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"This well-established book on injury biomechanics has been extensively revised and expanded for this new edition. It now includes a fundamental treatment of the mechanics at a cellular level, written by the new coauthor Prof. Barclay Morrison III from Columbia University. Furthermore, considerably more attention is paid to computer modeling, and in particular modeling the human body.The book addresses a wide range of topics in injury biomechanics, including anatomy, injury classification, injury mechanisms, and injury criteria. Further, it provides essential information on regional injury reference values, or injury criteria, that are either currently in use or proposed by both US and European communities. Although the book is intended as an introduction for doctors and engineers who are newcomers to the field of injury biomechanics, sufficient references are provided for those who wish to conduct further research, and even established researchers will find it useful as a reference guide to the biomechanical background of each proposed injury mechanism and injury criterion."

"Summary:Assuming that some beginning students of biomechanics possess weak backgrounds in mathematics, this title includes numerous sample problems and applications, along with practical advice on approaching quantitative problems"

"Latar belakang: Dispareunia adalah nyeri pelvik yang muncul saat berhubungan seksual. Ruptur perineum derajat III dan IV dapat menyebabkan nyeri yang lebih berat dibandingkan serajat I dan II. Beberapa faktor yang mempengaruhi trauma sfingter ani obstetri adalah persalinan dengan bantuan alat, paritas, dan berat bayi lahir.Metode: Merupakan studi potong lintang yang menggunakan data sekunder dan wawancara subjek di RSUPN Cipto Mangunkusumo di tahun 2016-2020. Dilakukan evaluasi dispareunia dalam 12 minggu pasca persalinan per vaginam pada perempuan dengan trauma sfingter ani obstetrik.Hasil: Sebanyak 66 subjek memenuhi kriteria inklusi dan eksklusi. Sebanyak 89,4% subjek tidak mengalami dispareunia dalam waktu 12 minggu pasca persalinan per vaginam. Ada 7 subjek yang mengalami dispareunia dan sebanyak 2 subjek tergolong nyeri berat. Ruptur perineum derajat IV memiliki perbedaan yang signifikan terhadap kejadian dispareunia (p 0,001).Kesimpulan: Prevalensi dispareunia pada perempuan dengan trauma sfingter ani obstetric sebesar 10,6%. Terdapat perbedaan yang signifikan pada ruptur derajat IV terhadap kejadian dispareunia. Material benang dan teknik penjahitan, dan faktor-faktor eksternal maish harus dilakukan studi lanjut.

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Introduction: Dyspareunia is a pelvic pain occur during or after sexual intercourse. The incidence of dyspareunia from 1,2% to 56,1%. Third degree and fourth degree tear can cause deliberately much pain than first and second degree tear. Several factors caused obstetric anal sphincter injury after vaginal delivery such as assisted vaginal delivery using vacuum and forceps prolonged second stage of labor, parity, and baby birth weight.

Methods : This study design is cross sectional using secondary data (medical records) and subjects interview which evaluates the prevalence of dyspareunia in 12 weeks after vaginal delivery on women with obstetric anal sphincter injury. This study took place in Cipto Mangunkusumo Hospital ( 2016-2020).

Results : Sixty six subjects were enrolled into this study after met the criteria. The results were based on demographic, clinical characteristics, and bivariate analysis. Based on the dyspareunia, showed 89,4% subjects did not have dyspareunia in 12 weeks after vaginal delivery. Total 7 subjects suffered from dyspareunia.The study showed the degree of perineal rupture was significantly correlated with dyspareunia on subjects ( p 0,001).

Conclusion : The prevalence of dyspareunia on women with OASIs is 10,6%. There was statistically significant association between the degree of rupture and dyspareunia. Suturing material and technique, and wound healing factors are still need to be analysed more in the further study."

