Sriwijaya Journal of Surgery

Analysis of Morphometric Variations in the Thickness of the Mandibular Symphysis in Patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia

Mufida Muzakkie — 2024-01-27

Introduction. Accurate knowledge of mandibular thickness is necessary for performing surgical treatments on the mandible. The Champy procedure has become the predominant approach for treating fractures of the mandible. Placing plates along these lines is believed to offer the best possible fixing and stability. The objective of this study is to analyze and compare the thickness of the mandible in patients, specifically depending on their gender. The purpose is to gain a more comprehensive understanding of the differences in mandibular architecture across various populations in South Sumatra, Indonesia.

Methods. This study is a cross-sectional analytical-observational study. The Department of Radiology of Dr. Mohammad Hoesin Central General Hospital, located in Palembang, conducted the study. We included a total of 103 research participants in this study, all of whom met the specified inclusion criteria.

Results. There is a notable difference in the thickness of the lower jawbone in the front part (A and B) that runs parallel to Champy's line, depending on the person's gender. Males have a greater morphometric thickness of the mandibular symphysis in comparison to females. The thickness of the mandibular symphysis closely links to gender disparities.

Conclusion. The thickness of symphysis A in men was substantially greater than in females, while the thickness of symphysis B in males was also significantly greater than in females, with a P value less than 0.001.

Sensitivity and Specificity of Pleural Fluid Cytology to Histopathology Examination in Lung Tumor Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Didy Kurniawan — 2024-01-30

Introduction. Lung tumors are pathological growths in the lung that are strongly associated with lung cancer. In 2018, lung cancer, a form of lung tumor, had the greatest occurrence among all types of cancer. It accounted for 2,093,876 new cases, which represented 11.6% of all cancer cases. The objective of this study was to assess the sensitivity and specificity of pleural effusion cytology testing compared to histopathological examination in patients with lung malignancies at Dr. Mohammad Hoesin General Hospital in Palembang, Indonesia.

Methods. This study was a retrospective analytical-observational study. This study encompassed a cohort of 35 patients who fulfilled the specified inclusion criteria. We used the SPSS version 22.0 for Windows application to perform bivariate analysis in data processing and analysis.

Results. The study yielded a sensitivity score of 13.63%, indicating the pleural fluid cytology method's accuracy in detecting lung cancer in individuals with low values. This study demonstrates a specificity value of 100%, indicating the frequency at which the pleural fluid cytology approach accurately identifies cancer.

Conclusion. The use of cytology as a screening tool for identifying lung tumor illnesses is limited, although it demonstrates a high level of specificity in ruling out healthy individuals.

Comparative Test of Reconstruction with the Modified Arthrodesis Metallic and Cement (MAMC) Technique and the Juvara Technique in Resisting Axial Compression After Distal Femur Resection

Randy Rakhmat Septiandani — 2024-02-09

Background: Limb salvage surgery (LSS) is a crucial treatment for malignancies, which mostly affects the distal femur and proximal tibia. LSS encompasses biological and non-biological reconstructions, including megaprosthesis. However, limited access to megaprosthesis in developing countries has led to alternative methods like arthrodesis such as modified arthrodesis with metal and cement (MAMC). LSS may lead to complications, requiring careful technique and implant selection but none of them conduct research about mechanical test. This research was comparing the effectiveness of techniques like MAMC with Juvara, in mechanical axial loading perspective.

Methods: In this true experimental study, conducted at the Metallurgy Laboratory of the Faculty of Engineering, Universitas Sriwijaya, femur and tibia bones from cattle were used. Five samples of each variable were used based on the purposive sampling method. The research focused on variables like deformity angle and yield point which assessed using X ray. Bone constructs underwent various fixation techniques, including MAMC and Juvara. Testing involved axial pressure on the femur head using a mechanical press machine. Statistical analysis compared implant angulation after compression between Juvara and MAMC techniques under 30 kg and 60 kg loads, ultimately measuring the yield point.

