Made Widhi Asih - Academia.edu (original) (raw)

Papers by Made Widhi Asih

Indonesia Journal of Biomedical Science : IJBS, Mar 8, 2023

JBN (Jurnal Bedah Nasional)

Aim: Assessed the correlation between prostate volume and intravesical prostatic protrusion with ... more Aim: Assessed the correlation between prostate volume and intravesical prostatic protrusion with detrusor wall thickness through transabdominal sonographic examination of benign prostate enlargement (BPE). Methods: The study is a paired-group analytical observational cross-sectional study during April – July 2020. Measurements were made of prostate volume, intravesical prostatic protrusion, and detrusor wall thickness using transabdominal sonography. An analysis was carried out to determine the correlation with bivariate analysis and the calculation of the research power. Results: Thirty-four BPE patients with a mean age of 62.41 years were included in the study. The mean value of prostate volume obtained was 44.24 cc; 8.66 mm for intravesical prostatic protrusion; and detrusor wall thickness is 1.49 mm. The correlation value between prostate volume and detrusor wall thickness was 0.12 (p=0.46), while the intravesical prostatic protrusion and detrusor wall thickness were 0.37 (p=0.0...

Bali Medical Journal, 2021

Indonesia Journal of Biomedical Science, 2021

Open access: ht p://isainsmedis.id/ Kimura’s disease: a neoplasm mimicking, a rare benign form of... more Open access: ht p://isainsmedis.id/ Kimura’s disease: a neoplasm mimicking, a rare benign form of chronic inflammatory disorder Harley Septian1*, Made Widhi Asih2, Nyoman Srie Laksminingsih3, Anak Agung Ayu Ngurah Susraini4 Background: Kimura’s Disease (KD) is a benign, rare form of chronic inflammatory disease of unknown origin, almost exclusively found in Asian males in their second to fourth decades of life. This rare condition is mostly present as soft tissue mass consists of multiple painless solitary subcutaneous nodules mostly localized in the head and neck region, with coexisting lymph node enlargement and eosinophilia. This case study aims to describe Kimura’s Disease (KD) characteristics and give an insight into the role of Computed Tomography (CT) scan in identifying KD and its imaging characteristics. Case Presentation: We reported a case of an Asian man with a history of 18 years left-sided painless facial mass, gradually increase in size with no history of hoarseness, ...

Clinical Epidemiology and Global Health, 2021

It has been known that carotid stiffness is a predilection for stroke. Strain elastography (SE) u... more It has been known that carotid stiffness is a predilection for stroke. Strain elastography (SE) ultrasound (US) is one of the new modalities which can evaluate carotid artery stiffness by obtaining its tunica intima media strain value. There were no studies that show the carotid artery SE US value in stroke patients, hence become the underlying reason this study was conducted. The aim of this study was to provide an evaluation of carotid artery SE US values in stroke patients. A pair-matched case-control study was conducted on 40 case subjects and 40 controls which met all inclusion and exclusion criteria. Carotid arteries SE US value was obtained through the average of 3 region of interest (ROI) on each intima media layer of 3 level carotid arteries assessed on both sides. Diagnostic accuracy study was analysed to determine the cut off value between stiff and not stiff. Subsequently, bivariate and multivariate analyses were performed. There were 65% male on both groups with mean age 56.7 ± 13.0 on the case group and 53.8 ± 11.8 on the control group. ROC curve analysis showed that all measurement locations were reliable with high numbers (91.03-97.8%). The cut of value of carotid artery stiffness was ≥0.9333 (97.5% sensitivity and 90% specificity). Carotid artery stiffness is a major risk factor of stroke with OR 351 (p value 0.000). Multivariate analysis showed that carotid artery stiffness remained a strong risk factor of stroke (OR 467.89, p value 0,000). Other radiologist can repeat this technique with good interobserver (r = 0.782-0.985) and intraobserver reliability (r = 0.802-0.954). Carotid artery stiffness is a strong risk factor for stroke, with carotid artery stiffness SE US cut off values of ≥0.9333.

Jurnal Ilmiah Kedokteran Wijaya Kusuma, 2019

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberc... more Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR’s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME cr...

