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Abstrak :
Juvenile hypertrophy of the breast (JHB) merupakan gigantomastia unilateral atau bilateral pada wanita peripubertal dan merupakan kasus jarang. Kelainan ini terbatas pada payudara berupa pertumbuhan dan perkembangan yang tidak normal. Pembesaran payudara bilateral atau unilateral tidak hanya mengakibatkan gangguan fisik tetapi juga psikis. Etiologinya sulit ditentukan, tetapi kelainan ini menggambarkan adanya hipersensitifitas organ akibat gangguan regulasi endokrin. Terapi terbaik berupa pembedahan yaitu mastektomi atau mammaplasti reduksi. Laporan ini menyajikan kasus seorang wanita berusia 30 tahun dengan JHB. Pertumbuhan payudara kirinya dimulai saat pubertas dan terus membesar selama setahun. Operasi dilaksanakan berupa reduksi mammaplasti dengan wise pattern based design. Setelah dua tahun pasien tidak memiliki tanda-tanda rekurensi dan kedua payudaranya tampak simetris dengan parut yang memuaskan.

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Abstract
Juvenile hypertrophy of the breast (JHB) is a rare condition leading to gigantomastia unilaterally or bilaterally in peripubertal females. The pathology is limited usually to the breast, with otherwise normal growth and development and without any other deformities. The rapid bilateral or unilateral growth of the breast in adolescent girls leads to severe physical and psychological problems. The etiology remains elusive, but it is believed to represent an end-organ hypersensitivity during a period of intense endocrine regulatory stress. The best treatment is surgical whereas the younger patients better treated with mastectomy to anticipate the high recurrency rate, while older women is best treated with reduction mammaplasty. We report one case of a woman who had a unilateral JHB. The growth of the left breast started in her pubertal age and kept growing for one year. She was treated surgically with Wise pattern based design. After two years, she had no recurrent enlargement and aesthetically, the symmetry of both breasts is achieved with a satisfying scar.

Abstrak :
Latar belakang: Latihan fisik aerobik adalah latihan fisik yang dilakukan secara teratur dan berkesinambungan sedangkan latihan fisik yang dilakukan dengan peningkatan durasi dan kecepatan secara bertahap termasuk dalam aerobik Overtraining. Penelitian ini bertujuan untuk menganalisa hipertrofi pada otot ventrikel jantung kiri tikus pasca latihan fisik aerobik serta pasca latihan fisik aerobik overtraining. Metode: Identifikasi morphologi kardiomiosit ventrikel kiri jantung tikus menggunakan pewarnaan hematoksilin eosin, sedangkan untuk jaringan fibrosis dengan pewarnaan Masson?s Trichrome. Identifikasi tersebut dilakukan pada kelompok kontrol, dan kelompok perlakuan aerobik dan overtraining yang dilakukan selama 11 minggu. Hasil: Analisis data menunjukkan terjadi hipertrofi yang ditandai dengan adanya peningkatan panjang (p=0,017), lebar (p=0,037) pada kelompok aerobik dibandingkan dengan kelompok overtraining. Peningkatan jaringan fibrosis pada kelompok overtraining dengan p= 0,00.

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Introduction : Aerobic exercise is physical exercise done regularly and continuously while physical exercise done by increasing the duration and speed gradually included in the aerobic Overtraining. This study aims to analyze hypertrophy in the left ventricle of the heart muscle of mice after aerobic exercise and aerobic exercise post overtraining. Methods : Left ventricular cardiomyocyte morphology rat heart is identified by hematoxylin eosin staining, whereas for fibrotic tissue with Masson's Trichrome staining. Such identification is performed in the control group and the treatment group performed aerobic and overtraining for 11 weeks. Conclucion: Analysis of the data showed that hypertrophy is characterized by an increase in length (p = 0.017), width (p = 0.037) in the aerobic group compared with the group of overtraining. Increased tissue fibrosis in the overtraining group with p = 0,00.

