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All Journal BALI MEDICAL JOURNAL (BMJ) Sport and Fitness Journal Buletin Udayana Mengabdi E-Jurnal Medika Udayana Kebijakan, Promosi Kesehatan dan Biostatiskik Indonesian Journal of Urology Panggung Master Bahasa JBN (Jurnal Bedah Nasional) Callosum Neurology Journal : Jurnal Berkala Neurologi Bali ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Pendidikan dan Kebudayaan Missio Bioscientia Medicina : Journal of Biomedicine and Translational Research Majalah Kedokteran Neurosains JCER (Journal of Chemistry Education Research) Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) Qaumiyyah: Jurnal Hukum Tata Negara Journal of Global Pharma Technology Physical Therapy Journal of Indonesia
Tjokorda Gde Bagus Mahadewa
Departemen Bedah Saraf, Fakultas Kedokteran, Universitas Udayana, Denpasar
Religion Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Posterior Spinal Surgery for Extradural Spinal Metastasis of Round Cell Tumor in the Lower Thoracal Region Marleen Marleen; Tjokorda GB Mahadewa; I Wayan Juli Sumadi
Neurologico Spinale Medico Chirurgico Vol 3 No 3 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i3.104

Abstract

Spinal cord dysfunction caused by a spinal tumor is not always easy to treat since the tumor itself possesses variably etiology and low ability of nerve impairment to recover. The most common extradural tumor is derived from metastases, followed by other pathology such as plasmacytoma, lymphoma, etc. Since histopathologically they may present as round cell tumors, pre-operative data and intraoperative findings may help the clinician to establish appropriate diagnosis. This case report aims to describe the role of posterior spinal surgery and the reasoning of the selected approach in the treatment of spinal metastasis mimicking plasmacytoma in the lower thoracal region. We report 56 years old male who has myelopathy symptoms caused by lower thoracal extradural mass lesion, which histopathological study shows round cell tumor findings. Laminectomy and posterior stabilization were undertaken, and additional rotational flap was made to close sacral decubitus ulcer defect. Axial pain was improved and the patient discharged from the hospital with improved quality of life.
Infectious diseases as complications following spinal cord injury John Nolan; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 4 No 1 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i1.122

Abstract

Background: Infectious complications in spinal cord injury (SCI) patients can increase the mortality and morbidity of the patients. The inability to do daily activity is the main cause of the occurrence of infectious complications. Good understanding and high awareness are needed to notice some infectious complications which are difficult to be diagnosed. Method: This paper is a literature review which was done by reviewing and searching journals with “infectious complication”, “spinal cord injury”, “infection” on the search engines. The authors found 52 articles are suitable to be composed as references for this paper. Outcome: Several infectious complications may occur following the incidence of SCI and have a lot of disadvantages. The causes of these infections are multifactorial. Urinary tract infection, infected pressure ulcer, pneumonia, and some other infectious diseases may appear as complications. Extra care in hygiene and sanitation is needed, besides, high awareness is needed to discover these complications. Conclusion: Monitoring post-SCI complications are complex and difficult. A high level of suspicion should be raised with frequent aseptic actions and procedures. Appropriate management including non-surgical or surgical procedures can be chosen to achieve the best outcomes. Early diagnosis and management are critical for the best treatment results.
Occipito-cervical fusion approach to Hangman’s fracture on osteoporosis patient Glen Sandi Saapang; I Gusti Ketut Agung Surya Kencana; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.163

Abstract

An unstable Hangman fracture in an elderly patient is a condition that requires special consideration in selecting a surgical approach. In a healthy sixty-year-old man with a good Karnofsky score, a cervical X-ray and non-contrast CT-scan (NCCT) were performed to confirm the diagnosis. Installation of cervical traction with light weights first followed by occipito-cervical fusion has shown improvement in fracture alignment without complications, even with limited resources. Postoperative radiological examination showed good realignment with lateral mass screw fixation. From this case, it can be seen that the selection of the right surgical procedure in elderly patients is important, especially for those who do not have significant comorbidities.
Surgery on displaced depressed skull fracture overlying sigmoid sinus: Rationale, techniques, and risk management Kadek Biondi; Tjokorda Gde Bagus Mahadewa; Marleen
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.164

