Iron as Preoperative Antituberculosis Supplement Increases Interleukin-12 Level in Spinal Tuberculosis and Iron Deficiency Patients

Iron deficiency remains the most prevalent micronutrient deficiency worldwide. Iron deficiency in TB patients, causes a poor outcome, reccurency, and treatment failure. Iron supplements on TB patients with iron deficiency will activate macrophage-derived monocytes (MDM) and interferon-gamma (IFN-γ), with a positive feedback mechanism pushing interleukin-12 (IL-12). This study is a single-blind randomized control trial comparing the effectivity of preoperative iron supplementation in IL-12 level between two different groups in Dr. Hasan Sadikin General Hospital Bandung, conducted from November 2018 until March 2019. Respondents are those having Spondylitis TB, with sTfR > 21,7 pg/mL and IL-12 21,7 pg/ml dan IL-12< 41 pg/mL. fase intensif OAT kategori 1sesuai dengan standar WHO. Kelompok eksperimen, 17responden diterapi 2 RHZE + tablet iron (III) hidroksi polimaltosa357 mg selama 2 bulan. Kelompok kontrol 17 responden diterapi 2RHZE. Peningkatan IL-12 pada kelompok eksperimen sebesar +364,53% lebih besar dari kelompok kontrol (p<0,05) dan; Penurunan kadar sTfR pada kelompok eksperimen sebesar –60,68% (p<0,05) lebih besar dari kontrol. Uji korelasi sTfR dan IL-12 dengan Pearson ; korelasi -0,763, menunjukkan korelasi kuat antara penurunan sTfR dan kenaikan nilai IL-12. Suplementasi Fe pada terapi preoperatif spondilitis TB dengan defisiensi Fe meningkatkan respon imun yang ditandai dengan meningkatnya IL-12

Relationship between Types of Cervical SpineTrauma and Occurrence of Neurological Deficits

Background: About 3,500 people died each year due to neck injury, according to a study in the USA. Trauma at cervical spine level causes injury in soft tissue, cervical vertebrae, and spinal cord that can cause neurological deficits. The aim of this study was to analyze the relationship between type of cervical trauma and the occurrence of neurological deficits.Methods: An analytic study was carried out to 121 medical records of patients  diagnosed with cervical spine trauma at Dr. Hasan Sadikin General Hospital Bandung in the period of January 2010−December 2012.  Data were classified according to age, sex, period of initial visit to hospital, mechanism of trauma, cervical trauma type, fracture’s or dislocation’s location (without any other vertebral injury) and neurological status. The collected data were analyzed using Chi-Square test and presented in tables.Results: There were 121 cases of cervical spine trauma. Most patients were male and in the productive age group (30−44 years). Most of the initial visits to the hospital were in 2010 and most of the mechanism was traffic accident (46.28%), while soft tissue injury was the most common type of cervical trauma (54.54%) and lower cervical vertebrae was the most common location of fractures or dislocations (76.36%). Sixty two patients were recorded with neurological deficits. Chi-Square test of relationship between  the type of cervical trauma and the occurrence of neurological deficit was statistically significant (p=0.000).Conclusions: There is relationship between the type of cervical trauma and occurrence of neurological deficits. DOI: 10.15850/amj.v4n2.108

Atomic Mineral Characteristics of Indonesian Osteoporosis by High-Resolution Inductively Coupled Plasma Mass Spectrometry

Clinical research indicates that negative calcium balance is associated with low bone mass, rapid bone loss, and high fracture rates. However, some studies revealed that not only calcium is involved in bone strengthening as risk factor of fracture osteoporosis. Thus, in this report, the difference of metallic and nonmetallic elements in osteoporosis and normal bones was studied by high-resolution inductively coupled plasma mass spectrometry (HR-ICP-MS). The influence of these elements on bone metabolic processes is also discussed. Inclusion criteria of bone samples consist of postmenopausal woman, trabecular bone fracture, normal and osteoporosis BMD value, and no history of previous disease. The results showed that the concentration of B, Al, S, V, Co, Mo, Te, Ba, La, Ni, As, and Ca/P ratio is higher in osteoporosis than normal. These atomic minerals have negative role to imbalance between bone resorption and bone formation activity. Conversely, concentrations of Na, Mg, P, K, Ca, Cr, Pd, Ag, Mn, Fe, Cu, Zn, Rb, Sr, Pb, and Se are lower in osteoporosis than in normal bones. Among these atoms, known to have important roles in bone structure, we found involvement of atomic mineral and calcium which are considerable to contribute to osteoporotic phenomena

Vertebra

Vertebra merupakan bagian penting dari tubuh manusia yg mempunyai hubungan dengan struktur jaringan lainnya, seperti jaringan ikat sendi dan otot. Secara umum , vertebrra berfungsi untuk menyokong tubuh, melindungi saraf yg berjalan melaluinya, juga sebagai sendi yg memungkinkan vertebra bergerak. Berdasarkan strukturnya, vertebra memiliki beberapa fungsi spesifik, yaitu statis, kinetis, keseimbangan, dan perlindungan. Vertebra merupakan kolumnayg tersusun dari sejumlah tulang dengan bentuk serupa, yg terhubung antara satu dengan lainnya melalui sejumlah artikulasi sehingga membentuk suatu struktur yg rigid, namun masih memiliki fleksibilitas dalam batas tertentu. Sifat tersebut memungkinkan vertebra menyokong postur tubuh, melindungi elemen saraf yg berjalan melaluinya, dan pada saat yg bersamaan memungkinkan terjadinya pergerakan fungsional

