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All Journal Journal of Medicine and Health Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Ilmu Bedah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Medicine and Health
Akhmad Imron
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Efficacy of Profilactic and Therapeutic Antibiotic in Congenital Hydrocephalus Shunt Infection Akhmad Imron; Kahdar Wiriadisastra
Journal of Medicine and Health Vol. 1 No. 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.856 KB) | DOI: 10.28932/jmh.v1i1.497

Abstract

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic  (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status. Keywords:  antibiotic,  prophylactic, infection, VP shunt, congenital hydrocephalus
Hubungan Gejala Klinis Dengan Tekanan Intraventrikuler Pada Hidrosefalus Akut Donny Argie; Muhammad Zafrullah Arifin; Achmad Adam; Akhmad Imron; Mirna Sobana; Agung Budi Sutiono
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.73

Abstract

Latar Belakang. Penelitian tentang gejala klinis atau tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut telah banyak dilakukan, tetapi penelitian yang menghubungkan antara gejala klinis dan tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut belum banyak dilakukan. Tujuan. Mengetahui hubungan antara gejala klinis dengan tekanan intraventrikuler pada pasien pediatrik penderita hidrosefalus akut. Metode. Penelitian prospektif analitik, dimana data diambil dari tanggal 1 Januari 2010 sampai dengan 17 Agustus 2013 di Departemen/ SMF Ilmu Bedah Saraf Fakultas Kedokteran Universitas Padjadjaran/ RSUP Dr. Hasan Sadikin Bandung. Hasil. Jumlah sampel pasien hidrosefalus akut, sebanyak 27 laki–laki (53%) dan 24 perempuan (47%). Penyebab hidrosefalus akut pada penelitian ini adalah neoplasma yaitu sebanyak 24 kasus (47%), dan infeksi 23 kasus (45%). Hasil uji secara statistik menunjukkan bahwa gejala klinis muntah dan penurunan kesadaran memiliki nilai yang bermakna dengan p<0.05 sedangkan nyeri kepala memiliki nilai yang tidak bermakna terhadap peningkatan tekanan intraventrikuler dengan nilai p >0.05. Kesimpulan. Gejala klinis muntah dan penurunan kesadaran mempunyai hubungan dengan tekanan tinggi intrakranial sehingga dapat digunakan sebagai deteksi dini pada pasien pediatrik penderita hidrosefalus akut yang dis- ebabkan oleh neoplasma maupun infeksi.
The Impact of Infection Prevention Bundles on Neurosurgical Outcomes and Healthcare Costs: A Systematic Review Putra, Fajar Faisal; Akhmad Imron; Muhammad Adam Pribadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1129

Abstract

Background: Post-operative infections represent a significant challenge in neurosurgery, leading to increased morbidity, mortality, and healthcare costs. The implementation of infection prevention bundles, which encompass a set of evidence-based practices, has emerged as a potential solution to mitigate these adverse outcomes. This systematic review aims to evaluate the effectiveness of infection prevention bundles in improving neurosurgical outcomes and reducing healthcare costs. Methods: A comprehensive search of electronic databases (PubMed, Scopus, Web of Science) was conducted to identify studies published between 2010 and 2023 that evaluated the impact of infection prevention bundles on neurosurgical outcomes and healthcare costs. The search strategy included keywords such as "neurosurgery," "infection prevention," "surgical site infection," "bundle," "outcomes," and "healthcare costs." Studies were included if they reported on at least one clinical outcome (e.g., surgical site infection rates, mortality, length of stay) and/or healthcare costs. Data extraction and quality assessment were performed independently by two reviewers. Results: The search yielded 45 studies that met the inclusion criteria. The studies encompassed a variety of neurosurgical procedures, including craniotomies, spinal surgeries, and deep brain stimulation. The infection prevention bundles implemented varied across studies but commonly included preoperative antibiotic prophylaxis, skin antisepsis, and intraoperative measures. The pooled analysis demonstrated a significant reduction in surgical site infection rates and length of stay associated with the use of infection prevention bundles. Moreover, several studies reported cost savings, primarily attributed to reduced complications and shorter hospital stays. Conclusion: The evidence suggests that infection prevention bundles are effective in improving neurosurgical outcomes and reducing healthcare costs. The implementation of these bundles should be considered a standard of care in neurosurgery to enhance patient safety and optimize resource utilization. Keywords: Neurosurgery, infection prevention, surgical site infection, healthcare costs, systematic review.
Selective Amygdalohippocampectomy versus Anterior Temporal Lobectomy in Mesial Temporal Lobe Epilepsy: A Meta-Analysis of Seizure Control and Cognitive Outcomes Putra, Fajar Faisal; Akhmad Imron; Muhammad Adam Pribadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1131

