Akhmad Imron - Academia.edu (original) (raw)

Papers by Akhmad Imron

Surgical Neurology International, 2021

Background: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, prob... more Background: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, probably under reported soft swelling in the scalp which usually develops in infancy that occurs weeks to months after birth. Although the exact etiology remains unclear, several theories have been postulated such as (i) cerebrospinal fluids (CSF) leak from microfractures of the skull and (ii) disrupted lymphatic drainage, gradually liquefying subaponeurotic bleeding. Here, we reported typical clinical findings of DSFC and analysis of the fluid aspirate from our patient. To the best of our knowledge, this is the first case reported from Asia, particularly from Indonesia. Case Description: A healthy 2-month-old girl infant presented with 2 weeks history of occipital painless fluctuant scalp mass with no swelling. She was born at term from a nulliparous mother; by emergency cesarean delivery following failed induction of labor. There was no history of scalp injury at birth nor recent head trau...

International Journal of Emergency Medicine, 2021

Background Tetanus is a rare disease caused by Clostridium tetani , which produces tetanolysin an... more Background Tetanus is a rare disease caused by Clostridium tetani , which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low–middle-income countries, tetanus still occurs (mostly in adults) due to the lack of immunization related to religious tenets, cultural belief, or inaccessibility to medical care. In addition, tetanus in the pediatric population shows features which are quite distinct from the adult group. Case presentation We report a case of a 7-year-old girl presented to our institution with a history of falling 10 days prior to admission, with only skin laceration on her forehead. For 1 day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed her as an unimmunized child with an open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw.” Periopera...

Ossification of the posterior longitudinal ligament (OPLL) is a complex multifactorial disease pr... more Ossification of the posterior longitudinal ligament (OPLL) is a complex multifactorial disease process combining both metabolic and biomechanical factors, most commonly found in men, the elderly and Asian patients. There are many diseases. There are many diseases associated with OPLL, such as diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and other spondyloarthropathies. Several factors have been reported to be associated with OPLL formation and progression, including genetic, hormonal, environmental, and lifestyle factors. However, the pathogenesis of OPLL is still unclear. Plain radiography, CT, and MR imaging are used to evaluate OPLL extension and the area of spinal cord compression. Management of OPLL continues to be controversial. Each surgical technique has some advantages and disadvantages, and the choice of operation should be made case by case, depending on the patient's condition, level of pathology, type of OPLL, and the surgeon's experience. I...

Introduction: As a result of many factors, the availability of neurosurgeons (NS) to care for tra... more Introduction: As a result of many factors, the availability of neurosurgeons (NS) to care for trauma patients (TP) is increasingly sparse. This study examines the profile of head-injured (HI) trauma patients in Bandung and their actual need for the specific expertise of a neurosurgeon. Methods: The Neurosurgical Department, RS. Hasan Sadikin (NDRSHS) data base was queried for specific information relating to the volume, nature, timeliness, and outcome of HI TP from September 2010 – August 2011. Results: Total number of NDRSHS data base patients studied was 5.274, of which 2.342 (44,4%) had a reported HI. Mild HI represented 30,6% of all TP and 68,9% of HI. Moderate HI was reported in 9,3% of all TP and was 20,96% of HI. Severe HI was reported in 4,49% of all TP and was 10,1% of HI. Craniotomy was performed in 133(5,68%) of all HI (2,52% of all TP). Mean Glasgow Coma Scale score (GCS) of craniotomy patients was 9, and 15 for the noncraniotomy group. Subdural hematoma occurred in 11,7...

Surgical Neurology International

Background: Coronavirus disease 2019 (COVID-19) pandemic has affected global health system; in th... more Background: Coronavirus disease 2019 (COVID-19) pandemic has affected global health system; in the context of the COVID-19 pandemic, both surgeon and anesthesiologist often dealt with emergency situation, optimal timing of surgery and safety protocol in hospital setting must be implemented with many facets for both patients and health-care providers. Case Description: We reported two cases. Case#1 - A 16-year-old male was referred to our hospital, due to a decreased of consciousness following a motor vehicle accident. Head CT scan revealed an epidural hemorrhage on the left temporoparietal. The patient was suspected for having COVID-19 from the reactivity of his serum against SARS-CoV-2 antigen. Procedures for the confirmation of COVID-19 and surgical preparation caused 12 h delayed from the admission. Nevertheless, the patient was deteriorated clinically before he was transported to the operating room and died after 6 cycles of cardiopulmonary resuscitation. Case#2 - A 25-year-old ...