Intisari Sains Medis, 2020

Inclusion and Exclusion Criteria This study was a cross-sectional observational analytic study wi... more Inclusion and Exclusion Criteria This study was a cross-sectional observational analytic study with a consecutive non-random sampling method conducted during May

Bali Medical Journal, 2019

Background: Subaxial cervical spine is the cervical segment which commonly undergo degenerative c... more Background: Subaxial cervical spine is the cervical segment which commonly undergo degenerative changes. There are numerous cervical lordosis angle measurement, however posterior tangential method is considered more accurate to detect any degenerative related changes. Aim: This study aimed to find the profile of cervical lordotic curve among patients with cervical degenerative disease, and to determine the correlation between degenerative process of subaxial cervical spine columns and cervical curve malalignment. Method: A cross sectional study was conducted by adopting the posterior tangent measurement. Cervical alignment was measured from cervical MRI mid sagittal section to identify loss of cervical lordotic and the presence of kyphosis. Degenerative disease of each vertebral column of subaxial cervical spine, anterior and posterior were evaluated. Spearman correlation test was done to identify the relationship between degenerative process of each column of subaxial cervical spine with loss of cervical lordosis and the presence of kyphosis. Multivariate analysis was done to adjust the effect of confounding variable. Result: Total of 90 subjects with male predominance (62%), mean age 54± 1.3 years. Neck pain contributes the most presenting complain (92%). As many as 51 subjects have hypo-lordosis, while 32 subjects have kyphotic changes. There was no significant correlation between degenerative process of each column of subaxial cervical spine and loss of cervical lordotic, but significant correlation was found between posterior listhesis and cervical kyphosis defomity. (p < 0.05). Conclusion: There was significant correlation between cervical kyphotic malalignment with posterior listheis in all three vertebra columns instead of hypo-lordosis.

Intisari Sains Medis, 2019

Background: Low back pain (LBP) is a common problem in almost all parts of the world. It may caus... more Background: Low back pain (LBP) is a common problem in almost all parts of the world. It may cause disability and a huge social and economic burden in the community. Radiological examination is often necessary to help the doctor in evaluating LBP. Aim: The study aims to find out the radiological characteristics of LBP as a preventive effort against those case. Method: The study was descriptive cross-sectional design involved 65 LBP patients as study respondents in Sanglah General Hospital from March 2016-October 2017. Result: Characteristics of LBP patients are male patients and patients aged 50-59 years. Both are the most frequent sample which were found out in the study. Conclusion: The most common radiological findings in each examination modality are as follows: osteophytes on Radiographic examination, burst fracture, compression fracture and fractures of spinous process on CT scan, and spinal canal stenosis on MRI examination.

Open Access Macedonian Journal of Medical Sciences, 2020

BACKGROUND: Human infection of Streptococcus suis in Indonesia was increasing in the following ye... more BACKGROUND: Human infection of Streptococcus suis in Indonesia was increasing in the following years. Many cases presented with meningitis and sepsis, but in the current case, we presented a rare case of meningitis S. suis infection with spondylodiscitis. CASE REPORT: A 60-year-old man, Balinese, presented with the 3-day onset of fever, headache, and nausea. Three-hour before admission, he became agitated and decreased of consciousness. He had a history of pork consumption 4 days before admission. He was subsequently diagnosed with acute bacterial meningitis and sensorineural hearing impairment. In the next 2 weeks, he developed low back pain, confirmed as spondylodiscitis from magnetic resonance imaging, a less common presentation of S. suis infection. After 4-week intravenous ceftriaxone treatment, he improved significantly with only hearing impairment remaining. CONCLUSION: Meningitis suis is a systemic infection which can manifest in any organ. The clinician should suspect any l...

