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"Latar Belakang: Kebocoran anastomosis merupakan komplikasi pada pembedahan kolorektal. Banyak faktor yang memngaruhi kejadian kebocoran anastomosis namun studi terbaru peran mikrobiota menjadi salah satu pencetus kebocoran anastomosis. Kasus kebocoran anastomosis berkisar 3-18 % yang meningkat seiring berbagai faktor yang dimiliki oleh pasien. Disbiosis mikrobiota selanjutnya dapat memicu gangguan penyembuhan dan merusak kolagen pada lumen usus. Diperlukan penelitian prospektif untuk dapat menilai karakteristik kebocoran anastomosis.Metode: Dilakukan pengambilan sampel pascaanastomosis lalu dilakukan kultur jaringan. Lendir mukosa dipisahkan dari lumen untuk mendapatkan gambaran mikrobiota pada lumen. Kejadian kebocoran diikuti 5 hari pascaanastomosis dan dinilai faktor-faktor yang memengaruhi kejadian kebocoran anastomosis. Data ditampilkan dalam bentuk deskriptif tabel dan persentase.Hasil: Terdapat satu kasus kebocoran anastomosis pada operasi lower anterior resection, usia 65 tahun, ASA III dengan komorbid hipertensi tingkat II. Didapat bakteri Escherichia coli terbanyak ditemukan selain Proteus spp dan Klebsiella spp. Bakteri ini merupakan bakteri komensal saluran cerna dan belum diketahui patogenitasnya serta hubungan dengan pemberian antibiotik preoperasi.Kesimpulan: Belum diketahuinya strain patogen pada temuan hasil kultur. Karakteristik subjek memiliki jarak anastomosis ke anal <10 cm, ASA III, usia >65 tahun dan memiliki komorbid tidak signifikan memiliki hubungan kejadian kebocoran anastomosis.

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Background: Anastomotic leak is a complication of colorectal surgery. Many factors influence the incidence of anastomotic leakage, but recent studies on the role of the microbiota are one of the triggers for anastomotic leakage. Anastomotic leak cases range from 3-18% which increases with various factors possessed by the patient. Microbiota dysbiosis can then trigger healing disorders and damage collagen in the intestinal lumen. Prospective studies are needed to assess the characteristics of anastomotic leak.

Methods: Post-anastomosis samples were taken and then tissue culture was performed. Mucous mucus is separated from the lumen to obtain an image of the microbiota in the lumen. The incidence of leakage was followed 5 days post-anastomosis and assessed the factors that influence the incidence of anastomotic leak. The data is displayed in the form of descriptive tables and percentages.

Results: There was one case of anastomotic leak during lower anterior resection surgery, age 65 years, ASA III with comorbid grade II hypertension. The most Escherichia coli bacteria were found besides Proteus spp and Klebsiella spp. These bacteria are commensal bacteria of the gastrointestinal tract and the pathogenicity and relationship with preoperative antibiotics are not known.

Conclusion: There is no known pathogenic strain in the culture findings. Characteristics of the subject had an anastomotic distance to the anal <10 cm, ASA III, age> 65 years and had no significant comorbid association with the incidence of anastomotic leak."