Abstrak :
Kerusakan target organ tersering pada hipertensi adalah left ventricular hypertrophy LVH dan mikroalbuminuria Radiografi toraks merupakan pemeriksaan non invasif untuk mengevaluasi LVH terutama proyeksi lateral dengan Hoffman Rigler sign. Penelitian bertujuan mengetahui hubungan antara LVH berdasarkan modalitas radiografi toraks dengan mikroalbuminuria pada pasien hipertensi. Sampel merupakan pasien hipertensi yang telah diberikan terapi dan dilakukan radiografi toraks PA dan lateral. Dari 66 pasien hipertensi 19 28 8 dengan mikroalbuminuria positif. Dari 35 pasien hipertensi dengan LVH 12 34 3 dengan mikroalbuminuria positif. Pada penelitian ini radiografi toraks PA dan lateral dapat digunakan untuk menilai tanda LVH.

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Common target organ damage in hypertension is left ventricular hypertrophy LVH and microalbuminuria Chest x ray is a non invasive examination to evaluate LVH especially lateral projection with Hoffman Rigler sign methode. The research aims to investigate the relationship between LVH based modalities PA and lateral chest x ray with microalbuminuria in hypertensive patients. Samples taken were hypertensive patients who have been given therapy and do PA and lateral chest x ray Of 66 hypertensive patients 19 28 8 with positive microalbuminuria Of 35 hypertensive patients with LVH 12 34 3 with positive microalbuminuria In this study PA and lateral chest x ray can be used to assess the sign of LVH.

Abstrak :
ABSTRAK
Pada overtraining, adaptasi fisiologis menjadi tertunda atau bahkan menghasilkan suatu adaptasi yang patologis, salah satunya efek pada sistem kardiovaskuler. Penelitian ini bertujuan menilai pengaruh overtraining dan efek pemberian H. Sabdariffa L HSL) pada kondisi overtraining terhadap indeks hipertrofi, kadar BNP dan PGC-1α jantung tikus. Penelitian ini menggunakan 25 ekor tikus jantan dewasa strain Wistar (Rattus-norvegicus) yang dibagi secara acak menjadi lima kelompok, yaitu kelompok kontrol yang diberi perlakuan placebo (K), kelompok kontrol yang diberi HSL 500mg/kgBB/hari (K-Hib), kelompok tikus dengan latihan aerobik (A), kelompok tikus dengan latihan fisik dengan kondisi overtraining(OT), serta kelompok tikus dengan latihan fisik dengan kondisi overtraining dan HSL 500mg/kgBB/hari (OT-Hib). Perlakuan dilakukan lima kali seminggu, selama 11 minggu. Indeks hipertrofi ditentukan dengan menghitung rasio berat jantung/berat badan, berat ventrikel/berat badan, dan berat ventrikel kiri/berat badan. Kadar BNP dan PGC-1α diukur menggunakan metode ELISA. Hasil penelitian didapatkan kelompok overtraining memiliki indeks hipertrofi dan kadar BNP jantung yang lebih tinggi, serta kadar PGC-1α jantung yang lebih rendah dibandingkan kelompok kontrol dan aerobik. Pemberian HSL pada kondisi overtraining cenderung mencegah penurunan indeks hipertrofi dan kadar BNP jantung tikus, meskipun tidak meningkatkan kadar PGC-1α jantung. Kondisi overtraining mengarahkan adaptasi jantung ke arah patologis dan tidak tertutup kemungkinan bahwa HSL memiliki potensi untuk mencegah terjadinya hipertrofi patologis.

