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e-CliniC
Published by Universitas Sam Ratulangi
ISSN : 23375949     EISSN : -     DOI : -
Core Subject : Health,
Health Professions
Jurnal e-CliniC (eCl) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia bekerja sama dengan Fakultas Kedokteran Universitas Sam Ratulangi Manado. Jurnal ini diterbitkan 3 (tiga) kali setahun (Maret, Juli, dan November). Sejak tahun 2016 Jurnal e-CliniC diterbitkan 2 (dua) kali setahun (Juni dan Desember). Jurnal e-CliniC memuat artikel penelitian, telaah ilmiah, dan laporan kasus di bidang ilmu kedokteran klinik.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 15 Documents
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Search results for , issue "Vol. 11 No. 3 (2023): e-CliniC" : 15 Documents clear
Faktor-faktor Risiko yang Berhubungan dengan Kejadian Multidrug-Resistant Tuberculosis (TB-MDR) di Kota Ternate, Maluku Utara Fathul R. S. Imam; Jootje M. L. Umboh; Josef S. B. Tuda
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44459

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is tuberculosis that does not respond to at least isoniazid and rifampicin, with or without other first line anti-TB drugs. Resistannt cases will lead to higher failure of TB therapy, increasing morbidity and mortality, and increasing financial burden in TB control. This study aimed to determine the risk factors associated with MDR-TB in Ternate. This was an analytical and observational study with a case-control design. There were 64 patients as samples, consisting of 32 case samples (MDR-TB) and 32 control samples (antituberculosis drug sensitive TB). Data were obtained using medical records of Dr. H. Chasan Boesorie Hospital in Ternate, and were analyzed with univariate, bivariate and multivariate tests using the SPSS. The results showed that there was a significant relation-ship between history of diabetes mellitus (p=0.021; OR=4.2; 95% CI:1.181-14.937) and history of TB treatment (p=0.010; OR= 6.818; 95% CI:1.356-34.274 ) with the incidence of MDR-TB. Meanwhile, variables that had no effect were sex, age, education level, and history of HIV-AIDS. The multivariate analysis showed that history of TB treatment had the strongest association with the incidence of MDR-TB (OR=5,.93; 95%CI:1.034-29.175). In conclusion, there are two risk factors associated with the incidence of MDR-TB in Ternate namely histories of diabetes mellitus and tuberculosis treatment. Keywords: risk factors; tuberculosis; multidrug-resistant tuberculosis; antituberculosis drugs   Abstrak: Multidrug-resistant tuberculosis (TB-MDR) adalah tuberkulosis (TB) yang resisten terhadap isoniazid dan rifampisin secara bersamaan, dengan atau tanpa disertai obat anti tuberkulosis (OAT) lini pertama lainnya. Kasus resistensi menyebabkan tingginya kegagalan terapi TB, meningkatkan angka kesakitan dan kematian, serta menambah beban pembiayaan dalam pengendalian TB. Penelitian ini bertujuan untuk mengetahui dan menganalisis faktor-faktor risiko yang berhubungan dengan kejadian TB-MDR di Kota Ternate, dengan lokasi penelitian di RSUD Dr. H. Chasan Boesorie Ternate. Jenis penelitian ialah analitik observasional menggunakan desain kasus-kontrol. Sampel berjumlah 64 pasien, yang terdiri dari 32 kasus (TB-MDR), dan 32 kontrol (TB sensitif OAT). Data penelitian diperoleh dari sumber data sekunder, yakni catatan rekam medis pasien. Analisis data yang dilakukan terdiri dari analisis univariat, bivariat, dan multivariat dengan program pengolah data SPSS. Hasil penelitian menunjukkan bahwa terdapat hubungan bermakna antara riwayat diabetes melitus (p=0,021; OR= 4,2;  95%CI: 1,181-14,937) dan riwayat pengobatan TB (p=0,010; OR= 6,818; 95%CI: 1,356-34,274) dengan kejadian TB-MDR. Variabel yang tidak berpengaruh ialah jenis kelamin, usia, tingkat pendidikan, dan riwayat HIV-AIDS. Hasil analisis multivariat mendapatkan bahwa riwayat pengobatan TB merupakan variabel yang paling kuat hubungannya dengan kejadian TB-MDR (OR=5,493; 95%CI:1,034-29,175). Simpulan penelitian ini ialah terdapat dua faktor risiko yang berhubungan dengan kejadian TB-MDR di Kota Ternate, yakni riwayat diabetes melitus dan riwayat pengobatan TB. Kata kunci: faktor risiko; tuberkulosis; multidrug-resistant tuberculosis; obat antituberkulosis
Penanganan Rehabilitasi Medik pada Pasca Artrodesis Kaki Charcot Tanpa Komplikasi Christina A. Damopolii; Joudy Gessal; Devan Perwira
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44762

