Background: Low back pain is a common complaint which is always found in old age due to degeneration process. Degeneration process of spine, especially in the lumbar region is called lumbar osteoarthritis (OA). Various factors are thought to be the cause of lumbar OA, including primarily due to hormonal changes of estrogen and increase of age and body mass index in postmenopausal women. Methods: The purpose of this study is to determine the role of hormonal changes pathogenesis in lumbar osteoarthritis in postmenopausal women and its correlation with age and body mass index. Cross sectional analytic method had been conducted to determine the role of age, body mass index and estrogen for lumbar OA in postmenopausal women. The study was conducted in Sanglah General Hospital from October 2015 until March 2016 by anthropometric measures and blood samples. Results: From 196 samples showed that the estrogen deficiency in postmenopausal women have a correlation with the symptomatic lumbar OA (r=0.252, p = 0.000). While age and the body mass index in postmenopausal women has a correlation with symptomatic lumbar OA (r = 0.150 and 0.198, p = 0.000 and 0.013). Conclusions:The aging process, body mass index and estrogen deficiency correlated with the symptomatic OA lumbar in post-menopausal women. Suyasa IK et al. Int J Res Med Sci. 2016 May;4(5):1325-1328 International 4-6 These three components are familiar with the three joint complex interplay in lumbar osteoarthritis. There are 3 clinical signs and stages of the degeneration of spinal biomechanics i.e. disc dysfunctions, instability and stability. Keywords7 Spinal degeneration include disc degeneration (DD), facet joint osteoarthritis (OA Facet joint), changes in components of muscle and ligament degeneration. [5][6][7] Hormonal changes that occur during menopause will affect the occurrence of osteoarthritis. In postmenopausal women, the use of HRT (Hormone Replacement Therapy) lowered radiological progression. Estrogen stimulates proteoglycan changes in cartilage, either directly or indirectly through cytokines. 8,9 Estrogen directly affects the tissue by estrogen receptors on human articular chondrocytes and indirectly by secondary messenger.10 Estrogen affects the levels of cytokines in vitro and in vivo. Identification over two estrogen receptors ERα and ERβ on chondrocyte prove that cartilage is sensitive to estrogen.11 Several in vivo and in vitro studies also showed that chondrocytes respond to estrogen and affect its metabolism. 11,12 METHODSThe study was conducted from October 2015 until March 2016 at the Sanglah General Hospital Denpasar Bali. The aim of this study is to prove the correlation of age, body mass index and hormonal changes with symptomatic lumbar osteoarthritis in postmenopausal women.This study is a cross sectional analytic design with the sample are post-menopausal women population with consecutive sampling method.One hundred and ninety six post-menopausal women from the population were taken the anthropometry measure i.e. body weight...

Osteoarthritis (OA) arises from imbalance of cartilage metabolism between the synthesis and degradation of type II collagen by the chondrocyte. Collagen type II degradation is characterized by increase in the biomarker of Ctelopeptide fragment of type II collagen (CTX-II), while the anabolic process of cartilage is characterized by an increase in the biosynthesis of procollagen amino terminal N-propeptide type IIA (PIIANP). Platelet derived growth factor (PDGF) with Hyaluronic Acid (HA) as a potent growth factor can be used to stimulate the higher formation of chondrocyte and PIIANP levels and lower CTX-II levels in mouse knee osteoarthritis model.

AIMTo determine the role of cartilage oligomeric matrix protein (COMP), interleukin (IL)-6, IL-10 and ratio of IL-6/IL-10 as risk factors of symptomatic lumbar osteoarthritis (OA) in postmenopausal women with estrogen deficiency.METHODSCase-control study had been conducted in Sanglah General Hospital from October 2015 until March 2016. The blood samples were obtained and analyzed by enzyme-linked immunosorbent assay (ELISA).RESULTSFrom 44 pairs of samples which divided into 44 samples as case group and 44 samples as control group showed that high level of COMP in estrogen deficiency postmenopausal women were not at risk (OR = 0.7; 95%CI: 0.261-1.751; P = 0.393) for symptomatic lumbar OA (cut-off point 0.946). Estrogen deficiency in postmenopausal women with the high level of IL-6 had 2.7 times risk (OR = 2.7; 95%CI: 0.991-8.320; P = 0.033) for symptomatic lumbar OA from the low level of IL-6 (cut-off point 2.264). At lower level of IL-10, there was no risk for symptomatic lumbar OA (OR = 0.6; 95%CI: 0.209-1.798; P = 0.345) than with the higher level of IL-10 (cut-off point 6.049). While the high ratio of IL-6/IL-10 level in estrogen deficiency postmenopausal women gave 3.4 times risk (OR = 3.4; 95%CI: 1.204-11.787; P = 0.011) for symptomatic lumbar OA than the low ratio of IL-6/IL-10 level (cut-off point 0.364).CONCLUSIONHigh ratio of IL-6/IL-10 plasma level was the highest risk factor for causing symptomatic lumbar OA in postmenopausal women with estrogen deficiency.

