Abstrak. Sebuah kasus, wanita berusia 22 tahun hamil 8-9 minggu dengan keluhan perdarahan pervaginam sejak 1 sebelum masuk rumas sakit (RS). Pemeriksaan ultrasonografi menunjukkan gambaran kantung gestasi tanpa pertumbuhan embrio dengan usia kehamilan 8 minggu. Terminasi kehamilan pada kasus ini dilakukan dengan metode dilatasi dan kuretase. Kehamilan anemebrionik merupakan salah satu bentuk kegagalan dalam kehamilan. Diperkirakan 10-15% hasil konsepsi tidak viabel dan akan mengalami abortus dan 3% diantaranya merupakan kehamilan anembrionik. Manifestasi klinis pada kasus ini meliputi riwayat amenorea, tanda-tanda kehamilan muda serta perdarahan pervaginam pada tahap akhir perjalananya. Berbagai faktor secara teoritis dikaitkan dengan kehamilan embrionik meliputi; faktor genetik paternal dan maternal, disfungsi hormonal serta infeksi dan kelainan imunologi. Kehamilan embrionik dapat ditegakkan melalui pemeriksaan ultrasonografi transabdominal maupun transvaginal dengan ditemukannnya kantung gestasi tanpa perkembangan embrio pada minggu 6-10 kehamilan. Kata Kunci: Kehamilan anembrionik, kuretaseAbstract. A case, 22-year-old woman with 8-9 weeks gestational aged with complaints of vaginal bleeding one day before hospital admission. Ultrasound examination showed a picture of gestational sac without embryo growth correspondent to 8 weeks gestational aged. Termination of pregnancy in this case was done by the method of dilation and curettage. Anembryonic Pregnancy is one form of failure in pregnancy. An estimated 10-15% of the pregnancy is not viable and will undergo abortion and 3% of it is anembryonic pregnancy. Clinical manifestations in this case includes a history of amenorrhea, signs of early pregnancy and vaginal bleeding at the final stage perjalananya. Various factors are theoretically associated with embryonic pregnancy include; paternal and maternal genetic factors, hormonal dysfunction, as well as infectious and immunological disorders. Embryonic Pregnancy can be enforced through a transabdominal or transvaginal ultrasound examination with detection of gestational sac without embryo development at 6-10 weeks gestation.Key words: Anembryonic pregnancy, curettage
Introduction: Splenectomy in thalassemia patient is indicated in the transfusion-dependent patient when hypersplenism increases blood transfusion requirement, prevents adequate control of body iron with chelation therapy and increased risk for infection.Method: This study was retrospective study aims to evaluate the outcome of splenectomy in pediatric thalassemia patients and its related factor. A total 34 thalassemia patient with post total splenectomy patients was included in this study.  Result: Mean age was 20.7 ± 6.5 years old with majority mild malnutrition (61.8%) and the majority of spleen size Schaffner 6-7 (73.5%). The duration between thalassemia diagnosis and total splenectomy was 6-7 years. Statistical analysis showed significant decreased of mean blood transfusion volume from 4691.4 cc per year to 3764.2 cc per year (p = 0.048), decreased mean blood transfusion volume from 219.6 cc per Kg Body Weight (BW) per year to 125.5 cc per Kg BW per year (p<0.001) and decreased of blood transfusion frequency from 12-14 times per year to 6-8 times per year (p<0.001). There is only one case subcutaneous emphysema as complication after splenectomy.Conclusion: Overall, this study showed total splenectomy improve the outcome of thalassemia with hypersplenism with low rate of complication.
Background: One-stage pull-through operation has become increasingly popular for the treatment of Hirschsprung's disease. The advantages of total transanal pull-through include minimal resection of the dilated ganglionic part of the colon, shorter hospital stay, decreased total cost, lower risk of adhesive intestinal obstruction.Methods: A retrospective study of patients with HD underwent transanal endorectal pull-through (TERPT) procedure treated at Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia between January 2010 – December 2013. We assessed patients characteristic, outcome and complication including Hirsch sprung associated enterocolitis (HAEC).Results: A total 77 patients were included in this study. The mean age was 13.01 months (range from 11 days – 8 years old). Most of the patients (55.8%) were male and female (44.2%). Clinical classification of HD: short segment 74 patients (96.1%) and ultra-short segment 3 patients (3.9%). The mean of bowel resection length in TERPT procedure was 18.64 cm (range from 7–25 cm). There is no mortality associated with TERPT procedure. Hirsch sprung associated enterocolitis (HAEC) occurred in 43 subjects (54.5%). Statistical analysis showed the significant relation between age at surgery and HAEC (p= 0.000) and no significant relationship between gender (p=0.425) and bowel resection length (p=0.780) with HAEC.Conclusions: Transanal endorectal pull-through procedure has been shown as an effective minimally invasive treatment in resolving obstructive symptoms in ultra–short segment of HD patients. The number of HAEC incidence among HD patients underwent TERPT significantly increased with older age of children.
Femoral neck fracture is an intracapsular hip fracture. Hemiarthroplasty is one of the treatment options that replaces femoral aspect of hip joint with a prosthesis, while leaving the acetabulum intact. The treatment’s goal is to return the patient to premorbid capacity. Harris Hip Score (HHS) is an assessment for the outcome of hip surgery which contains: pain, functional capacity, deformity and range of motion (ROM). The purpose of study is to determine relation of BMI and Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty. This study is analytic-observational study with cross-sectional design conducted in June-September 2014 in Orthopedic’s Polyclinic of General Hospital dr. Zainoel Abidin Banda Aceh. Respondents in this study is 26. Comparative assessment of outcome was analysed by Kruskal-Wallis test with Mann-Whitney test as Post-hoc analysis and correlative assessment was analysed by Spearman test. Comparative assessment present significant relation of BMI (p = 0,006; r=0.458) with Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty.
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