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THE EFFECT OF VITAMIN D3 SUPPLEMENTATION PER ORAL AND SUN EXPOSURE ON THE EMPLOYEES OF PROF. DR. R SOEHARSO ORTHOPEDIC HOSPITAL OF SURAKARTA WITH VITAMIN D INSUFICIENCY OR DEFICIENCY Pamudji Utomo; Mujaddid Idulhaq; Agus Wahyudi; 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

Background : Vitamin D insufficiency affects almost 50% of the population worldwide. About 1 billion people worldwide from all ethnicities and age groups, have a vitamin D deficiency. This pandemic of hypovitaminosis D closely related to to lifestyle (such as less of outdoor activities) and environmental (such as air pollution) factors that reduce exposure to sunlight, which is required for ultraviolet-B (UVB)-induced vitamin D production in the skin. High prevalence of vitamin D insufficiency is an important public health issue because hypovitaminosis D is an independent risk factor for total mortality in the general population. Last studies suggest that we may need more vitamin D to prevent chronic disease. As few foods contain vitamin D, guidelines recommended supplementation at suggested daily intake and tolerable upper limit levels. It is also suggested to take a measurement of the 25-hydroxyvitamin D level serum as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D2 or vitamin D3 is recommended for deficient patients. Subjects and Method : This study was an experimental study with one group design pretest and postest. Target population was employee of Prof dr R Soeharso Orthopaedic hospital with deficiency or insuficiency of vitamin D level. Total of 40 subjects has been measured serum 25-hydroxyvitamin D level. The result found that 1 sample is normal and excluded from the study, and 39 others are included in the study. All of them have been treated with vitamin D3 suplement 50.000 IU per week for eight weeks then measured serum 25-hydroxyvitamin D level post treatment. All the result was analized with Wilcoxon test respectively Results : All samples undergoing treatment with vitamin D3 suplement had a significant improvement on the result of Vitamin D level. Wilcoxon rank test shows the value of p = <0.001 (p <0.05) which means that there is a significant improvement of vitamin D serum levels before and after treatment.Conclusion : Normalization of hypovitaminosis D level with cholecalciferol (D3) treatment significantly reduces the severity of fatigue symptoms in person who has complain about fatigue conditions.

Total Elbow Arthroplasty as a Viable Reconstruction Option for Proximal Ulna Giant Cell Tumor: Case Report Mujaddid Idulhaq; Muhammad Haris Wibowo
Sriwijaya Journal of Surgery Vol. 8 No. 1 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i1.125

Introduction: Giant cell tumor (GCT) of bone is a relatively common primary bone tumor, typically benign but known for local aggressiveness and potential for recurrence. It commonly affects the epiphyseal regions of long bones, particularly around the knee. Occurrence in the proximal ulna is rare, accounting for less than 1% of skeletal tumors, posing significant treatment challenges due to the complex elbow anatomy. Treatment aims for complete tumor removal, preservation of function, and prevention of recurrence, with options ranging from curettage to wide resection. Reconstruction after resection, especially involving the joint, is complex. Case presentation: We report the case of a 39-year-old female presenting with a painful swelling in her right elbow three months after a fall. Clinical examination revealed swelling, tenderness, and limited range of motion. Radiographs and MRI showed an expansile lytic lesion in the proximal ulna, suggestive of GCT. The patient underwent wide resection of the tumor followed by reconstruction using total elbow arthroplasty (TEA). Histopathology confirmed the diagnosis of GCT. Conclusion: At 8-month follow-up, the patient demonstrated excellent functional recovery with a range of motion from 0° extension to 150° flexion, a DASH score of 6.7, and an MSTS score of 26, with no signs of local recurrence. This case illustrates that wide resection combined with TEA is a viable and effective treatment strategy for GCT of the proximal ulna, offering good functional outcomes and local tumor control.

Modular Megaprosthesis as a Definitive Salvage Strategy for Recalcitrant Distal Femoral Non-Unions: A Biological and Mechanical Reset in the Hostile Environment Mujaddid Idulhaq; Fajar Baskoro Gardjito; Agil Murthala
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1557

Background: The management of recalcitrant distal femoral non-unions characterized by massive bone loss and exhausted biological potential presents a formidable challenge in orthopedic surgery. This study evaluates the early functional outcomes and safety of modular knee megaprostheses as a radical salvage strategy, utilizing oncologic reconstructions as a benchmark for comparative analysis. Methods: A descriptive case series of eight consecutive patients, including six oncologic and two non-oncologic cases, was conducted between December 2022 and March 2025. Non-oncologic cases involved elderly patients with a mean age of 48.5 years and multiple failed prior fixations. A standardized infection rule-out protocol was strictly applied, involving serological markers and joint aspiration. Functional outcomes were quantified using the Musculoskeletal Tumor Society (MSTS) score with a mean follow-up of 14.8 months. Results: The mean MSTS score across the cohort was 20.2 out of 30. Non-oncologic patients demonstrated lower physical performance scores, averaging 18.5 compared to 20.8 in the oncologic group, primarily due to long-standing disuse atrophy and age-related confounders. However, these patients reported significantly higher emotional acceptance, averaging 4.5 out of 5, following the immediate restoration of limb stability. No acute periprosthetic infections or mechanical failures were observed within the short-term follow-up period. Conclusion: Megaprosthesis serves as a viable biological and mechanical reset for complex non-unions, converting a failed biological healing process into a reliable mechanical solution. While the procedure requires rigorous infection screening and carries long-term risks, it offers immediate stability and transformative pain relief in elderly or multiply-operated patients.

Modular Megaprosthesis as a Definitive Salvage Strategy for Recalcitrant Distal Femoral Non-Unions: A Biological and Mechanical Reset in the Hostile Environment Mujaddid Idulhaq; Fajar Baskoro Gardjito; Agil Murthala
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1557

Background: The management of recalcitrant distal femoral non-unions characterized by massive bone loss and exhausted biological potential presents a formidable challenge in orthopedic surgery. This study evaluates the early functional outcomes and safety of modular knee megaprostheses as a radical salvage strategy, utilizing oncologic reconstructions as a benchmark for comparative analysis. Methods: A descriptive case series of eight consecutive patients, including six oncologic and two non-oncologic cases, was conducted between December 2022 and March 2025. Non-oncologic cases involved elderly patients with a mean age of 48.5 years and multiple failed prior fixations. A standardized infection rule-out protocol was strictly applied, involving serological markers and joint aspiration. Functional outcomes were quantified using the Musculoskeletal Tumor Society (MSTS) score with a mean follow-up of 14.8 months. Results: The mean MSTS score across the cohort was 20.2 out of 30. Non-oncologic patients demonstrated lower physical performance scores, averaging 18.5 compared to 20.8 in the oncologic group, primarily due to long-standing disuse atrophy and age-related confounders. However, these patients reported significantly higher emotional acceptance, averaging 4.5 out of 5, following the immediate restoration of limb stability. No acute periprosthetic infections or mechanical failures were observed within the short-term follow-up period. Conclusion: Megaprosthesis serves as a viable biological and mechanical reset for complex non-unions, converting a failed biological healing process into a reliable mechanical solution. While the procedure requires rigorous infection screening and carries long-term risks, it offers immediate stability and transformative pain relief in elderly or multiply-operated patients.

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