International Journal of Integrated Health Sciences
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Normal Pressure Hydrocephalus Following Myodil Myelography
Get PDFObjective: Fat-saturated contrast agent-enhanced myelography was used for the purpose of diagnosing most spinal lesions from the beginning of the 19th century until the end of the 20th century. Myodil was among the agents used for many years for this purpose.Methods: A rare long-term complication of myodil myelography is presented with a cerebrospinal fluid (CSF) absorption disorder occurring years after myelography that caused a secondary normal pressure hydrocephalus.Results: A case of normal pressure hydrocephalus with a slowly developing clinical picture that emerged years after a ventriculoperitoneal shunt for a myodil myelography 25 years ago due to suspicion of lumbar spinal stenosis was treated. Conclusions: Many acute and chronic complications of fat-saturated contrast agents were reported. Because of these complications and with the technological developments in due course, these agents are replaced by computerized tomography (CT), magnetic resonance imaging (MRI), or hydrophilic contrast agents.Keywords: Normal pressure hydrocephalus, myelography, myodil DOI: 10.15850/ijihs.v3n1.40
Effectiveness in Dynamic Balance: a Comparison between Foot Muscle Strengthening Using Elastic Band and without Elastic Band in Children Aged 8–12 with Flexible Flatfeet
Get PDFObjective: To compare the effects of foot muscle strengthening exercises with and without elastic band to the dynamic balance function in children aged 8–12 years with flexible flatfeet.Methods: Forty-one children (aged 8–12 years) with flexible flatfeet and dynamic balance problem were randomly allocated into either the intervention or control group. Both groups received thrice weekly training for 6 weeks. The foot strengthening exercise regimens consisted of pronation, supination, short foot, and tiptoeing using elastic band for the intervention group and without elastic band for the control group. Star Excursion Balance Test (SEBT) was tested before and after 6 weeks of training. Results: A statistically significant difference of normalized SEBT scores was found for both groups in both legs (p=0.00, p<0.05). The intervention group was significantly better than the control group for both right and left legs (p=0.00, p<0.05). Conclusions: Foot muscle strengthening either with or without elastic band improves dynamic balance in children aged 8–12 years with flexible flatfeet. Exercise given with elastic band significantly shows better improvement in the dynamic balance compared to without elastic band.Keywords: Flexible flatfeet, strengthening exercises, elastic band, dynamic balance, star excursion balance test DOI: 10.15850/ijihs.v3n1.40
Ultrasound Guided Fine Needle Aspiration Biopsy in Renal Tumors
Get PDFObjective: To assess the sensitivity and specificity of ultrasound guided fine needle aspiration biopsy (FNAB) in renal tumors.Methods: A diagnostic study was performed on 23 patients with renal tumors who visited the Urology Division, Department of Surgery, Dr. Hasan Sadikin General Hospital from January 2011 to August 2012. First time ultrasound guided was performed to the patients before nephrectomy. Renal tissues that were obtained from both procedures were examined histopathologically, and the result from nephrectomy was used as the gold standard. Analysis was conducted by measuring the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ultrasound guided FNAB. Results: The results showed that the sensitivity value of ultrasound guided FNAB was 85.71%, with 50% specificity, 94.74% PPV and 25% NPV. From 23 patients, only 2 patients had hematoma. Conclusions: Ultrasound guided FNAB is sufficiently sensitive with a fair specificity for diagnosing renal tumors and is safe for patients.Keywords: Renal tumor, sensitivity, specificity, ultasound guided FNAB DOI: 10.15850/ijihs.v3n1.40
The Safety of Haemophilus influenzae Type b/Polyribosylribitol phosphate-Tetanus (Hib/PRP-T) Vaccine, Phase I Study
No full textObjective: To assess the safety and immunogenicity of Haemophilus influenzae type b/polyribosylribitol phosphate-Tetanus (Hib/PRP-T) liquid vaccine in healthy adults.Methods: An open label prospective intervention phase I study was conducted in Dr. Hasan Sadikin General Hospital from November to December 2010. Healthy adults aged 18−40 were eligible to participate. Participants received one dose of Hib/PRP-T liquid vaccine. Blood samples were taken before, 4 days and 1 month after vaccination. For a 28-day period following vaccination, solicited adverse events were collected in the subjects’ diary and assessed afterward. Results: Neither local reactions nor immediate systemic events were observed during a 30-minute period after immunization. There were no serious local or