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GIANT CELL TUMOR OF THE RIGHT DISTAL FEMUR REGION IN A MALE 25 YEARS OLD WITH HIV POSITIVE (RARE CASE) Riyadli, Muhammad; Idulhaq, Mujaddid; Utomo, Pamudji
Biomedika Vol 11, No 2 (2019): Biomedika Agustus 2019
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v11i2.8279

Abstract

Giant cell tumor (GCT) with Human Immunodeficiency Virus (HIV) infection is a rare case. At present, few literatures reported about GCT with HIV positive patients and there are no effective treatments of this disease currently. The aim of this article is to report the change the surgical treatment from limb salvage (wide excision and endoprostheses) to another way limb salvage (wide excision and knee arthrodesis) to minimize risk and further complication. A case of male, 25 years old, with diagnosis GCT of the right distal femur with HIV positive. In this case we administered antiretroviral treatment (ARV) and planned to limb salvage surgery (wide excision and knee arthrodesis).We follow up this patient in the first 4 weeks. There were no complaints, good postoperative wounds, no signs of infection, and histopathological examination postoperative showed the positive results of a GCT. The conclusion the surgical treatment from limb salvage (wide excision and endoprostheses) to another way limb salvage (wide excision and knee arthrodesis) could minimize risk and further complication.Keywords: Giant Cell Tumor, HIV,Limb Salvage Surgery, Wide Excision, Arthrodesis KneeGiant Cell Tumor (GCT) disertai dengan infeksi Human Imminodeficiency Virus (HIV) merupakan kasus yang jarang terjadi. Pada saat ini hanya sedikit literatur yang melaporkan kejadian pasien GCT dengan HIV positif dan belum ada standar terapi yang efektif. Tujuan dari artikel ini adalah melaporkan penggantian penatalaksanaan operatif sebelumnya berupa limb salvage (eksisi luas dan pemasangan endoprosthesis) menjadi eksisi luas dan arthrodesis knee untuk meminimalisir risiko dan kompikasi lebih lanjut. Kasus seorang laki-laki usia 25 tahun dengan diagnosis GCT pada distal femur kanan dengan infeksi HIV positif. Pada kasus ini, terapi yang diberikan adalah Anti Retroviral (ARV) dan operatif dengan limb salvage (eksisi luas dan arthrodesis lutut). Follow up pasien ini pada 4 minggu pertama post operasi. Keluhan nyeri berkurang, luka operasi baik, tidak ada tanda infeksi dan pemeriksaan histopatologi menunjukkan hasil GCT.Kesimpulannya bahwa penatalaksanaan operatif sebelumnya berupa limb salvage (eksisi luas dan pemasangan endoprosthesis) menjadi eksisi luas dan arthrodesis knee dapat meminimalisir risiko dan kompikasi lebih lanjut. Kata Kunci: Giant Cell Tumor, Hiv, Limb Salvage, Eksisiluas, Arthrodesis Lutut
Factors Affecting Ankle Functional Scores at Spastic Diplegia Cerebral Palsy Patients that Have Been Performed Single Event Multi Level Surgery Andryanto, Aryo Budiyogo; Satriadi, Anung Budi; Idulhaq, Mujaddid
Indonesian Journal of Medicine Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (147.364 KB)

