Characteristic tetanus infection in disaster-affected areas: case study of the Yogyakarta earthquakes in Indonesia

<p>Abstract</p> <p>Background</p> <p>Tetanus is an infectious disease caused by the contamination of wounds from bacteria that live in soil. The tetanus mortality rate remains high in developing countries affected by natural disasters. Whether the socio-demography and geographical conditions may influence the tetanus treatment outcome on the earthquake situation in Yogyakarta, Indonesia has not been investigated.</p> <p>Findings</p> <p>We present 26 tetanus patients who were admitted to eight hospitals following the earthquakes that occurred on May, 27, 2006, in Yogyakarta, Indonesia. The independent variables were age, gender, distance, admission, hospitalization, and type of hospital with the dependent variable surviving or perishing. Data were analyzed by logistic regression methods on SPSS 17.0. The distance from the patient's place of residence to the hospital were obtained and analyzed by using geospatial tools MapInfo 7.8 SCP and Global Mapper 7. Eight of the 26 patients were dead (30.8%) and statistical results showed that the distance (OR = 1.740, 95% CI = 1.068–2.835) and type of hospital (OR = 0.067, 95% CI = 0.001–3.520) were significant predictors of death.</p> <p>Conclusion</p> <p>Our findings show that in order to reduce the mortality rates, performing triage systems based on the distance and type of hospital priority for internally displaced persons could be proposed as well as making provisions for the generally old population in order to prevent an outbreak of tetanus following earthquakes in Yogyakarta, Indonesia.</p

Pattern of Prostate Specific Antigen and Gleason Score in Relation to Imunohistochemistry Features in Prostate Adenocarcinoma Patients in Dr. Hasan Sadikin General Hospital

Objective: To review the correlation between prostate specific antigen (PSA) and Gleason score and Cav-1 for diagnosing prostate adenocarcinoma.Methods: Data were collected from one hundred fifty-nine patients with prostate adenocarcinoma at the Department of Urology, Dr. Hasan Sadikin General Hospital in the period of January 2008–December 2010. The PSA levels were measured and classified into 10 ng/ml. The results were then analyzed and compared to the imunohistochemistry (caveolin-1) staining in the literature. The Gleason score was also noted and analyzed. Results: This study confirmed that positive caveolin-1 expression was related to the clinical markers of disease progression and was predictive of poor clinical outcome after surgery. The PSA results showed that one hundred fourty-one adenocarcinoma patients had a PSA level of >10 ng/ml with Gleason score of gleason 5–6 as the most common score. However, there was no correlation between PSA and Gleason score and caveolin-1 for diagnosing prostate adenocarcinoma.Conclusions: Caveolin-1 cannot be used to measure Gleason and PSA score due to different markers that have various advantages and disadvantages to predict carcinoma prostate. Therefore, further studies are needed. Keywords: Gleason score, imunohistochemistry, prostate adenocarcinoma, prostate specific antigen DOI: 10.15850/ijihs.v4n1.67

Breathing and Light- to Vigorous-Intensity Aerobic Exercises Improved Respiratory Functions and Functional Capacity of COVID-19 Survivor with Morbid Obesity

Introduction: A decrease in respiratory functions (RF) and functional capacity (FC) may present as complications of intensive care unit (ICU) admission. Morbid obesity worsens these complications. Case: A 31-year-old male patient with morbid obesity came for pulmonary rehabilitation (PR) one week after hospitalization. He suffered from COVID-19 and received 15 days of mechanical ventilation. The goal of PR was to improve RF and FC. A comprehensive PR, including hospital- and home-based programs, consisting of breathing, aerobic, resistance, and flexibility exercises, diet and psychological counseling was given. Breathing exercises were deep breathing, sustained-maximal breathing, and chest expansion. Hospital-based PR was given with moderate-intensity interval aerobic exercise (AE), while home-based PR was with low-intensity continuous, both with oxygen supplementation. The FC was needed to do his daily activities, and vocational was 1.0 to 6.3 metabolic equivalents (METs). The target of FC 6 METs in 12-18 weeks was set. After six weeks, the RF improved with decreased dyspnea and increased maximum inspiratory volume and chest expansion. The FC increased to 4.2 METs, and monitored-home-based AE was given with vigorous-intensity interval mode. He joined the residency program 10 weeks later and achieved 5.7 METs at the end of PR. We gave unsupervised home-based exercises for his long-term exercise. Conclusion: Breathing and AE improved RF and FC in a COVID-19 patient with morbid obesity admitted to the intensive care unit (ICU) to previous vocational activities

