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All Journal e-CliniC JURNAL BIOMEDIK Medical Scope Journal (MSJ)
Leo Rendy
Faculty of Medicine University of Indonesia/ Cipto Mangunkusumo Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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POLA PASIEN TRAUMA DI INSTALASI RAWAT DARURAT BEDAH RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI 2013 Masloman, Anugrah H.; Rendy, Leo; Wowiling, P. A.V.; Sapan, Heber B.
e-CliniC Vol 4, No 1 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.4.1.2016.11026

Abstract

Abstract: Trauma is the leading cause of death in the age group of young and productive in the world. The mortality rate can only be reduced through an optimal response given as early as possible on its victims. This research was conducted by using a retrospective descriptive method. The samples were all trauma patients in the surgical emergency department of Prof. Dr. R. D. Kandou Hospital. Based on research conducted found that the demographic patterns of trauma patients did not differ in terms of gender, age group, and the cause of trauma is still dominated by traffic accidents. It is largely a blunt trauma, with the highest injury site in the head and extremities.Keywords: Patient, Trauma, Pattern of traumaAbstrak: Trauma merupakan penyebab kematian utama pada kelompok usia muda dan produktif di seluruh dunia. Angka kematian ini hanya dapat diturunkan melalui upaya penanggulangan optimal yang diberikan sedini mungkin pada korbannya. Penelitian ini dilakukan dengan menggunakan metode deskriptif retrospektif. Sampel penelitian adalah semua pasien trauma di instalasi rawat darurat bedah RSUP Prof. Dr. R. D. Kandou Manado. Berdasarkan penelitian yang dilakukan didapatkan bahwa pola demografi pasien trauma tidak berbeda dalam hal jenis kelamin, kelompok usia, dan penyebab trauma yang masih didominasi oleh kecelakaan lalu lintas. Sebagian besar merupakan trauma tumpul dengan lokasi cedera terbanyak di kepala dan ekstremitas.Kata Kunci: Pasien, Trauma, Pola Trauma
Skor prediksi sindrom disfungsi multi-organ pada pasien multitrauma Rendy, Leo; Sapan, Heber B.; Kalesaran, Laurens T. B.; Lolombulan, Julius H.
JURNAL BIOMEDIK : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12669

Abstract

Abstract: Multiple organ dysfunction syndrome (MODS) in patients with major trauma remains to be frequent and devastating complication during clinical course in emergency department and intensive care unit (ICU). The ability to easily and accurately identify patients at risk for MODS postinjury especially in multitrauma cases would be very valuable. This study aimed to construct an instrument for prediction of the development of MODS in adult multitrauma patients using clinical and laboratory data available in the first day at prahospital and emergency department (hospital) setting. This was a prospective study. Samples were adult multitrauma patients with Injury Severity Score (ISS) ≥16, aged 16-65 years old, admitted to 4 academic Level-I trauma center from September 2014 to September 2015. Sequential organ failure assessment (SOFA) score was used to determine MODS during hospitalization. A risk score created from the final regression model consisted of significant variables as MODS predictor. The results showed that there were 98 multitrauma patients as samples. The mean age was 35.2 years old; mostly male (85.71%); the mean of ISS was 23.6; mostly (76.53%) were caused by blunt injury mechanism. MODS was encountered in 43 patients (43.87%). The prediction risk score consists of Revised Trauma Score (RTS) (<7.25) and serum lactate level ≥2 mmol/L. This study also verified several independent risk factors for post multitrauma MODS, such as ISS >25, presence of SIRS, shock grade 2 or more, and white blood cell count >12,000/mm3. Conclusion: We derived a novel, simple, and applicable instrument to predict MODS in adult following multitrauma. The use of this scoring system may allow early identification of multitrauma patients who are at risk for MODS and result in more aggressive targeted resuscitation and better referral allocation based on regional trauma system.Keywords: MODS, multitrauma, emergency department, MODS prediction scoreAbstrak: Sindrom disfungsi multi-organ (MODS) merupakan komplikasi buruk yang sering terjadi sepanjang perjalanan klinis pasien trauma mayor di Unit Gawat Darurat (UGD) maupun di ruang perawatan intensif. Suatu nilai patokan yang dapat memprediksi MODS pascatrauma secara akurat sejak dini tentunya sangat berharga bagi tatalaksana pasien terutama pada kasus multitrauma. Penelitian ini bertujuan untuk membuat suatu instrumen yang dapat memrediksi perkembangan MODS pada pasien dewasa multitrauma dengan menggunakan data klinis dan laboratorium yang tersedia pada 24 jam pertama pasca trauma pada seting fase prahospital maupun di fase hospital sejak di UGD. Jenis penelitian ini prospektif, mengumpulkan pasien multitrauma dengan Injury Severity Score (ISS) ≥16, rentang usia 16-65 tahun, di 4 pusat trauma level-1 rumah sakit pendidikan selama 1 tahun (September 2014-2015). Dilakukan pencatatan data klinis dan laboratorium sesuai perkembangan pasien. Skor sequential organ failure assessment (SOFA) digunakan untuk menentukan adanya MODS selama perawatan. Skor prediksi dibuat dengan membangun model regresi logistik yang signifikan untuk memrediksi terjadinya MODS pasca multitrauma. Hasil penelitian mendapatkan 98 sampel multitrauma yang memenuhi kriteria inklusi dengan rerata usia 35,2 tahun, sebagian besar laki-laki (85,71%) dengan rerata ISS 23,6, dan disebabkan oleh trauma tumpul (76,53%). MODS terjadi pada 43 pasien (43,87%). Skor prediksi terdiri dari RTS dengan (cut off point 7,25) dan kadar laktat serum (cut off point 3,44 mmol/mL). Penelitian ini juga memverifikasi beberapa faktor risiko individual terjadinya MODS pasca multitrauma yaitu ISS>25, adanya SIRS, syok derajat 2 atau lebih, dan leukositosis >12.000. Simpulan: Kami melaporkan instrumen baru yang praktis untuk memrediksi MODS pada pasien multitrauma dewasa. Skor ini memungkinkan identifikasi dini pasien trauma yang berisiko akan mengalami MODS sehingga dapat menjadi tanda alarm dilakukannya resusitasi yang lebih agresif dan tepat serta alokasi rujukan pasien yang lebih efisien berdasarkan sistem trauma regional.Kata kunci: MODS, multitrauma, UGD, skor prediksi MODS
Fetus in Fetu at Prof. Dr. R. D. Kandou Hospital: A Rare Case Report Lampus, Harsali F.; Candy, Candy; Rendy, Leo; Sorongku, Ronald; Saputra, Sabrandi P.
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.57283