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ABSTRACT
Overtraining causes physiological adaptation becomes delayed or even produces a pathological adaptation, one of which is the effect on the cardiovascular system. The aims of this study are to elucidate the effect of overtraining and administration of H. Sabdariffa L (HSL) in overtraining condition on the hypertrophy index, levels of BNP and PGC-1α in the rats' hearts. This study used 25 Wistar Rattus norvegicus adult male rats, which were divided randomly into five groups, namely the control group given placebo treatment (K), the control group given HSL 500mg/kgBW/day (K-Hib), groups of rats with aerobic exercise (A), groups of rats with overtraining physical exercise (OT), and groups of rats with physical exercise overtraining and HSL 500mg/kgBB/day (OT-Hib). Treatment is done five times a week, for 11 weeks. Hypertrophy index is determined by calculated the ratio of heart weight/body-weight, ventricular weigh/body-weight, left ventricular weight/body-weight). BNP and PGC-1α levels were measured using the ELISA method. The results of this study showed that overtraining increased the hypertrophy index and heart BNP levels while reducing the levels of PGC-1α of rats compared to the control and aerobic groups. HSL administration tended to decrease the hypertrophy index and BNP levels although not increase the levels of PGC-1α in overtraining condition. Overtraining condition tend to the heart adaptation to the pathological direction and it is possible that HSL has potency to prevent pathological hypertrophy.

Abstrak :
ABSTRAK
Latar Belakang: Hipertrofi jantung dapat timbul akibat stres patologis misal hipoksia yang merupakan respon jantung sebagai mekanisme homeostatis yang diperlukan untuk menormalkan stres dinding ventrikel kiri dan mempertahankan curah jantung. Hipoksia sistemik kronik merupakan stres lingkungan yang berat. Respon spesifik jantung terhadap stres jantung terlihat pada peningkatan kadar peptida di dalam plasma, yang membantu jantung dalam menghadapi beban yang meningkat. Menurut sejumlah peneliti, kadar Apelin berhubungan erat dengan disfungsi ventrikel. Apelin merupakan preproprotein dengan 77 asam amino yang disekresikan dari keluarga adipokine, berperan dalam mempertahankan performa jantung pada beban tekanan kronik. Pada tingkat molekular, respons adaptasi diperantarai oleh perubahan ekspresi gen. Tujuan penelitian: Menganalisis pola ekspresi gen Apelin dan gen BNP pada hipertrofi ventrikel akibat induksi hipoksia sistemik kronik dengan mengukur konsentrasi Apelin-13 dan konsentrasi BNP-45. Penelitian bersifat eksperimental menggunakan 28 ekor tikus Sprague-Dawley jantan, umur 8-12 minggu yang dibagi dalam 7 kelompok n=4 ekor/kelompok , terdiri dari kelompok kontrol normoksia, O2 atmosfir dan kelompok perlakuan hipoksia dalam sungkuphipoksia, 8 O2, masing-masing selama 6 jam, 1, 3, 5, 7 dan 14 hari . Parameter stres oksidatif akibat hipoksia jantung, dilakukan dengan pengukuran kadar malondialdehid MDA dan histopatologi dengan pewarnaan HE. Selain itu juga dilakukan pengukuran protein Apelin-13 dan BNP-45 menggunakan metoda ELISA dan pengukuran ekspresi relatif mRNA Apelin dan BNP-45 jantung, menggunakan real time RT-PCR kuantitatif dengan rumus Livak. Hasil penelitian: ekspresi relatif Apelin-13 di jantung menurun pada awal hipoksia dan kemudian meningkat mulai hari ke-3 sampai hari ke-14. Peningkatan kadar MDA yang signifikan terjadi sejak hipoksia 7 hari. Korelasi MDA terhadap peningkatan ekspresi relatif Apelin adalah kuat r=0.750 dan signifikan p=0.000 . Korelasi BNP-45 terhadap Apelin-13 adalah sangat kuat r=0.943 dan signifikan p=0.000 . Dapat disimpulkan bahwa adanya peningkatan MDA, peningkatan ekspresi relatif dan protein Apelin-13 dan peningkatan ekspresi relatif dan protein BNP-45 pada jaringan jantung mempunyai korelasi yang signifikan dan kuat, sesuai dengan peningkatan lamanya perlakuan hipoksia.

