONAL BALINESE BABI-GULING SPICES
Authors: Indraguna Pinatih G N , Suryadhi NT , Santosa A. , Muliartha IKG
Published: December 2022

The traditional Balinese richly spiced swine-grill (Babi-guling) has been increasingly popular even among both the domestic and foreign tourists. The traditional grill is very unique in taste as it contains two main components, i.e. the pork and the unique Balinese spices, which probably could work antagonistically one against the other in affecting people health. The pork because of its rich content of saturated fatty acid is a risk of atherosclerosis, while the spices appear to be rich in antioxidatns. This is a preliminary atherosclerosis experimental study designed to screen qualitatively the phytochemical contents of the spices and to test their antioxidant activity and strength in different concentrations in vitro. The methods used included Willstater test, NaOH 10% test, Meyer test, Leiberman-Burchard test, test for saponin, and test for phenol. The antioxidant activity was estimated by using DPPH (2,2-diphenyl-1-pricrylhydrazyl) test. The treatment applied to the spice before testing was raw and cooked by heating it inside the pigâ€™s body cavity. The concentrations of spices tested were 100, 1000 and 8000 ppm. The results of our study revealed that the phytochemical content of the spices were flavonoids, terpenoids and phenolic compounds, but saponin and alkaloids were not detected. The antioxidant activity was ineffective in concentration of 100 ppm (percentage of reduction < 50%), effective in concentration of 1000 ppm (percentage of reduction 50-60%), and too thick in concentration of 8000 ppm (percentage of reduction >100%. We inferred that the traditional Balinese richly spiced swine-grill contains flavanoids, terpenoids and phenol which can act as antioxidants in vitro, and the most effective concentrations to decrease the free radicals were between 1000-8000 ppm.
ORAL INTAKE OF SARDINELLA LONGICEPS OIL THE DECREASE OF TNF-Î± AND IL-6 LEVELS IN ATHEROSCLEROTIC WISTAR RAT
Authors: Wahjuni S. , Sudewa A.A.G. , Wita I Wayan , Astawa I.N. Mantik
Published: December 2022

Lifestyle changes to consumption of variegated instant food may be associated several heath hazards, such as obesity, dyslipidemia, and atheroschlerosis. This study was conducted to investigate the effects of orally administered Sardinella longiceps oil as an anti inflammatory agent on the serum levels of TNF-Î± and IL-6 considered as biomarkers for atherosclerosis. The study design is an true experimental with randomized pretest and posttest control group design, using 50 Wistar rat equaly divided into 5 groups, i.e. placebo control group 0% and 4 treatment groups each treated daily with 10%, 15 %, 20 % and 25 % fish oil respectively for 6 weeks. Before the treatment was started, all rats were orally fed daily with a high cholesterol diet for 13 weeks to induce atherosclerosis. Our study showed that the intake of 20%fish oil had resulted in the significantly greatest decrease of 45,63 % in the TNF-Î± serum levels,from 28.62 Â± 1.25 to 15.56 Â± 7.20 Ñ€g/mL and similar significant decrease 15,42% in of IL-6 serum levels from 134.64 Â± 1.98 to 113.87 Â± 4.30 Ñ€g/mL. The overall results of our study seemed to imply than in the Wistar rats, oral intake of Sardfinella longiceps oils signifacantly decreased serum levels of TNF-Î± and IL-6 probably through their anti-inflamatory effects. Futher research to determin the magnitude of effects sardinella longiceps oils on the serum levels TNF-Î± and IL-6 human.
ERGONOMICS-JOB STRESS INTERVENSION (ERGO-JSI) REDUCES STRESS OF EMPLOYEES AT NATIONAL BANK IN DENPASAR
Authors: Purnawati Susi , Pangkahila Alex , Raka Sudewi Anak Agung , Sutjana D. P.
Published: December 2022

