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All Journal International Journal of Public Health Science (IJPHS) Journal of the Medical Sciences (Berkala Ilmu Kedokteran) JBN (Jurnal Bedah Nasional) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Journal of Global Pharma Technology The Hip and Knee Journal

Rahadyan Magetsari

Departement Of Orthopaedi And Traumatologi Dr. Sardjito General Hospital, Faculty Of Medicine Universitas Gadjah Mada, Yogyakarta, Indonesia

Author-ID : 2410819

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Articles

Accuration of Fine Needle Aspiration Biopsy in Musculoskeletal Tumour Rahadyan Magetsari; Hengkie Marseno; Zikrina Lanodiyu; Punto Dewo
International Journal of Public Health Science (IJPHS) Vol 5, No 2: June 2016
Publisher : Intelektual Pustaka Media Utama

Fine needle aspiration biopsy (FNAB) has been reported to be the preferable choice of biopsy for musculoskeletal tumour. While FNAB appears to have advantages to core biopsy in the aspect of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. This research was designed to evaluate the diagnostic accuracy of fine needle aspiration in musculoskeletal tumour in Sardjito Hospital from 2010 until 2014. This was a descriptive study from medical record in Sardjito Hospital from 2010 until 2014. The inclusion criteria are musculoskeletal tumours in all age level that has been performed FNAB with subsequent operative treatment and confirmation of histopathology examination in Sardjito Hospital. There were 41 elligible subjects in this study. Concordance diagnosis of FNAB and histopathological examination in all musculoskeletal tumor cases was found to be 86%. In addition, the concordance in soft tissue tumor cases was 94% with the detail as follows: giant cell tumor was 86%, synovial sarcoma was 50% and liposarcoma was 50%. In bone tumours, the accuracy was found to be 60% with the detail as follows: distribute osteosarcoma was 60%, osteochondroma was 50% and chondrosarcoma was 50%. Our data showed that accuracy of FNAB for diagnosis of musculoskeletal tumours was 86% with soft tissue tumour 94%, bone tumour 60% and others 93%. Therefore, Fine needle aspiration biopsy is still important diagnosis tool in musculoskeletal tumours.

Structural evaluation and animal implantation of porous eggshell wastederived hydroxyapatite graft as bone substitution Yudha Mathan Sakti; Rahadyan Magetsari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The development of hydroxyapatite graft with high economically value is needed for orthopedic practice in developing countries. Eggsell waste is well known as natural substance for calcium resource. It has been used as raw material in producing hydroxyapatite. This study was conducted to synthesize porous hydroxyapatite from eggshell waste and evaluate its activity as bone substitution. The porous hydroxyapatite graft was manufactured from eggshell and sugar as a raw material using hydrothermal process. The porous eggshell waste-derived hydroxyapatite (EW-HAP) graft was characterized using X ray difractometer (XRD) and analytical scanning electron microscope (SEM) and compared with commercial hydroxyapatite (HAP) JCPDS 09-432 graft (Bangros®) as standard. The porous EW-HAP graft obtained was then implanted on critically sized femoral defects surgically created in the right thigh of male Wistar rats (Rattus norvegicus) with Bangros® as control. Radiological examination using XRD and histological examination using hematoxyline-and-eosin staining of the bone femour were performed at 28 days after implantation. The results showed that the XRD pattern for EW-HAP was likely similar with the HAP standard. However, the SEM examination showed that the pasticle size of EW-HAP graft (2.5-3 μm) was higher than those HAP standard graft (1.5-2 μm). Radiographs according to the International of Limb Salvage (ISOLS) radiological evaluation system between EW-HAP graft (6.1 ± 1.45) and HAP control graft (6.9 ± 2.10) was not significantly different (p>0.05). Moreover, histological examination according to Lane and Shandu scoring system between the both graft (4.0 ± 0.94 versus 4.4 ± 0.92) was also not significantly different (p>0.05). It can be concluded that the structure EW-HAP graft is similar with HAP graft standard. The both grafts have also equal outcome as bone substitution.