Abstract

Background: Mesial temporal lobe epilepsy (MTLE) is a common form of drug-resistant epilepsy often necessitating surgical intervention. The choice between selective amygdalohippocampectomy (SelAH) and anterior temporal lobectomy (ATL) remains a subject of debate, with each procedure offering potential advantages and disadvantages in terms of seizure control and cognitive outcomes. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Springer databases to identify studies published between 2013 and September 2024 that compared SELAH and ATL in patients with MTLE. The primary outcomes of interest were seizure freedom rates and changes in cognitive function, particularly IQ scores. A meta-analysis was performed using a random-effects model to pool the results of included studies. Results: The meta-analysis encompassed 5 studies involving 218 patients with MTLE (105 underwent SelAH, 113 underwent ATL). The pooled results demonstrated a statistically significant reduction in the odds of achieving seizure freedom following ATL compared to SelAH (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.24-0.81, p = 0.008). Regarding cognitive outcomes, no significant difference was observed in Performance IQ (PIQ) between the two groups. However, a trend towards improved Verbal IQ (VIQ) was noted in the SelAH group, although this did not reach statistical significance. Conclusion: The findings suggest that SelAH may offer superior seizure control compared to ATL in patients with MTLE. While both procedures appear to have comparable effects on PIQ, SelAH may be associated with a trend towards better preservation or even improvement in VIQ. The choice between SelAH and ATL should be individualized based on patient-specific factors, including preoperative cognitive profile and the relative importance of seizure control versus cognitive preservation.
Efficacy of Profilactic and Therapeutic Antibiotic in Congenital Hydrocephalus Shunt Infection Akhmad Imron; Kahdar Wiriadisastra
Journal of Medicine and Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i1.497

Abstract

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic  (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status. Keywords:  antibiotic,  prophylactic, infection, VP shunt, congenital hydrocephalus
The Impact of Infection Prevention Bundles on Neurosurgical Outcomes and Healthcare Costs: A Systematic Review Putra, Fajar Faisal; Akhmad Imron; Muhammad Adam Pribadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1129

Abstract

Background: Post-operative infections represent a significant challenge in neurosurgery, leading to increased morbidity, mortality, and healthcare costs. The implementation of infection prevention bundles, which encompass a set of evidence-based practices, has emerged as a potential solution to mitigate these adverse outcomes. This systematic review aims to evaluate the effectiveness of infection prevention bundles in improving neurosurgical outcomes and reducing healthcare costs. Methods: A comprehensive search of electronic databases (PubMed, Scopus, Web of Science) was conducted to identify studies published between 2010 and 2023 that evaluated the impact of infection prevention bundles on neurosurgical outcomes and healthcare costs. The search strategy included keywords such as "neurosurgery," "infection prevention," "surgical site infection," "bundle," "outcomes," and "healthcare costs." Studies were included if they reported on at least one clinical outcome (e.g., surgical site infection rates, mortality, length of stay) and/or healthcare costs. Data extraction and quality assessment were performed independently by two reviewers. Results: The search yielded 45 studies that met the inclusion criteria. The studies encompassed a variety of neurosurgical procedures, including craniotomies, spinal surgeries, and deep brain stimulation. The infection prevention bundles implemented varied across studies but commonly included preoperative antibiotic prophylaxis, skin antisepsis, and intraoperative measures. The pooled analysis demonstrated a significant reduction in surgical site infection rates and length of stay associated with the use of infection prevention bundles. Moreover, several studies reported cost savings, primarily attributed to reduced complications and shorter hospital stays. Conclusion: The evidence suggests that infection prevention bundles are effective in improving neurosurgical outcomes and reducing healthcare costs. The implementation of these bundles should be considered a standard of care in neurosurgery to enhance patient safety and optimize resource utilization. Keywords: Neurosurgery, infection prevention, surgical site infection, healthcare costs, systematic review.
Selective Amygdalohippocampectomy versus Anterior Temporal Lobectomy in Mesial Temporal Lobe Epilepsy: A Meta-Analysis of Seizure Control and Cognitive Outcomes Putra, Fajar Faisal; Akhmad Imron; Muhammad Adam Pribadi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1131

Abstract

Background: Mesial temporal lobe epilepsy (MTLE) is a common form of drug-resistant epilepsy often necessitating surgical intervention. The choice between selective amygdalohippocampectomy (SelAH) and anterior temporal lobectomy (ATL) remains a subject of debate, with each procedure offering potential advantages and disadvantages in terms of seizure control and cognitive outcomes. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Springer databases to identify studies published between 2013 and September 2024 that compared SELAH and ATL in patients with MTLE. The primary outcomes of interest were seizure freedom rates and changes in cognitive function, particularly IQ scores. A meta-analysis was performed using a random-effects model to pool the results of included studies. Results: The meta-analysis encompassed 5 studies involving 218 patients with MTLE (105 underwent SelAH, 113 underwent ATL). The pooled results demonstrated a statistically significant reduction in the odds of achieving seizure freedom following ATL compared to SelAH (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.24-0.81, p = 0.008). Regarding cognitive outcomes, no significant difference was observed in Performance IQ (PIQ) between the two groups. However, a trend towards improved Verbal IQ (VIQ) was noted in the SelAH group, although this did not reach statistical significance. Conclusion: The findings suggest that SelAH may offer superior seizure control compared to ATL in patients with MTLE. While both procedures appear to have comparable effects on PIQ, SelAH may be associated with a trend towards better preservation or even improvement in VIQ. The choice between SelAH and ATL should be individualized based on patient-specific factors, including preoperative cognitive profile and the relative importance of seizure control versus cognitive preservation.
Co-Authors Achmad Adam Agung Budi Sutiono Donny Argie Kahdar Wiriadisastra Mirna Sobana Muhammad Adam Pribadi Muhammad Zafrullah Arifin Putra, Fajar Faisal