Â Work stress may affect the quality of working life due to decrease of work ability, cognitive ability, and may also lead to risky behavior. The decrease in work stress could be reflected by the decrease in stressor, psychological distress and cortisol levels among employees. An ergonomic job stress intervention (Ergo-JSI) applied in this study has several advantages in regard to participatory ergonomics and individual orientation. The objective of this research is to analyze the decrease in job stress reflected by the decrease in stressor, psychological distress and cortisol levels among the employees of a National Bank in Denpasar, Bali, after the application of Ergo-JSI.This is an experimental study with treatment by subject design which was conducted from January to September 2011. Several dependent variables such as stressor and psychological distress were measured using the Indonesian version of Brief Job Stress Questionnaire (BJSQ), while the blood cortisol was measured using chemiluminescence technique. Totally 25 male employees of the Private National Bank in Denpasar 25 were used as the research subjects. They were randomly selected and their ages averaged 39.After the application of Ergo-JSI, a significant change (p < 0.05), that is, a 6.8% decrease in stressor and a 23.7% fall in cortisol were found. Apart from that, a significant change (p< 0.05), that is, a 28% decrease in psychological distress was also found.It could be concluded that the application of Ergo-JSI reduces job stress among the employees of the National Bank in Denpasar, Bali.
HEADACHE--A SINONASAL SYMPTOM AND MOREâ€¦ A REVIEW ARTICLE
Authors: Kaur A , Singh A
Published: December 2022

Headaches and facial pain are common complaints.Â  In many cases, patients are referred to an otolaryngologist to determine if head pain is sinus related.Â  In the absence of other nasal or sinus symptoms, some rhinogenic headaches can be overlooked or misdiagnosed.Â  A complete history and thorough ENT examination, including nasal endoscopy with or without coronal CT scans is key to the correct diagnosis.1Â Headache resulting from disease of the nose or paranasal sinuses are usually associated with symptoms (congestion, fullness, discharge, obstruction) that point to the site of origin.Â  Occasionally, however nasal or sinus disease can be manifested solely as headache.
Annular pancreas in two cases after diamond-shaped anastomosis duodenoduodenostomy: case reports
Authors: Suismaya Ni Luh Gede Wahyuni , Kardana I Made , Ariyanta Kadek Deddy
Published: December 2022

Background: Annular pancreas is an infrequent congenital disorder characterized as a partial or complete pancreatic tissue around the descending part of the duodenum. Prenatal control is essential in the early detection of the annular pancreas. Initial management might increase better prognosis. We report two cases of the annular pancreas in Sanglah General Hospital, Denpasar, Bali in 2016-2019 to describe the clinical characteristics and outcome of different ages in annular pancreas managed by diamond-shaped duodenoduodenostomy.Case Description: The first case was a six days old baby boy with bile stained vomiting every time he breastfed when she was three days old and got worsen. USG fetal showed polyhydramnios with duodenal or jejunal stenosis. Besides, the abdominal X-ray showed double bubble sign and the laboratory findings were in a standard limit. The second case was a nine months old girl with bile-stained vomiting when she was eight months old and got worsen along with the time. She found with severe malnutrition and mild-moderate dehydration. The laboratory examination revealed electrolyte imbalanced, and abdominal X-ray showed double bubble sign. Postoperative to first feed was 1 day in both cases and full feed duration was 5 and 10 days. Length of stay was 16 and 25 days—both of the cases without complication after surgery.Conclusion: Annular pancreas is a rare congenital malformation that manifests primarily by signs related to duodenal obstruction. Earlier identifications will help to ensure that appropriate treatment can be instigated as soon as possible. Treatment by surgical with duodenoduodenostomy procedure is a surgical technique in the treatment of annular pancreas, with the advances in neonatal intensive care, may reduce the postoperative complications and will make a better outcome.
A sore throat after endotracheal intubation in Sanglah General Hospital 2017
Authors: Shanmuganathan Sobhana , Putra Kadek Agus Heryana , Sucandra I Made Agus Kresna , Kurniyanta Putu
Published: December 2022

Background: Cuff volume additionally impacts a postoperative sore throat and dysphagia. The rate of a sore throat has likewise been discovered to be higher in the event of Laryngeal Mask Airway (LMA) than that of endotracheal intubation (ETT).Aim: To know the duration of a sore throat and level of severity of a sore throat after endotracheal intubation among patients of Sanglah General Hospital.Method: This cross sectional study was conducted on patients of Sanglah General Hospital. There were 100 students were participated in this study. They were asked to fill up a self-administered questionnaire. The variables assessed were their duration towards patients who have used anesthetic during surgery.Result: About 54% of 100 patient of Sanglah General Hospital, respectively had a sore throat for 4 to 6 days after endotracheal intubation. However, 28% of patients had a sore throat from day one to day three after the endotracheal intubation method. For the severity of a sore throat over 50% of the patients have experienced pain in eating, drinking, talking and for some people it has given them an enormous side effect towards their daily activity. Though the overall duration and severity of a sore throat among the patient, lasted less than a week and for the severity patient have voted respectively high. Patients with good diet control after the surgery tend to heal faster.
Deteksi gen Gtf-B Streptococcus mutans dalam plak dengan gigi karies pada siswa di SD N 29 Dangin Puri
Authors: Ambarawati I Gusti Agung Dyah , Sukrama I Dewa Made , Yasa I Wayan Putu Sutirta
Published: December 2022

