Bali is one of the most popular tourist destinations in Indonesia. As one of the islands in a tropical country, Bali has its own risk of disease transmission. The increasing number and pattern of international travelers can affect morbidity and mortality. Research on disease problems among international travelers in travel destination countries is rarely reported. This study examines health problems concerning foreign tourists visiting hospitals in Bali. This cross-sectional study used total sampling on all medical records of international travelers visiting an international hospital in Bali. A total of 999 medical records were analyzed in this study. The mean age of the patients was 35.55 years. Most patients were female (53.9%) and used travel insurance (55.3%). Most health problems are complaints in the gastrointestinal system (22.3%). The primary health problem is the gastrointestinal system. Most patients use insurance to finance their health. Keywords: Health Problems, Travelers, Infectious and Non-Infectious

Diabetes Melitus (DM) menjadi masalah kesehatan yang utama di dunia. Berbagai komplikasi dapat timbul akibat kadar gula darah yang tidak terkontrol. Salah satu komplikasi DM yang melibatkan ginjal adalah nefropati diabetik, yang ditandai dengan terjadinya proteinuria pada pasien DM. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian proteinuria pada pasien diabetes melitus di Puskesmas I dan IV Denpasar Selatan. Desain pada penelitian ini adalah penelitian analitik dengan pendekatan cross sectional dengan menggunakan data primer yang diperoleh dari wawancara dan pemeriksaan urinalisis. Besar sampel minimal dalam penelitian ini adalah 106 orang yang memenuhi kriteria inklusi dan eksklusi. Data dianalisis dengan menggunakan uji Chi Square dengan tingkat kemaknaan 5%. Jumlah responden dalam penelitian ini adalah 106 responden. Hasil dari penelitian ini didapatkan bahwa sebanyak 33% dari seluruh pasien DM mengalami proteinuria. Terdapat hubungan yang bermakna antara onset DM dengan kejadian proteinuria (p<0,05), sehingga dapat diartikan semakin lama durasi mengalami DM maka kejadian proteinuria akan semakin meningkat, begitu pula sebaliknya. Tidak terdapat hubungan yang bermakna antara usia, jenis kelamin, IMT, jenis terapi DM, dan kadar glukosa darah puasa dengan kejadian proteinuria (p>0,05). Pasien dengan onset DM lebih dari 10 tahun cenderung mengalami proteinuria. Pasien DM disarankan untuk melakukan pemeriksaan proteinuria secara berkala apabila onset DM sudah lebih dari 5 tahun.

Mangrove forest is a natural ecosystem that has been designated as a conservation and tourism area. Besides its function as an ecotourism area, mangrove forests also store biological wealth in the form of bacteria associated with soil from mangrove plants. Bacteria from mangrove communities are known to synthesize various secondary metabolites. However, the bacterial biodiversity associated with soil from mangrove plants, especially those in Bali, has not been explored optimally. This study was designed to analyze the potential of antioxidant activity and cytotoxicity of five bacterial isolates namely Bacillus sp. SA1, Bacillus sp. SA4, Bacillus sp. AM23, Bacillus sp. RM10 and Bacillus sp.RM 18 which were previously isolated from mangrove soil in Ngurah Rai mangrove forest Denpasar Bali. These five bacterial isolates were grown on ISP-2 liquid media and were fermented for seven days. Subsequently, the supernantant of each bacterial isolates was extracted using 100 mL of ethyl acetate with 1:1 ratio (v:v). The antioxidant activity of each ethyl acetate extract was analyzed in vitro using DPPH (1,1-diphenyl-2-picrylhydrazil) assay and the cytotoxicity activity was evaluated by the Brine Shrimp Lethality assay. Results showed that ethyl acetate extracts of the five bacterial isolates display weak antioxidant activity with IC50 values > 150 ppm. The cytotoxicity test showed that the etyhyl acetate crude extract of bacterial isolate RM10 inhibted 70% of Artemia salina larvae, followed by crude extract of Bacillus sp. RM18 and Bacillus sp. SA4 isolate extracts which equally inhibited 60% of these larvae. This results indicated the potential of isolate Bacillus sp.RM18, Bacillus sp.RM10 and Bacillus sp. SA4 in producing cytotoxic compounds. GC-MS chemical profiling of ethly acetate Bacillus sp. RM10 showed 11 different compounds. Three compounds namely 5hydroxymethylfurfural, 1,3,-propanediamine and 2-Aminononadecane were the most dominant compounds detected in the extract. Overall, these findings confirmed the potential bacteria associated with mangrove soil as the source of bioactive compounds.

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