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All Journal E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran

I Wayan Suryanto Dusak

Departemen Orthopaedi Dan Traumatologi, Fakultas Kedokteran, Universitas Udayana/RSUP Sanglah Denpasar, Bali, Indonesia

Author-ID : 5390371

Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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Pemberian kombinasi kalsium dengan asam askorbat meningkatkan kadar bone alkaline phosphatase dan osteocalcin serum dibandingkan kombinasi kalsium dengan vitamin D3 pada patah tulang panjang paska fiksasi internal di RSUP Sanglah, Bali, Indonesia Ni Made Puspa Dewi Astawa; I Ketut Siki Kawiyana; Ketut Gede Mulyadi Ridia; Putu Astawa; I Ketut Suyasa; I Wayan Suryanto Dusak; I Gede Eka Wiratnaya
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: It is expected that supplementation will be able to satisfy the needs of calcium as well as improve the process of fracture healing. The goal of this study is to show the efficacy of calcium and ascorbic acid (vitamin C) combination supplements in fracture bone healing compared to calcium and vitamin D3.Methods. This study is a randomized clinical trial involving 30 patients with long bone fractures of the lower extremity who have undergone internal fixation and are split into two classes. The calcium carbonate-ascorbic acid regiment combination was given to one group, while the calcium carbonate-vitamin D3 regiment was given to the other group. The effect of the regiment was tested on serum calcium, bone alkaline phosphatase (BAP) and osteocalcin (OC) levels. The findings were compared and interpreted statistically by SPSS version 21 for Windows.Results. Administration of calcium carbonate and ascorbic acid combination was be able to increase serum calcium significantly (p = 0.00, 95% CI = 0.59 – 0,87), but not as strong as combination of calcium carbonate with vitamin D3. An increased level of serum BAP and OC was found significantly higher in calcium carbonate and ascorbic acid supplementation group (p value = 0,033, CI -4,18 – -0,19 for BAP, p value = 0,04, CI -2,25 – -0,49 for OC).Conclusion. The administration of calcium carbonate and ascorbic acid combination supplement increases the serum calcium level, but not as strong as calcium carbonate and vitamin D3 combination. Latar Belakang: Pemberian suplemen diharapkan mampu untuk memenuhi kebutuhan kalsium sekaligus mempercepat proses penyembuhan patah tulang. Penelitian ini bertujuan untuk mengetahui keefektifan suplemen kalsium dan asam askorbat (vitamin C) dalam penyembuhan tulang pasca patah tulang dibandingkan pemberian suplemen kalsium dan vitamin D3.Metode: Penelitian ini merupakan uji klinis terandomisasi yang melibatkan 30 pasien patah tulang panjang ekstremitas bawah pasca fiksasi internal yang kemudian dibagi menjadi dua kelompok. Satu kelompok diberikan suplemen kombinasi kalsium karbonat-asam askorbat sedangkan kelompok lainnya diberikan kombinasi kalsium karbonat-vitamin D3. Efeknya terhadap kadar serum kalsium, bone alkaline phosphatase (BAP), dan osteocalcin (OC) kemudian diperiksa dan dibandingkan antara kadar sebelum dengan setelah perlakuan. Analisis statistik dilakukan dengan SPSS versi 21 untuk Windows.Hasil: Pemberian kombinasi kalsium karbonat-asam askorbat mampu meningkatkan serum kalsium secara bermakna (p=0.00, IK 95% = 0.59 – 0,87), namun tidak lebih kuat dibandingkan kombinasi kalsium karbonat-vitamin D3. Peningkatan kadar BAP dan OC juga ditemukan lebih tinggi secara bermakna pada kelompok dengan suplementasi kalsium karbonat-asam askorbat (nilai p 0,033 IK -4,18 – -0,19 untuk BAP, nilai p = 0,04, IK -2,25 – -0,49 untuk OC) apabila dibandingkan dengan suplementasi kalsium karbonat-vitamin D3.Simpulan: Pemberian kombinasi kalsium karbonat dan asam askorbat terbukti dapat meningkatan kadar serum kalsium, namun tidak sekuat pada kombinasi kalsium dan vitamin D3.

