Karang Taruna Kelurahan Temas Kota Batu beranggotakan beberapa pemuda yang mempunyai latar belaka... more Karang Taruna Kelurahan Temas Kota Batu beranggotakan beberapa pemuda yang mempunyai latar belakang yang berbeda-beda. Permasalahan yang dihadapi Karang Taruna ini adalah banyak para pemuda Karang Taruna yang belum bekerja dan korban PHK akibat pandemi. Melihat hal tersebut, diperlukan kegiatan positif dalam rangka mengembangkan kemampuan pengetahuan maupun ketrampilan remaja karang taruna dalam rangka peningkatan kewirausahaan. Salah satu kegiatan yang dilakukan sebagai solusi permasalahan adalah pelatihan pengecatan rak bunga dengan menggunakan spray gun. Pengecatan dengan menggunakan spray gun adalah merupakan metode pengecatan yang dilakukan dengan menggunakan alat bantu kompresor udara bertekanan. Metode pengecatan ini memberikan hasil yang lebih bagus dibandingkan dengan hasil pengecatan menggunakan kuas. Tujuan dari kegiatan pelatihan ini adalah meningkatkan pengetahuan remaja karang taruna secara umum, menambah ketrampilan khusus berupa pengecatan rak bunga, meningkatkan kew...
Mobile Ad-Hoc Network (MANET) merupakan sebuah arsitektur jaringan nirkabel yang terdiri dari beb... more Mobile Ad-Hoc Network (MANET) merupakan sebuah arsitektur jaringan nirkabel yang terdiri dari beberapa perangkat mobile sebagai node yang tidak memiliki infrastruktur tertentu maupun access point terpusat seperti base station. MANET memiliki 3 jenis protokol routing yaitu protokol routing reaktif, protokol routing proaktif, dan protokol routing hybrid. Ad-Hoc On-demand Distance Vector (AODV) merupakan salah satu contoh protokol routing reaktif. MANET tidak terlepas dari berbagai macam serangan yang dapat menghancurkan, memodifikasi, dan menghapus data serta informasi di dalamnya. Salah satu contoh serangan pada jaringan MANET adalah wormhole attack. Wormhole Attack merupakan serangan yang melibatkan dua atau lebih node attacker yang terhubung dalam suatu tunnel yang memanipulasi jalur routing serta dapat melakukan packet drop maupun selective packet drop. Pengujian dilakukan menggunakan OMNET++ dengan skenario pengujian berupa variasi jumlah node, jumlah node attacker, dan mobilitas...
Jurnal Pengabdian Polinema Kepada Masyarakat, 2021
Dalam Tri Darma Perguruan Tinggi, Perguruan Tinggi mempunyai peran yang sangat penting, yaitu sal... more Dalam Tri Darma Perguruan Tinggi, Perguruan Tinggi mempunyai peran yang sangat penting, yaitu salah satunya adalah ikut dalam mencerdaskan kehidupan bangsa dan negara sencara nyata di masyarakat. Salah satu langkahnya adalah menjadikan manusia bukan lagi menjadi obyek pembangunan tetapi menjadi subyek pembangunan. Sebagai subyek pembangunan tentunya diperlukan kemampuan dan kecakapan dalam penguasaan ilmu pengetahuan dan teknologi.Pemanfaatan teknologi pengelasan telah berkembang dan banyak digunakan dan dimanfaatkan ditengah masyarakat luas, baik untuk skala industri rumah tangga maupun untuk perbaikan perbaikan peralatan dirumah. Salah satu metode pengelasan adalah pengelasan SMAW, yaitu pengelasan dengan menggunakan busur listrik.Tujuan dari kegiatan ini adalah meningkatkan pengetahuan secara umum remaja karang taruna kampung teh kelurahan Temas Kecamatan Batu kota Batu, menambah ketrampilan kusus berupa pengelasan SMAW dan memberikan dorongan dan bantuan sehingga karang taruna k...
Perguruan Tinggi mempunyai peran penting dalam Tri Darma, yaitu ikut dalam mencerdaskan kehidupan... more Perguruan Tinggi mempunyai peran penting dalam Tri Darma, yaitu ikut dalam mencerdaskan kehidupan bangsa dan negara sencara nyata di masyarakat. Salah satu langkahnya adalah menjadikan manusia bukan lagi menjadi obyek pembangunan tetapi menjadi subyek pembangunan. Sebagai subyek pembangunan tentunya diperlukan kemampuan dan kecakapan dalam penguasaan ilmu pengetahuan dan teknologi. Pemanfaatan teknologi pengelasan telah berkembang dan banyak digunakan dan dimanfaatkan ditengah masyarakat luas, baik untuk skala industri rumah tangga maupun untuk perbaikan perbaikan peralatan dirumah. Salah satu metode pengelasan adalah pengelasan SMAW, yaitu pengelasan dengan menggunakan busur listrik.Tujuan dari kegiatan ini adalah meningkatkan pengetahuan secara umum remaja karang taruna kelurahan Temas Kecamatan Batu kota Batu, menambah ketrampilan kusus berupa pengelasan SMAW dan memberikan dorongan dan bantuan sehingga karang taruna kampung teh mampu mengadakan peralatan las.Manfaat dari kegiat...
