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Correlation between Head Computed Tomography Scan, Pre-operative Blood Lactate, and Pre-operative Glucose Level in Acute Traumatic Subdural Hematoma Jefri Henky; Ahmad Faried
Majalah Kedokteran Bandung Vol 53, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n2.2364

Acute traumatic subdural hematoma (SDH) is a focal brain injury resulting in alteration of cerebral perfusion and glucose metabolism, which would also results in hyperglicemia-induced-hyperlactatemia. A cross-sectional study was performed to analyze acute traumatic SDH patients by head CT scan and observe the effect on pre-operative blood lactate and blood glucose levels in 40 acute traumatic SDH patients at Dr. Hasan Sadikin Hospital, Bandung, Indonesia during the period of July-September 2013. Somers' D correlation were used in the analysis with a p-value of ≤0.05 considered as significant with 95% confidence interval. The mean values of pre-operative blood lactate and blood glucose levels were 3.16±1.49 mmol/L and 155.85±32.95 mg/dl, respectively with a strong positive correlation between the hematoma thickness and the increase in blood lactate (r= 0.656; p= 0.021) and a moderate positive correlation with increased blood glucose (r= 0.556; p= 0.025). In addition, the compressed cistern also had a very weak positive correlation with increase in blood lactate (r =0.156; p=0.043) and very weak positive correlation with increase in blood glucose (r= 0.139; p=0.056) while the midline shift had a weak positive correlation with increased blood lactate (r=0.353; p= 0.041) and a weak positive correlation with increased blood glucose (r = 0.333; p= 0.046). In conclusion, increased hematoma thickness, compressed cistern, and midline shift seen on head CT scan correlate with increasing blood lactate and glucose levels in acute traumatic SDH. Head CT scan, blood lactate level, and blood glucose level can be considered as one of the routine examinations to determine acute traumatic SDH severity at the macroscopic and cellular level.

Functional Recovery of Rare Case of Sciatic Nerve Schwannoma with Peripheral Nerve Block and without Intraoperative Neurophysiological Monitoring Jefri Henky; Ahmad Faried
Majalah Kedokteran Bandung Vol 52, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Schwannoma are benign peripheral nerve tumors derived from the Schwann cells in the neural sheath. Sciatic nerve schwannoma in the lower extremity is uncommon, accounting for only 1% of all schwannoma cases. This report aimed to describe the functional recovery after lower limb surgery of sciatic nerve schwannoma with peripheral nerve block and without intraoperative neurophysiological monitoring (IOM) performed in Semen Padang Hospital in 2019. A 78-year-old woman presented with a complaint of pain on her slowly growing mass at the right popliteal region, which had existed for 22 years. Microsurgical resection was performed with local peripheral nerve block and without intraoperative neurophysiological monitoring. Tumor was removed en-bloc by sharp dissection using a microscope without any complication. The patient had significant pain relief without any neurologic deficit three weeks after the surgery. Penyembuhan Secara Fungsi Kasus Langka Schwannoma Saraf Sciatic dengan Blok Saraf Perifer Tanpa Pemantauan Neurofisiologis Intraoperatif Schwannoma adalah tumor saraf tepi jinak yang berasal dari sel Schwann dalam selubung saraf. Pada ekstremitas bawah, schwannoma saraf sciatic jarang terjadi, terhitung 1% dari semua schwannoma. Laporan ini bertujuan menggambarkan pemulihan fungsional dengan blok saraf perifer setelah operasi tungkai bawah schwannoma saraf sciatic tanpa pemantauan neurofisiologis intraoperatif (IOM) di Rumah Sakit Semen Padang, 2019. Seorang wanita 78 tahun datang dengan keluhan nyeri pada massa yang tumbuh perlahan di daerah popliteal kanannya selama 22 tahun. Reseksi bedah mikro dilakukan dengan blok saraf perifer secara lokal dan tanpa pemantauan neurofisiologis intraoperatif. Tumor terangkat secara en-bloc dengan diseksi tajam menggunakan mikroskop tanpa ada komplikasi. Pada minggu ketiga pascaoperasi, pasien mengalami pengurangan rasa sakit yang signifikan tanpa defisit neurologis.