Background: Bacteria situated in the formation of dental plaque as a leading cause of caries is Streptococcus mutans. Streptococcus mutans use glycosyltransferase enzymes to convert saccharose saliva into an extracellular polysaccharide (PSE) through glycosylation process. One of the virulence factors of Streptococcus mutans is the gtf-B gene.Aim: This study aims to detect gtf-B gene in plaque with dental caries on students of SD Negeri 29 Dangin Puri.Method: The design of the study was descriptive observational research involved 51 carries children as a sample in SD Negeri 29, Dangin Puri. Bacterial culture was applied to detect colonies of Streptococcus. Additional gram staining and catalase test were also conducted to distinguish Streptococcus against Staphylococcus. After it revealed negative catalase test, PCR was continued optimally about 517 bp in size and 585 bp gtf B gene in size.Result and Conclusion: Streptococcus mutans are as many as 19 samples from 51 samples (37.25%). Three samples from 19 isolates of Streptococcus mutans were detected by gtf-B gen (16%). Bakteri yang berperan penting dalam pembentukan plak gigi sebagai penyebab karies adalah Streptococcus mutans. Streptococcus mutans memiliki enzim glikosiltransferase yang dapat mengubah sakarosa saliva menjadi polisakarida ekstraseluler (PSE) melalui proses glikosilasis. Salah satu faktor virulensi bakteri Streptococcus mutans sebagai penyebab karies gigi adalah gengtf-B Streptococcus mutans. Tujuan: Penelitian ini bertujuan untuk mendeteksi gen gtf-B Streptococcus mutans dalam plak dengan gigi karies pada anak di SD Negeri 29 Dangin Puri.Metode: Penelitian ini menggunakan 51 sampel anak di SD Negeri 29 Dangin Puri yang mengalami karies. Kultur bakteri digunakan untuk mendeteksi koloni Streptococcus Sp. kemudian dilakukan pengecatan gram, uji katalase untuk membedakan Streptococcus dengan Staphylococcus. Hasil uji katalase negatif dilakukan proses PCR Streptococcus Mutans dengan ukuran 517 bp dan gen gtf B Streptococcus mutans dengan ukuran 585 bp.Hasil dan Simpulan: ditemukan bakteri streptococcus mutans sebanyak 19 sampel dari 51 sampel (37,25%). Tiga sampel dari 19 isolat bakteri streptococcus mutans terdeteksi gen gtfB streptococcus mutans (16%).
Relationship between cardiovascular fitness and academic achievement among medical students of Udayana University in batch 2018
Authors: Narasimhanaidu Dashinnie , Wardana I Nyoman Gede , Karmaya I Nyoman Mangku
Published: December 2022

Background: Physical fitness especially cardiovascular fitness is one of the important factors in medical students’ academic achievement which has been neglected by majority of the students. Through cardiovascular fitness the stress level could be reduced which will eventually help the students to achieve better academic results.Aim: This study aims to determine the relationship between the cardiovascular fitness and academic achievements by medical students of Medical Faculty of Universitas Udayana from batch 2018.Method: An experimental survey method has been used identify the relationship between cardiovascular fitness level and academic achievement. Respondents who attended this study were 79 students from the batch 2018. The cardiovascular fitness level will be measured by Fartlek training which is conducted in medical faculty campus parking area. The students’ academic achievement will be measured through their 1st biomedic exam results. Then, the pulse rate collected from the Fartlek training and the academic achievement from exam was compared to identify the relationship the cardiovascular fitness and academic achievement.Results: The data was not normally distributed from the normality test. Spearman’s rho test shows that the data is not significant with the (p = -0.056).Conclusion: There was no significant relationship between the level of cardiovascular fitness and the academic achievement of the medical students.
Depression among first-year medical students in Universitas Udayana in 2016
Authors: Jebakum Shireen Anusha Gnanadoss , Wahyuni Anak Ayu Sri
Published: December 2022

