About 70% of all nosocomial infections occur in surgical patients. In open fracture, there is contact with the environment or unsterilebody compartment, so that bacterial contamination may occur and cause infection. Besides debridement, prophylactic antibiotics havebeen used as a standard procedure in the open fracture management. This procedure may cause antibiotics resistance leading to increasethe number of infections. The aim of this retrospective study was to know the characteristics, microbial pattern, and sensitivity of 35cultures and sensitivity test of open fracture patients in Orthopaedics Department of Wahidin Sudirohusodo Hospital during the period ofJune 2009–June 2010. The most common bacteria found were Proteus mirabilis (26%), Klebsiella pneumonia (14. 8%), and Providenciaalcalifaciens (14%). The sensitivity test for antimicrobials showed that most of the 19 antimicrobials, were resistant. The sensitiveantimicrobial is Meropenem.
Acute appendicitis is one of the acute abdominal conditions encountered in almost all hospitals in Indonesia. Acute inflammation of the appendix requiring immediate surgery to prevent complications, so it should takes several particular checking’s to support the diagnosis quickly. These are leukocytes count, especially neutrophils and lymphocytes as the sensitive marker of the inflammatory process which belong to the simple laboratory examination and can be used as a diagnostic marker of acute appendicitis as well. The inflammatory immune response can be described of the percentage of neutrophils to the lymphocytes ratio in the circulation. A retrospective study was performed on patients whom suspected for acute appendicitis those undergoing appendectomy from January 2010−May 2011. The data were grouped according to post appendectomy diagnosis and the ratio of neutrophils/lymphocytes (NLR) compared with other parameter. The NLR in each group was compaed by one way ANOVA analyzing. A total of 59 patients were identified: 19 catarrhally, 19 phlegmonous, 10 gangrenous and 11 with perforation. Compared with other markers, NLR is much better in predicting acute appendicitis. NLR increased in all groups (mean>7), specifically on the perforated appendicitis that is greatly increased (mean=12.273). But this was not significantly different NLR from the group (p=0.098). Based on this study it can be concluded, that NLR is the better marker for diagnosis rather than leukocyte and USG. But unfortunately, it can not be used to differentiate the grading in acute appendicitis.
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