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

Histological Description of Meningeal and Periosteal Dural Layers at the Porus of Internal Acoustic Canal in the Vestibular Schwannoma

Objective: To study the transformation point of meningeal and periosteal dural at the porus of internal acoustic canal (IAC) in order to verify the different thickness of meningeal and periosteal dura in vestibular schwannomas (VS). Methods: Three IAC cadaver specimens and ten samples of VS patients from porus were obtained and analyzed. Samples were stained by using Masson trichrome technique after cutting in 6 micron of thickness. The samples were then observed under light microscopes to understand the meninges pattern in the IAC. Results: The meningeal dura is becoming thin at the porus and disappears at the meatal portion to form epineurium. However, the periosteal dura is lining continuously to the fundus. In VS, the meningeal dura becomes thick and forms a pseudo-capsule in the middle of meatus, known as perineurium. The residual nerve filament was compressed by the tumor parenchyma. Between the tumor and nerve interface, three or more perineureal layers are seen. The perineurium in the cisternal portion was consistently loose and forms the tumor and arachnoid nerve interface. Almost all the nerve filaments are displaced to the tumor periphery near the pseudocapsule. In contrast, the periosteal dural of VS is becoming thin and disappear nearby the middle of meatal portion. This changing site establishes “meningo-periosteal ring” of VS because of the encircling nearby the porus. Conclusions: In IAC, the meningeal dural becomes thin. The periosteal dura is lining continuously to the fundus. In VS, the meningeal dura becomes thick, joins perineurium and forms pesudocapsule near the porus, but the periosteal dura disappeared. This changing point is called meningo-periosteal ring.     Keywords: Meningeal,  periosteal, porus, vestibular schwannomasDOI: 10.15850/ijihs.v1n1.10

Anterior Interhemispheric Approach for Olfactory Groove Meningioma

Objective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM). Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT) scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma.Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively.Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.Keywords: Anterior interhemispheric approach, olfactory groove meningioma DOI: 10.15850/ijihs.v4n2.83

PERHITUNGAN KONSTRUKSI GEDUNG KANTOR SEWA LIMA LANTAI DI PONTIANAK

Perancangan Gedung kantor sewa lima lantai fiktif merupakan perencanaan dengan data tanah (deep boring. Proyek pembangunan gedung sekolah di Jalan Sisingamangaraja berada di Kota Pontianak. Perencanaan gedung kantor sewa lima lantai di Pontianak menggunakan mutu baja pabrikan yang tersedia yakni 240 MPa, untuk tulangan polos, 400 MPa tulangan ulir dan menggunakan mutu beton 25 Mpa. Perencanaan berdasarkan SNI 2847-2013 beton, SNI 1726-2012. Pembebanan gempa dan PPPURG SKBI 1.3.53.1987 untuk pembebanan struktur. Pembebanan gedung dengan sistem pembebanan vertikal berupa berat sendiri(D), beban mati tambahan(SD), beban hidup(L), beban air hujan serta beban horizontal berupa beban gempa(E) dan angin(W) dimana analisis struktur dibantu dengan bantuan program komputer (ETABS 9.7.2).Hasil penelitian perencanaan meliputi dimensi pelat, balok, kolom dan pondasi, untuk pelat lantai dasar, hingga lantai dack setebal 120 mm, untuk balok induk tangga (tipe 1) berukuran 40/80, balok tipe 2 berukuran 30/60, balok tipe 3 berukuran 25/55 dan balok tipe 4 berukuran 15/30 dengan balok lantai dasar yang menggunakan tie beam yang dimana penyaluran momen tiang dapat didistribusikan sehingga ukuran pondasi lebih hemat dan efisien, untuk kolom lantai 1-5 berukuran 45/45, serta untuk pondasi menggunakan pondasi tiang pancang (minipile) dengan dimensi 25x25 yang tiap titiknya berkisar dari 1 s/d 6 tiang pancang.Kata kunci : beton bertulang, gedung kantor sewa lima lantai, perhitungan struktur program struktur ETAB