Background: Depression is categorized as a mood disorder which causes changes in a person’s activity as well as life perception and could even cause suicides. Medical students are more distressed than the general population.Aim: This research was conducted to determine the degree of depression among 1st year medical students of Universitas Udayana.Method: This is research is using based on descriptive cross sectional study in order to obtain data about the amount of knowledge students about depression in Udayana University from November 2015 – January 2016. 100 sample sizes are needed for this study. The Beck’s Depression Inventory (BDI) questionnaire is also used in this study.Results: Most of the students in the Medical Faculty of Udayana University have a relatively normal feeling of good and bad that happens in life. A smaller number of students have shown to have mild mood disturbances and but does not indicate the presence depression. The majority of students who suffered from depression are 17 years old based on the BDI scoring, which consisted of 4 students.Conclusion: There female students, they who were living alone, and they who were unable to sleep normally, had the higher prevalence of suffering depression.
Hubungan antara peningkatan kadar immunoglobulin-e (IgE) dengan matrix metalloproteinase-9 (MMP-9) pada pasien sindrom koroner akut (SKA) di RSUP Sanglah, Denpasar, Bali
Authors: Prabundari Anak Agung Yunda , Suardamana Ketut , Suryana Ketut , Saturti Tjok Istri Anom
Published: December 2022

Introduction. Acute Coronary Syndrome (ACS) is a cardiovascular disease that has a high mortality rate. One of the markers which play a role in the pathophysiology of ACS is Immunoglobulin E (Ig E), one of the antibodies released by B lymphocytes as the result of complex interactions that can activate mast cells. Mast cells will activate Metalloproteinase-9 (MMP-9) then facilitate pathogenesis of acute myocardial infarction or acute coronary syndrome phase. This study aimed to determine the relationship between increasing levels of IgE and MMP-9 in ACS patients at Sanglah Hospital, Denpasar, Bali.Method. This was a cross-sectional analytic study, and the samples were collected from ACS patients at Sanglah Hospital, Denpasar, Bali, using a consecutive sampling method. A total of 73 samples were included in this study, then statistical tests and Pearson correlation test was conducted.Results. Seventy-three samples included in this study contain 59 men (80.8%) and 14 women (19.2%). The IgE level is between 0.5-1000 and MMP-9 levels between 6.91-29.56. There is a statistically significant correlation between IgE levels and MMP-9 levels in Acute Coronary Syndrome patients (p = 0.018: r = 0.277).Conclusion. We found a significant association between increased IgE and MMP-9 in patients with Acute Coronary Syndrome at RSUP Sanglah, Denpasar, Bali. Pendahuluan. Sindrom Koroner Akut (SKA) merupakan penyakit kardiovaskular dengan angka kematian yang sangat tinggi. Salah satu marker yang berperan dalam patofisiologi SKA adalah Immunoglobulin E (IgE). IgE merupakan salah satu antibodi yang dilepaskan oleh limfosit B sebagai interaksi kompleks yang dapat mengaktivasi sel mast. Sel mast yang sudah aktif akan mengaktivasi Metallopriteinase-9 (MMP-9) yang ikut berperan dalam patogenesis miokard infark akut atau sindrom koroner akut. Penelitian ini bertujuan unuk mengetahui hubungan peningkatan kadar IgE dan MMP-9 pasien SKA di RSUP Sanglah, Denpasar, Bali.Metode. Penelitian ini merupakan penelitian potong lintang analitik yang dilakukan pada populasi SKA di RSUP Sanglah, Denpasar, Bali. Sampel keseluruhan berjumlah 73 orang pasien SKA secara konsekutif diikutsertakan dalam penelitian ini, kemudian dilakukan uji statistik dan uji korelasi Pearson.Hasil. Dari hasil penelitian pada 73 sampel tersebut, didapatkan jumlah sampel 59 orang laki-laki (80,8%) dan 14 orang perempuan (19,2%). Adapun kadar IgE dalam rentang antara 0,5-1000 dan kadar MMP-9 antara 6,91-29,56. Terdapat korelasi yang bermakna antara kadar IgE dengan kadar MMP-9 pada pasien Sindrom Koroner Akut (p=0,018; r=0,277).Kesimpulan. Terdapat hubungan yang signifikan antara peningkatan kadar IgE dengan peningkatan kadar MMP-9 pada pasien Sindrom Koroner Akut di RSUP Sanglah, Denpasar, Bali.
The characteristic of anxiety disorder among medical students of Universitas Udayana, Bali, Indonesia in the 2019 period
Authors: Ravichandran Kuganesh , Dewi Dewa Ayu Shintya , Aryabiantara I Wayan
Published: December 2022