systemic reactions in this study. All of local and systemic reactions observed were slight, transient, self-limiting in time, without lasting for more than 72 hrs. after the administration of the vaccine, and resolved without any medical intervention. Hematologic and biochemical indices before and 4 days after vaccination showed in normal limits. All subjects (100%) reached protective levels of antibodies (seroprotectivity) against Hib. All subjects demonstrated antibodies performing high bactericidal activities 1 month after immunization. Conclusions: This study demonstrated that liquid Hib/PRP-T vaccine is highly immunogenic and have a beneficial safety when administered to healthy adults. Keywords: Adults, Hib vaccines, immunogenicity, safety DOI: 10.15850/ijihs.v3n2.58
Validity of Mycobacterium tuberculosis Antigens Cocktail: ESAT-6, CFP-10 and MPT64 in Sputum and Cerebrospinal Fluid for Pulmonary Tuberculosis and Tuberculous Meningitis Diagnosis
Get PDFObjective: Rapid and accurate TB diagnostics play an important role in detecting the disease. Currently, antigens secreted (ESAT-6, CFP-10 and MPT64) by M. tuberculosis and encoded by genes “Region of Difference” (RD)1, RD2 and RD3 give an opportunity for rapid TB diagnosis. Genomic region RD1-RD3 was deleted in M. bovis BCG strains and absent in mycobacteria other than M. tuberculosis. This property is advantageous because it enable to create a specific diagnostic tools for M. tuberculosis infection. The aim of this study is to determine the validity of TB antigens cocktail (ESAT-6, CFP-10 and MPT64) for pulmonary tuberculosis and TB meningitis diagnosis. Methods: This is a descriptive observational study design. The study was conducted at the Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital during September 2012 until March 2013 for the pulmonary tuberculosis study and from January 2014 to May 2014 for the TB meningitis study. The TB antigen cocktail rapid immunochromatography (ICT) test was done on all of the samples. The sputum and CSF were cultured as gold standards. Results: There were 149 pulmonary and 41 TB meningitis subjects. The sensitivity of TB antigens cocktail rapid ICT for diagnosing pulmonary tuberculosis was 95.7% with a specificity of 87.2%. Of 41 TB meningitis subjects, based on Marais criteria, there were 6 (16%) subjects with a definite TB meningitis, 26 (63%) subjects with probable TB meningitis and 9 (21%) subjects with possible TB meningitis. The sensitivity and specificity of TB antigens cocktail rapid ICT for TB meningitis diagnosis were 83.3% and 68.5% respectively. Conclusions: In this study, rapid ICT TB antigens cocktail (ESAT-6, CFP-10 and MPT64) from sputum sample has good validity for diagnosing a pulmonary tuberculosis, and from CSF sample has moderate validity to diagnose TB meningitis. Keywords: M. tuberculosis culture, pulmonary TB, TB meningitis, TB antigens cocktail (ESAT-6, CFP-10 and MPT64) rapid ICT DOI: 10.15850/ijihs.v3n2.58
Comparison of Superficial Surgical Site Infection in Simple Interrupted and Hybrid Mattress Suture after Posterior Approach for Spine Surgery
Get PDFObjective: To compare the incidences of superficial surgical site infection after posterior approach procedures in simple interrupted suture groups compared with hybrid mattress suture group. Methods: A number of 38 patients who underwent posterior approach procedure were randomized into two groups. First group was sutured using simple interrupted suture while the second was using hybrid mattress suture. Bivariate statistical analysis was performed using Chi square test and Mann Whitney test. The superficial surgical site infection incidence was evaluated and recorded for both groups.Results: A superficial surgical site infection was found in 26.3% of the simple interrupted group and no infection was found in the hybrid mattress group. Statistical analysis showed a p value of 0.046.Conclusions: Compared to simple interrupted suture, hybrid mattress suture has less superficial surgical site infection in posterior approach for spine surgery.Keywords: Hybrid mattress suture, simple interrupted suture, superficial surgical site infection, wound healing DOI: 10.15850/ijihs.v3n2.58
Robotic Surgery for Giant Presacral Dumbbell-Shape Schwannoma
