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Fauzi, Asra Al
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Clinical and Radiological Study of Patients With Skull Base Fracture After Head Injury Oktavian, Puguh; Romdhoni, Achmad Chusnu; Dewanti, Linda; Fauzi, Asra Al
Folia Medica Indonesiana Vol. 57, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Traumatic brain injury (TBI) is the largest contributor to morbidity and mortality in various parts of the world. Skull base fracture (SBF) is one of the many manifestations that can occur in cases of mild to severe TBI. With varying patterns of TBI, it was necessary to review the characteristics of SBF, clinical manifestations, cerebrospinal fluid leakage, and complications. The data were taken from the medical records of SBF patients who were treated at RSUD (Regional Public Hospital) Dr. Soetomo in the period January 2014 - July 2019. Then, the data obtained were written on the collection sheet and analyzed descriptively using RKward. It was found that SBF most often occurs due to severe TBI (60.14%). 77.7% of SBF patients were male and 35.1% of all patients aged 15-24 years. The most frequent cause was traffic accidents (86.5%). The anterior cranial fossa (ACF) was the most frequently fractured part of the skull base (30.4%). There was a significant relationship between the severity of TBI with the occurrence of CSF leakage and complications. About 33 patients (22.3%) had complications such as pneumocephalus and 9 patients (6.1%) had meningitis. Complications in the form of brain abscess and hydrocephalus in 1 (0.7%) patient each. SBF often occurred in men of productive age 15-24 years. The ACF was the most frequently fractured part. The majority were caused by traffic accidents accompanied by severe brain injuries. The most common complications were pneumocephalus, meningitis, brain abscess, and hydrocephalus.
A Study on Knowledge Towards Brain Death among Residents in Indonesia Fauzi, Asra Al; Waloejo, Christrijogo Sumartono; Machin, Abdulloh; Shodiq, Muhammad Ja'far
Folia Medica Indonesiana Vol. 56, No. 2
Publisher : Folia Medica Indonesiana

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This research was conducted to evaluate the knowledge and diagnosis of brain death among resident in Indonesia. This study used an observational analytic study with a cross-sectional study design using a questionnaire. The research subjects consisted of 132 level 2 (after 2 years of residency) and level 3 (after 4 years of residency) residents, the total sampling for which was taken from the departments of Neurosurgery, Anesthesiology, and Neurology at Dr. Soetomo Academic Medical Center Hospital, Surabaya, Indonesia. Data were taken from November 2018 to January 2019. A total of 132 residents of Neurosurgery, Neurology, and Anesthesiology participated in this study. From the series of studies, residents' knowledge of the concept of brain death was in the sufficient category (41.7%), residents' knowledge of the technical diagnosis of brain death was in the good category (40.2%), residents' knowledge of brain death examination was in the less category (43.2%), and finally, it was found that the resident's knowledge of brain death was in a good category (35.6%). There were also significant differences in knowledge of brain death between Neurosurgery, Neurology, and Anesthesiologist Resident (P <0.001) and knowledge of brain death between level 2 and level 3 residents (P=0.032). In general, the Indonesian resident doctors' knowledge of brain death is adequate, but knowledge of the clinical examination of brain death is still lacking. Further research must be carried out to promote knowledge of brain death in residents as well as professional doctors/specialists, so that the number of organ transplants, especially in Indonesia, will increase.
Case Report: Ventriculoperitoneal Shunt Catheter Migration and Transanal Extrusion in Persistent Vegetative State Adult Patient Fauzi, Asra Al; Parenrengi, Muhammad Arifin; Wahyuhadi, Joni; Subagio, Eko Agus; Turchan, Agus
Folia Medica Indonesiana Vol. 55, No. 4
Publisher : Folia Medica Indonesiana

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Hyaluronic acid (HA) is a glycosaminoglycan with a straight-chain polymer arrangement defined as the extracellular matrix constituent. High molecular weight HA has normal physicochemical, biological, and physiological properties whereas low molecular weight has the property of angiogenesis, inflammation, and suppresses apoptosis. This study occupied the samples of 35 paraffin block from poorly and well differentiated retinoblastoma tissue and 8 normal retinal block which have been collected for 4 years from 2010-2013 at Dr. Soetomo Hospital, Surabaya, Indonesia. Afterwards, the paraffin blocks were immunohistochemically examined for HA staining, expression of cell proliferation (Ki-67), and cell apoptosis to determine intratumoral aggressiveness of retinoblastoma. HA on poorly differentiated retinoblastoma stain with a high immunostaining of 76.2%, while well differentiated retinoblastoma on the highest HA staining was revealed to be at moderate level of 64.3%, and not appear in normal retina. In poorly differentiated retinoblastoma, the location of most HA stain is in the cell cytoplasm (87.5%). In the well differentiated retinoblastoma, the HA immunostaning mainly occurred in the cell membrane (73.7%). Histopathological retinoblastoma grading showed a significant correlation (p <0.01) towards several variables of HA immunostaining, Ki-67, and cell apoptosis. In addition, the histopathological retinoblastoma grading also revealed a significant correlation (p <0.01) towards the location of HA staining (cell membrane and cytoplasm). Both stainings are also play role in retinoblastoma differentiation. The malignancy of retinoblastoma can be proven by the increased HA staining at cytoplasm in poorly differentiated and associated with increased of cell proliferation along with decreased apoptosis.
Co-Authors Christrijogo Soemartono Waloejo Joni Wahyuhadi, Joni Linda Dewanti Machin, Abdulloh Oktavian, Puguh Parenrengi, Muhammad Arifin Romdhoni, Achmad Chusnu Shodiq, Muhammad Ja'far Subagio, Eko Agus Turchan, Agus