European Journal of Case Reports in Internal Medicine, 2022
Introduction: Lymphoplasmacytic lymphoma (LPL) is a rare low-grade B-cell neoplasm that accounts ... more Introduction: Lymphoplasmacytic lymphoma (LPL) is a rare low-grade B-cell neoplasm that accounts for approximately 2% of all haematological malignancies. Most patients have the clinical syndrome of Waldenstrom macroglobulinemia (WM), which is defined as LPL with an associated immunoglobulin M (IgM) serum monoclonal protein. Roughly 5% of LPL patients secrete non-IgM paraproteins (e.g., IgG, IgA, kappa, lambda) or are non-secretory. Case description: We report the case of a 41-year-old woman who was diagnosed with non-IgM LPL with lambda light chain monoclonal paraprotein production and normal serum immunoglobulin levels. The MYD88 L265P mutation was detected on fluorescence in-situ hybridization (FISH) analysis of the bone marrow. The patient underwent treatment with a combination of ibrutinib and rituximab. There was an initial response but she died 8 months after diagnosis.  Discussion: Non-IgM LPL poses diagnostic and therapeutic challenges to clinicians as it is an exceptional...
Introduction Biloma forms due to common bile duct (CBD) injury as a laparoscopic cholecystectomy ... more Introduction Biloma forms due to common bile duct (CBD) injury as a laparoscopic cholecystectomy complication. Spontaneous localized biloma forming cysts in the biliary duct is rare. Presentation of case We report a 47-year-old male with complaint of a painful lump in the upper abdomen two months after laparoscopic cholecystectomy. Magnetic resonance cholangiopancreatography (MRCP) found a large epigastric cyst mass, without any signs of CBD injury. Patient was managed with percutaneous drainage in the outpatient clinic and kept the contents of the drainage bag for evaluation. After two months follow-up the outcome was favorable. Discussion Biloma forming cysts is a very rare complication post laparoscopic cholecystectomy. Biloma most common occurs as free fluid in the abdominal cavity. Clinical diagnostics, intraoperative historical evaluation and support with MRCP may determine the treatment options. Decision to manage with non-operative procedures by percutaneous drainage and eva...
Perbincangan mengenai wilayah dan bahan kajian suatu penelitian tidak dapat dipisahkan dari panda... more Perbincangan mengenai wilayah dan bahan kajian suatu penelitian tidak dapat dipisahkan dari pandangan filsafat ilmu. Menurut filsafat, penelitian sebagai unsur dinamik ilmu bersandar pada 3 (tiga) pilar penyangga, yaitu ontologi, epistemologi, dan aksiologi. Ontologi merupakan asas penetapan objek dan wilayah kajian dan karenanya menjawab pertanyaan apa yang dikaji. Epistemologi merupakan asas penetapan bagaimana cara mempelajari atau memperolehnya, dan karenanya menjawab pertanyaan bagaimana mengkajinya. Pilihan metodologik penelitian, tentu saja tak dapat dipisahkan dari pandangan dan kaidah-kaidah epistemolotik ilmu. Aksiologi merupakan asas penetapan tujuan dan manfaat pengetahuan, dan karenanya menjawab pertanyaan apa tujuan dan manfaat pengetahuan yang akan dikaji tersebut. Apakah suatu topik penelitian dapat dikategorikan sebagai penelitian pembelajaran bahasa atau bukan, sudah barang tentu harus ditetapkan berdasarkan penjabaran ontologik atas cakupan makna pembelajaran baha...
Introduction Acute blunt traumatic diaphragmatic rupture (BTDR) caused by falling from a height i... more Introduction Acute blunt traumatic diaphragmatic rupture (BTDR) caused by falling from a height is rare. Transabdominal diaphragmatic repair in an acute setting following BTDR requires good clinical decision-making and diagnostic tests. Case presentation A 36-year-old male was involved in a work accident. He fell from a 30-m radio transmitter tower while wearing an attached safety body harness. He arrived in the emergency room with complaints of breathing difficulty, abdominal and pelvic pain. We discovered a diaphragmatic rupture with abdominal organ herniation based on the imaging. We decided to perform an emergency laparotomy. We discovered a 12cm diaphragmatic defect on the anteromedial side of the left during surgery. We carried out the evacuation by suction and controlled the bleeding in the wound at the edge of the diaphragm. On postoperative day 4 (POD), the patient complained of dyspnea, and chest radiology revealed a hemothorax in the left lung. We then installed a water-s...
Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be life... more Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be lifethreatening both for the mother and fetus. Surgical approach is recommended in this complicated disease to prevent morbidity and mortality. During COVID-19 pandemic, additional precautions are needed when dealing with abdominal complaints. Presentation of case: We present a 37-year-old female patient, pregnant at 22 weeks gestational age, who complained of fever, diffuse abdominal pain, and shortness of breath. Laboratory examination results revealed anemia, leukocytosis and an increase in amylase level. SARS-CoV-2 antibody is non-reactive. Imaging strongly suggested cholelithiasis and cholecystitis. The patient was given antibiotics for three days but there was no significant improvement. Open cholecystectomy with subcostal (Kocher) incision was performed. Patient was released from the hospital without post-operative complications. Discussion: Treatment of gallstone induced severe acute cholecystitis with acute pancreatitis during pregnancy is challenging with the surgical complications. In the second and third trimester of pregnancy, it is more difficult to perform laparoscopic cholecystectomy because of the size of uterus. Laparoscopic procedure is also not recommended in early Covid-19 pandemic period. Therefore, open cholecystectomy with Kocher incision becomes the surgery of choice to avoid preterm birth. Conclusions: Based on our case, open cholecystectomy with Kocher incision is a safe and effective procedure for pregnant patients with cholelithiasis, cholecystitis, and pancreatitis.
COVID-19 pandemic has made impact both in clinical and educational settings. The number of surger... more COVID-19 pandemic has made impact both in clinical and educational settings. The number of surgeries has decreased; thus, the surgery videos of all cases are important for both documentation and education. This study aimed to compare three kinds of cameras in recording digestive surgery. Methods: We compared three cameras: Panasonic HV-770 Full HD Camcorder, Sony FDR-X3000 Action-cam, and Ordro EP7 Hands-Free FPV Camera. Each camera was used in several recording for superficial and visceral digestive surgeries and we compared the following: operation field, image focus, surgeon's comfort, practicality, and record settings. Results: Camcorder needs 10-15 min to set up and longer dismounting time, has steady vantage view and focus, good image quality, can be zoomed, but the recording may be obstructed by the surgeon's head. Action camera needs 5-10 min to set up and the dismounting time was equal between Camcorder and Ordro. Action camera depicts surgeon's vision, however, zoom could not be applied while recording. Sony FDR-X3000 used in this study had good image quality, but the use of this camera in a long surgery may generate neck stiffness due to its weight. Ordro EP7 was comfortable in any surgery but it had inferior image quality compared to the others. Conclusions: Panasonic HC-V770 and Sony FDR X3000 had good image quality, where camcorder excelled in longer surgeries due to its comfort, action-cam excelled for shorter surgeries due to ease of use and settings. Ordro EP7 was the most comfortable among all but has lowest image quality.
International Journal of Surgery Case Reports, 2020
BACKGROUND: The COVID-19 pandemic has changed patient management in all sectors. All patients nee... more BACKGROUND: The COVID-19 pandemic has changed patient management in all sectors. All patients need to be examined for COVID-19, including in digestive surgery emergency cases. In this paper, we report four digestive surgery emergency cases with clinical and radiological findings similar to COVID-19. CASE PRESENTATION: We report four digestive surgery emergency cases admitted with fever and cough symptoms. Case 1 is a 75-year-old male with gastric perforation and pneumonia, case 2 is a 32-year-old female with intestinal and pulmonal tuberculosis, case 3 is a 30-year-old female with acute pancreatitis with pleuritis and pleural effusion, and the last case is a 56-year-old female with rectosigmoid cancer with pulmonal metastases. All the patients underwent emergency laparotomy, were hospitalized for therapy, and discharged from the hospital. After 1-month follow-up after surgery, 1 patient had no complaints, 2 patients had surgical site infection, and 1 patient died because of ARDS due to lung metastases. DISCUSSION: For all four cases, the surgeries were done with strict COVID-19 protocol which included patient screening, examination, laboratory assessment, rapid test screening, and RT-PCR testing. There were no intrahospital mortalities and all the patients were discharged from the hospital. Three patients were followed-up and recovered well with 2 patients having surgical site infection which recovered within a week. However, 1 patient did not show up for the scheduled follow-up and was reported dead 2 weeks after surgery because of ARDS due to lung metastases. CONCLUSIONS: Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.