Abstract

Skull fracture may occur at all parts of the skull after direct trauma. Skull fragment overlying dural venous structure, may inherit the risk of infection, thrombosis, and massive bleeding. Controversy arises among institutions whether the surgical measure is superior to the conservative option. The occurrence of depressed skull fracture overlying sigmoid sinus is seldom discussed in trauma literature, but some authors reported that the risk of infection and sepsis might occur in a delayed fashion in this group of patients. Several reports on the radiological study in depressed skull fracture overlying venous sinus found that fracture may predispose to venous sinus thrombosis. However, the risk of profuse bleeding when attempting to elevate bone fragments could place the patient into serious and devastating conditions, which need aggressive and effective bleeding control. We report a case of a middle-aged man who had a displaced depressed skull fracture overlying the right sigmoid sinus after falling from height. Surgery was performed in order to decompress the right sigmoid sinus structure and repair the cerebrospinal fluid leak at the overlying duramater. The patient was discharged from the hospital with minimal conductive hearing disturbance, with no sign of infection and neurologic deficits.
Comparison of Alvarado scores, Tzanakis scores, and RIPASA scores in the diagnosis of acute appendicitis in Sanglah Hospital I Made Maha Satya Dwi Palguna; Made Agus Dwianthara Sueta; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.204

Abstract

Background: Acute appendicitis (AA) is the most common cause of gastrointestinal emergency surgery worldwide. However, to confirm the diagnosis of acute appendicitis, it is largely dependent on clinical judgment, causing the rate of negative appendectomy or misdiagnosis reach 20 – 40%. Several scoring systems have been developed to identify patients who did not require surgery, thereby reducing the burden of negative appendectomy. Methods This study is a cross-sectional observational study with diagnostic tests. The study was conducted at the Surgical Department of Sanglah Hospital, Denpasar from January 1st, 2020 to December 31st, 2020. All patients enrolled in this study were calculated with Alvarado, Tzanakis, and RIPASA scores to determine the need for appendectomy. In patients undergoing surgery, the diagnosis of AA was confirmed by histopathological examination. Descriptive analysis, receiver operating characteristics (ROC) analysis, and diagnostic tests were used to assess the effectiveness of the three scoring systems. Results: The total respondents in this study who met the inclusion and exclusion criteria were 103 people. This study found that acute appendicitis was more common in male patients with a mean age of 28.26 years. The RIPASA scoring system has better sensitivity and accuracy than the Alvarado and Tzanakis scores, so it is recommended to use the RIPASA score as a diagnosis of acute appendicitis. However, if an ultrasound facility is available, the Tzanakis score can be used. Conclusion: RIPASA score is the best score to diagnose acute appendicitis.
Validity of predictive score of mortality in peptic ulcer perforation (POMPP) in predicting perforated peptic ulcer mortality operated in Sanglah General Hospital, Denpasar, Bali I Gusti Putu Agung Pratama Putra; Ketut Sudiasa; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.210

Abstract

Introduction: Peptic ulcer perforation is a non-traumatic emergency that is often encountered and gives a mortality rate of up to 70%. The need for a system that is easy and simple in predicting and screening patients in the initial triage to predict the incidence of mortality after surgery is important. This study aim to test the validity of predictive score of mortality in peptic ulcer perforation (POMPP) in predicting mortality in patients with perforated peptic ulcer surgery. Methods: This study was a diagnostic study with 50 peptic ulcer perforation patients operated between February 2019 to February 2020, and collected with consecutive sampling method. All patients who were operated was calculated for the preoperative POMPP scores, with parameters of age, blood urea nitrogen, and albumin. Patients who were deceased or refused to participate were excluded. The best cut-off point was calculated, then sensitivity, specificity, positive and negative predictive value (PPV/NPV), accuracy of score and POMPP score validity were calculated in predicting post-operative patient mortality. Results: The best cut-off value obtained from receiver operating characteristic (ROC) curve was ≥1.5, where patients with POMPP ≥1 were exposed to a high risk of postoperative mortality (80.8%), and POMPP <1.5 had a low risk of postoperative mortality (19.2%). Other scores were calculated as follow: sensitivity 80.7%, specificity 91.6%, PPV 91.3%, NPV 81.4%, accuracy 86% and the validity test score of 50 patients reached 100%. Conclusion: POMPP has good validity and can be used as a screening tool for patients with perforated peptic ulcer surgery.
LAPORAN KASUS: HEMATOMA EPIDURAL SPINAL SPONTAN Alvin Hendellyn; Desie Yuliani; Tjokorda Gede Bagus Mahadewa
Callosum Neurology Vol 3 No 1 (2020): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1874.57 KB) | DOI: 10.29342/cnj.v3i1.96