International Journal of Research in Medical Sciences, 2019

Medulloblastoma is a common malignant brain tumor of childhood which characterized as an infraten... more Medulloblastoma is a common malignant brain tumor of childhood which characterized as an infratentorial mass in the roof of the 4th ventricle, causing mass effect and non-communicating hydrocephalus. A 3 years old boy with history of chronic progressive weakness one-month prior admission, followed by difficulty in walking and ataxia. His MRI examination showed an intraaxial well defined mass, partial irregular border, size 4.2x4.0x4.1 cm at pons, hypointense in T1W1, hyperintense in T2W1, iso-hypointense in flair, and showing inhomogen contras enhancement after gadolinium administration. It pressed the 4th ventricle without dilatation of other ventricles, suggesting a pontine glioma. Patient underwent surgery to remove mass and the pathological examination revealed small round cells, with differential diagnose of medulloblastoma and anaplastic astrocytoma. This case presented as there was a discrepancy in the clinicoradiological diagnosis with the pathological diagnose of medullobla...

Indonesian Journal of Physics and Nuclear Applications, 2019

The purpose of this study was to determine the factors that influence the infant mortality rate i... more The purpose of this study was to determine the factors that influence the infant mortality rate in Karangasem, Bali. The method used in this research is the Log Linier model. In the Log linear model analyze relationship pattern among group of categorical variables which include an association of two or more variables, either simultaneously or partially. A Patterned relationship between variables can be seen from the interaction between variables. Log linear analysis does not distinguish between explanatory variables and response variables. The population in this study was all babies born in Karangasem in 2015 that is as many as 7,895 babies with live birth status and as many as 7,835 babies and 60 infants died. As a sample, 100 babies were taken, of which 60 were live and 40 died. The results show that infant mortality is affected by infant weight, how old the mother during childbirth, and interaction between birth spacing and infant weight

World Neurosurgery, 2018

Background: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pa... more Background: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pathophysiology underlying this condition remains unclear. Some theories have been proposed. The authors present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH Case Description: A 59-year-old female admitted with terrible back pain two weeks after minor head injury. The pain was getting worse when walking or standing and a little bit relieved by sitting. There was no clinical evidence of back injury. There was no neurological deficit. MRI of the spine showed subacute spinal SDH from T12 to S1. Due to the progressive worsening of back pain, bilateral laminectomy of L1-S1 and drainage of subacute spinal SDH were performed. The pain was completely relieved after surgery. However, on day 4, the patient was noted unconscious with GCS E2, V3, and M5. Head CT scan showed subacute bilateral cranial SDH. Burr hole drainage was performed. The patient was completely recovered. Conclusions: Our case suggests the possibility that spinal SDH development as a result of cranial SDH migration to the most dependent spinal subdural space. The doctor should aware of developing symptomatic cranial SDH following spinal SDH evacuation.

Piramida, Jan 7, 2012

The 9 years compulsory education program purposes to give minimum education to the Indonesian cit... more The 9 years compulsory education program purposes to give minimum education to the Indonesian citizen for developing their potency in order to live independently in their community or to continue their education to the higher education. This research aimed to know response of isolated Village Community towards 9 years compulsory education program and also the variables that influencing those responses. This research located at Munti Gunung Village The variables that identifies influencing the responses of Munti Gunung Village Community towards 9 years compulsory education program is analyzed through multinomial logistic regression method. From 221 samples, 66,52 percent families support the program, 5,43 percent families are apathetic, and 28,05 percet families do not support the program of 9 years compulsory education program. The result that is analyzed by multinomial logistic regression method produces the best models: • The apathetic statement that is compared with supported statement model. g 1 (x)=-28,27236 + 22,45813x 1-0,00000896x 7 + 0,2349989x 2-1,90424x 3 • The unsupported statement that is compared with supporting statement model. g 2 (x) =-9.427904 + 3.773763x 1-0.00000901x 7 + 0.2554591x 2-1.011138x 3 Based on the best models that are formed, the independent variables that significantly influencing the responses of the Munti Gunung Village Community towards 9 years compulsory education program are children's sex (x 1) and the age of the head of family (x 2), both of those variables are influencing positively, otherwise the head of family's education (x 3) and family's income (x 7) influencing negatively. The determination coefficient value that is formed based on the best model is 60, 57 percent.

