Comparison of the sacral ratio between children with Hirschsprung disease and non-Hirschsprung

Background: Hirschsprung's disease is a congenital gastrointestinal disorder that is the most common cause of intestinal obstruction in children. One of the factors that influence gastrointestinal disorders is the sacrum bone. The sacral index can review the evaluation of the sacral bone, an instrument that can evaluate the development of the sacral bone in different clinical conditions. This study assessed the value of the sacral ratio in children with Hirschsprung's disease and non-Hirschsprung's disease at Dr. Hospital. Hasan Sadikin Bandung.

Methods: This study was a descriptive-analytic study with a case-control design. Sampling was done retrospectively by collecting medical record data and the enema barium readings from October 2019 to July 2020. The study was conducted at the Department of Radiology Hospital Dr. Hasan Sadikin Bandung from September to October 2020. Data processing uses an unpaired T-test.

Results: The total sample was 58 objects, consisting of 29 with Hirschsprung’s disease and 29 non-Hirschsprung, with an average age of Hirschsprung’s disease was 3.14±3.905 years. In the Hirschsprung’s disease group, the mean sacral ratio value was 0,62 and, and the mean sacral ratio in the non-Hirschsprung group was 0,74. Statistical test results with unpaired T-test showed significant mean differences in the case and control groups (p=0.0001).

Conclusion: The sacral ratio value in children with Hirschsprung’s disease compared to non-Hirschsprung were different significantly. 

Root cause analysis of maternal deaths at Dr. Soetomo General Academic Hospital Surabaya, Indonesia in 2019

Introduction: Maternal mortality in Indonesia especially in dr. Soetomo General Hospital is still very high, and the biggest problem is obstetric complications. It is possible that the mother who has obstetric complications is safe and recovered or died. This study aimed to identify the root cause of maternal death at Dr. Soetomo General Academic Hospital in 2019.

Methods: This is a descriptive retrospective study with the Root Cause Analysis method to analyze total of 87 maternal deaths at Dr. Soetomo General Academic Hospital in 2019.

Results: There were 87 cases of maternal death at Dr. Soetomo General Academic Hospital in 2019. Direct maternal death was the leading cause of maternal death, contributing 59 cases (67.8%). From 59 cases, 31 cases (35.6%) direct maternal deaths were caused by preeclampsia/eclampsia. Contributing factors that influence maternal mortality are including organizational management, medical personnel, equipment, materials, & ward, environmental, and family barriers factors. Organizational management factors, the most common factor that causes maternal death is a poor information sharing system at the referring hospital, as many as 17 cases (27.4%). Medical personnel factors, maternal death was mostly caused by lack of knowledge and skills during antenatal care, as many as 42 cases (44.2%). Equipment, materials,  and ward factors, the most common cause was the unavailability of the ward, contributing 5 cases (55.6%). Family barrier factors, most maternal deaths were caused by the families that did not understand about the emergency condition of the patient, as many as 52 cases (67.5%).

Conclusion: The maternal deaths at Dr. Soetomo General Academic Hospital in 2019 were mostly caused by the family barrier factor which did not understand about patient’s emergency condition, followed by the medical personnel factor which was lack of knowledge and skills during antenatal care.

Functional Movement Screen (FMS) as a determinant factor to assess the risk of injuries in young athletes at Jakarta Province, Indonesia

Background: Lower extremity injuries are the most common injuries in young athletes due to running, jumping, sudden change of movement, and contact with the other player in most of the sport’s activities. Preventive efforts are the most effective ways to decrease the risk of lower extremity injuries. Functional Movement Screen (FMS) can be considered effective ways in helping to identify risk factors in the young athlete. This study aims to evaluate the FMS as a determinant factor to assess the risk of injuries in young athletes in Jakarta Province, Indonesia

Methods: Participants were young athletes who train in Provincial Student Sports Training Center (PSSTC), South Jakarta. Athlete age less than 18 years old, agree to participate in this research and has normal physical health will be included in this research and proceed to be asked time exposure of training and history of injuries; body posture and FMS examination. Analysis bivariate dan multivariate were done to see if there is the association of seven components of FMS, sex, time exposure of training, history of injuries, body posture and lower extremity injuries. Data were analyzed using SPSS version 20 for Windows.

Results: There was 87 participant that participated in this research. The data showed that ankle (36.7%), thigh (36.7%) and knee (16.0%) were the three most common lower extremity injuries. Bivariate analysis showed a significant association between hurdle step, time exposure of training, and histories of injuries with the incidence of injuries (p<0.25). Logistic regression multivariate analysis showed that history of injuries (OR=4.276; 95%CI=1.599-11.437) and time exposure of training (OR=3.470; 95%CI=1.274-9.448) had a significant association with incidence of injuries (p<0.05)

Conclusions: There was no association of seven components of FMS with lower extremities injuries. However, there was a significant association of injury histories and training exposure with the incidence of injuries.

A rare case of porokeratosis mibelli in 3-year-old boy

Introduction: Porokeratosis mibelli is a rare, chronic, and slowly progressive genodermatotic characterized by abnormality of keratinization. The clinical manifestations are hyperkeratotic papules or plaques surrounded by a thread-like elevated border that widens centrifugally. Rarity of this case means the science behind it is underdeveloped. Thus, we present this case as an educational vehicle and to further develop the body of knowledge surrounding this disease.

Case report: We reported a 3 years old boy, suspect of porokeratosis mibelli. His mother complained of a few reddish spots and patches that sometimes itchy, healed into white and brownish patches with atrophic centers in the last 5 months before admission. Physical examination: few lesions on the back, waist, left side of buttock, back of the neck, and lateral upper left arm. Hypopigmented and hyperpigmented patches with atrophic centers, and erythematous plaques with central erosion were found. No abnormality of internal organs or laboratory findings. Histopathology examination showed epidermis contains of invagination rete malpighia filled keratin. Slightly thinned stratum germinativum with corneum contains basket weave pattern. Topical therapy with 1% 5-fluorourasil cream twice daily showed mild improvement after 10 days.

Conclusion: Although clinical examinations of the lesions on this patient did not fit the criteria of porokeratosis mibelli, however, the results of histopathology examination supported the diagnosis. Treatment with 1% 5-fluorourasil cream showed slow but progressive healing on the patient