"Latar Belakang: Kekuatan gigit merupakan salah satu indikator status fungsional dalam sistem pengunyahan yang diperankan oleh gerakan otot-otot pengunyahan pada proses biomekanik kraniomandibula. Pengukuran nilai kekuatan gigit dapat menggambarkan status fungsional sistem pengunyahan pada individu yang dihasilkan oleh gerakan otot-otot rahang pada proses biomekanik kraniomandibular. Tindakan reseksi mandibula yang disebabkan kondisi patologis dapat menurunkan nilai kekuatan gigit pascaoperasi dengan cara menghasilkan ketidakseimbangan pada otot-otot pengunyahan, gerakan mandibula dan penurunan tekanan kunyah. Prosedur rekonstruksi diperlukan untuk mengembalikan fungsi menelan, fungsi bicara dan fungsi kunyah yang dapat dinilai dari kekuatan gigit. Tujuan Penelitian: Mengetahui perbedaan nilai kekuatan gigit pascareseksi rekonstruksi menggunakan vascular fibula graft, pelat rekonstruksi dibandingkan dengan nilai kekuatan gigit subyek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015-2020. Metode Penelitian: 45 subjek penelitian diambil dari pasien Rumah Sakit Ciptomangunkusumo. Setelah dilakukan informed consent, subjek penelitian dibagi menjadi 3 kelompok, yaitu kelompok kontrol, kelompok vascular fibula graft dan kelompok pelat rekonstruksi. Subjek penelitian diukur kekuatan gigit menggunakan alat bite force meter sebanyak 3 kali dan diambil nilai tertinggi. Data kekuatan gigit selanjutnya diuji statistik menggunakan Oneway Anova. Hasil: Terdapat perbedaan bermakna nilai kekuatan gigit antara kelompok kontrol (535.1N), kelompok vaskular fibula graft (241.8N) dan kelompok pelat rekonstruksi (148,9N) dengan nilai Sig.0.000 (p<0.05) pada uji Oneway Anova. Nilai kekuatan gigit dipengaruhi oleh jenis kelamin pada kelompok kontrol Sig.0.015 (p<0.05), dan tipe defek mandibula pada kelompok vaskular fibula graft Sig 0.009 (p<0.05). Kesimpulan: Terdapat perbedaan nilai kekuatan gigit pascareseksi dan rekonstruksi mandibula dibandingkan dengan nilai kekuatan gigit subjek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015-2020.

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Background: Bite force is an indicator of functional status of the masticatory system, which is controlled by the movement of the masticatory muscles in the craniomandibular biomechanical processes. The measurement of the bite force value can describe the functional status of the masticatory system in individuals produced by the movement of the jaw muscles in the craniomandibular biomechanical processes. Mandibular resection caused by pathological conditions can reduce the value of postoperative bite force due to imbalances in the masticatory muscles, mandibular movement, and a decrease in masticatory load. Reconstructive procedures are needed to restore swallowing, speech and chewing functions which can be assessed by the bite force.

Aim: To investigate the differences of the bite force values post mandibular resection reconstructed with vascular fibula grafts, reconstruction plate, and of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020.

Methods: 45 research subjects were recruited from Ciptomangunkusumo Hospital patients according to the inclusion and exclusion criteria. After informed consent, the research subjects were divided into 3 groups, namely the control group, the vascular fibula graft group, and the plate reconstruction group. The bite force values of the research subjects were measured three times using a bite force meter, and the highest value was taken. The bite force data was then statistically compared using Oneway Anova.

Results: Significant differences were found in the bite force values between the control group (535.1N), the fibula graft vascular group (241.8N) and the plate reconstruction group (148.9N) with a Sig. 0.000 (p<0.05) value in Oneway Anova test. The value of the bite force was influenced by sex in the control group Sig.0.015 (p<0.05), and the type of mandibular defects in the vascular fibula graft with Sig.0.009 (p<0.05).

Conclusion: Statistically significant differences were found in the value of the bite force post resection and reconstruction of the mandible compared to that of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020."

"Latar Belakang: Kebocoran anastomosis adalah komplikasi yang dapat terjadi pasca dilakukannya reduksi manual, reseksi dan anastomosis end-to-end pada kasus intususepsi. Faktor-faktor yang mempengaruhi kebocoran anastomosis antara lain teknik operator, kondisi lokal usus, kondisi umum pasien dan grading kolagen yang terbentuk pada proses penyembuhan luka. Tujuan: Mengetahui pengaruh perubahan grading kolagen usus pasca reseksi anastomosis terhadap kebocoran pada kasus intususepsi. Metode: Dua puluh satu tikus Sprague-dawley dilakukan laparatomi untuk dibuat model intususepsi (IN). Setelah 45 menit dilakukan destrangulasi selama 10 menit, dinilai adanya nekrosis dan dilanjutkan reseksi anastomosis. Tikus dibagi menjadi 3 kelompok, kelompok A : reseksi anastomosis pada batas usus yang nekrosis, kelompok B : reseksi anastomosis pada batas usus yang mengalami trombosis pembuluh darah mesenteriumnya, dan kelompok C : reseksi anastomosis pada batas usus yang sehat. Sampel usus yang direseksi diperiksa secara Histopatologi untuk menilai grading kolagen. Setelah 5 hari dilakukan laparatomi ulang, dinilai secara subjektif ada tidaknya kebocoran anastomosis, lalu diambil sampel segmen anastomosis usus untuk dinilai kembali grading kolagennya. Diharapkan jika terjadi kenaikan grading kolagen, anastomosis akan paten, sebaliknya jika terjadi penurunan akan terjadi perforasi. Hasil: Kelompok A: grading kolagen menurun dengan perforasi 6 (85,7%), grading kolagen tetap tanpa perforasi 1 (14,2%). Kelompok B: grading kolagen menurun dengan perforasi 2 (28,6%), tetap dengan perforasi 1 (14,3%), meningkat tanpa perforasi 4 (42,9%). Kelompok C: grading kolagen meningkat tanpa perforasi 5 (71,4%), menetap tanpa perforasi 2 (28,6%). Kesimpulan: Terdapat perubahan grading kolagen pasca reseksi anastomosis usus yang mempengaruhi tingkat kebocoran anastomosis pada kasus intususepsi.

