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All Journal Majalah Kedokteran Bandung Althea Medical Journal
Bambang Tiksnadi
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Medicine & Pharmacology

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Distribution of Risks for Major Osteoporotic Fracture Based on Fracture Risk Assessment Tool in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia Rahhim, Nik Fatin Farhana Binti Mohd; Tiksnadi, Bambang; Buchori, Eppy
Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Althea Medical Journal

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Background: Osteoporosis has become a growing public health problem in Indonesia. A definite estimation of osteoporosis prevalence in Indonesia is not available due to the limited access of dual energy X ray absorptiometry (DXA) facilities.  In 2008, the World Health Organization has developed a tool called Fracture Risk Assessment Tool to identify fracture risk based on the clinical risk factors. The study aimed to identify the risk factors of osteoporotic fracture using Fracture Risk Assessment Tool in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.Methods: This descriptive study was conducted from June–December 2013 in Orthopedic & Traumatology, Internal Medicine, Geriatric and Surgery polyclinics Dr. Hasan Sadikin General Hospital, Bandung to 77 respondents, aged 40–90 years, using the random sampling method. Fracture risks were calculated online, and the data obtained were analyzed and presented using frequency distribution in tables.Results: Most of the respondents had low risk for osteoporotic fracture, and only 5.19% of them had moderate risk. The main risk factors were rheumatoid arthritis (57.14%), followed by current smoking (27.27%) and prolonged glucocorticoids consumption (25.98%).  The moderate risk group was females, above 60 years old and with normal BMI or underweight with risks of previous fracture, parent’s previous hip fracture, rheumatoid arthritis and prolonged glucocorticoids exposure.Conclusions: Majority of the respondents have low risk for osteoporotic fracture. It must be taken into consideration that increasing age, rheumatoid arthritis, current smoking, prolonged glucocorticoids consumption, previous fracture and parent’s previous hip fracture can cause increased risk. DOI: 10.15850/amj.v2n3.514
Herniated Nucleus Pulposus in Dr. Hasan Sadikin General Hospital Bandung Indonesia Ikhsanawati, Annisa; Tiksnadi, Bambang; Soenggono, Arifin; Hidajat, Nucki Nursjamsi
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