Background: Anxiety is a normal stress reaction and can be beneficial in some dangerous situations. The symptoms are individual, whereas most of them include restlessness, feeling keyed up on edge, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. This study aims to determine the characteristic of anxiety disorder among medical students of Universitas Udayana, Bali, Indonesia, in the 2019 periodMethods: A cross-sectional study was conducted among 75 medical students who met the inclusion criteria in this study. The characteristic of anxiety disorders depicted in this study was the prevalence, anxiety severity, characteristic of anxiety, and possible stressors. Depression Anxiety and Stress Scale- 21 (DASS-21) used to assess anxiety among medical students. Data were analyzed descriptively using SPSS version 21 for Windows and presented in percentages.Results: From 75 medical students, 11 (14.67%) students were batch 2016, 25 (33.33%) students were batch 2017, and 39 (52.0%) students were batch 2018. Based on the DASS-21 score, there were 53 students (70.7%) experienced anxiety. According to the severity of anxiety, we found that the vast majority of students (45.3%) belong to the extremely severe anxiety group, followed by severe anxiety (20.8%), moderate anxiety (15.1%) and mild anxiety (11.3%).Conclusion: The characteristic of anxiety disorder among medical students were predominant by the severe anxiety group based on the DASS-21 score.
Faktor yang berhubungan dengan perilaku tes HIV pada ibu hamil di Puskesmas Abiansemal I
Authors: Purwani Ni Luh Putu Suci Hary , Yuliana Yuliana , Wardana I Nyoman Gede
Published: December 2022

Background: HIV transmission vertically within children or infants become essential point of view for reducing HIV cases. Aim: The study aims to find out the related factors of HIV test behavior among pregnant women in public primary healthcare Abiansemal I.Method: This study used analytical cross-sectional design and consecutive sampling among pregnant women who have routine examination in public primary healthcare Abiansemal I Badung, Bali. Respondents asked to fill a self-administered questionnaire from Health Belief Model to asses of respondent’s perception about HIV screening test.Result and conclusion: There are 43 pregnant women as respondents with mean age 27 years. Of 49 respondents, 71.4% is pregnant women with equal or below of high school education. 16.3% of respondents did not work and 51% have a good knowledge about HIV. Through bivariate analysis have found gestational age, education level, knowledge, and risk perception have significant associations that can included into multivariate analysis (p<0.25). From multivariate analysis, we found that risk perception have independent association to HIV test among pregnant women (p<0.05; OR 0.121; 95%CI 0.021 – 0.690). Penularan HIV kepada anak-anak atau bayi menjadi fokus permasalahan penting dalam program reduksi kasus HIV. Tujuan: Untuk mengetahui faktor yang berhubungan dengan perilaku tes HIV (human immunodeficiency virus) pada ibu hamil di Puskesmas Abiansemal I.Metode: Penelitian ini menggunakan desain cross-sectional analitik dengan purposive sampling pada sampel ibu hamil yang rutin melakukan pemeriksaan kehamilan di Wilayah Pelayanan Puskesmas Abiansemal I, Badung. Seluruh responden mengisi kuesioner adaptasi health belief model untuk menilai persepsi responden mengenai tes skrining HIV.Hasil dan simpulan: Total responden pada penelitian ini adalah 49 orang dengan rerata usia 27 tahun. Dari 49 responden tersebut, 71,4% memiliki riwayat pendidikan terakhir, yaitu di bawah atau sama dengan sekolah menengah atas (SMA). Terdapat 16,3% responden yang tidak bekerja dan 51% responden memiliki pengetahuan yang baik mengenai HIV. Melalui analisis bivariat, ditemukan bahwa usia kehamilan, tingkat pendidikan, pengetahuan, dan persepsi risiko memiliki hubungan yang dapat diinklusi dalam analisis multivariat (p<0,25).  Pada analisis multivariat, ditemukan bahwa persepsi risiko memiliki hubungan independen terhadap perilaku tes HIV ibu hamil (p<0,05; OR 0,121; 95%IK 0,021 - 0,690).
Penanganan pasien status hiperglikemik hiperosmoler yang disertai pankreatitis akut
Authors: Tersinanda Ni Nyoman Trisna Yuliharti , Suastika Ketut
Published: December 2022

