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Journal : Global Health Management Journal

Correlation between Types of Bleeding Brain Lesion with Glasgow Coma Scale in Head Injury Patients at Gunung Jati Regional Hospital, Cirebon, Indonesia Tantowijaya, Bibit; Debyanti, Merliana; Kusnandang, Agus
GHMJ (Global Health Management Journal) Vol. 8 No. 1s (2025): Special Issues
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-81s1166

Abstract

Background: Head injuries were a leading cause of morbidity and mortality worldwide, often resulting in bleeding brain lesions such as epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and intracerebral hematoma. The Glasgow Coma Scale (GCS) was a widely used tool to assess the level of consciousness in head injury patients. Understanding this relationship was essential for guiding clinical management and predicting patient outcomes, especially in regions with high incidences of traumatic brain injuries, such as Cirebon, Indonesia. Aims: To analyze the relationship between bleeding brain lesions and the Glasgow Coma Scale in head injuries at Gunung Jati Regional Hospital, Cirebon, Indonesia. Methods: This study used an analytical observational method with a cross-sectional approach. Data collection was conducted using total sampling with a sample size of 28. The inclusion criteria were patients with CT-confirmed brain hemorrhages (epidural, subdural, subarachnoid, or intracerebral hematomas).  Data were obtained from medical records in 2023 at Gunung Jati Regional Hospital. The analysis was performed using the Spearman rank correlation test to evaluate the relationship between the type of brain hemorrhage and GCS scores. Results: The total sample of 28 included 21 patients (75%) with Intracerebral Hematoma, 3 patients (10.7%) with Subdural Hematoma, 2 patients (7.1%) with Epidural Hematoma, and 2 patients (7.1%) with Subarachnoid Hematoma. The level of consciousness in these patients was as follows: 15 patients (53.6%) with mild injuries, 8 patients (28.6%) with moderate injuries, and 5 patients (17.9%) with severe injuries. Spearman correlation analysis showed no significant relationship between Bleeding Brain Lesions and Glasgow Coma Scale in head injuries (p =0.645). The absence of correlation might have been due to unaccounted factors in this study, such as hemorrhage volume, lesion location, midline shift, and injury mechanism. Conclusion: There is no significant relationship between types of bleeding brain lesions and Glasgow Coma Scale in head injury patients. The study's limitations included a small sample size and the exclusion of variables such as hemorrhage volume and location, which could affect the level of consciousness. Future research was recommended to involve larger sample sizes and additional clinical factors to better understand the dynamics between types of brain hemorrhages and patients' levels of consciousness, potentially improving clinical management strategies.
Comparison of Healing Time in Closed Fractures of the Tibial Diaphysis and Tibial-Fibula after ORIF Plate and Screw at Waled Regional Public Hospital, Indonesia Sakinah, Dede Nurlaela; Putro, Widiyatmiko Arifin; Debyanti, Merliana
GHMJ (Global Health Management Journal) Vol. 8 No. 2 (2025)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35898/ghmj-821200

Abstract

Background: Fractures are projected to become the fourth leading cause of death by 2030. A fracture is a discontinuity in the bone that is often accompanied by damage to the surrounding tissues. The healing process of fractures is influenced by various factors, the greater the damage to the bone and surrounding tissues, the longer the healing time. In cases of tibia and fibula fractures, the most commonly used surgical procedure in Indonesia is Open Reduction and Internal Fixation (ORIF) using Plates and Screw. Aims: To compare of healing time in closed fractures of the tibial diaphysis and tibial-fibula after ORIF Plate and Screw at Waled regional public hospital. Methods: This research uses a cross sectional design. A total of 77 samples were obtained using total sampling. Statistical tests use Mann Whitney. Results: There were 37 patients with closed fractures of the tibia diaphysis and 40 patients with closed fractures of the tibia-fibula diaphysis. The healing time for closed tibial diaphyseal fractures was ≤ 24 weeks in 12 patients (32.4%), while > 24 weeks was 25 patients (67.6%). In patients with closed fractures of the tibia-fibula diaphysis within ≤ 24 weeks and > 24 weeks, the number was the same, namely 20 patients (50.0%). In the Mann-Whitney test, a significance value of 0.032 (p<0.05) was obtained, indicating a significant difference in the healing time between closed fractures of the tibial diaphysis and tibia-fibula after ORIF Plate and Screw at Waled Regional Hospital, with an average healing of 44.69 weeks for closed fractures of the tibial diaphysis, whereas for fractures closed tibia-fibula diaphysis 33.74 weeks.   Conclusion: The average healing time for closed tibial diaphyseal fractures is longer than for tibia-fibula.