Journal Of Medicine & Health, Feb 27, 2015

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with... more Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status.

The mortality rate after traumatic acute subdural hematoma (TASDH) is around 50 – 90%. There are ... more The mortality rate after traumatic acute subdural hematoma (TASDH) is around 50 – 90%. There are many factors that affect the management of TASDH. Operative measures include decompressive craniectomy or craniotomy evacuation. This research compares both of these operative techniques in TASDH. This research is an observational analysis with cross sectional design. Data was compiled retrospectively through patient medical records since January 2006 – December 2009 in Neurosurgery Department Hasan Sadikin Hospital Bandung. Statistical analysis was applied using chi square test, multiple regression logistic analysis and Pearson chi square test. Significance of test results will be determined based on the value of p <0.05. There were 148 ATSDH operations consisting of 117 males and 31 females with age range of 1 – 75 years (x; 33,7 ; SB=16,5). Eighty four patients underwent craniotomy while 64 under went craniectomy. Mortality rate corresponded significantly with age (p<0,01), GCS ...

Surgical Neurology International, 2021

Background: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, prob... more Background: Delayed subaponeurotic fluid collection (DSFC) is a relatively uncommon problem, probably under reported soft swelling in the scalp which usually develops in infancy that occurs weeks to months after birth. Although the exact etiology remains unclear, several theories have been postulated such as (i) cerebrospinal fluids (CSF) leak from microfractures of the skull and (ii) disrupted lymphatic drainage, gradually liquefying subaponeurotic bleeding. Here, we reported typical clinical findings of DSFC and analysis of the fluid aspirate from our patient. To the best of our knowledge, this is the first case reported from Asia, particularly from Indonesia. Case Description: A healthy 2-month-old girl infant presented with 2 weeks history of occipital painless fluctuant scalp mass with no swelling. She was born at term from a nulliparous mother; by emergency cesarean delivery following failed induction of labor. There was no history of scalp injury at birth nor recent head trau...

International Journal of Emergency Medicine, 2021

Background Tetanus is a rare disease caused by Clostridium tetani , which produces tetanolysin an... more Background Tetanus is a rare disease caused by Clostridium tetani , which produces tetanolysin and tetanospasmin. In 2018, there were only approximately ten tetanus cases reported in Indonesia. Despite widespread vaccination, especially in low–middle-income countries, tetanus still occurs (mostly in adults) due to the lack of immunization related to religious tenets, cultural belief, or inaccessibility to medical care. In addition, tetanus in the pediatric population shows features which are quite distinct from the adult group. Case presentation We report a case of a 7-year-old girl presented to our institution with a history of falling 10 days prior to admission, with only skin laceration on her forehead. For 1 day prior to admission, the patient looked drowsy and difficult to be awakened, accompanied with stiffness of her jaw; we diagnosed her as an unimmunized child with an open depressed skull fracture of her frontal bone and wound infection complicated with “lockjaw.” Periopera...

Ossification of the posterior longitudinal ligament (OPLL) is a complex multifactorial disease pr... more Ossification of the posterior longitudinal ligament (OPLL) is a complex multifactorial disease process combining both metabolic and biomechanical factors, most commonly found in men, the elderly and Asian patients. There are many diseases. There are many diseases associated with OPLL, such as diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and other spondyloarthropathies. Several factors have been reported to be associated with OPLL formation and progression, including genetic, hormonal, environmental, and lifestyle factors. However, the pathogenesis of OPLL is still unclear. Plain radiography, CT, and MR imaging are used to evaluate OPLL extension and the area of spinal cord compression. Management of OPLL continues to be controversial. Each surgical technique has some advantages and disadvantages, and the choice of operation should be made case by case, depending on the patient's condition, level of pathology, type of OPLL, and the surgeon's experience. I...

