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Cervical cancer is the fourth most prevalent malignancy in women globally and and the 2nd in Indonesia. In 2008, the Indonesian Cancer Foundation projected that 52 million Indonesian women are at risk for cervical cancer, and that 36% of all cancer patients are cervical cancer patients. Increasing by 0.6% per year. There are 9,496 cervical cancer-related deaths in Indonesia, compared to an estimated 24,400 worldwide. The crude incidence rate of cervical cancer in Indonesia is 17 per 100.000 women. The majority of individuals with cervical cancer who passed away have received chemotherapy and radiation therapy. In recent years, tremendous progress has been made in immune therapy studies focused at preventing cancers from evading the immune response of the tumor. Among them is PD-I research. The association between PD-1 and its PDL-1 ligand suppresses cytotoxic T cells in the immune response to tumors. PDL-1 overexpression was also associated with a poor prognosis in a few other carcinomas. This study intends to determine whether PDL I overexpression is a risk factor for cervical cell carcinoma metastasis. Metastasis is indicative of a poor prognosis in cancer.

Papillary thyroid carcinoma (PTC) comprises 80% of well-differentiated thyroid carcinomas. PTC progression is determined by a variety of biological markers, some of which are connected to the activities of Tumor-Associated Macrophage (TAM). TAM activity is difficult to observe using simply traditional histology techniques. Matrix Metalloproteinase 9 (MMP-9) is an important marker for identifying the development of PTC. However, no studies have linked the expression of MMP-9 to intratumoral macrophages in PTC patients, demonstrating that these macrophages are TAMs implicated in the development of PTC. Through MMP-9 expression on intratumor macrophages, the objective of this work was to evaluate TAM's involvement as a progression determinant of PTC. This cross-sectional study analyzed 40 samples, which included 21 PTC patients with intratumor macrophages and 19 PTC instances without intratumor macrophages. Medical records and paraffin blocks of the Biomedical Laboratory, Faculty of Medicine and Healthcare, Warmadewa University were used to collect samples. The proportion of MMP-9 expression in both groups' macrophages was then determined by immunohistochemical labeling and evaluated using Chi-Square with a significance level (a) of p

Objective: In Indonesia, 45% of the total penile cancer cases are concentrated in Bali province, where penile cancer is ranked as the most common cancer during 2013. However, the incidences of penile cancer in Bali and other provinces in Indonesia are still unknown. The purpose of this study is to determine the age-standardized incidence rate (ASR), age-specific incidence rate (AR), and crude rate incidence (CRI) of penile cancer in Bali and other provinces in Indonesia. Methods: The data were obtained from 11 provinces in Indonesia over a period of 10 years (2004-2013). The samples were 1032 new cases of penile cancer collected manually from the registry. ASR, AR, and CRI were calculated based on the number of new penile cancer cases per 100,000 men in a given province. Indonesian population standard was used to calculate the age-standardized incidence rate. Result: There were variations on ASR, AR, and CRI for penile cancer in Indonesia. We found that the average CRI in Indonesia is 0.1 per 100,000 men. The incidence is found to be higher in Bali compared to other provinces. The average ASR in Bali is 2.1 per 100,000 men, CRI is 2.5 per 100,000 men, and the peak of AR being 12.9 per 100,000 men in the age group of 55-64 years old. The incidence of penile cancer is found to increase with age. In Bali, the peak incidence is in the 6th and 7th decades of life. The ASR and CRI of penile cancer in other provinces were less than 1 per 100,000 males. Conclusion: The highest incidence of penile cancer is found in the Bali province compared to other provinces in Indonesia. This problem requires more serious attention and further research to identify the risk factors.

BACKGROUND: Injury, especially road traffic accident caused injury, was the most cause of death in international traveler worldwide. Estimated more than 1 million people deaths and become disability after injury. Facial fracture was the most common injury in plastic surgery division among international traveler. AIM: This study is aimed to describe the pattern of facial fracture among foreign travelers in Bali to provide prompt prevention and treatment. METHODS: The retrospective study was did using the medical record, imaging analysis including computed tomographies and conventional radiographs of 126 cases of facial fracture from the period of January 2009 to September 2012. The patterns of facial fractures were divided into four main categories of craniofacial, maxillofacial, nasal, and mandibulofacial. RESULTS: The result showed that fractures involving nasal region were the most common (n = 65, 51.6%) followed by midface region (n = 58, 46.0%), craniofacial (n = 50, 39.7%), and mandibulofacial (n = 20, 15.9%), respectively. CONCLUSION: It can be concluded, nasal fracture and midfacial fracture were the most common type of facial fracture with the major cause of motor vehicle accidents.