Abstract

Abstract: Fetus in fetu (FIF) is a rare congenital disorder in which a malformed fetus-like structure is inside the actual body of the fetus. We reported a 3-day old female baby, born through sectio caesaria with a lump on her right abdomen. On physical examination, a rounded mass of 8x8 cm was palpable in the right hypochondrium. CT-scan of the abdomen with contrast revealed a heterogeneous mass of mixed cystic and solid accompanied by calcification in the form of vertebrae and extremities in the upper right abdomen (size ±5,6 x 6 x 6 cm). The mass appeared to be abutting with the liver, gallbladder, pancreas, and right kidney by pressing the intestinal loops to the left. A laparotomy was performed with extensive tumor excision, and a malformed fetus-shaped mass with good differentiation characterized by a hand-like structure, fairly complete toes and skin on its surface was found. The tumor was diagnosed as a FIF since the benchmark for diagnosing FIF was the shape of a fetus-like mass, a mature bone structure with components such as cranium, vertebrae, pelvis, extremities and even fingers as found in this patient. The patient was carried out a 5-day treatment after surgery, and then was referred to the Pediatric Surgery polyclinic for a follow-up on the histopathological result to confirm the diagnosis but the patient did not come for further treatment. Keywords: fetus in fetu; fetal tumor; aberrant monozygotic twinning; CT-scan abdomen
Ovarian Cyst Torsion: A Case Report Lampus, Harsali; Rendy, Leo; Candy, Candy; Rangan, Andy
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.61259

Abstract

Abstract: Accidents involving ovarian cysts might include cyst rupture, hemorrhage, and torsion. Any girl who has abdominal pain or a pelvic or abdominal mass should be evaluated for ovarian torsion, a rare issue in the juvenile age group. We reported a 10-year-old girl presented with complaints of lower left abdominal pain that began three days prior to her hospital admission. Initially, the pain was intermittent but subsequently became persistent and intensified, with no pain-free intervals. CT-Scan of the abdomen – pelvis without contrast revealed cystic mass with fat components and intralesional calcification, in the suprapubic quadrant. The impression came from the ovary (difficult to determine the right/left ovary), which urged the bladder to the anteroinferior and urged the uterus to the posterior, suspected of mature cystic ovarian teratoma. The patient was managed with intravenous fluids (IVFD), antibiotics, and analgesics for pain control. Due to the high suspicion of ovarian torsion, emergency exploratory laparotomy was performed. Anatomical differences in the paediatric population and their effects on surgery were also be considered. Intraoperative findings confirming a left ovarian cyst measuring approximately 8 x 6 x 4 cm, which had undergone torsion twice. Detorsion was performed, and the ovary was found to be viable. Cystectomy was carried out, preserving healthy ovarian tissue. The right ovary appeared normal. In conclusion, this case underscores the importance of timely surgical intervention, even beyond the traditional "golden period" of 6–12 hours, as collateral blood supply may help maintain ovarian viability. The shift from oophorectomy to ovarian preservation in the management of ovarian torsion reflects evolving clinical practices, emphasizing better reproductive and long-term health outcomes. Early recognition, prompt imaging, and surgical intervention are crucial to preserving ovarian function and improving patient prognosis. This case also highlights the need for increased awareness of ovarian torsion in pediatric and adolescent populations, given its rarity and diagnostic complexity. Keywords: torsion cyst; ovarian cyst; paediatric surgery
Faktor-faktor yang Memengaruhi Fungsi Anus setelah Prosedur PSARP pada Pasien Malformasi Anorektal Suryoprabowo, Vincent; Lampus, Harsali F.; Rendy, Leo
e-CliniC Vol. 14 No. 1 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i1.65307

