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Wound Healing: Tensional Factor Pathomechanism In Occurance Of Abnormal Scar Laksono, Gerardo AK; Tahalele, Paul L; Anggorwasito, Jose L; Wihastyoko, HYL
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 1, No 3 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Wound healing is a series of biophysiological processes, beginning with tissue injury, and ending with repairs from the wound tissue itself to a complete state consisting of several phases including inflammation, proliferation and remodeling. Every process of wound healing always leaves a scar. Hypertrophic and keloid is a product of abnormal wound healing. This abnormal scar formation is influenced by several factors, one of which is the wound stress. A tension that is too large in a wound will cause a hypoxic state in the wound itself. This hypoxic state will cause recurrent inflammation which leads to abnormal scar formation. One of abnormal scars formation prevention is reduction in wound tension. Reduction in wound tension reduce the inflammation process.

The Difference In Neutrophil/Lymphocyte Ratio In Patients With Acute Appendicitis Without And With Perforation Wismaya, IGP Wegen; Tahalele, Paul L; Rahayu, Titien
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 1, No 4 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Introduction: Acute appendicitis is an inflammation of the appendix vermiformis and is the most frequent cause of acute abdominal. Inflammation occurs due to microorganisms infection that enter the submucosal layer of the appendix and eventually involves all layers of the appendix wall. Acute inflammation can lead to an appendix lumen obstruction, resulting in venous blood engorgement and arterial stenosis. One of the acute appendicitis physiological response from the immune system is an increasing of neutrophils and decreasing of lymphocytes. The result of increasing neutrophils and decreasing lymphocyte are increasing the absolute ratio between neutrophils and lymphocytes Aim: To know the difference of neutrophil / lymphocyte ratio in patients with acute appendicitis without perforation and with perforation at Dr. M. Soewandhie District General Hospital Surabaya. Methods: This research is an analytical research with cross sectional study, with paired categorical analysis sampling method. Respondent of this research is 62 patients, which consist of 31 patients acute appendicitis without perforation and 31 patients acute appendicitis with perforation that fulfilled inclusion and exclusion criteria in January 2016-August 2017. This research was conducted at Dr. M. Soewandhie District General Hospital Surabaya from Saturday, August 19th, 2017 until Saturday, September 30th, 2017. Results: the difference of neutrophil / lymphocyte ratio in acute appendicitis patient without perofration and with perforation analyze by using Fisher?s Exact Test comparative statistic test, p value 0.000

The Efficacy Of Modified Anti Tension Tape (HypafixÂ®) As A Prevention Of Hypertrophic Scar In Facial Region Measured By Vancouver Scar Scale (VSS) Laksono, Gerardo AK; Tahalele, Paul L; Anggowarsito, Jose L; Joseph, Herman
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 1, No 1 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Introduction : Every wound healing process always leaves a scar, hypertrophic scar is a result of abnormal wound healing. Many therapeutic modalities have been discovered that can be used to deal with abnormal scar, but it?s expensive. A modified Anti Tension tape can be used as a modality for hypertrophic scar prevention therapy with an affordable price Aim : The purpose of this study is to find out the effect of application modified anti tension tape (Hypafix®) with the scar quality measured by Vancouver Scar Scale . Methods : This is an observational analytic study using primary data and Cohort study method. The sample in this study were 32 people divided into 2 groups treatment and control group with Non-probability - Consecutive sampling as a data collection techniques. The statistical test used is chi square. Results : From 16 samples treatment group, 14 samples have a good scar quality, 2 samples have a medium/bad scar quality. From 16 samples control group, 5 samples have a good scar quality, 11 samples fall into medium/bad scar quality. Chi square score p= 0,004 Conclusion : There is a positive significant effect between the application modified anti tension tape (Hypafix®) with the scar quality measured by Vancouver Scar Scale

Acute Limb Ischemia (Ali): An Overview Of Clinical Diagnosis And Treatment Laksono, Gerardo AK; Erwin, Ferdinand; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 2, No 2 (2020): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Acute limb ischemia (ALI) is one of vascular emergency. It is defined as a rapid and sudden decrease in limb blood flow due to acute occlusion It is considered to be acute if it occurs within 14 days after the first symptom onset. The incidence of ALI is around 1.5/10.000 people per year. It has reported a mortality rate of 15%-20% in 30 days and high amputation rates 10%-15% if appropriate treatment not administered. The causes of ALI are divided into embolism and thrombosis. Thrombosis can occurred due to atherosclerotic lesion while most cases of embolism are cardiogenic one. Classic features of ALI are known as 6Ps: pain, pallor, paralysis, paraesthesia, pulselessness, poikilothermia. A good history taking and physical examination are needed to assess further treatment needed. Severity of ALI also need to be set based on Rutherford Classification. If the limb was diagnosed as irreversible damage, amputation should be taken as treatment choice without hesitation. ALI can be treated with administered of heparin, endovascular and open surgical. Post treatment follow up also needed to rule out any possible complication such as compartment syndrome and ischemic-reperfusion injury.