Abstract

Impact of diabetes on the occurrence of Charcot's foot provides conservative treatment to the benefits of arthrodesis. Charcot foot is a debilitating joint disease characterized by progressive multiple bone destruction, dislocations, and severe deformities of the foot and ankle. Its prevalence may increase in the general high-risk population. Initial treatment of Charcot foot is often conservative and involves the use of bracing, casting, and special orthopedic shoes. This intervention allows the patient to functionally ambulate without resorting to more invasive interventions. Arthrodesis is an effective limb-saving method for patients with Charcot neuroarthropathy who have severe deformity and instability. This technique is usually used for chronic cases with irreversible deformity and/or joint instability to increase plantar pressure and balance of the foot and to minimize the risk of foot ulceration and amputation. In conclusion, non-weight bearing treatment dan immobilisation are the most effective rehabilitation management for active-phase Charcot foot accompanied by surgery consideration to maximize the functional of the foot. Keywords: Charcot foot; diabetes; arthrodesis; rehabilitation management   Abstrak: Diabetes berdampak terhadap terjadinya kaki Charcot dengan penanganan secara konservatif hingga tindakan artrodesis. Kaki Charcot merupakan salah satu penyakit sendi yang merusak dan ditandai dengan progresifitas kerusakan tulang multipel, dislokasi dan deformitas parah pada kaki dan pergelangan kaki dengan prevalensi yang meningkat pada populasi dengan risiko tinggi. Perawatan awal kaki Charcot seringkali konservatif dan melibatkan penggunaan bracing, casting, dan sepatu ortopedi khusus. Intervensi ini memungkinkan pasien untuk ambulasi secara fungsional tanpa menggunakan intervensi yang lebih invasif. Artrodesis merupakan metode penyelamatan anggota tubuh yang efektif untuk pasien dengan neuropati Charcot yang memiliki deformitas parah dan ketidakstabilan. Teknik ini biasanya digunakan untuk kasus kronis dengan deformitas ireversibel dan/atau ketidakstabilan sendi untuk meningkatkan tekanan dan keseimbangan plantar kaki dan untuk meminimalkan risiko ulserasi dan amputasi kaki. Simpulan studi ini ialah penanganan non-weight bearing dan imobilisasi merupakan penanganan rehabilitasi untuk kaki Charcot fase aktif dengan pertimbangan tindakan pembedahan untuk memaksimalkan fungsi kaki. Kata kunci: kaki Charcot; diabetes; arthrodesis; penanganan rehabilitasi
Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP): A Single Centre 5-Year Experience Michael Tendean; Toar D. B. Mambu; Ferdinand Tjandra; Billy Salem; Jimmy Panelewen; Everly Corputty
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.46027

Abstract

Abstract: Endoscopic retrograde cholangiopancreatography (ERCP) and related procedures are established as necessary techniques in the diagnosis and treatment of biliopancreatic diseases. Caution is needed due to the high risk of complications that can be fatal. The main complications are pancreatitis, bleeding, perforation, biliary stents, and lithiasis treatment issues. This study aimed to evaluate the therapeutic ERCP at Prof. Dr. R. D. Kandou Hospital between 2017-2021. This was a retrospective study using patients’ medical record data. The results obtained a total of 196 ERCP procedures performed at Prof. Dr. R. D. Kandou Hospital in that period. Variations of etiology, technical difficulties, and morbidities were recorded. The success rate of endoscopic stone extraction was 77.9 %, EPBD 10.71 %, and stenting for biliary drainage 97.3 %. Etiology varied from bile duct stone (74%); malignancies of the pancreas (8%), duodenum (2%), and periampullary (4%); Klatskin tumor (5.6%); and other malignancies (5%). Associated morbidities were melena 2%, pancreatitis 1%, and cholangitis 0.5%. In conclusion, endoscopic retrograde cholangiopancreatography is a reliable method for the diagnosis and treatment of hepatobiliary and pancreatic diseases, shown by the low incidence of morbidities and mortalities. Keywords: endoscopic retrograde cholangiopancreatography; biliopancreatic diseases
Gambaran Pelayanan Antenatal pada Masa Pandemi COVID-19 di Indonesia 2020-2021 Anggraini Lolitasari; Hermie M. M. Tendean; Erna Suparman
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.45182