International Journal of Surgery Case Reports, 2020
INTRODUCTION: Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital... more INTRODUCTION: Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital intestinal motility disorder and characterized by the absence of ganglion cells (aganglionosis) in the myenteric plexus and submucosa of the distal intestine. PRESENTATION OF CASE: This study reports three cases of adult HSCR, with all young female patients who underwent colostomy for obstructive ileus. The chosen definitive therapies were Duhamel pull-through procedure combined with a temporary coloanal stump. DISCUSSION: The three patients underwent Duhamel pull-through procedure with temporary anal stump in conjunction with stoma reversal. The temporary anal stumps were removed within 1-2 weeks after pull-through procedure. All patients were discharged from the hospital and underwent routine followup. All patients had fecal incontinence in early follow-up which resolved shortly afterwards. Long term follow-up showed normal intestinal functions and good cosmetic results. CONCLUSIONS: The combination of Duhamel pull-through procedure with temporary coloanal stump in definitive therapy of adults with HSCR is a safe and effective technique.
Infection with SARS-CoV-2 (COVID-19) can cause prothrombotic complications. We aim to study the f... more Infection with SARS-CoV-2 (COVID-19) can cause prothrombotic complications. We aim to study the frequency of thrombotic complications and impact of anticoagulation on outcomes in hospitalized patients. We conducted a retrospective chart review of 921 consecutive patients admitted to our hospital with COVID-19. Patients were divided into four groups depending on whether they were on anticoagulation prior to admission, started anticoagulation during the admission, received prophylactic anticoagulation, or did not receive any anticoagulation. At the time of analysis, 325 patients (35.3%) had died, while 544 patients (59%) had been discharged resulting in inpatient mortality of 37.3%. Male sex, age > 65 years, and high D-dimer at admission were associated with higher mortality. Sixteen patients (1.7%) had venous thromboembolism confirmed with imaging, 11 patients had a stroke, and 2 patients developed limb ischemia. Treatment with therapeutic anticoagulation was associated with improved inpatient mortality compared with prophylactic anticoagulation alone (63% vs 86.2%, p < 0.0001) in patients requiring mechanical ventilation. Other outcomes such as rates of liberation from mechanical ventilation and duration of mechanical ventilation were not significantly impacted by the type of anticoagulation.
Background: The spectrum of FL varies from an indolent disease course spanning decades to early t... more Background: The spectrum of FL varies from an indolent disease course spanning decades to early transformation and death. Longitudinal studies have identified a subset of high risk patients (pts) who progress within 24 months of frontline therapy. It is still unclear how best to treat these patients and as yet, there is no standard 2nd line therapy for FL. Given the multitude of treatments available and the heterogenous disease course, it is challenging to compare outcomes of 2nd line therapy. It is unclear if the efficacy of second-line therapy in FL is influenced by the type of therapy, disease biology (early vs. late progression) or both. We conducted a single institute, retrospective study to determine the clinical benefit of 2nd line therapy in FL and to evaluate if any particular type of therapy was associated with improved outcomes in FL patients with early progression (EP). Methods: All patients with relapsed/refractory FL treated at our Institute between 1990 and 2014 were ...
S554 but it has not gained widespread acceptance.We compared the clinical effi cacy of EBL and Cl... more S554 but it has not gained widespread acceptance.We compared the clinical effi cacy of EBL and Clip in the treatment for colonic diverticular hemorrhage. Methods: Th is was a retrospective study of 48 hospitalized patients who identifi ed active bleeding from the colonic diverticulum or visible vessel in the colonic diverticulum under an endoscopy and endoscopic hemostasis was performed using EBL or Clip from October 2012 to October 2014. Location of hemorrhage, endoscopic fi ndings, diverticular inversion with EBL, number of Clip performed, blood transfusion volume, duration of hospitalization, disappearance of diverticulum, and rebleeding rate were assessed. Results: Th ere were 37 cases of EBL and 11 cases of Clip. Th e average age was EBL 71.3 years and Clip 68.1 years, and the gender (male/female) was EBL 31/6 and Clip 8/3. Th e location of hemorrhage,
The incidence of cardiovascular disease is increasing in young adults. We are reporting a case of... more The incidence of cardiovascular disease is increasing in young adults. We are reporting a case of acute stroke in a young patient with severe ischaemic cardiomyopathy in the absence of traditional risk factors. After ruling out atherosclerotic disease, his presentation was attributed to synthetic cannabinoid use. We then discussed the typical barriers in early diagnosis and limitations of laboratory testing in this condition. Due to the increase in abuse of these synthetic drugs among young adults, there is a need for high clinical suspicion which can help with early recognition and improve morbidity and mortality associated with these chemicals.
The performance of molybdenum carbide catalyst for partial oxidation of methane to syngas has bee... more The performance of molybdenum carbide catalyst for partial oxidation of methane to syngas has been evaluated in a micro-reactor under various conditions. The molybdenum carbide catalyst is stable in methane partial oxidation to syngas at high reaction temperatures, high ...