Bali Medical Journal, 2021

Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and ot... more Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and other malignant bone tumors. The radiologists' ability to accurately diagnose osteosarcoma will determine the therapy and diagnostic consistency. Currently, there is lack of evidence on radiography interpretation reliability of osteosarcoma performed by radiologists. This study aimed to evaluate the interobserver and intraobserver radiologists' compatibility to confirm the diagnosis of osteosarcoma and explore the interpretation variability of radiological description. Methods: This was an interobserver and intraobserver reliability study for osteosarcoma radiograph interpretation. The osteosarcoma radiographs, which have been histopathologically diagnosed, were evaluated retrospectively by two observers and twice by one observer in a different timeline. The components of osteosarcoma identified through the radiographs are bone destruction and its pattern, zone of transition, type of periosteal reaction, type of matrix calcification, skip metastasis, and soft tissue mass. The data analyzed with reliability testing through agreement analysis and Kappa value. Results: After evaluation of 30 radiographs of osteosarcoma, substantial reliability score for periosteal reaction (Kappa 0.79) to almost perfect for bone destruction, types of bone destruction, transitional zone, types of periosteal reaction, calcification matrix, and presence of soft tissue mass (Kappa 0.84-1) were found. There is a strong level of agreement (96.7%) found for skip metastasis. Intraobserver reliability also showed substantial value for the presence of soft tissue mass (Kappa 0.78) and almost perfect for other characteristics of osteosarcoma (0.84-0.93). Conclusion: Intraobserver and interobserver reliability of osteosarcoma radiograph interpretation was substantial and almost perfect.

JBN (Jurnal Bedah Nasional), 2022

Background: Increasing number of cancer survivor motivates clinical practitioner to focus on chro... more Background: Increasing number of cancer survivor motivates clinical practitioner to focus on chronic effect of chemotherapy agent, especially those with vascular toxicity effect, which may attenuate the incidence of thrombosis and atherogenesis. Ultrasonography examination on carotid intima media thickness (C-IMT) provides acurate result in evaluating atherosclerotic. The purposes of this research are to find out any structural changes of carotid artery, especially atheroclerosis changes in breast cancer patient after chemoteraphy. Methods: Analytic cross sectional study using a pre post test group design in breast cancer patients. Eligible subjects undergo carotid ultrasonography examination prior to chemoteraphy and after they had completed the 3 cycles of chemoteraphy for the second exam. The examination was perfomed with the same USG machine, high frequency linier transducer (>7mHz) in B-mode under the auspecies of two reputable radiologist consultant. Results: Total patient...

Medicina

Introduction: Pituitary apoplexy (PA) is a rare clinical syndrome in adolescents that can cause a... more Introduction: Pituitary apoplexy (PA) is a rare clinical syndrome in adolescents that can cause a life-threatening situation. This review describes the main clinical and MRI findings in two patients with pituitary macroadenoma presenting with pituitary apoplexy in Sanglah Hospital. Case Report: A 61-year-old male patient was admitted to the Sanglah Hospital because of a sudden intense headache, accompanied by nausea and vomiting, and a history of blurred vision. Physical examination showed papil atrophy in his left and right eyes. His laboratory finding was unremarkable. The second case is a 57-year-old female patient, was admitted because of sudden-onset severe headache, with vomiting and fever as well. Laboratory testing showed an elevated prolactin level. Discussion: Haemorrhage and necrosis within a pituitary tumor are frequently incidentally observed by Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). They are often asymptomatic, configuring the subclinical pituitary apoplexy, and occur in 14-22% of patients with a pituitary macroadenoma. MRI predominantly showed an intra-and suprasellar expanding mass with different signal intensities on T1WI and T2WI, depending on the presence of hemorrhage and on its stage. In first patient the MRI findings are extraaxial mass from intra to supra sella which attached to cavernous sinus and caused compression of chiasma opticum to superior. The second patient showed a pituitary tumor without supra-sellar expansion. In these two patient, the masses showed isointense and hyperintense signal intensity in T1W1, T2W1, FLAIR indicating the presence of intratumoral hemorrhage, and after Gad revealed inhomogen contrast enhancement. Conclusion: Two patient in Sanglah Hospital showed acute clinical syndrome appearance of apoplexy, simultaneously with the presence of pituitary macroadenoma hemorrhage in MRI findings. The situation must be reported immediately because early diagnostic and prompt treatment it's very important for a better prognosis.