Abstract

Abstract: Antenatal care (ANC) is an essential examination during pregnancy to monitor the health of mothers and babies and is one of the efforts to reduce MMR and IMR. However, with the COVID-19 pandemic being declared a national disaster in Indonesia in 2020, there were restrictions on health services including antenatal care. To ensure that ANC continues to run well, guidelines have been created that regulate the implementation of ANC during the COVID-19 pandemic in Indonesia, which are important to comply with. This study aims to describe antenatal care during the COVID-19 pandemic in Indonesia in 2020-2021. The research method used is literature review. The results of the study show that in 2020-2021 most health facilities in Indonesia have carried out antenatal care according to the guidelines, by making appointments and screening for COVID-19 before antenatal care, health workers using PPE according to the guidelines, requiring implementation of health protocols, conducting ANC according to standards, ask pregnant women to study the MCH handbook, carry out classes for pregnant women according to guidelines, and run a planned referral system. Factors affecting antenatal care during the COVID-19 pandemic were human resources, facilities and infrastructure, sources of funds, changes in policies and SOPs, adherence of health workers to using PPE, fear of pregnant women, knowledge and attitudes of pregnant women, and adherence of pregnant women to implementing health protocols. Keywords: antenatal care; antenatal care guidelines; COVID-19 pandemic   Abstrak: Antenatal care (ANC) adalah pemeriksaan esensial pada masa kehamilan untuk memantau kesehatan ibu dan bayi dan merupakan salah satu upaya untuk menurunkan AKI dan AKB. Namun, dengan adanya pandemi COVID-19 yang ditetapkan sebagai bencana nasional di Indonesia pada tahun 2020, terjadi pembatasan pelayanan kesehatan termasuk pemeriksaan antenatal. Untuk menjamin ANC tetap berjalan dengan baik, dibuat pedoman yang mengatur pelaksanaan ANC selama masa pandemi COVID-19 di Indonesia, yang penting untuk dipatuhi. Penelitian ini bertujuan untuk mengetahui gambaran pelayanan antenatal pada masa pandemi COVID-19 di Indonesia pada tahun 2020-2021. Metode penelitian yang digunakan adalah literature review. Hasil penelitian menunjukkan pada tahun 2020-2021 sebagian besar fasilitas kesehatan di Indonesia telah melakukan pelayanan antenatal sesuai dengan pedoman, dengan melakukan pembuatan janji temu dan skrining COVID-19 sebelum pemeriksaan antenatal, petugas kesehatan menggunakan APD sesuai pedoman, mewajibkan penerapan protokol kesehatan, melakukan ANC sesuai standar, meminta ibu hamil mempelajari buku KIA, melaksanakan kelas ibu hamil sesuai pedoman, dan menjalankan sistem rujukan terencana. Faktor-faktor yang mempengaruhi pelayanan antenatal pada masa pandemi COVID-19 adalah SDM, sarana dan prasarana, sumber dana, perubahan kebijakan dan SOP, kepatuhan tenaga kesehatan menggunakan APD, rasa takut ibu hamil, pengetahuan dan sikap ibu hamil, dan kepatuhan ibu hamil menerapkan protokol kesehatan. Kata kunci: pelayanan antenatal; pedoman antenatal care; pandemi COVID-19
Gambaran Tingkat Kecemasan Ibu Hamil Primigravida dan Multigravida dalam Menghadapi Persalinan di Indonesia Falentine Arikalang; Frank M. M. Wagey; Hermie M. M. Tendean
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.48483

