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Bali Medical Journal    Follow    
  This is an Open Access Journal Open Access journal
     ISSN (Print) 2089-1180 - ISSN (Online) 2302-2914
     Published by Sanglah General Hospital Homepage  [1 journal]
  • HIGH BLOOD LEVELS PROCALCITONIN AS SYSTEMIC IMFLAMATORY RESPONSE SYNDROME
           PREDICTOR IN SEVERE AND MODERATE HEAD INJURY
    • Authors: B. Sinaga, T. G. B. Mahadewa, and; S. Maliawan
      Abstract: Background Numerous studies have shown that procalcitonin (PCT) was not related to degree of trauma. High PCT serum levels have been found in patients with bacterial or fungal infection and also in acute phase of trauma. Currently, there has been no research discussed about changes in serum levels of PCT in particular head injuries and severe head injuries. Moderate and severe head injuries were common trauma cases in Emergency Room (ER) and had high mortality rate. Based on Glasgow Coma Scale (GCS), moderate and severe head injuries were scored between 3 and 13. This research aim to determine whether high blood levels PCT can be used as a predictor of the occurrence of SIRS. Method: A cohort prospective study was applied in this research to determine high blood levels of PCT as a predictor for SIRS in moderate and severe head injury. This study was conducted from June 2013 - August 2013 at Sanglah General Hospital with 40 research subjects. Data was presented in tables and analyzed with Chi Square test at 95% CI and p <0.05% was considered significant. Results: From the 40 samples, there were 34 males (85%) and 6 females (15%), 18 samples (45%) had moderate head injury and 22 samples (65%) had severe head injury. One sample (2.5 %) was 0-10 years old, 15 samples (37.5%) were 10-20 years old, 13 samples (32.5%) were 20-40 years old, 7 samples (17.5%) were 40-60 years old and 4 samples (10%) were>60 years old. PCT levels in the blood obtained on day first were normal in 6 samples (15%) and elevated in 34 samples (85%), SIRS (+) were found in 35 samples (87.5%) and 5 samples (12.5%) were SIRS (-). Using bivariate analysis between PCT levels and SIRS showed p = 0.000 (p < 0.05), and multivariate analysis of the control variables showed no significant correlation between variables with PCT levels. Conclusion: From 40 samples moderate head injury and severe head injury, there were 34 samples (85%) with elevated PCT level on the first day, while 35 samples (87.5%) had SIRS on the third day (p=0,000, CI=95%). Elevated PCT level could be used as a predictor for SIRS in moderate and severe head injury patients.
      PubDate: 2014-01-03
      Issue No: Vol. 3 (2014)
       
  • IMMUNE RESPONSE AND COST ANALYSIS OF INTRADERMAL RABIES VACCINATION FOR
           POST-EXPOSURE PROPHYLAXIS REGIMEN IN HUMAN
    • Authors: N. S. Budayanti, N. M. Susilawathi, A. E. Darwinata, I. B. P. Dwija, N. D. Fatmawati, K. Wirasandhi, K. Subrata, N. K. Susilarini, F. S. Wignall, A. A. R. Sudewi, and; G. N. K. Mahardika
      Abstract: The outbreak of rabies in human in Bali-Indonesia is causing an extraordinary pressure for the government in providing adequate doses of anti-rabies vaccine for post-exposure prophylaxis (PEP). Here, we directly compare the immune response and benefit of the intradermal (ID) protocol for rabies vaccine delivery with the intramuscular (IM) route. Methods: Sixty health workers who were willing to participate in this study have been randomly selected and grouped into ID, IM, and control groups, each with 20 volunteers. The Thai Red Cross ID- and Zangreb IM-protocols have been applied to the respective group. The sera of the volunteers were collected at day 0, week 1, week 3, week 4, month 3, month 6, month 9, and month 12 after the first vaccination. Anti-rabies virus IgG was detected using PlateliaTM Rabies II Kit (Bio-Rad). Results: Anti-rabies IgG could be detected in the ID-group at one week. The ID-vaccine delivery induced a slightly higher maximum antibody titer compared to IM, though not statistically significant (p>0.05). ID vaccination caused less adverse reactions and produces longer lasting protective immune response. Cost minimization analysis (CMA) on the provincial and national PEP data in 2009-2011 shows that the ID-delivery will reduce the total cost for a completed regimen by USD 28.5, and would have saved the Indonesian government budget approximately USD 3.6 and 4.3 million for complete regimens in Bali and Indonesia, respectively. Conclusion: The ID administration of anti-rabies vaccine induces a similar immune response compared to that of intramuscular injection. It also produces longer lasting protective immune response. It offers additional advantages of potential net cost savings as well as decreasing the pressure on vaccine availability due to the high number of dog bite cases.
      PubDate: 2014-01-03
      Issue No: Vol. 3 (2014)
       
