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"ABSTRAK Mucoceles are considered to be the most common oral lesion, with an approximate prevalence of around 2.4 cases per 1,000 people. The exact prevalence in children is not reported, but they are thought to occur more frequently in younger individuals when compared to adults. The age old treatment for mucocele involves surgical excision, which is associated with mental trauma and discomfort to the patient. Other treatment options that can be considered include cryosurgery, CO2 laser ablation, micro marsupialization, intralesional corticosteroid injection, marsupialization and electrocautery. Cryosurgery is the procedure where there is deliberate destruction of tissue by freezing, using liquid nitrogen. This treatment is well received by patients, as minimal or no local anesthesia is used, relative lack of discomfort, no bleeding and minimal to no scarring after healing. This paper discuses two cases of oral mucocele treated via surgical excision and cryosurgery."

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"Latar Belakang: Luka bakar merupakan suatu cedera berat yang memerlukan tata laksana khusus multidisiplin. Untuk mengukur kinerja dari pelayanan luka bakar dibutuhkan luaran yang terstandardisasi untuk memungkinkan perbandingan dan penentuan efek dari tata laksana tersebut. Penulis ingin mengevaluasi efek dari eksisi dini sebagai tata laksana awal pada kondisi sumber daya yang terbatas menggunakan LA50 sebagai luaran.Metode: Sebuah studi kohort retrospektif terhadap pasien luka bakar akut dilakukan dari bulan Januari 2013 hingga Desember 2018 untuk menentukan luaran dari pelayanan luka bakar yang mencakup mortalitas dan LA50 serta untuk membandingkan luaran dari eksisi dini (EEWG) sebagai tata laksana awal dibandingkan dengan eksisi dini dan tandur kulit (EESG) atau eksisi tertunda dan tandur kulit (DESG).Hasil: Terdapat 256 pasien yang memenuhi kriteria penelitian, mayoritas berada dalam kelompok usia 15-44 tahun dengan lebih dari setengah pasien memiliki luas luka bakar 20-50% TBSA dan median TBSA 26%. Angka mortalitas keseluruhan adalah 17.9% dengan peningkatan seiring usia dan TBSA. Peningkatan mortalitas yang signifikan didapatkan pada kelompok TBSA 40.5-50.0%, yang terus meningkat dan mencapai puncaknya pada TBSA 70% ke atas. Akibat keterbatasan sampel dan jumlah kematian, hanya kelompok usia 15-44 tahun dan 45-64 tahun yang dapat memberikan LA50, masing-masing sebesar 43% dan 45%. Angka LA50 keseluruhan adalah 49% terlepas dari adanya penurunan angka mortalitas. Data awal menunjukkan bahwa persentase tertinggi kematian didapatkan pada kelompok tanpa perlakuan, dengan tidak adanya pasien yang meninggal pada kelompok EESG dan DESG. Rasio odds pada kelompok EEWG adalah 2.11 (p-value 0.201, CI95% = 0.65-6.80) dibanding kelompok DEWG.Simpulan: Penggunaan luaran yang terstandardisasi berupa LA50 memberikan masukan yang lebih objektif dibanding angka mortalitas dan memungkinkan perbandingan internal dan eksternal di masa mendatang. Pembedahan pada pasien dengan TBSA 40- 50% perlu diprioritaskan untuk meningkatkan kesintasan. Pengembangan dari sumber daya untuk menutup defek perlu ditingkatkan untuk memungkinkan eksisi dini secara total. Sedikitnya jumlah pasien tindakan eksisi dini dan tandur kulit menunjukkan perlunya skrining dan triase yang lebih cermat untuk pasien yang membutuhkan tindakan tersebut. Diperlukan studi lebih lanjut dengan jumlah sampel yang lebih besar untuk menentukan efek dari eksisi dini tanpa tandur kulit sebagai tata laksana awal pada pusat pelayanan dengan sumber daya terbatas.

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Background: Burn is a highly debilitating injury requiring a specialized and multidisciplinary care. Measuring the outcome of burn care demands a standardized outcome to enable comparison and determine impact of treatment. In a limited resource setting, the author sought to evaluate the effect of early excision as a preliminary treatment using LA50 as an outcome measurement.

Methods: A retrospective cohort study of acute burn patients was conducted from January 2013 to December 2018 to establish outcomes of burn care including mortality and LA50 and to compare the outcomes between treatment groups undergoing early excision without skin graft (EEWG), early excision and skin graft (EESG), and delayed excision and skin graft (DESG).

Results: Out of 390 patients available for screening, 256 were eligible for further study. Most patients were within age group 15-44 years and almost half were within 20-50% TBSA with median TBSA percentage of 26%. The overall mortality was 17.9% with an increase linear with age and TBSA. A significant mortality increase was observed from 40.5-50.0% TBSA group, which reached a plateau from TBSA 70% and up. Due to limited sample size and patient deaths, only age groups 15-44 years and 45-64 years could provide individual LA50 at 43% and 45%, respectively. The overall LA50 was identified at 49% despite lower mortality compared to a previously published number. Preliminary data showed that the highest percentage of deaths was seen in no treatment group, with no deaths seen in treatment groups EESG and DESG. The odds ratio for mortality in EEWG group was 2.11 (p-value 0.201, CI95% = 0.65-6.80) compared to DEWG group.