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Background: Herniated nucleus pulposus (HNP) is one of the most common diseases of the spine. For an optimal management and prevention, there’s a need for data on factors related to the onset of complaints because this disease lowers the quality of life and increases morbidity. This study is aimed to see the scale and pattern of the HNP in Dr. Hasan Sadikin General Hospital, Bandung.Methods: This is a descriptive study with the design of case series, data was obtained from medical records of patients with the diagnosis of HNP in the inpatient care of Dr. Hasan Sadikin General Hospital in the period of 2007–2011.Results: According to the study on 79 patients, with 43 men and 36 women, the highest incidence was at the age group of 51–60 years old (31.6%) and most common occupation was civil servant (11.4%). The most common clinical symptoms were sciatica (51.9%) and low back pain (51.9%). Most frequent location was in the lumbar vertebrae at the level of L5–S1 (58.2%). Trauma was found to be the highest relatable history in the patients (39.2%). Therapy of choice was primarily conservative (58.2%) and most patients went home after the progression (84.8%). The year 2007 showed the highest prevalence of HNP at 25.3%. The most common clinical symptoms were sciatica (51.9%) and low back pain (51.9%)Conclusions: The most common clinical symptoms were sciatica and low back pain. Most frequent location was in the lumbar vertebrae at the level L5–S1. [AMJ.2015;2(1):179–85]
Young to Middle-Aged Adults and Low Education: Risk Factors of Spondylitis Tuberculosis with Neurological Deficit and Deformity at Dr. Hasan Sadikin General Hospital Ismiarto, Adrian F.; Tiksnadi, Bambang; Soenggono, Arifin
Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Background: Incidence of tuberculosis has risen again, including extrapulmonary tuberculosis. Spondilitis tuberculosis is one the most commonly encountered which can cause disability and even death. The aim of this study was to evaluate characteristics of spondilitis tuberculosis patients and probable risk factors.Methods: This was a descriptive, cross sectional study from all medical records of spondylitis tuberculosis patients at Dr. Hasan Sadikin General Hospital from January 2012 to December 2013. Variables evaluated were demographic data, history related to tuberculosis, nutrinutional status, patient’s characteristics, and treatments received.Results: Spondylitis tuberculosis represented 65.6% of bone and joints tuberculosis.  From 78 cases, the male to female ratio was 1.2:1, and mostly found in young and middle-aged adults (79.6%) between 20−64 years old.  Patients’ level of education were mostly elementary school (30.8%) and unemployed.  Clinical symptoms were mostly neurological disorders, deformity (kyphotic/gibbus), and tenderness. Predilections sites were thoracal and lumbal vertebrae. Forty eight percents of cases were also sufferring from TB in other organs.  Treatments given for these cases were anti tuberculosis drugs (80.8%) and operative procedures (62.8%).Conclusions: Most common clinical manifestations are neurologial deficit, deformity, and tenderness; mostly have pulmonary tuberculosis as a comorbid disease; probable risk factors are young and middle-aged adults, low education level, and unemployment.
Keberhasilan Fusi Tulang Belakang pada Spondilitis Tuberkulosis Rahim, Agus Rahadian; Tiksnadi, Bambang; Hidayat, Nucki N.; Ramdan, Ahmad
Majalah Kedokteran Bandung Vol 43, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Fusi tulang belakang pada spondilitis tuberkulosis bertujuan untuk menghilangkan sumber infeksi, koreksi deformitas, dan mengatasi komplikasi neurologis. Data tingkat keberhasilan fusi ini masih belum tersedia. Kendala lain adalah harga instrumentasi bermerek untuk operasi fusi tulang belakang sangat mahal. Penelitian studi kohort retrospektif ini untuk evaluasi keberhasilan fusi tulang belakang pada spondilitis tuberkulosis di Rumah Sakit Dr. Hasan Sadikin, Bandung tahun 2005–2009. Didapatkan 115 kasus spondilitis tuberkulosis yang dioperasi terdiri atas 34 (29,3%) kasus anterior decompresion spinal fusion (ADSF) dan 81 (70,7%) kasus dengan menggunakan instrumentasi posterior. Dari 81 kasus tersebut, terdapat 3, 27, 26, dan 19 orang berturut-turut mengalami fusi tulang belakang setelah 4, 3, 2, dan 1 tahun pascaoperasi. Hanya 6 kasus yang belum mengalami fusi. Tingkat keberhasilan fusi tulang belakang pada kasus spondilitis tuberkulosis terbukti tinggi, 93%. Selain itu, instrumentasi lokal dapat digunakan sebagai alternatif instrumentasi yang bersifat cost effective untuk tindakan operasi fusi tulang belakang pada kasus spondilitis tuberkulosis dengan p=0,63. Sebagai kesimpulan, kasus spondilitis tuberkulosis yang memerlukan tindakan operasi fusi tulang belakang dapat ditangani dengan baik di RS Dr. Hasan Sadikin, dengan tingkat keberhasilan tinggi dan cost effective. [MKB. 2011;43(3):134–9].Kata kunci: Fusi tulang belakang, spondilitis tuberkulosisSuccessful Rate of Spinal Fusion in Spondylitis TuberculosisSpinal fusion for spondylitis tuberculosis is performed to diminish infection source, correct deformity and overcome neurologic complication. Data of spinal fusion rate has not been available yet. The other problem is that branded instrumentation price is very expensive. The aim of this retrospective cohort study was to evaluate successful rate of spinal fusion in spondylitis tuberculosis performed in Dr. Hasan Sadikin General Hospital, Bandung year 2005–2009. There were 115 cases of spondylitis tuberculosis which treated by operations, 34 cases (29.3%) with anterior decompresion spinal fusion (ADSF) and 81 cases (70.7%) using posterior instrumentation. From those 81 cases, 3, 27, 26, and 19 patients after surgery 4, 3, 2, dan 1 year had spinal fusion, consecutively. Only 6 cases who had not fused yet. The successful rate of spinal fusion in spondylitis tuberculosis, Bandung was proved to be high, 93%, and local instrument product could be used as a costly effective and good alternative treatment in operative management of spondylitis tuberculosis with p=0.63. As a conclusion, spondylitis tuberculosis cases which need spinal fusion can be well treated in Dr. Hasan Sadikin Hospital with high successful rate and cost effective. [MKB. 2011;43(3):134–9].Key words: Spinal fusion, spondylitis tuberculosis DOI:  http://dx.doi.org/10.15395/mkb.v43n3.59
Co-Authors Agus Hadian Rahim Ahmad Ramdan Annisa Ikhsanawati, Annisa Arifin Soenggono, Arifin Eppy Buchori Ismiarto, Adrian F. Nik Fatin Farhana Binti Mohd Rahhim, Nik Fatin Farhana Binti Mohd Nucki N. Hidayat Nucki Nursjamsi Hidajat, Nucki Nursjamsi