"Latar belakang: Trauma toraks memiliki spektrum klinis yang luas sehingga kemungkinan komplikasi dan lama rawat berbeda-beda. Lung Injury Score LIS dapat dipakai untuk menilai disfungsi respirasi yang terjadi sehingga dapat dijadikan prediksi mortalitas dan lama rawat. Metode: Penelitian dengan desain kohort retrospektif untuk menguji validitas LIS pada kasus trauma toraks baru le; 24 jam yang ditangani di RSCM pada periode Januari 2017 ndash; Maret 2018. Variabel-variabel LIS foto toraks, P/F rasio, PEEP, dan komplians paru dicatat dan dihitung skornya kemudian dihubungkan dengan luaran berupa mortalitas dan lama rawat, Pada uji statistik dihitung menggunakan Mann Whitney mortalitas dan Rank-Spearman Correlation lama rawat . Cut off point diukur menggunakan kurva ROC. Hasil: Didapatkan total 56 pasien yang memenuhi kriteria. Mortalitas pada 3 pasien. rata-rata LIS 1,52. Rata-rata lama rawat 10 hari. Tidak ada korelasi yang bermakna antara LIS dengan mortalitas p=0,52 , didapatkan korelasi yang bermakna antara LIS dengan lama rawat p < 0.001 . Dari kurva ROC, didapatkan cut off point LIS dengan mortalitas pada skor 2,25, namun tidak bermakna secara statistik, dan cut off point LIS terbaik untuk lama rawat 8 hari pada skor 1,25. Kesimpulan: LIS memiliki korelasi yang bermakna dengan lama rawat, namun tidak memiliki korelasi dengan mortalitas. LIS dapat digunakan untuk memprediksi lama rawat pada pasien yang tidak membutuhkan ventilator dengan Cut off point LIS terbaik pada skor 1,25 untuk lama rawat 8 hari.

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Introduction : Thoracic trauma has wide clinical spectrum, resulting in complications and different hospital length of stay. The Lung Injury Score LIS is assumed could be used for measuring degree of respiratory disfunction and degree of thoracic trauma and predicts mortality and length of stay.

Methods : Validity study was performed on 56 new trauma cases le; 24 jam treated in Cipto Mangunkusumo Hospital from January 2017 ndash; March 2018 with cohort retrospective design. LIS rsquo; variables was measured thoracic X-ray, P/F ratio, PEEP and lung compliance and converted into LIS then connected with hospital length of stay and mortality as the outcome. Statistical analysis using Mann Whitney Whitney mortality dan Rank-Spearman Correlation length of stay . Cut off point measured using ROC.

Results : We have 56 patients, with 3 mortality cases, average of LIS is 1,52, average of length of stay are10 days. There is no significant correlation between LIS and mortality p=0,52 , but LIS has significant correlation with length of stay p < 0.001 Cut off point LIS-mortality was at 2,25 and cut off point LIS-8 days length of stay was at 1,25.

Conclusions : LIS has significant correlation with length of stay but not with mortality. LIS could be used to predict hospital length of stay in thoracic trauma patients without ventilators with cut off point 1.25."

"Trauma Brain Injury (TBI) merupakan kondisi cedera pada otak yang terjadi ketika terjadi serangan fisik secara tiba-tiba dari kondisi eksternal. Kerusakan dapat bersifat focal (terbatas pada satu area otak) atau diffuse (terjadi di lebih dari satu area otak). Perubahan fisiologis pada pasien geriatri seperti penurunan fungsi ginjal, fungsi hati dan komposisi tubuh menyebabkan adanya perbedaan farmakokinetika dan farmakodinamika pada pasien geriatri. Dengan dilakukannya PTO diharapkan dapat mengoptimalkan efek terapi obat dan mencegah atau meminimalkan efek merugikan akibat penggunaan obat. Apoteker berperan penting dalam pelaksanaan PTO untuk mencegah terjadinya masalah terkait obat. Tujuan dalam penyusunan laporan tugas khusus ini adalah melakukan pemantauan terapi obat dan mengidentifikasi masalah terkait penggunaan obat pada pasien Ny. YS di lantai 6 Selatan Gedung Anggrek di Rumah Sakit Umum Pusat Fatmawati. Berdasarkan hasil kegiatan Pemantauan Terapi Obat pada pada pasien Ny. YS dengan Trauma Brain Injury di Gedung Teratai Lantai 6 Selatan RSUP Fatmawati dapat disimpulkan bahwa pengobatan yang diterima oleh pasien Ny. YS telah tepat indikasi dan tepat dosis. Penggunaan antibiotik seftriakson telah tepat sesuai dengan PPK KSM Bedah Saraf RSUP Fatmawati dengan diagnosis Trauma Brain Injury. Namun durasi penggunaannya terlalu lama yaitu 22 hari.