Abstract

Latar Belakang: Hematoma epidural spinal spontan atau Spontaneous Spinal Epidural Hematome (SSEH) adalah akumulasi darah di ruang epidural tulang belakang yang menekan medula spinalis dan menimbulkan defisit neurologis. SSEH dapat terjadi pada berbagai  segmen medula spinalis. Penyebab dan sumber perdarahan yang pasti hingga saat ini masih belum diketahui. Diagnosis SSEH dapat ditegakkan dengan pemeriksaan penunjang MRI. Tatalaksana pilihan untuk kasus SSEH adalah laminektomi dekompresi dan evakuasi hematoma. Kasus: Pada kasus ini, pasien datang dengan keluhan paraparesis inferior tipe UMN dan gangguan sensibilitas yang akut tanpa riwayat trauma dan faktor risiko yang berhubungan dengan SSEH. Pasien menjalani laminektomi dan menunjukkan perbaikan klinis yang signifikan. Diskusi: Penyebab SSEH pada kasus ini adalah suatu kavernoma. Pasien pada kasus ini mengalami perbaikan klinis yang signifik setelah mendapatkan tindakan laminektomi. Kesimpulan: Hematoma epidural spinal spontan (SSEH) merupakan kasus yang jarang terjadi tetapi memiliki prognosis yang baik apabila diberikan tatalaksana yang tepat dan cepat. Tindakan laminektomi menjadi pilihan utama tatalaksana pada pasien. Prognosis pada kasus SSEH ini sangat ditentukan oleh status neurologis sebelum operasi dilakukan. Kata Kunci: Paraparesis Inferior, Hematoma Epidural Spinal Spontan, Laminektomi
Unilateral laminectomy approach for total resection of intradural extramedullary spinal tumor Steven Awyono; Putu Eka Mardhika; Tjokorda Gde Bagus Mahadewa; Akbar Wido; Hizkia Lumban Gaol; Intan Permata Wijaya
Neurologico Spinale Medico Chirurgico Vol 2 No 2 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (796.537 KB) | DOI: 10.36444/nsmc.v2i1.5

Abstract

Spinal tumors found in about 5-15% of the central nervous system neoplasm. Intradural-extramedullary spinal cord tumors are one of the types that usually managed with total laminectomy but with many postoperative complications. A 76-year-old woman with paraplegia caused by intradural-extramedullary intraspinal tumor at thoracic 4 level. For this patient, we performed unilateral laminectomy without any fusion or stabilization from the left side then we performed total excision of the tumor. The surgery was successfully done with fast improvement of patient condition, minimal pain after surgery, no blood transfusion needed, shorter intensive care period needed, and fast recovery time are the prominent things in this case. Three days after surgery, the patient’s motoric power already improved and then the patient is permitted to go home at the fifth day.
Hemopneumothorax associated with pneumorrachis following blunt chest trauma (Retracted) Putu Eka Mardhika; Tjokorda Gde Bagus Mahadewa; Citra Aryanti
Neurologico Spinale Medico Chirurgico Vol 2 No 2 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (666.771 KB) | DOI: 10.36444/nsmc.v2i2.10

Abstract

In late August 2020, we found that this article has previously been published elsewhere (Redundant publication). We then conducted the steps following COPE guidelines and we came to the conclusion that this article will be retracted from our journal (September 15th, 2020) A "retracted" watermark is already given to the article and the article will be retained online in order to maintain the scientific record. View retraction statement here
Diagnostic validity of PULP (peptic ulcer perforation) score in predicting mortality in patient with operated perforated peptic ulcer in Sanglah Hospital- Denpasar Inge Kurniawati; I Ketut Wiargitha; Tjokorda Gde Bagus Mahadewa; Bianca Jeanne
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (379.326 KB)