Introduction. The hyperosmolar hyperglycemic state is a dangerous complication that can arise with diabetes mellitus. The emergent treatment is necessary to reinstate hemodynamic stability, as mortality rates for the hyperosmolar hyperglycemic state are exceptionally high and can have multiple complications.Case. A 40-year-old male presented unresponsive to the emergency department. Upon arrival, the patient examination was consistent with dehydration and tachycardia. Review of systems included a one-week history of epigastrial pain, nausea and vomiting without a history of diabetes. The presenting blood sugar level was 1099 mg/dl with high osmolarity. Abdominal ultrasound revealed peripancreatic fluid suspicious for acute pancreatitis. Following successful treatment of acute pancreatitis and hyperglycemia with fluid and insulin, his serum glucose and pancreatic enzyme level decreased to normal range. The patient recovered and was discharged in stable condition.Conclusion. This case study postulates that the correlation between hyperosmolar hyperglycemic state and pancreatitis may be explained by two causal relationships, one of them is the hyperosmolar hyperglycemic state can be induced by ischemic pancreatitis. This is important because hyperglycemia superimposed on any ischemic insult can increase the risk of multiorgan failure, as with our patient. Thus, recognition and management of resulting complications need to be emergent. Pandahuluan. Status hiperglikemik hiperosmoler merupakan komplikasi berbahaya dari diabetes melitus. Terapi yang cepat sangat penting untuk mengembalikan stabilitas hemodinamik, dimana angka mortalitas untuk status hiperglikemik hiperosmoler sangat tinggi dan memiliki banyak komplikasi.Kasus. Seorang pria usia 40 tahun datang dalam keadaan penurunan kesadaran ke unit gawat darurat. Saat datang, pasien didapatkan dehidrasi dan takikardia dari pemeriksaan tanda vital. Didapatkan riwayat nyeri ulu hati sejak satu minggu, mual dan muntah tanpa riwayat diabetes sebelumnya. Kadar glukosa darah sewaktu saat itu 1099 mg/dl dengan osmolaritas yang tinggi. Dari pencitraan ultrasound abdomen didapatkan cairan peripankreatik yang mengarah ke pankreatitis akut. Dengan berhasilnya terapi cairan dan insulin untuk penanganan pankreatitis akut dan hiperglikemia, kadar glukosa darah dan enzim pankreas pasien ini membaik ke rentang normal. Kondisi pasien membaik dan dipulangkan dalam keadaan yang stabil.Kesimpulan. Laporan kasus ini menggambarkan korelasi antara status hiperglikemik hiperosmoler dan pankreatitis yang dapat dijelaskan dengan hubungan dua arah, dimana salah satunya bahwa status hiperglikemik hiperosmoler dapat dicetuskan oleh pankreatitis iskemik. Hal ini penting karena hiperglikemia yang dicetuskan oleh kondisi iskemik dapat meningkatkan risiko gagal multiorgan, seperti pada kasus ini. Sehingga, deteksi dan penanganan dari komplikasi ini harus dilakukan dengan segera.
Glutathione administration reduces the DNA fragmentation index in sperm preparation with the Swim-Up (SU) and mini-Density Gradient Centrifugation (mini-DGC) methods at Doctor Soetomo General Hospital, Surabaya, Indonesia
Authors: Hardiyanto Lutfi , Amarudin Amarudin , Mansur Indra Gusti , Supardi Supardi , Ramelan Wahyuning , Lunardhi Hamdani
Published: December 2022