Karang Taruna Kelurahan Temas Kota Batu beranggotakan beberapa pemuda yang mempunyai latar belaka... more Karang Taruna Kelurahan Temas Kota Batu beranggotakan beberapa pemuda yang mempunyai latar belakang yang berbeda-beda. Permasalahan yang dihadapi Karang Taruna ini adalah banyak para pemuda Karang Taruna yang belum bekerja dan korban PHK akibat pandemi. Melihat hal tersebut, diperlukan kegiatan positif dalam rangka mengembangkan kemampuan pengetahuan maupun ketrampilan remaja karang taruna dalam rangka peningkatan kewirausahaan. Salah satu kegiatan yang dilakukan sebagai solusi permasalahan adalah pelatihan pengecatan rak bunga dengan menggunakan spray gun. Pengecatan dengan menggunakan spray gun adalah merupakan metode pengecatan yang dilakukan dengan menggunakan alat bantu kompresor udara bertekanan. Metode pengecatan ini memberikan hasil yang lebih bagus dibandingkan dengan hasil pengecatan menggunakan kuas. Tujuan dari kegiatan pelatihan ini adalah meningkatkan pengetahuan remaja karang taruna secara umum, menambah ketrampilan khusus berupa pengecatan rak bunga, meningkatkan kew...
Mobile Ad-Hoc Network (MANET) merupakan sebuah arsitektur jaringan nirkabel yang terdiri dari beb... more Mobile Ad-Hoc Network (MANET) merupakan sebuah arsitektur jaringan nirkabel yang terdiri dari beberapa perangkat mobile sebagai node yang tidak memiliki infrastruktur tertentu maupun access point terpusat seperti base station. MANET memiliki 3 jenis protokol routing yaitu protokol routing reaktif, protokol routing proaktif, dan protokol routing hybrid. Ad-Hoc On-demand Distance Vector (AODV) merupakan salah satu contoh protokol routing reaktif. MANET tidak terlepas dari berbagai macam serangan yang dapat menghancurkan, memodifikasi, dan menghapus data serta informasi di dalamnya. Salah satu contoh serangan pada jaringan MANET adalah wormhole attack. Wormhole Attack merupakan serangan yang melibatkan dua atau lebih node attacker yang terhubung dalam suatu tunnel yang memanipulasi jalur routing serta dapat melakukan packet drop maupun selective packet drop. Pengujian dilakukan menggunakan OMNET++ dengan skenario pengujian berupa variasi jumlah node, jumlah node attacker, dan mobilitas...
Jurnal Pengabdian Polinema Kepada Masyarakat, 2021
Dalam Tri Darma Perguruan Tinggi, Perguruan Tinggi mempunyai peran yang sangat penting, yaitu sal... more Dalam Tri Darma Perguruan Tinggi, Perguruan Tinggi mempunyai peran yang sangat penting, yaitu salah satunya adalah ikut dalam mencerdaskan kehidupan bangsa dan negara sencara nyata di masyarakat. Salah satu langkahnya adalah menjadikan manusia bukan lagi menjadi obyek pembangunan tetapi menjadi subyek pembangunan. Sebagai subyek pembangunan tentunya diperlukan kemampuan dan kecakapan dalam penguasaan ilmu pengetahuan dan teknologi.Pemanfaatan teknologi pengelasan telah berkembang dan banyak digunakan dan dimanfaatkan ditengah masyarakat luas, baik untuk skala industri rumah tangga maupun untuk perbaikan perbaikan peralatan dirumah. Salah satu metode pengelasan adalah pengelasan SMAW, yaitu pengelasan dengan menggunakan busur listrik.Tujuan dari kegiatan ini adalah meningkatkan pengetahuan secara umum remaja karang taruna kampung teh kelurahan Temas Kecamatan Batu kota Batu, menambah ketrampilan kusus berupa pengelasan SMAW dan memberikan dorongan dan bantuan sehingga karang taruna k...
Perguruan Tinggi mempunyai peran penting dalam Tri Darma, yaitu ikut dalam mencerdaskan kehidupan... more Perguruan Tinggi mempunyai peran penting dalam Tri Darma, yaitu ikut dalam mencerdaskan kehidupan bangsa dan negara sencara nyata di masyarakat. Salah satu langkahnya adalah menjadikan manusia bukan lagi menjadi obyek pembangunan tetapi menjadi subyek pembangunan. Sebagai subyek pembangunan tentunya diperlukan kemampuan dan kecakapan dalam penguasaan ilmu pengetahuan dan teknologi. Pemanfaatan teknologi pengelasan telah berkembang dan banyak digunakan dan dimanfaatkan ditengah masyarakat luas, baik untuk skala industri rumah tangga maupun untuk perbaikan perbaikan peralatan dirumah. Salah satu metode pengelasan adalah pengelasan SMAW, yaitu pengelasan dengan menggunakan busur listrik.Tujuan dari kegiatan ini adalah meningkatkan pengetahuan secara umum remaja karang taruna kelurahan Temas Kecamatan Batu kota Batu, menambah ketrampilan kusus berupa pengelasan SMAW dan memberikan dorongan dan bantuan sehingga karang taruna kampung teh mampu mengadakan peralatan las.Manfaat dari kegiat...