Abstract

Background: Single Event Multi Level Surgery (SEMLS) is the treatment most often used to correct deformities and functional in children with Spastic Diplegic Cerebral Palsy. There is no research in Indonesia that assesses the ankle function in patients with Spastic CP Diplegic has done SEMLS. The purpose of this study was to determine the influence of age, gender and time period after surgery with functional ankle patients with CP Spastic Diplegic that has been done SEMLS in the RSO. Prof. Dr. R. Soeharso Surakarta (RSO).Subjects and Method: This study was a cross sectional study in 43 patients (25 male and 18 female) patients with Spastic Cerebral Palsy Diplegia that has been done SEMLS in pediatric orthopedics clinic RSO. Prof.dr.R.Soeharso Surakarta at least 3 months postoperatively, since January 1st 2013 to December 31st 2014. We assessed ankle function using the Oxford Ankle Foot Questionnaire for Children. From the results of the questionnaire we value outcomes as a percentage and we regrouped into 4 groups: value of 91% - 100% for excellent value, 81% - 90% for good, 71% - 80% for fair and if less than 70% for poor. Then we did impact assessment for age, sex and time of the postoperative with functional ankle score of patients with examination of linear regression model analysis.Results: There were 52 patients with Spastic CP Diplegi have done SEMLS but only 43 patients who qualified the inclusion criteria, the youngest patient was 5 years old and the oldest 15 years old with a mean age of 8.3 years. From the 43 patients, 25 are men and 18 were women. Postoperative time with the fastest time of observation was 5 months and the longest was 26 months with a mean of 14.3 months postoperatively SEMLS. From the 43 patients there are 11 patients (25%) function are excellent, 21 patients (49%) are good, 8 patients (19%) are fair, and 3 (7%) are poor. Age factor significantly influence the functional ankle score (p = 0.013) and postoperative time factors also significantly influence the functional score Ankle with (p = 0.04). While gender has no effect on the functional ankle score (p= 0.266).Conclusion: Paediatri Orthopaedic clinic at RSO. Prof. Dr. R. Soeharso has succed treated patients with CP Spastic Diplegic that have performed SEMLS. Age and time of postoperative significantly influence the functional ankle score in patients with CP Spatik Diplegic that have been done SEMLS. While the sex of the patients had no effect on the functional ankle score in patients with CP Spastic Diplegic that have been done SEMLS.Keywords: RSO Prof. Dr. R. Soeharso, CP Spastic Diplegic, SEMLS, Ankle Functional ScoreCorrespondence: Aryo Budiyogo Andryanto. Student of Orthopaedic and Traumatology school of Medicine, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java.Indonesian Journal of Medicine (2019), 4(3): 228-231https://doi.org/10.26911/theijmed.2019.04.03.05
Multiple Hereditary Exostosis of Distal Ulna with Dislocation of Radial Head: A Case Report Utomo, Pamudji; Idulhaq, Mujaddid; Brilianto, Bagus Iman
Indonesian Journal of Medicine Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Multiple hereditary exostosis of the forearm is typically formed in the distal ulna causing disturbances in the growth of the ulna and functional disability. Multiple hereditary exo­stosis inhibits the growth of the ulna leading to an acquisition of a varus deformity in the ra­dius which sometimes leads to dislocation of the radial head, the development of limitations in the pronation-supination of the forearm, and cos­me­tic problems. This study aimed to report the mul­ti­ple hereditary exostosis of distal ulna with dis­location of radial head.Case Presentation: We present a case of a 14 year-old girl with main complaint of a bony prominence on her right elbow which limits the elbow flexion range of motion. 3D CT-Scan re­vealed a dislocation of radial head, shortening and posterior bowing of ulna. We performed excision of the prominent radial head, recons­truction, and temporary arthrodesis of the elbow.Results: The forearm deformity in patients with multiple hereditary exostosis related to the cross-sectional area of the distal ulnar physis was only one-quarter of the distal radius, the distal ulna is more involved in the condition. There was more longitudinal growth at the distal ulnar physis than at the distal radial physis, the distal ulnar physis contributed more total Ulnar Length than the distal radial physis did to Radial length. Known surgical interventions including simple excision, ulnar lengthening, corrective radial os­teo­­tomy, hemi-epiphyseal stapling of the distal radius, the Sauve-Kapandji procedure.Conclusion: Simple excision could improve the range of movement of the forearm but would not halt the progression of disease, particularly in younger patients. It was not effective in con­troll­ing progression of the deformity. Mature patients did not recur, but in patients that had been excis­ed before puberty the results were varied and unpredictable.Keywords: multiple hereditary exostosis, radial head dislocation, excisionCorrespondence: Pamudji Utomo. Department of Orthopaedics and Traumatology Prof. Dr. R.Soeharso Ortho­paedics Hospital, Surakarta. Email: utomodr­@yahoo.com.Indonesian Journal of Medicine (2020), 05(01): 63-69https://doi.org/10.26911/theijmed.2020.05.01.10
ANEURYSMAL BONE CYST (ABC) IN FIFTH METACARPAL RIGHT HAND OF A MALE CHILD WITH HEMOPHILIA TREATED BY STEROID INJECTION: A CASE REPORT Wahyudi, Agus; Idulhaq, Mujaddid; Saputra, Rhyan Darma; Utomo, Pamudji
Biomedika Vol 12, No 2 (2020): Biomedika Agustus 2020
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v12i2.10541