Indonesia Journal of Biomedical Science : IJBS, Mar 8, 2023

JBN (Jurnal Bedah Nasional)

Aim: Assessed the correlation between prostate volume and intravesical prostatic protrusion with ... more Aim: Assessed the correlation between prostate volume and intravesical prostatic protrusion with detrusor wall thickness through transabdominal sonographic examination of benign prostate enlargement (BPE). Methods: The study is a paired-group analytical observational cross-sectional study during April – July 2020. Measurements were made of prostate volume, intravesical prostatic protrusion, and detrusor wall thickness using transabdominal sonography. An analysis was carried out to determine the correlation with bivariate analysis and the calculation of the research power. Results: Thirty-four BPE patients with a mean age of 62.41 years were included in the study. The mean value of prostate volume obtained was 44.24 cc; 8.66 mm for intravesical prostatic protrusion; and detrusor wall thickness is 1.49 mm. The correlation value between prostate volume and detrusor wall thickness was 0.12 (p=0.46), while the intravesical prostatic protrusion and detrusor wall thickness were 0.37 (p=0.0...

Bali Medical Journal, 2021

Indonesia Journal of Biomedical Science, 2021

Open access: ht p://isainsmedis.id/ Kimura’s disease: a neoplasm mimicking, a rare benign form of... more Open access: ht p://isainsmedis.id/ Kimura’s disease: a neoplasm mimicking, a rare benign form of chronic inflammatory disorder Harley Septian1*, Made Widhi Asih2, Nyoman Srie Laksminingsih3, Anak Agung Ayu Ngurah Susraini4 Background: Kimura’s Disease (KD) is a benign, rare form of chronic inflammatory disease of unknown origin, almost exclusively found in Asian males in their second to fourth decades of life. This rare condition is mostly present as soft tissue mass consists of multiple painless solitary subcutaneous nodules mostly localized in the head and neck region, with coexisting lymph node enlargement and eosinophilia. This case study aims to describe Kimura’s Disease (KD) characteristics and give an insight into the role of Computed Tomography (CT) scan in identifying KD and its imaging characteristics. Case Presentation: We reported a case of an Asian man with a history of 18 years left-sided painless facial mass, gradually increase in size with no history of hoarseness, ...

Clinical Epidemiology and Global Health, 2021

It has been known that carotid stiffness is a predilection for stroke. Strain elastography (SE) u... more It has been known that carotid stiffness is a predilection for stroke. Strain elastography (SE) ultrasound (US) is one of the new modalities which can evaluate carotid artery stiffness by obtaining its tunica intima media strain value. There were no studies that show the carotid artery SE US value in stroke patients, hence become the underlying reason this study was conducted. The aim of this study was to provide an evaluation of carotid artery SE US values in stroke patients. A pair-matched case-control study was conducted on 40 case subjects and 40 controls which met all inclusion and exclusion criteria. Carotid arteries SE US value was obtained through the average of 3 region of interest (ROI) on each intima media layer of 3 level carotid arteries assessed on both sides. Diagnostic accuracy study was analysed to determine the cut off value between stiff and not stiff. Subsequently, bivariate and multivariate analyses were performed. There were 65% male on both groups with mean age 56.7 ± 13.0 on the case group and 53.8 ± 11.8 on the control group. ROC curve analysis showed that all measurement locations were reliable with high numbers (91.03-97.8%). The cut of value of carotid artery stiffness was ≥0.9333 (97.5% sensitivity and 90% specificity). Carotid artery stiffness is a major risk factor of stroke with OR 351 (p value 0.000). Multivariate analysis showed that carotid artery stiffness remained a strong risk factor of stroke (OR 467.89, p value 0,000). Other radiologist can repeat this technique with good interobserver (r = 0.782-0.985) and intraobserver reliability (r = 0.802-0.954). Carotid artery stiffness is a strong risk factor for stroke, with carotid artery stiffness SE US cut off values of ≥0.9333.

Jurnal Ilmiah Kedokteran Wijaya Kusuma, 2019

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberc... more Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR’s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME cr...