Correlation between vascular endothelial growth factor (VEGF) expression with histopathological findings in osteosarcoma Fikar Arsyad Hakim; Yuni Artha Prabowo Putro; Yudha Mathan Sakti; Rahadyan Magetsari; Irianiwati Widodo; Ery Kus Dwianingsih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Vascular endothelial growth factor (VEGF) expression is associated with malignancy progression, metastasis, and poor prognosis in many malignancies, including osteosarcoma. However, studies concerning correlations between VEGF expression and histopathological prognostic factors ofosteosarcoma are limited. This study aimed to evaluate the correlations between VEGF expression and histopathological findings in osteosarcoma’spatients.This was a cross-sectional study using formalin-fixed paraffin embedded (FFPE) samples of 32 osteosarcoma’s patients from Dr. Sardjito General Hospital, Yogyakarta. Histopathological findings of specimens were re-evaluated by two independent observers, recorded for the subtypes, invasiveness, grading, mitotic counts, and tumor infiltrating lymphocytes (TIL). Expression of VEGF was determined based on immunostaining and evaluated using immunoreactivity score (IRS).Chi-square and Spearman correlation test were used to analyze the association between variables. Range of VEGF expression score was 0 to 11, with mean 5.09. Significant negative correlation between the VEGF expression and TIL was observed (p=0.046). However, there was no significant correlations between the VEGF expression and osteosarcomas subtypes, invasion, grading or mitotic counts (p> 0.05). In conclusion, the VEGF expression is associated with TIL. Further study is needed to evaluate the roles of VEGF and lymphocytes in osteosarcoma development dan progression in order to better understand of the role of VEGF in immunotherapy of osteosarcoma.

Comparison of diagnostic accuracy between clinical examination and magnetic resonance imaging (MRI) in diagnosing anterior cruciate ligament (ACL) rupture on Indonesian population Luthfi Hidayat; Aditya Fuad Robby Triangga; Muhamad Afrizal Farkhan; Bernadeta Fuad Paramita Rahayu; Rahadyan Magetsari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Anterior cruciate ligament (ACL) injury is the most common knee ligament injured. Anterior drawer and Lachman tests are the most common physical examinations for helping diagnose ACL injuries, while magnetic resonance imaging (MRI) is the first choice of supporting examination for evaluating any internal abnormality of the knee. However, studies concerning the accuracy of those examinations in the Indonesian population are limited. This study aimed to compare the accuracy between the anterior drawer test, Lachman test, and MRI in diagnosing ACL injury in Javanese patients. This retrospective study used medical records data of patients who underwent knee arthroscopy in the Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital, Yogyakarta in 2018. The MRI and the clinical examination results were compared to the arthroscopy results as the gold standard. The study showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the anterior drawer test were 86.67% (95%CI: 69.28-96.24%), 80% (CI: 44.39-97.48%), 92.86% (CI: 78.88-97.84), 66.67% (CI: 43.28-83.98%), and 85% (CI: 70.16-94.29%), respectively. Lachman test had 96.67% (CI: 82.78-99.92%) sensitivity, 90% (CI: 55.50-99.75%) specificity, 96.67% (CI: 81.86-99.47%) PPV, 90% (CI: 56.44-98.43%) NPV, and 95% (CI: 83.08-99.39%) accuracy. The diagnostic parameters of MRI were 83.33% (CI: 65.28-94.36%) for sensitivity, 60% (CI: 26.24-87.84%) for specificity, 86.21% (CI: 74.21-93.14%) for PPV, 54.55% (CI: 31.77-75.57%) for NPV, and 77.50% (CI: 61.55-89.16%) for accuracy. In conclusion, the Lachman test has better accuracy than the anterior drawer test. Both the anterior drawer and Lachman tests had higher accuracy compared to the MRI.

Penatalaksanaan Giant Cell Tumor pada Distal Radius: Sebuah Laporan Kasus Yuliaji Narendra Putra; Rahadyan Magetsari
JBN (Jurnal Bedah Nasional) Vol 3 No 1 (2019): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Latar belakang: giant cell tumor adalah suatu tumor jinak tulang yang meskipun jarang menyebabkan kematian, tetapi berpotensi untuk menjadi agresif dan mempunyai kemampuan untuk bermetastasis. Kasus: seorang perempuan berusia 20 tahun datang ke rumah sakit dengan keluhan terdapat benjolan di pergelangan tangan sebelah kiri yang telah berlangsung selama 6 bulan. Benjolan tersebut semakin lama dirasakan semakin membesar dan nyeri namun tidak mengganggu pergerakan dari pergelangan tangan. Pada pemeriksaan fisik ditemukan massa solid berukuran 5x3x2 cm dengan kesan terfiksir tulang tanpa tanda peradangan. Range of motion sendi pergelangan tangan masih dalam batas normal. Pada pemeriksaan radiologi ditemukan ekspansil, osteolitik ekstraosseus, serta lesi radiolusen tanpa batas sklerotik, dan reaksi periosteal pada akhir distal radius. Pasien ini didiagnosis dengan giant cell tumor radius distal kiri, kemudian dilakukan penanganan berupa eksisi tumor dan rekonstruksi dengan auto bone graft dari fibula. Evaluasi rutin selama 5 tahun menunjukkan hasil yang baik yang mana tidak tampak tanda-tanda rekurensi, tidak ada reaksi penolakan graft, dan range of motion sendi pergelangan tangan tetap dalam batas normal. Simpulan: tatalaksana giant cell tumor dengan eksisi dan rekonstruksi menggunakan auto bone graft menunjukkan hasil yang baik dan memuaskan.