European Journal of Case Reports in Internal Medicine, 2022
Introduction: Lymphoplasmacytic lymphoma (LPL) is a rare low-grade B-cell neoplasm that accounts ... more Introduction: Lymphoplasmacytic lymphoma (LPL) is a rare low-grade B-cell neoplasm that accounts for approximately 2% of all haematological malignancies. Most patients have the clinical syndrome of Waldenstrom macroglobulinemia (WM), which is defined as LPL with an associated immunoglobulin M (IgM) serum monoclonal protein. Roughly 5% of LPL patients secrete non-IgM paraproteins (e.g., IgG, IgA, kappa, lambda) or are non-secretory. Case description: We report the case of a 41-year-old woman who was diagnosed with non-IgM LPL with lambda light chain monoclonal paraprotein production and normal serum immunoglobulin levels. The MYD88 L265P mutation was detected on fluorescence in-situ hybridization (FISH) analysis of the bone marrow. The patient underwent treatment with a combination of ibrutinib and rituximab. There was an initial response but she died 8 months after diagnosis.  Discussion: Non-IgM LPL poses diagnostic and therapeutic challenges to clinicians as it is an exceptional...
Introduction Biloma forms due to common bile duct (CBD) injury as a laparoscopic cholecystectomy ... more Introduction Biloma forms due to common bile duct (CBD) injury as a laparoscopic cholecystectomy complication. Spontaneous localized biloma forming cysts in the biliary duct is rare. Presentation of case We report a 47-year-old male with complaint of a painful lump in the upper abdomen two months after laparoscopic cholecystectomy. Magnetic resonance cholangiopancreatography (MRCP) found a large epigastric cyst mass, without any signs of CBD injury. Patient was managed with percutaneous drainage in the outpatient clinic and kept the contents of the drainage bag for evaluation. After two months follow-up the outcome was favorable. Discussion Biloma forming cysts is a very rare complication post laparoscopic cholecystectomy. Biloma most common occurs as free fluid in the abdominal cavity. Clinical diagnostics, intraoperative historical evaluation and support with MRCP may determine the treatment options. Decision to manage with non-operative procedures by percutaneous drainage and eva...
Perbincangan mengenai wilayah dan bahan kajian suatu penelitian tidak dapat dipisahkan dari panda... more Perbincangan mengenai wilayah dan bahan kajian suatu penelitian tidak dapat dipisahkan dari pandangan filsafat ilmu. Menurut filsafat, penelitian sebagai unsur dinamik ilmu bersandar pada 3 (tiga) pilar penyangga, yaitu ontologi, epistemologi, dan aksiologi. Ontologi merupakan asas penetapan objek dan wilayah kajian dan karenanya menjawab pertanyaan apa yang dikaji. Epistemologi merupakan asas penetapan bagaimana cara mempelajari atau memperolehnya, dan karenanya menjawab pertanyaan bagaimana mengkajinya. Pilihan metodologik penelitian, tentu saja tak dapat dipisahkan dari pandangan dan kaidah-kaidah epistemolotik ilmu. Aksiologi merupakan asas penetapan tujuan dan manfaat pengetahuan, dan karenanya menjawab pertanyaan apa tujuan dan manfaat pengetahuan yang akan dikaji tersebut. Apakah suatu topik penelitian dapat dikategorikan sebagai penelitian pembelajaran bahasa atau bukan, sudah barang tentu harus ditetapkan berdasarkan penjabaran ontologik atas cakupan makna pembelajaran baha...
Introduction Acute blunt traumatic diaphragmatic rupture (BTDR) caused by falling from a height i... more Introduction Acute blunt traumatic diaphragmatic rupture (BTDR) caused by falling from a height is rare. Transabdominal diaphragmatic repair in an acute setting following BTDR requires good clinical decision-making and diagnostic tests. Case presentation A 36-year-old male was involved in a work accident. He fell from a 30-m radio transmitter tower while wearing an attached safety body harness. He arrived in the emergency room with complaints of breathing difficulty, abdominal and pelvic pain. We discovered a diaphragmatic rupture with abdominal organ herniation based on the imaging. We decided to perform an emergency laparotomy. We discovered a 12cm diaphragmatic defect on the anteromedial side of the left during surgery. We carried out the evacuation by suction and controlled the bleeding in the wound at the edge of the diaphragm. On postoperative day 4 (POD), the patient complained of dyspnea, and chest radiology revealed a hemothorax in the left lung. We then installed a water-s...
Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be life... more Gallstone-induced severe acute cholecystitis with acute pancreatitis during pregnancy can be lifethreatening both for the mother and fetus. Surgical approach is recommended in this complicated disease to prevent morbidity and mortality. During COVID-19 pandemic, additional precautions are needed when dealing with abdominal complaints. Presentation of case: We present a 37-year-old female patient, pregnant at 22 weeks gestational age, who complained of fever, diffuse abdominal pain, and shortness of breath. Laboratory examination results revealed anemia, leukocytosis and an increase in amylase level. SARS-CoV-2 antibody is non-reactive. Imaging strongly suggested cholelithiasis and cholecystitis. The patient was given antibiotics for three days but there was no significant improvement. Open cholecystectomy with subcostal (Kocher) incision was performed. Patient was released from the hospital without post-operative complications. Discussion: Treatment of gallstone induced severe acute cholecystitis with acute pancreatitis during pregnancy is challenging with the surgical complications. In the second and third trimester of pregnancy, it is more difficult to perform laparoscopic cholecystectomy because of the size of uterus. Laparoscopic procedure is also not recommended in early Covid-19 pandemic period. Therefore, open cholecystectomy with Kocher incision becomes the surgery of choice to avoid preterm birth. Conclusions: Based on our case, open cholecystectomy with Kocher incision is a safe and effective procedure for pregnant patients with cholelithiasis, cholecystitis, and pancreatitis.
COVID-19 pandemic has made impact both in clinical and educational settings. The number of surger... more COVID-19 pandemic has made impact both in clinical and educational settings. The number of surgeries has decreased; thus, the surgery videos of all cases are important for both documentation and education. This study aimed to compare three kinds of cameras in recording digestive surgery. Methods: We compared three cameras: Panasonic HV-770 Full HD Camcorder, Sony FDR-X3000 Action-cam, and Ordro EP7 Hands-Free FPV Camera. Each camera was used in several recording for superficial and visceral digestive surgeries and we compared the following: operation field, image focus, surgeon's comfort, practicality, and record settings. Results: Camcorder needs 10-15 min to set up and longer dismounting time, has steady vantage view and focus, good image quality, can be zoomed, but the recording may be obstructed by the surgeon's head. Action camera needs 5-10 min to set up and the dismounting time was equal between Camcorder and Ordro. Action camera depicts surgeon's vision, however, zoom could not be applied while recording. Sony FDR-X3000 used in this study had good image quality, but the use of this camera in a long surgery may generate neck stiffness due to its weight. Ordro EP7 was comfortable in any surgery but it had inferior image quality compared to the others. Conclusions: Panasonic HC-V770 and Sony FDR X3000 had good image quality, where camcorder excelled in longer surgeries due to its comfort, action-cam excelled for shorter surgeries due to ease of use and settings. Ordro EP7 was the most comfortable among all but has lowest image quality.
International Journal of Surgery Case Reports, 2020
BACKGROUND: The COVID-19 pandemic has changed patient management in all sectors. All patients nee... more BACKGROUND: The COVID-19 pandemic has changed patient management in all sectors. All patients need to be examined for COVID-19, including in digestive surgery emergency cases. In this paper, we report four digestive surgery emergency cases with clinical and radiological findings similar to COVID-19. CASE PRESENTATION: We report four digestive surgery emergency cases admitted with fever and cough symptoms. Case 1 is a 75-year-old male with gastric perforation and pneumonia, case 2 is a 32-year-old female with intestinal and pulmonal tuberculosis, case 3 is a 30-year-old female with acute pancreatitis with pleuritis and pleural effusion, and the last case is a 56-year-old female with rectosigmoid cancer with pulmonal metastases. All the patients underwent emergency laparotomy, were hospitalized for therapy, and discharged from the hospital. After 1-month follow-up after surgery, 1 patient had no complaints, 2 patients had surgical site infection, and 1 patient died because of ARDS due to lung metastases. DISCUSSION: For all four cases, the surgeries were done with strict COVID-19 protocol which included patient screening, examination, laboratory assessment, rapid test screening, and RT-PCR testing. There were no intrahospital mortalities and all the patients were discharged from the hospital. Three patients were followed-up and recovered well with 2 patients having surgical site infection which recovered within a week. However, 1 patient did not show up for the scheduled follow-up and was reported dead 2 weeks after surgery because of ARDS due to lung metastases. CONCLUSIONS: Emergency surgery, especially digestive surgery cases, can be done in the COVID-19 pandemic era with strict prior screening and examination, and safety protocol.
