The functional anatomy of hip abductors

The gluteal region was dissected in 18 adult cadavers. The attachments, directions, and orientations of the fibres of the tensor fasciae latae, gluteus medius, and gluteus minimus muscles were noted. The gluteus medius was found to be formed of three distinct parts, while the gluteus minimus was formed of two parts only; each part of these muscles had its separate innervations from the superior gluteal nerve. The tensor fasciae latae muscle arose from the anterior part of the outer lip of the iliac crest and was attached to the iliotibial tract slightly below and in front of the greater trochanter. The direction of the fibres of the anterior and middle parts of the gluteus medius and the anterior part of the gluteus minimus suggested that they have vertical pull and initiate abduction which is then completed by the tensor fasciae latae. The function of the posterior parts of the gluteus medius and minimus, being parallel to the neck of the femur, would be stabilization of the femoral head in the acetabulum during the different stages of the gait cycle. By resolving the line of action of the tensor fasciae latae muscle, it was found to help the muscle to fix the hip and femur together during the stance phase and to counteract the weight of the body during standing position

Anatomical localisation of the marginal mandibular branch of the facial nerve

The marginal mandibular nerve was studied post mortem in 50 human subjects. The nerve was found to be presented by one branch (32%), two branches (40%) and three branches (28%). The relationship of the nerve to the lower border of the mandible was variable: it was either totally above the lower border of the mandible (28%), below the mandible (44%) or in 28% of cases lying above and below it. The branch which lay below the lower border of the mandible crossed it opposite the masseter muscle or opposite the facial artery or else anterior to the facial artery. The branches which lay above the lower border of the mandible were always deep into the superficial layer of the parotid fascia, while below the mandible all the branches ran intrafascially. The termination of the nerve was always deep to the muscles of the lower lip. The results of the present study were discussed and correlated with the results of other authors from the anatomical and surgical points of view. It is concluded that the lower border of the mandible can serve as an important landmark to help avoid injury to the nerve; above it a subplatysmal flap is satisfactory but below it a subfascial flap is much safer

Validitas Gejala Klinis sebagai Indikator untuk Memprediksi Kasus Malaria di Indonesia (Analisis Data Riskesdas 2010)