Abstract

Abstract: Research in Indonesia shows that pregnant women who experience high levels of anxiety can increase the risk of premature birth and even miscarriage resulting in increased mortality and morbidity rates in pregnant women. This study aimed to describe the level of anxiety of primigravidas and multigravidas facing childbirth in Indonesia. This was a literature review study using Google Scholar with specified criteria. The results obtained 12 literatures. Most primigravidas experienced anxiety with different levels of anxiety. Among primigravidas, 17% had no anxiety, 21.05% mild anxiety, 32.8% moderate anxiety, and 29.15% severe anxiety. Moreover, among multigravidas, 53.58% had no anxiety, 18.85% mild anxiety, 10.77% moderate anxiety, 10.38% severe anxiety, and 6.15% very serious anxiety. In conclusion, the majority of pregnant women facing childbirth in Indonesia experience various levels of anxiety. Primigravidas experience moderate anxiety, followed by severe anxiety and mild anxiety. Meanwhile, most multigravidas do not experience anxiety. Keywords: anxiety level, pregnant women, primigravida, multigravida   Abstrak: Penelitian di Indonesia menunjukkan bahwa ibu hamil yang mengalami kecemasan tingkat tinggi dapat meningkatkan risiko kelahiran bayi prematur bahkan keguguran yang berdampak pada penigkatan angka mortalitas dan morbiditas pada ibu hamil. Penelitian ini bertujuan untuk mengetahui gambaran tingkat kecemasan ibu hamil primigravida dan multigravida dalam menghadapi persalinan di Indonesia. Jenis penelitian alah suatu literature review. Pencarian data menggunakan database Google scholar dengan kriteria yang ditentukan. Hasil penelitian mendapatkan 12 literatur. Sebagian besar ibu hamil primigravida mengalami kecemasan dengan tingkat kecemasan berbeda, yaitu sebanyak(17% tidak cemas, 21,05% cemas ringan, 32,8% cemas sedang dan 29,15% cemas berat. Pada ibu hamil multigravida sebanyak 53,58% tidak cemas, 18,85% cemas ringan, 10,77% cemas sedang, 10,38% cemas berat, dan 6,15% cemas berat sekali. Simpulan penelitian ini ialah mayoritas ibu hamil dalam menghadapi persalinan di Indonesia mengalami kecemasan dengan tingkat bervariasi. Ibu hamil primigravida paling banyak mengalami kecemasan sedang, diikuti kecemasan berat dan ringan. Ibu hamil multigravida sebagian besar tidak mengalami kecemasan. Kata kunci: tingkat kecemasan; ibu hamil; primigravida; multigravida
Rehabilitasi Medik pada Nyeri Bahu Hemiplegia Pasca Stroke Joshua Manurung; Christopher Lampah; Joudy Gessal
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.45280