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Background: Anastomosis leakage is a common complication following manual reduction, resection and end-to-end anastomosis in treating intussusceptions. Factors influencing the anastomosis leakage such as surgeon?s technique, local bowel condition, systemic condition of patients and the concentration of collagen in the bowel tissue during the anastomosis healing.

Aim: To study the effect of collagen concentration changes after resection and anastomosis procedure, in relation to the anastomosis leakages in intussusceptions case.

Methods: 21 Sprague-dawley rats were performed laparotomy to create the intussusception model (IN). The IN models were applied for 45 minute, after the bowel considered necrotic, destrangulation were performed for 10 minutes continued with resection and anastomosis on 3 group of resection margin: A on necrotic margin of bowel, B: on the thrombotic mesenterium vessel margin, C: on normal bowel margin. Resected bowels were sent for histopathology examination of collagen concentrations. After 5 days, another laparotomy was performed and the anastomosis leakages were subjectively assessed. The anastomosed segments were sampled for collagen concentration and grade.

Results: In study group A the collagen grading were found to be decreased with 6 leakages occurred (85.7%) and 1 subject (14.2%) with stable collagen grading and no leakages. From group B, subjects with decreased collagen and leakages were 2 (28.6%), and 1 subjects (14.3%) were stable in grading with leakages, and 4 subjects (42.9%) with increased collagen without leakages. In Group C, 5 rats (71.4%) had increased collagens without leakages, and 2 rats were at stable collagen grade without leakages.

Conclusion: There were collagen grade changes in bowel anastomosis that affect the extent of leakages in intussusceptions case."

"ABSTRAKPendahuluan. Tumor Ganas Jaringan Lunak Soft Tissue Sarcoma merupakan kelompok heterogen tumor ganas mesenkim dengan jumlah kasus yang sangat sedikit dengan gejala klinis sulit dibedakan dengan tumor jinak, menjadikan tumor ini sering ditangani tanpa mengetahui batas tumor yang jelas unplanned excision . Penanganan tumor ganas jaringan lunak secara inadekuat ini mengakibatkan tumor masih tersisa sehingga beresiko terjadi rekurensi dan mortalitas. Penelitian ini bertujuan untuk mengetahui rekurensi dan mortalitas pasien tumor ganas jaringan lunak ekstremitas yang telah dilakukan unplanned excision, serta faktor-faktor yang memengaruhinya.Metode Penelitian. Penelitian ini merupakan penelitian deskriptif analitik dengan rancangan kohort retrospektif yang menggunakan data pasien RS Cipto Mangunkusumo tahun 2005 hingga 2015. Pada penelitian ini, didapati yang memenuhi kriteria sebanyak 87 subjek, yakni pasien unplanned excision tumor ganas jaringan lunak ekstremitas yang dilakukan analisis angka rekurensi dan mortalitas serta faktor-faktor yang berhubungan dengan rekurensi dan mortalitas tersebut.Hasil Penelitian. Terdapat hubungan yang bermakna antara tingkat rekurensi dengan operator yang tidak berkompeten non orthopaedi onkologi p0,05 . Tidak terdapat hubungan yang bermakna secara statistik antara mortalitas dengan operator pembedahan, lokasi tumor, ukuran awal tumor dan tipe rumah sakit P>0,05 .Kesimpulan. Faktor yang memengaruhi rekurensi pada pasien unplanned excision tumor ganas jaringan lunak yakni operator non orthopaedi onkologi.