Intisari Sains Medis, 2020

Inclusion and Exclusion Criteria This study was a cross-sectional observational analytic study wi... more Inclusion and Exclusion Criteria This study was a cross-sectional observational analytic study with a consecutive non-random sampling method conducted during May

Bali Medical Journal, 2019

Background: Subaxial cervical spine is the cervical segment which commonly undergo degenerative c... more Background: Subaxial cervical spine is the cervical segment which commonly undergo degenerative changes. There are numerous cervical lordosis angle measurement, however posterior tangential method is considered more accurate to detect any degenerative related changes. Aim: This study aimed to find the profile of cervical lordotic curve among patients with cervical degenerative disease, and to determine the correlation between degenerative process of subaxial cervical spine columns and cervical curve malalignment. Method: A cross sectional study was conducted by adopting the posterior tangent measurement. Cervical alignment was measured from cervical MRI mid sagittal section to identify loss of cervical lordotic and the presence of kyphosis. Degenerative disease of each vertebral column of subaxial cervical spine, anterior and posterior were evaluated. Spearman correlation test was done to identify the relationship between degenerative process of each column of subaxial cervical spine with loss of cervical lordosis and the presence of kyphosis. Multivariate analysis was done to adjust the effect of confounding variable. Result: Total of 90 subjects with male predominance (62%), mean age 54± 1.3 years. Neck pain contributes the most presenting complain (92%). As many as 51 subjects have hypo-lordosis, while 32 subjects have kyphotic changes. There was no significant correlation between degenerative process of each column of subaxial cervical spine and loss of cervical lordotic, but significant correlation was found between posterior listhesis and cervical kyphosis defomity. (p < 0.05). Conclusion: There was significant correlation between cervical kyphotic malalignment with posterior listheis in all three vertebra columns instead of hypo-lordosis.

Intisari Sains Medis, 2019

Background: Low back pain (LBP) is a common problem in almost all parts of the world. It may caus... more Background: Low back pain (LBP) is a common problem in almost all parts of the world. It may cause disability and a huge social and economic burden in the community. Radiological examination is often necessary to help the doctor in evaluating LBP. Aim: The study aims to find out the radiological characteristics of LBP as a preventive effort against those case. Method: The study was descriptive cross-sectional design involved 65 LBP patients as study respondents in Sanglah General Hospital from March 2016-October 2017. Result: Characteristics of LBP patients are male patients and patients aged 50-59 years. Both are the most frequent sample which were found out in the study. Conclusion: The most common radiological findings in each examination modality are as follows: osteophytes on Radiographic examination, burst fracture, compression fracture and fractures of spinous process on CT scan, and spinal canal stenosis on MRI examination.

Open Access Macedonian Journal of Medical Sciences, 2020

BACKGROUND: Human infection of Streptococcus suis in Indonesia was increasing in the following ye... more BACKGROUND: Human infection of Streptococcus suis in Indonesia was increasing in the following years. Many cases presented with meningitis and sepsis, but in the current case, we presented a rare case of meningitis S. suis infection with spondylodiscitis. CASE REPORT: A 60-year-old man, Balinese, presented with the 3-day onset of fever, headache, and nausea. Three-hour before admission, he became agitated and decreased of consciousness. He had a history of pork consumption 4 days before admission. He was subsequently diagnosed with acute bacterial meningitis and sensorineural hearing impairment. In the next 2 weeks, he developed low back pain, confirmed as spondylodiscitis from magnetic resonance imaging, a less common presentation of S. suis infection. After 4-week intravenous ceftriaxone treatment, he improved significantly with only hearing impairment remaining. CONCLUSION: Meningitis suis is a systemic infection which can manifest in any organ. The clinician should suspect any l...