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Trauma Brain Injury (TBI) is a condition of injury to the brain that occurs when there is a sudden physical attack from external conditions. Damage can be focal (limited to one area of the brain) or diffuse (occurring in more than one area of the brain). Physiological changes in geriatric patients such as decreased kidney function, liver function and body composition lead to differences in pharmacokinetics and pharmacodynamics in geriatric patients. Drug Therapy Monitoring can optimize the effects of drug therapy and prevent or minimize adverse effects due to drug use. Apothecary play an important role in implementing Drug Therapy Monitoring to prevent drug-related problems. The purpose of preparing this special assignment report is to monitor drug therapy and identify problems related to drug use in Mrs. YS on the 6th floor South of the Orchid Building at Fatmawati General Hospital. Based on the results of monitoring drug therapy activities in patients Ny. YS with Trauma Brain Injury at Teratai Building South Floor 6 Fatmawati Hospital, it can be concluded that the treatment received by patient Ny. YS has the right indication and the right dose. The use of ceftriaxone antibiotics was appropriate according to PPK KSM Neurosurgery at Fatmawati Hospital with a diagnosis of Trauma Brain Injury. But the duration of use is too long (22 days).

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"Latar Belakang : International Olympic Committee (IOC) menganjurkan untuk melakukan monitoring kondisi kesehatan berkesinambungan namun belum tersedia self-reported tools yang dapat digunakan untuk monitoring di Indonesia. Penelitian ini bertujuan untuk mengembangkan Kuesioner OSTRC tentang cedera dan sakit ke dalam versi Bahasa Indonesia dan digunakan untuk monitoring kondisi kesehatan. Metode: Adaptasi dilakukan menurut kaidah ISPOR, dengan tahap uji validitas dan reliabilitas dilakukan kepada 40 atlet remaja selama 2 minggu, dan tahap surveilans yang dilakukan kepada 46 atlet remaja selama 8 minggu. Sensitivitas dan spesifisitas di hitung berdasarkan hasil surveilans 8 minggu. Hasil : Kuesioner OSLO versi Bahasa Indonesia (Sakit dan Cedera) memiliki validitas yang baik dengan Pearson Correlation Test (p<0.001). Cronbach-α mencapai 0,905, 0,940, 0,933 dan 0,840. Interclass corelation coefficient kuesioner sakit 0,905, kuesioner cedera bahu 0,94, kuesioner cedera lutut 0,933 dan kuesioner cedera pergelangan kaki 0,840. Sensitivitas kuesioner sakit mencapai 97,6% dan spesifisitas 99,4%, sedangkan sensitivitas kuesioner cedera mencapai 100% dan spesifisitas mencapai 99,4%. Kesimpulan: OSLO Sports Trauma Research Center Injury and Health Problem versi Bahasa Indonesia valid dan reliabel serta memiliki sensitivitas dan spesifisitas yang tinggi.

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Background: The International Olympic Committee (IOC) recommends continuous monitoring of health conditions, but until now, there are no self-reported tools that can be used for monitoring in Indonesia. This research aims to develop the OSTRC Questionnaire into Bahasa version and use it to monitor athlete conditions. Method: Adaptation was carried out according to ISPOR rules, with the validity and reliability testing, and the surveillance stage carried out for 8 weeks. Sensitivity and specificity were calculated based on the results of 8 weeks of surveillance. Results: The Indonesian version of the OSLO Questionnaire (Pain and Injury) has good validity with the Pearson Correlation Test (p<0.001), with cronbach-α reached 0.905, 0.940, 0.933 and 0.840. The interclass correlation coefficient for the pain questionnaire was 0.905, the shoulder injury questionnaire was 0.94, the knee injury questionnaire was 0.933 and the ankle injury questionnaire was 0.840. The sensitivity of the pain questionnaire reached 97.6% and specificity 99.4%, while the sensitivity of the injury questionnaire reached 100% and specificity reached 99.4%. Conclusion: The Indonesian version of OSLO Sports Trauma Research Center Injury and Health Problems is valid and reliable and has high sensitivity and specificity."