Vertebrata

xi, 160 hlm. : ilus. ; tab. ; 23 cm

PENGARUH TARIF INA CBG’S TINDAKAN CABG TERHADAP KUNJUNGAN PELAYANAN JANTUNG DAN PENDAPATAN DI SANTOSA HOSPITAL BANDUNG CENTRAL

This study aims to determine and analyze the effect of CABG rates on cardiac service visits and income. The research method used is descriptive analysis and verification. The data collection used is a questionnaire accompanied by observation techniques and literature, Sampling using saturated sampling. Data collection in the field will be carried out in 2022. The data analysis technique uses path analysis.The results showed that there was an effect of CABG action rates on service visits and hospital income in a positive direction, where the higher cardiac service visits would result in increased income at Class A Hospital Santosa Hospital Bandung Central, so it was necessary to evaluate the method of calculating the INA CBGs rate which based on the case base rate method, in order to use a cost of treatment approach based on clinical pathways. &nbsp; &nbsp

REKAM MEDIS ODONTOGRAM SEBAGAI ALAT IDENTIFIKASI DAN KEPENTINGAN PEMBUKTIAN DI PENGADILAN

Identifikasi melalui rekam medis odontogram bertujuan untuk memenuhi persyaratan sebagai tenaga professional dokter, dokter gigi ataupun tenaga kesehatan lainnya di dalam pembuatan rekam medis. Pelaksanaannya harus sesuai dengan peraturan yang telah ditetapkan, selain banyak manfaatnya rekam medis ini dapat dipakai sebagai alat bukti di pengadilan. Saat ini belum semua dokter gigi maupun perawat gigi di Indonesia melakukan pencatatan rekam medis odontogram secara benar. Masih belum adanya keseragaman dalam tata cara penulisan maupun pengistilahan yang digunakan dalam pencatatan rekam medis odontogram sehingga menimbulkan kesalahpahaman saat rekam medis tersebut dimanfaatkan dalam suatu proses hukum. Standar Operasi Prosedur mengenai rekam medis odontogram perlu diterapkan dan dilaksanakan pada setiap pelayanan kesehatan baik instansi pemerintah, swasta maupun pratik perseorangan dengan standar Nasional maupun Internasional secara manual, digital maupun secara elektronik

Bone microstructure and atomic periodic disharmonization in osteoporosis

Background Both cortical and cancellous bone display a complex, porous microstructure whose properties depend on the macrostructure of bone as well as age and health of the individual. The aim of this study was to compare the microstructure and characteristics of mineral atoms in osteoporotic and normal bone. Methods A prospective laboratory experimental study was conducted from August to December 2010 at several hospitals in Banjarmasin. Twenty patients with osteoporosis and twenty six normal patients were involved in this study. Bone obtained from surgery was analyzed for microstructure by scanning electron microscopy (SEM), while mapping of mineral atoms was performed by means of SEM-Energy dispersive X-ray spectroscopy (SEM-EDAX) at the Brawijaya University, Malang.      Results The osteoporotic subjects with mean age of 64.65 ± 16.41 years were older than the normal bone subjects with mean age of 39.38 ± 17.16 years. The body mass index was similar in both groups of subjects. From SEM-EDAX results, three patterns of mineral atoms were apparent in osteoporotic and normal bone. In osteoporotic bone, these patterns were indicative of a disordered substitution or incorporation process. SEM results showed degeneration of microarchitecture (resorption cavities, perforations, and prominent granules) in osteoporotic but not in normal bone. There was a significant difference in microstructure between osteoporotic and normal bone, which was caused by differences in atomic properties.      Conclusions Microstructural abnormalities of bone and disharmonization of mineral atoms in the periodic system were found in osteoporosis

Assessment of microarchitecture and crystal structure of hydroxyapatite in osteoporosis

Osteoporosis is characterized by lower bone mineral density (BMD) and microarchitectural degeneration, which tends to increase bone fragility and fracture risk. Bone microstructure depends on interactions between the mineral atoms, which may perform substitution or incorporation into bone crystals, and may dynamically take over the function of calcium or may become a complementary part. The mineral atoms may also become a composite in the hydroxyapatite crystals. The aim of this study was to find an association between the bone microstructure and hydoxyapatite crystal structure in osteoporosis, in comparison to normal bone. The subjects of this study were surgery patients at the Department of Orthopedics of Ulin General Hospital in Banjarmasin and other centers. Inclusion criteria consisted of the presence of fracture of trabecular bone, normal or osteoporotic BMD values, and no past history of chronic disease. Bone was obtained from fracture patients during surgery. The characteristics of the hydroxyapatite crystals were analyzed by X-ray diffraction (XRD) and the microarchitecture by scanning electron microscopy (SEM). SEM showed degeneration of the microarchitecture of osteoporotic bone, in comparison with normal bone. On XRD there was a peak of hydoxyapatite crystals only and no other crystal phases. Diffraction patterns showed a larger crystal size in osteoporotic bone as compared to normal bone, indicating higher porosity. It may be concluded that there is a difference in crystal size and morphologic distribution of hydoxyapatite in osteoporotic bone, determining bone microarchitecture