A Systematic Overview Of Abdominal Aortic Aneurysm (AAA) Laksono, Gerardo AK; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 2, No 1 (2020): January
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

An abdominal aortic aneurysm (AAA) is defined as an abnormal dilatation of the abdominal aorta more than 50% of its diameter. The aortic wall continues to weaken and become unable to hold the forces of the luminal blood pressure, resulting in progressive dilatation and rupture. The rupture of the aneurysm wall is influenced by several factors, such as the aneurysm size, expansion rate, continued smoking, and persistent hypertension. The AAA is a common degenerative condition with high mortality in older people. The AAA increases these last two decades. It is occurring in 7-8% of men at the age of over 65 years old. The disease prevalence is six times higher in men than in women. It is also increasing dramatically by the presence of the following factors: age older than 60 years old, smoking, hypertension, and ethnicity. Repair of large or symptomatic AAA by open surgery or endovascular is recommended, but not significant in the small aneurysm.

Spontaneous Pneumothorax Following Bronchopleural Fistula In Geriatric Patient: A Case Report And Emergency Management Erwin, Ferdinand; Laksono, Gerardo AK; Sarvasti, Dyana; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 3, No 1 (2021): January
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v3i1.3009

Introduction: Bronchopleural fistula (BPF) is a pathological connection between thebronchial tree and the pleural space. Clinical manifestation of BPF may be classified as acute,subacute, and delayed or chronic forms. Acute BPF can be a life-threatening condition due totension pneumothorax or asphyxiation from pulmonary flooding. Purpose: To report the patient survival from the upper lobe of the right lung bronchopleuralfistula wedge resection and to use staplers as upper lobe pulmonary wound closure. Case Report: 72-year-old male referred from pulmonologist with a chief complaint ofprogressive shortness of breath and nonproductive cough for four days. The patient had ahistory of tuberculosis and COPD and a heavy smoker for the last 50 years. Chestradiography showed a decreased opacity of the right hemithorax, with 40% collapsed of the lung parenchyma. Chest tube insertion performed on the right hemithorax, then the patient got immediate relief. On the seventh day, the patient complained of worsening dyspnea. Achest x-ray showed lung collapsed on the right hemithorax. Multislice CT-scan (MSCT) ofthe chest showed right-sided pneumothorax with bronchopleural fistula. Wedge resection forthe 3 cm in diameter fistula was performed. On the seventh day postoperative, the patient wasfully recovered then discharged from the hospital.Conclusion: Seven days postoperatively of wedge resection, the patient discharge from thehospital without any complication and stable hemodynamic. The patient went to theoutpatient department for follow up one week after.

HEMOTHORAX FOLLOWING PENETRATING THORACIC INJURY (GUNSHOT WOUND) IN GERIATRIC PATIENT: A CASE REPORT AND EMERGENCY MANAGEMENT Laksono, Gerardo AK; Erwin, Ferdinand; Sarvasti, Dyana; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 3, No 2 (2021): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v3i2.3180

Introduction: Penetrating chest trauma is highly lethal. Studies have reported up to 60% mortality depending on the mechanism of injury. While penetrating chest trauma is lesscommon than blunt trauma, it can be more deadly. High-velocity gunshot injury resulting inpenetrating thoracic trauma in geriatric patients poses a significant challenge for the traumaticsurgeon. Hemothorax is usually a consequence of penetrating chest trauma. It can be caused byintercostal arterial bleeding, especially the posterior part. Initial treatment, including chest tubedrainage insertion, is needed to avoid lung compression and to assess future treatment needed. Purpose: To report the patient survival from massive hemothorax caused by penetratingThoracic injury caused by an air rifle, treated by chest tube insertion and posterolateralthoracotomy to take out the bullet several days after.Case Report: 70-year male patient came to the Emergency Room (ER) Adihusada HospitalSurabaya with a penetrating chest injury caused by an air rifle on the right side of the chest. The patient had chest pain, shortness of breath, and hypoxia. By inserting a chest tube,emergency management was done by a general surgeon due to the massive right hemothorax.An immediate chest tube insertion was needed to overcome the patientâ€™s breathing problem toassess the future treatment needed. Chest X-ray and CT-Scan was done immediately after thepatientâ€™s hemodynamic were stable. Three days after hospitalizing, the Cardiothoracic andvascular surgeon performed posterolateral thoracotomy to take the bullet out of the chest.Conclusion: Seven days postoperatively, the patient was discharged from the hospital withoutany complications and stable hemodynamic. The patient went to the outpatient department forfollow-up one week after.