Correlation between the effect of increasing body weight with plantar pressure and ankle-knee radiographic angle parameters changes Dimas Triaryo; Luthfi Hidayat; Rahadyan Magetsari
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 10, No 1, (2019)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol10.Iss1.art5

Background: Understanding the biomechanical structure of the body is important to preventing and treating the musculoskeletal system problems. The increase in body mass index contributes to the elevated peak plantar pressure and decreased longitudinal arch of the foot. This condition, consequently, may cause mal-alignment of the lower extremity, leading to promote cartilage breakdown, osteophyte formation, subchondral bone hypertrophy, lead to progression of knee joint destruction and functional deficits. Objective: The aim of the study was to examine the correlation between body weight, plantar pressures, ankle and knee angle measurement parameters.Methods: The research study sample included 30 female who met inclusion and exclusion criteria. In order to evaluate the structural characteristic of plantar foot, we used the blueprint method on bare-foot and also when carrying 15 and 25 kilogram of load. Furthermore, to measure knee-angle parameters, we also performed a bilateral standing radiograph approach of lower extremity. Results: This study showed a significant correlation between BMI/Body mass index and HW/heel width (p = 0,00) with low positive correlation for both sides. Furthermore, BMI and PAW/plantar arch width (p = 0,00) showed a moderate positive correlation for both sides. In contrast to that, BMI and MFA/mid-foot area (p = 0,00) showed a moderate positive correlation for the right side but low positive correlation for the left side. Another measurement such as BMI and AI/arch index (p = 0,00) had a strong positive correlation on the right side and moderate positive correlation on the left side. Moreover, BMI and AAL/Ankle angle alignment (p = 0,00) revealed a strong positive correlation for both sides, BMI and XCTP/trans-condylar tibial plateau angle (p < 0,05) had a low positive correlation for both sides, meanwhile BMI and AA/ankle angle (p = 0,00) showed a low positive correlation for both sides. Conclusion: Increasing axial load was statistically significant correlated with increasing plantar pressure and ankle-knee radiographic angle parameter. The results also revealed that increasing axial load was found to have strong correlation to the arch index (AI) and ankle angle alignment (AAL). It was a compensatory phenomenon, which can cause structural disturbances and function of the lower limb.

Clinical Correlates of the Severity of Diabetic Foot Ulcers Rahadyan Magetsari; Meirizal Hasan; Yossie Atyandhari
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (388.796 KB)

OBJECTIVE Severe diabetic foot ulcer leads to amputation and is associated with higher risk of mortality. The purpose of this study is to identify clinical correlates of severe diabetic foot ulcers. METHODS The design of the study was cross-sectional survey of medical records on patients treated in Sardjito Hospital from 1 January to 31 July, 2014. Severe foot ulcer was measured as grade 4 and 5 according to Wagner classification. ABI (Ankle Brachial Index) to estimate blood flow to lower extremities and Semmes-Weinstein test using monofilament to detect neuropathy, classified as positive or negative, were done in all patients. HbA1C, serum sodium and creatinine levels were measured during the latest hospital visit. RESULTS The results of this study showed that 77 (36.5%) among 211 patients had severe foot ulcers (grade 4 and 5, Wagner classification). ABI and Semmes-Weinstein monofilament test failed to predict severity of diabetic foot ulcers. HbA1c increased the odds of severe ulcers while higher serum sodium level and higher diastolic blood pressure protected patients against severe ulcers. CONCLUSION Better glycemic control and caution against excessive reduction of diastolic blood pressure, usually due to anti-hypertension medication, should be recommended to prevent the development of severe foot ulcer. KEYWORDS: diabetic foot ulcers, severity, glycemic control, hypertension, poor circulation, neuropathy