Abstract

Abstract: In anorectal malformations (ARM), posterior sagittal anorectoplasty (PSARP) procedure is the standard management, however, the anorectal functional outcomes vary. This study aimed to assess the factors affecting anorectal function after the PSARP procedure using the Rintala score. This was a retrospective cohort study of 29 ARM patients who underwent PSARP at Prof. Dr. R. D. Kandou Hospital Manado during the 2019–2022 period. Medical records and patient follow-up data were analyzed using the chi-square test and linear regression. The results showed that of the 29 patients (13 males, 16 females), 86.2% underwent staged repair, while the rest had one-stage repair. The mean Rintala score was 14.59±4.17; 24.1% had normal function, 62.1% good, 6.9% fair, and 6.9% poor. Adequate bowel management was performed in all patients. Surgical wound infection was found in one patient (3.4%). Re-do PSARP was performed in four patients (13.8%). There were no cases of malnutrition or musculoskeletal abnormalities. Syndromic diseases were found in three patients (10.3%). Multivariate analysis showed that no variables were significantly associated with the Rintala score (p>0.05). In conclusion, the majority of patients have good–normal anal function after PSARP. There is no significant relationship between bowel management, surgical wound infection, redo PSARP, malnutrition, musculoskeletal abnormalities, or syndromic diseases and anal function. Continuous bowel management education remains important for long-term outcomes. Keywords: anorectal malformation; PSARP; anal function; Rintala score    Abstrak: Pada malformasi anorektal (MAR), prosedur posterior sagittal anorectoplasty (PSARP) merupakan standar tatalaksana, namun luaran fungsi anus bervariasi. Penelitian ini bertujuan untuk menilai faktor-faktor yang memengaruhi fungsi anus setelah prosedur PSARP menggunakan skor Rintala. Jenis penelitian ialah kohort retrospektif terhadap 29 pasien MAR yang menjalani PSARP di RSUP Prof. Dr. R. D. Kandou Manado periode 2019–2022. Data rekam medis dan follow-up pasien dianalisis menggunakan uji chi-square dan regresi linear. Hasil penelitian mendapatkan dari 29 pasien (13 laki-laki, 16 perempuan), 86,2% menjalani staged repair, sisanya one stage repair. Skor Rintala rerata 14,59±4,17; 24,1% fungsi normal, 62,1% baik, 6,9% cukup, dan 6,9% buruk. Businasi adekuat dilakukan pada seluruh pasien. Infeksi luka operasi ditemukan pada satu pasien (3,4%). Re-do PSARP dilakukan pada empat pasien (13,8%). Tidak terdapat kasus malnutrisi maupun kelainan muskuloskeletal. Penyakit sindromik penyerta ditemukan pada tiga pasien (10,3%). Analisis multivariat menunjukkan tidak terdapat variabel yang berhubungan bermakna dengan skor Rintala (p>0,05). Simpulan penelitian ini ialah mayoritas pasien memiliki fungsi anus baik–normal pasca-PSARP. Tidak terdapat hubungan bermakna faktor businasi, infeksi luka operasi, re-do PSARP, malnutrisi, kelainan muskuloskeletal, maupun penyakit sindromik terhadap fungsi anus. Edukasi businasi berkelanjutan tetap penting untuk luaran jangka panjang. Kata kunci: malformasi anorektal; PSARP; fungsi anus; skor Rintala
Co-Authors Anugrah H. Masloman, Anugrah H. Candy, Candy Harsali F. Lampus Heber B. Sapan, Heber B. Julius H. Lolombulan, Julius H. Laurens T. B. Kalesaran, Laurens T. B. P. A.V. Wowiling, P. A.V. Rangan, Andy Saputra, Sabrandi P. Sorongku, Ronald Suryoprabowo, Vincent