Get PDFObjective: To demonstrate the feasibility of using da Vinci robotic surgical system to perform spinal surgery.Methods: Magnetic resonance imaging (MRI) of a 29-year-old female patient complaining right pelvic pain for 1 month revealed a 17x8x10 cm non-homogeneous dumbbell shape encapsulated mass with cystic change located in the pelvic cavity and caused an anterior displacement of urinary bladder and colon.Results: There was no systemic complication and pain decrease 24 hours after surgery and during 2 years of follow up. The patient started a diet 6 hours after the surgery and was discharged 72 hours after the surgery. The pathological diagnosis of the tumor was schwannoma. Conclusions: Giant dumbbell shape presacral schwannomas are rare tumours and their surgical treatment is challenging because of the complex anatomy of the presacral. Clinical application of da Vinci robotic surgical system in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures. However, robotic surgery is expected to play a practical future role as it is minimally invasive. The advent of robotic technology will prove to be a boon to the neurosurgeon.Keywords: da Vinci robotic surgical system, presacral, schwannoma DOI: 10.15850/ijihs.v3n1.40
Mycoplasma Genitalium Infection Prevalence in Patients with Human Immunodeficiency Virus
Get PDFObjective: To determine the prevalence of Mycoplasma genitalium (M. genitalium) infection in HIV positive patients by PCR examination in Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung in order to reduce sexually transmitted diseases, especially M. genitalium infection in HIV positive patients.Methods: This study was a cross-sectional study with consecutive sampling methods. Eighty one HIV positive patients attending the Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung were recruited to be the subjects of this study. All subjects underwent history taking, physical examination, and PCR examination for M. genitalium. Specimens were taken from cervical smear in females and first void urine in male.Results: The prevalence of M. genitalium based on the PCR examination in HIV positive patients attended to Teratai Clinic Dr. Hasan Sadikin General Hospital Bandung was 9%. Conclusions: Mycoplasmal infection identification based on PCR examination should be considered for routine screening test to reduce the incidence of sexually transmitted diseases in HIV positive patients.Keywords: Human immunodeficiency virus, Mycoplama genitalium, polymerase chain reaction DOI: 10.15850/ijihs.v2n1.27
Gonorrhoea Infection Prevalence in Human Immunodeficiency Virus Positive Patients Based on Polymerase Chain Reaction Examination
Get PDFObjective: To determine the prevalence of gonorrhoea infection in male and female HIV positive patients based on polymerase chain reaction (PCR) examination at the Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung.Methods: This study was conducted in July, 2012 at the Teratai Clinic, while the PCR examination was performed at the Molecular Biology Laboratory of Microbiology Department, Faculty of Medicine, Universitas Padjadjaran, Bandung. This was a cross-sectional observational study. The subjects were 81 HIV positive patients who were taken in consecutive admission. They underwent history taking and physical examination. Samples were taken from urethral swab in males and cervical swab in females for PCR examination.Results: The PCR examination result was positive for gonorrhea in 36% subjects. From all male subjects participating in the study, 37% were positive while 33% of the female subjects were also positive for gonorrhea. Conclusions: The prevalence of gonorrhoea infection in male and female HIV positive patients at the Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung is quite high, i.e 37% and 33%, respectively.Keywords: Gonorrhoea, human immunodeficiency virus, polymerase chain reaction, prevalence DOI: 10.15850/ijihs.v2n1.27
TYT Curve : Pilot Study on Alternatives Standards of Reference to Determine Intrauterine Growth in Low Resource Setting In Indonesia
Get PDFObjective: To develop a new intrauterine growth curve based on local population for accurate intrauterine growth retardation (IUGR) infant identification. Methods: An observational analytic method was applied to develop Tina-Yessika-Tetty (TYT) curve derived from 13,405 neonatal anthropometric measurements taken from the medical record database of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. The infants included in this study were born during the period of January 1st, 2005 to December 31st, 2009. The new curve was then compared to the Lubchenco and Alisjahbana curves. Only 6,814 data met the inclusion and exclusion criteria. Results: The mean birth weight in this study was lower compared to that of the Lubchenco and Alisjahbana studies. Comparison of the three curves showed that there was a significant difference among the three curves (R=0.998, R2=0.996, p<0.001), which indicates a probability for a newborn classification.Conclusions: TYT curve may be used as an alternative to identify IUGR immediately after birth, especially when detection during pregnancy is not available in low resource setting. A prospective study with a larger population is needed; However, this study has provided an evidence to support the need for timely evaluation for such growth chart as they change over time. Keywords: Alisjahbana curve, intrauterine growth, Lubchenco curve, TYT curveDOI: 10.15850/ijihs.v2n1.27