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ABSTRACTIntroduction. Soft tissue sarcoma is part of mesenchymal malignant tumor heterogeneous group with very little number of cases. Unplanned excision often become the choice of treatment due to difficulties to differentiate it with benign tumor. The inadequate treatment of this soft tissue sarcoma often leave trace of the tumor, leading to recurrence and mortality. We studied the recurrence and mortality of patients with unplanned excision on soft tissue sarcoma of extrimities, including affecting factors.Methods. This is an analytical descriptive study with retrospective cohort design, using patient rsquo s data in Cipto Mangunkusumo hospital during 2005 to 2015. Our study acquired 87 subjects with unplanned excision on soft tissue sarcoma of extrimities. Analysis of recurrence rate, mortality rate, and related factores were examined and analysed.Results. There was significant relationship between recurrence rate with incompetent surgeon non oncology orthopaedics p0,05 . However, this study could not find statistical significance between mortality with non oncology orthopaedic surgeon, location of the tumour, initial size of the tumour, and hospital type P 0,05 .Conclusion. There is relationship between recurrence rate with non oncology orthopaedics operator. "

"Latar Belakang : Angka kejadian reseksi anastomosis pada kasus intususepsimasih sangat tinggi. Hal ini dikarenakan masih seringnya pasien datang terlambatsetelah 72 jam, kurangnya SDM untuk melakukan reduksi non operatif, dankurangnya penunjang seperti USG untuk menegakkan diagnosa. Penting untukmemperhatikan presisi, tehnik dan mempertimbangkan usus yang tersisa dalammelakukan reseksi anastomosis. Hingga saat ini belum ada standar operasi khususyang dapat menjadi panduan bagi para dokter bedah dalam melakukan reseksiakibat intususepsi. Karena itu, peneliti tertarik untuk mencari batas reseksi yangdiperlukan untuk menghasilkan suatu anastomosis end-to-end yang optimal danrendah tingkat kebocorannya. Penelitian akan dilakukan kepada tikus sebagai pilotstudy sebelum dilakukan penelitian lebih lanjut.Tujuan : Mengetahui batas reseksi usus yang optimal dinilai dari kebocorananastomosis berdasarkan grading kolagen pada batas reseksi tersebut.Metode : Penelitian ini merupakan penelitian eksperimental dengan hewan cobatikus putih Sprague Dawley. Tikus putih dilakukan intususepsi denganmenggunakan stylet, dari proksimal ke distal. Setelah 45 menit, intususepsi direduksi.Tikus putih dikelompokkan dalam tiga kelompok sesuai batas reseksianastomosis, yang kemudian batas reseksi ini dilakukan pemeriksaan gradingkolagen. Setelah 5 hari, dilakukan laparotomi untuk menilai kebocorananastomosis.Hasil : Pada perbandingan grading kolagen dengan reseksi usus didapatkangrading terbanyak pada batas 1 adalah grading 2 (57,1 %), pada batas 2 grading 2(71,4 %) ,batas 3 grading 3 (71,4%).Perforasi terbanyak ditemukan pada grading2 sebanyak 5 sampel. Pada perbandingan batas reseksi dengan perforasididapatkan perforasi terbanyak pada batas 1 (85,7 %)Simpulan : Terdapat perbedaaan grading kolagen pada batas reseksi usus dimanabatas kelompok batas 3 memiliki grading kolagen yang lebih baik ( grade 3 dan 4)sehingga kelompok batas 3 lebih direkomendasikan secara histopatologis.Grading kolagen dapat dinilai untuk melihat kemungkinan perforasi hasilanastomosis. Terdapat faktor-faktor lain yang dapat mempengaruhi kejadianperforasi selain grading kolagen.

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Background : There is still high presentation of intussuseption cases with resection and

anastomose, caused of multi factors as : patient delay more than 72 hours, less on

profesional expert to do non operative reduction and less of examination such as ultra

sound to make a diagnose. That is important to take attention with pretition, tehniques

and less of intestine when do the resection. There is still no operative standard about the

boundary of resection cause of intussuseption, thats why the author want to do the

experimental to find the optimal part of resection with minimal leakage. The experimental

will do on rat as a pilot study.

Aim : How to get the optimal part of resection compared with anastomotic leakege based

on collagen grading.