International Journal of Surgery Case Reports, 2020
INTRODUCTION: Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital... more INTRODUCTION: Hirschsprung's disease (HSCR) or megacolon congenital is the most common congenital intestinal motility disorder and characterized by the absence of ganglion cells (aganglionosis) in the myenteric plexus and submucosa of the distal intestine. PRESENTATION OF CASE: This study reports three cases of adult HSCR, with all young female patients who underwent colostomy for obstructive ileus. The chosen definitive therapies were Duhamel pull-through procedure combined with a temporary coloanal stump. DISCUSSION: The three patients underwent Duhamel pull-through procedure with temporary anal stump in conjunction with stoma reversal. The temporary anal stumps were removed within 1-2 weeks after pull-through procedure. All patients were discharged from the hospital and underwent routine followup. All patients had fecal incontinence in early follow-up which resolved shortly afterwards. Long term follow-up showed normal intestinal functions and good cosmetic results. CONCLUSIONS: The combination of Duhamel pull-through procedure with temporary coloanal stump in definitive therapy of adults with HSCR is a safe and effective technique.
Infection with SARS-CoV-2 (COVID-19) can cause prothrombotic complications. We aim to study the f... more Infection with SARS-CoV-2 (COVID-19) can cause prothrombotic complications. We aim to study the frequency of thrombotic complications and impact of anticoagulation on outcomes in hospitalized patients. We conducted a retrospective chart review of 921 consecutive patients admitted to our hospital with COVID-19. Patients were divided into four groups depending on whether they were on anticoagulation prior to admission, started anticoagulation during the admission, received prophylactic anticoagulation, or did not receive any anticoagulation. At the time of analysis, 325 patients (35.3%) had died, while 544 patients (59%) had been discharged resulting in inpatient mortality of 37.3%. Male sex, age > 65 years, and high D-dimer at admission were associated with higher mortality. Sixteen patients (1.7%) had venous thromboembolism confirmed with imaging, 11 patients had a stroke, and 2 patients developed limb ischemia. Treatment with therapeutic anticoagulation was associated with improved inpatient mortality compared with prophylactic anticoagulation alone (63% vs 86.2%, p < 0.0001) in patients requiring mechanical ventilation. Other outcomes such as rates of liberation from mechanical ventilation and duration of mechanical ventilation were not significantly impacted by the type of anticoagulation.
Background: The spectrum of FL varies from an indolent disease course spanning decades to early t... more Background: The spectrum of FL varies from an indolent disease course spanning decades to early transformation and death. Longitudinal studies have identified a subset of high risk patients (pts) who progress within 24 months of frontline therapy. It is still unclear how best to treat these patients and as yet, there is no standard 2nd line therapy for FL. Given the multitude of treatments available and the heterogenous disease course, it is challenging to compare outcomes of 2nd line therapy. It is unclear if the efficacy of second-line therapy in FL is influenced by the type of therapy, disease biology (early vs. late progression) or both. We conducted a single institute, retrospective study to determine the clinical benefit of 2nd line therapy in FL and to evaluate if any particular type of therapy was associated with improved outcomes in FL patients with early progression (EP). Methods: All patients with relapsed/refractory FL treated at our Institute between 1990 and 2014 were ...
S554 but it has not gained widespread acceptance.We compared the clinical effi cacy of EBL and Cl... more S554 but it has not gained widespread acceptance.We compared the clinical effi cacy of EBL and Clip in the treatment for colonic diverticular hemorrhage. Methods: Th is was a retrospective study of 48 hospitalized patients who identifi ed active bleeding from the colonic diverticulum or visible vessel in the colonic diverticulum under an endoscopy and endoscopic hemostasis was performed using EBL or Clip from October 2012 to October 2014. Location of hemorrhage, endoscopic fi ndings, diverticular inversion with EBL, number of Clip performed, blood transfusion volume, duration of hospitalization, disappearance of diverticulum, and rebleeding rate were assessed. Results: Th ere were 37 cases of EBL and 11 cases of Clip. Th e average age was EBL 71.3 years and Clip 68.1 years, and the gender (male/female) was EBL 31/6 and Clip 8/3. Th e location of hemorrhage,
The incidence of cardiovascular disease is increasing in young adults. We are reporting a case of... more The incidence of cardiovascular disease is increasing in young adults. We are reporting a case of acute stroke in a young patient with severe ischaemic cardiomyopathy in the absence of traditional risk factors. After ruling out atherosclerotic disease, his presentation was attributed to synthetic cannabinoid use. We then discussed the typical barriers in early diagnosis and limitations of laboratory testing in this condition. Due to the increase in abuse of these synthetic drugs among young adults, there is a need for high clinical suspicion which can help with early recognition and improve morbidity and mortality associated with these chemicals.
The performance of molybdenum carbide catalyst for partial oxidation of methane to syngas has bee... more The performance of molybdenum carbide catalyst for partial oxidation of methane to syngas has been evaluated in a micro-reactor under various conditions. The molybdenum carbide catalyst is stable in methane partial oxidation to syngas at high reaction temperatures, high ...
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Papers by Ahmad Hanif