Differences in union time, dash score and range of motion between giving bisphosphonate and without giving bisphosphonate of osteoporosis patients with distal radius fracture: a systematic review and meta-analysis Dwiwahyonokusuma Dwiwahyonokusuma; Putu Astawa; I Wayan Suryanto Dusak; I Ketut Suyasa; Made Bramantya Karna
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Osteoporosis is a common health problem. Meanwhile, the incidence of distal radius fracture increases with osteoporosis. The standard modality for osteoporosis is a combination of pharmacological therapy, one example of which is the administration of bisphosphonates. There is some disagreement about bisphosphonates' effect on the treatment of distal radius fractures in osteoporosis patients. This study aims to conclude the effect of bisphosphonates for this condition on both functional and radiological outcomesMethods: A systematic search was carried out on the PUBMED database and Google Scholar on studies comparing the timing of bone fusion, Disability of Arm, Shoulder, And Hand (DASH) scores, and wrist Range of Motion (ROM) among distal radius fracture patients with or without additional bisphosphonate therapy. A prospective or retrospective cohort study and a randomized controlled trial were included in this study during 2000-2020. Inclusion and exclusion criteria were used for sample selection. Weight Mean Difference (WMD) was used to assess the statistical results in RevMan version 5.3 for Windows.Results: A search through the PUBMED and Google Scholar databases yielded 376 studies. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 6 articles. In total, there were 973 patients with distal radius fractures who received different treatment on bisphosphonate therapy. There was a significant difference in time to union with bisphosphonates (WMD=0.56; 95% CI=-0.94-2.06). Meanwhile, there was no significant difference in the assessment of DASH and ROM scores (WMD=0.27; 95% CI= -1.01-1.55).Conclusion Bisphosphonates provide a slower time to union in osteoporotic patients with distal radius fracture.

Bacterial growth from the surgical wound base smear at the end of the operation and superficial surgical site infection in the administration of cefazolin single dose, ceftriaxone single dose, and ceftriaxone 3 days as prophylactic antibiotics in cases of Mario Daniel Simatupang; I Wayan Suryanto Dusak; I Ketut Suyasa; I Gede Eka Wiratnaya
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: The use of prophylactic antibiotics in hospitals still often found to be not in accordance with the guidelines of prophylactic antibiotics used and therapy published by the hospital itself. This study aims to compare the effectiveness of prophylactic antibiotics between cefazolin and ceftriaxone in single-dose administration in patients with closed long bone fractures after implant surgery in Sanglah General Hospital on the incidence of Surgical Site Infection (SSI) and germ growth on the base of the surgical wound.Methods: This study used a randomized clinical trial design from a population of closed long bone fracture patients who underwent implant surgery at Sanglah General Hospital. The sample selection was carried out by consecutive sampling during the period July-August 2020. The statistical test was the Chi-Square Test or Fisher Exact Test using the SPSS version 20 for Windows.Results It was found that there was no growth of germs, or in other words, negative culture results were obtained in all study subjects (growth of N (%) 0 (0%), p = -) bacteria in all three groups on a single dose and 3-days dose. SSI did not occur in all study subjects in the three groups so that it could automatically be concluded that there was no difference in the proportion of SSI incidents in the three groups (SSI incidence N (%) 0 (0%), p = -) on single-dose and 3 days dose antibiotics administration, so that the proportional comparison test, either the Chi-Square test or the Fisher Exact test, cannot be performed.Conclusion The prophylactic antibiotics (which are the cephalosporins, namely single dose generic cefazolin and single-dose generic ceftriaxone and 3 days dose) have the same effectiveness in preventing the growth of germs on the surgical wound base smear and prevent the occurrence of superficial SSI on the 30th postoperative day.

Co-Authors Aakash Aakash Anak Agung Gde Bagus Adidharma Anak Agung Gde Yuda Asmara Anak Agung Wiradewi Lestari Dwiwahyonokusuma Dwiwahyonokusuma Eka Wiratnaya Elysanti Dwi Martadiani Gusti Ngurah Putra Stanu Herryanto Agustriadi Simanjuntak I Gusti Ngurah Pramartha Wijaya Putra I Gusti Ngurah Wien Aryana I Ketut Suyasa I Wayan Subawa Ivander Purvance Ketut Gede Mulyadi Ridia Ketut Siki Kawiyana Komang Septian Sandiwidayat Made Bramantya Karna Made Priska Arya Agustini Made Wirabhawa Mario Daniel Simatupang Ni Made Puspa Dewi Astawa Putu Astawa Soehartono Hadi Pranata

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