Evaluation of Histologic Changes of Facet Joint Cartilage and Nerve at the Sheep Postradiofrequency 60 and 120 Seconds After Exposure for Immediate, Three and Six Weeks

Introduction. Facet joint, also known as zygapophyseal joint, is considered as an important structure to play role as one of source of pain in the back that had been recognized since fifth decade ago. Radio frequency is one of treatment modality based on minimal invasive technique for back pain due to pathology of facet joint. Unfortunately, radiofrequency does not give permanent result, so it must be repeated in certain time. The radiofrequency works by producing heat thus it denervates nerve at facet joint. This heat can also destroy surrounding tissues, such as cartilage of facet joint that will further lead to source of back pain. The purpose of this research to evaluate and compare histology changes of facet joint nerve and cartilage of sheep that performed radiofrequency for different time and exposure. Material and methods. This is an experimental study that uses six sheeps as animal trial test. Radiofrequency was applied for 60 and 120 seconds for immediate, three and six weeks. Towards euthanasia, these sheep were given good care and observed for the effect of radiofrequency. After six weeks, these sheep were performed euthanasia then was evaluated histologically using neuropathology score for the nerve and modified-mankins score for the cartilage. Results. This experimental study showed that neuropathology score differed significantly between groups but for modified-mankin score, no difference was found. Besides, there is no negative effect of radiofrequency to six sheeps such as infection and paralysis of extremity. Conclusions. Radiofrequency does not give rise in infection, paralysis of extremity and death either for exposure 60 and 120 seconds clinically. Radiofrequency does not influence facet joint cartilage, only nerve histologically

Desain Majalah Guna Media Penunjang Informasi Pada PT. Pramesta Baja Utama

Setiap perusahaan pada umumnya, baik perusahaan swasta maupun pemerintah mengharapkan dapat menciptakan media promosi yang bagus dan dapat di lihat oleh masyarakat luas. Mengingat pentingnya media promosi PT. Pramesta Baja Utama membuat desain majalah yang hasilnya nanti akan di berikan kepada calon customer, agar calon customer tertarik dengan produk yang ada di PT. Pramesta Baja Utama. Adapun metode yang di gunakan untuk membuat majalah tersebut menggunakan aplikasi photoshop CS6

Gambaran Klinis dan Radiologis pada Pasien dengan Uji Mantoux Positif di Bangsal Rawat Inap Anak RSUD Tangerang

Latar belakang. Tuberkulosis pada anak mempunyai permasalahan yang berbeda dengan orang dewasa karena terdapat berbagai permasalahan dalam diagnosis, pengobatan, dan pencegahan. Pemeriksaan penunjang yang dilakukan untuk menegakkan diagnosis tuberkulosis adalah dengan uji tuberkulin, pemeriksaan radiologis, serologi, darah tepi, dan histopatologik. Tujuan. Mengetahui gambaran klinis dan radiologis anak dengan uji Mantoux positif. Metode. Studi deskriptif di ruang rawat inap anak RSUD Tangerang selama Juni-September 2007. Hasil. Penelitian ini mendapatkan 59 pasien dengan uji Mantoux positif dari 150 pasien yang dilakukan uji Mantoux. Gambaran radiologis dada AP/lateral sebagai berikut: 40 limfadenopati, 25 kelainan parenkim, 14 penebalan pleura, 5 efusi pleura, kavitas dan kalsifikasi masing-masing 1 kasus. Gejala sistemik berupa demam tidak tinggi dan lebih dari 2 minggu didapatkan pada 19 dari 59 anak, malaise (47 dari 59 anak), berat badan turun/sulit naik (53 dari 59 anak), anoreksia (51 dari 59 anak). Batuk lebih dari 2 minggu (20 dari 59 anak) kemungkinan karena tuberkulosis, sedang sesak napas (14 dari 59). Pembesaran kelenjar getah bening merupakan gejala yang tidak khas pada tuberkulosis anak (6 dari 59 anak). Kesimpulan. Indeks tuberkulin pada penelitian ini adalah 59 dari 150 pasien (40%), gambaran radiologis anak dengan uji Mantoux positif bervariasi, sedangkan gejala klinis dapat overlap dengan penyakit primer yang sedang diderita subjek

Does Accelerometer-based Navigation Have Any Clinical Benefit Compared with Conventional TKA? A Systematic Review

Background Accelerometer-based navigation is a handheld navigation tool that was introduced to offer a simpler technique compared with more-cumbersome computer-assisted surgery (CAS). Considering the increasing number of adopters, it seems important to evaluate the potential clinical benefits of this technology compared with conventional TKA.Questions/purposes In this systematic review, we asked: (1) Is accelerometer-based navigation more accurate than conventional TKA? (2) Does accelerometer-based navigation provide better functional outcome than conventional TKA? (3) Does accelerometer-based navigation increase surgical time or decrease the risk of complications or reoperations compared with conventional TKA?Methods This systematic review included all comparative prospective and retrospective studies published in the MEDLINE/PubMed and Cochrane libraries over the last 10 years. Inclusion criteria were all studies in English that compared accelerometer-based navigation with conventional TKA. Eleven studies met these criteria with 621 knees in accelerometer-based navigation group and 677 knees in conventional TKA group. Results related to alignment, objective and subjective functional scores, duration of surgery, complications and reoperations were extracted and compared between accelerometer-based-navigation and conventional TKA. Methodological quality was assessed using Methodological Index for Non-Randomized Studies (MINORS) tool (for nonrandomized control trials) and Cochrane Risk of Bias (for randomized control trials (RCTs). All studies with fair or better quality were included. Four RCTs and six nonrandomized studies comparing accelerometer-based navigation to conventional TKA were found.Results Inconsistent evidence on mechanical axis alignment was found, with five of nine studies slightly favoring the accelerometer-based navigation group, and the other four showing no differences between the groups. Only two of eight studies favored accelerometer-based navigation in terms of tibial component alignment in the coronal plane; the other six found no between-group differences. Similarly, mixed results were found regarding other metrics related to component alignment; a minority of studies favored accelerometer-based navigation by a smallmargin, and most studies found no between-group differences. Only three studies evaluated functional outcome and none of them showed a difference in range of motion or patient-reported outcomes. Most studies, six of seven, found no between-group differences concerning surgical time; one study demonstrated a slight increase in time with accelerometer-based navigation. There were no between-group differences in terms of the risk of complications, which generally were uncommon in both groups, and no reoperations or revisions were reported in either group.Conclusions We found conflicting evidence about whether accelerometer-based navigation reduces the number of coronal-plane outliers or improves alignment to a clinically important degree, and we found no evidence that it improves patient-reported outcomes or reduces the risk of complications or reoperations. Accelerometer-based navigation may increase surgical time. The overall quality of the evidencewas low, which suggested that any observed benefits were over-estimated. Given the absence of higher-quality evidence demonstrating compelling benefits of this accelerometer-based navigation technology, it should not bewidely adopted.Orthopaedics, Trauma Surgery and Rehabilitatio

Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery

Aim: To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis.Methods: This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confi rm the symptomatic VTE. These patients were followed up to one month after surgery.Results: A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1%) underwent hip fracture surgery (HFS). The median time from injury to surgery was 23 days (range 2 to 197 days), the median duration of surgery was 90 minutes (range 60 to 255 minutes), and the median duration of immobilization was 3 days (range 1 to 44 days). Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2%) at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%), all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study.Conclusion: The incidence of asymptomatic (69.2%) and symptomatic (23.1%) VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA), and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted. (Med J Indones 2009; 18: 249-56)Keywords: venous thromboembolism (VTE), orthopedic surgery, Indonesia</p