Background Low back pain (LBP) is a common clinical condition encountered by most physicians, but the cause and risk factors are still unclear. Cytokines such as IL-6 play an important role in cartilage degeneration, but the role of IL-6 in osteoarthritis (OA) is still debatable. Herein, we aimed to determine the association between high IL-6 levels and lumbar OA in patients older than 55 years with LBP. Method This was a case–control study. Patients included 10 men and 14 women over 55 years of age with lumbar OA. The control group comprised 10 men and 14 women over 55 years of age without lumbar OA. IL-6 analysis was performed for all study subjects. Result The mean age of patients in the case group for both men and women were 67.7±10.4 and 74.4±10.5 years, while that of the control group for both men and women were 67.7±6.3 and 64.9±6.1 years, respectively. Body mass index was not statistically significantly different between the two groups (men and women). Chi-squared analysis showed no statistically significant differences between nutritional status and lumbar OA. Conclusion The probability of lumbar OA in LBP patients with high IL-6 levels (>6.60 pg/ mL) is five times greater than in those with low IL-6 levels ( P =0.009). Women with high IL-6 levels have a 6.9-times greater probability of developing lumbar OA than men ( P =0.03).

Background: Vertebrae are the bones supporting the head and torso. Vertebra protects the spinal cord, and as a liaison ribs and muscles. At the location of the vertebra the spinal cord that are the source of innervation of peripheral and connecting parts neurological signals between the brain with other body parts. Thus, the injuries that occur in the vertebra is fatal and can result in neurological defects such as paralysis. In Indonesia is still very little research on spine injury and spinal cord injury. Therefore, the authors wanted to know about the profile of patients with spine injuries due to trauma in Sanglah Hospital 2015Methods: This study uses descriptive observational research with cross sectional design is to collect data one by using medical records. In terms of retrospective time, respondents in this study were selected through the total sampling. Variables examined in this study include gender, age, location of the injury, and the most common cause of the injury.Results: According on the research profile vertebra due to trauma patients injured in Sanglah Hospital in 2015 is largely male sex (75%), are in the age group 51-60 years (26.7%), with the most common cause is a fall from a height (62.9%), the location of most injured are the cervical part with 45.8%, and most cases of spine injury patients are without SCI with a percentage of 52.4%.Conclusions: Based on the results, it can be concluded profiles of patients with spine injuries due to trauma in 2015 under the Sanglah Hospital is the same when compared to other literatures and experiments with just little differences Latar Belakang: Tulang belakang merupakan tulang penyangga kepala dan batang tubuh. Tulang belakang berfungsi melindungi spinal cord. Pada lokasi tulang belakang terdapat spinal cord yang menjadi sumber persarafan bagian perifer dan menghubungkan sinyal neurologis antara otak dengan bagian tubuh lainnya. Maka dari itu cedera yang terjadi pada bagian tulang belakang sangatlah fatal dan mengakibatkan defek – defek neurologis seperti kelumpuhan. Di Indonesia masih sedikit penelitian mengenai cedera tulang belakang dan spinal cord injury. Oleh karena itu penulis ingin mengetahui mengenai profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015Metode: Penelitian ini menggunakan metode deskriptif observasional dengan desain cross sectional study yaitu dengan melakukan pengumpulan data satu kali dan menggunakan data rekam medis. Dari segi waktu secara retrospektif, Responden dalam penelitian ini dipilih melalui total sampling. Variabel yang diteliti pada penelitian ini antara lain jenis kelamin, umur, lokasi cedera, penyebab terbanyak cedera pada tulang belakang.Hasil: Hasil penelitian di RSUP Sanglah menunjukkan bahwa profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015 adalah sebagian besar berjenis kelamin laki-laki (75%), berada dalam kelompok umur 51-60 tahun (26.7%), dengan penyebab terbanyak adalah jatuh dari ketinggian (62.9%), lokasi terbanyak yang mengalami cedera adalah pada bagian cervical dengan 45.8% dan paling banyak kasus penderita cedera tulang belakang adalah tanpa disertai SCI dengan presentase 52.4%.Simpulan: Berdasarkan hasil penelitian, dapat disimpulkan profil penderita cedera tulang belakang akibat trauma di RSUP Sanglah tahun 2015 sesuai dengan hasil penelitian lain dan literatur yang ada.