Background: Spermatozoa requires Reactive Oxygen Species (ROS) in physiological quantities for capacitation for fertilization purposes. However, if the balance between ROS production and antioxidant capacity is disrupted, it can result in oxidative stress, negatively affecting chromatin spermatozoa, leading to male infertility. This study evaluates the glutathione administration reduces the DNA fragmentation index in sperm preparation with the Swim-Up (SU) and mini-Density Gradient Centrifugation (mini-DGC) methods at Doctor Soetomo General Hospital, Surabaya, Indonesia.Methods: A true experimental study by post-test only control group was conducted using ejaculate fluid of 9 infertile patients with normozoospermic at the Department of Medical Biology, Faculty of Medicine, Universitas Indonesia, Jakarta in January - February 2019 period. The spermatozoa DNA fragmentation was examined by following the instructions for using Spermfunc® DNAf Kit for Determination of the DNA Fragmentation Level in Spermatozoa by Sperm Chromatin Dispersion (SCD) for both preparation methods. Data were analyzed using SPSS version 16.0 for Windows.Results: SU vs. SU+glutathione method gave a lower but insignificant DNA fragmentation effect (p>0.05). The mini-DGC vs. mini-DGC+glutathione method showed significant results (p<0.05). SU+glutathione vs mini-DGC+glutathione showed no significant results (p>0.05). Meanwhile, the SU vs. mini-DGC method showed significant results (p <0.05). The recovery rate (RR) of the mini-DGC method has a higher value and is even better if glutathione is given compared to the SU method.Conclusion: Spermatozoa preparation in the SU method gives a lower DNA fragmentation effect than the mini-DGC method. The administration of glutathione can be a particular consideration in carrying out spermatozoa preparation to protect spermatozoa from damage during preparation.
Characteristics retinometry pre and post cataract surgery on senile cataract patients in Sanglah Hospital, Bali-Indonesia
Authors: Suryathi Ni Made Ari , Jayanegara Wayan Gede , Manuaba Ida Bagus Putra
Published: December 2022

Background: WHO, with program Vision 2020-the Right to Sight, has a responsibility to control the most cause of blindness, which is a cataract. General-purpose of this research is to identify the retinometry pre and post cataract surgery on senile cataract patients.Method: This study design is an analytical cross sectional study. All data were collected retrospectively from the medical report of retinometry of pre and post cataract surgery in Sanglah General Hospital.Results: A total number of 60 eyes from 59 patients were included in this study. The majority of the patients were male (63.3%), aged 61-70, and came from Denpasar District (38.3%). The grading of cataract (Burrato) in this study is Burrato III (60%). A nuclear cataract is common in this study (41.7%). There were relationships between the differences of retinometry post dan pre cataract surgery with the grading of cataract (Burrato) (p<0.05), but there is no relationship with the type of cataract (p>0.05).Conclusions: There is a significant difference between retinometry pre and post cataract surgery, no significant difference between retinometry post-cataract surgery with BCVA and type of cataract. Higher grades of cataract (Burrato V) significantly correlate with higher retinometry pre and post-cataract surgery.
Fenomena raynaud sekunder pada seorang penderita kanker kolon
Authors: Kusuma I Gusti Agung Indra Adi , Kambayana Gede
Published: December 2022