  • DIFFERENCES OF TUMOR MASSES AND HEMOGLOBIN LEVELS IN CERVICAL CANCER
           SQUAMOUS CELL TYPE PATIENTS TREATED WITH COMBINATION OF PACLITAXEL AND
           CARBOPLATIN CHEMOTHERAPY
    • Authors: R. Noviyani, K. Suwiyoga, I. Lesmana, R. Niruri, K. Tunas, and; I N. G. Budiana
      Abstract: Background: Paclitaxel and carboplatin are standard operating procedure for chemotherapy treatment of cervical cancer squamous cell carcinoma at Sanglah General Hospital, Bali-Indonesia. Chemotherapy improves outcome of cancer treatment. However, chemotherapy brings also a variety of adverse effects and complications. This study aims to evaluate the therapeutic and adverse effects of chemotherapy in patients with squamous cell cervical cancer. Methods: This is a case study of six patients with cervical cancer underwent chemotherapy paclitaxel and carboplatin 3-series at Sanglah General Hospital, Bali-Indonesia during January to November 2013. The therapeutic effect of chemotherapy was assessed from cervical cancer tumor mass measured before and after chemotherapy 3-series. The adverse effect of chemotherapy was determined from hemoglobin levels measured before and after chemotherapy. Data were analyzed using a paired t-test with a level of confidence of 95% using the SPSS to find out the differences. Results: In this study we found that there is a difference between tumor mass pre and post 3 series chemotherapy within p < 0.05. In term of toxic effect, we also obtained that there were difference of hemoglobin between pre and post of treatment within p < 0.05. Conclusion: Paclitaxel carboplatin as a chemotherapy drug in patients with cervical cancer is highly recomended when seen from the effects of reduced tumor size, and has a low side effect of anemia (anemia grade 1).
      PubDate: 2014-01-03
      Issue No: Vol. 3 (2014)
       
  • RENAL FUNCTION TEST ON THE BASIS OF SERUM CREATININE AND UREA IN TYPE-2
           DIABETICS AND NONDIABETICS
    • Authors: P. Singh, S. Khan, and R. K. Mittal
      Abstract: Background: Type-2 diabetes mellitus has quickly become a global health problem due to rapidly increasing population growth, aging, urbanization and increasing prevalence of obesity and physical inactivity. Diabetic nephropathy is one of the major causes of chronic renal failure. Both serum urea and creatinine are widely used to assess the function of kidney. This study was conducted to observe the impaired renal function in type 2 diabetics and compare with non-diabetics controls. Method: To determine the incidence of renal dysfunction in diabetics in Nepalgunj medical college and Hospital , Nepalgunj , Banke, Nepal , blood samples from 100 diabetic subjects and 100 non-diabetic controls were taken between the period 1st February  , 2012  to  31st January , 2013 for investigation of  plasma glucose fasting(FPG), blood urea and serum creatinine. These biochemical parameters were determined by using a fully automated clinical chemistry analyzer. Results: Our findings showed that the level of blood urea (P<0.0001, 95%Cl) and serum creatinine (P≈0.0004,95%Cl ) were significantly higher in type 2 diabetics as compared to non-diabetics in both male and female. There was no significant difference between diabetic male and female. 15 out of 100 diabetes samples have high urea level whereas 7 out of 100 had increased creatinine level. In control only 3 samples had high urea value and 1 had high creatinine level. There was statistical significant increased in urea level with increased in blood sugar level. Conclusion: Blood urea and creatinine is widely accepted to assess the renal functions. Good control of blood glucose level is absolute requirement to prevent progressive renal impairment.
      PubDate: 2014-01-03
      Issue No: Vol. 3 (2014)
       
  • ORAL ADMINISTRATION OF NUTMEG ON MEMORY BOOSTING AND REGAINING IN WISTAR
           ALBINO RATS
    • Authors: G. Jissa, K. Sai-Sailesh, and J. K. Mukkadan
      Abstract: Background: This study provides further evidence for improvement of memory by oral consumption of nutmeg. The present study was undertaken with an objective to study the effects of oral administration of nutmeg on memory boosting and regaining. Methods: Here we investigate the influence of oral intake of nutmeg on behavioral task performance by using T-maze and radial arm maze and physiological measures relative to a milk control group. Results: We have observed significant memory boosting and memory regaining effects of nutmeg when administered orally. This effect may be due to facilitation of acetylcholine activity by decreasing acetylcholinesterase activity of nutmeg. Hence we recommend further research in this area by investigating compound metabolism to optimize quantification of memory performance following nutmeg consumption.
      PubDate: 2014-01-02
      Issue No: Vol. 3 (2014)
       
  • TRAUMATIC GASTRIC RUPTURE FOLLOWING BLUNT TRAUMA ABDOMEN: A Case Series
    • Authors: P. K. Hota, M. Babu, G. Satyam, and Ch. Praveen
      Abstract: Background: Gastric rupture following blunt injury abdomen is a rare presentation with a reported incidence of 0.02-1.7% in current literature. History of recent meal has been implicated in traumatic gastric rupture. Commonly traumatic gastric rupture is associated with other injuries like splenic injury and fractures. Prompt diagnosis and early intervention reduces mortality and morbidity. Primary two layered closure can be done for a better surgical outcome. We report 2 cases of blunt injury abdomen with gastric rupture, one with road traffic accident and other being from a fall from a height, which were managed successfully without any post operative morbidity and mortality.
      PubDate: 2014-01-02
      Issue No: Vol. 3 (2014)
       
  • Letter to the Editor
    • Authors: R. Danasekaran, K. Annadurai, G. Manu, and J. Ramasamy
      Abstract: MERS-CoV: An Emerging Public Health Threat
      PubDate: 2014-01-02
      Issue No: Vol. 3 (2014)
       
 
 
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