OUTCOME ANALYSIS OF POSTOPERATIVE DECOMPRESSION AND STABILIZATION PATIENTS WITH DEGENERATIVE THORACO-LUMBAR VERTEBRAL FRACTURE Jefri Henky
Jurnal EduHealth Vol. 12 No. 02 (2022): : March, Jurnal EduHealth
Publisher : Sean Institute

Degenerative thoraco-lumbar fractures are structural and functional changes that occur in the thoracal and lumbar vertebrae regions. The degenerative process that occurs as a result of the aging process in each individual is different, as well as in the spinal region. The type of data used in this study is secondary data obtained through medical records conducted by researchers at the Semen Padang Hospital Medical Record Unit, the data includes variables of age, gender, occupation, smoking status, BMI, level of thoraco-lumbar fracture, mean VAS postoperative decompression and stabilization at Semen Padang Hospital. The research was conducted in December 2021 until completion which includes the preparation and reporting stages. This research is a form of analytical study with a cross sectional design. The affordable population was postoperative decompression and stabilization surgery patients in 2019 as many as 30 patients with a total sampling technique. Univariate data analysis is presented in the form of frequency distribution and percentage and data processing using computerized SPSS version 24.0 program. And the results of this study explain that based on the characteristics of the patient's risk factors, the most age is the early elderly 46-55 years, namely 10 people (33.3%), the most gender is female, namely 16 people (53.3%), occupation, which most people are not lifting weights, namely 22 people (73.3%), smoking status is not smoking, namely 24 people (80.0%) and the highest BMI is normal (≥18.5 - <24.9) which is 19 people (63.3%). The highest number of damage levels were 1 and 2 damage levels, respectively, which were 14 people (46.7%). The most pain based on VAS was mild pain, namely 12 people (40.0%). There was a significant effect of the number of levels of damage on the pain scale in postoperative decompression and stabilization patients at Semen Padang Hospital (p= 0.021), and there was a significant effect of the number of levels of damage on the level of post operative decompression and stabilization pain in degenerative thoraco-lumbar fracture patients in Semen Padang Hospital

The Relationship of Body Mass Index In Third Trimester of Pregnancy With Low Back Pain Incidence Jefri Henky; Efriza; Aprillia
Scientific Journal Vol. 1 No. 3 (2022): SCIENA Volume I No 3, May 2022
Publisher : CV. AKBAR PUTRA MANDIRI

Background : Low Back Pain is pain in the lower back which is a sign of disorder that causes a state of discomfort in performing daily activities and is felt in the anatomical area, especially in the fifth lumbal and sacral area. Low Back Pain will increase as gestational ages. This discomfort begins between the fifth and seventh months of pregnancy. Purpose : To find the relationship between body mass index in the third trimester of pregnancy with Low Back Pain incidence. Method : This research is an observational analytical research with cross-sectional approach. The population of this research is pregnant women in the third trimester who visited poly Obstetrics and Gynecology Hermina Padang Hospital with 77 samples by using consecutive sampling technique. Data analysis uses univariate and bivariate analysis with data processing using the computerized SPSS 23.0 version. Results : The most age were 26-35 years which is 44 people (57,1%), the most likely respondents were those who did not work which is 48 people (62,3%), and the most respondents gestational age is > 36 weeks that is 40 people (51,9 %). The average body weight of the respondent is 65.8277 kg with a minimum body weight 51.51 kg and maximum 80.40 kg. The average height of respondent is 157.99 cm with a minimum height 148 cm and maximum 170 cm. The majority of respondents with an overweight body mass index were 50 people (64,9%), the highest level of LBP pain is 2 (a little pain) which is 26 people (33,8%), with respondents experienced LBP of 61 people (79,2%). Based on the bivariate analysis, it is known that there is a relationship between body mass index in the third trimester of pregnancy with Low Back Pain incidence (p=0.022). Conclusion : The third trimester of pregnant women, the most age is early adulthood (26-35 yars), with the most work is not working, and the most gestational age >36 weeks. The average body weight of the respondent is 65.8277 kg and the average height of the respondent is 157.99cm, the most body mass index is overweight, the highest level of LBP pain is 2 (a little pain), and in the third trimester pregnant women experience the most LBP incidence is yes and there is a relationship between body mass index in the third trimester of pregnancy with low back pain incidence.

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