Introduction: Secondary Raynaud's phenomenon (RP) is a transient microvascular spasm associated with other etiologies with clinical features of triphasic manifestations. Malignancy is a rare cause of secondary RP. Case Report: A man, 46 years, came to Sanglah General Hospital with secondary RP and colorectal malignancy. Discoloration white at the distal digits of the right manus and digits 3-5 left and sometimes accompanied thick at the fingertips, involved proximal to the medial phalanges. Laboratory examination showed albumin 2.55 g / dL, globulin 2.12 g / dL, LDH 323 IU / L, CRP 6.5 mg / dL, CEA 5.83 ng / mL plain abdominal radiograph impression of thickening on the part of the wall and show colitis appearance, be suspected ileus in the upper left abdominal region. Base on histopathological examination, ascending colon presents well-differentiated adenocarcinoma, and abdominal CT shows liver metastases. Management of patients with secondary RP with lifestyle and pharmacological interventions and chemotherapy for colorectal adenocarcinoma as the underlying cause. Pharmacological therapy of RP with intraoral amlodipine Conclusion: Malignancy in this patient as a cause of RP and management is carried out to treat primary disease and Raynaud's  Pendahuluan:    Fenomena Raynaud (RP) sekunder merupakan vasokontriksi transien pada mikrovaskular dikaitkan dengan etiologi lain dengan gambaran manifestasi trifasik. Keganasan menjadi kausa yang jarang pada RP sekunder.Laporan Kasus: Seorang laki-laki, usia 46 tahun, datang ke RSUP Sanglah dengan RP sekunder dan keganasan kolorektal. Dengan pucat  pada distal digiti manus dekstra dan digiti 3-5 sinistra dan disertai kadang tebal di ujung jari, meliputi proksimal sampai  medial falang. Pemeriksaan laboratorium menunjukkan albumin 2,55 g/dL, dan globulin 2,12 g/dL, LDH 323 IU/L, CRP  6,5 mg/dL, CEA 5,83 ng/mL dengan foto polos abdomen kesan penebalan pada sebagian dinding usus menunjukkan suatu gambaran kolitis yang diduga ileus pada regio abdomen kiri atas, kolon asenden dengan gambaran well differentiated adenokarsinoma  pada hasil biopsi histopatologi dan CT abdomen menunjukkan metastasis pada hepar. Penatalaksanaan pasien RP sekunder dengan intervensi gaya hidup dan farmakologis serta kemoterapi untuk adenokarsinoma kolorektal sebagai penyebab dasar. Terapi farmakologis RP dengan pemberian amlodipin intra oral.Simpulan: Kondisi keganasan pada pasien sebagai kausa dari RP dan tatalaksana  pengobatan spesifik RP.
The role of mean platelet volume (MPV) level as an independent predictor for varicocele in late adolescent
Authors: Parisudha Ryuu Damara , Suwedagatha I Gede
Published: December 2022

Background: Recent studies have reported significant associations between varicocele and platelet volume indices (PVIs). PVIs are inexpensive and widely used indicators consisting of mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) and are related to platelet volume and function. The possibility of PVIs as a predictor for varicocele is yet to be exposed. This study aimed to assess the role of PVIs as a predictor for varicocele in the late adolescent.Methods: This retrospective case-control study involved 89 varicocele subjects (group I) and 89 healthy controls (group II) of similar age, stature, and body mass index. The data were consecutively taken from medical records at Bhayangkara Denpasar Hospital between January 2017 and May 2019. The diagnosis of varicocele was based on the findings from both physical examination and color doppler ultrasound (CDU). PVIs indicators were analyzed among the two groups. Statistical analysis was performed using receiver operating characteristic (ROC) curve to determine optimum cut-offs, bivariate chi-square test, and multivariate analysis using binary logistic regression, with p<0.05 considered statistically significant.Results: ROC curve analysis showed optimum cut-offs of 8.05, 12.05, and 15.1 for MPV, PDW and P-LCR respectively (Youden index: 0.494, 0.326, 0.292; p < 0.001, p <0.001, p=0.001 respectively). Chi-square test showed significant associations between the PVIs indicators and varicocele (p < 0.001). Binary logistic regression analysis revealed that MPV level of â‰¥ 8.05 is an independent predictor for late adolescent varicocele (OR=6.001; 95%CI 2.547-14.139; p < 0.001).Conclusion: MPV can be used as an independent predictor for assessing varicocele in the late adolescent.
Priapism as an initial presentation in Chronic Myeloid Leukemia (CML): a case report
Authors: Herawati Ni Luh Putu , Dharmayuda Tjokorda Gde
Published: December 2022

Background: Priapism is a persistent, usually painful erection that lasts for more than four hours and occurs without sexual stimulation. Priapism is a rare clinical sign of Chronic Myeloid Leukemia (CML), with an incidence of 1-5 cases per 100,000 people per year. In men who suffer from CML, ischemic priapism occurs secondary to hyperleukocytosis and venous obstruction by thrombus and microthrombus. Case Presentation: In this case, a 24-year-old male, a Balinese ethnicity, present with prolonged erectile complaints accompanied by increased pain. From the examination performed, it was concluded that the patients had the ischemic type of priapism. From CBC, the patient was obtained hyperleukocytosis and continued with peripheral blood smear and bone marrow puncture. The patients concluded with CML, and initial intervention includes therapeutic aspiration, irrigation, hydroxyurea and other supportive therapies. It is a urological emergency requiring urgent treatment to prevent long-term complications, in particular erectile dysfunction.Conclusion: Priapism is an unusual clinical manifestation of CML, whereas priapism is a urological emergency requiring immediate therapy. Treatment delay can cause complications of erectile dysfunction in men.