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Cognitive and Functional Outcome of Patients with Ischemic Stroke at Dr. Hasan Sadikin Hospital Bandung Najmia Shabrina Nahrowi; Paulus Anam Ong; Achmad Adam
Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1924.771 KB) | DOI: 10.15850/amj.v5n2.1173

Abstract

Background: Stroke is the second leading cause of death and adult disability throughout the world in which the risk of cognitive impairment tripled after stroke. Approximately 30% of the patients experience residual disabilities and over half of patients remain physically dependent following a stroke. This study aimed to describe cognitive and functional outcome of patients with ischemic stroke at Dr. Hasan Sadikin Hospital Bandung.Methods: This retrospective descriptive study used secondary data from medical records  (January-December 2013) of patients with ischemic stroke at Dr. Hasan Sadikin Hospital, Bandung, and was conducted from June–September 2017. Cognitive outcome was determined by the final score of the Indonesia version of MoCA (MoCA-INA), classified into impaired if the score was <26 and normal if the score was >26.Whereas functional outcome was determined by degradation of Barthel Index (BI), from complete dependence to independence.  Data were analyzed, presented in the form of tables.Results: Out of a total of 91 subjects consisting of 46 female (50.55%) and 45 male (49.45%), the result showed 55 subjects (60.44%) had cognitive impairment with memory (75.82%) as the highest prevalence of impaired cognitive domain. The functional outcome was 34 patients (37.37%) had moderate to complete dependence whereas only 13 patients (14.29%) were independent.Conclusions: Cognitive impairment occurs in more than 75% ischemic stroke patients with memory as the most commonly impaired domain and more than one third of ischemic stroke patients still have moderate to complete dependence in activities of daily living (ADL). 
Comparison of Superficial Surgical Site Infection in Simple Interrupted and Hybrid Mattress Suture after Posterior Approach for Spine Surgery Ajid Risdianto; Rully Hanafi Dahlan; Achmad Adam; Firman Priguna; Muhammad Zafrullah Arifin
International Journal of Integrated Health Sciences Vol 3, No 2 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3397.679 KB)

Abstract

Objective: To compare the incidences of superficial surgical site infection after posterior approach procedures in simple interrupted suture groups compared with hybrid mattress suture group. Methods: A number of 38 patients who underwent posterior approach procedure were randomized into two groups. First group was sutured using simple interrupted suture while the second was using hybrid mattress suture. Bivariate statistical analysis was performed using Chi square test and Mann Whitney test. The superficial surgical site infection incidence was evaluated and recorded for both groups.Results: A superficial surgical site infection was found in 26.3% of the simple interrupted group and no infection was found in the hybrid mattress group. Statistical analysis showed a p value of 0.046.Conclusions: Compared to simple interrupted suture, hybrid mattress suture has less superficial surgical site infection in posterior approach for spine surgery.Keywords: Hybrid mattress suture, simple interrupted suture, superficial surgical site infection, wound healing DOI: 10.15850/ijihs.v3n2.589
Pre-operative Embolization as Resection Strategy in Brain Tumor with No Neurological Deficit Andi N. Sendjaja; Yogi Rosbianto; Agung B. Sutiono; Bilzardy F. Zulkifli; Roland Sidabutar; Achmad Adam; Muhammad Z. Arifin
Journal of Medicine and Health Vol. 2 No. 1 (2018)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (673.761 KB) | DOI: 10.28932/jmh.v2i1.747

Abstract

Meningioma is an intracranial tumor that generally involves meninges. This tumor canbe found along the dura layers at the skull base. Meningioma has vast vascularization from thearteries near dura attachment. Pre-operative embolization technique is an effective strategy toprevent intra-operative complications and better outcomes. The patient was a 24 year-oldwoman who has been complaining of headaches since 2 months ago. The CT Scan resulted in a12 x 9 x 7 cm isodense mass in the left temporoparietal enhanced homogenously by contrast.Pre-operative embolization was performed on the tumor feeding artery as a strategy to preventintra-operative blood loss. A left frontotemporosphenoidal craniotomy was performed 10 daysafter embolization to remove the tumor. A complete resection was successfully achieved withless intraoperative blood loss and without complication. The pathology examination resulted inmeningotheliomatous meningioma. A follow-up picture showed no recurrent tumor afterresection and the patient had no symptoms and neurological deficits until 6 months after thesurgery. In conclusion, meningioma is a common intracranial tumor with a lot of blood supply.However, tumor resection can be safely and efficaciously performed with good pre-operativestrategy.Keywords: brain tumor, embolization, meningioma, resection, skullbase
Hubungan Gejala Klinis Dengan Tekanan Intraventrikuler Pada Hidrosefalus Akut Donny Argie; Muhammad Zafrullah Arifin; Achmad Adam; Akhmad Imron; Mirna Sobana; Agung Budi Sutiono
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.73

