A CASE REPORT OF NECROTIZING FASCIITIS OF THE NECK AND ANTERIOR CHEST WALL CAUSED BY ODONTOGENIC INFECTION IN ELDERLY: DIAGNOSIS AND MANAGEMENT IN RURAL AREA

Introduction: Necrotizing Fasciitis (NF) is bacterial infection spreading rapidly affecting soft tissue and muscular fascia. It's life threatening and fatal, leads to tissue necrosis, sepsis, and death. It has high mortality number especially in elderly.Purpose: To report a rare case of odontogenic NF in elderly patient extending to the neck, left upper limb and anterior chest wall, diagnosed and treated in district hospital with limited facilities.Case Report: A 65 years old male with painful left neck swelling and fluctuating gangrenous appearance start form the mastoid bone to infraclavicular area crossing to the right close with sternal area. Swelling and fluctuating area also found in left axillar and left arm. Thirteen hours after hospital admission, the patient was sent to operating room to do the wound debridement. Wound care was carried out daily in intensive care unit and inpatient ward. 14 days postoperatively patient was send out to continue the wound care in outpatient department. 28 days postoperatively, skin grafting was done.Conclusion: Fourteen days postoperatively patient was sent to outpatient department to continue his wound care. After wound care in order to wound prepare for skin grafting. 28 days postoperatively, 14 days after patient discharge from hospital, skin grafting was done to close the wound defect

COMPLICATIONS RELATED COMORBIDITIES OF ARTERIOVENOUS FISTULA (AVF) CREATION AS HEMODIALYSIS ACCESS FOR END STAGE RENAL DISEASE (ESRD) IN BEN MBOI DISTRICT HOSPITAL, RUTENG FLORES INDONESIA

Introduction: Since Brescia and Cimino(1966) posted AV Fistula technique, there has been increase of long term survival of patients with End Stage Renal Disease (ESRD). AV fistula has its own set of indications, benefits, and complications. Purpose: To show AV Fistula creation outcomes, complications and its related comorbidities in Ben Mboi District Hospital, Ruteng Flores IndonesiaMethod: An analytical study design using a cross sectional approach was employed in this study. Using medical record data from 2019 to 2022, all men and women who received hemodialysis through AV Fistula were included. Bivariate analysis was carried out from baseline data such as age, sex, comorbidities, location of an av fistula (AVF), previous dialysis insertion with complications that arise using Chi-square. Results: Age, sex, hypertension and AV Fistula creation location has no significant correlation with complications such as failed to mature, thrombosis, infection, venous hypertension. Diabetes mellitus has a significant correlation with occurrence of failed to mature (p=0.012), thrombosis (p=0.014), venous hypertension (p=0.08). Obesity has a significant correlation with occurrence of failed to mature (p=0.000), thrombosis (p=0.000). Previous insertion of CDL in right subclavian vein has a significant correlation with occurrence of venous hypertension (p=0.000).Conclusion: Diabetes mellitus has a significant correlation with occurrence of complications such as failed to mature, thrombosis and venous hypertension. Obesity has a significant correlation with occurrence of failed to mature and thrombosis. History of CDL insertion in right subclavian vein has a significant correlation with venous hypertension