Reconstruction of A Huge Soft Tissue Deffect in Flank Region Using Rectus Femoris Flap Meirizal Hasan; Rahadyan Magetsari; Rezky Saraswaty
Journal of Global Pharma Technology Volume 13 Issue 04 (2021) April 2021
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction:Coverage of full-thickness large flank defect is a challenging procedure for surgeons. The rectus femoris (RF) muscle flap is an excellent donor muscle for many reconstructions. The vascularized rectus femoris (RF) muscle flap has been proved to be effective to cover infected vascular grafts in the flank region. Outcome of the treatment can be evaluated by evaluating the patient daily activity. Case Report:This was a case report conducted on patient with huge soft tissue deffect in flank region. A 62 years old male with large defect of the right flank region due to infection of the abdominal cavity after appendectomy 2 months ago. The wound size 15 x 7 x 7 cm, with the base is bowel, with serohemoragic discharge. Then perform debridement and rectus femoris flap. A month after operation, the patient came to the Sardjito General Hospital with defect of the right hypogastric region and then VAC was performing in this patient. Two month after VAC, the wound was covered by granulating tissue and then the patient underwent FTSG. A month after the second operation, the patient came to outpatient clinic, able to walk, with the condition of the wound was good, no visible sign of infection. Conclusion:From this case report shows that rectus femoris flap has a good result to coverage the huge soft tissue defect in flank region. The patient can perform a simple daily living. Keywords: Rectus femoris, Flank defect, Flap.

Donor Site Morbidity after Anterior Iliac Bone Graft Harvesting Rahadyan Magetsari
Journal of Global Pharma Technology Volume 12 Issue 06 (2020) June 2020
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Bone substitutes are being increasingly used especially in oncologic surgery, traumatology, revision prosthetic surgery and spine surgery. Bone substitute can be defined as a synthetic, inorganic or biologically organic combination which can be inserted for the treatment of a bone defect instead of autogenous or allogenous bone. Despite the improvement of research, human bone grafts persist to be the most effective bone substitutes to replace bone loss. This research was retrospective study conducted in consecutive sampling in Sardjito General Hospital Yogyakarta from January 2014 to Desember 2018. Patients underwent anterior iliac crest bone graft harvesting was included. 4 months after the procedure, the donor site morbidity was identified. The parameters used in this study are pain score using visual analog scale, paresthesia, problem in walking, wound infection, scar satisfaction and major morbidity. Anterior iliac bone graft harvesting resulted in minimal morbidity and neither pain or functional limitations. It also provides the optimal bone graft material, yields minimal morbidity, and is an acceptable choice in autologous bone graft harvesting.

Correlation of Anthropometric Features with Peroneus Longus and Hamstring Tendons Graft Size for ACL reconstruction Aditya Fuad Robby; Luthfi Hidayat; Rahadyan Magetsari
The Hip and Knee Journal Vol 2, No 1 (2021): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Background: Reconstruction of the anterior cruciate ligament (ACL) is a commonly performed surgical procedure in recent years. Surgeons have to consider several factors including patient’s anthropometric variables to harvest the best graft. The hamstring tendon has its’ limitation, such as the tendon graft size deemed unfit especially for people of small statures. The peroneus longus tendon is a relatively new choice compared to hamstring. This study was conducted to know the correlation between anthropometric features with graft parameters or graft size in patients who underwent ACL reconstruction using peroneus longus and hamstring tendons.Materials and Methods: This cross-sectional study was performed in patients who underwent ACL reconstruction using peroneus longus or hamstring tendon autografts. We evaluated their anthropometric variables (age, gender, body mass index (BMI), height and weight) and correlated them with the graft diameter obtained during surgery. Post-operative results were assessed with Karlsson and Peterson Scoring System which represent the ankle function.Results: Twenty-three non-athletic patients underwent ACL reconstruction surgery. Patients with hamstring graft have the average height of 170 cm and 163.6 cm for the peroneal graft group. The average body weight of the hamstring graft group was 72.917 kg and the peroneal graft group was 68.82 kg. The measured BMI of the hamstring graft group was 25.2 kg/m2 and 7.833 mm of graft diameter in average, with 25.5 kg/m2 and 7.636 mm respectively for the peroneus graft group. There were strong positive correlations between weight and BMI with hamstring tendon graft diameter, but negative weak correlations with peroneus tendon graft diameter.Conclusion: We found that body weight and BMI correlate with the diameter of both peroneus and hamstring tendon grafts. Both autografts showed equally good functional results.

Co-Authors Aditya Fuad Robby Bernadeta Fuad Paramita Rahayu Dimas Triaryo Dwianingsih, Ery Kus Fikar Arsyad Hakim Hengkie Marseno Irianiwati Widodo Luthfi Hidayat Meirizal Hasan Meirizal Hasan Muhamad Afrizal Farkhan Punto Dewo Rezky Saraswaty Triangga, Aditya Fuad Robby Yossie Atyandhari Yudha Mathan Sakti Yuliaji Narendra Putra Yuni Artha Prabowo Putro Zikrina Lanodiyu

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