Salah satu upaya yang cukup efektif dalam surveilans malaria adalah melakukan screening (penapisan) malaria untuk meningkatkan sistem kewaspadaan dini di kelompok masyarakat daerah endemis malaria. Hasil penapisan positif atau meragukan harus dirujuk ke dokter untuk penegakkan diagnosis dan pengobatan. Penelitian ini bertujuan untuk menganalisis validitas gejala klinis sebagai indicator untuk memprediksi kasus malaria di Indonesia dengan menggunakan disain cross-sectional. Sampel dalam penelitian ini adalah semua responden yang diwawancarai, dilakukan pemeriksaan darah dengan Rapid Diagnostic Test (RDT). Validitas gejala klinis diukur dengan melakukan summary statistic untuk diagnostic test. Di wilayah endemis tinggi sensitivitas gejala klinis demam saja sebagai prediktor malaria hanya 26,9% (95% CI: 22-32,2) dan PPV 11,4% (95% CI: 9,2-13,9) dengan spesifisitas 96% (95% CI: 95,6-96,3). Sensitivitas, PPV, dan spesifisitas gejala demam saja di daerah endemis sedang secara berturut-turut adalah sebesar 26,1% (95% CI: 17,5-36,3), 5.0% (95% CI: 3,2-7,4), dan 96,9% (95% CI: 96,6-97,2). Di daerah endemis rendah sensitivitas demam sebagai alat diagnosa kasus malaria hanya sebesar 3,5% (95% CIH: 1,6-6,6) dengan PPV 1,1% (95% CI: 0,5-2,1) sedangkan spesifisitas 98% (95% CI: 97,8-98,1). Kombinasi gejala klinis demam, menggigil, sakit kepala, berkeringat, mual, dan muntah dalam analisis data Riskesdas menunjukkan sensitifitas yang lebih tinggi bila dibandingkan dengan demam saja (36,4%). Sebaliknya PPV kombinasi gejala tersebut lebih rendah bila dibandingkan dengan PPV demam saja (3,8%). Gejala klinis malaria kurang valid untuk digunakan untuk mendeteksi kasus malaria baik pada daerah endemis tinggi, sedang, maupun rendah. Akan tetapi penggunaannya untuk daerah endemis tinggi masih dimungkinkan, seperti yang direkomendasikan oleh WHO terutama untuk anak-anak.Kata kunci: malaria, gejala klinis, validitas, sensitivitas, spesifisitasAbstractOne of the effective ways in malaria surveillance is screening to improve early warning system in communities in malaria endemic area. Positive screening or doubted results should be referred to physician for diagnosis and treatment. The aim of this study was to analyse the validity of clinical symptoms as an indicator to predict malaria case in Indonesia. Samples of this study were all respondents interviewed by the National Health Research in 2010 whose blood were examined for malaria using RDT. Validity of clinical symptoms was analysed by using summary statistic for diagnostic test. The results showed that the sensitivity of fever alone as a predictor of malaria in high endemic area was only 26.9% (95% CI: 22-32.2). However, the specificity was 96% (95% CI: 95.6-96.3) and positive predictive value (PPV) 11.4% (95% CI: 9.2-13.9). In low endemic area, sensitivity and PPV of fever alone were low with 3.5% (95% CI: 1.6-6.6) and 1.1% (95% CI:0.5-2.1) respectively. On the other hand, the specificity was relatively high with 98% (95% CI: 97.8-98.1). Combination of fever, chill, headache, sweat, nausea, and vomit showed higher sensitivity (36.4%; 95% CI:28.9-40.5) and specificity (84.2%; 95% CI: 83.6-84.8) compare to fever alone in high endemic area, whereas the PPV was lower (3.8%: 95% CI: 3.1-4.6). In low endemic area, symptoms combination had a higher sensitivity (14.7%; 95% CI: 10.6-19.7) compare to fever alone. However, the specificity and PPV were lower with 91.2% (95% CI: 90.9-91.4) and 1% (95% CI: 0.7-1.4) respectively. Conclusion: The validity of clinical signs and symptoms to diagnose malaria is low in high and low transmission area. However, the use of clinical symptoms as a predictor of malaria is still possible in high transmission area as recommended by WHO, particularly for children.Key words: malaria, clinical symptoms, validity, sensitivity, specificit

Kejadian Penyakit Cacing Usus di Kota Palu dan Kabupaten Donggala, Sulawesi Tengah

Infeksi cacing usus masih merupakan masalah kesehatan masyarakat yang utama di Indonesia terutama di daerah pedesaan. Pada anak-anak, cacingan akan berdampak pada gangguan kemampuan untuk belajar, sedangkan pada orang dewasa akan menurunnya produktivitas kerja. Penelitian ini bertujuan untuk mengetahui prevalensi kecacingan di Kota Palu dan Kabupaten Donggala, Sulawesi Tengah. Penelitian cross-sectional ini dilaksanakan Bulan April sampai November 2009. Telur cacing diidentifikasi menggunakan metode langsung. Proporsi jenis cacing yang paling banyak ditemukan di dua kelurahan di Kota Palu adalah Trichuris trichiura (43,01 %), diikuti oleh infeksi Ascaris lumbricoides (27,96%) dan Oxyuris vermicularis (9,68%) serta infeksi campuran (1,08%), sedangkan di Kabupaten Donggala adalah Hookworm (11,95%), Ascaris lumbricoides (7,55%), Trichuris trichiura (2,52%), dan infeksi campuran (0,63%)

Origin of profunda femoris artery and its circumflex femoral branches: anatomical variations and clinical significance

