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Jimbaran, Indonesia

Udayana University is a public university in Denpasar, Indonesia. It was established on September 29, 1962. Its current rector is Dr. dr. I Made Bakta, SpPD . The university's name was derived from 10th century Balinese King Udayana of Warmadewa Dynasty. Wikipedia.

Rena N.M.,Udayana University
Acta medica Indonesiana | Year: 2010

Albumin infusions have been used for many years in the management of patients with decompensated cirrhosis in an attempt to reduce the formation of ascites, to improve circulatory and renal function, or in SBP patients. While some of these indications for albumin infusions are supported by the results of randomised studies, others are based on clinical experience and have not been proved in prospective investigations. Therefore, the use of albumin infusions in patients with cirrhosis is still controversial. However, despite the controversies, the use of albumin at least has been proven to be safe. Some guidelines recommended the use of albumin infusion in decompensated cirrhosis with spontaneous bacterial peritonitis, hepatorenal syndrome, large volume parecentesis and decompensated cirrhosis with complications.

Suega K.,Udayana University
Acta medica Indonesiana | Year: 2011

to examine the relationship between clinical stage of solid cancers and plasma D dimer value. patients with solid cancer treated in Sanglah hospital who met study ctiteria were consecutively recruited and studied in order to examine the relationship between clinical stage of solid cancers and plasma D dimer value. Plasma D dimer was measured by ELISA (Nycocard) and TNM system to assign each patient into stage I,II,III and IV according to American Joint Committee on Cancer. Rank Spearman analysis was used to determine the relationship and one way Anova to compare the mean difference of D dimer between group of clinical stages. there were 79 patients included, mostly female (72,2%) and 57% was in age group of 40-59 years old. Level of D dimer >500 ng/ml were found in 60 patients and 19 patients with D dimer <500 ng/ml. The most frequent cancer was cervix (32.9%) then followed by nasopharyng cancer (16.5%). Clinical stage I,II,III, and IV were 6.3%, 16.5%, 53.2% and 24.1% respectively. Thrombocytosis (>400.103/uL) was found 50.6% as well as leukocytosis 62%. Although the differences of mean D dimer in each type of solid cancers were big enough but it was not statistically significant (p = 0.156). Plasma D dimer was positively correlated with clinical stage of solid cancers (r = 0.367; p = 0.001). plasma D dimer level was positively correlated with clinical stage of solid cancers. High plasma D dimer could be a marker for advanced stage of a patient with solid cancer.

to confirm the beneficial effect of BMCs therapy over placebo in AMI patients with inclusion only to the randomized double blind placebo-controlled trials. we searched multiple database (MEDLINE, CENTRAL, CINAHL) through January 2011 for randomized, double-blind, placebo-controlled trials evaluating the efficacy and safety of BMCs for the treatment of AMI. We subsequently performed a random-effect meta-analysis to assess the eligible studies included related to the primary outcomes (mean LVEF, LVESV, and LVEDV changes from baseline) and secondary outcomes (all-cause mortality, recurrent MI, rehospitalization for HF). ten RCTs (total=906 patients) were included. BMCs therapy was proven superior to placebo regarding mean LVEF change (2.07%; 95% CI, 0.55% to 3.59%; [I2=57%; p=0.008]), LVESV (5.52 mL; 95% CI, -7.68 mL to -3.36 mL; [I2=16%; p<0.00001]), and LVEDV (3.08 mL; 95% CI, -5.57 mL to -0.58 mL; [I2=23%, p=0.02]) from baseline. BMCs therapy showed no difference with regards to mortality events when compared to placebo (OR 1.01; 95% CI, 0.35 to 2.94; [I2=0%; p=0.98]), but exerts protective effects toward recurrent MI (OR 0.45; 95% CI, 0.09 to 2.16; [I2=8%; p=0.32]) and rehospitalization for HF (OR 0.39; 95% CI, 0.08 to 1.85; [I2=0%; p=0.24]). All outcomes were sustained for a long period of time (up to 5 years). the resulting meta-analysis concluded that BMCs therapy consistently improves cardiac performance parameters (LVEF, LVESV, and LVEDV) when compared to placebo, even after the establishment of primary intervention. It is also safe to use and prevents the development of recurrent MI and HF.

Soejitno A.,Udayana University
Acta medica Indonesiana | Year: 2010

An immediate reperfusion therapy after acute myocardial infarction (AMI) is a prerequisite to prevent further cardiac damage and minimize ventricular remodelling. Although a rigorous and sophisticated set of therapeutic procedure has been applied in the disease management, mortality rate has yet unchanged during the last twenty years. This fact necessitates an alternative or adjuvant therapy that is critically safe and capable of repairing the injured vascular as well as regenerating the infarcted myocardium without omitting the ethical considerations. Stem cell therapy could be the answer. It has gained major basic and clinical research interest, ever since its discovered potential to repair the injured vascular in 1997. Multiple cell types across lineages have been shown to be able to transdifferentiate into mature functioning cardiomyocytes either in vitro through similar phenotypical and genotypical characteristics or in vivo by regenerating the infarcted myocardium and improve contractile function. Although the exact repairing mechanisms are still in a major debate, numerous clinical trials have demonstrated favorable effects toward the use of autologous stem cells in AMI patients with considerably low side effects. Despite the relatively novel discovery, stem cell therapy offers a promising prospect to confer a better protection, prevent later complications, and perhaps reduce the mortality among patients with ischemic heart disease. This ultimate outcome would likely be achieved through a stringent and coordinated of either basic and clinical research.

Masyeni S.,Udayana University
Acta medica Indonesiana | Year: 2013

to evaluate factors which influence bone mineral density in ARV-naive patients in Sanglah Hospital, Bali. a cross-sectional BMD measured by dual X-ray absorptiometry at the lumbar spine (LS) and femoral neck (FN) in 73 ARV-naive HIV-infected patients in out patient clinic of Sanglah Hospital, consecutively, from January to June 2012. Inclusion criteria are ARV-naive HIV-infected patients age 13-50 year old. The relationship among factors influence BMD, CD4 level, HIV RNA, HIV stage (WHO) analysed with Anova and Spearman's correlation test. this study involved 49 males and 24 females. Mean age was 33.08±8.29. Mean CD4 was 144.71±143.40 cell/mmc with the lowest CD4 is 1. Mean viral load (VL) was 272.330±282.990 copies/ml, the lowest VL 400 copies/ml, and the highest 750 000 copies/ml. Low BMD found in 32/73 (43.8%). Osteopenia and osteoporosis were diagnosed in 26/73 (35.6%) and 6/73 (8.2%). 13 (40.6%) of the low BMD cases occurred on the age group 21-30 year. Significant correlation found between low BMD with HIV stage (r=0.337; p<0.001). patients with higher HIV stage have higher risk of low BMD in ARV-naive patient. Further study is needed to evaluate correlation of low BMD with its risk factors.

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