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ABSTRACT
Background: Cardiac hypertrophy can result from pathological stress eg hypoxia as a response to ventricular wall stress and to maintain cardiac output. Chronic systemic hypoxia is a severe environmental stress. During cardiac stress certain peptides are release by the heart into the plasma, which help the heart to compensate the increased myocardial load. According to several authors, apelin levels are increased during cardiac dysfunction. Apelin is a preproprotein with 77 amino acids from adipokine, which contributes to maintaining cardiac performance at chronic stress loads. At the molecular level, the adaptation response is mediated by changes in gene expression. Objective: To analyze the expression pattern of Apelin-13 and BNP-45 on ventricular hypertrophy due to induction of chronic systemic hypoxia by measuring Apelin-13 and BNP-45 concentrations. The experimental study used 28 male Sprague-Dawley rats, 8-12 weeks old divided into 7 groups 4 per group , consisting of control group normoxia, atmospheric O2 and 4 hypoxia treatment groups, which underwent systemic hypoxia in hypoxic chamber containing 8 oxygen, respectively for 6 hours, 1, 3, 5, 7 and 14 days . The presence of oxidative stress due to cardiac hypoxia was determined by malondialdehyde MDA and cardiac structural alteration was examined by HE staining. Apelin-13 and BNP-45 proteins were determined using the ELISA method and the relative expression of cardiac Apelin and BNP-45 mRNA were determined using quantitative RT-PCR real time with Livak formula. Results: Relative expression of Apelin-13 in the heart decreased early in hypoxia and then increased from day 3 to day 14. Significant increases in MDA levels occurred after 7 days hypoxia. There was a strong and significant correlation between MDA levels and Apelin relative expression r = 0.750, p = 0.001 . Similar results were obtained for of BNP-45 and Apelin-13 r = 0.943, p = 0.001 . From the results, it can be concluded that during chronic systemic hypoxia there was an increase in oxidative stress, relative expression and Apelin-13 proteins and relative expression and BNP-45 protein of the rat cardiac tissue.

Abstrak :
Hipertrofi ventrikel kiri atau Left ventricle hypertrophy (LVH) adalah faktor risiko independen terjadinya gagal jantung pada pasien hipertensi. Diagnosis dini LVH diperlukan untuk mencegah kerusakan lebih lanjut pada otot jantung. Cardiotropin-1 (CT-1) diproduksi oleh kardiomiosit dan fibroblas, yang kadarnya dilaporkan meningkat pada pasien hipertensi primer. Tujuan : Membuktikan manfaat CT-1 serum untuk mendeteksi LVH pada pasien hipertensi primer. Metode : Penelitian uji diagnostik dilaksanakan di RSCM Jakarta periode Februari s/d Maret 2013. Subyek penelitian adalah 75 pasien hipertensi primer dengan atau tanpa LVH. Diagnosis LVH dilakukan dengan ekokardiografi sebagai baku emas dan elektrokardiografi/EKG (kriteria Sokolow Lyon voltage, Cornell voltage dan Cornell product). Kadar CT-1 serum diperiksa dari sampel darah vena dengan metode ELISA. Hasil : Berdasarkan ekokardiografi 46 orang (61,3%) LVH dan 29 orang (38,7%) tidak LVH. Kadar CT-1 subyek LVH adalah 82,96 ± 351,843 pg/mL dan subyek tanpa LVH 4,55 ± 1,281 pg/mL (p=0,01). Korelasi CT-1 dengan LVMI adalah tidak bermakna (p=0,1). Luas area dibawah kurva ROC CT-1 untuk diagnosis LVH adalah 0,67 (p=0,01). Nilai cut-off CT-1 adalah 4,45 pg/mL. Uji diagnostik CT-1: Sensitifitas 54,4%, spesifisitas 75,9, NDP 78,1%, NDN 51,2 dan akurasi 61,3%. Uji diagnostik kombinasi CT-1 dan EKG (salah satu kriteria positif LVH): sensitifitas 67,4%, spesifisitas 72,4% , NDP 79,5%, NDN 58,3% dan akurasi 69,3%. Simpulan. CT-1 kurang sensitif namun cukup spesifik untuk diagnosis hipertrofi ventrikel kiri (LVH). Kombinasi CT-1 dengan EKG meningkatkan nilai diagnostik pemeriksaan untuk deteksi LVH pada pasien hipertensi primer.