Method : The experimental test using a Sprague Dawley rat. We make a intussuseption

on gut rat using a styleth from proximal to distal. The release do after 45 minutes. The

rats then separated into three boundaries group, and did resection-anastomose with each

gut from groups were performed a histopatologic test to count collagen grading. Leakage

of anastomose were examinated after 5 days

Result : In comparison between collagen grading and the extent of resection

obtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2

(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5

sample).in comparison the extent of resection and leakage,the highest is group 1

(85,7%).

Summary : There are differences about collagen gradingin the extent of bowel

resection which is the third group of resection has higher collagen grading (3 and

4 ) and then more recommended as histopatologic exam. Collagen grading could

be marked to see possibilities of anastomotic leakage. There is some factors that

affect a leakage besides collagen grading."

"ABSTRAK Latar Belakang : Angka kejadian reseksi anastomosis pada kasus intususepsi masih sangat tinggi. Hal ini dikarenakan masih seringnya pasien datang terlambatsetelah 72 jam, kurangnya SDM untuk melakukan reduksi non operatif, dankurangnya penunjang seperti USG untuk menegakkan diagnosa. Penting untukmemperhatikan presisi, tehnik dan mempertimbangkan usus yang tersisa dalammelakukan reseksi anastomosis. Hingga saat ini belum ada standar operasi khususyang dapat menjadi panduan bagi para dokter bedah dalam melakukan reseksiakibat intususepsi. Karena itu, peneliti tertarik untuk mencari batas reseksi yangdiperlukan untuk menghasilkan suatu anastomosis end-to-end yang optimal danrendah tingkat kebocorannya. Penelitian akan dilakukan kepada tikus sebagai pilotstudy sebelum dilakukan penelitian lebih lanjut. Tujuan : Mengetahui batas reseksi usus yang optimal dinilai dari kebocorananastomosis berdasarkan grading kolagen pada batas reseksi tersebut. Metode : Penelitian ini merupakan penelitian eksperimental dengan hewan cobatikus putih Sprague Dawley. Tikus putih dilakukan intususepsi denganmenggunakan stylet, dari proksimal ke distal. Setelah 45 menit, intususepsi direduksi.Tikus putih dikelompokkan dalam tiga kelompok sesuai batas reseksianastomosis, yang kemudian batas reseksi ini dilakukan pemeriksaan gradingkolagen. Setelah 5 hari, dilakukan laparotomi untuk menilai kebocorananastomosis. Hasil : Pada perbandingan grading kolagen dengan reseksi usus didapatkangrading terbanyak pada batas 1 adalah grading 2 (57,1 %), pada batas 2 grading 2(71,4 %) ,batas 3 grading 3 (71,4%).Perforasi terbanyak ditemukan pada grading 2 sebanyak 5 sampel. Pada perbandingan batas reseksi dengan perforasi didapatkan perforasi terbanyak pada batas 1 (85,7 %)Simpulan : Terdapat perbedaaan grading kolagen pada batas reseksi usus dimana batas kelompok batas 3 memiliki grading kolagen yang lebih baik ( grade 3 dan 4)sehingga kelompok batas 3 lebih direkomendasikan secara histopatologis.Grading kolagen dapat dinilai untuk melihat kemungkinan perforasi hasilanastomosis. Terdapat faktor-faktor lain yang dapat mempengaruhi kejadian perforasi selain grading kolagen. ;Background ABSTRACT There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. ;Background : There is still high presentation of intussuseption cases with resection andanastomose, caused of multi factors as : patient delay more than 72 hours, less onprofesional expert to do non operative reduction and less of examination such as ultrasound to make a diagnose. That is important to take attention with pretition, tehniquesand less of intestine when do the resection. There is still no operative standard about theboundary of resection cause of intussuseption, thats why the author want to do theexperimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege basedon collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseptionon gut rat using a styleth from proximal to distal. The release do after 45 minutes. Therats then separated into three boundaries group, and did resection-anastomose with eachgut from groups were performed a histopatologic test to count collagen grading. Leakageof anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resectionobtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5sample).in comparison the extent of resection and leakage,the highest is group 1(85,7%). Summary : There are differences about collagen gradingin the extent of bowelresection which is the third group of resection has higher collagen grading (3 and4 ) and then more recommended as histopatologic exam. Collagen grading couldbe marked to see possibilities of anastomotic leakage. There is some factors thataffect a leakage besides collagen grading. "