Adult Cardiac Surgery During Covid-19 Pandemic Laksono, Gerardo AK; Hutama, Andreas MS; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 2, No 4 (2020): October
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v2i4.2740

Coronavirus Disease 2019 (COVID-19), which is caused by the SARS Coronavirus 2 (SARS-CoV-2), has affected over 200 countries worldwide. First case of COVID-19 wasfound in Wuhan, China, precisely around December 2019. COVID-19, especially in thosewith underlying health conditions or comorbidities, has an increasingly rapid and severeprogression, often leading to death. This virus is a single-strand RNA coronavirus, binding the angiotensin-converting enzyme 2 (ACE2) receptor which enters human cells. Coronavirusdisease has been reported to affect cardiac and vascular organs. cardiomyocyte death andinflammation are results of a direct mechanism that involves viral infiltration into myocardialtissue. Some cardiovascular manifestations of myocardial injuries associated with COVID-19are arrhythmias, myocardial infarction, heart failure, and elevated biomarkers (cardiactroponin I and brain-type natriuretic peptide). Some of this manifestation requires immediate intervention or surgery. Criteria are needed for hospitals or institutions that mostly maintain cardiac surgery services and surgery-urgent patients depending on severity of the disease and hospital resources. These criteria also limit the risk of exposure to patients and healthcare workers and allocate resources appropriately to those in greatest need. This paper aims to share our discussion and give an overview of patients undergoing cardiac surgery, providing clinicians with recommendations to triage and plan these procedures during the COVID-19 outbreak effectively.

Thoracic Surgery Preparation, Patient Election, and Its Management During Covid-19 Pandemic: Surabaya Experiences Laksono, Gerardo AK; Hutama, Andreas MS; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 2, No 3 (2020): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v2i3.2666

A novel coronavirus pneumonia outbreak began in Wuhan, Hubei Province, in December 2019. It has spread rapidly from China to worldwide. The COVID-19 pandemic of 2020 posed a historic challenge to health care systems around the world, healthcare systems needed to consider providing clinical services to other patients in need. The specialty of general thoracic surgery includes the management of serious diseases such as chest wall congenital anomaly, lung cancers, esophageal cancers, mediastinal tumor, chest wall infection, and trauma. Thoracic surgery is one of high risk procedure in this pandemic, however, a high level of evidence supports the surgical management of potential patients with thoracic disease and anomaly is still lacking. Critical determinants of robust thoracic surgery service provision are pre-existing plans for epidemic response. "Flatten the curve" as an aggressive action is needed. Prioritizations of thoracic surgery cases are needed to differ between elective and emergency cases to limit any contamination. Before surgery, important pre-operative assessments were conducted aims to identify patients' high risk and adjust the procedure. example of a recommendation, if urgent / emergency surgery with symptoms clear clinical pneumonia or rapid test (+). The lessons learned can apply to the other areas during this pandemic, and the world, in preparation for the next one.

THE EFFECT OF ADMINISTERING AFRICAN BITTER LEAF EXTRACT ON SPERMATOGENIC CELLS OF HYPERGLYCEMIC WISTAR RATS Kartana, Kartana; Tahalele, Paul L; Suwasanti, Niluh
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 3, No 3 (2021): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v3i3.3337

Introduction: Diabetes is still a world health problem that can cause many complications.Male infertility is one of the diabetic complications. This condition is caused by oxidativestress in diabetic patients. African bitter leaf is believed to contain an antioxidant compoundthat can repair male infertility. Purpose: This study aims to determine the effect of administering African bitter leaf extracton spermatogenic cell count in hyperglycemic Wistar rats. Method: This study use Rattus norvegicus as an animal model, which was administrated withalloxan to induce hyperglycemic. P0 group were given Na CMC 0,1%, Control group were given glibenclamide 0,63/kg bodyweight for 14 days. 100mg/kg bodyweight (P1), 200mg/kg (P2), and 400mg/kg (P3) of African bitter leaf extract were administrated for 14 days. In theend, the animals were sacrificed, and testicle histopathologic sections were made. Results: Significant result (P<0,05) comparing spermatogonium, primary spermatocyte, andspermatid count between groups. Post-hoc test shows the significant result on comparison ofprimary spermatocyte and spermatid count between P0 and P1.Conclusions: There is an effect of bitter leaf extract administration on spermatogenic cellcount in hyperglycemic Wistar rats. The best improvement can be observed in the P1 group,administered with 100mg/kg bodyweight African bitter leaf.

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