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INDONESIA
BALI MEDICAL JOURNAL (BMJ)
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Bali Medical Journal (BMJ), P-ISSN 2089-1180, E-ISSN 2302-2914 is an international and peer-reviewed journal published quarterly in print and online by Sanglah General Hospital in collaboration to Indonesian Physician Forum and Indonesian College of Surgeon, Bali-Indonesia which was founded in 2011. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship, and to encourage a vigorous dialogue between medical scholars and practitioners. The Journal welcomes contributions which promote the exchange of ideas and rational discourse between practicing educators and medical researchers all over the world.
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Articles 179 Documents
COMMUNITY EMPOWERMENT THROUGH ERGONOMICS TRAINING WITH LOCAL WISDOM ORIENTED TO IMPROVE QUALITY OF SCULPTOR HEALTH IN THE PELIATAN VILLAGE, UBUD, GIANYAR, BALI-INDONESIA Sutajaya, I Made
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
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Background: Until recently, data applied for reference of Balinese workers in their work stations and processes, including anthropometric data still applying secondary data source from literature review. This was probably inappropriate due to different size, since the literature data generally on the basis of western size of anthropometry. The objective of this research, therefore, was to establish community empowerment through ergonomics training with local wisdom oriented to improve the sculptor health care quality and productivity. Ergonomics training through workshops conducted with a systemic, holistic, interdisciplinary, and participatory (SHIP) approach. The training is done to make people aware of the work as a sculptor that is very important to apply ergonomics in the workplace. The results showed that ( a) participants judge that ergonomics workshop can open their insights about the importance of the application of ergonomics in the workplace, (b) work equipment is not in accordance with sculptor anthropometric, (c) inadequate working conditions, because the workers were exposed to noise working tool more than 80 decibel and the room temperature exceeds 34OC and work a lot of cockroaches and rats roam, and (d) the data of sculptor health quality is very poor, increase the workload at about13.5 %, musculoskeletal complaints at about 41.3 % , and fatigue at about 46.8 % ( p < 0.05 ) between before and after working. That means the work is very necessary sculptor redesigned in order to achieve comfort, safe, healthy, effective, and efficient of working conditions. It can be concluded that the ergonomics training with local wisdom oriented is required in an effort to implement the principles of ergonomics to achieve adequate health care quality sculptors and maximum productivity.
TRANSFUSION REACTIONS AS AN INDICATOR OF SERVICE QUALITY OF BLOOD TRANSFUSION IN SANGLAH GENERAL HOSPITAL DENPASAR BALI-INDONESIA Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah; Yasa, I Wayan Putu Sutirta
BALI MEDICAL JOURNAL Vol 5 No 3 (2016)
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Background: One of the fatal side effects of transfusion is transfusion reactions. The incidence of transfusion reaction in Sanglah Hospital is still relatively high and far from national target which is 0.01%. To achieve the target of quality, it is necessary to set up an active program so that the number of incidence of transfusion reactions can be decreased. Methods: Pre and post test interventional study was conducted for 6 months in Sanglah Hospital Bali. All nurses in wards which is blood product frequently used was involved in this study. The intervention in this study was in the form of education and training programs on the application of the closed system and cold chain in the distribution of blood products as well as improved service system. Results: The results showed a decline in the incidence of transfusion reactions occurred every month during the study. The incidence of transfusion reactions occurred each month was 0.77%, 0.56%, 0.5%, 0.49%, 0.45% and 0.38% respectively. The average reduction in the incidence of transfusion reactions was 0.08% every month. The type of transfusion reaction that occurred was 59% urticaria, 29% fever, 7% shortness of breath, 4% fever and chills, and 1% shock. Conclusion: Education and training programs on the application of the cold chain system and closed system in the distribution of blood products as well as the improvement of service system helped reduce the number of the incidence of transfusion reactions in Sanglah Hospital Bali.