"[Pendahuluan: Trauma akibat benda tumpul pada kepala adalah salah satu traumayang dapat bersifat fatal, berkaitan dengan organ intrakranial yang bersifat vitalbagi kehidupan. Namun, luka kekerasan tumpul pada kepala tidak seluruhnya dapatmenyebabkan kerusakan organ intrakranial, berkaitan dengan berbagai faktor yangmenyebabkan luka, antara lain lokasi, besar gaya, arah gaya. Pada penelitian iniakan dilihat hubungan antara luka kekerasan tumpul dengan adanya kerusakan otak.Penelitian epidemiologi forensik ini digunakan untuk menunjang opini ahli dokterforensik pada temuan luka akibat kekerasan tumpul di kepala dengan kerusakanorgan intrakranial. Metode: Penelitian ini merupakan penelitian cross-sectionaldengan data sekunder yang berasal dari visum et repertum pasien di DepartemenForensik dan Medikolegal FKUI-RSCM. Hasil: Sebanyak 1% hubungan antaramemar pada kepala memiliki hubungan yang bermakna dengan kerusakan otak, 1%hubungan antara ekskoriasi pada kepala memiliki hubungan yang bermakna dengankerusakan otak, sebanyak 82% hubungan antara laserasi pada kepala memilikihubungan yang bermakna dengan kerusakan otak, dan sebanyak 95,3% hubunganantara fraktur pada kepala memiliki hubungan yang bermakna dengan kerusakanotak. Diskusi: Hasil penelitian menunjukkan bahwa terdapat variasi hubunganantara luka kekerasan tumpul dengan adanya kerusakan otak berdasarkan jenis sertalokasi luka luar dan lokasi kerusakan intrakranialnya. Variasi hasil ini terjadi karenaluka kekerasan tumpul, yaitu memar, ekskoriasi, laserasi, dan fraktur, masingmasingmemiliki mekanisme yang berbeda, dan timbul akibat besar gaya yangberbeda. Memar dan ekskoriasi, luka kekerasan tumpul yang disebabkan oleh gayayang kecil dan menyebabkan diskontinuitas jaringan luar hanya sedikit hanyamemiliki sedikit hubungan dengan kerusakan otak. Laserasi dan fraktur memilikibanyak hubungan dengan kerusakan otak oleh karena gaya penyebab lukakekerasan tumpul tersebut bersifat lebih besar, Introduction: Blunt head trauma had a high fatality rate, as the head protectsintracranial organs that are vital to the continuity of life. However, not all blunthead trauma cause the same damage to intracranial organs, due to the variousfactors such as location, the strength of the force, and the direction from which thestriking force came. This forensic epidemiological study is designed to supportexpert opinions in forensic practice regarding the findings of blunt head trauma andintracranial organ damage. In this study, the correlation between blunt head traumaand traumatic brain injury were analyzed. Methods: This study is a cross-sectionalstudy with secondary data from patients’ visum et repertum in the Forensic andMedicolegal Department of Cipto Mangunkusumo General Hospital. Results:Results show that 1% of the correlations between bruise findings on the head hadsignificant association with traumatic brain injury, 1% of the correlations betweenexcoriation findings on the head had significant association with traumatic braininjury, 82% of the correlations between laceration findings on the head hadsignificant association with traumatic brain injury, and 95,3% of the correlationsbetween fracture findings on the skull had significant association with traumaticbrain injury. Discussion: This study showed that the relationship between blunthead injury with traumatic brain injury varied based on the location and type of theexternal injury and the location of the intracranial organ. This variation in resultshappened as external blunt head trauma such as bruise, excoriation, laceration, andfracture each had different mechanisms, and were caused by various force intensity.Bruising and excoriation, which were usually caused by smaller force and onlycaused little damage externally, were found to have little correlation with traumaticbrain injury findings. On the other hand, laceration and fracture were found to havemore correlation with traumatic brain injury findings, since both traumas wereusually caused by a greater force.]"