Abstract

Abstract: According to WHO 2019, stroke is the second leading cause of death worldwide and a significant cause of long-term disability. One of the complications that often occurs after a stroke is hemiplegic shoulder pain that affects the patient with decreased functional use of the arm, decreased quality of life, higher rates of depression, prolonged hospitalization, and impaired rehabilitation. This study aimed to discuss about rehabilitation efforts in post stroke patients with hemiplegic shoulder pain. This was a literature review study by searching three databases (Google Scholar, Pubmed, and Clinical Key) to determine medical rehabilitation for hemiplegic shoulder pain. The results obtained 13 literatures that matched the criteria. Hemiplegic shoulder pain in many ways, such as reducing the functional use of the arm, reducing quality of life, increasing levels of depression, prolonged hospitalization, is to the point of interfering with the recovery process, namely rehabilitation. In conclusion, medical rehabilitation for hemiplegic shoulder pain has shown quite successful efforts in treating or restoring the condition of patient with hemiplegic shoulder pain. It is possible to carry out more extensive research regarding the underlying causes, examinations to diagnose hemiplegic shoulder pain, and more effective rehabilitation in the future. Keywords: medical rehabilitation; hemiplegic shoulder pain; post stroke; quality of life   Abstrak: Menurut WHO 2019, stroke merupakan penyebab kematian kedua di dunia dan salah satu penyebab yang bermakna bagi disabilitas jangka panjang. Salah satu komplikasi yang sering terjadi setelah kejadian stroke ialah nyeri bahu hemiplegia yang memengaruhi penderita dengan penurunan penggunaan fungsional lengan, penurunan kualitas hidup, tingkat depresi yang lebih tinggi, rawat inap yang berkepanjangan, gangguan rehabilitasi. Penelitian ini bertujuan untuk mengetahui rehabilitasi medik pada nyeri bahu hemiplegia pada pasien pasca stroke menggunakan metode literature review dengan penelusuran pada tiga database (Google Scholar, Pubmed, dan Clinical Key). Hasil penelitian mendapatkan 13 literatur yang sesuai dengan kriteria. Nyeri bahu hemiplegia dalam banyak hal, seperti penurunan penggunaan fungsional lengan, penurunan kualitas hidup, tingkat depresi yang bertambah, rawat inap yang berkepanjangan, sampai mengganggu proses pemulihan membutuhkan rehabilitasi. Simpulan penelitian ini ialah penanganan rehabilitasi medik pada pasien pasca stroke dengan nyeri bahu hemiplegia telah menunjukkan upaya yang cukup berhasil dalam mengobati atau memulihkan kondisi tersebut Tidak menutup kemungkinan dilakukan penelitian yang lebih luas mengenai penyebab yang mendasari, pemeriksaan untuk mendiagnosis keadaan nyeri bahu hemiplegia maupun rehabilitasi yang lebih efektif di masa mendatang. Kata kunci: penanganan rehabilitasi medik; nyeri bahu hemiplegia; pasca stroke; kuallitas hidup
Hubungan Fibronektin Serum dengan Tingkat Kesadaran Menurut Klasifikasi CT-Marshall pada Pasien Cedera Otak Sedang dan Berat akibat Trauma Diornald J. Mogi; Eko Prasetyo; Maximillian Ch. Oley; Ferdinan Tjungkagi; Yovanka N. Manuhutu
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.46563

Abstract

Abstract: Traumatic brain injury (COT) is the main cause of brain damage in the young and productive age generations. Although there is no accurate biological markers for detecting brain damages so far, many studies about fibronectin have been reported as a promising biological marker. This study aimed to obtain the relationship between serum fibronectin and level of consciousness based on CT-Marshal in patients with moderate and severe COT. This was an observational and analytical study with a cross-sectional design. Samples that met the study criteria were taken sequentially from the study hospital without differentiating exposure status (serum fibronectin levels) or outcome (CT-Marshall category). The regression test on the main variable serum fibronectin levels with awareness using the CT-Marshall category was carried out and showed significant relationship between serum fibronectin level and the patient's CT-Marshall category. The higher the serum fibronectin level, the higher the patient's CT-Marshall category which meant that a patient had a degree of severity and poor consciousness. In conclusion, there is a significant relationship between serum fibronectin level and level of consciousness based on the CT-Marshall category in traumatic brain injury patients. Keywords: traumatic brain injury; biological markers; fibronectin; level of consciousnes                                                                                                               Abstrak: Cedera otak akibat trauma (COT) merupakan penyebab utama kerusakan otak pada generasi muda dan usia produktif. Saat ini, belum terdapat penanda biologis yang akurat untuk mendeteksi kerusakan otak traumatik ataupun menilai prognosis terkait kerusakan otak traumatik namun perhatian terhadap penanda biologis telah meningkat akhir-akhir ini yaitu antara lain fibronektin. Penelitian ini bertujuan untuk mengetahui hubungan fibronektin serum dengan tingkat kesadaran menurut klasifikasi CT-Marshall pada pasien COT sedang dan berat. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel yang memenuhi kriteria penelitian diambil berurutan dari rumah sakit tempat penelitian tanpa membedakan status paparan (kadar fibronektin serum) ataupun luaran (kategori CT-Marshall). Pengambilan data dilakukan hanya sekali untuk keseluruhan variabel selama masa pengumpulan data. Hasil uji regresi terhadap kadar fibronektin serum dengan kesadaran menggunakan kategori CT-Marshall mendapatkan adanya hubungan bermakna yaitu semakin tinggi kadar fibronektin serum, semakin tinggi pula kategori CT-Marshall pasien yang berarti pasien memiliki derajat keparahan dan kondisi kesadaran yang buruk. Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar fibronektin serum terhadap kesadaran menggunakan kategori CT-Marshall pada pasien cedera otak traumatik. Kata kunci: cedera otak akibat trauma; penanda biologis; fibronektin; tingkat kesadaran
Trikoepitelioma Multipel Familial: Laporan Kasus Meilany Durry; Anggreiny Iwisara; Fera Mawu; Sthefanie Gaghana
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44627