International Journal of Research in Medical Sciences, 2019

Medulloblastoma is a common malignant brain tumor of childhood which characterized as an infraten... more Medulloblastoma is a common malignant brain tumor of childhood which characterized as an infratentorial mass in the roof of the 4th ventricle, causing mass effect and non-communicating hydrocephalus. A 3 years old boy with history of chronic progressive weakness one-month prior admission, followed by difficulty in walking and ataxia. His MRI examination showed an intraaxial well defined mass, partial irregular border, size 4.2x4.0x4.1 cm at pons, hypointense in T1W1, hyperintense in T2W1, iso-hypointense in flair, and showing inhomogen contras enhancement after gadolinium administration. It pressed the 4th ventricle without dilatation of other ventricles, suggesting a pontine glioma. Patient underwent surgery to remove mass and the pathological examination revealed small round cells, with differential diagnose of medulloblastoma and anaplastic astrocytoma. This case presented as there was a discrepancy in the clinicoradiological diagnosis with the pathological diagnose of medullobla...

Indonesian Journal of Physics and Nuclear Applications, 2019

The purpose of this study was to determine the factors that influence the infant mortality rate i... more The purpose of this study was to determine the factors that influence the infant mortality rate in Karangasem, Bali. The method used in this research is the Log Linier model. In the Log linear model analyze relationship pattern among group of categorical variables which include an association of two or more variables, either simultaneously or partially. A Patterned relationship between variables can be seen from the interaction between variables. Log linear analysis does not distinguish between explanatory variables and response variables. The population in this study was all babies born in Karangasem in 2015 that is as many as 7,895 babies with live birth status and as many as 7,835 babies and 60 infants died. As a sample, 100 babies were taken, of which 60 were live and 40 died. The results show that infant mortality is affected by infant weight, how old the mother during childbirth, and interaction between birth spacing and infant weight

World Neurosurgery, 2018

Background: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pa... more Background: Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. The pathophysiology underlying this condition remains unclear. Some theories have been proposed. The authors present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH Case Description: A 59-year-old female admitted with terrible back pain two weeks after minor head injury. The pain was getting worse when walking or standing and a little bit relieved by sitting. There was no clinical evidence of back injury. There was no neurological deficit. MRI of the spine showed subacute spinal SDH from T12 to S1. Due to the progressive worsening of back pain, bilateral laminectomy of L1-S1 and drainage of subacute spinal SDH were performed. The pain was completely relieved after surgery. However, on day 4, the patient was noted unconscious with GCS E2, V3, and M5. Head CT scan showed subacute bilateral cranial SDH. Burr hole drainage was performed. The patient was completely recovered. Conclusions: Our case suggests the possibility that spinal SDH development as a result of cranial SDH migration to the most dependent spinal subdural space. The doctor should aware of developing symptomatic cranial SDH following spinal SDH evacuation.

Piramida, Jan 7, 2012

The 9 years compulsory education program purposes to give minimum education to the Indonesian cit... more The 9 years compulsory education program purposes to give minimum education to the Indonesian citizen for developing their potency in order to live independently in their community or to continue their education to the higher education. This research aimed to know response of isolated Village Community towards 9 years compulsory education program and also the variables that influencing those responses. This research located at Munti Gunung Village The variables that identifies influencing the responses of Munti Gunung Village Community towards 9 years compulsory education program is analyzed through multinomial logistic regression method. From 221 samples, 66,52 percent families support the program, 5,43 percent families are apathetic, and 28,05 percet families do not support the program of 9 years compulsory education program. The result that is analyzed by multinomial logistic regression method produces the best models: • The apathetic statement that is compared with supported statement model. g 1 (x)=-28,27236 + 22,45813x 1-0,00000896x 7 + 0,2349989x 2-1,90424x 3 • The unsupported statement that is compared with supporting statement model. g 2 (x) =-9.427904 + 3.773763x 1-0.00000901x 7 + 0.2554591x 2-1.011138x 3 Based on the best models that are formed, the independent variables that significantly influencing the responses of the Munti Gunung Village Community towards 9 years compulsory education program are children's sex (x 1) and the age of the head of family (x 2), both of those variables are influencing positively, otherwise the head of family's education (x 3) and family's income (x 7) influencing negatively. The determination coefficient value that is formed based on the best model is 60, 57 percent.