Abstract

Latar Belakang. Penelitian tentang gejala klinis atau tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut telah banyak dilakukan, tetapi penelitian yang menghubungkan antara gejala klinis dan tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut belum banyak dilakukan. Tujuan. Mengetahui hubungan antara gejala klinis dengan tekanan intraventrikuler pada pasien pediatrik penderita hidrosefalus akut. Metode. Penelitian prospektif analitik, dimana data diambil dari tanggal 1 Januari 2010 sampai dengan 17 Agustus 2013 di Departemen/ SMF Ilmu Bedah Saraf Fakultas Kedokteran Universitas Padjadjaran/ RSUP Dr. Hasan Sadikin Bandung. Hasil. Jumlah sampel pasien hidrosefalus akut, sebanyak 27 laki–laki (53%) dan 24 perempuan (47%). Penyebab hidrosefalus akut pada penelitian ini adalah neoplasma yaitu sebanyak 24 kasus (47%), dan infeksi 23 kasus (45%). Hasil uji secara statistik menunjukkan bahwa gejala klinis muntah dan penurunan kesadaran memiliki nilai yang bermakna dengan p<0.05 sedangkan nyeri kepala memiliki nilai yang tidak bermakna terhadap peningkatan tekanan intraventrikuler dengan nilai p >0.05. Kesimpulan. Gejala klinis muntah dan penurunan kesadaran mempunyai hubungan dengan tekanan tinggi intrakranial sehingga dapat digunakan sebagai deteksi dini pada pasien pediatrik penderita hidrosefalus akut yang dis- ebabkan oleh neoplasma maupun infeksi.
Efek Tindakan Bedah Terhadap Kadar Laktat Darah dan Glasgow Outcome Scale Penderita Hematoma Subdural Akut Traumatik Jefri Henky; Achmad Adam; Muhammad Zafrullah Arifin
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.74

Abstract

Pendahuluan. Hematoma subdural merupakan salah satu cedera otak lokal yang menyebabkan defisit neurologis, memiliki gejala sisa bahkan kematian. Hematoma subdural akut traumatik memicu iskemia serebri melalui peningkatan tekanan intrakranial akibat edema yang menyebabkan gangguan perfusi otak. Angka keberhasilan pengobatan dan perawatan hematoma subdural akut traumatik dinilai menggunakan Glasgow outcome scale yang sederhana, cepat dan mudah dilakukan. Metode. Studi akuasi eksperimental dengan one group pre–post test design dilakukan terhadap 40 penderita hematoma subdural akut traumatik yang masuk Unit Gawat Darurat RS Dr Hasan Sadikin Bandung periode Agustus–Oktober 2013. Penelitian ini menggunakan uji t–test berpasangan dan uji korelasi Spearman. Kemaknaan ditentukan berdasarkan nilai p<0,05 dan confidence interval sebesar 95%. Hasil. Hasil penelitian menunjukkan nilai rerata kadar laktat darah pra dan pasca bedah adalah 3,16+1,49 mmol/L dan 2,38+1,23 mmol/L, terdapat penurunan yang bermakna rerata kadar laktat pasca bedah (p<0,001). Uji korelasi Spearman didapatkan bahwa kadar laktat pra bedah memiliki korelasi negatif lemah dengan nilai glasgow outcome scale (r=–0,346; p = 0,026). Kesimpulan. Pemeriksaan kadar laktat darah pra dan pasca bedah dapat dipertimbangkan sebagai salah satu pemeriksaan rutin dalam menentukan kerusakan seluler dan nilai glasgow outcome scale akibat hematoma subdural akut traumatik