"Latar Belakang: Pasien TB-HIV yang mengalami lost to follow-up dapat menjadi sumber penularan, resistensi obat, meningkatnya angka morbiditas dan mortalitas. Dibutuhkan data tentang proporsi lost to follow-up pasien TB-HIV, serta faktor-faktor yang memengaruhi. Tujuan : Mengetahui profil lost to follow-up pasien TB-HIV dan faktor-faktor yang memengaruhi. Metode: Desain penelitian menggunakan kohort retrospektif terhadap pasien TB-HIV rawat jalan di RSCM tahun 2015-2017. Analisis univariat untuk mendapatkan data profil pasien TB-HIV. Analisis bivariat dan multivariat untuk mengetahui besar pengaruh faktor-faktorr terkait lost to follow-up pasien TB-HIV. Analisis multivariat untuk mendapatkan Odds Ratio (OR) dari setiap faktor. Hasil: Hasil analisis univariat menunjukkan proporsi lost to follow-up pasien TB-HIV sebesar 39% dengan karakteristik sebagai berikut, laki-laki (74,4%), usia ≥30 tahun (76,9%), jumlah penghasilan dibawah upah minimum regional Jakarta (87,2%), status fungsional ambulatory-bedridden (51,3%), frekuensi ganti transportasi 2 kali (51,3%), lama menunggu pengobatan ≥ 2jam (87,2%), jumlah obat <12 (56,4%), tempat tinggal di Jakarta (92,3%), mengalami efek samping obat (56,4%) dan status imunodefisiensi berat (84,6%). Lost to follow-up TB-HIV paling banyak terjadi pada bulan ke-2 pengobatan TB. Hasil analisis multivariat menunjukkan jumlah penghasilan dibawah upah minimum regional Jakarta (OR 6,58; IK 95%(2,27-19,08); nilai p=0,001) paling berpengaruh terhadap lost to follow-up pasien TB-HIV. Kesimpulan : Proporsi lost to follow-up pasien TB-HIV sebesar 39%. Lost to follow-up TB-HIV paling banyak terjadi pada bulan ke-2 pengobatan TB. Jumlah penghasilan dibawah upah minimum regional Jakarta menjadi faktor paling memengaruhi lost to follow-up pasien TB-HIV

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Background. TB-HIV patients whose lost to follow-up can be followed up for transmission, drug resistance, patients and mortality. We required data for proportion of lost to follow up TB-HIV, factors associated within.

Aim.To find out the profile of lost to follow-up in TB-HIV patients and influencing factors.

Methods. The study design used a retrospective cohort of outpatient TB-HIV patients at the RSCM in 2015-2017. Univariate analysis to obtain profile data for TB-HIV patients. Bivariate and multivariate analysis to determine the effect of factors related to lost to follow-up of TB-HIV patients. Multivariate analysis to get Odds Ratio (OR) from each factor.

Results. The results of univariate analysis were the proportion of lost to follow-up TB-HIV patients by 39%. The basic characteristics of each patient lost to follow-up TB-HIV were: Men (74.4%), age ≥30 years (76.9%), total income under the regional minimum wage of Jakarta (87.2%), functional status of ambulatory bedridden (51.3%), frequency of change transportation twice (51.3%), long waiting for treatment ≥2 hours (87.2%), number of drugs <12 (56.4%), place of residence in Jakarta (92.3%), experiencing drug side effects (56 , 4%), severe immune status (84.6%). Most lost during the second month of TB treatment. The results of multivariate analysis of income under the minimum regional of Jakarta (OR 6.58; IK 95%(2.27-19.08)) most influence the lost to follow-up of TB-HIV patients.

Conclusion. The proportion of lost to follow-up for TB-HIV patients was 39%. Most were lost on the second month of TB treatment. Total income of under the minimum regional of Jakarta was the most influential factor in lost to follow-up of TB-HIV patients."