This study was aimed at determining the description of predominant physical component profile (physical fitness, fat thickness, agility, muscle endurance, flexibility, power, muscle strength and balance) of the Persipura Junior Football Athletes. This study used a survey of PERSIPURA Junior Football athletes involving 39 people. The inclusions of the athletes inculde male gender, aged 21 years, height 177 cm, an ideal body weight, a healthy body, and moderate to good categories of physical fitness. The instrument used in this study were dynamometer for muscle strength; crunches for muscular  endurance, push-ups, squat jumps, beam side step for agility, flexometer for flexibility, vertical jump for power, and 2.4 km running test for physical fitness. The results showed that the Persipura Junior Football athletes had a good physical fitness, less triceps fat thickness, a normal sub scapular thickness, a normal supra iliaca thickness, lack of agility, a good endurance of arm and shoulder muscles, a good endurance of abdominal muscles, an adequate flexibility, a perfect vertical jump muscle power, a good medicine ball muscle explosive power, a good full muscle strength, lack push muscle strength, and a very good balance. It concludes that to gain an optimal predominant physical component, sports science with measurable and well-programmed exercises should be applied, so that the physical component of triceps fat thickness, agility, and push muscle strength could increase. Abstrak Penelitian ini bertujuan  untuk mengidentifikasi Profil Komponen Fisik Predominan (Kebugaran Jasmani, Ketebalan Lemak, Kelincahan, Daya Tahan Otot, Kelentukan, Daya Ledak Otot, Kekuatan Otot dan Keseimbangan) Atlet Pemain Sepak Bola Persipura Junior. Penelitian ini menggunakan survei terhadap atlet Sepak Bola PERSIPURA Junior sebanyak 39 orang, yang memiliki inklusi: jenis kelamin laki-laki, umur 21 tahun, tinggi badan 177 cm, berat badan ideal, berbadan sehat dan kebugaran fisik dengan kategori sedang sampai kategori baik. Instrumen untuk mengukur kekuatan otot dengan dinamometer; daya tahan otot diukur dengan sit-up, push-up, squat jumps; kelincahan diukur dengan beam side step, kelentukan diukur dengan fleksometer, daya ledak otot diukur dengan vertical jump, dan kebugaran jasmani diukur dengan tes lari 2,4 km. Hasil Penelitian menunjukkan atlet Pemain Sepak Bola Persipura Junior memiliki kebugaran jasmani baik, ketebalan lemak triceps kurang, ketebalan sub scapula normal, ketebalan supra iliaca normal, kelincahan kurang, daya tahan otot lengan dan bahu baik sekali, daya tahan otot perut baik, kelentukan cukup, daya ledak otot vertical jump sempurna, daya ledak otot medicine ball baik, kekuatan otot full baik , kekuatan otot push kurang, keseimbangan baik sekali. Agar komponen fisik predominan optimal, hendaknya menerapkan sports science dengan latihan terukur dan terprogram dengan baik sehingga komponen fisik ketebalan lemak triceps, kelincahan dan kekuatan otot push meningkat.

Background: Spinal Injury is a devastating injury with life-long impact on an individual’s health and quality of life. Sport­ing activities, such as water sport, is also known contributed to the spinal injury.  This study aims to evaluate the water sport-related spine injury (WS-RSI) which is occurred in Bali during 2017 as a preliminary study at BROS Hospital.Methods: A cross-sectional study was conducted retrospectively among 55 patients who got an injury during water-sport activity in 2017 and admitted to BROS Hospital, Denpasar, Bali by medical records. There was 28 patient-related spine injury. Demographic status regarding age, sex, length of stays, hemoglobin (Hb), random blood glucose, nationality, country origin, treatment, patient’s status, history of alcohol intake, type of water sport, and the location of spine injury were recorded. Data were analyzed using SPSS version 25 for Windows in mean±SD, percentage, and odds ratio (OR) as well as statistically significant if P-value less than 0.05.Results: Indonesian travelers were predominant in WS-RSI (53.6%), followed by China and Australia (17.9%), India, Japan, and European countries (3.6%, respectively). The average age of patients was higher in spine injury (47.89±15.98 years; P=0.047). Both sexes were equal (50%). There was no significant difference in Hemoglobin (Hb) (11.08±1.30 g/dL) and random blood glucose (100.65±21.37 mg/dL) (P>0.05) levels. However, there was a significant difference among nationality, type of treatment, patient’s status, and type of WS-RSI compared with non-spine injury (P<0.05). Based on variables, banana boat, foreign travelers, conservative treatment, and outpatient status were having a higher risk in WS-RSI (OR= 4.275; 5.143; 5.014; 7.389; P<0.05, respectively)Conclusion: As a preliminary study, recent findings at BROS Hospital, Denpasar, Bali suggest that several factors are having a higher risk towards water sport-related spine injuries such as older age, banana boat, foreign travelers, conservative treatment, and outpatient status