"Latar belakang: luka bakar berat dapat disertai dengan trauma inhalasi, yang akan memicu respons lokal dan sistemik, sehingga menyebabkan berbagai komplikasi, termasuk systemic inflammatory response syndrome (SIRS) dan sepsis. Berbagai kondisi ini menyebabkan hipermetabolime dan hiperkatabolisme, yang membutuhkan tatalaksana nutrisi adekuat untuk membantu proses penyembuhan pasien. Berbagai kelompok ahli telah memberikan rekomendasi tatalaksana nutrisi pada luka bakar berat dan sakit kritis. Namun, akibat keterbatasan sarana dan prasarana, tidak semua rekomendasi dapat dilaksanakan, sehingga tatalaksana nutrisi diberikan secara optimal. Metode: serial kasus ini terdiri atas empat pasien luka bakar berat, yang disebabkan oleh api, dan disertai trauma inhalasi, yang menyebabkan berbagai komplikasi, sepsis, multiple organ dysfunction syndrome (MODS) dan multiple organ failure (MOF). Tatalaksana nutrisi diberikan secara bertahap sesuai dengan keadaan pasien. Pemberian nutrisi diawali dengan nutrisi enteral dini (NED) dalam waktu 2448 jam setelah luka bakar, sebesar 10 kkal/kg BB, menggunakan drip intermiten. Selanjutnya, nutrisi diberikan sebesar 2025 kkal/kg BB pada fase akut dan 2530 kkal/kg BB/hari pada fase anabolik. Setelah pasien keluar dari intensive care unit (ICU), target kebutuhan energi menggunakan persamaan Xie, dengan protein 1,52,0 g/kg BB/hari, lemak 2530%, dan karbohidrat (KH) 5565%. Mikronutrien diberikan berupa multivitamin antioksidan, vitamin B, asam folat, dan vitamin D. Pasien dalam serial kasus ini juga mendapatkan nutrisi spesifik glutamin sebesar 0,3 g/kg BB/hari, selama 510 hari. Hasil: tiga pasien mengalami perbaikan klinis, kapasitas fungsional, dan laboratorium. Pasien selamat dan dipulangkan untuk rawat jalan. Masa rawat pasien yang selamat berturut-turut 33 hari, 70 hari, dan 43 hari. Seorang pasien mengalami perburukan dan MOF, hingga meninggal dunia setelah dirawat selama 23 hari di ICU. Kesimpulan: tatalaksana nutrisi optimal dapat menunjang penyembuhan luka serta menurunkan angka morbiditas dan mortalitas pasien luka bakar berat dengan trauma inhalasi dan sepsis.

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;Background: severe burn trauma combined with inhalation injury initiates local and systemic response, resulting in various complications such as systemic inflammatory response syndrome (SIRS) and sepsis. These conditions stimulate hypercatabolic process, leading to the increase of nutrition requirement. Adequate nutritional support is necessary in order to control both inflammatory and metabolic response, and also to improve healing process. To date, nutritional recommendations specific for severe burn trauma and critical illness have been established. However, many problems including patient?s condition and lack of resources exist, so optimal nutritional support that fits our settings was delivered. Method: this serial case focused on four severely burned patients caused by flame. Subjects with inhalation trauma and complications such as sepsis, multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF) were included in this study. Nutritional support was delivered according to clinical conditions, patient?s tolerance, and laboratory findings. Early enteral nutrition was initiated within 2448 hours post burns, starting from 10 kcal/kg BW/day with intermittent gravity drip method. Nutrition was gradually increased in order to reach the target of energy for critically ill patients, which is 2025 kcal/kg BW/day in acute phase or 2530 kcal/kg BW/day in anabolic recovery phase. Xie Equation was used to calculate target of total energy for burned patient. Protein requirement was 1.52.0 g/kg BW/day. Lipid and carbohydrate given were 2530% and 5565% from calorie intake, respectively. Micronutrient supplementation including antioxidants, vitamin B, folic acid, and vitamin D was also provided. Glutamin as specific nutrient was delivered by 0.3 g/kg BW/day in 510 days. Results: improvement of clinical condition, functional capacity, and laboratory parameters was observed in three patients, who could be discharged from hospital and asked to come back for outpatient care. Their lengths of stay were 33 days, 70 days, and 43 days, respectively. However, one patient experienced worsening of condition and died after 22 days of care in Intensive Care Unit (ICU). Conclusions: optimal nutritional support for severely burned patients with inhalation trauma and sepsis is necessary in order to improve healing process, as well as decrease morbidity and mortality."