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"ABSTRAKLatar belakang : Beberapa tahun belakangan, penanganan luka dengan madutelah banyak diterapkan oleh para praktisi klinis diseluruh dunia. Namun sampaisekarang, belum ada prosedur standar tentang bagaimana aplikasi madu pada luka.Di divisi Bedah Plastik RSCM, madu diaplikasikan pada luka dengan frekuensisatu kali perhari, dan secara observasional hasilnya memuaskan. Namunbagaimana jika madu diaplikasikan setiap dua hari? Apakah hasilnya akan lebihmemuaskan? Kami ingin mencari metode mana yang akan memberikan hasil yangpaling memuaskan dan nantinya akan dijadikan standar aplikasi madu di divisikami.Metodologi: Penelitian ini bersifat prospektif eksperimental, dilakukan di RSCMpada bulan Juli – September 2012. Melibatkan 14 pasien dengan luka partialthickness akut yang akan diwakili oleh luka donor STSG. Jumlah sampel inidiyakini cukup untuk keakuratan penelitian ini. Pasien dibagi dalam 2 kelompok,kelompok kontrol akan diberikan aplikasi madu pada luka tiap hari dan kelompokperlakuan akan diberikan aplikasi madu tiap dua hari. Laju penyembuhan lukaakan dinilai sebagai persentase reduksi area yang belum terjadi epitelialisasi padahari ketujuh. Area yang telah epitelialisasi dan yang belum akan ditentukanmenggunakan program AnalyzingDigitalImages®. Data yang didapatkan akandianalisa secara statistik menggunakan SPSS versi 17. Data akan dibandingkanmenggunakan Wilcoxon signed rank test dimana p<0,05 secara statistik akandianggap terdapat perbedaan yang bermakna.Hasil : Rerata persentase reduksi area non epitelialisasi pada kelompok perlakuanadalah 86,76%, sedangkan rerata persentase reduksi area non epitelialisasi padakelompok kontrol adalah 97,97%. Dari analisa statistik didapatkan perbedaanpersentase reduksi yang bermakna antara kelompok perlakuan dan kelompokkontrol (p 0,00)Kesimpulan: Rerata persentase reduksi area non epitelialisasi pada luka denganpenggantian balutan madu tiap hari dan tiap 2 hari, berdasarkan uji statistikdidapatkan berbeda secara bermakna. Namun dalam 2 hari, meskipun efektifitasmadu sudah berkurang, madu masih dapat memberikan hasil yang baik.Penemuan ini akan berguna untuk pasien dengan luka partial thickness dimanapenggantian balutan madu tiap hari tidak dapat/sukar dilakukan.

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ABSTRACTBackgrounds: In the past few years, clinicians worldwide have been using honeyfor wound treatment. But until now, there was no such standard on method ofhoney application on wound. In our center, honey was applied on wound by oncea day application and the result was observationally satisfactory. What ifapplication of honey were done once every two days? Would the result becomemore satisfactory? This study aims to search honey application method, whichgives the best result on wound treatment.Methods: This is a single-blinded non-randomized clinical trial, which wasconducted in Cipto Mangunkusumo Hospital Jakarta from July until September2012. 14 patients with acute partial thickness wound resulted from STSGharvesting were involved in this study. Patients were divided into 2 groups:control (once a day application of honey) and treatment (once every two daysapplication of honey) and the rate of wound healing were evaluated. Rate ofwound healing will be assessed as number of percentage of reduced nonepithelializedareas on the seventh day of application.Results: The mean percentage of non-epithelialized area reduction on treatmentgroup was 86.76%, and 97,97% on control group. There was significantdifference on percentage of reduced area between control and treatment group (p<0,00).Conclusion: There was statistically significant difference between once a day andonce every two days application of honey. However, changing of honey dressingonce a day is still a preferable method in wound treatment"

"This practical reference is a comprehensive guide to the anesthetic and perioperative management of patients before and during all procedures performed by general and subspecialist surgeons requiring anesthetic management. The book explains each procedure from both the surgeon and anesthesiologist perspectives, presents details on anesthetic technique, and guides the anesthesiologist and surgeon through the decisions that must be made before, during, and after surgery. Emphasis is on factors that impact the anesthesiologist, including patient positioning, duration of surgery, and complications."