Conclusion: The use of a standardized outcome in the form of LA50 provides a more objective insight compared to crude mortality and enables future internal and external comparison. Surgery for patient with 40-50% TBSA should be prioritized to increase survival, and development of resources for defect closure should be encouraged to enable total early excision. The small number of patients undergoing early excision and skin grafting calls for a more attentive screening to triage and select candidates who may benefit from this procedure. Further study with bigger sample size is required to examine the effect of early excision without skin grafting as a preliminary procedure in a limited resource setting."

"ABSTRAKPendahuluan. Tumor Ganas Jaringan Lunak Soft Tissue Sarcoma merupakan kelompok heterogen tumor ganas mesenkim dengan jumlah kasus yang sangat sedikit dengan gejala klinis sulit dibedakan dengan tumor jinak, menjadikan tumor ini sering ditangani tanpa mengetahui batas tumor yang jelas unplanned excision . Penanganan tumor ganas jaringan lunak secara inadekuat ini mengakibatkan tumor masih tersisa sehingga beresiko terjadi rekurensi dan mortalitas. Penelitian ini bertujuan untuk mengetahui rekurensi dan mortalitas pasien tumor ganas jaringan lunak ekstremitas yang telah dilakukan unplanned excision, serta faktor-faktor yang memengaruhinya.Metode Penelitian. Penelitian ini merupakan penelitian deskriptif analitik dengan rancangan kohort retrospektif yang menggunakan data pasien RS Cipto Mangunkusumo tahun 2005 hingga 2015. Pada penelitian ini, didapati yang memenuhi kriteria sebanyak 87 subjek, yakni pasien unplanned excision tumor ganas jaringan lunak ekstremitas yang dilakukan analisis angka rekurensi dan mortalitas serta faktor-faktor yang berhubungan dengan rekurensi dan mortalitas tersebut.Hasil Penelitian. Terdapat hubungan yang bermakna antara tingkat rekurensi dengan operator yang tidak berkompeten non orthopaedi onkologi p0,05 . Tidak terdapat hubungan yang bermakna secara statistik antara mortalitas dengan operator pembedahan, lokasi tumor, ukuran awal tumor dan tipe rumah sakit P>0,05 .Kesimpulan. Faktor yang memengaruhi rekurensi pada pasien unplanned excision tumor ganas jaringan lunak yakni operator non orthopaedi onkologi.

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ABSTRACTIntroduction. Soft tissue sarcoma is part of mesenchymal malignant tumor heterogeneous group with very little number of cases. Unplanned excision often become the choice of treatment due to difficulties to differentiate it with benign tumor. The inadequate treatment of this soft tissue sarcoma often leave trace of the tumor, leading to recurrence and mortality. We studied the recurrence and mortality of patients with unplanned excision on soft tissue sarcoma of extrimities, including affecting factors.Methods. This is an analytical descriptive study with retrospective cohort design, using patient rsquo s data in Cipto Mangunkusumo hospital during 2005 to 2015. Our study acquired 87 subjects with unplanned excision on soft tissue sarcoma of extrimities. Analysis of recurrence rate, mortality rate, and related factores were examined and analysed.Results. There was significant relationship between recurrence rate with incompetent surgeon non oncology orthopaedics p0,05 . However, this study could not find statistical significance between mortality with non oncology orthopaedic surgeon, location of the tumour, initial size of the tumour, and hospital type P 0,05 .Conclusion. There is relationship between recurrence rate with non oncology orthopaedics operator. "

"Phleomorphic adenoma is the most commonly found tumor of the salivary glands. This tumor is usually found in the postero-lateral region of the hard palate. In this case, a phleomorphic adenoma tumor situated in the oropharynx region was reported. The CT-Scan results showed an expansive and infiltrative appearance, suspected to be a malignancy, where wide excision was previously planned to be carried out. During surgery, the mass was found pedunculated in the soft palate. It was then decided to perform an excision as the choice of therapy."

"[ABSTRAK Luka bakar menyebabkan terbentuknya eskar. Endotoksin bakteri pada eskar dan mediator inflamasi yang terbentuk saat lisis eskar menyebabkan sepsis. Eksisi tangensial dini merupakan upaya menurunkan risiko sepsis melalui pembuangan eskar. Prokalsitonin (PCT) adalah penanda inflamasi yang baik pada sepsis yang akan menurun kadarnya dengan tatalaksana yang adekuat.Sampai saat ini belum ada penelitian yang menghubungkan eksisi dini dengan PCT. Penelitian ini bertujuan untuk mengetahui pengaruh tindakan eksisi tangensial dini terhadap kadar PCT serum pasien luka bakar berat. Desain penelitian ini adalah analitik observasional pre and post intervention study. Besar sampel yang digunakan adalah empat puluh. Data PCT diambil dari data sekunder yaitu dari rekam medis kemudian dianalisis menggunakan uji Wilcoxon. Didapati perbedaan bermakna antara PCT sebelum operasi dengan PCT sesudah operasi (2,78 (0,09-50,62) vs 1,31 (0,02-83,14), p < 0,005).ABSTRACT Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).;Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005)., Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn’t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).]"