Introduction: As a result of many factors, the availability of neurosurgeons (NS) to care for tra... more Introduction: As a result of many factors, the availability of neurosurgeons (NS) to care for trauma patients (TP) is increasingly sparse. This study examines the profile of head-injured (HI) trauma patients in Bandung and their actual need for the specific expertise of a neurosurgeon. Methods: The Neurosurgical Department, RS. Hasan Sadikin (NDRSHS) data base was queried for specific information relating to the volume, nature, timeliness, and outcome of HI TP from September 2010 – August 2011. Results: Total number of NDRSHS data base patients studied was 5.274, of which 2.342 (44,4%) had a reported HI. Mild HI represented 30,6% of all TP and 68,9% of HI. Moderate HI was reported in 9,3% of all TP and was 20,96% of HI. Severe HI was reported in 4,49% of all TP and was 10,1% of HI. Craniotomy was performed in 133(5,68%) of all HI (2,52% of all TP). Mean Glasgow Coma Scale score (GCS) of craniotomy patients was 9, and 15 for the noncraniotomy group. Subdural hematoma occurred in 11,7...

Surgical Neurology International

Background: Coronavirus disease 2019 (COVID-19) pandemic has affected global health system; in th... more Background: Coronavirus disease 2019 (COVID-19) pandemic has affected global health system; in the context of the COVID-19 pandemic, both surgeon and anesthesiologist often dealt with emergency situation, optimal timing of surgery and safety protocol in hospital setting must be implemented with many facets for both patients and health-care providers. Case Description: We reported two cases. Case#1 - A 16-year-old male was referred to our hospital, due to a decreased of consciousness following a motor vehicle accident. Head CT scan revealed an epidural hemorrhage on the left temporoparietal. The patient was suspected for having COVID-19 from the reactivity of his serum against SARS-CoV-2 antigen. Procedures for the confirmation of COVID-19 and surgical preparation caused 12 h delayed from the admission. Nevertheless, the patient was deteriorated clinically before he was transported to the operating room and died after 6 cycles of cardiopulmonary resuscitation. Case#2 - A 25-year-old ...

Journal Of Medicine & Health, Feb 27, 2015

Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with... more Prophylactic dose antibiotic are indicated in patients having neurosurgical clean operations with implant surgery. The aim of this study is to evaluate the efficacy of prophylactic dose antibiotic in shunt infection. Between 1 October 2009 until 31 September 2011, 102 patients with congenital hydrocephalus who underwent VP shunt surgery. Fifty-one received profilactic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 5 days post-operative, and 51 patients received therapeutic antibiotic (ceftriaxone 50-75 mg/kgBW), 30-60 minutes before surgery until 1 days post-operative. All patient were followed for 1-6 months to evaluate shunt infection. Collected data will be statistically analyzed. The study found that the rate of infection is 17,6% (9 patients of 51 patients) who received therapeutic antibiotic, and 17,6% (9 patients of 51 patients) who received profilactic antibiotic.There is not statistically significant between all group in shunt infection (p=1,000). Others risk factors significantly influence shunt infection are enlargement of the head (p=0,002), length of surgery (p=0,00327), time of surgery (p=0,00077) and nutrition status (p=0,01343). The results of this study indicate that profilactic antibiotic effective to prevent shunt infection in congenital hydrocephalus. Others risk factors significantly influence are enlargement of the head, length of surgery, time of surgery and nutrition status.

The mortality rate after traumatic acute subdural hematoma (TASDH) is around 50 – 90%. There are ... more The mortality rate after traumatic acute subdural hematoma (TASDH) is around 50 – 90%. There are many factors that affect the management of TASDH. Operative measures include decompressive craniectomy or craniotomy evacuation. This research compares both of these operative techniques in TASDH. This research is an observational analysis with cross sectional design. Data was compiled retrospectively through patient medical records since January 2006 – December 2009 in Neurosurgery Department Hasan Sadikin Hospital Bandung. Statistical analysis was applied using chi square test, multiple regression logistic analysis and Pearson chi square test. Significance of test results will be determined based on the value of p <0.05. There were 148 ATSDH operations consisting of 117 males and 31 females with age range of 1 – 75 years (x; 33,7 ; SB=16,5). Eighty four patients underwent craniotomy while 64 under went craniectomy. Mortality rate corresponded significantly with age (p<0,01), GCS ...