Abstract

Abstract: Trichoepithelioma is a benign tumor of folliculosebaceous-apocrine germ cell origin. There are three clinical variants of trichoepithelioma, as follows: solitary, multiple, and desmoplastic. The clinical features of trichoepithelioma are skin-colored papules up to 0.5 cm in size. with predilection areas on the nose, upper lip, and cheeks. The specific variant of familial multiple trichoepithelioma is inherited in an autosomal-dominant type and usually occurs in childhood and puberty. We reported a 36-year-old woman with complaints of skin-colored papules on the face and neck. There were family members with the same complaint. Histopathological examination showed skin tissue with dermal tumor consisting of basaloid cells arranged in palisade form in the periphery, and several horn-cysts among the cells that indicated a trichoepithelioma. The patient was planned to be treated with topical imiquimod and electric surgery. In conclusion, based on anamnesis, physical examination, and histopathological result, the diagnosis of this case was familial multiple trichoepithelioma. Keywords: trichoepitelioma; cylindromatosis; skin appendageal tumor; histopathological examination   Abstrak: Trikoepitelioma merupakan suatu tumor asal sel germinal folliculosebaceous-apocrine. Terdapat tiga varian klinis trikoepitelioma yaitu soliter, multipel, dan desmoplastik. Gambaran klinis trikoepitelioma ialah papula sewarna dengan kulit ukuran sampai 0,5 cm dan lokasi predileksi yaitu hidung, bibir atas, dan pipi. Terdapat satu varian spesifik yaitu trikoepitelioma multipel familial yang diwariskan secara dominan autosomal dan biasanya timbul pada masa kanak-kanak dan pubertas. Kami melaporkan seorang perempuan berusia 36 tahun dengan keluhan bintil-bintil sewarna kulit, multipel pada area wajah dan leher. Di dalam keluarga pasien terdapat anggota keluarga dengan keluhan yang sama. Hasil pemeriksaan histopatologik mendapatkan jaringan kulit dengan tumor pada dermis yang terdiri dari sel-sel basaloid, bagian tepi tersusun palisade, dan di antaranya tampak beberapa horn-cyst yang menunjukkan suatu trikoepitelioma. Pasien ini direncanakan diberikan terapi dengan imiquimod topical dan bedah listrik. Simpulan kasus ini ialah suatu trikoepitelioma multipel familial yang ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan histopatologik. Kata kunci: trikoepitelioma; cylindromatosis; skin appendageal tumor; pemeriksaan histopatologik
Identifikasi Nervus Laringeus Rekuren pada Tiroidektomi dan Ismolobektomi dengan Menentukan Vasa Nervorum pada Nervus Laringeus Rekuren Saat Pembedahan di RSUP Prof. Dr. R. D. Kandou Manado Periode 2017-2018 Diornald J. Mogi; Nico Lumintang
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44763