Adolescent are a transition period and highly sensitive to the influence of new values. The problems they face are also quite complex, one of which concerns reproductive health. Some studies suggest that peers are the most dominant factor in influencing the adolescent reproductive health behaviors. This dedication activity aims to increase adolescent knowledge and activate the role of peers and counseling teachers in disseminating correct information about reproductive health. The method of implementing activities in the form of providing material on adolescent reproductive health by a talk from the expert, training and mentoring to peer groups in carrying out mini counseling, as well as training and counseling for counseling teachers. After the implementation of this program obtained increased peer group knowledge and counseling teachers on adolescent reproductive health respectively as much as 50% and 30.8%. In addition, all peer groups are able to conduct mini-counseling as well as to do better counseling. Through this activity it is hoped that peer group partners and counseling is able to play an active role in continuously spreading information about adolescent reproductive health so that it can produce other peers who help keep the healthy atmosphere of the adolescents.

Cervical cancer is the most common type of cancer in Balinese women, and most of the cervical cancer patients came in advanced condition. The health survey conducted in the village of Puhu, Payangan, Gianyar, found that the coverage of cervical cancer screening is 12%, which is considered as low. Payangan’s sub-district health centers (Puskesmas) have made an effort to give free PAP smear screenings to the local community, but it still has not received a good response. This is related to the community’s lack of knowledge on cervical cancer, low awareness of cancer screening, and false stigma about PAP smear examination. To overcome this problem, an effort is needed to increase awareness about the need for PAP smear screening by shaping it into a cervix cancer awareness movement "Gardavi", involving village midwives and housewife members of Empowerment and Family Welfare Group (PKK) in Puhu Village as cadres. Methods that are used in this community service include training for midwives, activation of tiered information system involving midwives-cadres and the community, knowledge provision as well as motivating cadres. This event is done to increase the role of village midwives and cadres to actively participate in PAP smear screenings in their region, therefore, it may increase screening outcomes and lower mother morbidity and mortality numbers due to cervical cancer. This event results in increased midwives’ knowledge and skill on the technique of sampling PAP smear independently, increased visits to the Community Health Sub-Center (Pustu) for PAP smear examination, creation of a midwives-cadres-community coordination system, cadres independently playing an active role in motivating the village community to do screening, as well as increased cadres’ optimism.

Background: : Penile cancer is a rare type of cancer in men and was the highest in Bali compared to other regions in Indonesia. Around 95% of malignancies in the penis are squamous cell carcinoma (SCC) type. One of the risk factors associated with penile squamous cell carcinoma is an infection caused by Human Papillomavirus (HPV). Human Papillomavirus E6 and E7 oncoproteins play a significant role in penile squamous cell carcinoma carcinogenesis. Overexpression of p16 protein can be used as a marker of HPV infection. This study aims to determine the expression of p16 protein in penile squamous cell carcinoma.Methods: This study was conducted to determine the prevalence of p16 protein expression was assessed by immunohistochemical examination from paraffin block tumors of penile cancer patients. Expression of p16 was observed to be positive when stained with a strong brown color in the nucleus and cytoplasm of tumor cells. The analysis method used in this study is a descriptive statistic to provide a general description of the characteristics of each research variable. The data were processed using SPSS to determine the frequency and median of the age of patients with penile squamous cell carcinoma and the prevalence of p16 protein expression in cell penile squamous cell carcinoma. The data shown in this study are the age range and prevalence of p16 protein expression in penile squamous cell carcinoma using the prevalence table.Results: This study used 142 penile squamous cell carcinoma samples derived from biopsy, partial, and total penectomy. The results of the IHC examination showed that the expression of p16 protein was positive in penile cancer tumor cells in 68 cases (47.9%), with the highest age distribution in the 50–59-year age group (28.2%).Conclusions: Further research is needed to confirm the correlation between HPV infection and p16 protein overexpression in penile squamous cell carcinoma, including HPV genotyping