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Left ventricle hypertrophy (LVH) is independent risk factor of heart failure on hypertension patients. Early detection of LVH is necessary to prevent extensive damage of heart muscle. Cardiotropin-1 (CT-1) is produce by cardiomyosite and fibroblast, that the level of CT-1 has been reported increase on primary hypertension patients. Aim : To prove the benefit of CT-1 serum to detect LVH on primary hypertension patients. Methods : A diagnostic study has been conducted on RSCM Jakarta on the periode of February to March 2013. Research subjects were 75 primary hypertension patients with and without LVH. LVH diagnosis was performed by echocardiography examination as gold standard and electrocardiography/ECG (Sokolow Lyon voltage, Cornell Voltage and Cornell product criterias). CT-1 level was measured by ELISA method from vein blood sample. Results : Based on echocardiography examination 46 patients (61.3%) were diagnosed as LVH and 29 patients (38.7%) without LVH. The level of CT-1 of patients with LVH was 82.96 ± 351.843 pg/mL and 4.55 ± 1.,281 pg/mL on patients without LVH (p=0.01). Correlation between CT-1 and Left Ventricular Mass Index was not significant (p=0.1). Area under the ROC curve was 0.67 (p=0.01). The cut-off of CT-1 level for diagnosis of LVH was 4.45 pg/mL. Diagnostic test yield the sensitivity of CT-1 for diagnosis of LVH was 54.4%, specificity 75.9%, PPV 78.1%, NPV 51.2% and accuracy was 61.3%. Diagnostic test of combination CT-1 and ECG (positive LVH by one or more ECG’s criteria) yield sensitivity 67.4%, specificity 72.4% , PPV 79,5%, NPV 58.3% and accuracy 69.3%. Conclusion. CT-1 examination was not sensitive but specific for LVH diagnosis. Combination of CT-1 and ECG examination was improve diagnostic value of CT-1 for detection of LVH on primary hypertension patients.

Abstrak :
OBJECTIVE: To determine if Intravesical prostatic protrusion (IPP), total prostate volume, transition zone volume and transition zone index is correlated with the severity of clinical benign prostatic hyperplasia. PATIENTS AND METHODS: From January to May 2005, 56 patients with symptom of BPH were enrolled in this study. All patients were requested to undergo urofiowmetry, postvoid residual urine measurement and international Prostate Symptom Score (IPSS). TRUS was used to calculate the total prostate volume, transition zone (ZT) volume and the transition zone index (TZ index = TZ volume/total prostate volume). And IPP was measured by transabdominal ultrasonography. RESULT: There were a significant correlation between IPSS and post void residual with total prostate volume, transition zone, transition zone index and intravesical prostatic protrusion. Only transition zone and transition zone index were significant correlation with Q max. Strongest correlation in IPSS and postvoid residual was transition zone (ZT) volume (r = 0.480 and r = 0.621 ) in Q max was transition zone index (r = 0.508). CONCLUSION : From this study there were correlation between intravesical prostatic protrusion, prostate volume, transition zone volume and transition zone index however the correlation is weak.