"Latar Belakang : Lupus Eritematosus Sistemik ( LES ) adalah penyakit reumatik autoimun yang ditandai adanya inflamasi luas yang melibatkan hampir seluruh sistem organ. Penyakit ini menyerang wanita muda dengan insiden puncak usia 15-40 tahun. Manifestasi klinik LES beragam tergantung organ yang terlibat. Risiko kematian pada pasien LES meningkat apabila tidak terdiagnosis dan tidak ditangani secara tepat. Tujuan : Mengetahui kesintasan pasien LES di RSCM beserta faktor-faktor yang memengaruhi kesintasan.Metode : Penelitian ini merupakan penelitian kohort retrospektif dengan menggunakan data rekam medis dari pasien yang terdiagnosis LES pertama kali pada tahun 2014-2019 di RSCM. Dilakukan analisis survival terhadap usia, jenis kelamin, anemia hemolitik, trombositopenia, NPSLE, anti ds-DNA tinggi, C3 dan C4 rendah, penggunaanglukokortikoid dosis tinggi, limfopenia, Anti Cardiolipin Antibody ( ACA ) positif, penyakit kardiovaskular, dan nefritis lupus. Dilakukan analisis multivariat dengan cox regression.Hasil: Terdapat 448 subjek yang diteliti. Kesintasan lima tahun pasien LES di RSCM adalah 88%. Rerata kesintasan 56 bulan (IK95% 55-57). Pada analisis multivariat, ditemukan bahwa NPSLE [HR 3,595 (IK95% 1,932-6,688)], kadar C3 dan C4 rendah [HR 2,501 (IK95% 1,330-4,701)], penyakit kardiovaskuler [HR 2,851 (IK95% 1,198-6,787)], dan anemia hemolitik [HR 2,106 (IK95% 1,008-4,404)] berpengaruh signifikan terhadap kesintasan 5 tahun pasien LES.Kesimpulan: Kesintasan kumulatif 5 tahun pasien LES di RSCM adalah 88% dengan neuropsikiatri lupus (NPSLE), kadar C3 dan C4 rendah, penyakit kardiovaskuler, dan anemia hemolitik berpengaruh signifikan terhadap kesintasan pasien LES di RSCM.

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Background : Systemic Lupus Erythematosus (SLE) is an autoimmune rheumatic disease characterized by widespread inflammation involving almost all organ systems. This disease attacks young women with a peak incidence aged 15-40 years. The clinical manifestations of SLE vary depending on the organs involved. The risk of death in SLE patients increases if it is not diagnosed and treated appropriately.

Objective : knowing the survival of SLE patients at RSCM along with the factors that influence survival.

Methods : This study is a retrospective cohort study using medical record data from patients diagnosed with SLE for the first time in 2014-2019 at RSCM. Survival analysis was carried out on age, gender, hemolytic anemia, trombocytopenia, NPSLE, high anti ds-DNA, low C3 and C4, use of high doses of glucocorticoids, lymphopenia, positive Anti-Cardiolipin Antibody (ACA), cardiovascular disease, and lupus nephritis. Multivariate analysis with cox

regression was carried out.

Results : There were 448 subjects studied. The 5 year survival of SLE patients at RSCM is 88%. Mean survival time 56 months (95%CI 55-57). In the multivariate analysis, it was found that NPSLE [HR 3,595 (95%CI 1,932-6,688)], low C3 dan C4 [HR 2,501 (95%CI 1,330-4,701)], cardiovascular disease [HR 2,851 (95% CI 1,198-6,787 )], dan hemolytic anemia [HR 2,106 (95% CI 1,008-4,404)] had a significant effect on 5 year SLE survival.

Conclusion : The 5 year survival cumulative of SLE patients at RSCM is 88% with neuropsychiatric lupus (NPSLE), low C3 dan C4, cardiovascular disease, dan hemolytic anemia have a significant effect on the survival of SLE patients at RSCM."

"Latar BelakangRetinopati diabetik (DR) merupakan komplikasi mikrovaskuler yang umum terjadi pada pasien diabetes dan salah satu penyebab utama gangguan penglihatan serta kebutaan di dunia. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi kebutaan pada pasien DR di Indonesia.MetodePenelitian cross-sectional yang dilakukan di RSCM Kirana menggunakan data rekam medis pasien retinopati diabetik tahun 2020-2023. Faktor yang diteliti meliputi usia onset diabetes, durasi diabetes, dan hipertensi.HasilSebanyak 359 pasien diinklusi, dengan karakteristik didominasi oleh perempuan (51,5%), usia >50 tahun (55,4%), usia onset diabetes <45 tahun (64,9%), durasi diabetes <10 tahun (52,6%), dan memiliki hipertensi (74,1%). Proporsi derajat DR didominasi oleh proliferative DR/PDR (81,1%), diikuti dengan severe non-proliferative DR/NPDR (13,1%), moderate NPDR (5,6%), dan mild NPDR (0,3%). Sebanyak 9,7% pasien mengalami kebutaan akibat retinopati diabetik. Terdapat hubungan signifikan antara usia onset diabetes (<45 tahun) dengan kebutaan (OR = 2,322, 95% CI = 0,984-5,479, p = 0.049).KesimpulanKebutaan pada pasien retinopati diabetik dipengaruhi oleh onset usia diabetes yang lebih muda.