Abstract

ABSTRACTAneurysma bone cyst (ABC) is a rare case, rapidly growing, and destructive benign bone tumor that rarely involves the bones of the hand. Pathogenesis of these tumors remains controversial and may be vascular, traumatic, or genetic disorders.  This study aimed to evaluate patient’s out come after steroid injection. A male child presented with a history of pain and local swelling over his fifth metacarpal right hand of two months duration with hemofilia condition. Physical and radiographic examination of the hand was consistent with aneurysmal bone cyst. The patient the VIII factor 2 hours before doing steroid injection on his lump over fifth metacarpal right hand. A month evaluation after injection for this patient, we had a good result clinically and radiologically. Radiological evaluation obtained appearance of cortex thickening on the bone affected. We concluded that steroid injection should be considered as one of ABC’s treatment with hemophilia, but the outcome still needed more evaluation.  Keywords: Aneurysmal Bone Cyst, Hemophilia, Steroid Injection ABSTRAK Kista tulang aneurisma adalah kasus yang jarang terjadi, tumbuh dengan cepat, dan tumor tulang jinak destruktif yang jarang melibatkan tulang-tulang tangan. Patogenesis tumor ini masih kontroversial dan mungkin bersifat kelainan vaskular, traumatis, atau genetik. Penelitian ini bertujuan untuk mengevaluasi pasien setelah injeksi steroid. Seorang anak laki-laki dengan riwayat nyeri dan pembengkakan lokal pada metacarpal kelima tangan kanannya selama dua bulan dengan kondisi hemofilia. Pemeriksaan fisik dan radiografi tangan menegakkan adanya kista tulang aneurisma. Pasien diberi faktor VIII 2 jam sebelum injeksi steroid pada benjolan di atas metacarpal kelima tangan kanannya. Evaluasi sebulan setelah injeksi untuk pasien ini, kami memiliki hasil yang baik secara klinis dan radiologis. Evaluasi radiologis diperoleh penampilan penebalan korteks pada tulang yang terkena. Kami menyimpulkan bahwa injeksi steroid harus dipertimbangkan sebagai salah satu pengobatan kista tulang aneurisma dengan hemofilia, namun hasilnya masih perlu evaluasi lebih lanjut.Kata kunci: Kista Tulang Aneurisma, Hemofilia, Injeksi steroid
Osteokondroma Raksasa Pada Rami Pubis: Laporan Kasus Idulhaq, Mujaddid; Utomo, Pamudji; Jiwandono, Bayu Sakti; Tulandi, M qathar RF Tulandi
JAMBI MEDICAL JOURNAL "Jurnal Kedokteran dan Kesehatan" Vol. 8 No. 2 (2020): JAMBI MEDICAL JOURNAL Jurnal Kedokteran Dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (297.109 KB) | DOI: 10.22437/jmj.v8i2.10451

Abstract

ABSTRAK Pendahuluan Osteokondroma adalah tumor tulang jinak yang paling umum. Osteokondroma merupakan malformasi perkembangan daripada neoplasma sejati.Osteokondroma biasanya mempengaruhi tulang yang berkembang oleh osifikasi endokondral dan jarang berasal dari tulang yang berkembang secara osifikasi intramembran seperti tulang rami pubis, skapula, klavikula, dan tulang rusuk. Objektif Makalah ini dimaksudkan untuk menyajikan kasus osteokondroma pubis yang jarang terjadi dan mengevaluasi hasil setelah eksisi luas. Kasus Seorang pria 34 tahun dengan benjolan di daerah selangkangan kanan mengeluh selama 10 tahun. Di RSO Prof Soeharso, pasien menjalani eksisi lebar ramus pubis kanan, di mana banyak struktur berbahaya yang harus dihindari. Kami mendapatkan seluruh jaringan tumor dengan diameter 12 sentimeter. Menurut Konferensi Klinikopatologi tumor disimpulkan sebagai osteokondroma. Lokasi tumor dan presentasi klinis jarang terjadi. Tumor ini tidak memiliki keterlibatan viseral atau vaskular meskipun lesi tersebut sangat dekat dengan banyak struktur vital pada ramus pubis superior. Hasil Setelah 1 tahun evaluasi, kondisi klinis pasien baik. Pasien tidak merasakan keluhan apapun, tidak ada tanda-tanda kambuh, dan tidak ada komplikasi pada luka operasi. Kesimpulan Kami telah melakukan eksisi ekstensif tumor di ramus pubis pria berusia 34 tahun. Hasil pemeriksaan histopatologi sesuai dengan gambaran osteokondroma. Osteokondroma yang muncul dari panggul adalah presentasi yang tidak biasa yang harus diingat sebagai diagnosis banding saat mengevaluasi pasien dengan massa di panggul.
Survival and prognostic factors in pediatric osteosarcoma: A 5-year single-center experience in Central Java, Indonesia Riza, Muhammad; Salimo, Harsono; Wasita, Brian; Idulhaq, Mujaddid; Saputra, Rhyan Darma; Widyaningsih, Vitri; Soestrisno, Soestrisno; Zahidah, Fairuz; Wayanshakty, Janur
Paediatrica Indonesiana Vol. 64 No. 1 (2024): January 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.1.2024.10-6