Anterior Interhemispheric Approach for Olfactory Groove Meningioma

Objective: To evaluate the surgical technique with bifrontal interhemispheric approach for total removal of tumor in olfactory groove meningioma (OGM). Methods: This study described a case of a 38-year-old woman with bilateral blindness, anosmia, and behaviour changes. Imaging studies show a tumor mass in midfrontal base. Surgery using a bifrontal interhemispheric approach was performed and total removal was achieved and postoperative computed tomography (CT) scan was performed to confirm the result. Histopathological findings established a diagnosis of meningioma.Results: A coronal skin incision behind the hairline was utilized. The scalp was elevated, taking care to reserve the vascularized pericranium medial to the linea temporalis of each side, and preserving the 2 supraorbital nerves. Eight burr holes were used, with the two initial holes made on each side of the orbitotemporal region, and the other four holes at the midline. A bifrontal craniotomy was performed. The tumor was first detached from its attachment with bipolar cautery and debulked. During this step, the main tumor feeder arteries from the anterior and posterior ethmoidal artery were interrupted, and the tumor devascularized. Total tumor removal through surgical intervention was achieved and confirmed by head CT-scan postoperatively.Conclusions: This case report supports the suitability of the bifrontal interhemispheric approach for OGM resection with additional radiation therapy.Keywords: Anterior interhemispheric approach, olfactory groove meningioma DOI: 10.15850/ijihs.v4n2.83

Histological Description of Meningeal and Periosteal Dural Layers at the Porus of Internal Acoustic Canal in the Vestibular Schwannoma

Objective: To study the transformation point of meningeal and periosteal dural at the porus of internal acoustic canal (IAC) in order to verify the different thickness of meningeal and periosteal dura in vestibular schwannomas (VS). Methods: Three IAC cadaver specimens and ten samples of VS patients from porus were obtained and analyzed. Samples were stained by using Masson trichrome technique after cutting in 6 micron of thickness. The samples were then observed under light microscopes to understand the meninges pattern in the IAC. Results: The meningeal dura is becoming thin at the porus and disappears at the meatal portion to form epineurium. However, the periosteal dura is lining continuously to the fundus. In VS, the meningeal dura becomes thick and forms a pseudo-capsule in the middle of meatus, known as perineurium. The residual nerve filament was compressed by the tumor parenchyma. Between the tumor and nerve interface, three or more perineureal layers are seen. The perineurium in the cisternal portion was consistently loose and forms the tumor and arachnoid nerve interface. Almost all the nerve filaments are displaced to the tumor periphery near the pseudocapsule. In contrast, the periosteal dural of VS is becoming thin and disappear nearby the middle of meatal portion. This changing site establishes “meningo-periosteal ring” of VS because of the encircling nearby the porus. Conclusions: In IAC, the meningeal dural becomes thin. The periosteal dura is lining continuously to the fundus. In VS, the meningeal dura becomes thick, joins perineurium and forms pesudocapsule near the porus, but the periosteal dura disappeared. This changing point is called meningo-periosteal ring.     Keywords: Meningeal,  periosteal, porus, vestibular schwannomasDOI: 10.15850/ijihs.v1n1.10