Background: Knowledge of the anatomical variations of the profunda femoris artery and its circumflex branches is important during angiographic diagnostic procedures as well as during performing surgery in the femoral region. The aim of this study was to examine the original sites, distances and variations of the profunda femoris artery and its circumflex branches. Materials and methods: The study was conducted in the Department of Anatomy, Faculty of Medicine, King Abdulaziz University from October, 2011 to May, 2013 after the approval of the medical ethical committee. Dissections of 90 femoral triangles of 25 male and 20 female adult human cadavers were performed to demonstrate the origin and distribution of the profunda femoris artery and its circumflex branches. Results: The profunda femoris artery mostly originated from the posterolateral aspect of the femoral artery in 42% of male limbs and in 42.5% of female limbs, from the posterior side in 24% of male and 27.5% of female limbs, from the lateral side in 20% of males and female limbs and from the posteromedial aspect in 14% of male limbs and in 7.5% of female limbs. The mean distance of origin of profunda femoris artery from the midpoint of inguinal ligament was 51.5 ± 1.9 mm in right male, 49.7 ± 1.9 mm in left male, 48.5 ± 2.2 mm in right female and 48.9 ± 2.2 mm in left female limbs. The medial and lateral circumflex arteries originated mostly from the profunda femoris artery (60% in males; 57.7% in females) at a mean distance of 18.6 ± 2.1 mm and 20.2 ± 2.2 mm in right male, 19.6 ± 1.9 mm and 22.5 ± 2.3 mm in left male, 18.8 ± 2.7 mm and 21 ± 2.6 mm in right female and 19.1 ± 2.1 mm and 21.7 ± 2.6 mm in left female limbs, respectively. The original incidence of the medial and lateral circumflex femoral arteries from the femoral artery including the common trunk was 40% in male and 42.3% in female limbs. Conclusions: Awareness of the original sites and distances of the profunda femoris artery and its circumflex femoral branches will allow the surgeon to define the vascular pattern before performing any invasive procedure and to avoid unexpected iatrogenic injuries

Situasi Terkini Daerah Fokus Keong Hospes Perantara di Daerah Endemis Schistosomiasis di Sulawesi Tengah

Schistosomiasis is only found in three areas of Indonesia, namely, Napu, Lindu, and Bada highlands. Napu and Bada highlands are located in Poso District whereas Lindu highland is located in Sigi District. The presence of snails is as an indicator for determining the focus areas of intermediate host of the worm. The purpose of this study was to determine the distribution of snail focus areas of schistosomiasis in 2017 by conducting habitats and snail survey. The result showed that there were 242 foci areas of O.hupensis lindoensis in 21 villages covering a total of 1,407,225 m2 marshland area. This indicates that there is a slight reduction in the number of focus in 2017 compared to the previous year. In order to eliminate schistosomiasis in the endemic areas, a multi sectoral collaborations to modify the environment is very essential. Elimination can only be succesful if the snails and their intermediate host can be eliminated by environmental management, as to converse the snail habitats into more productive agricultural area. These data can be used as updated baseline data to eliminate the snail intermediate host. Moreover, the community involvement is needed to ensure the sustainability of the schistosomiasis control program

The infection with HBV and HCV and their relationship to ABO blood group among blood donors

Background: Hepatitis B virus (HBV) and C virus (HCV) known to be transmitted through blood and blood products and has been implicated as a major cause of chronic liver disease and hepatocellular carcinoma worldwide. Objective: This study aim to detect the relationship between the HBV and HCV infections with ABO blood groups and age of blood donor in Al- Ramadi city. Patients & Methods: We conducted Hepatitis B surface antigen test strip (ACON Laboratories) (USA) and HCVAb, as step to detect the infections among blood donors at the laboratories for central blood bank in Alanbar health directory, M.O.H. The results of this study were analyzed statistically using the T-test to find the significance of probability level according to SPSS ver12 program. (P) Value < 0.05 were considered significant. Results: Among (430) volunteer blood donors, there were 71(16.511%) positive for HBs Ag and 12(2.790%) for HCVAb. Hepatitis B and C infections were significantly associated with blood group of the donors; percentage of HBs Ag and HCVAb were found to be higher in donors who has blood group O and lowest in blood group AB donors, while the distribution of Rh in hepatitis infected donors was higher among Rh positive donors. HCV infections show a high percentage at age group (26–35) years old, while the percentage of HBV infections increase with progress of age group among blood donors. Conclusion: There were a significant association between blood group of donors and hepatitis infections and the infections of HCV increase among (26-35) years old blood donors while the HBV infections increase with progress of age groups

The Comparison of Qingming Festival in Bengkalis City, Riau, and in Sungailiat, Bangka

Qingming Festival is a great festival and tradition for Chinese to commemorate their ancestors. This activity is considered necessary to do by Chinese nation. Qingming festival reflects xiaoxin (孝心) which means devotion toward the elderly or ancestor and is regarded as an educational culture. This tradition is well preserved until now. This study is objected to compare the Qingming festival held in Bengkalis City, Riau, and one held in Sungailiat, Bangka. By visiting directly those places and interviewing some Chinese people there, we will study and conclude some comparison on this subject