CLINICAL INITIAL RESPONSE OF NEOADJUVANT CHEMOTHERAPHY IN TRIPLE NEGATIVE, HER-2, AND LUMINAL TYPES OF BREAST CANCER IN DENPASAR (A PRELIMINARY STUDY) Yarso, K. Y.; Sudarsa, I W; Wibawa-Manuaba, I B. T
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
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Objectives: Triple Negative, Luminal, HER-2 subtypes of breast cancer are markers to predict behavior, aggressiveness, and response to chemotherapy. The aim of this study is to understand character and response to standard neoadjuvant chemotherapy in different subtypes of breast cancer. Method: This is a descriptive study of breast cancer subtypes. From 687 patients (2003-2010) 351 patients have IHC data which divided into 3 groups, Triple negative, Luminal, and HER-2. We used 10% as a cut off point for ER, PR, while 30% & positive 3 for HER-2. We determined initial clinical response after 3 cycles of neoadjuvant chemotherapy although only 77 got standard neoadjuvant chemotherapy and had clinical response data. We used 50% diameters depreciation & no metastasis as cut off point for respond group. Results: There were 116 (33%) Triple Negative, 60 (17%) HER-2, and 175 (50%) Luminal Subtypes. The mean of age for 351 patients are 48.32 (23-82) years. In this study, it was obtained that no significant difference of means of age (p=0.24) in these 3 groups. Triple negative group significantly more advance in grade if compared with the other two groups (p=0.02). HER-2 group had highest response with standard neoadjuvant chemotherapy (50%), Luminal group had (49%), and Triple negative group had only (15%) response. One pCR in HER-2 group. There were no difference ages in subtypes.  Triple negative has more advances in grade. HER-2 group has highest response to standard neoadjuvant chemotherapy and Triple negative has lowest response to standard neoadjuvant chemotherapy.
HIGH SERUM PROSTATE SPECIFIC ANTIGEN AS A RISK FACTOR FOR MODERATE-SEVERE PROSTATE INFLAMMATION IN PATIENT WITH BENIGN PROSTATIC HYPERPLASIA Duarsa, Gede Wirya K.; Lesmana, Rika; Mahadewa, Tjokorda G. B.
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
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Background: Benign Prostatic Hyperplasia (BPH) is one of the most common degenerative disease found in men. Theories have been delivered to elucidate etiology, one of them is the theory of inflammation, and PSA is considered as one of risk factor for prostate inflammation. Undetected chronic inflammation could be a problem in BPH due to the obstructive and irritative symptoms it causes. Assessing risk factor could provide a better treatment outcome. Methods: A retrospective case control study in Sanglah Hospital, Indonesia. 70 men with BPH who underwent TURP in 2014, prostate inflammation is evaluated histologically from prostate specimens by one pathologist to avoid subjectivity. Those without inflammations and with mild inflammations are categorized as control group (n=35), and those with moderate and severe inflammations are categorized as case group (n=35). Preoperative total serum PSA retrieved from medical record Results: Median PSA is higher in case group, 2,83 compared to 14,12, with odd ratio 1,18 (p
CORRELATION BETWEEN RESPECT, RESPONSIBILITY, INTERPERSONAL RELATIONSHIP, SUPERVISION, AND COMPENSATION TO THE PERFORMANCE OF OFFICIAL RECORDER AT STATE HOSPITALS BUKITTINGGI WEST-SUMATRA INDONESIA Alhamda, Syukra
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
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Objective: Primary survey was conducted on November 10, 2012 at The State Hospitals Bukittinggi, with randomly selected of 100 hospital medical records. There were incomplete contents of 61.66% and 48.33% of late files. This issue is very disturbing process for management of recording medical data. Therefore, it will disrupting functions of medical recorders. Method: This study applied cross-sectional study to determine the correlation between respect, responsibility, interpersonal relations, supervision and compensation for the performance of official recorders at The State Hospitals Bukittinggi West-Sumatra Indonesia. Questionnaires from the subjects were proceed and computed by applying chi-square test. Results: The results showed that there were significant correlation between the performance of official award recorders (p = 0.003 and OR = 9.208), responsibilities (p = 0.012 and OR = 6.094), interpersonal (p = 0.0025 and OR = 5.417), performance of official (p = 0.012 and OR = 6.094), and compensation of official recorders (p = 0.025 and OR = 5.417) to recorders performance. Conclusion: In this research, we observed that there was a significant correlation between respect, responsibility, interpersonal relations, supervision and compensation to the performance of official recorders. A greater attention should be considered in order to produce a good performance of the medical recorder.
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) Sumarya, I M.; Adiputra, N.; Sukrama, I D. M.; Manuaba, Ida Bagus Putra
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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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.