Abstract

Background The advent of chemotherapy with multimodal treatment has improved the survival rate of osteosarcoma. However, the survival rate of patients with osteosarcoma in low- and middle-income countries (LMICs) remains lower than in high-income countries (HICs). Objective To assess prognostic factors associated with survival rate of pediatric patients with osteosarcoma in Moewardi Hospital, Surakarta. Methods This retrospective study was performed in pediatric osteosarcoma patients at Moewardi Hospital, Surakarta from 2018 to 2022. We described patients’ clinical presentations and assessed prognostic factors. Survival rate was calculated using Kaplan–Meier survival analysis. Prognostic factors were analyzed using univariate and multivariate Cox regression methods. Results Of the 82 patients included in the study, 40 (48.8%) were male and 42 (51.2%) were female. Most subjects (75.6%) were diagnosed with osteosarcoma at the age of >10 years, 45 patients (54.9%) had primary tumors in the femur, and 16 patients (19.5%) had limb salvage surgery. The mean event-free survival duration was 13.6 (95%CI 9.7 to 17.5) months. The mean duration of overall survival was 22.7 (95%CI 17.3 to 28.1) months, with a 44.1% survival probability. Type of surgery was a significant prognostic factor (P=0.018), with limb salvage having better survival probability (93.3%) than amputation (19.8%). Conclusion The overall survival rate of osteosarcoma patients at our center is still lower than in other regional centers. Limb salvage surgery was a significant prognostic factor for survival, while gender, location of primary tumor, histological subtype, and metastasis at the time of diagnosis were not.
Total Knee Replacement of Synovial Haemangioma of The Knee Joint in a 44-Year-Old Male: A Case Report Idulhaq, Mujaddid; Saputra, Rhyan Darma; Wasita, Brian; Sabariyah, Lely; Gardjito, Fajar Baskoro; Nursulistyo, Fajar
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.911

Abstract

Introduction: Synovial hemangioma is a rare illness frequently misdiagnosed, leading to years of inaction. In this study, we aim to discover the consequences of untreated hemangioma of the knee joint. Case Presentation: Our patient was a 44-year-old male who experienced recurring pain in his left knee. The previous year, the patient experienced pain in his left knee while walking, which has subsided with rest. Although he has been performing radiography at multiple hospitals since 2019, no problems have been recorded. We detected a mass after performing magnetic resonance imaging. The T1-weighted sequence + contras near the medial femoral condyle revealed a homogeneous mass with high intensity. We decided to conduct surgical intervention and total knee replacement. Postsurgical, the patient regained symptom-free. Conclusions: Because of the limited radiographic capacity, synovial hemangioma is uncommon and challenging to diagnose on an outpatient basis. Magnetic resonance imaging and angiography are highly beneficial. If intraarticular hemangiomas are not considered, they can cause bony dysplasia and multiple clinical manifestations. Initial total excision can be conducted to decrease the chance of hemarthrosis.
Umbilical cord mesenchymal stem cells and their secretome in peripheral nerve regeneration: a narrative review promising therapeutic strategy Sumarwoto, Tito; Hadinoto, Seti Aji; Romaniyanto; Rhatomy, Sholahudin; Utomo, Pamudji; Idulhaq, Mujaddid; Santoso, Asep; Suroto, Heri
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.24055

Abstract

The injuries of peripheral nerves remain a substantial clinical challenge because of their limited regenerative capacity, the complexity of nerve repair, and limitations of current treatment strategies. Umbilical cord mesenchymal stem cells (UC-MSCs) and their secretome have shown promise as regenerative treatments due to their distinct biological characteristics. This review explores the possibility of UC-MSCs and their secretome in promoting peripheral nerve regeneration, by their action mechanisms, therapeutic applications, and current preclinical - clinical evidence. UC-MSCs have proven to be capable of support Wallerian degeneration, improving axonal growth, reducing inflammation, and improving functional recovery in both animal models and early clinical studies. Their secretome has been shown to promote neuroprotection and functional repair, avoiding the risks of receiving a direct stem cell transplant. Challenges remain in standardizing UC-MSC-based therapies, ensuring long-term safety, and enhancing delivery strategies. Further clinical trials are needed to determine the efficacy, safety, and scalability of UC-MSC therapies for widespread clinical use. UC-MSCs and their secretome provide a unique, cell-free and cell-based strategy to peripheral nerve regeneration. Future advancements in biomaterial integration, gene editing, and personalized medicine will be essential to implementing these treatments in clinical settings.