" We have entered a new era of surgery in which minimally invasive surgery, robotic surgery, and the use of computers and genomic information have improved the outcomes and quality of life for patients. With these advances in mind, all chapters have been updated with an emphasis on evidence-based, state-of-the-art surgical care. An exciting new chapter, "Fundamental Principles of Leadership Training in Surgery," expands the scope of the book beyond the operating room to encompass the actual development of surgeons. This edition is also enriched by an increased number of international chapter authors and a new chapter on Global Surgery. More than ever, Schwartz's Principles of Surgery is international in scope--a compendium of the knowledge and technique of the world's leading surgeons."

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"Pendahuluan: Cidera ginjal akut akibat kontras radiografi yang sering disebut sebagai Contrast-induced nephropathy (CIN) telah menjadi sumber morbiditas dan mortalitas di rumah sakit dengan terus meningkatnya penggunaan media kontras iodinasi dalam pencitraan diagnostik dan prosedur intervensi seperti angiografi pada pasien berisiko tinggi (mencapai 50%) pada 10 sampai 15 tahun terakhir. Terjadi dapat dalam 2 sampai 5 hari setelah tindakan. Metodologi: Sebanyak 101 pasien elektif untuk tindakan kateterisasi jantung diambil dalam studi eksperimental ini dengan metode consecutive sampling, mulai bulan Agustus hingga November 2013. Sampel penelitian dibagi menjadi dua kelompok metode hidrasi yaitu metode hidrasi LVEDP dan metode hidrasi standar. Diagnosis cidera ginjal akut akibat kontras ditegakkan berdasarkan kenaikan kadar serum kreatinin sebesar 0.5 mg/dL atau 25% dalam 3 hari setelah tindakan. Hasil: Dalam studi kami, terdapat 5 orang mengalami cidera ginjal akut akibat kontras, 3 orang (5.7%) dari metode hidrasi LVEDP dan 2 orang (4.2%) dari metode hidrasi standar. Secara statistik angka kejadian cidera ginjal akut pada dua kelompok tidak berbeda bermakna dengan nilai p=0.731. Setelah melalui uji regresi multivariat terhadap variabel-variabel yang dapat mempengaruhi didapatkan nilai odds rasio metode hidrasi LVEDP sebesar 3.6 (95% CI 0.4 - 31.3) terhadap metode hidrasi standar. Kesimpulan: Angka kejadian cidera ginjal akut akibat kontras radiografi antara metode LVEDP dan metode standar tidak berbeda bermakna secara statistik tetapi tampaknya metode LVEDP memiliki kecenderungan meningkatkan risiko untuk terjadi cidera ginjal akut sebesar 3.6 kali dibandingkan dengan metode standar yang digunakan di Rumah Sakit Pusat Jantung Nasional Harapan Kita.

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Background: Contrast Induced Nephropathy (CIN) remains a major problem because of the use of iodinated contrast media in heart catheterization is increasing. Incidence of CIN among high-risk patients is up to 50%. Intravenous hydration with normal saline before and after cardiac catheterization is the most effective methods to prevent this problem, but the hydration rate, duration and total hydration amount is still a question. By using Left Ventricular End Diastolic Pressure (LVEDP) data, we could adjust the hydration according to the needs of each patient.

Methods: A total of 101 high-risk patients (estimated Glomerular Filtration Rate by Cockroft-Gault <60mL/min/1.73m2) who undergoes elective heart catheterization were included in this study from August to November 2013 at the Cardiovascular Hospital Harapan Kita Jakarta. Samples were divided into two groups of hydration methods (standard and LVEDP based) by consecutive sampling methods. CIN is diagnosed by absolute rise of > 0.5% mg/dL or 25% increase of serum creatinine from baseline within 3 days after procedures.

Results: There were total of 5 patients who experienced CIN, 3 (5.7%) patients from LVEDP hydration method and 2 (4.2%) patients from standard hydration method. Statistically, the incidence of CIN between two groups was not significant with p=0.731. After a multivariate regression analysis, the odd ratio of LVEDP hydration method is 3.6 (95% confident interval of 0.4 - 31.3).

Conclusion: There is no statistically significant difference incidence of CIN between LVEDP hydration method and standard hydration methods, but LVEDP hydration method seems tend to increase the risk of CIN."