Results: All five samples from each group, subjected to both 30kg and 60kg pressure, exhibited no discernible changes. The average yield point for the MAMC group was notably 160KgF higher than Juvara, with respective means of 296 and 126kgF (p>0.05). Further analysis employing an Independent T-test confirmed a significant disparity between the MAMC and Juvara techniques concerning the yield point with a p-value of <0.001.

Conclusion: Both the MAMC and Juvara techniques in this study effectively supported 30 and 60-kilogram loads, demonstrating their suitability for full weight-bearing compression, with MAMC exhibiting significantly greater compression resistance compared to Juvara (p = 0.001).

Relationship Between the Use of Topical Hypothermia with Ice Water to Postoperative Pulmonary Complications of Coronary Artery Bypass Graft

Sri Agustina — 2024-03-18

Introduction: Open heart surgery such as coronary artery bypass graft (CABG) is a heart surgery technique that uses a machine cardiopulmonary bypass (CPB) which can cause postoperative complications such as systemic inflammatory response syndrome (SIRS) and myocardial damage. Myocardial protection can be achieved through topical hypothermia techniques by lowering the heart temperature using a cold solution or ice cubes. Although several studies have shown its benefit in protecting the myocardium, the use of topical hypothermia remains controversial due to its uneven cooling effect and risk of tissue injury. This study aims to evaluate the relationship between the use of topical hypothermia of ice water and pulmonary complications of open heart surgery.

Methods: This research is an analytical observational cohort retrospective comparison of pulmonary complications postoperatively in cardiac surgery patients who received systemic cardioplegia alone versus those who received a combination of systemic cardioplegia and topical hypothermia. Data collection was carried out using techniques consecutive sampling.

Results: Of the 32 research subjects, the results of the analysis showed that the use of topical hypothermia did not have a statistically significant relationship (p>0.05) on the incidence of leukocytosis, pulmonary edema, duration of surgery, duration of ventilator use, duration of hospitalization, and mortality compared to the group that only received systemic cardioplegia. There was a significant relationship (p<0.05) between the incidence of pleural effusion in the topical hypothermia group.

Conclusion: The use of topical hypothermia in cardiac surgery has a significant association with a higher incidence of pleural effusion.

Analysis of Clinical Skill Performance During Medical Internship at Department of Surgery, Debre Tabor University, Ethiopia

Yalew Hasen — 2024-03-21

Introduction: Direct observation of procedural skill (DOPS) is a method of assessing a trainee's performance in a work setting. It involves a supervisor monitoring the trainee while they carry out a procedural skill using a structured checklist. This study aimed to investigate the perceptions and levels of satisfaction among medical interns and their assessors during their surgical clinical attachments at the Department of Surgery, Debre Tabor University, Ethiopia.

Methods: The research was based on the steps of an action research project. The test includes basic surgery procedures like securing a peripheral IV line and drawing blood for testing, as well as skills like suturing and knot tying, putting in a nasogastric tube (NGT), and putting in a trans-urethral urinary catheter. The data gathering instruments used were self-administered, semi-structured questionnaires for both interns and their evaluators. After the implementation of the DOPS interventions, the questionnaire was distributed to both students and instructors. The data were analyzed using SPSS version 26.0 software, calculating frequency and percentage values for comparison.

Results: Most of participants believe that DOPS has the potential to enhance the objectivity of assessing students' skills. The majority of participants strongly agreed that DOPS enhances the relationship between students and teachers, provides valuable feedback to medical interns, should continue in other departments in the future, and is an effective teaching and learning tool. The DOPS performance showed a significant improvement between the first and second assessments in all four procedures.

Conclusion: DOPS can serve as a standard tool for assessing fundamental practical abilities in the surgical fields. Given that action research involves a paradigm shift and necessitates ongoing reflection and improvement, it is advisable to conduct additional studies to evaluate the performance of interns in all other departments.