Abstract

Background: Perforated peptic ulcer (PPU) is one of the most common non-traumatic emergency cases in the emergency unit, and have a high mortality rate, more than 70% in the elderly. Accurate and early identification of high-risk surgical patients with PPU is important for triage and risk stratification. The objective of this study was to evaluate the mortality in patients with operated PPU. Methods: Between January 2015 to December 2016, 50 consecutive patients with PPU who performed laparotomy were studied retrospectively. This study was a diagnostic test to evaluate the validity of PULP (Peptic Ulcer Perforation) score to predict mortality in patient with operated PPU and determine the best cut-off point. Presentation ≥ or < 24 hours, age of 65 years old, the presence of preoperative shock, ASA score, the presence of AIDS or active malignancy, liver failure, concomitant use of steroids and serum creatinine > 14.7 g/dL were evaluated in PULP score. Results: The cut-off point for PULP the score in the present study is > 7, based on the optimal cut-off value, patients could be divided into low-risk patients (a score of < 7 points), and high-risk patients (a score of > 7 points). PULP score had 91.7% sensitivity, 65.4% specificity, and 78% accuracy in this study. Positive predictive value and negative predictive the values were 71% and 89.9%. Conclusion: The PULP score is sensitive to predict the mortality risk in patients operated for perforated peptic ulcer and can assist in risk stratification and triage.
Co-Authors A. Winata, A. Adityas Sukmadi Karjosukarso Adityawarma, Anak Agung Ngurah Agung Harawikrama Agung Bagus S. Satyarsa Akbar Wido Alex Pangkahilla Aluh Sri Yuliana Ulfa Alvin Hendellyn Anak Agung Gede Eka Septian Utama and D. M. Subawa Arasy, Mohd Firdaus Ariyanta, Kadek Deddy Astawa N. M., Astawa N. Astawa P., Astawa B. Sinaga Bagus Komang Satriyasa Bertha Melyana Bianca Jeanne Bramastha A Rosadi, Bramastha A Budiarta, Ida Bagus Chriswidarma, Dewa Gede Cita Rosita Sigit Prakoeswa Citra Aryanti D.P.W. Wardhana Desak Made Wihandani Desak Putu Dewi Kasih Desie Yuliani Dewa Putu Gede Purwa Samatra Dewa Putu Wisnu Wardhana Dwikinta, Made Anindya Dyah Esti Pranwengrum Ekaputra Ekaputra, Ekaputra Fenty Fauziah G. I. B Bomba Gede Andry Nicolas Gede Wirata Gede Wirya Kusuma Duarsa Glen Sandi Saapang Gunawan, Made Favian Budi Gungun Gunardi Hizkia Lumban Gaol I Dewa Made Sukrama I Dewa Putu Sutjana I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Bagus Dharma Prakasa Musti I Gusti Ketut Agung Surya Kencana I Gusti Putu Agung Pratama Putra I Ketut Wedarthana Aditya Prana I Ketut Wiargitha I Komang Yose Antara I Made Bakta I Made Kasmadi Gunawan, I Made Kasmadi I Made Maha Satya Dwi Palguna I Made Mahayasa I MADE MULIARTA . I Made Prema Putra I Made Stepanus Biondi Pramantara I Nyoman Semadi I P G. Adiatmika I Putu Adiartha Griadhi I Putu Gede Sudiartha I W. Sudarsa I Wayan Juli Sumadi I Wayan Niryana I Wayan Yudiana I. B. Tjakra Wibawa Manuaba Ida Ayu Putu Sri Widnyani Inge Kurniawati Intan Permata Wijaya John Nolan K.K. Putra Kadek Biondi Kadek Budi Santosa Ketut Sudiasa Ketut Tirtayasa Koerniawan, Heru Sutanto Krishna, I Komang O. Kurniyanta, I Putu L. R. M. Lengkong Lauren, Christopher Luh Made Indah Sri Handari Adiputra M Wiryana Made Agus Dwianthara Sueta Made Indra Erlangga Prathiwindya Mardliyah, Mumtazah Marleen Marleen Marleen Melissa Krisanty Moses Kharisma Setyawan Muh. Ali Imron Nani Darmayanti Ni Luh Putu Julita Yanti Niryana, , I Wayan Nova Juwita Nyoman Golden Oka, AA Gde Oka, Anak A.G. Pande Made Wisnu Tirtayasa Paulus Adrianus K. L. Ratumakin Pradiptha, I Nyoman Tri Putu Astawa Putu Eka Mardhika Putu Eka Mardhika Putu Pramana Suarjaya Rajab Bahry Raka Janitra Raka-Sudewi A. A. Regitha Aulia Putri Rika Lesmana, Rika S Indra Lesmana S. Awyono S. F. Laura, S. F. Satoto D., Satoto Sidemen, IGP Sukrana Sista Satyarsa, Agung Bagus Sista Soetomo, Cindy Thiovany Sri Maliawan Stanley-Ketting Oliver Steven Awyono Sugianto, Ronald Sugijanto - Sulfandi Sulfandi Sunanda Naibaho Suryadi N. T., Suryadi N. Suryawisesa, Ida Bagus Made Susy Purnawati Tito Ade Putra Tjokorda Gde Agung Senapathi Udiyana, Nyoman Dwi Maha W. A., W. Wahyuddin, Wahyuddin Wibawa, I Gusti Agung Bagus Krisna Wildan Wildan Wiryana M., Wiryana Yustinus Robby Budiman Gondowardojo