Abstrak :
Latar Belakang: Salah satu penyebab kematian pada pasien penyakit ginjal kronis adalah gangguan kardiovaskular. Adanya hipertrofi pada ventrikel kiri dijadikan surrogate marker kondisi kardiomiopatik dan progresivitas penyakit ginjal kronis. Penelitian terbaru menunjukkan adanya peran FGF23 dalam menstimulasi terjadinya hipertrofi jantung dan meningkatkan aktivitas sistem renin-angiotensin-aldosteron serta berfungsi sebagai faktor parakrin dengan peran dalam remodelling jantung. Metode: Penelitian ini dilakukan dengan menggunakan tikus model nefrektomi 5/6 yang diberikan terapi irbesartan, simvastatin dan kombinasi keduanya selama satu bulan. Tekanan darah diukur pada saat sebelum dan sesudah pemberian obat. Tikus kemudian ditempatkan pada kandang metabolik selama 24 jam untuk pengambilan urin. Nekropsi dilakukan untuk mengambil darah dan jantung. Pemeriksaan yang dilakukan antara lain pemeriksaan indeks massa ventrikel kiri jantung, volume dan kadar protein dalam urin, kadar urea dan kreatinin dalam serum, serta kadar FGF23 dan hormon PTH dalam serum. Hasil: Hasil dari pemeriksaan tersebut menunjukkan bahwa penggunaan irbesartan dapat menurunkan tekanan darah dan indeks massa ventrikel kiri secara signifikan. Penggunaan irbesartan, simvastatin dan kombinasi keduanya tidak menunjukkan penurunan yang signifikan terhadap hasil pemeriksaan fungsi ginjal, kadar hemoglobin, indeks massa ventrikel kiri, FGF23 dan hormon paratiroid. Kesimpulan: Dari hasil penelitian ini, dapat disimpulkan bahwa baik penggunaan irbesartan, simvastatin, maupun keduanya memiliki kecenderungan untuk mengurangi kejadian kardiomiopatik uremik pada tikus model nefrektomi 5/6 ......Introduction: Cardiovascular events is one of the causes of chronic renal disease’s mortality. Left ventricular hypertrophy was a surrogate marker for cardiomyopathy and progressivity of chronic renal disease. Latest study mentioned about the role of FGF23 on stimulating cardiac hypertrophy and renin-angiotensin-aldosterone activity and also a paracrine factor of cardiac remodeling. Methods: This study was done using 5/6 nephrectomy rats getting irbesartan, simvastatin and combination of both treatments for 30 days. Blood pressure was measured before and after the treatment. Urine sample was collected for 24 hours for protein assay. Sacrificing the animals was done at the end of study to harvest the heart and blood sample. Heart sample was weighed and measured for left ventricle mass index. Blood sample was used for hemoglobin assay. Serum sample was used for urea, creatinine, FGF23 and PTH assay. Result: Irbesartan significantly lowered the blood pressure and cardiac mass index, but not significantly improved renal function, hemoglobin level, left ventricular mass index, FGF23 and PTH hormone. Simvastatin and combination of both treatments did not significantly improve renal function, hemoglobin level, left ventricular mass index, FGF23 and PTH hormone. Conclusion: The use of irbesartan, simvastatin and both combinations tend to improve uremic cardiomyopathy condition on 5/6 nephrectomy rats’ heart.

