Andreas Vincent Handoyo
Bagian Orthopaedi dan Traumatologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung

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Operative Management of Tuberculous Spondylitis with Local Instrument Products Rahim, Agus Hadian; Tiksnadi, Bambang; Ramdan, Ahmad; Kamijantono, Harry; Setiawan, Herry; Handoyo, Andreas Vincent; Yusman, Arrio
Journal of the Indonesian Medical Association Vol. 61 No. 7 July 2011
Publisher : Journal of the Indonesian Medical Association

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Abstract

The high demand of spine instrumentation was caused by the increased number of spine tuberculosis, mainly in low income population. The high price of branded instntment leads to local instrument products usage for low income population. This is a descriptive report of tuberculous spondylitis operative management using local instrument performed in Hasan Sadikin General Hospital, Bandung during 2005-2008. There were 61 cases of tuberculous spondylitis which underwent surgery and then evaluated in the outpatient clinic. Nine patients who got local instrument have their vertebral bone healed in 12-17 months after surgery while only seven in patients who got branded instrument. Nine patients who had local instrument expeienced healing after 18-23 months post operation compared to ten who got branded instrument. After 23 month post operation six patients who had local instrument and two who had branded instrument experienced healing of their vertebra. About 18 patients have not shown vertebral healing after this observation ended. Local instrument was reported to give stability of damaged vertebral segment and caused vertebral healing. To be used as an alternative instrument, further research should be conducted to measure the effectiveness of local instrument compared to branded instrument. J Indon Med Assoc. 2011:61:285-8Keywords : tuberculous spondylitis, local instrument
Karakteristik dan Faktor Risiko Obstetrical Brachial Plexus Palsy pada Bayi Baru Lahir Handoyo, Andreas Vincent; Ismiarto, Yoyos Dias
Majalah Kedokteran Bandung Vol 42, No 2 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Obstetrical brachial plexus palsy (OBPP) merupakan cedera sebagian/seluruh plexus brachialis akibat proses kelahiran. Insidensi di negara berkembang berkisar 0,15%. Faktor risiko meliputi intrapartum dan intrauterin. Dibedakan tiga jenis OBPP yaitu Duchenne Erb, Klumpke, dan whole arm palsy. Penelitian bersifat retrospektif, melihat karakteristik dan faktor risiko terjadinya OBPP di RS. Hasan Sadikin, Bandung, periode Januari 2002-April 2007. Data diperoleh dari catatan medik bagian perinatologi, kemudian dilakukan analisis binary logistic regression. Hasil penelitian menunjukkan insidensi OBPP 0,141%, seluruhnya Erb palsy dan kehamilan tunggal. Sebanyak 68,75% presentasi belakang kepala, 50% lahir spontan, 18,75% disertai meconeal staining, 62,5% berat lahir ≥3.500 g, 56,25% laki-laki, 68,75% asfiksia, 12,5% distosia bahu, dan 6,25% fraktur klavikula. Faktor risiko yang bermakna adalah presentasi kaki (OR 9,357; 95%CI), letak lintang (OR 5,136; 95%CI), ekstraksi vakum (OR 5,240;95%CI), ekstraksi forseps (OR 4,320; 95%CI), ekstraksi bokong/kaki (OR 14,411; 95%CI), berat lahir 3.500- 3.999 g (OR 4,571; 95%CI), berat lahir ≥ 4.500 g (OR 57,759; 95%CI), asfiksia (OR 5,992; 95%CI) dan asfiksia berat (OR 6,094; 95%CI). Sectio Cesarea cenderung protektif {OR 0,244; 95%CI; p=0,062 (>0,05)}. Pada penelitian ini dapat disimpulkan bahwa faktor risiko yang terutama berperan adalah presentasi kaki, ekstraksi bokong, dan berat lahir >4.500 g.Characteristics and Risk Factors of Obstetrical Brachial Plexus Palsy in Newborn BabyObstetrical brachial plexus palsy (OBPP) is an injury of entire or part of brachial plexus correlated with delivery process. Incidence in developing countries is around 0.15%. Risk factors include intrapartum and intrauterine. Three types of OBPP are Duchenne Erb, Klumpke, and whole arm palsy. This was a retrospective study of characteristic and risk factors of OBPP in Hasan Sadikin Hospital, Bandung, period January 2002-April 2007. Data were collected from perinatology ward medical records, and analyzed using binary logistic regression. OBPP incidence was 0.141%. All were Erb palsy and single pregnancy, 68.75% were head-occiput posterior presentation, 50% were spontaneous birth, 18.75% had meconeal staining, 62.5% had birth weight ≥3,500 g, 56.25% were male, 68.75% asphyxia, 12.5% shoulder dystocia, and 6.25% clavicle fracture. Risk factors significantly correlated were foot presentation (OR 9.357; 95%CI), transverse fetal position (OR 5.136; 95%CI), vacuum, forceps, breech/foot extraction (OR 5.240;95%CI, 4.320; 95%CI, 14.411; 95%CI, respectively), birth weight 3,500-3,999 g (OR 4.571;95%CI), birth weight ≥4,500 g (OR 57.759; 95%CI), asphyxia (ORs 5.992; 95%CI), and severe asphyxia (OR 6.094; 95%CI). Sectio cesarea tend to have protective effect {OR 0.244; 95%CI; p=0.062 (>0.05)}. The important risk factors of OBPP are foot presentation, breech/foot extraction, and birth weight >4,500 g.DOI: http://dx.doi.org/10.15395/mkb.v42n2.9