Background: Fractures contribute to a substantial proportion of the emergency department cases. Surgical procedures such as internal fixation of lower limb fractures posed a risk to develop deep vein thrombosis (DVT). The current diagnosis of DVT is still a challenge, as the current main parameter, the D-dimer, requires additional laboratory time and cost. Threrefore, an easier and faster alternative should be used in clinical decision making. Caprini score is among a simple method to assess the risk of a DVT, but validation is still needed before it can be implemented.Methods: This is an cross-sectional analytic study aimed to determine the relationship between Caprini scores and D-dimer level in patients with post-internal fixation of long bone fractures in lower extrimities at Sanglah Hospital Denpasar. Caprini scores were determined before surgery then D-dimer measurements were taken postoperatively. Statistical analysis was performed using the Pearson correlation method and ROC curve were generated to determine the cut-off point of Caprini Score equivalent of high risk DVT with the D-dimer as the predictor.Result: The average Caprini score was 9.37 (7-13). Mean preoperative D-dimer was 6.59 µg/ml (2.50-13.20 µg/ml), postoperatively 11.50 µg / ml (3.71-19.89 µg/ml) and mean delta D -Dimer 5.23 µg/ml (0.56-12.28 µg/ml). Pearson correlation test obtained a strong positive relationship (r = 0.726 and p≤0,0001). Analysis of the ROC curve to determine the cut-off point for Caprini score which equivalent to the high risk of DVT from D-dimer prediction (> 7.2 µg / ml) resulted in AUC of 0.824 (95% CI 0.669-0.979, p= 0.024) with the optimal cut-off point for Caprini score was 8.Conclusion: Caprini and D-dimer scores show a strong positive correlation.  Caprini scores can be considered to estimate the risk of DVT in post-internal fixation patients of lower extremities long bone fractures. Latar Belakang. Kejadian fraktur memiliki proporsi yang substansial dari total pasien yang datang ke unit gawat darurat rumah sakit. Prosedur operasi seperti pemasangan fiksasi internal pada fraktur ekstremitas bawah memiliki resiko untuk terjadinya trombosis vena dalam (DVT). Penegakan diagnosis DVT saat ini masih merupakan suatu tantangan salah satunya karena pemeriksaan laboratorium D-dimer membutuhkan waktu dan biaya tambahan, sehingga dibutuhkan alternatif yang lebih mudah dan cepat digunakan dalam pengambilan keputusan klinis. Skor Caprini merupakan salah satu cara untuk menilai resiko terjadinya suatu DVT, akan tetapi masih diperlukan validasi sebelum dapat diimplementasikan. Metode: Penelitian cross-sectional analitik dilakukan untuk mengetahui hubungan Skor Caprini dengan kadar D-dimer pada pasien paska operasi fiksasi internal fraktur tulang panjang ekstremitas bawah di RSUP Sanglah Denpasar. Skor Caprini ditentuakan sebelum operasi kemudian pengukuran D-dimer dilakukan paska operasi. Analisis statistik dilakukan dengan metode korelasi Pearson dan penentan titik potong risiko DVT dengan prediktor D-dimer menggunakan metode kurva ROC.Hasil: Rerata Skor Caprini adalah 9,37 dengan rentang skor 7-13. Rerata D-dimer sebelum operasi sebesar 6,59 µg/ml (2,50-13,20 µg/ml), paska operasi 11,50 µg/ml (3,71-19,89 µg/ml) dan rerata delta D-Dimer 5,23µg/ml (0,56-12,28 µg/ml). Uji korelasi Pearson diperoleh hubungan positif kuat antara Skor Caprini dengan kadar D-dimer (nilai r=0,726 dan nilai p≤0,0001). Analisis kurva ROC untuk menentukan itik potong  Skor Caprini yang setara dengan resiko tinggi terjadinya DVT dari prediksi D-dimer (>7,2 µg/ml) memperoleh Area Under Curve 0,824 (95% CI 0,669-0,979, p = 0,024) dengan titik potong optimal skor Caprini 8.Kesimpulan: Skor Caprini dan D-dimer menunjukkan korelasi positif yang kuat pada pasien paska fiksasi internal fraktur tulang panjang ekstremitas bawah. Skor Caprini dapat dipertimbangkan sebagai acuan dalam menentukan resiko terjadinya  DVT.