Abstrak :
Latar belakang: Pembesaran Prostat Jinak (PPJ) merupakan masalah prostat yang umum terjadi pada laki-laki, Infeksi Saluran Kemih (ISK) dapat disebabkan oleh PPJ akibat dari obstruksi pada Bladder outlet, instrumentasi, bahkan akibat dari sistoskopi atau kateterisasi. Tujuan: Tujuan penelitian ini adalah untuk menggambarkan pola kuman dan kuman terbanyak yang menyebabkan ISK pada pasien PPJ di Rumah Sakit Umum Pusat Dr. Sardjito Metode: Data dikumpulkan secara retrospektif dari rekam medis pasien Rumah Sakit Umum Pusat Dr. Sardjito mulai Januari 2001 sampai Desember 2011. Pola kuman dan sensitivitas obat dicatat. Hasil: Terdapat 92 pasien dengan usia 46-95 tahun yang didiagnosis dengan PPJ dan Prostatitis. Didapatkan 81,40% merupakan bakteri gram negatif, 9,3% bakteri gram positif, dan 9,3% jamur. Kemudian didapatkan Streptococcusfaecalis (11,62%) merupakan bakteri gram positif terbanyak yang ditemukan di dalam kultur urin. Obat yang dipakai untuk sensitivitas melipuit : Amikacin, Ampicillin, Ampicillin/Sulbactam, Cefepim, Cefpiron, Ceftazidime, Ceftriaxone, Cefotaxime, Cefuroxime, Chloramphenicol, Fosfomycin, Gentamycin, Nalidixic acid, Imipenem, Netilmicin, Nitrofurantoin, Norfloxacin, Tetracyclin, Tobramycin, Vancomycine, Ciprofloxacine, Trimethoprim-Sulfamethoxazole. Kesimpulan: Bakteri paling banyak yang ditemukan pada pasien dengan BPH adalah Pseudomonas aerogenosa (25.58%) dan bakteri yang paling jarang ditemukan adalah Citrobacterfreundii (2.32%). Menurut penelitian ini, 82.05% pasien BPH dengan infeksi saluran kemih sensitif terhadap pengobatan dengan Imipenem, diikuti dengan Amikacin (74.35%).

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Background: Benign prostatic hyperplasia (BPH) is the most common condition in men with prostate problems. Urinary tract infection can be caused by BPH due to Bladder outlet obstruction, instrumentation either from cystoscopy or catheterization. Objective: The aim of this study is to describe microorganism pattern and the most common caused urinary tract infection in BPH patient hospitalized in Dr. Sardjito general hospital. Method: Data were retrospectively collected from Dr. Sardjito general hospital medical record patients from January 2011 to December 2011. Microorganism pattern and drug sensitivity data were collected. Results: There were 92 patients age 46-95 years old diagnosed histophatologically as BPH and prostatitis. The 81.40% microorganism pattern were Gram negative bacteria, 9.3% Gram positive bacteria and 9.3% yeast. On the other hand , Streptococcus faecalis (11,62%)is the main gram positif bacteria found in the urine culture. The drug used for sensitivity including; Amikacin, Ampicillin, Ampicillin/Sulbactam, Cefepim, Cefpiron, Ceftazidime, Ceftriaxone, Cefotaxime, Cefuroxime, Chloramphenicol, Fosfomycin, Gentamycin, Nalidixic acid, Imipenem, Netilmicin, Nitrofurantoin, Norfloxacin, Tetracyclin, Tobramycin, Vancomycine, Ciprofloxacine, Trimethoprim, and Sulfamethocazole. Conclusion: The most frequent bacteria found in BPH patients is Pseudomonas Aerogenosa (25.58%) and the least frequentbacteria is Citrobacter freundii (2.32%). According to this study, 82.05% UTI patients sensitive to Imipenem medication, followed by Amikacin (74.35%).

Abstrak :
This book describes in details an innovative surgical technique called modified inferior turbinoplasty, which offers an excellent solution to the problems associated with the lower turbinate hypertrophy. A turbinate (or nasal concha) is a long, narrow, curled bone shelf that protrudes into the breathing passage of the nose. Most surgical interventions treat only the soft parts of hypertrophic turbinates using laser therapy, radiofrequency treatment, and electrocoagulation, but these procedures often lead to relapse. With this technique, in contrast, all anatomic parts of the turbinate are treated, including bone tissue: the surgeon reduces the inferior nasal concha and the internal nasal tissue, and the mucosa is then remodeled with sutures. The modified inferior turbinoplasty allows the complete avoidance of swabs in the nose, which is fundamental for patients well-being and grant them a quicker recovery.