Abstract

Abstract: There are two sets of nerves near the thyroid gland for voice control namely recurrent laryngeal nerve and external branch of the superior laryngeal nerve. There peripheral nerves rely on blood supply to maintain their structural and functional requirements, therefore, their vasa nervorum have to be identified in thyroidectomy and isthmolobectomy. This study aimed to obtain data on vasa nervorum whether it was visible or not in the recurrent laryngeal nerve during thyroidectomy and isthmolobectomy. This was a retrospective study using medical record data of observed vasa nervorum in all patients undergoing elective surgery for thyroidectomy and isthmolobectomy at Prof. Dr. R. D. Kandou Hospital in 2017-2018. The results obtained 48 cases who underwent elective surgery for thyroidectomy and isthmolobectomy. There were 33 cases with excellent visualization of the vasa nervorum against the recurrent laryngeal nerve (+++), 15 cases were visible but not very clear (++), and three cases were vague and difficult to observe (+). In conclusion, in most thyroidectomy and isthmolobectomy surgeries at Prof. Dr. R. D. Kandou Hospital visualization of vasa nervorum on recurrent laryngeal nerve is excellent to prevent nerve injury. Visual identification and dissection of this nerve is a standard technique to prevent the nerve injury during thyroidectomy or isthmolobectomy and other open neck surgeries. Keywords: recurrent laryngeal nerve; superior laryngeal nerve; thyroidectomy; isthmolobectomy   Abstrak: Terdapat dua kelompok saraf di dekat kelenjar tiroid yang membantu mengendalikan suara, yaitu nervus laringeus rekuren dan cabang eksternal nervus laringeus superior. Saraf perifer ini bergantung pada pasokan darah untuk mempertahankan kebutuhan struktural dan fungsional; oleh karena itu, vasa nervorum perlu diidentifikasi pada operasi tiroidektomi dan ismolobektomi. Penelitian ini bertujuan untuk mendapatkan data tentang vasa nervorum yang teramati pada nervus laringeus rekuren selama operasi tiroidektomi dan ismolobektomi. Jenis penelitian ialah retrospektif menggunakan rekam medis mengenai kasus vasa nervorum yang diamati pada semua pasien yang menjalani operasi elektif untuk tiroidektomi dan isthmolobectomi di RSUP Prof. Dr. R. D.  Kandou Manado pada 2017-2018. Hasil penelitian mendapatkan 48 kasus yang menjalani operasi elektif untuk tiroidektomi dan ismolobectomi. Terdapat 33 kasus dengan visualisasi vasa nervorum terhadap nervus laringeus rekuren sangat baik (+++), 15 kasus terlihat tetapi tidak terlalu jelas (++), dan tiga kasus samar-samar dan sulit diobservasi (+). Simpulan penelitian ini ialah pada sebagian besar operasi tiroidektomi dan ismolobektomi di RSUP Prof. Dr. R. D. Kandou Manado telah dilakukan visualisasi vasa nervorum terhadap nervus laringeus rekuren yang jelas untuk menghindari cedera pada nervus laringeus rekuren. Identifikasi visual dan diseksi nervus laringeus rekuren sekarang merupakan teknik standar untuk menghindari cedera nervus tersebut selama tiroidektomi atau ismolobektomi dan operasi leher terbuka lainnya. Kata kunci: nervus laringeus rekuren; nervus laringeus superior; tiroidektomi; ismolobektomi
Treatment of Non-Union with Bone Loss in Femur Fracture Using Non-vascularized Fibular Graft: A Case Report Andriessanto Lengkong; Stefan Kambey; Rangga Rawung; Haryanto Sunarso; Albertus D. Noersasongko; Tommy Suharso; Ryan A. Senduk
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44768

Abstract

Abstract: Fibula is a very versatile source of autogenous graft and has been used for decades in the field of limb reconstruction. Bony defects of the lower extremity are usually the result of high-energy trauma, tumor resection, or severe sepsis. Non-vascularized fibular graft (NVFG) is useful in the reconstruction of skeletal defects, especially in cases of scarred and avascular recipient sites, or in patients with combined bone and soft tissue defects. This study aimed to assess the effectiveness of NVFG in the management of non-union bone fracture. We reported a 16-years-old male with non-union femur fracture. Debridements were applied at the first time of admission to the hospital. Open reduction of fracture with internal femur fixation. Fibula bone was extracted as the donor of vascularized graft for the bone loss. After two years of follow-up, the patient acquired his motor functions back well, and was able to carry out daily activities as expected. In conclusion, taking together the repair and reconstruction of non-union bone in the lower extremity with NVFG and internal fixation is an effective and important option for treating non-union femoral fracture. NVFG osteosynthesis has encouraging results in such instances. It is technically less demanding, simple, and can be performed in almost all centers where image intensifier is available. Keywords: bone fracture; non-vascularized fibular graft; reconstructive microsurgery; femoral non-union

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