Comparison of Diagnostic Accuracy of Tuberculosis Spondylitis between Genexpert and Histopathological Examination

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Spinal TB is associated with poor functional outcomes. Histopathological examination requires a long waiting times to obtain the results thus impractical for screening and may delay diagnosis. GeneXpert offers rapid tests for prompt screening and diagnosis. This study aimed to assess the diagnostic accuracy of GeneXpert in patients with spinal TB when compared to the histopathology test as the gold standard. This study was performed on patients in the Spine Clinic of the Department of Orthopedic and Traumatology, Dr. Hasan Sadikin General Hospital Bandung who were diagnosed with spinal TB during the period of May 2019–May 2020. Blood samples were collected from the patients and tested using GeneXpert and histopathological assessment. Results demonstrated 34 patients with a positive result and 6 patients with negative results on both diagnostic methods. Twenty nine out of 40 patients (72.5%) had rifampin-sensitive TB. Diagnostic accuracy of GeneXpert, when compared to histopathological examination, is represented by the sensitivity of 88.2%, specificity of 33.3%, positive predictive value of 88.2%, and negative predictive value of 33.3%. High sensitivity results forpatients with spinal TB on GeneXpert suggests that the test is appropriate to be used as a screening method and as a high-yield rapid diagnostic test for patients suspected for spinal TB

Profile of traumatic brain injury (TBI) in relation with maxillofacial and thoracic injury Dr. Hasan Sadikin General Hospital, Bandung

Traumatic brain injury (TBI) has a relation with concomitant injuries, which are mostlymaxillofacial and thoracic injury. This study aimed to know which injury was common inTBI patients and the difference in the severity of TBI when patients were associated withone or both types of injuries. This was a descriptive retrospective study. The data used wasmedical records from Department of Neurosurgery, Dr. Hasan Sadikin General Hospital,Bandung, Indonesia from the period of August 2015 to July 2016. Total sampling methodwas used in this study. The variables were patients with TBI, maxillofacial injury, thoracicinjury, accident related mechanism and non-accident related mechanism and the GlasgowComa Score (GCS). The total cases for this study were 47 patients. The highest case wasmales with 37 cases and 10 for females. Accident related trauma had 23 cases whereasnon accident related trauma had 24 cases. The total cases of maxillofacial injury were 32,thoracic were 6 cases whereby for both injuries were 9 cases. Patients with mild TBI were28 cases, moderate TBI were 13 cases, and severe TBI had 6 cases in total. The rate ofTBI was higher in single injury which was the maxillofacial injury. However, the thoracicand both injuries combined had higher severity of TBI compared to maxillofacial injury

Successful megaprosthesis in a nearly amputated lower extremity after crush injury:A case report and literature review

Crush injury is one of the most challenging decisions for a surgeon to decide whether to proceed with an amputation or salvage a limb. We presented a 24-year-old man who complained of having suffered a crushed thigh 12 h before admission to the hospital. The patient was driving a truck and hit the iron bridge barrier, which penetrated his left thigh. The patient's left foot was cold, pallid, and pulseless, with a MESS score of 11. The femur x-ray showed a displaced fracture of the left femur associated with a 15 cm bone defect. The patient was diagnosed with a crush injury on the left femur with vascular compromise. We performed a proximal femoral megaprosthesis for a crush injury on the lower extremity, After the sixth year's follow-up, it shows a good outcome and increased quality of life for this patient. In addition, there was an improvement in the Harris Hip Score and EQ5D score. Megaprosthesis used to treat a crush injury revealed good functional outcomes despite the MESS score of 11. A multi-professional approach to the patient is essential for decision-making regarding limb salvage rather than the use of a score.</p

Successful megaprosthesis in a nearly amputated lower extremity after crush injury:A case report and literature review

Crush injury is one of the most challenging decisions for a surgeon to decide whether to proceed with an amputation or salvage a limb. We presented a 24-year-old man who complained of having suffered a crushed thigh 12 h before admission to the hospital. The patient was driving a truck and hit the iron bridge barrier, which penetrated his left thigh. The patient's left foot was cold, pallid, and pulseless, with a MESS score of 11. The femur x-ray showed a displaced fracture of the left femur associated with a 15 cm bone defect. The patient was diagnosed with a crush injury on the left femur with vascular compromise. We performed a proximal femoral megaprosthesis for a crush injury on the lower extremity, After the sixth year's follow-up, it shows a good outcome and increased quality of life for this patient. In addition, there was an improvement in the Harris Hip Score and EQ5D score. Megaprosthesis used to treat a crush injury revealed good functional outcomes despite the MESS score of 11. A multi-professional approach to the patient is essential for decision-making regarding limb salvage rather than the use of a score.</p

Successful megaprosthesis in a nearly amputated lower extremity after crush injury: A case report and literature review

Crush injury is one of the most challenging decisions for a surgeon to decide whether to proceed with an amputation or salvage a limb.We presented a 24-year-old man who complained of having suffered a crushed thigh 12 h before admission to the hospital. The patient was driving a truck and hit the iron bridge barrier, which penetrated his left thigh. The patient's left foot was cold, pallid, and pulseless, with a MESS score of 11. The femur x-ray showed a displaced fracture of the left femur associated with a 15 cm bone defect. The patient was diagnosed with a crush injury on the left femur with vascular compromise.We performed a proximal femoral megaprosthesis for a crush injury on the lower extremity, After the sixth year's follow-up, it shows a good outcome and increased quality of life for this patient. In addition, there was an improvement in the Harris Hip Score and EQ5D score.Megaprosthesis used to treat a crush injury revealed good functional outcomes despite the MESS score of 11. A multi-professional approach to the patient is essential for decision-making regarding limb salvage rather than the use of a score