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Introduction

Diabetic retinopathy (DR) is a common microvascular complication in diabetic patients and one of the leading causes of vision impairment and blindness worldwide. This study aims to identify the factors influencing blindness in DR patients in Indonesia.

Method

A cross-sectional study was conducted at RSCM Kirana using medical record data of diabetic retinopathy patients from 2020-2023. The factors examined included age at diabetes onset, duration of diabetes, and hypertension.

Results

A total of 359 patients were included, with characteristics dominated by females (51.5%), age >50 years (55.4%), age at diabetes onset <45 years (64.9%), duration of diabetes <10 years (52.6%), and hypertension (74.1%). The proportion of DR severity was dominated by proliferative DR/PDR (81.1%), followed by severe non-proliferative DR/NPDR (13.1%), moderate NPDR (5.6%) and mild NPDR (0.3%). A total of 9.7% of patients was blind due to diabetic retinopathy. There was a significant relationship between the age at diabetes onset (<45 years) and blindness (OR = 2.322, 95% CI = 0.984-5.479, p = 0.049). Conclusion

Blindness in diabetic retinopathy patients is influenced by younger age at diabetes onset."

"ABSTRAK Pendahuluan Intussusepsi merupakan kegawatdaruratan yang sering terjadi pada anak di bawah dua tahun dengan salah satu plihan tata laksananya adalah operasi Dalam terapi operatif dapat dilakukan dengan dua jenis operasi yaitu reseksi anastomosis langsung atau pembuatan stoma sementara Studi ini dilakukan untuk mengevaluasi keluaran kedua jenis operasi tersebut berupa lama rawat masa awal asupan oral infeksi daerah operasi dan re operasi Metode Studi retrospektif dengan desain potong lintang berdasarkan kelompok jenis operasi reseksi anastomosis langsung atau pembuatan stoma sementara dilakukan di RSCM melalui penelusuran rekam medis Pengambilan sampel secara consecutive sampling dengan kriteria inklusi usia 0 18 th menjalani operasi reseksi anastomosis langsung ditunda di RSCM sedangkan kriteria ekslusi adalah data tidak lengkap atau tidak dilakukan reseksi Data diolah secara statistik dengan analisis komparatif numerik dengan uji Chi square atau uji T tidak berpasangan bila sebaran data normal bila tidak normal dengan uji Mann Whitney Hasil Terdapat 106 subjek dilakukan operasi dengan 40 subjek menjalani operasi reseksi anastomosis langsung dan 46 subjek dengan pembuatan stoma sementara serta 20 subjek dieklusi karena tidak dilakukan reseksi Lama rawat inap dengan median 11 hari 4 36 hari dengan masa awal asupan oral dengan median tiga hari 1 7 hari durasi gejala dengan median tiga hari ABSTRACT Introduction Intussusception is an emergency that found mostly under two years old which one of the therapy is operative management There are two kinds of operation mostly done which are resection anastomosis and temporary stoma followed by stoma closure This study aims to explain outcome of each techniques operation including length of stay duration to start oral intake surgical site infection and re operation Methods Retrospective study using cross sectional design grouping as resection anastomosis group and temporary stoma group was done at RSCM by reviewing patients rsquo medical records Sample achieved by methods of consecutive sampling with inclusion criterias are ages 0 18 years old underwent surgical resection and anastomosis delayed anastomosis at RSCM hospital while the exclusion criterias are incomplete data or not have surgical resection The data were processed statistically Chi square test or unpaired T test used to analyze comparative numerical variables if data distribution is normal While it rsquo s not normal Mann Whitney test was used Results There were 106 subjects consisted of 40 patients belonged to resection anastomosis group and 46 subjects were temporary stoma group while 20 subjects were exluded Median of overall length of stay was 11 days 4 36 days the median of duration to the first oral intake was 3 days 1 7 days and median of clinical onset was three days"