SNP8NRG433E1006 NEUREGULIN-1 GENETIC VARIATION IN BATAKS ETHNIC WITH SCHIZOPHRENIA PARANOID AND HEALTHY CONTROL Effendy, Elmeida; Loebis, Bahagia; Amir, Nurmiati; Siregar, Yahwardiah
BALI MEDICAL JOURNAL Vol 3 No 2 (2014)
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The neuregulin 1 (NRG1) gene which influences the development of white matterconnectivity has been associated with schizophrenia. It influences neuronal migration, synaptogenesis,gliogenesis, neuron-glia communication, myelination, and neurotransmission in the brain and others.NRG1 is located in 8p13, and it is frequently replicated in schizphrenia. SNP8NRG433E1006 geneNRG1 is one of core at risk haplotype of schizphrenia. This study looked forward differencesSNP8NRG433E1006 neuregulin 1 between Bataks ethnic with schizophrenia paranoid and Bataksethnic healthy control. Methods: Batak ethnic with schizophrenia paranoid were recruited andinterviewed with semi-structured MINI ICD-X to establish the diagnosis. All the eligible subjectswere requested their permission for blood sampling. Healthy Batak ethnic were also recruited bymathcing the age and gender. The blood samples went through DNA isolation, Nested PCR, and DNAsequencing. Results: Ninety three subjects were recruited, but only 74 blood samples weresuccesfully sequenced. We found three types of polymorphisms, i.e. G/A allele at base pair (bp) 76,G/T allele at bp 112, and deletion at bp 110 in Batak ethnic with schizophrenia. There were two kindsequences at bp 113-116 in Batak ethnics, and Batak ethnics with ATCG were at higher risk forhaving schizophrenia. This study support that NRG1 is a schizophrenia-susceptibility gene.
STEREOTACTIC RADIOSURGERY FOR CLASSICAL TRIGEMINAL NEURALGIA Kodrat, Henry; Novirianthy, Rima
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
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Trigeminal neuralgia is a debilitating pain syndrome with a distinct symptom mainly excruciating facial pain that tends to come and go unpredictably in sudden shock-like attacks. Medical management remains the primary treatment for classical trigeminal neuralgia. When medical therapy failed, surgery with microvascular decompression can be performed. Radiosurgery can be offered for classical trigeminal neuralgia patients who are not surgical candidate or surgery refusal and they should not in acute pain condition. Radiosurgery is widely used because of good therapeutic result and low complication rate. Weakness of this technique is a latency period, which is time required for pain relief. It usually ranges from 1 to 2 months. This review enlightens the important role of radiosurgery in the treatment of classical trigeminal neuralgia.
CURRENT ISSUES ON JOB STRESS IN JAPAN AND WORKSITE MENTAL HEALTH APPLICATION AMONG JAPANESE COMPANY A CASE STUDY ANALYSIS Purnawati, S.
BALI MEDICAL JOURNAL Volume 2 Number 2, May-August 2013
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Background: Issues about job stress is more popular in the world currently. Not just for Japan, Korea and Taiwan, but also an important issue in EU countries, especially the UK and Finland Increase of awareness about job stress effects on work performance, productivity and mental health is as one reason of the phenomenon. Objective: The present study aimed to explore the issue of job stress in Japan for the reference of good practices to Indonesia. Methods: This study, based on observational studies in the period of September-December in year 2010 in Tokyo, Kawasaki and Kitakyushu Japan. Observations on Japanese Company and discussions with experts, such as: occupational physician of Riken Company, experts from:  Tokyo University and Tokyo University?s occupational physician, Department of ergonomics, the Institute of Industrial Ecological Sciences UOEH (University of Occupational and Environmental Health), Institute for Science of Labor, and researcher of Japan NIOSH. Two stress management training and occupational mental health? application program were observed in the period of October-December. Result: The trend of current occupational mental health research in Japan has being moved from job stress to more advanced issues of work engagement and work-life balance. There are three approaches to prevention of job stress. Considering the three approach could improve of worker productivity and well-being. The training for Tokyo University?s staffs was as one session of individual-oriented stress prevention approach. It was conducted in very interactive class lecture. During 2 hours session, the participants learned some knowledge about job stress and its risk factors, exercised to construct better cognitive for stress prevention and productivity, practiced of progressive muscle relaxation technique, group work, did some home works and filled an evaluation sheet after the session was finish. We also observed the occupational mental health program at Riken Company that was covered of primary, secondary and tertiary prevention of occupational mental health program of workers mostly on job stress issue. Conclusion: It was concluded that although many efforts has made to anticipate the problem of job stress in Japan, it is still need further studies to find the most appropriate instruments for the indicator of job stress and methods of intervention which are most effective for employees and company, as well as general improvement for well-being of workers and their family as they are a part of community.
EVALUATION AND PRIORITIZATION OF SERVICE QUALITY DIMENSIONS USING DEMATEL AND TOPSIS (A CASE STUDY IN IRAN) Khanjankhani, Khatere; Rafiei, Sima; Ezzatabadi, Mohammad Ranjbar; Askari, Roohollah; Abooee, Fatemeh; Shafii, Milad
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
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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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