Bali Medical Journal, 2021

Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and ot... more Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and other malignant bone tumors. The radiologists' ability to accurately diagnose osteosarcoma will determine the therapy and diagnostic consistency. Currently, there is lack of evidence on radiography interpretation reliability of osteosarcoma performed by radiologists. This study aimed to evaluate the interobserver and intraobserver radiologists' compatibility to confirm the diagnosis of osteosarcoma and explore the interpretation variability of radiological description. Methods: This was an interobserver and intraobserver reliability study for osteosarcoma radiograph interpretation. The osteosarcoma radiographs, which have been histopathologically diagnosed, were evaluated retrospectively by two observers and twice by one observer in a different timeline. The components of osteosarcoma identified through the radiographs are bone destruction and its pattern, zone of transition, type of periosteal reaction, type of matrix calcification, skip metastasis, and soft tissue mass. The data analyzed with reliability testing through agreement analysis and Kappa value. Results: After evaluation of 30 radiographs of osteosarcoma, substantial reliability score for periosteal reaction (Kappa 0.79) to almost perfect for bone destruction, types of bone destruction, transitional zone, types of periosteal reaction, calcification matrix, and presence of soft tissue mass (Kappa 0.84-1) were found. There is a strong level of agreement (96.7%) found for skip metastasis. Intraobserver reliability also showed substantial value for the presence of soft tissue mass (Kappa 0.78) and almost perfect for other characteristics of osteosarcoma (0.84-0.93). Conclusion: Intraobserver and interobserver reliability of osteosarcoma radiograph interpretation was substantial and almost perfect.

JBN (Jurnal Bedah Nasional), 2022

Background: Increasing number of cancer survivor motivates clinical practitioner to focus on chro... more Background: Increasing number of cancer survivor motivates clinical practitioner to focus on chronic effect of chemotherapy agent, especially those with vascular toxicity effect, which may attenuate the incidence of thrombosis and atherogenesis. Ultrasonography examination on carotid intima media thickness (C-IMT) provides acurate result in evaluating atherosclerotic. The purposes of this research are to find out any structural changes of carotid artery, especially atheroclerosis changes in breast cancer patient after chemoteraphy. Methods: Analytic cross sectional study using a pre post test group design in breast cancer patients. Eligible subjects undergo carotid ultrasonography examination prior to chemoteraphy and after they had completed the 3 cycles of chemoteraphy for the second exam. The examination was perfomed with the same USG machine, high frequency linier transducer (>7mHz) in B-mode under the auspecies of two reputable radiologist consultant. Results: Total patient...

Medicina

Introduction: Pituitary apoplexy (PA) is a rare clinical syndrome in adolescents that can cause a... more Introduction: Pituitary apoplexy (PA) is a rare clinical syndrome in adolescents that can cause a life-threatening situation. This review describes the main clinical and MRI findings in two patients with pituitary macroadenoma presenting with pituitary apoplexy in Sanglah Hospital. Case Report: A 61-year-old male patient was admitted to the Sanglah Hospital because of a sudden intense headache, accompanied by nausea and vomiting, and a history of blurred vision. Physical examination showed papil atrophy in his left and right eyes. His laboratory finding was unremarkable. The second case is a 57-year-old female patient, was admitted because of sudden-onset severe headache, with vomiting and fever as well. Laboratory testing showed an elevated prolactin level. Discussion: Haemorrhage and necrosis within a pituitary tumor are frequently incidentally observed by Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). They are often asymptomatic, configuring the subclinical pituitary apoplexy, and occur in 14-22% of patients with a pituitary macroadenoma. MRI predominantly showed an intra-and suprasellar expanding mass with different signal intensities on T1WI and T2WI, depending on the presence of hemorrhage and on its stage. In first patient the MRI findings are extraaxial mass from intra to supra sella which attached to cavernous sinus and caused compression of chiasma opticum to superior. The second patient showed a pituitary tumor without supra-sellar expansion. In these two patient, the masses showed isointense and hyperintense signal intensity in T1W1, T2W1, FLAIR indicating the presence of intratumoral hemorrhage, and after Gad revealed inhomogen contrast enhancement. Conclusion: Two patient in Sanglah Hospital showed acute clinical syndrome appearance of apoplexy, simultaneously with the presence of pituitary macroadenoma hemorrhage in MRI findings. The situation must be reported immediately because early diagnostic and prompt treatment it's very important for a better prognosis.